Combination Of Diet Research Articles

Ezetimibe Markedly Reduces Hepatic Triglycerides and Cholesterol in Rats Fed on Fish Oil by Increasing the Expression of Cholesterol Efflux Transporters.

Besides diet therapy, hypolipidemic pharmacological therapy may be a crucial component of nonalcoholic fatty liver disease (NAFLD) treatment. Ezetimibe may be a promising drug for treatment of NAFLD. n-3 polyunsaturated fatty acids, which are abundant in fish oil, reduce serum and hepatic cholesterol and triglycerides in rodents. The aim of this study was to examine the combined effects of dietary fish oil and ezetimibe on lipid metabolism in rats. Seven-week-old male Sprague-Dawley rats were allocated to four different diets containing 1) 10% soybean oil (C), 2) 10% fish oil (F), 3) 10% soybean oil + 0.005% ezetimibe, and 4) 10% fish oil + 0.005% ezetimibe (F+E) for 4 weeks, when the liver, jejunum, blood, and fecal samples were collected. Compared with the C group, the F+E diet decreased hepatic triglycerides and cholesterol 84% and 86%, but it did not increase fecal cholesterol. In liver, the expression of lipogenic enzymes was decreased in the F+E diet, whereas β-oxidation-related genes were not increased. Abcg5/g8 mRNA expression was increased 1380%/442% when ezetimibe was added to the F diet. These gene expression changes are related to the decrease in hepatic lipids. In jejunum, Abcg5/g8 mRNA was increased 244%/841% when ezetimibe was added to the F diet. Hepatic induction of Abcg5/8 rather than intestinal induction correlates with the marked decrease in liver cholesterol when ezetimibe was added to the F diet. These data suggest that fish oil diet and ezetimibe in combination may be a beneficial therapy for NAFLD by increasing hepatic Abcg5/g8 and decreasing lipogenic genes. SIGNIFICANCE STATEMENT: There is currently no single treatment for NAFLD. Thus, lifestyle modifications including dietary regulation and physical activity are also important options. In this study, ezetimibe, a cholesterol absorption inhibitor, was evaluated for the treatment of liver steatosis in rats fed on the different diets. We found that ezetimibe and fish oil in combination markedly improved fatty liver by increasing cholesterol efflux transporters. The combination therapy of fish oil agents and ezetimibe may be effective for NAFLD.

A Comparison of the Weight Loss Effect between a Low-carbohydrate Diet and a Calorie-restricted Diet in Combination with Intragastric Balloon Therapy.

Objective Intragastric balloon (IGB) therapy is a low-invasion treatment for obesity. Recently, a low-carbohydrate diet has shown effectiveness for encouraging weight loss, but whether or not a low-carbohydrate diet improves the efficacy of IGB therapy remains unclear. Therefore, we examined the effectiveness of a low-carbohydrate diet compared with a calorie-restricted diet in combination with IGB therapy. Methods A prospective study was conducted on 51 patients who had undergone IGB therapy from October 2012 to December 2017. Overall, 31 of the 51 patients were included in this study (12-month assessment after IGB placement). These 31 cases consisted of 18 IGB plus low-carbohydrate diet and 13 IGB plus calorie-restricted diet. We compared the two groups with respect to body weight loss as outcomes. Results At 12 months after IGB placement, the body weight was significantly lower than that observed at baseline in both the IGB plus low-carbohydrate diet group (baseline 101.9±25.8 kg, 12 months 88.2±21.9 kg) (p<0.0001) and the IGB plus calorie-restricted diet group (baseline 103.5±17.0 kg, 12 months 89.1±6.2 kg) (p<0.005). The percentage of excess weight loss in the IGB plus low-carbohydrate diet group was slightly higher than that in the IGB plus calorie-restricted diet group, but there was no significant difference between the 2 groups at 12 months after IGB placement (IGB plus low-carbohydrate 49.9±60.0%, IGB plus calorie-restricted diet 33.1±27.0%). Conclusion Our study demonstrated that both a low-carbohydrate diet and a calorie-restricted diet were effective interventions for weight reduction in combination with IGB therapy.

Astragalus polysaccharides protect renal function and affect the TGF-β/Smad signaling pathway in streptozotocin-induced diabetic rats.

ObjectivesThe objective was to observe the effects of Astragalus polysaccharides on diabetes and on regulation of the TGF-β/Smad signaling pathway.MethodsA type 2 diabetic rat model was established with a high-fat diet in combination with low-dose streptozotocin (35 mg/kg). Astragalus polysaccharides were applied as treatment intervention and changes in blood glucose and kidney morphology and function were assessed.ResultsEight weeks after model establishment, kidney weight as a proportion of total weight (KW/TW) in the high-, medium-, and low-dose Astragalus polysaccharide groups was significantly lower than that in the model group, and the KW/TW value gradually decreased with increasing dose of polysaccharides in each treatment group. Fasting blood glucose in the low- and medium-dose Astragalus polysaccharide groups was numerically lower than that in the model group and fasting blood glucose in rats in the high-dose group was significantly lower than that in the model group. Levels of 24-hour urinary microalbumin, creatinine, blood urea nitrogen, collagens I, III, and IV, α-smooth muscle actin, transforming growth factor-β1, and Smad3 in Astragalus polysaccharide groups (all doses) were significantly lower than those in the model group.ConclusionsAstragalus polysaccharide significantly improved blood glucose and protected kidney function in a rat diabetes model.

