Adult Diet Research Articles

Mediterranean Diet and Brain Health in Hispanic or Latino Adults

Mediterranean Diet and Brain Health in Hispanic or Latino Adults

Efficacy of the ketogenic diet in Chinese adults versus children with drug-resistant epilepsy: A pilot study

ObjectiveWe compared the efficacy and safety of ketogenic diet (KD) therapy as a treatment for Chinese adults versus children with drug-resistant epilepsy. MethodsThe classic KD was initiated in 19 adults and 29 children with drug-resistant epilepsy. The KD ratio and the dosage of antiseizure medication (ASM) were delicately modulated by the ketogenic team. ResultsAt 12 months after diet initiation, 11 adults (8 on a KD ratio of 3:1 and 3 on a ratio of 2:1) and 20 children (9 on a ketogenic diet ratio of 3:1 and 11 on a ratio of 2:1) remained on the diet. The retention rate for adult KD therapy recipients was 79.0% at 6 months and 57.9% at 12 months after diet initiation, which was not significantly different from the retention rate for children (82.8% at 6 months and 68.9% at 12 months; P > 0.05). The efficacy rate of KD therapy (seizure freedom or ≥50% reduction in seizure frequency) did not significantly differ between adults (63.2%) and children (75.8%, P = 0.517). Alleviation of seizure severity was observed in 68.4% of adults and 63.6% of children who were not seizure free on KD therapy. Antiseizure medication was reduced in 34 out of all 48 individuals at the final follow-up. ConclusionOur study demonstrated that KD therapy is a safe and effective treatment for Chinese adults as well as children with drug-resistant epilepsy.

Effect of limited protein consumption during the larval and adult stage on life‐history traits of the Mexican fruit fly

AbstractAnastrepha ludens Loew (Diptera: Tephritidae) is an important mango and citrus pest. The sterile insect technique (SIT) is currently used to control this fly. The SIT involves the release of sterile insects to reduce wild populations through the induction of sterility. Prior to release, insects are mass‐reared on artificial diets. The rearing of A. ludens involves the provision of protein both in the larval and adult stage, thus we studied trade‐offs between larval and adult diets. We compared various yeast concentrations in the larval diet and two formulations in the adult diet, both at small and semi‐mass scale. We determined the quality of the insects at all developmental stages. Low concentrations of torula yeast (TY) (2.9 and 3.6%) produced larvae and pupae of low weight, fewer larvae and pupae, and more males than higher TY concentrations (6.1%), but this was only discernable at a small scale. Adult survival without water and food was significantly lower for non‐irradiated males and females, and irradiated males when reared on 6.1% TY. For mating success, we found that non‐irradiated males reared on 4.8% TY but fed only sugar (S) as adults had lower probability of mating than males fed yeast hydrolysate (YH). For irradiated males, larval diet had no effect on mating competitiveness, only males fed with S + YH in the adult diet had higher mating success than those fed with S only. We propose reducing TY in the larval diet to 5.1%; however, for release colonies S + YH will need to be provided in the adult diet. Knowledge on larval and adult nutritional requirements will aid in our understanding of insect nutritional ecology and will also improve mass‐rearing diets.

Barriers to a healthy diet and physical activity in Mexican adults: results from the Mexican Health and Nutrition Survey.

This study aims to (1) identify the most prevalent perceived barriers for healthy eating and performing physical activity among adults in Mexico; and (2) determine the association between perceived barriers, with body mass index (BMI) categories, geo-demographic and socio-economic characteristics. We carried out a cross-sectional, secondary analysis of publicly available data from the Mexican Health and Nutrition Survey 2016. We extracted data from 6406 adults, aged 20-65 years, including: perceived barriers for healthy eating and for performing physical activity, BMI, residence area, region of Mexico, sex, age and socio-economic status. Logistic regression models were used to evaluate the association between perceived barriers with the categories of obesity, geographic and socio-demographic variables. Seventy-four point nine percent of the respondents were categorised as having either overweight or obesity, 80.5% reported at least one barrier to healthy eating and 78.3% at least one barrier to performing physical activity. Of the listed barriers, the most reported barriers were 'lack of affordability' (58.6%) for healthy eating and 'lack of time' (51.2%) for performing physical activity. Females (OR 1.27, 95% CI 1.11 to 1.46) and people with obesity (OR 1.19, 95% CI 1.01 to 1.41) were more likely to report barriers to a healthy diet; and females (OR 1.39, 95% CI 1.41 to 1.59), people with obesity (OR 1.41, 95% CI 1.19 to 1.69) and those living in rural areas (OR 1.49, 95% CI 1.30 to 1.72) were more likely to report barriers to performing physical activity. There was a high prevalence of reported barriers for healthy eating and performing physical activity. Females, people with obesity, and those living in rural areas are more likely to report barriers for healthy eating and for performing physical activity. Targeted health programmes and tailored interventions that address the barriers to a healthy lifestyle that these groups experience may encourage healthier lifestyle behaviours in a greater proportion of Mexican adults.

