Dietary Restriction Group Research Articles

Elucidating the effective age for dietary restriction and the key metabolites involved

Dietary restriction (DR) extends lifespan in various species, but its effect at different ages, especially when started later, is unclear. This study used Caenorhabditis elegans to explore the impact of DR at different ages. Worms were divided into control and DR groups, with daily survival monitored. To confirm the occurrence of DR, the expression of DR-sensitive genes namely acdh-1, pyk-1, pck-2 and cts-1 were determined using RT-qPCR. Liquid chromatography mass spectrometry (LC-MS) was employed to observe the changes in metabolites affected by DR. The results indicated that young worms subjected to mild DR displayed the longest lifespan, highlighting the effectiveness of initiating DR at a young age. Increased expression of acdh-1 and pck-2 suggests activation of beta-oxidation and gluconeogenesis, while decreased cts-1 expression indicates a reduced citric acid cycle, further supporting the observed effects of DR in these worms. Metabolomic results indicated that DR decreased the activity of mechanistic Target of Rapamycin (mTOR) and the synthesis of amino acids namely leucine, tyrosine and tryptophan to conserve energy for cell repair and survival. DR also decreased levels of N-acetyl-L-methionine and S-adenosyl-methionine (SAM) in methionine metabolism, thereby promoting autophagy, reducing inflammation, and facilitating the removal of damaged cells and proteins. In conclusion, initiating dietary restriction early in life extends the lifespan by modulating amino acid metabolism and enhancing the autophagy pathway, thereby maintaining cellular wellbeing.

Impact of dietary restriction on development, mating, and reproduction in the natural predator Pardosa pseudoannulata.

Dietary restriction-influenced biological performance is found in many animal species. Pardosa pseudoannulata is a dominant spider species in agricultural fields and is important for controlling pests. In this study, three groups - a control group (CK group), a re-feeding group (RF group), and a dietary restriction group (RT group) - were used to explore development, mating, reproduction, and the expression levels of Vg (vitellogenin) and VgR (vitellogenin receptor) genes in the spider. The findings indicated that when subjected to dietary restriction, the carapace size, weight of the spiderlings, and weight of the adults exhibited a decrease. Furthermore, the preoviposition period and egg stage were observed to be prolonged, while the number of spiderlings decreased. It was also observed that re-feeding reduced cannibalism rates and extended the preoviposition period. Dietary restriction also affected the expression of the Vg-3 gene in the spider. These results will contribute to the understanding of the impact of dietary restriction in predators of pest control, as well as provide a theoretical foundation for the artificial rearing and utilisation of the dominant spider in the field.

Multicenter, open label, randomized controlled superiority trial for availability to reduce nocturnal urination frequency: The TOP-STAR study.

Nocturia impairs the quality of life in patients with type 2 diabetes mellitus. Although sodium glucose co-transporter 2 inhibitors (SGLT2i) such as tofogliflozin increase urine volume, their impact on nocturia, in conjunction with dietary salt restriction, is less clear. This multicenter, open-label, randomized, parallel-group trial included 80 subjects with type 2 diabetes and nocturia. The patients were divided into two groups: one receiving tofogliflozin, the shortest half-life, without salt restriction, and the other receiving both tofogliflozin and dietary salt restriction. The primary endpoint was nocturia frequency at 12 weeks. The secondary outcomes included changes in daytime urination frequency, urine volume, and home blood pressure. At 12 weeks, there were no significant differences in nocturia changes between both groups. Nocturia frequency did not change in the tofogliflozin without salt restriction group from 1.5 ± 0.8 to 1.3 ± 1.1 times per night (P = 0.297), and significantly decreased from 1.6 ± 1.0 to 1.3 ± 0.7 times per night in the tofogliflozin and dietary salt restriction group (P = 0.049). There was a trend toward increased urine volume and frequency during the daytime in the group with salt restriction, indicating a time-shift effect of the short half-life tofogliflozin and salt restriction on urinary time. The frequency of nocturia after tofogliflozin did not increase. Tofogliflozin reduced nocturia when combined with salt restriction. Furthermore, daytime urine volume and frequency showed an increasing trend, suggesting a shift in urine production to daytime hours due to the short half-life of tofogliflozin. Dietary modifications can enhance the therapeutic benefits of tofogliflozin in managing nocturia in people with type 2 diabetes.

