Hypocaloric Mediterranean Diet Research Articles

Influence of visceral manipulation on hormonal profile in women with polycystic ovarian syndrome: A randomized trial

Background. Polycystic ovary syndrome (PCOS) is the most common endocrine condition in women of reproductive age and has been suggested as a risk factor for cardiometabolic disease. Depending on which diagnostic criteria are applied, approximately 10–15% of the women of reproductive age are affected by PCOS.Objective. To examine how viscera manipulation Influences hormonal profile in women with PCO. Design. A prospective randomized single-blind controlled trial. Setting. Outpatient clinics of Sadat General Hospital. Methods. Thirty patients of PCO females were recruited and randomized into two equal groups: the control group received a diet guidelines therapy in the form of the hypocaloric Mediterranean diet for 12 weeks, and the study group received the same control group interventions in addition to visceral manipulation (VM). biochemical analysis (FSH & LH) and BMI was the primary outcome. All variables were measured at the baseline and after 12 weeks of the intervention. Results. Statistical analysis was done by using paired’ test which showed significant improvement in both groups. Therefore, using mixed design MANOVA and multiple pairwise comparison tests (Post hoc tests) for the BMI and LH/FSH ratio post-treatment revealed that there were significant decreases in LH/FSH ratio (p =0.007) in favor to group B when compared with group A, with no significant differences in BMI between both groups (p = 0.443), showing that VM group (B) is more effective than group (A) on biochemical analysis (p < 0.05). Conclusion. Using visceral manipulation with a standard program of hypocaloric Mediterranean diet has more beneficial effects on hormonal profile in women with PCO.

Dysbiosis and nutrition in steatotic liver disease: addressing the unrecognized small intestinal bacterial overgrowth (SIBO) challenge.

Steatotic liver disease (SLD) is characterized by hepatic fat accumulation, potentially causing major consequences such as liver decompensation. Currently, we lack medications for the treatment of SLD. Therapeutic recommendations for patients include a hypocaloric diet, weight loss, and physical activity. In particular, the Mediterranean diet is frequently recommended. However, this diet might exacerbate intestinal problems in a subset of patients with coexisting small intestinal bacterial overgrowth (SIBO). Previous studies have reported that SIBO is more predominant in patients with fatty liver than in healthy individuals. Both our research and the findings of others have highlighted a challenge related to nutritional therapy in patients with fatty liverwho also suffer from SIBO inasmuch as SIBO induces several phenomena (like bloating or abdominal pain) that can adversely affect patients' quality of life and might be exacerbated by the Mediterranean diet. This may lower their adherence to the intervention. As a solution, we suggest introducing additional diagnostics (e.g., breath test) in patients with SLD who complain of SIBO-like symptoms. The next step is to modify their diets temporarily starting with several weeks of "elimination and sanitation." This would involve restricting products rich in fermentable sugars and polyols, while simultaneously treating the bacterial overgrowth. In summary, while the hypocaloric Mediterranean diet is beneficial for patients with fatty liver, those with coexisting SIBO may experience exacerbated symptoms. It is vital to consider additional diagnostics and dietary modifications for this subset of patients to address both liver and intestinal health concurrently.

Effect of ketogenic diet and hypocaloric Mediterranean diet on metabolic and endocrine parameter in women suffering from Polycystic Ovary Syndrome

ABSTRACT PCOS is the most prevalent female endocrine disorder and is characterized by polycystic ovaries, hyperandrogenism, and protracted anovulation. In PCOS, obesity, low-grade chronic inflammation, and insulin resistance (IR) frequently coexist. The Mediterranean diet (MD) and Ketogenic diet act as an anti-inflammatory eating plan that is high in complex carbohydrates, fiber, and monounsaturated fat, whereas the Keto diet is high in fat content. PCOS is associated with obesity, low-grade chronic inflammation, insulin resistance, and hormonal imbalances. The aim of the present study was to measure the metabolic and endocrine effects of a ketogenic and hypocaloric Mediterranean diet in women with polycystic ovarian syndrome. For this purpose, 80 participants were divided into two groups. Group 1 was on the ketogenic diet and Group 2 was on the Mediterranean diet for 9 weeks. The result of the present study showed that significant weight was reduced among the keto group (−10.9 kg) as compared to the Mediterranean group (−5.1 kg). Total cholesterol and Low-Density Lipoprotein among the keto group was 181. 5 ± 22.2 and 85.3 ± 16.2 U/L whereas, in the Mediterranean group 190.3 ± 22.7 and 91.3 ± 15.9 U/L were observed. Blood glucose levels among the Keto and Mediterranean groups reduced significantly 83.47 ± 5.81 and 91.7 ± 5.8 (mg/dl). C-peptide, LH, and FSH also improved more significantly as compared to the Mediterranean group respectively. This study revealed that a ketogenic diet is superior to a hypocaloric Mediterranean diet for lowering Triglyceride, Cholesterol, LDL, blood glucose, insulin, C peptide, HOMA-IR, LH/FSH, Serum Albumin, Facilitating Hormone, and Sex hormone-binding globulin levels. Females having PCO may improve health with the ketogenic diet

