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Journal of Internal Medicine Aug 2023Short-term clinical trials have shown the effectiveness of low-carbohydrate diets (LCDs) and low-fat diets (LFDs) for weight loss and cardiovascular benefits. We aimed...
BACKGROUND
Short-term clinical trials have shown the effectiveness of low-carbohydrate diets (LCDs) and low-fat diets (LFDs) for weight loss and cardiovascular benefits. We aimed to study the long-term associations among LCDs, LFDs, and mortality among middle-aged and older people.
METHODS
This study included 371,159 eligible participants aged 50-71 years. Overall, healthy and unhealthy LCD and LFD scores, as indicators of adherence to each dietary pattern, were calculated based on the energy intake of carbohydrates, fat, and protein and their subtypes.
RESULTS
During a median follow-up of 23.5 years, 165,698 deaths were recorded. Participants in the highest quintiles of overall LCD scores and unhealthy LCD scores had significantly higher risks of total and cause-specific mortality (hazard ratios [HRs]: 1.12-1.18). Conversely, a healthy LCD was associated with marginally lower total mortality (HR: 0.95; 95% confidence interval: 0.94, 0.97). Moreover, the highest quintile of a healthy LFD was associated with significantly lower total mortality by 18%, cardiovascular mortality by 16%, and cancer mortality by 18%, respectively, versus the lowest. Notably, isocaloric replacement of 3% energy from saturated fat with other macronutrient subtypes was associated with significantly lower total and cause-specific mortality. For low-quality carbohydrates, mortality was significantly reduced after replacement with plant protein and unsaturated fat.
CONCLUSIONS
Higher mortality was observed for overall LCD and unhealthy LCD, but slightly lower risks for healthy LCD. Our results support the importance of maintaining a healthy LFD with less saturated fat in preventing all-cause and cause-specific mortality among middle-aged and older people.
Topics: Middle Aged; Humans; Aged; Diet, Fat-Restricted; Prospective Studies; Diet, Carbohydrate-Restricted; Proportional Hazards Models; Fatty Acids; Carbohydrates
PubMed: 37132226
DOI: 10.1111/joim.13639 -
Advances in Kidney Disease and Health Nov 2023As the diet for people with CKD changes based on new clinical trials, patients are not clear on how to accurately use their diet to protect their kidneys or best manage... (Review)
Review
As the diet for people with CKD changes based on new clinical trials, patients are not clear on how to accurately use their diet to protect their kidneys or best manage their electrolytes if they are on dialysis. They often make restrictions where they shouldn't and miss the dietary interventions that could actually make a difference. In this article, I present four recipes that can be tailored to any stage of kidney disease. They are low in sodium, easy to make at home, and can be adapted to low phosphorus, low protein, or low potassium diets as needed.
Topics: Humans; Renal Dialysis; Kidney Diseases; Diet, Protein-Restricted; Kidney
PubMed: 38453272
DOI: 10.1053/j.akdh.2023.08.001 -
FP Essentials Apr 2024Dietary modifications can help to prevent and manage many chronic diseases. The Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diets emphasize... (Review)
Review
Dietary modifications can help to prevent and manage many chronic diseases. The Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diets emphasize consumption of fruits and vegetables while reducing intake of red meat. These diets are supported by well-established evidence for patients with cardiovascular disease and hypertension, respectively. Whole-food, plant-based diets have been shown to result in reduced body weight, lower A1c levels, and decreased insulin resistance in patients with diabetes. Patients with diabetes and hypertension should adhere to a heart-healthy diet, such as the DASH diet. For patients with diabetes and at risk of diabetes, key nutritional recommendations include emphasizing intake of nonstarchy vegetables, minimizing intake of added sugars and refined grains, and choosing whole foods instead of processed foods. The recommend that adults limit sodium intake to less than 2,300 mg/day. Patients with chronic kidney or liver disease should follow sodium restriction and protein intake guidelines. Patients with irritable bowel syndrome should follow a low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet with fiber supplementation. For patients with gastrointestinal symptoms, fiber can effectively manage constipation and stool irregularity. Probiotic supplements or foods can be useful for digestive problems.