Stochasticity in Dietary Restriction-Mediated Lifespan Outcomes in Drosophila.

Dietary restriction (DR) is widely considered to be one of the most potent approaches to extend healthy lifespan across various species, yet it has become increasingly apparent that DR-mediated longevity is influenced by biological and non-biological factors. We propose that current priorities in the field should include understanding the relative contributions of these factors to elucidate the mechanisms underlying the beneficial effects of DR. Our work conducted in two laboratories, represents an attempt to unify DR protocols in Drosophila and to investigate the stochastic effects of DR. Across 64 pairs of survival data (DR/ad libitum, or AL), we find that DR does not universally extend lifespan. Specifically, we observed that DR conferred a significant lifespan extension in only 26.7% (17/64) of pairs. Our pooled data show that the overall lifespan difference between DR and AL groups is statistically significant, but the median lifespan increase under DR (7.1%) is small. The effects of DR were overshadowed by stochastic factors and genotype. Future research efforts directed toward gaining a comprehensive understanding of DR-dependent mechanisms should focus on unraveling the interactions between genetic and environmental factors. This is essential for developing personalized healthspan-extending interventions and optimizing dietary recommendations for individual genetic profiles.

Stochasticity in Dietary Restriction-Mediated Lifespan Outcomes in Drosophila.

Dietary restriction (DR) is widely considered to be one of the most potent approaches to extend healthy lifespan across various species, yet it has become increasingly apparent that DR-mediated longevity is influenced by biological and non-biological factors. We propose that current priorities in the field should include understanding the relative contributions of these factors to elucidate the mechanisms underlying the beneficial effects of DR. Our work conducted in two laboratories, represents an attempt to unify DR protocols in Drosophila and to investigate the stochastic effects of DR. Across 64 pairs of survival data (DR/ad libitum, or AL), we find that DR does not universally extend lifespan. Specifically, we observed that DR conferred a significant lifespan extension in only 26.7% (17/64) of pairs. Our pooled data show that the overall lifespan difference between DR and AL groups is statistically significant, but the median lifespan increase under DR (7.1%) is small. The effects of DR were overshadowed by stochastic factors and genotype. Future research efforts directed toward gaining a comprehensive understanding of DR-dependent mechanisms should focus on unraveling the interactions between genetic and environmental factors. This is essential for developing personalized healthspan-extending interventions and optimizing dietary recommendations for individual genetic profiles.

The Effects of Short-Term Electromyostimulation Exercises and Different Diet Types on Body Composition in Obese Women

Obesity is one of the world's most risky health problems with increasing prevalence. This study aimed to investigate the effect of calorie-restricted diet and intermittent fasting diet on body composition with electromyostimulation (EMS) applications in obese females. The study was conducted with 90 obese females. Participants were randomly divided into 5 groups, EMS, EMS+intermittent fasting (EMS+IF), EMS+calorie restricted (EMS+CR), intermittent fasting (IF), and calorie restricted (CR) diet groups. EMS groups received 27min/2g/week EMS exercise protocol for 4 weeks. Furthermore, dietary interventions were conducted with all groups (except EMS). Body composition measurements of the participants were obtained with a bioelectrical impedance device. Two-way repeated measures ANOVA was used to analyze the obtained data. BMI, body mass, and body fat weight decreased significantly in the EMS+IF, and EMS+CR groups compared to the EMS group while skeletal muscle weight decreased dramatically in all four groups compared to the EMS group. In body analysis regional (right-left arm, right-left leg, and trunk) parameters, fat weight decreased significantly in EMS+IF, and EMS+CR groups compared to the other groups. Moreover, muscle mass decreased more in the EMS+CR and EMS+IF groups compared to the other groups. Dietary interventions in the form of CR or IF with EMS significantly affected body composition measurements in obese participants. EMS and IF dietary interventions may be therapeutic tools to combat obesity.Keywords:Calorie-Restricted Diet, Electromyostimulation, Exercise, Intermittent Fasting, Obesity

Dietary restriction plus exercise change gene expression of Cxcl12 abundant reticular cells in female mice.