FRI062 Efficacy And Durability Of A Very Low Calorie Ketogenic Diet Protocol On Cardiometabolic Parameters

Abstract Disclosure: E. Camajani: None. S. Proietti: None. A. Persichetti: None. A. Feraco: None. A. Armani: None. L. Baccaro: None. M. Lombardo: None. S. Basciani: None. M. Caprio: None. Metabolic Syndrome (MetS) is characterized by the association of insulin resistance, hypertension, dyslipidemia, non-alcoholic fatty liver disease, impaired glucose tolerance, and is strictly related to increased cardiovascular risk. Recent scientific evidence confirms that very low calorie ketogenic diet (VLCKD) is a valuable treatment for patients with insulin resistance and visceral obesity. After the VLCKD phase it is essential to gradually reintroduce carbohydrates and increase calories in order to switch towards a Mediterranean nutritional approach. The aim of this study was to evaluate the efficacy and durability of a VLCKD protocol on cardiometabolic parameters related to the MetS. Twentynine patients with MetS, obesity and insulin resistance [12 males and 17 females, homeostatic model assessment index (HOMA) ≥ 2.5, age 56.7 ± 6.4 years, body mass index (BMI) 35.3± 3.9 kg/m2)] followed a VLCKD for 45 days (≤800 kcal/day). After the VLCKD phase (45 days), they followed a low calorie diet (LCD, 1100-1200Kcal) with a low carbohydrate content (60-80g/day) for 45 days. Subsequently, patients were switched to a hypocaloric Mediterranean diet (HMD-1500 Kcal) with 120-130g/day carbohydrate content and monitored till for additional 60 days (150 days). Anthropometric indexes, blood and urine chemistry, and body composition were assessed. Results: Body weight [−8.7±3.3, p<0.001], BMI [−3.2±1.0 kg/m2, p<0.001], blood pressure (-9.1±14.2 mmHg, p=0.002], waist circumference [-6.4±3.0 cm, p<0.001], HOMA index [-4.3±5.8, p<0.001], insulin [-13.6±14.4 µIU, p<0.001], total and low-density lipoprotein cholesterol (LDL) [-49.5±31.2 mg, p<0.001; -36.7±20.6 mg, p<0.001 respectively] and triglycerides [-65.9±93.6 mg, p<0.001] markedly decreased in all participants during the VLCKD phase (day 45). Importantly, body weight [-3.5±1.7 Kg, p<0.001], BMI [-1.3±0.6 kg/m2, p<0.001], total and LDL cholesterol [-21.4±20.8 mg, p<0.001; -19.2±17.2 mg, p<0.001, respectively] showed a further significance decrease during the LCD phase (day 90), as compared to the end of VLCKD phase. Noteworthy, a significant reduction of visceral adipose tissue (VAT) was observed at the end of VLCKD phase [-103.5±128.7 cm3, p<0.001], as well as the end of LCD phase [-80.5±120.3 cm3, p=0.002]. Importantly, a trend in body weight reduction [-0.6±1.5 Kg, p=0.125] was observed at the end of the HMD phase (day 150), compared with the end of the LCD phase (day 90). Our study confirms that VLCKD protocol is an effective strategy in the management of obesity and its metabolic comorbidities, due to its pleiotropic effects, particularly on the reduction of visceral adipose tissue. Indeed, favourable effects on body weight and metabolic risk factors persist also after the reintroduction of carbohydrates and the switch to a HMD. Presentation: Friday, June 16, 2023

Dietary Patterns, Foods, and Nutrients to Ameliorate Non-Alcoholic Fatty Liver Disease: A Scoping Review.

Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease without pharmacological treatment yet. There is also a lack of specific dietary recommendations and strategies to treat the negative health impacts derived from NAFLD. This scoping review aimed to compile dietary patterns, foods, and nutrients to ameliorate NAFLD. A literature search was performed through MEDLINE, Scopus, Web of Science, and Google Scholar. Several guidelines are available through the literature. Hypocaloric Mediterranean diet is the most accepted dietary pattern to tackle NAFLD. Coffee consumption (sugar free) may have a protective effect for NAFLD. Microbiota also plays a role in NAFLD; hence, fibre intake should be guaranteed. A high-quality diet could improve liver steatosis. Weight loss through hypocaloric diet together with physical activity and limited sugar intake are good strategies for managing NAFLD. Specific dietary recommendations and a Mediterranean plate have been proposed to ameliorate NAFLD.

Interaction of the variant in the adiponectin gene rs3774261 with serum lipid profile and adiponectin levels after 9 months with a high monounsaturated fat hypocaloric diet with Mediterranean pattern.

The role of ADIPOQ gene variants on weight loss and serum lipid changes after a dietary intervention is an important topic area with little scientific evidence. We designed a study in order to analyze the effects of rs3774261 of ADIPOQ gene on metabolic response and adiposity parameters after a hypocaloric Mediterranean diet pattern for 9 months and with a high amount of monounsaturated fatty acids. 133 patients with obesity were enrolled. Adiposity parameters, blood pressure, and serum parameters (lipid profile, insulin, HOMA-IR; glucose, C reactive protein, adiponectin, resistin, and leptin levels) were measured, at basal time and after dietary intervention (3 and 9 months). All patients were genotyped rs3774261 and evaluated in a dominant model (AA vs. GA+AA). Genotype frequencies were 46 (34.6%) AA, 66 (49.6%) AG, and 21 (15.8%) GG. After dietary intervention and in both genotypes, BMI, weight, fat mass, systolic blood pressure, waist circumference, glucose, insulin, HOMA-IR, and leptin decreased. In patients with the AA genotype, there was a significant improvement at (3 and 9 months) in low-density lipoprotein (LDL) cholesterol levels (-10.1±0.9 mg/dl vs. -5.6±1.7 mg/dl, p=0.01) (-19.1±0.9 mg/dl vs. -6.9±0.7 mg/dl, p=0.03), total cholesterol (-9.4±0.8 mg/dl vs. -5.8±0.9 mg/dl, p=0.02) (-17.4±1.8 mg/dl vs. -9.8±1.9 mg/dl, p=0.02), triglycerides (-12.3±0.8 mg/dl vs. -8.0±0.9 mg/dl, p=0.01) (-26.1±0.8 mg/dl vs. -11.0±0.3 mg/dl, p=0.01), C reactive protein (CRP) (-0.8±0.2 mg/ dl vs. -0.4± 0.3 mg/dl, p=0.01) (-1.1±0.2 mg/ dl vs. -0.7±0.1 mg/dl, p=0.01) and adiponectin (28.2±11.1 ng/ml vs. 4.1±2.8 ng/ml, p=0.02) (30.1±8.1 ng/ml vs. 7.1±4.8 ng/ml, p=0.02). Finally, higher values of adiponectin and adiponectin/leptin ratio were detected at 3- and 9-months post-treatment in patients with AA genotype. G allele carriers of ADIPOQ gene variant (rs3774261) showed no improvement in serum levels of adiponectin, adiponectin/leptin ratio, total-cholesterol, LDL-cholesterol, triglycerides, and CRP after weight loss with a hypocaloric fat monounsaturated diet.