The associations between adherence to the Mediterranean diet and physical fitness in young, middle-aged, and older adults: A protocol for a systematic review and meta-analysis.

A healthy diet and high health-related physical fitness levels may be part of an overall healthy lifestyle. The relationship between adherence to the Mediterranean diet and physical fitness levels has been analyzed in several studies. However, no studies have synthesized evidence on this relationship throughout adulthood. Moreover, in addition to the overall Mediterranean dietary pattern, the associations of individual components of the Mediterranean diet with physical fitness indicators are also unclear. This protocol for a systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis for Protocols statement and the Cochrane Collaboration Handbook. Systematic literature searches will be performed in the MEDLINE (PubMed), Scopus, Web of Science, SPORTDiscus and Cochrane CENTRAL databases to identify studies published up to 31 January 2022. The inclusion criteria will comprise observational studies and randomized controlled trials reporting the associations between adherence to the Mediterranean diet and physical fitness levels on general healthy or unhealthy adults (≥18 years). When at least five studies addressing the same outcome are available, meta-analysis will be carried out to estimate the standardized mean difference of physical fitness according to the adherence to Mediterranean diet. Subgroup analyses will be performed according to the characteristics of the population, the individual dietary components of the Mediterranean diet and physical fitness parameters as long as there are sufficient studies. This systematic review and meta-analysis protocol is designed for updating evidence on the associations between adherence to overall Mediterranean diet (and specific Mediterranean foods) and physical fitness levels in young, middle-aged, and older adults. Findings from this review may have implications for public health. The results will be disseminated through peer-reviewed publication, conference presentation, and infographics. No ethical approval will be required since only published data will be used. CRD42022308259.

Eating Competence and Aspects Related to a Gluten-Free Diet in Brazilian Adults with Gluten-Related Disorders.

This cross-sectional study aims to assess eating competence (EC—an intra-individual approach to food, behaviors, and attitudes related to food) and aspects related to a gluten-free diet (GFD) in Brazilian adults with gluten-related disorders (GRDs). The research was conducted using an online survey with a self-reported instrument consisting of 40 items, organized into three parts: (I) Socioeconomic and demographic data; (II) the Brazilian version of the Eating Competence Satter Inventory (ec-SI2.0™BR); and (III) questions about adherence and difficulties in following the gluten-free diet. EC was measured by the ecSI2.0™BR instrument, with scores ≥32 were considered competent eaters. The instrument was applied nationwide through the GoogleForms® platform from 14 February 2022 to 30 March 2022. The publicity for the recruitment was supported by Brazilian celiac local and national associations (Acelbras and Fenacelbra), pages of food services or personal pages of tips and posts about gluten-related disorders, and specialized stores that offer gluten-free foods. The recruitment occurred through social networks (emails, Facebook groups, WhatsApp, and Instagram). A total of 1030 Brazilians with GRDs answered the questionnaire. Most participants were female, aged 40 years or older, with an income >R$3000, and a high education level. The main difficulty regarding adherence to GFD was the high cost of gluten-free foods. Individuals younger than 40 years old had lower EC scores, with no differences between men and women. Increasing socioeconomic status, schooling, and culinary practices increased the total score. Participants who “never/almost never” felt socially judged because their diet had higher scores for total EC. Competent eaters GRD individuals (EC ≥ 32) were mostly individuals aged ≥40 y/o; with income > R$3000; following a GFD; satisfied with purchased gluten-free products; consuming gluten-free products prepared at home, mainly by themselves; who do not feel judged because of the GRD and who feel that they can live a normal life with GRD. Our study showed that individuals who strictly adhere to the GFD have higher scores on eating competence than those who sometimes follow the treatment.