Low energy availability due to excessive exercise lowers bone mass and impairs various physiological functions, including immunity and hematopoiesis. We focused on Cxcl12 abundant reticular (CAR) cells, which are bone marrow mesenchymal stem cells and are essential for the maintenance of hematopoietic and immune cells in bone marrow. We examine the functional changes in CAR cells resulting from dietary restriction combined with exercise. Five-week-old wild-type female mice were divided into an ad libitum group (CON), a 60% dietary restriction group (DR), an ad libitum with exercise group (CON + ex), and a 60% dietary restriction with exercise group (DR + ex). Blood parameters, bone structure parameters, and bone marrow fat volume were evaluated after 5weeks. In addition, bone marrow CAR cells were isolated by cell sorting and analyzed for gene expression by RT-qPCR. Bone mineral density (BMD) was significantly decreased in DR and DR + ex compared to CON and CON + ex. Especially, cortical bone mass and thickness were significantly decreased in DR and DR + ex groups, whereas trabecular bone mass was significantly increased. Bone marrow fat volume was significantly increased in DR and DR + ex groups compared to CON and CON + ex. The number of leukocytes in the blood was significantly decreased in the DR + ex group compared to the other three groups. RT-qPCR showed a significant decrease in gene expression of both Foxc1 and Runx2 in CAR cells of the DR + ex group compared to CON. Dietary restriction combined with exercise promotes CAR cell differentiation into bone marrow adipocyte and suppresses osteoblast differentiation.

Evaluation of the Effectiveness of Three Interventions on Mineralization of Young Permanent Teeth Using DIAGNOdent™ Pen: A Double-Blind Randomized Controlled Trial

Background: The occurrence of dental caries is influenced by the interplay of host factors, microbial factors, and environment factors collectively forming the epidemiological triad of dental caries. Modification of the caries epidemiological triad limits the caries progression by shifting the equilibrium toward re-mineralization. Aim: The aim of this study was to evaluate the effectiveness of dietary sugar intake modification, plaque control measures, and fluoride toothpaste on the mineralization of enamel using DIAGNOdent™ pen scores. Methodology: 108 children aged 13–15 years, qualified the preset inclusion and exclusion criteria were randomly allocated into one among the three interventional groups such as Group 1: Diet counseling; Group 2: Educational intervention of toothbrushing and oral rinsing; and Group 3: Fluoride toothpaste. The sugar scores from 1 week’s diet history, plaque index scores, the weight of the fluoride toothpaste, and DIAGNOdent™ pen scores were recorded at the baseline visit and subsequently at 6- and 12-week intervals. Statistical analysis was done using Chi-square, repeated measure analysis of variance, and Tukey’s post hoc tests to determine the relationship between the variables. Results: The percentage reduction in DIAGNOdent pen score at 12-week time interval in Group 1 was 25.37%, Group 2 was 6.77%, and Group 3 was 13.37%. Intergroup comparison revealed that Group 1 showed a statistically significant difference (P < 0.05) as compared to Group 2 and Group 3, but Group 2 was as effective as Group 3 in teeth remineralization. Conclusion: the results suggest that among the abovementioned interventions, the dietary sugar restriction group is related to improved mineralization when compared to the instructed toothbrushing, oral rinsing, and fluoride toothpaste groups.

Restricted carbohydrate diets below 45% energy are not associated with risk of mortality in the National Health and Nutrition Examination Survey, 1999-2018.