Changes in objectively measured sleep after a multidisciplinary lifestyle intervention in children with abdominal obesity: A randomized trial

Background/objectivechildhood obesity and sleep disorders have a well-established cross-sectional association, but lifestyle interventions' effects on sleep quality remain under-researched. This study aimed to evaluate the sleep quality of 122 participants (7–16 years) with abdominal obesity after a 2-year necessary lifestyle intervention. Patients/methodsparticipants were assigned to either the intervention group (moderate hypocaloric Mediterranean Diet) or the usual care group (standard recommendations on a healthy diet). Sleep was objectively assessed using triaxial accelerometry, and sleep parameters analyzed included latency, efficiency, wake after sleep onset, total time in bed, total sleep time, number of awakenings, and awakening duration. Results and conclusionsthe results showed that the intervention group significantly improved sleep latency at 12 and 24 months and improved sleep efficiency at 2 and 12 months, compared to the usual care group. Wake after sleep onset and the number of awakenings were significantly reduced at 24 months in the intervention group. Wake after sleep onset and leptin levels were positively associated in all participants. Total time in bed was inversely associated with triglycerides and metabolic score, and total sleep time was inversely associated with leptin, triglycerides, and metabolic score after the 2-month intervention. Triglyceride levels were inversely associated with total time in bed and total sleep time at one year, while the metabolic score was directly associated with wake after sleep onset and the number of awakenings and inversely associated with efficiency. In conclusion, the multidisciplinary intervention in children and adolescents with abdominal obesity reduced anthropometric parameters and improved sleep habits.

Diet Plus Inositols, α-Lactalbumin and Gymnema sylvestre: The Successful Combo to Restore Body Weight and Metabolic Profile in Obese and Dysmetabolic Patients.

The primary control of dysmetabolic patients is extremely challenging worldwide, with inadequate dietary habits and sporadic physical activity among the key risk factors for metabolic syndrome onset. Nowadays, there is no exclusive treatment for this condition, and considering that preventive measures usually fail, new therapeutic approaches need to be proposed and investigated. This present pilot study compared the effects of diet alone and in association with a combination of myo-inositol and d-chiro-inositol in their 40:1 ratio, α-lactalbumin, and Gymnema sylvestre on different metabolic parameters in obese dysmetabolic patients. To this purpose, 37 patients with BMI between 30 and 40 and fasting blood glucose between 100 and 125 mg/dL were divided into two groups: (i) the control group followed a hypocaloric Mediterranean diet, (ii) while the study group was also supplemented with a daily dosage of two sachets, each one containing 1950 mg myo-inositol, 50 mg d-chiro-inositol, 50 mg α-lactalbumin, and 250 mg Gymnema Sylvestre. After a 6-month treatment, all parameters improved in both groups. Nevertheless, the treated group experienced a greater improvement, especially concerning the variation from the baseline of HOMA index, triglycerides, BMI, body weight, and waist circumference. These findings support the supplementation with myo-inositol and d-chiro-inositol in the 40:1 ratio, α-lactalbumin, and Gymnema sylvestre as a therapeutical strategy to potentiate the beneficial effects induced via dietary programs in dysmetabolic patients.

High-intensity interval training prevents muscle mass loss in overweight Chilean young adults during a hypocaloric-Mediterranean diet: a randomized trial.

The hypocaloric Mediterranean diet (MD) mainly reduces fat mass but inevitably causes a loss of skeletal muscle mass. High-intensity interval training (HIIT) seems to have advantages in preserving muscle mass during a hypocaloric regime. Our study compares body composition and metabolic changes in overweight and obese Chilean women and men after 3 months of weight loss treatment with a Mediterranean-type hypocaloric diet, HIIT, or a combination of both. The study included 83 overweight or obese women and men between the ages of 25 and 50. The subjects were randomly assigned to one of the three intervention groups: (1) MD, (2) EX, and (3) MD + EX. Baseline and post-intervention measurements included: (a) body composition by dual-beam densitometry, muscle, and fat measurements by thigh ultrasound and computed tomography; (b) handgrip and quadriceps muscle strength; (c) exercise performance by peak oxygen consumption, peak load, work efficiency, and exercise energy expenditure; and (d) metabolic parameters. Out of 83 participants, the retention rate was 49% due to low compliance with the interventions. As expected, the MD group resulted in significantly greater weight loss (MD -7%, EX -0.6% and MD + EX -5.3%) and appendicular fat mass loss (MD -11.1%, EX -2.9, MD + EX -10.2%) but was associated with significant lean tissue loss (2.8%), which was prevented by HIIT (EX -0.1 and MD + EX -0.6%). Metabolic and glycoxidative parameters remained unchanged, irrespective of changes in body composition. Hypocaloric diets remain the most effective means to lose weight and body fat. However, it induces a loss of lean body mass when not accompanied by exercise training. This study shows that HIIT prevents the loss of muscle mass caused by a hypocaloric Mediterranean diet.

