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American Family Physician Jun 2017
Topics: Acne Vulgaris; Administration, Oral; Administration, Topical; Anti-Bacterial Agents; Consensus; Dermatologic Agents; Dermatology; Diet Therapy; Humans; Practice Guidelines as Topic
PubMed: 28671431
DOI: No ID Found -
Gerontology 2021Older adults often have a greater need for health information and health care services because access to these helps them manage their health and the chronic conditions... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Older adults often have a greater need for health information and health care services because access to these helps them manage their health and the chronic conditions of aging. Therefore, low health literacy bears a special significance for the population of older adults.
OBJECTIVES
The aim of this study was to examine the effects of an active learning program on health literacy, lifestyle behaviors, physical function, and mental health among community-dwelling older adults with low health literacy.
METHODS
This single-blind, randomized controlled trial involved 60 participants aged ≥65 years with a low health literacy who were randomly assigned to an intervention (n = 30) or control (n = 30) group. Across 24 weeks, the intervention group attended weekly 90-min active learning program sessions, which involved exploratory learning, group work, and the self-planning of behavior changes that promote a healthy lifestyle. The control group attended a 90-min class, which was taught in accordance with the didactic teaching method. For both groups, the programs focused on the role of exercise, diet/nutrition, and cognitive activity for promoting health among older adults. The outcome measures were administered at baseline and week 24. Comprehensive health literacy (i.e., primary outcome) was assessed using the Health Literacy Scale-14. Lifestyle factors (i.e., physical activity, dietary variety, life-space mobility, and social network size), physical function, and depressive symptoms were measured. We used a linear mixed model to estimate the intervention effects in accordance with the intention-to-treat approach.
RESULTS
When compared to the control group, the intervention group demonstrated a significant improvement in communicative health literacy, step count, engagement in moderate-to-vigorous physical activity, dietary variety, life-space mobility, social network size, grip strength, gait speed, and depressive symptoms.
CONCLUSIONS
The active learning program can promote a healthy lifestyle and prevent functional decline among older adults who lack the confidence to engage in health communication.
Topics: Aged; Aging; Cognition; Diet Therapy; Exercise; Female; Health Literacy; Health Promotion; Healthy Lifestyle; Humans; Independent Living; Male; Outcome Assessment, Health Care; Physical Functional Performance; Problem-Based Learning; Single-Blind Method; Social Network Analysis
PubMed: 33271536
DOI: 10.1159/000511357 -
Epilepsy Research Nov 2020High fat, low carbohydrate ketogenic diets (KD) have been in use for the treatment of epilepsy for almost a hundred years. Remarkably, seizures that are resistant to... (Review)
Review
High fat, low carbohydrate ketogenic diets (KD) have been in use for the treatment of epilepsy for almost a hundred years. Remarkably, seizures that are resistant to conventional anti-seizure drugs can in many cases be controlled by the KD therapy, and it has been shown that many patients with epilepsy become seizure free even after discontinuation of the diet. These findings suggest that KD combine anti-seizure effects with disease modifying effects. In addition to the treatment of epilepsy, KDs are now widely used for the treatment of a wide range of conditions including weight reduction, diabetes, and cancer. The reason for the success of metabolic therapies is based on the synergism of at least a dozen different mechanisms through which KDs provide beneficial activities. Among the newest findings are epigenetic mechanisms (DNA methylation and histone acetylation) through which KD exerts long-lasting disease modifying effects. Here we review mechanisms through which KD can affect neuroprotection in the brain, and how a combination of those mechanisms with epigenetic alterations can attenuate and possibly reverse the development of epilepsy.
Topics: Brain; DNA Methylation; Diet, Carbohydrate-Restricted; Diet, Ketogenic; Epilepsy; Humans; Neuroprotection; Seizures
PubMed: 32854046
DOI: 10.1016/j.eplepsyres.2020.106444 -
Tidsskrift For Den Norske Laegeforening... Sep 2017Children with pharmacoresistant epilepsy should be offered ketogenic dietary therapy. The diet, which is rich in fat and low in carbohydrate, has a beneficial effect in... (Review)
Review
Children with pharmacoresistant epilepsy should be offered ketogenic dietary therapy. The diet, which is rich in fat and low in carbohydrate, has a beneficial effect in reducing seizures in this patient group. It may also have a beneficial effect in adults, but there is less evidence than in children. Dietary treatment of epilepsy is a specialist therapy, and in order to adhere to the diet, strong motivation of the patient and relatives as well as close follow-up from the specialist health service are necessary.