Cardiometabolic diseases (CMD) are the leading causes of death for people living in the United States. Dietary strategies, such as restricting carbohydrate intake, are becoming popular strategies for improving health status. However, there is limited and often contradictory evidence on whether restricting carbohydrate intake is related to all-cause, CMD, or cardiovascular disease (CVD) mortality. The objective of the present study was to evaluate the association between restricted carbohydrate diets (<45%en) and mortality from all-causes, CMD, and CVD, stratified by fat amount and class. Data were acquired using the National Health and Nutrition Examination Survey (1999-2018) linked with mortality follow-up until December 31, 2019 from the Public-use Linked Mortality Files. Multivariable survey-weighted Cox proportional hazards models estimated hazard ratios for 7,958 adults (≥20 y) that consumed <45%en from carbohydrates and 27,930 adults that consumed 45-65%en from carbohydrates. During the study period a total of 3,780 deaths occurred, including 1,048 from CMD and 1,007 from CVD, during a mean follow-up of 10.2 y. Compared to individuals that met carbohydrate recommendations (45-65%en), those that consumed carbohydrate restricted diets (<45%en) did not have significantly altered risk of mortality from all-causes (HR: 0.98; 95% CI: 0.87, 1.11), CMD (1.18; 0.95, 1.46), or CVD (1.20; 0.96, 1.49). These findings were maintained when the restricted carbohydrate diet group was stratified by intake of total fat, saturated fat (SFA), monounsaturated fat (MUFA), and polyunsaturated fat (PUFA). Carbohydrate restriction (<45%en) was not associated with mortality from all-causes, CVD, or CMD. Greater efforts are needed to characterize the risk of mortality associated with varied degrees of carbohydrate restriction, e.g., low (<26%en) and high (>65%en) carbohydrate diets separately.

Dietary restriction inhibits bone formation in alveolar bone modeling and remodelling

Objective: Methods: Balb/C mice weaned at the age of 21 days were assigned to one of the following groups: control group fed a regular hard diet ad libitum (food consumption was measured daily), and dietary restricted group (DR) received 75% of the amount of food consumed by the respective control mice the previous day. Body weight of all animals was recorded throughout. Mice were euthanized in groups of ten at 25 and 60 days of experience. Mandibles were dissected, descalcified in EDTA and embedded in paraffin. Buccolingual sections of the mesial root of the first lower molar were stained with hematoxylin-eosin and submitted to histomorphometric studies. Results: At 25 days, DR mice shows bone formation values lower than control animals for modeling and remodeling sides, coupled to an increase with bone at rest values in the modeling side. At 60 days, DR mice shows bone formation values lower than control animals in the modeling side linked with a similar increase in values corresponding to bone resorption and bone at rest. In the remodeling side, no differences in bone formation were observed between control and DR mice. However, high bone resorption and a decrease in bone at rest areas were observed. Conclusions: Dietery restriction impaires bone formation in physiologic alveolar bone modeling and remodeling.

Development of a novel Guinea Pig model producing transgenerational endothelial transcriptional changes driven by maternal food restriction and a second metabolic insult of high fat diet

Developmental programming of chronic adverse cardiovascular health outcomes has been studied both using numerous human populations and an array of animal models. However, the mechanisms that produce transgenerational effects have been difficult to study due to a lack of developmentally relevant models. As such, how increased disease risk is carried to the second generation has been poorly studied. We hypothesized that the endothelium which mediates many acute and chronic vascular inflammatory responses is a key player in these effects, and epidemiological studies implicate transgenerational nutritional effects on endothelial health. To study the mutigenerational effects of maternal undernutrition on offspring endothelial health, we developed a model of transgenerational nutritional stress in guinea pigs, a translationally relevant precocial species with a relatively short lifespan. First- and second-generation offspring were subjected to a high fat diet in adolescence to exacerbate negative cardiovascular health. To assess transcriptional changes, we performed bulk RNA-sequencing in carotid artery endothelial cells, with groups stratified as prenatal control or food restricted, and postnatal control or high fat diet. We detected statistically significant gene alterations for each dietary permutation, some of which were unique to treatments and other transcriptional signatures shared by multiple or all conditions. These findings highlight a core group of genes altered by high fat diet that is shared by all cohorts and a divergence of transgenerational effects between the prenatal ad libitum and dietary restriction groups. This study establishes the groundwork for this model to be used to better understand the interplay of prenatal stress and genetic reprogramming.