Role of Decorin (rs7139228) gene polymorphism with metabolic response after a hypocaloric mediterranean diet

BackgroundThe SNP (rs7139228) of the DCN gene is a polymorphism that has been associated with metabolic disorder in subjects with obesity, and its effect on metabolic response after dietary intervention has not been evaluated. ObjectiveOur objective was to analyse the effects of the polymorphism of the DCN gene rs7139228 on metabolic changes secondary to weight loss with a hypocaloric Mediterranean diet. Design1000 obese Caucasian patients were evaluated. An anthropometric evaluation and a biochemical analysis were performed before and after 12 weeks of a hypocaloric Mediterranean diet. The statistical analysis was performed as a dominant model (GG vs GA+AA). ResultsImprovements in anthropometric parameters, leptin levels and systolic blood pressure were similar in both genotype groups. In non- A allele carriers, levels of resistin, insulin, HOMA-IR, triglycerides and C-reactive protein decreased. The improvements were statistically significant in this group; resistin (−1.3+0.1ng/dL: p=0.02), triglycerides (−22.9+4.9mg/dl: p=0.02), CRP (−2.7+0 0.4mg/dl: p=0.02), insulin −6.5+1.8 mIU/L: p=0.02) and HOMA-IR (−2.2+0.8: p=0, 03). In addition, insulin, HOMA-IR and resistin levels were higher in A allele carriers than in non-carriers. Finally, the prevalence of metabolic syndrome and hyperglycaemia were higher in A allele carriers, and these percentages only decreased after intervention in non-A allele carriers. ConclusionThe A rs7139228 allele is associated with a worse metabolic response (insulin, HOMA-IR, triglycerides and CRP) after weight loss with a hypocaloric Mediterranean diet. A non-significant decrease in the prevalence of metabolic syndrome and hyperglycaemia were detected in A allele carriers.

Association of rs3138167 polymorphism with metabolic response after a hypocaloric Mediterranean diet.

Background: the single nucleotide polymorphism (SNP) (rs3138167) is a polymorphism that has been associated with metabolic disorder in obese subjects and its effect on the metabolic response after a dietary intervention has not been evaluated. Objective: our aim was to analyze the effects of the rs3138167 on metabolic changes secondary to weight loss with a hypocaloric diet with a Mediterranean pattern. Method: one thousand and eight Caucasian obese patients were evaluated. Before and after 12 weeks on a hypocaloric diet with Mediterranean pattern, an anthropometric evaluation and a biochemical analysis were performed. The statistical analysis was performed as a dominant model (CC vs CT + TT). Results: the values of insulin, HOMA-IR and resistin were higher in T allele carriers than non-T allele carriers in pre- and post-intervention time. In non-T allele carriers, resistin, insulin, HOMA-IR, triglycerides and C-reactive protein levels decreased. The improvement was statistically superior in non-T allele carriers; resistin (-1.2 ± 0.2 ng/dl; p = 0.02), triglycerides (-18.3 ± 4.3 mg/dl; p = 0.02), C-reactive protein (-2.6 ± 0.3 mg/dl; p = 0.02), insulin -4.4 ± 1.9 mUI/l; p = 0.02) and HOMA-IR (-2.1 ± 0.7; p = 0.03). Conclusion: we report an association of rs3138167 with a worse metabolic response (insulin, HOMA-IR, triglyceride and C-reactive protein) in T allele carriers after weight loss with a hypocaloric diet with Mediterranean pattern.