Regulatory and Clinical Expert Perspective of the 2022 FDA Draft Guidance “Celiac Disease: Developing Drugs for Adjunctive Treatment to a Gluten-Free Diet”

Regulatory and Clinical Expert Perspective of the 2022 FDA Draft Guidance “Celiac Disease: Developing Drugs for Adjunctive Treatment to a Gluten-Free Diet”

Association of Dietary Inflammatory Index With Depression and Suicidal Ideation in Older Adult: Results From the National Health and Nutrition Examination Surveys 2005-2018.

BackgroundThe relationship between diet and psychological disorders in older adults has attracted considerable attention as the global trend of aging. This study examines the relationship between Dietary inflammatory index (DII) and the risk of depression and suicide in older adults using the National Health and Nutrition Examination Survey (NHANES) as a large cross-sectional study.MethodsThe data were extracted from NHANES from 2005 to 2018, and cross-sectional studies were conducted on older adults (age ≥ 60 years). According to their median DII, participants were classified into High-DII (DII ≥ 1.23) and Low-DII (DII < 1.23) groups. Depression was the primary outcome, and suicidal ideation was a secondary outcome. Utilizing multi-factor logistic regression to correlate DII with outcomes.ResultsThere were 10,956 elderly participants included in the analysis. In comparison to Low-DII group, High-DII group exhibited a higher rate of depression (8.9% vs. 6.7%; P < 0.001) and higher ideation to commit suicide (3.7% vs. 3.0%; P = 0.039). Moreover, in terms of gender ratio, men accounted for 44% of the High-DII group, which was significantly lower than 56.2% of the Low-DII group (P < 0.001). Furthermore, logistic regression revealed that High-DII group had a higher risk of depression in the previous 2 weeks (OR = 1.358, 95% CI: 1.180–1.564; P < 0.001) and a higher risk of suicidal ideation (OR = 1.244, 95% CI: 1.010–1.532; P = 0.040). Additionally, after adjusting for demographic covariates such as age, gender and race, High-DII group still had a higher risk of depression (OR = 1.293, 95% CI: 1.121–1.493; P < 0.001) and suicidal ideation (OR = 1.261, 95% CI: 1.021–1.55; P = 0.031). Furthermore, after adjusting for various covariates like demographic, social factors, and comorbidities, the High-DII group remained at higher risk for depression (OR = 1.178, 95% CI: 1.019–1.363; P = 0.027), and the risk of comorbid suicidal ideation remained high (OR = 1.136, 95% CI: 0.917–1.408), but the difference was not significant (P = 0.243).ConclusionIn older adults, high levels of DII are associated with depression and suicidal ideation. Multiple factors affect the mental health of older adults, and it is unknown to what extent a pro-inflammatory diet contributes to depression and suicidal thoughts in older adults. Nonetheless, daily dietary management in older adults should be emphasized.

Effect of personalized dietary advice to increase protein intake on food consumption and the environmental impact of the diet in community-dwelling older adults: results from the PROMISS trial

PurposeDiet modelling studies suggest that increasing protein intake with no consideration for sustainability results in a higher environmental impact on the diet. To better understand the impact in real life, the aim of this study was to assess the effect of dietary advice to increase protein intake on food consumption and the environmental impact of the diet in community-dwelling older adults.MethodsFood consumption and environmental impact were analyzed among 124 Dutch older adults with lower habitual protein intake (< 1.0 g/kg adjusted body weight/day) participating in the six-month PROMISS trial. Dietary intake data from three 24-h dietary recalls, aided by food diaries, and results from life cycle assessments were used to examine the differences in changes in food consumption and environmental impact between those who received dietary advice to isocalorically increase protein intake to ≥ 1.2 g/kg aBW/d (Protein + ; n = 84) and those who did not receive dietary advice (Control; n = 40).ResultsCompared to the Control, Protein + increased protein intake from animal-based food products (11.0 g protein/d, 95% CI 6.6–15.4, p < 0.001), plant-based food products (2.1 g protein/d, 95% CI 0.2–4.0, p = 0.031) and protein-enriched food products provided during the trial (18 g protein/d, 95% CI 14.5–21.6, p < 0.001) at the 6-month follow-up. Diet-associated greenhouse gas emissions increased by 16% (p < 0.001), land use by 19% (p < 0.001), terrestrial acidification by 20% (p = 0.01), and marine eutrophication by 16% (p = 0.035) in Protein + compared to the Control.ConclusionThis study found that dietary advice increased protein intake, favoring animal-based protein, and increased the environmental impact of the diet in older adults.Trial registrationClinicalTrials.gov. NCT03712306. October 2018.