Topics: Adult; Child; Diet, Carbohydrate-Restricted; Diet, Ketogenic; Drug Resistant Epilepsy; Humans; Motivation; Patient Compliance; Seizures
PubMed: 28871763
DOI: 10.4045/tidsskr.16.0486 -
Journal of Hepatology Aug 2019It is unclear if a reduction in hepatic fat content (HFC) is a major mediator of the cardiometabolic benefit of lifestyle intervention, and whether it has prognostic... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND & AIM
It is unclear if a reduction in hepatic fat content (HFC) is a major mediator of the cardiometabolic benefit of lifestyle intervention, and whether it has prognostic significance beyond the loss of visceral adipose tissue (VAT). In the present sub-study, we hypothesized that HFC loss in response to dietary interventions induces specific beneficial effects independently of VAT changes.
METHODS
In an 18-month weight-loss trial, 278 participants with abdominal obesity/dyslipidemia were randomized to low-fat (LF) or Mediterranean/low-carbohydrate (MED/LC + 28 g walnuts/day) diets with/without moderate physical activity. HFC and abdominal fat-depots were measured using magnetic resonance imaging at baseline, after 6 (sub-study, n = 158) and 18 months.
RESULTS
Of 278 participants (mean HFC 10.2% [range: 0.01%-50.4%]), the retention rate was 86.3%. The %HFC substantially decreased after 6 months (-6.6% absolute units [-41% relatively]) and 18 months (-4.0% absolute units [-29% relatively]; p <0.001 vs. baseline). Reductions of HFC were associated with decreases in VAT beyond weight loss. After controlling for VAT loss, decreased %HFC remained independently associated with reductions in serum gamma glutamyltransferase and alanine aminotransferase, circulating chemerin, and glycated hemoglobin (p <0.05). While the reduction in HFC was similar between physical activity groups, MED/LC induced a greater %HFC decrease (p = 0.036) and greater improvements in cardiometabolic risk parameters (p <0.05) than the LF diet, even after controlling for VAT changes. Yet, the greater improvements in cardiometabolic risk parameters induced by MED/LC were all markedly attenuated when controlling for HFC changes.
CONCLUSIONS
%HFC is substantially reduced by diet-induced moderate weight loss and is more effectively reduced by the MED/LC diet than the LF diet, independently of VAT changes. The beneficial effects of the MED/LC diet on specific cardiometabolic parameters appear to be mediated more by decreases in %HFC than VAT loss.
LAY SUMMARY
High hepatic fat content is associated with metabolic syndrome, type 2 diabetes mellitus, and coronary heart disease. In the CENTRAL 18-month intervention trial, a Mediterranean/low-carbohydrate diet induced a greater decrease in hepatic fat content than a low-fat diet, conferring beneficial health effects that were beyond the favorable effects of visceral fat loss. ClinicalTrials.gov Identifier: NCT01530724.
Topics: Adult; Cohort Studies; Diet, Fat-Restricted; Diet, Mediterranean; Dyslipidemias; Exercise; Fatty Liver; Female; Humans; Intra-Abdominal Fat; Magnetic Resonance Imaging; Male; Middle Aged; Obesity, Abdominal; Treatment Outcome; Weight Loss
PubMed: 31075323
DOI: 10.1016/j.jhep.2019.04.013 -
Frontiers in Endocrinology 2021While the prevalence of cardio-metabolic diseases (CMDs) has become a worldwide epidemic, much attention is paid to managing CMDs effectively. A ketogenic diet (KD)... (Review)
Review
While the prevalence of cardio-metabolic diseases (CMDs) has become a worldwide epidemic, much attention is paid to managing CMDs effectively. A ketogenic diet (KD) constitutes a high-fat and low-carbohydrate diet with appropriate protein content and calories. KD has drawn the interests of clinicians and scientists regarding its application in the management of metabolic diseases and related disorders; thus, the current review aimed to examine the evidences surrounding KD and the CMDs to draw the clinical implications. Overall, KD appears to play a significant role in the therapy of various CMDs, which is manifested by the effects of KDs on cardio-metabolic outcomes. KD therapy is generally promising in obesity, heart failure, and hypertension, though different voices still exist. In diabetes and dyslipidemia, the performance of KD remains controversial. As for cardiovascular complications of metabolic diseases, current evidence suggests that KD is generally protective to obese related cardiovascular disease (CVD), while remaining contradictory to diabetes and other metabolic disorder related CVDs. Various factors might account for the controversies, including genetic background, duration of therapy, food composition, quality, and sources of KDs. Therefore, it's crucial to perform more rigorous researches to focus on clinical safety and appropriate treatment duration and plan of KDs.