Papel del polimorfismo del gen de la resistina (rs7139228) en la respuesta metabólica tras una dieta mediterránea hipocalórica

BackgroundThe SNP (rs7139228) of the DCN gene is a polymorphism that has been associated with metabolic disorder in subjects with obesity, and its effect on metabolic response after dietary intervention has not been evaluated. ObjectiveOur objective was to analyse the effects of the polymorphism of the DCN gene rs7139228 on metabolic changes secondary to weight loss with a hypocaloric Mediterranean diet. Design1000 obese Caucasian patients were evaluated. An anthropometric evaluation and a biochemical analysis were performed before and after 12 weeks of a hypocaloric Mediterranean diet. The statistical analysis was performed as a dominant model (GG vs.GA + AA). ResultsImprovements in anthropometric parameters, leptin levels and systolic blood pressure were similar in both genotype groups. In non- A allele carriers, levels of resistin, insulin, HOMA-IR, triglycerides and C-reactive protein decreased. The improvements were statistically significant in this group; resistin (-1.3 + 0.1 ng/dL: p = 0.02), triglycerides (-22.9 ± 4.9 mg/dl: p = 0.02), CRP (-2.7 ± 0 .4 mg/dl: p = 0.02), insulin -6.5 ± 1.8 mIU/L: p = 0.02) and HOMA-IR (-2.2 ± 0.8: p = 0, 03). In addition, insulin, HOMA-IR and resistin levels were higher in A allele carriers than in non-carriers. Finally, the prevalence of metabolic syndrome and hyperglycaemia were higher in A allele carriers, and these percentages only decreased after intervention in non-A allele carriers. ConclusionThe A rs7139228 allele is associated with a worse metabolic response (insulin, HOMA-IR, triglycerides and CRP) after weight loss with a hypocaloric Mediterranean diet. A non-significant decrease in the prevalence of metabolic syndrome and hyperglycaemia were detected in A allele carriers.

Short-time effects of ketogenic diet or modestly hypocaloric Mediterranean diet on overweight and obese women with polycystic ovary syndrome.

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women during reproductive age. It is characterized clinically by oligo-ovulation or anovulation, hyper-androgenism, and the presence of polycystic ovaries. Often comorbid with insulin resistance, dyslipidemia, and obesity, it also carries significant risk for the development of cardio-vascular and metabolic sequelae, including diabetes and metabolic syndrome. In light of these evidences, the most therapeutic option prescribed to PCOS women with obesity, regardless of the phenotype from the severity of clinical expression, is lifestyle correction by diet and physical activity. The aim of this study was to evaluate the association between PCOS with KD in overweight and/or obese women with PCOS, and evaluate the possible beneficial effects on metabolic and endocrine parameters, compared to a standard, balanced hypocaloric diet such as Mediterranean diet (MD). Participants were assigned to receive, in a 1:1 ratio, one of the two following dietary sequences: KD or MD. In all subjects anthropometric parameters, body composition and metabolic and endocrine parameters were obtained at baseline and after dietetic treatment. Our results showed a significant change in the anthropometric and biochemical parameters in both groups after both diet therapies, with statistically significant differences (p < 0.001). Though, the reductions of all parameters were significantly greater in KD group than in MD group. Our results suggest that a reduction of dietary intake of carbohydrates by KD may be considered as a valuable non-pharmacological treatment for PCOS.

The Synergic Effect of a Nutraceutical Supplementation Associated to a Mediterranean Hypocaloric Diet in a Population of Overweight/Obese Adults with NAFLD.

Overweight/obesity is often associated with a non-alcoholic fatty liver disease (NAFLD). The study aim was to investigate the effects of a nutraceutical supplementation associated to a Mediterranean-hypocaloric-diet (MHD) on ultrasound-liver-steatosis (ULS) grade improvement in overweight/obese patients with NAFLD. A total of 68 subjects (BMI ≥ 25 kg/m2) with NAFLD were recruited, randomized into 2 groups and treated for 3 months: the Nutraceutical group was treated with MHD plus nutraceutical supplementation (Vitamin E, L-glutathione, silymarin and hepato-active compounds); the Control-group only with a MHD. Anthropometric measurements, body composition, biochemical parameters and Hepatic steatosis index (HSI) were evaluated at baseline and after 3 months; patients with HSI &gt;36 underwent a liver ultrasound to determine liver steatosis grade (3 severe, 2 moderate, 1 mild). In all patients, a significant improvement in nutritional and biochemical parameters was observed after treatment. After treatment, the nutraceutical group showed a significant improvement in hepatic steatosis, either according to ULS-grade (11.1% and 5.6% of patients with mild and moderate liver steatosis, respectively, showed a complete NAFLD regression; 33.3% and 22.2% of patients with moderate and severe liver steatosis, respectively showed a regression to mild liver steatosis), or according to HSI (49.3 ± 10.1 vs. 43.3 ± 9.0, p = 0.01), suggesting that a healthy diet is still the best choice, although the use of specific supplements can enhance the efficacy of dietary intervention in overweight/obese patients with NAFLD.