Breast Cancer: A Lifestyle Medicine Approach.

Breast cancer is the most common female cancer diagnosis in the United States (excluding skin cancers), and the second leading cause of female cancer death. This article highlights the role that lifestyle plays in primary breast cancer prevention, breast cancer treatment, and tertiary breast cancer prevention. Current data regarding the benefits of a predominantly plant-based diet in combination with physical activity and maintenance of a healthy body weight will be reviewed. The evidenced-based patient-focused recommendations developed by the World Cancer Research Fund/American Institute for Cancer Research will be discussed in the context of an overall lifestyle strategy. It is our hope that this publication empowers clinicians to provide patients with personalized cancer-protective lifestyle prescriptions.

A Dietary Combination of Forskolin with Homotaurine, Spearmint and B Vitamins Protects Injured Retinal Ganglion Cells in a Rodent Model of Hypertensive Glaucoma

There is indication that nutritional supplements protect retinal cells from degeneration. In a previous study, we demonstrated that dietary supplementation with an association of forskolin, homotaurine, spearmint extract and B vitamins efficiently counteracts retinal dysfunction associated with retinal ganglion cell (RGC) death caused by optic nerve crush. We extended our investigation on the efficacy of dietary supplementation with the use of a mouse model in which RGC degeneration depends as closely as possible on intraocular pressure (IOP) elevation. In this model, injecting the anterior chamber of the eye with methylcellulose (MCE) causes IOP elevation leading to RGC dysfunction. The MCE model was characterized in terms of IOP elevation, retinal dysfunction as determined by electrophysiological recordings, RGC loss as determined by brain-specific homeobox/POU domain protein 3A immunoreactivity and dysregulated levels of inflammatory and apoptotic markers. Except for IOP elevation, dysfunctional retinal parameters were all recovered by dietary supplementation indicating the involvement of non-IOP-related neuroprotective mechanisms of action. Our hypothesis is that the diet supplement may be used to counteract the inflammatory processes triggered by glial cell activation, thus leading to spared RGC loss and the preservation of visual dysfunction. In this respect, the present compound may be viewed as a potential remedy to be added to the currently approved drug therapies for improving RGC protection.

Findings of a Pilot Study Investigating the Effects of Mediterranean Diet and Aerobic Exercise on Cognition in Cognitively Healthy Older People Living Independently within Aged-Care Facilities: The Lifestyle Intervention in Independent Living Aged Care (LIILAC) Study.

ABSTRACTBackgroundCognitive decline and Alzheimer disease are more prevalent in our aging population. Modifiable risk factors, such as diet and sedentary lifestyle, have been proposed as key to potentially ameliorating cognitive decline. Both exercise and Mediterranean diet (MedDiet) have been linked to reduced levels of cardiovascular disease and other comorbidities. Higher levels of exercise and MedDiet adherence may prove to be cognitively protective, both individually and synergistically.ObjectivesThe aim was to investigate the effect of a 6-mo program of MedDiet, exercise, and a combination of both, on cognition, mood, and general health in older persons living independently in aged-care communities.MethodsThe Lifestyle Intervention in Independent Living Aged Care (LIILAC) Study (ACTRN12614001133628) involved 102 participants, aged 60–90 y, who were randomly assigned to 1 of 4 intervention groups. Change in overall memory performance was assessed as the primary outcome. Additionally, changes in cognitive task performance, as well as mood, wellness, cardiovascular function, and blood biomarkers, were investigated.ResultsWhile there was no significant change in overall memory performance, there was a significant improvement in spatial working memory performance in the combined exercise and diet group, relative to controls. This combined intervention group also showed an overall improvement in their emotional state, as assessed by the Depression Anxiety Stress Scale, as did the exercise-only group.ConclusionsThis research indicates that diet and exercise programs have the potential to improve aspects of cognition and mood in an aging population. However, given the lower than optimal sample size and lack of resources to reinforce the interventions during the trial, further larger randomized controlled trials are required to substantiate whether the introduction of diet and exercise programs into independent-living facilities is a viable method to preserve cognitive health in older people. This trial was registered at www.ANZCTR.org.au ACTRN 12614001133628 (LIILAC Study)

Anti-hyperglycemic activity of myricetin, through inhibition of DPP-4 and enhanced GLP-1 levels, is attenuated by co-ingestion with lectin-rich protein.