Topics: Cardiovascular Diseases; Diabetes Complications; Diet, Carbohydrate-Restricted; Diet, Ketogenic; Humans; Metabolic Diseases
PubMed: 34795641
DOI: 10.3389/fendo.2021.753039 -
World Journal of Gastroenterology Apr 2017Celiac disease is an immune-mediated disorder that causes severe architectural disturbance in the small intestinal mucosa of genetically-predisposed individuals....
Celiac disease is an immune-mediated disorder that causes severe architectural disturbance in the small intestinal mucosa of genetically-predisposed individuals. Impaired absorption of multiple nutrients results and diarrhea and weight loss develop. Evidence has accumulated that a strict gluten-free diet can result in resolution of diarrhea, weight gain and normalization of nutrient malabsorption. In addition, histopathological changes also normalize, but this histopathological response appears to be time-dependent, sex-dependent and age-dependent. Compliance to a gluten-free diet is difficult and costly resulting in poor compliance and only a limited clinical response. This poses a risk for later long-term complications, including malignancy. A major practical clinical problem is the assessment of compliance to the gluten-free diet. Although symptoms may resolve and serological antibody markers may improve, multiple studies have documented ongoing architectural disturbance and inflammatory change, and with these continued inflammatory changes, a persistent risk for long-term complications. Recent immunological studies have suggested that peptides can be detected in both urine and fecal specimens that may be indicative of limited compliance. At the same time, multiple biopsy studies have demonstrated that complete normalization of the mucosa may occur in some patients within 6 mo of initiation of a gluten-free diet, but more often, up to 2 years or more may be required before repeated biopsies eventually show mucosal recovery and mucosal healing.
Topics: Celiac Disease; Diagnosis, Differential; Diet, Gluten-Free; Humans; Patient Compliance
PubMed: 28487600
DOI: 10.3748/wjg.v23.i15.2635 -
Clinical Obesity Apr 2021Poor adherence is a barrier to successful weight control. Intermittent energy restriction (IER) provides an alternative approach to those for whom daily energy... (Randomized Controlled Trial)
Randomized Controlled Trial
Poor adherence is a barrier to successful weight control. Intermittent energy restriction (IER) provides an alternative approach to those for whom daily energy restriction is not ideal. This study assessed changes in weight, body composition, and macronutrient intake for an IER and a continuous energy restriction (CONT) approach within a multicomponent weight management intervention. We randomized 35 adults with overweight/obesity (BMI = 31.2 ± 2.4 kg/m ) to CONT or IER for 24 weeks (12-week weight loss intervention and 12 weeks of weight loss maintenance). Diets were delivered within a multimodal weight management program including weekly group meetings with a registered dietitian, increased physical activity, and a comprehensive lifestyle change program. Retention and adherence were similar for CONT and IER. Weight, BMI, fat mass, percentage body fat, waist circumference, hip circumference, blood pressure, and heart rate all decreased after 24 weeks (all, P < .01), but there were no main effects of group (all, P > .27). Weight loss was clinically relevant in both CONT (11.38 ± 7.9%) and IER (9.37 ± 9.7%), and the proportion of each group achieving 5% weight loss was 82 and 61% (P = .16), respectively. Participant satisfaction was high in both groups. The results from this study (a) support the feasibility of IER as an alternative for weight loss and weight loss maintenance, (b) indicate that IER is an effective alternative to CONT for weight control and improvements in body composition, and (c) emphasize the importance of intensive lifestyle interventions with ongoing support for effective behaviour modification.
Topics: Body Composition; Caloric Restriction; Diet, Reducing; Humans; Overweight; Pilot Projects; Weight Loss
PubMed: 33305526
DOI: 10.1111/cob.12430 -
Nutrients Oct 2021The daily intake of dietary fiber is well below the recommended levels in the US. The effect of adopting a low-fat vs. a low-carbohydrate weight loss diet on fiber... (Randomized Controlled Trial)
Randomized Controlled Trial
Changes in Quantity and Sources of Dietary Fiber from Adopting Healthy Low-Fat vs. Healthy Low-Carb Weight Loss Diets: Secondary Analysis of DIETFITS Weight Loss Diet Study.