Dynamics of Gut Microbiota and Clinical Variables after Ketogenic and Mediterranean Diets in Drug-Naïve Patients with Type 2 Diabetes Mellitus and Obesity.

Type 2 diabetes mellitus (T2DM), the most common form of diabetes, is a progressive chronic metabolic disease that has increasingly spread worldwide, enhancing the mortality rate, particularly from cardiovascular diseases (CVD). Lifestyle improvement through diet and physical activity is, together with drug treatment, the cornerstone of T2DM management. The Mediterranean diet (MD), which favors a prevalence of unprocessed vegetable foods and a reduction in red meats and industrial foods, without excluding any food category, is usually recommended. Recently, scientific societies have promoted a very low-calorie ketogenic diet (VLCKD), a multiphasic protocol that limits carbohydrates and then gradually re-introduces them, with a favorable outcome on body weight and metabolic parameters. Indeed, gut microbiota (GM) modifications have been linked to overweight/obesity and metabolic alterations typical of T2DM. Diet is known to affect GM largely, but only a few studies have investigated the effects of VLCKD on GM, especially in T2DM. In this study, we have compared anthropometric, biochemical, lifestyle parameters, the quality of life, and the GM of eleven patients with recently diagnosed T2DM and overweight or obesity, randomly assigned to two groups of six and five patients who followed the VLCKD (KETO) or hypocaloric MD (MEDI) respectively; parameters were recorded at baseline (T0) and after two (T2) and three months (T3). The results showed that VLCKD had more significant beneficial effects than MD on anthropometric parameters, while biochemical improvements did not statistically differ. As for the GM, despite the lack of significant results regarding the alpha and beta diversity, and the Firmicutes/Bacteroidota ratio between the two groups, in the KETO group, a significant increase in beneficial microbial taxa such as Verrucomicrobiota phylum with its members Verrucomicrobiae, Verrucomicrobiales, Akkermansiaceae, and Akkermansia, Christensenellaceae family, Eubacterium spp., and a reduction in microbial taxa previously associated with obesity (Firmicutes and Actinobacteriota) or other diseases (Alistipes) was observed both at T2 and T3. With regards to the MEDI group, variations were limited to a significant increase in Actinobacteroidota phylum at T2 and T3 and Firmicutes phylum at T3. Moreover, a metagenomic alteration linked to some metabolic pathways was found exclusively in the KETO group. In conclusion, both dietary approaches allowed patients to improve their state of health, but VLCKD has shown better results on body composition as well as on GM profile.

Comparison of hypocaloric mediterranean diet plus intermittent fasting against classic hypocaloric mediterranean diet on body composition and metabolic parameters in obese individuals

Background and Aims : To evaluate the effect of a hypocaloric Mediterranean Diet combined with intermittent fasting (TRFMedDiet) on body composition and metabolic parameters in obese individuals compared with a classic hypocaloric Mediterranean Diet (MedDiet).

Effect of a hypocaloric mediterranean diet on body composition and metabolic profile in overweight and obesity individuals

Effect of a hypocaloric mediterranean diet on body composition and metabolic profile in overweight and obesity individuals

Effects of 2-Year Nutritional and Lifestyle Intervention on Oxidative and Inflammatory Statuses in Individuals of 55 Years of Age and over at High Cardiovascular Risk.