Dipeptidyl peptidase-4 (DPP-4) is a proteolytic enzyme responsible for the rapid degradation of Glucagon-like peptide 1 (GLP-1) that is required for the secretion of insulin. DPP-4 also influences activation of node like receptor family, pyrin domain containing 3 (NLRP3) inflammasome under diabetic conditions. Although several polyphenols are reported for various bioactivities, they are consumed as part of the food matrix and not in isolation. Horsegram (Macrotyloma uniflorum) is a rich source of myricetin (Myr) (35 μg/g flour), reported for its anti-hyperglycemic effect. In this investigation, we aimed to study the effect of Myr, singly, and in the presence of co-nutrient horsegram protein (HP) on DPP-4 activity and its consequential impact on GLP-1, insulin, and NLRP3 inflammasome in high-fat diet and single low dose streptozotocin (STZ)-induced diabetic male Wistar rats. In diabetic control (DC), the activity of DPP-4 and its expression were higher compared to treated groups. The consequential decrease in the circulating GLP-1 levels in the DC group, but not treated groups, further indicated the effectiveness of our test molecules under diabetic conditions. Specifically, Myr decreased DPP-4 activity and its expression levels with enhanced circulating GLP-1 and insulin levels. Myr administration also resulted in a lessening of diabetes-induced NLRP3 inflammasome activation and enhanced antioxidant enzyme activities. HP also proved to be efficient in reducing elevated blood glucose levels and enhancing antioxidant enzyme activities. However, Myr, in the presence of HP as a co-nutrient, had diminished capacity to inhibit DPP-4 and, consequently, reduced potential in ameliorating diabetic conditions. Myr proved to be a potent inhibitor of DPP-4 in vitro and in vivo, resulting in enhanced circulating GLP-1 and insulin levels, thereby improving diabetic conditions. Though Myr and HP, individually ameliorate diabetic conditions, their dietary combination had reduced efficiency.

Selection of locally available diets for rearing Scylla paramamosain megalopa to first crablet stage

The aim of this research was to investigate the efficacy of seven different diets including live Acetes (LA), minced shrimp meat (MSM), locally formulated feed (LFF), a commercial feed (CF), and three combination diets of LA with MSM (LA + MSM), LFF (LA + LFF) and CF (LA + CF) on the nursery production of mud crab (Scylla paramamosain) crablets. To avoid the influence of cannibalism on the test diets, these diets were simultaneously tested under individual and communal culture conditions. For individuals, individual one-day-old megalopa was reared in 0.5 L plastic beakers. For commune, 250 megalopae were reared in earthen dugout holes. The average survival (mean ± SD) of first crablet stage was 93.6 ± 5.56 in individual culture system and 67.0 ± 14.95 in communal culture system, however, the gap survival between individual and communal culture within the different diets was similar, indicating that cannibalism didn't effect on results of evaluating test diets. The LA resulted in higher survival of crablets than MSM, LFF and CF, but not significantly different to combination diets. All megalopa fed exclusively LA or LA + CF synchronously moulted into the crablet stage one day earlier than those fed MSM, LFF, CF, LA + MSM and LA + LFF. However, none of the test diets influenced the growth of the first crablets. The present research indicates that all the test diets are appropriate to rear megalopa into crablet stage as reflected by successful moults and high survival of first crablets, in which LA is the optimal diet that resulted in increased survival, synchronous moulting, and reduced duration period required for metamorphosis.

Waist‐to‐height Ratio as an Indicator to Determinate Obesity and Central Obesity in Pediatric Population