Snapshot of health-related behaviours in adults living with disabilities 1 year into the COVID-19 pandemic: a cross-sectional survey study

ObjectivesThis survey aimed to assess the status of a range of health-related behaviours 1 year after the coronavirus outbreak was declared a pandemic in adults living with disabilities comparative with...

Therapeutic Potential of the 4 Strategies to SUlfide-REduction (4-SURE) Diet in Adults with Mild to Moderately Active Ulcerative Colitis: An Open-Label Feasibility Study

Diet therapy may bridge the therapeutic gap in ulcerative colitis (UC). The novel 4-SURE diet (4-strategies-to-SUlfide-REduction), designed to modulate colonic fermentation and influence production of excess hydrogen sulfide, was examined in a feasibility study for tolerability, clinical efficacy, and effects on microbial endpoints. Adults aged ≥18 y old with mild to moderately active UC were advised to increase intake of fermentable fibers, restrict total and sulfur-containing proteins, and avoid specific food additives for 8 wk. The primary outcome was tolerability of diet [100-mm visual analogue scale (VAS) with 100-mm being intolerable]. Secondary exploratory outcomes were self-reported adherence (always adherent ≥76-100%), clinical and endoscopic response (reduction in partial Mayo ≥2 and Mayo endoscopic subscore ≥1), modulation of fecal characteristics including markers of protein and carbohydrate fermentation, and food-related quality of life (IBD-FRQoL-29). Primary analysis was by intention to treat, performed using paired t and Wilcoxon signed-rank statistical tests. Twenty-eight adults with UC [mean (range) age: 42 (22-72) y, 15 females, 3 proctitis, 14 left-sided, and 11 extensive] were studied. Prescribed dietary targets were achieved overall. The diet was well tolerated (VAS: 19mm; 95% CI: 7, 31mm) with 95% frequently or always adherent. Clinical response occurred in 13 of 28 (46%) and endoscopic improvement in 10 of 28 participants (36%). Two participants (7%) worsened. Fecal excretion of SCFAs increased by 69% (P<0.0001), whereas the proportion of branched-chain fatty acids to SCFAs was suppressed by 27% (-1.34%; 95% CI: -2.28%, -0.40%; P=0.007). The FRQoL improved by 10 points (95% CI: 4, 16; P<0.001). The 4-SURE dietary strategy is considered tolerable and an acceptable diet by adults with mild to moderately active UC. The dietary teachings achieved the prescribed dietary and fecal targets. Given signals of therapeutic efficacy, further evaluation of this diet is warranted in a placebo-controlled trial. This trial was registered at https://www.anzctr.org.au (Australian New Zealand Clinical Trials Registry) as ACTRN12619000063112.

Estimation of Dapagliflozin in Pure and Marketed Formulation by Validated Reverse Phase-High Performance Liquid Chromatographic Method

Dapagliflozin is a highly selective, orally active and reversible inhibitor of the human sodium glucose co- transporter 2 (SGLT2). The dapagliflozin is a diabetic drug which is used with proper diet and exercise in adults with type 2 diabetes to improve the glycemic control. The aim of this study is to develop a rapid, precise and accurate RP- HPLC method for estimation of dapagliflozin in bulk and formulation as per ICH guidelines. The chromatography was carried on Sunsil C18 (150 X4.5mm, 5µ) column HPLC (Water’s) using a mixture of methanol and water at different ratios and finally optimized with 85:15 v/v as mobile phase with flow rate 1.0ml/min at 225nm. The correlation regression is found to be 0.999. The retention time was found to be 2.74min. The accuracy of the present method was evaluated at 50%, 100% and 150%. The recoveries of dapagliflozin API and tablet were found to be in the range of 98.5% - 100.6%. Precision studies were carried out and the relative standard deviation values were less than two. The method was found to be robust. The limit of detection and limit of quantification were determined as 0.011µg/ml and 0.034µg/ml. The proposed method was found to be rapid, precise, accurate and robust and can be used for the estimation of dapagliflozin in API and Pharmaceutical dosage form.&#x0D;