Obesity and overweight are disorders with high impact on the morbidity and mortality of chronic diseases, such as type 2 diabetes mellitus (T2DM) and cardiovascular diseases (CVD). We aim to assess the effects of 2-year nutritional and lifestyle intervention on oxidative and inflammatory status in individuals of 55 years of age and over at high CVD risk. Participants (n = 100 individuals of 55 years of age and over living in the Balearic Islands, Spain) were randomized into control and intervention group. Anthropometric and haematological parameters, blood pressure and physical activity were measured before and after the intervention. Oxidative and inflammatory biomarkers in plasma, urine, peripheral blood mononuclear cells (PBMCs) and neutrophils were determined. A higher reduction in abdominal obesity, blood pressure and triglycerides levels was observed after a 2-year intervention. An improvement of oxidative stress and proinflammatory status was demonstrated with a significant reduction in myeloperoxidase, xanthine oxidase, malondialdehyde and monocyte chemoattractant protein-1 (MCP1) levels, and an increase in polyphenols in plasma was observed. A decrease in reactive oxygen species production in PBMCs and neutrophils levels after zymosan and lipopolysaccharide activation was found in the intervention group with respect to the control group. The intervention with hypocaloric Mediterranean Diet and customized physical activity improves oxidative stress and proinflammatory status and could contribute to decreasing the CVD risk.

A Pilot Study of Gene Expression Analysis in Peripheral Blood Mononuclear Cells in Response to a Hypocaloric Mediterranean Diet.

Background Few studies have examined gene expression in peripheral blood mononuclear cells (PBMCs) after a dietary intervention. Objective Our study is aimed at evaluating in a pilot study the peripheral blood gene expression in obese patients after weight loss secondary to a hypocaloric Mediterranean diet. Design A sample of 11 obese subjects without metabolic syndrome was enrolled. Biochemical, anthropometric parameters and microarray analysis were performed at baseline and after 6 months of dietary intervention. Results The mean age was 43.1 ± 6.3 years, and the mean body mass index (BMI) was 38.6 ± 8.1 kg/m2. All the next improvements were statistically significant: body weight −7.4 ± 1.9 kg, BMI -2.5 ± 0.2 kg, fat mass −5.7 ± 1.2 kg, waist circumference −5.8 ± 1.2 cm, triglycerides −17.4 ± 6.5 mg/dl, C-reactive protein −3.1 ± 1.5 mg/dL, insulin −2.1 ± 1.0 mUI/L, and HOMA-IR −0.7 ± 0.2 units. We identified 634 differentially expressed genes: 262 genes with relative higher expression levels and 372 with lower expression levels. Cluster analysis showed 35 genes in nutritional disease and 17 genes in endocrine system. The most relevant gene was thyroid peroxidase (TPO), and this gene was overexpressed, and the next genes carbonic anhydrase VI (CA6), caveolin protein 1 (CAV1) and solute carrier family type 12 (SLLC12A3), soluble carrier family type 12 (SLLC12A3), beta 3 receptor (ADRB3), and glutamate receptor ionotropic N methyl D aspartate 2 A (GRIN2A) were all underexpressed. Conclusion In PBMC from obese patients after a diet with a Mediterranean pattern, the expression of 634 genes, of the endocrine system and of nutritional disease, is modified.

METABOLIC IMPROVEMENT AND LONGTERM WEIGHT MANAGEMENT FOLLOWING WCRF DIETARY RECOMMENDATION FOR SECONDARY BREAST CANCER PREVENTION

Overweight or obesity are the second preventable cause of cancer, being related to 20%of diagnosis, moreover about 33%of postmenopausal breast cancers could be prevented by lifestyle modification(1). Excessive white adipose tissue (WAT) promotes a pro-oxidative microenvironment with low-grade systemic inflammation, contributing to insulin resistance and leading to altered hormonal pathways, promoting tumor cells growth and metastasis(2). We have enrolled 155 women at the end of their breast cancer treatment (surgery, chemo and/or radiotherapy) between January 2014 and 2020, most of them were taking oral hormonal therapy. Women with obesity (WwO) were 58%, type I obesity 53%. Our dietary counselling was a personalized hypocaloric (about 500-800 Kcal deficit) mediterranean diet with lifestyle modification, following recommendations of the latest WCRFreport(1). Weight loss and gluco-homeostasis data are shown in table 1. Notably, after 6 months only 53% (56% in WwO) followed dietary-lifestyle therapy. After 12 months another 48% of patients dropped out (35% in WwO). Maintaining a healthy weight or achieving weight loss through Mediterranean diet pattern(3)and healthy lifestyle as suggested by WCRF may reduce breast cancer risk improving metabolic parameters (FIG1),especially those related to insulin resistance, moreover metabolic improvement can be maintained even after a slight weight regain.