Topics: Humans; Chronic Disease; Dietary Approaches To Stop Hypertension; Dietary Fiber; Irritable Bowel Syndrome; Renal Insufficiency, Chronic; Hypertension; Diabetes Mellitus; Cardiovascular Diseases; Diet, Mediterranean; Constipation; Liver Diseases; Probiotics
PubMed: 38648172
DOI: No ID Found -
The British Journal of Nutrition Mar 2024Plant-based diets have emerged as athletic performance enhancers for various types of exercise. Therefore, the present study evaluated the effectiveness of plant-based... (Meta-Analysis)
Meta-Analysis Review
Plant-based diets have emerged as athletic performance enhancers for various types of exercise. Therefore, the present study evaluated the effectiveness of plant-based diets on aerobic and strength/power performances, as well as on BMI of physically active individuals. This systematic review and meta-analysis was conducted and reported according to the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. A systematic search of electronic databases, including PubMed, Web of Science and SPORTDiscus, was performed. On the basis of the search and inclusion criteria, four and six studies evaluating the effects of plant-based diets on aerobic and strength/power performances in humans were, respectively, included in the systematic review and meta-analysis. Plant-based diets had a moderate but positive effect on aerobic performance (0·55; 95 % CI 0·29, 0·81) and no effect on strength/power performance (-0·30; 95 % CI -0·67, 0·07). The altogether analyses of both aerobic and strength/power exercises revealed that athletic performance was unchanged (0·01; 95 % CI -0·21, 0·22) in athletes who adopted plant-based diets. However, a small negative effect on BMI (-0·27; 95 % CI -0·40, -0·15) was induced by these diets. The results indicate that plant-based diets have the potential to exclusively assist aerobic performance. On the other hand, these diets do not jeopardise strength/power performance. Overall, the predicted effects of plant-based diets on physical performance are impactless, even though the BMI of their adherents is reduced.
Topics: Humans; Diet, Plant-Based; Athletic Performance; Diet; Exercise; Exercise Therapy; Muscle Strength
PubMed: 37869973
DOI: 10.1017/S0007114523002258 -
Nutrients Dec 2023Migraines display atypical age dependence, as the peak of their prevalence occurs between the ages of 20-40 years. With age, headache attacks occur less frequently and... (Review)
Review
Migraines display atypical age dependence, as the peak of their prevalence occurs between the ages of 20-40 years. With age, headache attacks occur less frequently and are characterized by a lower amplitude. However, both diagnosis and therapy of migraines in the elderly are challenging due to multiple comorbidities and polypharmacy. Dietary components and eating habits are migraine triggers; therefore, nutrition is a main target in migraine prevention. Several kinds of diets were proposed to prevent migraines, but none are commonly accepted due to inconsistent results obtained in different studies. The ketogenic diet is featured by very low-carbohydrate and high-fat contents. It may replace glucose with ketone bodies as the primary source of energy production. The ketogenic diet and the actions of ketone bodies are considered beneficial in several aspects of health, including migraine prevention, but studies on the ketogenic diet in migraines are not standardized and poorly evidenced. Apart from papers claiming beneficial effects of the ketogenic diet in migraines, several studies have reported that increased levels of ketone bodies may be associated with all-cause and incident heart failure mortality in older adults and are supported by research on mice showing that the ketogenic diets and diet supplementation with a human ketone body precursor may cause life span shortening. Therefore, despite reports showing a beneficial effect of the ketogenic diet in migraines, such a diet requires further studies, including clinical trials, to verify whether it should be recommended in older adults with migraines.
Topics: Humans; Animals; Mice; Aged; Young Adult; Adult; Diet, Ketogenic; Migraine Disorders; Ketone Bodies; Headache; Diet
PubMed: 38068855
DOI: 10.3390/nu15234998 -
Maturitas Dec 2023Cancer is one of the main noncommunicable diseases in terms of health impact. Factors such as a progressively aging population point to future increases in the incidence... (Review)
Review
Cancer is one of the main noncommunicable diseases in terms of health impact. Factors such as a progressively aging population point to future increases in the incidence of cancer on a global level. The elevated number of affected individuals, together with continuous improvements in cancer prevention and therapy, is creating a growing population of cancer survivors, with often inadequately met needs. Lifestyle is a key modulator of cancer risk and of associated morbidity and mortality, and is included in all approaches to the long-term management of cancer. Diet is a principal component of lifestyle, and most of the available evidence is centered on the Mediterranean diet. Our objective was to provide a narrative review of the evidence on the effect of the Mediterranean diet on cancer risk and health threats related to cancer survivorship. For this purpose, we searched the PubMed database for articles published between January 1, 2000, and June 12, 2023. Current data show that the Mediterranean diet is inversely associated with risk, or is risk neutral, for most types of cancer. Tumors of the digestive system have received preferential interest, but studies have also been published on tumors in other organs. The evidence, however, is meager due to the observational nature of most studies, although it is reassuring that benefit is reproduced in studies performed in different populations and environments. Evidence related to cancer survivors is limited by the paucity of studies, yet several findings regarding survival, recurrence, and short- and long-term morbidity suggest a potential role for the Mediterranean diet that warrants further research.
Topics: Humans; Aged; Diet, Mediterranean; Survivorship; Neoplasms; Risk; Cancer Survivors
PubMed: 37660598
DOI: 10.1016/j.maturitas.2023.107841 -
Clinical Gastroenterology and... Apr 2024Celiac disease, non-celiac gluten sensitivity, and wheat allergy comprise 3 of the main conditions with wheat- and gluten-containing foods as the symptom trigger.... (Review)
Review
Celiac disease, non-celiac gluten sensitivity, and wheat allergy comprise 3 of the main conditions with wheat- and gluten-containing foods as the symptom trigger. Distinguishing between these entities can be daunting. In this review, we compare and contrast celiac disease, non-celiac gluten sensitivity, and wheat allergy to allow clinicians to determine which diagnosis fits their patient to facilitate high-quality management and longitudinal care.