IntroductionIn school‐age children and adolescents, the obesity is a public health alarm that particularly has been increasing. The highest prevalence rates of childhood obesity have been observed in developed countries; still, its prevalence is increasing in developing countries as well. The best evidence to date suggests that measures of central adiposity should be used in order to best identify individuals at increased risk of obesity‐related ill health. In the clinical environment, techniques such as Body Mass Index (BMI), waist circumference (WC) have been used extensively, but the waist‐to‐height ratio (WHtR) could be a better tool to detect central obesity.ObjectiveThe objective was to evaluate the association of body mass index (BMI) and waist to height ratio in overweight and obese paediatric age group.MethodsIs a cross‐sectional study, schoolchildren in a Mexican population, ages from 9 to 18 years. The anthropometric variables measured were waist circumference, body mass index, waist‐to‐height ratio, Waist circumference at the midpoint between the last rib and the iliac crest. The use of The Center for Disease Control and Prevention growth tables classified overweight as at or above 85th percentile and obesity as at or above 95th percentile of BMI. The relationship between waist‐to‐height ratio (WHtR) and body mass index (BMI) was analyzed by X2, t‐test and ANOVA.ResultsA cross‐sectional study of 594 children and adolescents from 9 to 18 years of age. In the analysis the population was grouped by aged group of 9 to 11(23%), 12 to 14 (33%) and 15 to 18 years(44%). The body mass index (BMI) for age showed 18% for overweight and 13% for obesity. The waist to height ratio was 24% for higher cardiometabolic risk with a mean of 0.47 and a waist circumference of 73.9cm. A cardiometabolic risk by WtHR was 4% in normal BMI/age, in overweight 8% and in Obesity was 12% (p=0.01).ConclusionThe prevalence of overweigh and obesity was 31%. It is important to recognize the capacity of anthropometric measurements on identifying overweight and obesity diagnosis. A combined diet and physical activity intervention conducted in the community with a school component should be applied preventing obesity or overweight. The waist to height ratio was 24% for cardiometabolic risk. Anthropometric measurements such as weight, height and waist circumference are simple and effective as global indicator for health risks.Support or Funding InformationUPAEP UNIVERSITY Anthropometric measurements in the paediatric group AGE (yrs) Weight (kg) Height (cm) Waist circumference (cm) BMI (kg/m2) WHtR Mean 13.6 55.6 158.6 73.9 21.9 0.47 SD 2.34 14.4 11.6 10.3 4.1 0.06 Min 9.0 23.0 127.0 50.0 13.6 0.34 Max 18.0 115.0 195.0 125.0 40.5 0.74 Range 9.0 92.0 68.0 75.0 26.9 0.4 *Standard DeviationProportion categorized by WHtR Risk and BMITable 2

Dietary Fish Oil and Medium Chain Triglycerides Together Modulate Feline Gut Microbiome Function but not Composition

ObjectivesWe previously reported that dietary combination of fish oil (FO) and medium chain triglycerides (MCT) decreases blood levels of feline gut microbial metabolites (postbiotics). The objective of the current study was to assess the effect of these oils in combination on the composition of the feline fecal microbiome as well as fecal levels of microbial postbiotics.MethodsRandomized crossover design with two groups, Control group (CON, n = 15) which contained no added dietary MCT or FO versus Test group (FO/MCT, n = 16) whose food contained 0.4% n3‐eicosapentaenoate and 0.3% n3‐docosahexaenoate from FO as well as 3.6% caprylate and 2.7% caprate from MCT. Cats were fed for 6 weeks and group or individually housed in environments promoting social interaction, having access to natural light that varied with season and opportunity to exercise. Health was confirmed through clinical indices. Collections were under IACUC approved protocols. Cats were fed to maintain healthy body weight. Serum and fecal samples were assessed for gut microbiome postbiotics by LC‐MS. Composition of fecal gut microbiome was assessed by sequencing of the V3‐V4 region of 16S ribosomal DNA. Univariate paired t‐tests were performed on log‐transformed serum and fecal metabolites as well as Aitchison‐transformed microbiome counts at the genera level. Significance was set at alpha = 0.05 with FDR correction.ResultsThe results showed that FO/MCT intervention decreased circulating microbial‐derived indole and phenolic postbiotics in serum as well as feces; both unconjugated and host‐sulfated postbiotics were reduced. Dietary FO/MCT also induced a broad reduction in fecal endocannabinoid immune modulators that may be produced by gut microbes; stearoyl‐, palmitoyl‐, oleoyl‐, docosahexaenoyl‐ and arachidonoyl‐ ethanolamides were decreased. Unexpectedly, fecal microbiome composition at the genera level was not markedly different when FO/MCT was consumed, even though fecal microbial postbiotics were broadly decreased. There was no effect of diet order in the crossover design, indicating that the effect of FO/MCT to reduce serum and fecal postbiotics was reversible.ConclusionsSince microbial postbiotics were decreased in feces, the proxy for colonic site of postbiotic production, the effect of FO/MCT did not appear to stem from an effect on host absorption of postbiotics into serum. As well, it is not likely that FO/MCT decreased host conjugation of postbiotics since both sulfated and non‐sulfated postbiotic forms were reduced. The effect on serum postbiotics appears to be a general phenomenon, as both the feline subjects and sources of oils were different from our previously reported study which did not examine feces. Since relative abundances of microbial genera were largely not impacted by diet, it would appear that FO/MCT intervention in cats alters microbial function without modulating microbial populations per se. In summary, the combination of dietary FO/MCT may provide an effective means to reversibly reduce production of postbiotics by gut microbes.Support or Funding InformationHill’s Pet Nutrition, Inc. Topeka, Kansas, USA

Effects of Dietary Hemp Seed and Flaxseed on Growth Performance, Meat Fatty Acid Compositions, Liver Tocopherol Concentration and Bone Strength of Cockerels.