What’s on Our Plate?

Plant-based and pescatarian diets, as recommended for primary prevention of cardiovascular disease, have been found to be highly protective from moderate to severe COVID-19 illness, and may be protective from an inflammatory response to SARSCoV-2 vaccines. The authors initially sought to correlate the self-reported nutritional habits of physicians in two Chicago-area academic medical centers, with the occurrence of symptoms after each of their two COVID-19 vaccinations. However, of the 274 respondents, 196 (72%) were eating an unrestricted omnivorous diet. The restricted diet group included 41 (15%) semi-vegetarians (reducing, but not eliminating, animal products), 14 (5%) who consumed vegetables, eggs, and dairy, but no fish or red meat, 12 (4%) who consumed vegetables, seafood, eggs, and dairy, but no red meat, 10 (4%) who ate vegetables and seafood without red meat, eggs, or dairy, and one physician (0.3%) who consumed no animal products. Thus, this study was underpowered for the healthy dietary patterns (i.e., pescatarian/vegetarian) as published in the 2019 American College of Cardiology/American Heart Association (ACC/AHA) Guideline on the Primary Prevention of Cardiovascular Disease, as most physicians surveyed were on an unrestricted American diet in these two academic medical centers. These findings call for more vigorous physician nutrition education and implementation strategies for evidence-based guidelines.

1758-P: Intracellular Metabolic Change in Rodent Pancreatic ß-Cells under Diabetic Condition Is Flexible and May Compensate for Glucose Intolerance

Background: In pancreatic β-cells under diabetic conditions, metabolic stressors cause mitochondrial dysfunction and reduce oxidative phosphorylation, resulting in impaired intracellular metabolism. It has been suggested that aberrant activation of 6-phosphofructo-2-kinase/fructose-2,6-biphosphatase 3 (PFKFB3) plays a role in this impairment. However, the pathological significance of PFKFB3 activation and its flexibility are not clear. Methods: Eight-week-old ob/ob mice were fed a standard chow ad lib or the same diet restricted to 2 g/day, or tofogliflozin added chow ad lib for 4 weeks. The body mass and glucose tolerance were compared among the groups. The expression of glycolytic enzymes in the pancreatic islets was evaluated using western blotting, immunohistochemistry and DNA microarray analysis. Next, INS-1 cells were cultured in medium containing a low (5.5 mM; low-G) or a high (22 mM: high-G) glucose concentration, or high-G with PFKFB3 inhibiter (3PO) for 48 hours. The expression of mafa and pdx-1 were evaluated using real time PCR. Results: Ad lib-fed mice showed hyperglycemia and greater weight gain than food restricted mice and tofogliflozin treated mice. The expression of PFKFB3 and other glycolytic enzymes were higher in ad lib-fed mice, whereas such aberrant expression were suppressed by restricted feeding and tofogliflozin. DNA microarray analysis revealed increased expression of genes related to glycolytic pathway in ad lib-fed mice. However, these changes were corrected in a restricted diet and tofogliflozin groups. In INS-1 cells, high-G caused elevated pfkfb3 and decreased mafa and pdx-1 expression compared with low-G exposure. Inhibition of glycolytic pathway by 3PO in high-G environment did not normalize the defect of mafa and pdx-1. Conclusion: The intracellular metabolic changes in pancreatic β cells associated with obesity and diabetes are flexible and may compensate for glucose intolerance. Disclosure K.Chiba: None. H.Nomoto: Speaker's Bureau; Novo Nordisk, Sumitomo Pharma, Co., Ltd. R.Izumihara: None. H.Kameda: None. H.Miyoshi: Research Support; Abbott, LifeScan Diabetes Institute, Taisho Pharmaceutical Holdings Co., Ltd., Speaker's Bureau; AstraZeneca, Boehringer Ingelheim Japan, Inc., Eli Lilly Japan K.K., Kowa Company, Ltd., MSD Life Science Foundation, Novo Nordisk, Ono Pharmaceutical Co., Ltd., Sanofi K.K., Mitsubishi Tanabe Pharma Corporation. A.Nakamura: Research Support; Abbott Japan Co., Ltd., Boehringer Ingelheim Japan, Inc., Daiichi Sankyo, Taisho Pharmaceutical Holdings Co., Ltd., Teijin Pharma Limited, Kowa Company, Ltd., Mitsubishi Tanabe Pharma Corporation. T.Atsumi: Speaker's Bureau; Eli Lilly Japan K.K., Kowa Company, Ltd.