Anatomy and Symbiosis of the Digestive System of the Vent Shrimp Rimicaris Exoculata and Rimicaris Chacei Revealed Through Imaging Approaches

The shrimp Rimicaris exoculata and Rimicaris chacei are visually dominant fauna co-occurring at deep-sea hydrothermal sites of the Mid-Atlantic Ridge (MAR). Their co-existence was related to contrasted life-history traits, including differences in their diet and reliance on chemoautotrophic symbionts at the adult stage. Both species of shrimp are colonized by diversified chemosynthetic symbiotic microbial communities in their cephalothoracic cavity. Symbiotic association with bacteria was also evidenced in their digestive system, and the major lineages were identified through sequencing (with Mycoplasmatales in the foregut and Deferribacteres in the midgut) but their precise distribution within each host species was not assessed. For the first time, we used Fluorescence in situ Hybridization (FISH) to visualize these lineages and describe their association with digestive structures of their host. The aim of the study was to identify possible differences between host species that could be related to their different life-history traits. For this purpose, we developed new specific FISH probes targeting Deferribacteres and Mycoplasmatales lineages identified in the digestive system of these shrimp. Our FISH results showed a partitioning of the bacterial lineages according to the digestive organ corroborating sequencing data, and highlighted their association with specific anatomical structures. Despite morphological differences between the foreguts of R. exoculata and R. chacei that could be related to the adult diet, our FISH results showed overall similar distribution of digestive symbionts for the two host species. However, a more comprehensive study is needed with specimens at different life or molt stages to reveal potential host specific patterns. Such comparisons are now possible thanks to our newly designed FISH probes. The tools used in our study are valuable for tracking symbiont lineages in the environment, allowing a better understanding of their relationship with their host along its life cycle, including their acquisition mechanisms.

Risk Factors and Clinical Presentation in Dogs with Increased Serum Pancreatic Lipase Concentrations-A Descriptive Analysis.

Simple SummaryOver the past several years, there has been an increasing importance placed on clinical presentation as part of a diagnosis of pancreatitis, and yet there is comparatively little data investigating the full array of clinical signs that may be seen in dogs with pancreatitis. Our study showed that dogs with increased pancreatic lipase immunoreactivity concentrations could display a wide range of clinical signs, which may be related to pancreatitis or a concurrent disease. Non-specific clinical signs, such as anorexia, were prevalent. Additionally, overt abdominal pain was infrequently reported, and veterinarians should be cautious in ruling out pancreatitis due to a lack of abdominal pain alone. Additionally, limited data is available on potential risk factors for pancreatitis in dogs; this information could be important in the development of disease prevention strategies. In our study, the most common concurrent disease was hepatobiliary abnormalities. Additional studies are needed to determine whether this is a causative or associative relationship. Drug use reflected common prescribing practices, and anti-epileptic drug use was low despite prior studies documenting clear associations between phenobarbital and potassium bromide and drug-associated pancreatitis. Adult maintenance diets, in addition to human foods and dog treats, were commonly fed prior to the development of an increased pancreatic lipase concentration.Limited data exist regarding the full array of clinical signs seen in dogs with pancreatitis and potential risk factors for the disease. Laboratory submissions from the Gastrointestinal Laboratory at Texas A&M University were retrospectively reviewed for dogs with an increased serum pancreatic lipase immunoreactivity (cPLI) concentration (≥400 µg/L), and an internet-based survey was distributed to the attending veterinarian and/or technician on each case. The survey contained questions related to (i) clinical signs, (ii) prior gastrointestinal upset, (iii) comorbidities, (iv) pre-existing medical therapies, and (v) dietary history. One hundred and seventy (170) survey responses were recorded. The top three clinical signs reported were inappetence (62%), diarrhea (53%), and vomiting (49%). Abdominal pain was noted in only 32% of dogs, likely associated with poor pain detection. Additionally, the majority of dogs (71%) had prior episodes of gastrointestinal upset within the past 12 months, lending support for the commonality of recurrent acute pancreatitis, or acute on chronic disease. Hepatobiliary abnormalities (24%) were the most common concurrent disease, and endocrine disorders were seen in a low proportion of respondents (5–8%). Adult maintenance diets (65%), dog treats (40%), and human foods (29%) were commonly consumed by dogs prior to the discovery of increased cPLI concentration.