The aim of the study is to determine the effect of hemp seed (HS) of the nonpsychotropic variety Futura and extruded flaxseed (EF) in the diet of cockerels on cockerel growth performance, breast muscle and liver α- and γ-tocopherol concentrations, breast muscle fatty acid concentrations and tibia strength. Five hundred and forty one-day-old male Ross 308 cockerels are equally allocated into six groups. Each group has three replicates of 30 cockerels in pens with litter. The formulated diets are isoenergetic (the metabolisable energy ranged from 12.4 to 12.8 MJ/kg) and isonitrogenic (the protein concentration ranged from 209.7 to 210.9 g/kg) and provided ad libitum. During the experiment, which lasts 35 days, the control group is fed a diet without EF or HS. Rapeseed oil was the lipid source in the control diet. The diet for the second group contains EF at 60 g/kg, the diet for the third group contains HS at 40 g/kg, and the diets for the fourth to sixth groups contain HS and EF at 30 and 60 g/kg, 40 and 60 g/kg and 50 and 60 g/kg, respectively. At the end of the experiment, 15 cockerels of average weight are slaughtered per group, and the breast muscle, liver and tibia bone are dissected for chemical analyses. The all dietary combination of HS and EF increases (p < 0.001) cockerel body weight (2375-2493 g) more than HS alone (2174 g) or EF alone (2254 g). A similar finding is observed for the diet composition and tocopherol content in the liver, but the doses of HS required to achieve this effect are higher (40 and 50 g/kg). The tocopherol content in the breast muscle is not influenced by the diet. The dietary combination of 60 g/kg EF and 40 g/kg HS results in the most promising findings of the experiment, since it leads to the lowest n-6/n-3 polyunsaturated fatty acids ratio (p < 0.001; 1.75). Incorporation of HS into the diet increases cockerel tibia strength (p < 0.001), which is of great practical importance due to the frequent occurrence of limb fractures. To conclude, the dietary supplementation with 40 g/kg HS and 60 g/kg EF improves cockerel performance, meat and bone quality and deposition of α-tocopherol in the liver.

Supplement of microbiota-accessible carbohydrates prevents neuroinflammation and cognitive decline by improving the gut microbiota-brain axis in diet-induced obese mice

BackgroundWestern pattern diets induce neuroinflammation and impair cognitive behavior in humans and animals. Neuroinflammation and cognitive impairment have been associated with microbiota dysbiosis, through the gut-brain axis. Furthermore, microbiota-accessible carbohydrates (MACs) found in dietary fiber are important in shaping the microbial ecosystem and have the potential to improve the gut-brain-axis. However, the effects of MACs on neuroinflammation and cognition in an obese condition have not yet been investigated. The present study aimed to evaluate the effect of MACs on the microbiota-gut-brain axis and cognitive function in obese mice induced by a high-fat and fiber deficient (HF-FD) diet.MethodsC57Bl/6 J male mice were fed with either a control HF-FD or a HF-MAC diet for 15 weeks. Moreover, an additional group was fed with the HF-MAC diet in combination with an antibiotic cocktail (HF-MAC + AB). Following the 15-week treatment, cognitive behavior was investigated; blood, cecum content, colon, and brain samples were collected to determine metabolic parameters, endotoxin, gut microbiota, colon, and brain pathology.ResultsWe report MACs supplementation prevented HF-FD-induced cognitive impairment in nesting building and temporal order memory tests. MACs prevented gut microbiota dysbiosis, including increasing richness, α-diversity and composition shift, especially in Bacteroidetes and its lower taxa. Furthermore, MACs increased colonic mucus thickness, tight junction protein expression, reduced endotoxemia, and decreased colonic and systemic inflammation. In the hippocampus, MACs suppressed HF-FD-induced neuroglia activation and inflammation, improved insulin IRS-pAKT-pGSK3β-pTau synapse signaling, in addition to the synaptic ultrastructure and associated proteins. Furthermore, MACs’ effects on improving colon–cognitive parameters were eliminated by wide spectrum antibiotic microbiota ablation.ConclusionsThese results suggest that MACs improve cognitive impairments via the gut microbiota-brain axis induced by the consumption of an HF-FD. Supplemental MACs to combat obesity-related gut and brain dysfunction offer a promising approach to prevent neurodegenerative diseases associated with Westernized dietary patterns and obesity.

Influence of feeding systems on selected beef quality and sensory attributes

Feeding systems and other factors associated with processing influence meat quality, and therefore sensory attributes. This study was conducted to assess the meat quality attributes of young grain-fed and older grass-fed steers that mostly affect consumer acceptability of beef. Eighty Bonsmara steers consisting of 20 each of A-age (0-tooth) grain-fed (AC) and grain-fed supplemented with zilpaterol (AZ), 20 each of grass-fed AB (1-2 teeth) and B-age (3 - 6 teeth) animals were used. This combination represented the typical feeding systems of South Africa and other countries using similar classification systems, therefore describes the typical feeding systems of the South African beef industry. The longissimus lumborum (LL), semitendinosus (ST), and biceps femoris (BF) muscles were tested for colour, moisture properties, lipid oxidation and sensory attributes. It was found that diet in combination with animal age influenced meat colour. Muscles of the older grass-fed steers were generally darker and duller (darker red) compared to muscles of young grain-fed animals. Moisture loss was consistently higher in zilpaterol supplemented meat samples compared to the feedlot controls, while muscles of the grass-fed animals had lower moisture loss. A sensory panel clearly distinguished between cuts of grain-fed (AZ and AC) and grass-fed carcasses (AB and B) on the grounds of flavour characteristic. The AB and B cuts scored higher for grassy, animal-like and rancid flavour overtones and lower for roasted flavour and sourness than AZ and AC grain-fed cuts. This indicated that typical flavours related to diet define expected eating quality.&#x0D; Keywords: age, grain, grass, meat quality, zilpaterol