Diet Restriction Impact on High-Fat-Diet-Induced Obesity by Regulating Mitochondrial Cardiolipin Biosynthesis and Remodeling.

Diet restriction (DR) ameliorates obesity by regulating mitochondrial function. Cardiolipin (CL), a mitochondrial phospholipid, is closely associated with mitochondrial function. This study aimed to evaluate the anti-obesity effects of graded levels of DR based on mitochondrial CL levels in the liver. Obese mice were treated with 0%, 20%, 40%, and 60% reductions in the normal diet compared to normal animals (0 DR, 20 DR, 40 DR, and 60 DR groups, respectively). Biochemical and histopathological analyses were performed to evaluate the ameliorative effects of DR on obese mice. The altered profile of mitochondrial CL in the liver was explored using a targeted metabolomics strategy by ultra-high-pressure liquid chromatography MS/MS coupled with quadrupole time-of-flight mass spectrometry. Finally, gene expression associated with CL biosynthesis and remodeling was quantified. Tissue histopathology and biochemical index evaluations revealed significant improvements in the liver after DR, except for the 60 DR group. The variation in mitochondrial CL distribution and DR levels showed an inverted U-shape, and the CL content in the 40 DR group was the most upregulated. This result is consistent with the results of the target metabolomic analysis, which showed that 40 DR presented more variation. Furthermore, DR led to increased gene expression associated with CL biosynthesis and remodeling. This study provides new insights into the mitochondrial mechanisms underlying DR intervention in obesity.

Metabolomics analysis of dietary restriction results in a longer lifespan due to alters of amino acid levels in larval hemolymph of Bombyx mori

Dietary restriction (DR) has been a very important discovery in modern aging biology research. Its remarkable anti-aging effect has been proved in a variety of organisms, including members of Lepidoptera, but mechanisms by which DR increases longevity are not fully understood. By using the silkworm (Bombyx mori), a model of lepidopteran insect, we established a DR model, isolated hemolymph from fifth instar larvae and employed LC–MS/MS metabolomics to analyze the effect of DR on the endogenous metabolites of silkworm, and tried to clarify the mechanism of DR to prolong lifespan. We identified the potential biomarkers by analyzing the metabolites of the DR and control groups. Then, we constructed relevant metabolic pathways and networks with MetaboAnalyst. DR significantly prolonged the lifespan of silkworm. The differential metabolites between the DR and control groups were mainly organic acids (including amino acid), and amines. These metabolites are involved in metabolic pathways such as amino acid metabolism. Further analysis showed that, the levels of 17 amino acids were significantly changed in the DR group, indicating that the prolonged lifespan was mainly due to changes in amino acid metabolism. Furthermore, we identified 41 and 28 unique differential metabolites in males and females, respectively, demonstrating sex differences in biological responses to DR. The DR group showed higher antioxidant capacity and lower lipid peroxidation and inflammatory precursors, with differences between the sexes. These results provide evidence for various DR anti-aging mechanisms at the metabolic level and novel reference for the future development of DR-simulating drugs or foods.