Plasma Metabolite Response to Simple, Refined and Unrefined Carbohydrate-Enriched Diets in Older Adults—Randomized Controlled Crossover Trial

Food intake data collected using subjective tools are prone to inaccuracies and biases. An objective assessment of food intake, such as metabolomic profiling, may offer a more accurate method if unique metabolites can be identified. To explore this option, we used samples generated from a randomized and controlled cross-over trial during which participants (N = 10; 65 ± 8 year, BMI, 29.8 ± 3.2 kg/m2) consumed each of the three diets enriched in different types of carbohydrate. Plasma metabolite concentrations were measured at the end of each diet phase using gas chromatography/time-of-flight mass spectrometry and ultra-high pressure liquid chromatography/quadrupole time-of-flight tandem mass spectrometry. Participants were provided, in random order, with diets enriched in three carbohydrate types (simple carbohydrate (SC), refined carbohydrate (RC) and unrefined carbohydrate (URC)) for 4.5 weeks per phase and separated by two-week washout periods. Data were analyzed using partial least square-discrimination analysis, receiver operating characteristics (ROC curve) and hierarchical analysis. Among the known metabolites, 3-methylhistidine, phenylethylamine, cysteine, betaine and pipecolic acid were identified as biomarkers in the URC diet compared to the RC diet, and the later three metabolites were differentiated and compared to SC diet. Hierarchical analysis indicated that the plasma metabolites at the end of each diet phase were more strongly clustered by the participant than the carbohydrate type. Hence, although differences in plasma metabolite concentrations were observed after participants consumed diets differing in carbohydrate type, individual variation was a stronger predictor of plasma metabolite concentrations than dietary carbohydrate type. These findings limited the potential of metabolic profiling to address this variable.

Effect of Intragastric Botulinum Type A Injection Combined with a Low-Calorie High-Protein Diet in Adults with Overweight or Obesity.

(1) Background/aims: Intragastric botulinum toxin A injection (IGBI) combined with diet control is a new and effective weight loss method for grade 2 obese patients. However, the application of IGIB on overweight or obese adults still needs further research to confirm its efficacy. (2) Methods: We retrospectively collected medical data from 1 July 2021 to 1 January 2022 from a total of 71 patients without diabetes who participated in the bariatric clinic with a body mass index (BMI) > 25 kg/m2. Forty-nine participants opted for intragastric botulinum injection (IGBI) using 300 units of botulinum injected into the antrum, body, and fundus, followed with a low-calorie high-protein diet course. Another 22 people participated only in the low-calorie high-protein diet course as a placebo group. This study analyzes the weight loss percentage of the two groups. Adverse events after IGBI are also reported in a safety assessment. (3) Results: In terms of the characteristics of the two groups, the mean BMI was 29.3 kg/m2 in the IGBI group and 28.0 kg/m in the placebo group (p = 0.63 without significant difference). Comparing the percent weight loss from baseline in the two groups after 12 weeks, the IGBI group lost 11.5% of their body weight and the placebo group lost 1.8%. In terms of group analysis, the percentages of participants with a weight reduction of at least 5% for the IGBI and placebo groups were 95% and 4%, respectively. For weight reduction of at least 10%, these values for the IGBI and placebo groups were 63% and 4%, respectively. In terms of adverse events after IGBI for 12 weeks, 12 participants (24.4%) had constipation, which was the main side effect. No serious adverse events were observed during the study period. (4) Conclusion: The combination of a low-calorie high-protein diet and IGBI is an effective and safe procedure in overweight or obese adults for weight reduction, but further larger studies are needed.