SAT-161 TREATMENT OF DIABESITY WITH DIET AND NEWER ANTIGLYCEMIC MEDICATIONS IN PLACE OF INSULIN: EFFECT ON DIABETIC KIDNEY DISEASE

Type 2 diabetes is the result of several years of prediabetes and the metabolic syndrome. The goal of treatment is weight loss to reduce insulin resistance, and to reduce the need for glucose-lowering medications including insulin. Long term data from the Diabetes Control and Complications trial showed that tight HbA1C correction does not lead to better cardiovascular disease (CVD) outcomes, yet tight control does correct microvascular complications. Recent reports suggested that insulin therapy does not treat the biochemical components of metabolic syndrome, whereas the oral antihyperglycemic medications especially metformin, the incretin mimetics (GLP-1 receptor agonists) and the sodium-glucose co-transporter-2 (SGLT2) inhibitors do indeed correct this. Weight loss correction also needs a caloric deficit but this becomes hard with insulin therapy which often causes weight gain. Standards of Medical Care in Diabetes by American Diabetes Association stated that SGLT2 inhibitors and GLP-1 RA should be considered for patients with type 2 diabetes, established atherosclerotic CVD and chronic kidney disease (CKD) who require another drug or cannot tolerate metformin to attain target HbA1C as these agents appear to reduce risks of CKD progression, CVD events, and hypoglycemia. We treated patients of type 2 diabetes and obesity with combined low-carbohydrate diets and intermittent fasting, along with metformin and newer antiglycemic agents, stopping of insulin therapy wherever feasible. The associations between weight loss, improvement in renal function and treatments were reported using correlation coefficient r and probability p value where significant. Total of 60 patients were reviewed between February 2014 and July 2019 in our outpatient clinic. Mean age was 62.5 years with male to female ratio 3:2. The observed average weight loss was 10.74kg, with 13.2kg and 7.06kg loss for male and female patients respectively. Estimated glomerular filtration rate (eGFR) has improved by 3.13ml/min/1.73m2 and proteinuria was reduced by 12.4 units on average, in terms of albumin creatinine ratio. Mean HbA1C reduction was 0.7%. Mean reduction in insulin therapy was by 16 units with a maximum 202 units in one patient. Clinic blood pressure measurement during the follow-up period was largely unchanged. Weight reduction seems to improve eGFR (r 0.2, p 0.0012, 95% CI from 3.6716 to 13.4304). Combined use of SGLT-2 inhibitor and GLP-1 RA seems to have effect on improvement in eGFR (p 0.01) regardless of weight loss.View Large Image Figure ViewerDownload Hi-res image Download (PPT) It seems possible to control blood sugar in type 2 diabetes by combining metformin, SGLT-2 inhibitor and or GLP-1 RA with intermittent fasting and low-calorie diets avoiding extra-insulin therapy, with resultant improvement in renal function (eGFR and proteinuria) along with weight loss. Therefore, oral antihyperglycemic agents with proven cardiovascular benefit and renal protection should be considered earlier to achieve the treatment goals where drug-specific effects are important on the basis of patient factors.

Comparing the assimilation of dietary nitrogen supplied by animal-, plant- and microbial-derived ingredients in Pacific white shrimp Litopenaeus vannamei: A stable isotope study

In order to become a more profitable and sustainable industry, the aquaculture sector is constantly exploring alternative nutrient sources. In the present study, the natural stable isotope signatures of different animal-, plant- and microbial-derived ingredients were determined to evaluate the assimilation of dietary nitrogen in Pacific white shrimp. Experimental diets were manufactured to replace fish meal and squid meal with microbial- and plant- derived ingredients (48 and 66 % dietary inclusion) and were also used as additives (4%). Ingredients were also used as additives to study their effects on growth performance and assimilation. Corn gluten, soy protein isolate, Arthrospira (Spirulina) biomass and a bacterial meal (ProFloc™) were used to formulate six, isotopic control diets containing one source of dietary nitrogen, while six combined diets had varying proportions of ingredients. At the end of the trial, survival rates were similar among treatments (88 ± 9%) but there were significant differences in mean final weight. Microbial and animal proteins promoted similar final weight when combined (1080−1537 mg), while plant ingredients and Arthrospira caused lower growth when used alone (420−970 mg). Isotopic values indicated significant differences in the assimilation proportions of dietary nitrogen, mainly attributed to the ingredients’ different amino acid profiles. The dietary nitrogen contained in microbial-derived ingredients was assimilated at similar, or even higher proportions than fish meal and squid meal. Diet formulated with 33 % fish meal, Arthrospira and corn gluten, contributed 31, 36 and 33 % of dietary nitrogen to muscle growth, respectively. The second 33 % combination supplied 42, 34 and 24 % from squid meal, bacterial meal and soy protein. When ingredients were used at 4%, additive levels, they also contributed structural nitrogen to shrimp muscle tissue despite low dietary inclusions. Results demonstrated the viable use of stable isotopes to evaluate the assimilation of dietary nitrogen supplied by emerging alternative ingredients.