Maternal undernutrition model of two generations of rats: Changes in the aged retina.

The impact of maternal undernutrition on morphological changes of the retina was assessed in two generations of aged offspring. Wistar 18 rats (9 of each generation of 20-month-old female offspring; in total - 27 eyes) were analyzed. The first generation offspring were born to mothers who: (a) were restricted to food only before pregnancy (pre-pregnancy); (b) whose food was restricted before and during pregnancy. The control group and all the offspring were fed normally. After enucleating the eyes, paraffin sections were stained with hematoxylin and eosin. The thickness of retina layers was measured. Cryosections were immunostained using glial fibrillary acidic protein, ionized calcium-binding adaptor molecule1, RNA-binding protein with multiple splicing for evaluation of macroglia, microglia and retinal ganglion cells by digital image analysis tools. Our data have shown atrophy of photoreceptor layer and degeneration of outer nuclear layer in all investigated groups, but less damage was found in the control group. Higher Müller cell activity and greater number of microglial cells was observed in the second generation offspring born from both restricted diet groups. Higher numbers of microglial and retinal ganglion cells were observed in the second generation in comparison to the first generation offspring. Malnutrition of the mother may be one of the possible causes of degeneration of the outer layers of the retina and activation of Müller cells in the second generation offspring. The effect of maternal nutritional restriction on the number of microglial and retinal ganglion cells is unclear.

Mizoribine combined with steroids and dietary sodium restriction on the treatment of primary membranous nephropathy: a prospective study.

We aimed to initially explore the efficiency and safety of mizoribine (MZR) combined with steroids and dietary sodium restriction on the treatment of primary membranous nephropathy (MN) compared with cyclophosphamide (CPM)-based steroids. Patients with primary MN were enrolled. According to the therapy, they were divided into theMZR combined with steroids and dietary sodium restriction group (N = 30) and CPM-based steroids group (N = 30). Both groups were followed up for 1year to monitor safety and efficacy. Compared with the CPM-based steroids group, theMZR combined with steroids and dietary sodium restriction group had significantly lower daily sodium intake, serum sodium, blood pressure (BP), and 24h urine protein (all P < 0.05). Conversely, plasma albumin and complete remission rate in the MZR group were higher at the 12th follow-up (40.39 ± 5.14g/L vs. 37.63 ± 5.40g/L; 86.67% vs. 66.67%; all P < 0.05). These two groups showed similar adverse events rates (20.00% vs. 26.67%, P = 0.54). This study demonstrates that MZR combined with steroids and dietary sodium restriction is superior to CPM-based steroids in terms of completeremission and 24h urine protein in patients with primary MN.

Effect of the Melanocortin 4-Receptor Ile269Asn Mutation on Weight Loss Response to Dietary, Phentermine and Bariatric Surgery Interventions.

The loss of function melanocortin 4-receptor (MC4R) Ile269Asn mutation has been proposed as one of the most important genetic contributors to obesity in the Mexican population. However, whether patients bearing this mutation respond differently to weight loss treatments is unknown. We tested the association of this mutation with obesity in 1683 Mexican adults, and compared the response of mutation carriers and non-carriers to three different weight loss interventions: dietary restriction intervention, phentermine 30 mg/day treatment, and Roux-en-Y gastric bypass (RYGB) surgery. The Ile269Asn mutation was associated with obesity [OR = 3.8, 95% CI (1.5-9.7), p = 0.005]. Regarding interventions, in the dietary restriction group only two patients were MC4R Ile269Asn mutation carriers. After 1 month of treatment, both mutation carriers lost weight: -4.0 kg (-2.9%) in patient 1, and -1.8 kg (-1.5%) in patient 2; similar to the mean weight loss observed in six non-carrier subjects (-2.9 kg; -2.8%). Phentermine treatment produced similar weight loss in six carriers (-12.7 kg; 15.5%) and 18 non-carriers (-11.3 kg; 13.6%) after 6 months of pharmacological treatment. RYGB also caused similar weight loss in seven carriers (29.9%) and 24 non-carriers (27.8%), 6 months after surgery. Our findings suggest that while the presence of a single MC4R loss of function Ile269Asn allele significantly increases obesity risk, the presence of at least one functional MC4R allele seems sufficient to allow short-term weight loss in response to dietary restriction, phentermine and RYGB. Thus, these three different interventions may be useful for the short-term treatment of obesity in MC4R Ile269Asn mutation carriers.