Topics: Humans; Glutens; Celiac Disease; Wheat Hypersensitivity; Diet, Gluten-Free
PubMed: 37879521
DOI: 10.1016/j.cgh.2023.09.042 -
Clinical Nutrition (Edinburgh, Scotland) Oct 2023Non-pharmacological measures are recommended as the first-line treatment for individuals with high-normal blood pressure (BP) or mild hypertension. Studies directly... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND & AIMS
Non-pharmacological measures are recommended as the first-line treatment for individuals with high-normal blood pressure (BP) or mild hypertension. Studies directly comparing the BP effects of the Dietary Approaches to Stop Hypertension (DASH) vs. the Mediterranean diet (MedDiet) on a salt restriction background are currently lacking. Thus, our purpose was to assess the BP effects of a 3-month intensive dietary intervention implementing salt restriction either alone or in the context of the DASH, and the MedDiet compared to no/minimal intervention in adults with high normal BP or grade 1 hypertension.
METHODS
We randomly assigned never drug-treated individuals to a control group (CG, n = 60), a salt restriction group (SRG, n = 60), a DASH diet with salt restriction group (DDG, n = 60), or a MedDiet with salt restriction group (MDG, n = 60). The primary outcome was the attained office systolic BP difference among the randomized arms during follow-up.
RESULTS
A total of 240 patients were enrolled, while 204 (85%) completed the study. According to the intention-to-treat analysis, compared to the CG, office and 24 h ambulatory systolic and diastolic BP were reduced in all intervention groups. A greater reduction in the mean office systolic BP was observed in the MDG compared to all other study groups (MDG vs. CG: mean difference = -15.1 mmHg; MDG vs. SRG: mean difference = -7.5 mmHg, and MDG vs. DDG: mean difference = -3.2 mmHg, all P-values <0.001). The DDG and the MDG did not differ concerning the office diastolic BP and the 24 h ambulatory systolic and diastolic BP; however, both diets were more efficient in BP-lowering compared to the SRG.
CONCLUSIONS
On a background of salt restriction, the MedDiet was superior in office systolic BP-lowering, but the DASH and MedDiet reduced BP to an extent higher than salt restriction alone.
Topics: Humans; Adult; Blood Pressure; Dietary Approaches To Stop Hypertension; Diet, Mediterranean; Diet, Sodium-Restricted; Hypertension; Sodium Chloride; Sodium Chloride, Dietary
PubMed: 37625311
DOI: 10.1016/j.clnu.2023.08.011 -
Clinical Nutrition ESPEN Oct 2023The ketogenic diet (KD) is a low-carb diet that has been indicated as a possible coadjuvant in cancer therapy, mainly due to its capacity to reduce glycolysis... (Review)
Review
The ketogenic diet (KD) is a low-carb diet that has been indicated as a possible coadjuvant in cancer therapy, mainly due to its capacity to reduce glycolysis production, inflammation, and oxidative stress. However, KD's role in metastasis remains poorly explored. This study aims to provide a critical review of the literature about KD's efficacy in metastasis therapy and the possible molecular mechanisms behind it. Initially, general concepts on KD and metastasis are discussed. Then, it delves deeper into the main cancer mechanisms explored by KD experimental studies, discussing the central results obtained in metastasis research and their main limiting conditions. Following, there is a critical analysis of clinical trials, including those in the grey literature. In the end, there is a summary of the actual studies' limitations and barriers to future research. To date, it is possible to conclude that there is not enough evidence supporting the efficacy of KD in the treatment of metastasis.
Topics: Humans; Diet, Ketogenic; Inflammation; Oxidative Stress
PubMed: 37739657
DOI: 10.1016/j.clnesp.2023.06.038 -
Appetite Aug 2023Vegetarian and vegan (Veg*n) diets are increasingly popular in Western societies and an increasingly common topic of psychological research. Animal-free diets hold...
Vegetarian and vegan (Veg*n) diets are increasingly popular in Western societies and an increasingly common topic of psychological research. Animal-free diets hold considerable potential for helping curb the climate crisis and improving interspecies justice. This special issue presents recent contributions from research on the psychology of meat eating and veg*nism. To situate these articles in a broader context, we first establish the importance of studying veg*nism. We then review papers in this special issue, organized into themes of motivations and characteristics of veg*ns, attitudes towards veg*ns, attitudes toward meat and alternative proteins, intentions to eat meat or plant-based foods, consumption of meat or plant-based foods, and meat reduction interventions. We conclude with future directions for this blossoming field of study.
Topics: Animals; Humans; Diet, Vegetarian; Diet; Diet, Vegan; Vegetarians; Attitude; Meat
PubMed: 37121487
DOI: 10.1016/j.appet.2023.106582