The daily intake of dietary fiber is well below the recommended levels in the US. The effect of adopting a low-fat vs. a low-carbohydrate weight loss diet on fiber intake is of interest but not well-documented, especially when both approaches promote high-quality food choices. The objective of this paper is to compare the quantity and sources of dietary fiber between a healthy low-fat (HLF) vs. healthy low-carbohydrate (HLC) diet group when consumed over 12 months in a weight loss diet study. In this secondary analysis of the Diet Intervention Examining The Factors Interacting with Treatment Success (DIETFITS) study, the amount and sources of dietary fiber were examined in generally healthy adults, 18-50 years of age, Body Mass Index (BMI) 28-40 kg/m, randomized to HLF or HLC for 12 months, who had available 24-h recalls at 0 ( = 609), 3 ( = 549), 6 ( = 491), and 12 ( = 449) months. The dietary intake was estimated by the Nutrition Data System for Research (NDS-R). The sources of fiber were determined for the major food groups. Significantly more total dietary fiber was consumed by HLF at every post-randomization time point, and, at 12 m, was 23.04 ± 9.43 g vs. 18.61 ± 8.12 g for HLF vs. HLC, respectively, < 0.0001. In both diet groups at 12 months, the highest amount of dietary fiber came from non-starchy vegetables (4.13 ± 3.05 g and 5.13 ± 3.59 g). The other primary sources of fiber at 12 months for the HLF group were from whole grains (3.90 ± 3.13 g) and fruits (3.40 ± 2.87 g), and, for the HLC group, were from plant protein and fat sources, such as nuts and seeds, their butters, and avocados (2.64 ± 2.64 g). In the DIETFITS study, the difference in the total fiber intake for the HLF vs. HLC groups was more modest than expected. The HLC group consumed reasonably high amounts of fiber from high-protein and high fat plant-based sources.
Topics: Adolescent; Adult; Body Mass Index; Diet, Carbohydrate-Restricted; Diet, Fat-Restricted; Diet, Reducing; Dietary Fiber; Female; Fruit; Humans; Male; Middle Aged; Obesity; Overweight; Vegetables; Weight Loss; Whole Grains; Young Adult
PubMed: 34684626
DOI: 10.3390/nu13103625 -
Obesity (Silver Spring, Md.) Sep 2016To evaluate the safety and tolerability of alternate-day fasting (ADF) and to compare changes in weight, body composition, lipids, and insulin sensitivity index (Si)... (Comparative Study)
Comparative Study Randomized Controlled Trial
OBJECTIVE
To evaluate the safety and tolerability of alternate-day fasting (ADF) and to compare changes in weight, body composition, lipids, and insulin sensitivity index (Si) with those produced by a standard weight loss diet, moderate daily caloric restriction (CR).
METHODS
Adults with obesity (BMI ≥30 kg/m(2) , age 18-55) were randomized to either zero-calorie ADF (n = 14) or CR (-400 kcal/day, n = 12) for 8 weeks. Outcomes were measured at the end of the 8-week intervention and after 24 weeks of unsupervised follow-up.
RESULTS
No adverse effects were attributed to ADF, and 93% completed the 8-week ADF protocol. At 8 weeks, ADF achieved a 376 kcal/day greater energy deficit; however, there were no significant between-group differences in change in weight (mean ± SE; ADF -8.2 ± 0.9 kg, CR -7.1 ± 1.0 kg), body composition, lipids, or Si. After 24 weeks of unsupervised follow-up, there were no significant differences in weight regain; however, changes from baseline in % fat mass and lean mass were more favorable in ADF.
CONCLUSIONS
ADF is a safe and tolerable approach to weight loss. ADF produced similar changes in weight, body composition, lipids, and Si at 8 weeks and did not appear to increase risk for weight regain 24 weeks after completing the intervention.
Topics: Adult; Body Composition; Body Weight; Caloric Restriction; Diet, Reducing; Energy Intake; Fasting; Female; Humans; Male; Middle Aged; Obesity; Pilot Projects; Treatment Outcome; Weight Loss
PubMed: 27569118
DOI: 10.1002/oby.21581