Appetitive and Metabolic Responses to an Exercise versus Dietary Intervention in Adults with Obesity.

Dietary restriction (DIET) and aerobic exercise (AEX) interventions may impact energy balance differently. Our aim was to describe the effects of weight loss interventions via DIET or AEX on measures of energy balance. Adults with overweight or obesity were randomized to 12 weeks of DIET or AEX with similar calorie deficit goals. A study day was conducted before and after the intervention to assess subjective and hormonal (ghrelin, peptide-YY, glucagon-like peptide-1) appetite responses to a control meal, ad libitum energy intake (EI) at a single meal, and over three days of free-living conditions and eating behavior traits. Resting metabolic rate (RMR) was measured with indirect calorimetry and adjusted for body composition measured by dual X-ray absorptiometry. Non-exercise activity was measured using accelerometers. Forty-four individuals were included (age: 37 ± 9 years, body mass index: 30.6 ± 3.1 kg/m2). Both interventions resulted in weight and fat mass loss. The DIET group lost fat-free mass, although differences between groups were not significant (DIET: -1.2 ± 1.7 kg, p<0.001; AEX: 0.4 ± 1.5 kg, p=0.186; p=0.095 interaction). There were no differences in RMR after body composition adjustment. Both interventions were associated with an increase in dietary restraint (DIET: 4.9 ± 1.2, AEX: 2.8 ± 0.7; p<0.001 in both groups). Hunger decreased with DIET (-1.4 ± 0.5, p=0.003), and disinhibition decreased with AEX (-1.5 ± 0.5, p<0.001), although these changes were not different between groups (i.e., no group × time interaction). No other differences in appetite, EI, or non-exercise physical activity were observed within or between groups. AEX did not result in compensatory alterations in appetite, ad libitum EI, or physical activity, despite assumed increased energy expenditure. Modest evidence also suggested that disinhibition and hunger may be differentially impacted by weight loss modality.

Comparison of the Effect of Dietary Restriction and Free Diet on Postoperative Bleeding After Tonsillectomy

Background and Objectives There have been several studies on the factors affecting posttonsillectomy bleeding; however, investigations on the relationship between postoperative bleeding and diet are insufficient. Different countries have different types of food, and while there have been studies on the effects of diet in other countries, no such studies have been reported in Korea. Therefore, we aimed to investigate the relationship between Korean diet and postoperative bleeding after tonsillectomy.Subjects and Method To compare the postoperative bleeding outcomes, patients who underwent tonsillectomy by a single surgeon between January 2017 and 2020 were divided into those who had a diet restriction after surgery and those who had a free diet. Postoperative bleeding outcomes were divided according to the degree of intervention for hemostasis and compared.Results The study included 115 and 124 patients in the diet-restricted group and free-diet group, respectively. There were no statistical differences between the two groups in terms of gender, age, presence of snoring and frequent tonsillitis, and surgical method. Bleeding occurred in four patients in the diet-restricted group and three patients in the free-diet group. There was no statistical difference between the two groups in the frequency and severity of postoperative bleeding.Conclusion Since dietary restriction after tonsillectomy was not helpful to prevent postoperative bleeding, a free and sufficient diet after surgery may prove to be better.