Changes in Adiposity and Cerebrospinal Fluid Biomarkers Following a Modified Mediterranean Ketogenic Diet in Older Adults at Risk for Alzheimer's Disease.

BackgroundKetogenic diets have been used to treat both obesity and neurological disorders, including epilepsy and more recently Alzheimer’s disease (AD), likely due to favorable effects on both central and peripheral metabolism. Improvements in body composition have also been reported; however, it is unclear if diet-induced changes in adiposity are related to improvements in AD and related neuropathology.PurposeWe examined the effects of a Modified Mediterranean Ketogenic (MMK) diet vs. an American Heart Association (AHA) diet on body weight, body composition, and body fat distribution and their association with cerebrospinal fluid (CSF) biomarkers in older adults at risk for AD.MethodsTwenty adults (mean age: 64.3 ± 6.3 years, 35% Black, 75% female) were randomly assigned to a crossover trial starting with either the MMK or AHA diet for 6 weeks, followed by a 6-week washout and then the opposite diet for 6 weeks. At baseline and after each diet adiposity was assessed by dual-energy x-ray absorptiometry and CSF biomarkers were measured. Linear mixed effect models were used to examine the effect of diet on adiposity. Spearman correlations were examined to assess associations between adiposity and CSF biomarkers.ResultsAt baseline there was a high prevalence of overweight/obesity and central adiposity, and higher visceral fat and lower peripheral fat were associated with an adverse CSF biomarker profile. The MMK and AHA diets led to similar improvements in body composition and body fat distribution. Significant correlations were found between changes in adiposity and changes in CSF biomarkers (r’s = 0.63–0.92, p’s < 0.05), with notable differences by diet. Decreases in body fat on the MMK diet were related to changes in Aβ biomarkers, whereas decreases in body fat on the AHA diet were related to changes in tau biomarkers and cholinesterase activity. Interestingly, increases in CSF Aβ on the MMK diet occurred in those with less fat loss.ConclusionAn MMK diet leads to favorable changes in body composition, body fat distribution, and CSF biomarkers. Our data suggest that modest weight loss that maximizes visceral fat loss and preserves peripheral fat, may have the greatest impact on brain health.Clinical Trial Registration[www.ClinicalTrials.gov], identifier [NCT02984540].

Low glycaemic index and glycaemic load diets in adults with excess weight: Systematic review and meta-analysis of randomised clinical trials.

To compare the effects of low and high glycaemic index/glycaemic load (GI/GL) diets on body weight in adults with excess weight. We searched for randomised controlled trials comparing low GI/GL vs. high GI/GL diets from Medline (via PubMed), Embase, Scopus and Web of Science. The variables of interest were anthropometric measurements, fasting glucose and fasting insulin levels and lipid profile, and 10 studies were included in the meta-analysis. The sample size ranged from 19 to 203 participants. Low GI/GL is not superior to high GI/GL diets on body weight reduction in adults with excess weight (body mass index [BMI] ≥ 25 kg m-2 ). However, low GI/GL diets show greater body weight reductions in adults with BMI ≥ 30 kg m-2 (-0.93 kg; 95% confidence interval [CI] = -1.73 to -0.12; p = 0.045). Compared with high GI/GL diets, low GI/GL diets may also help reduce fasting glucose (-1.97 mg dl-1 ; 95% CI = -3.76 to 0.19; p = 0.030) and fasting insulin (-0.55 µU ml-1 ; 95% CI = -0.95 to -0.15; p = 0.007). No differences in fat mass, fat-free mass, waist circumference and lipid profile were observed between low GI/GL and high GI/GL diets. The risk of bias for body weight was classified as 'low risk' (25% of the studies) and 'some concerns' for all domains of RoB 2 tool in most studies. When compared with high GI/GL diets, low GI/GL diets appear to more effectively reduce fasting glucose and insulin and promote greater body weight reduction in adults with obesity (BMI ≥ 30 kg m-2 ).