Effects of Intervention Characteristics on Willingness to Initiate a Weight Gain Prevention Program.

To determine characteristics of weight gain prevention programs that facilitate engagement. Randomized factorial experiment (5 × 2). Recruited nationally online. Adults aged 18 to 75 with body mass index ≥25 who decline a behavioral weight loss intervention (n = 498). Participants were randomly presented with one of 10 possible descriptions of hypothetical, free weight gain prevention programs that were all low dose and technology-based but differed in regard to 5 behavior change targets (self-weighing only; diet only; physical activity only; combined diet, physical activity, and self-weighing; or choice between diet, physical activity, and self-weighing targets) crossed with 2 financial incentive conditions (presence or absence of incentives for self-monitoring). Participants reported willingness to join the programs, perceived program effectiveness, and reasons for declining enrollment. Logistic regression and linear regression to test effects of program characteristics offered on willingness to initiate programs and programs' perceived effectiveness, respectively. Content analyses for open-ended text responses. Participants offered the self-weighing-only programs were more willing to initiate than those offered the programs targeting all 3 behaviors combined (50% vs 36%; odds ratio [OR] = 1.79; 95% confidence interval [CI], 1.01-3.13). Participants offered the programs with financial incentives were more willing to initiate (50% vs 33%; OR = 2.08; 95% CI, 1.44-2.99) and anticipated greater intervention effectiveness (β = .34, P = .02) than those offered no financial incentives. Reasons for declining to initiate included specific program features, behavior targets, social aspects, and benefits. Targeting self-weighing and providing financial incentives for self-monitoring may result in greater uptake of weight gain prevention programs. https://osf.io/b9zfh, June 19, 2018.

Nutrology and type 2 diabetes: Nutrient pathophysiology and the transition from health to disease

From a Nutrology point of view, type 2 diabetes is a multi-factorial form of clinical “malnutrition” resulting from theintake of an imbalanced diet in combination with adverse environmental conditions and in the presence ofpredisposing genetic factors. In this review article, we present evidence of a close association between clinicalobesity in a specific genetic background as the pillars of the process underlying the development of type 2 diabetes.We review the basics of the energy balance and the role of fat storage and body distribution in the pathogenesis ofinsulin resistance. We describe some molecular aspects of nutrients under normal physiology and during themetabolic and hormonal abnormalities that accompany type 2 diabetes. We conclude with a brief discussion of theprinciples behind popular dietary recommendations aimed at preventing the full development of diabetes mellitusand its complications.

The Effect of an 8 Week Prescribed Exercise and Low-Carbohydrate Diet on Cardiorespiratory Fitness, Body Composition and Cardiometabolic Risk Factors in Obese Individuals: A Randomised Controlled Trial.

Background: Low-carbohydrate (LC) diets are an effective method for treating obesity and reducing cardiometabolic risk. However, exposure to LC diets is associated with reductions in muscle mass and increased osteoporosis risk in obese individuals. The combination of exercise with a LC diet appears to attenuate muscle mass loss induced by LC diets alone, and to further improve cardiometabolic profile. However, evidence to date in obese individuals is limited. We assessed the effect of LC diet in combination with supervised exercise on cardiorespiratory fitness, body composition and cardiometabolic risk factors in obese individuals. Methods: Male and female participants in the experimental (EX-LC; structured supervised exercise program + low-carbohydrate meals; n = 33; 35.3 years) and control (EX-CO; structured supervised exercise program + standard dietary advice; n = 31; 34.2 years) conditions underwent measurements of cardiorespiratory fitness (VO2peak), body fat, lean muscle mass (LMM), and cardiometabolic biomarkers before and after an 8 week intervention. Results: Participants in the EX-LC condition demonstrated greater improvements in VO2peak (p = 0.002) and fat mass index (FMI, p = 0.001) compared to the EX-CO condition. Achieving a ketogenic state (β-hydroxybutyrate, βHB ≥0.3 mmol/L) was associated with greater reductions in total body fat (p = 0.011), visceral adipose tissue (p = 0.025), FMI (p = 0.002) and C-reactive protein (CRP, p = 0.041) but also with greater reductions in LMM (p = 0.042). Conclusion: Short-term LC diet combined with prescribed exercise enhanced cardiorespiratory fitness and the cardiometabolic profile of obese individuals but was also associated with greater muscle mass loss compared to similar exercise training and standard dietary advice. The long-term effects of the LC diet should be further explored in future studies.