Sugar-Sweetened Beverage and 100% Fruit Juice Consumption on Body Weight in Children and Adults: A Systematic Review and Meta-Analysis

ObjectivesSugar-sweetened beverages (SSBs) have been increasingly linked to the obesity epidemic, however, the evidence on 100% fruit juice and body weight remains controversial. The objective of this research was to synthesize the available evidence on SSBs and 100% fruit juice on body weight in children and adults.MethodsMEDLINE, EMBASE, and Cochrane were searched through October 11th, 2020 for prospective cohort studies (≥ 6 months) and randomized controlled trials (RCTs) (≥ 2 weeks) assessing the effect of SSBs and 100% fruit juice on BMI and body weight in children and adults. Eligible trials assessed SSBs or 100% fruit juice added to the diet in adults, and reduced from the diet in children against a non-caloric control. Data were pooled using random effects models and presented as b coefficients with 95% CIs for cohort studies and mean differences (MD)s with 95% CIs for RCTs. Results are reported in compliance with the PRISMA guidelines, and the protocol was registered on PROSPERO (ID: CRD42020209915).ResultsSixty-two articles were identified for SSBs: 40 in children (33 cohorts, 7 RCTs) and 22 in adults (14 cohorts, 8 RCTs), and 22 articles were identified for 100% fruit juice: 13 in children (13 cohorts, 0 RCTs), and 9 studies in adults (3 cohorts, 6 RCTs). Among cohort studies, each serving/day increase in SSB was associated with an increase in BMI in children and body weight in adults (0.06 kg/m2; 95% CI: 0.03, 0.10 and 0.47 kg; 95% CI: 0.24, 0.69, respectively). For 100% fruit juice, each serving/day increase was associated with an increase in body weight in adults (0.19 kg; 95% CI: 0.04, 0.34) while no association was found for children (0.02 kg/m2; 95% CI: −0.01, 0.05). RCTs in children indicated a reduction in BMI gain when SSB consumption was reduced (MD = −0.21 kg/m2; 95% CI: −0.42, 0.00). RCTs in adults indicated an increase in body weight when SSBs were added to the diet (MD = 0.76 kg; 95% CI: 0.51, 1.0), however no effect on weight was found for the addition of 100% fruit juice (MD = 0.08 kg; 95% CI: −0.79, 0.96).ConclusionsSSB consumption promotes weight gain in both children and adults. Evidence from cohort studies indicate a positive association between 100% fruit juice and weight gain in adults and a marginal association among children. Findings from RCTs on 100% fruit juice in adults showed no effect, and there is a need for trials among children.Funding SourcesNone.

Dietary Guidelines for Americans Dietary Patterns Are Associated with Significant Improvements in Healthy Life As Assessed by the Health Nutritional Index (HENI)

ObjectivesTo assess health burden as measured by disability adjusted life years (DALY) of current US adult diets and of Dietary Guidelines for American (DGA) recommended diets.MethodsA nationally representative sample of Americans aged 25 + years old (N = 13,331) from the National Health and Nutrition Examination Survey (NHANES) 2011–2016 database were used to determine current self-reported dietary patterns and to estimated health burden (DALY) in minutes of healthy life using the Health Nutritional Index (HENI), an epidemiology-based multiplicatively adjusted nutritional assessment tool based on 14 dietary risk factors identified in the Global Burden of Disease (GBD). Additionally, we estimated the health burden/benefit of DGA recommended dietary patterns for 2000 kcal/day: 1) Healthy US Style; 2) Healthy Vegetarian Style; and 3) Healthy Mediterranean Style. The maximum benefit if the threshold intakes in GBD were consumed was also evaluated.ResultsThe currently consumed diet was associated with a gain of 0.2 minutes of healthy life/day. Current diets in females were associated with a gain of 5 minutes of heathy life/day while in males current diets were associated with a decrease of 4 minutes of healthy life/day. The Healthy US Style diets was associated with a gain of 32 minutes of healthy life/day while the Healthy Vegetarian Style and Healthy Mediterranean Style diets were associated with gains of 56 and 38 minutes of healthy life/day, respectively. The maximal benefit, consuming threshold intakes in the GBD, was associated with a gain of 84 minutes of healthy life/day. The largest components of the gains were due to increases in intake of fruit (15–19 min/day), whole grains (11 min/d), vegetables (6 min/d) and milk (4–6 min/day); the increases fish in the Healthy Mediterranean Style diet provided additional benefits (10 min/day).ConclusionsResults indicate that DGA recommended diets may provide significant improvements in healthy life over current diets.Funding SourcesNational Dairy Council.