Lipidaemic and Hepatic Status of Type 2 Diabetic Rats Treated with the Polyherbal Capsule Glucoblock

The scourge of diabetes has led to an increase in the use of complementary and alternative medicine. The lack of regulation and control leads to the indiscriminate use of these herbals, with potential risk to patients.&#x0D; Aim: This study evaluates the lipidaemic and hepatic status of type 2 diabetic rats treated with the polyherbal capsule glucoblock.&#x0D; Methodology: A total of 35 male Wistar albino rats weighing between 120-220 g were used for this study. The rats were placed on high fat diet and diabetes was induced by a single intraperitoneal injection of freshly prepared streptozotocin (STZ) (45 mg/kg body wt). Fasting plasma glucose (FPG) was determined using the glucose oxidase method. Total Cholesterol (TC), Triglyceride (TG) and High Density Lipoprotein Cholesterol (HDL-C) were determined using enzymatic methods. Low Density Lipoprotein Cholesterol (LDL-C) was calculated using the Friedewald’s equation. Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST) were determined using Reitman-Frankel method, while alkaline phosphatase (ALP) was determined using the colorimetric phenolphthalein method. Liver sections were stained using haematoxylin and eosin (H&amp;E) staining technique, and phytochemical analysis was also done on the herbal capsule.&#x0D; Results: The results show no significant differences in TC levels in all groups compared to the negative control. TG level was significantly higher in the diabetic control group when compared to the negative control. TG level in the singular treatment groups were significantly lower, but the combination group (glibenclamide + glucoblock) showed no significant difference compared to the diabetic control. The negative control had significantly higher HDL-C compared to the diabetic control and treatment groups. There were no significant differences in HDL-C levels in all the treatment groups, when compared to the diabetic control. The negative control had significantly lower LDL-C compared to the diabetic control and treatment groups. There were no significant differences in LDL-C levels in all the treatment groups, when compared to the diabetic control. ALT, AST and ALP levels were significantly higher in the diabetic control, but was significantly reduced to normal levels by the treatments. Liver sections of the negative control showed normal histoarchitecture. The diabetic control showed inflammation and fatty deposition. The treatment groups showed a nearly normal histoarchitecture, with fatty deposits.&#x0D; Conclusion: High fat diet in combination with a sub-diabetic dose of streptozotocin produced significant diabetes in the Wistar rats with dyslipidaemia and elevated liver enzyme levels. The anti-diabetic treatments, glibenclamide and glucoblock did not correct the dyslipidaema caused by diabetes. However, the treatments had equipotent hepatoprotective effect and restored liver enzyme levels to normal as well as improving liver histology.

Effect of Feed Supplemented with Selenium-Enriched Olive Leaves on Plasma Oxidative Status, Mineral Profile, and Leukocyte DNA Damage in Growing Rabbits.

Simple SummaryOlive trees (Olea europaea L., Oleaceae) are among the most extensively cultivated crops in the Mediterranean countries (98% of the world’s olive production) and are used for oil extraction or table olives, whereas the residues from pruning (olive leaves and wood) and extraction process (olive pomace) are considered waste or by-products. Furthermore, many agronomic practices, such as foliar spray administration of selenium used to reduce the water stress damage of olive trees, could further improve the nutritional value of these “wastes”. The use of by-products as part of the rabbit diet can be a very effective example of recovery of healthy molecules while at the same time a way of developing a more sustainable production system. Accordingly, the idea of the present research is to administer the by-product “olive leaves” to growing rabbits to improve their health status and partially solve the problem of waste disposal of olive trees.This study investigated the effect of a dietary combination of selenium and olive leaves on rabbit health status in order to evaluate the potential use of these combinations as functional ingredients in feed and food. Sixty weaning rabbits were fed with three diets: control feed (C), control feed + 10% normal olive leaves (OL), or olive leaves enriched in Se (2.17 mg Se/kg d.m.; SeOL). The plasma mineral profile, antioxidant status, and leukocyte DNA damage were determined. Inorganic Se was the most abundant form in the OL diet, while the organic one was higher in SeOL than C and OL. A similar trend was found in the plasma. Protein oxidation showed higher values in both supplemented groups; in addition, dietary Se led to a significant improvement (+40%) in ferric reducing ability of plasma (FRAP). A marked reduction in DNA damage (9-fold) was observed in the SeOL group compared to C. The combination of selenium and olive leaves in the diet of growing rabbits increased plasma SeMet and FRAP and reduced leukocyte DNA damage.