Low-carb Research Articles

Two models of insulin resistance development and the strategy to combat age-related diseases: literature review

Insulin resistance (IR) is the root cause of most age-related diseases (ARD), the major challenge for today's health systems. Therefore, adequate understanding of the mechanisms underlying IR is essential to build effective ARD prevention. Analyze the existing models of IR causation and progression in order to justify the most effective ARD prevention strategy. Search and analysis of publications on IR and hyperinsulinemia (HI) from databases elibrary.ru, PubMed, and Google Scholar. Two models of IR development are analyzed along with the relationship between IR, HI, and obesity. The prevailing model considers obesity (imbalance of caloric intake and energy expenditure) as the main factor in the development of IR; HI is seen as a consequence of IR, mostly insignificant for the outcomes of IR. The model contradicts many experimental and clinical findings. The strategy to combat ARDs that follows from the model (hypocaloric diet and pharmacotherapy of IR) has proven mostly ineffective.The alternative model (IR as a consequence of HI, and obesity as one of IR manifestations) is more consistent with the pool of experimental and clinical data. It more precisely predicts ARD development and allows more adequate correction of adverse lifestyle factors. It corresponds to a different strategy for combating ARD: emphasis on low-carb diet and longer fasting window combined with consideration of other factors of IR. If the prevailing model of IR development is revised, this should open up opportunities for more effective early prevention of a wide range of chronic diseases in which the role of IR is significant.

A New Diet Therapy Protocol to Manage Type 1 Diabetes Mellit us in Adults

Type 1 diabetes mellit us (T1DM) is an autoimmune disease characterized by the destruction of beta cells and absolute insulin deficiency. T1DM usually appears in childhood and adolescence, but it can also be diagnosed in adulthood. For decades, American Diabetes Association (ADA) guidelines recommended consuming 50-60% of a diabetic's daily calories as carbohydrates. With these guidelines, the average number of patients with T1DM in the therapeutic goal (less than 7%) of glycated hemoglobin (HbA1c) in the world is no more than 10-15%, that is, we are not being effective in the treatment, either due to inadequate guidance, such as poor adherence due to difficulty in following the diet proposed by the ADA. Since 2019, the ADA recognized, albeit timidly, the low-carbohydrate diet (low-carb diet) as an acceptable approach, being the most studied, safe and effective strategy for the treatment of type 2 diabetes mellit us (T2DM). We recognize these advances, but we know that much remains to be elucidated, especially with regard to the treatment of T1DM. With that in mind, we developed a protocol [1], which aim a reduction in glycemic levels, a longer time on target with less hypoglycemia, a reduction in glycated hemoglobin and insulin doses, thus promoting an improvement in the patient's health and quality of life.

Low Carb Diet-Related Quality of Life (QOL) and Health Outcomes

To develop a questionnaire to measure the influence of Low Carb Diet Therapy on patients’ Quality of Life, and also assess the effect of Low Carb Diet on biochemical, anthropometric and dietary intake parameters reflecting on the evaluation of care, health status and thus the efficacy of online consultation and review methods during COVID-19 Pandemic. Thirty five patients visiting the Diabetologist / Endocrinologist through online methods prescribed Low Carb Diets were administered the QOL questionnaire in Google Form through WhatsApp at online visit to the doctor and the subsequent visit. Other demographic, biochemical, anthropometric parameters, and diet recall were gathered at baseline and the subsequent review. Exploratory Factor Analysis (EFA), Reliability Analysis (RA) using Cronbach’s alpha, test-retest reliability were done. The questionnaire assessed 15 aspects or questions in the QOL. Exploratory factor analysis suggested a three-factor solution with eigen values >1 and factor loadings >0.3. The first factor contained 5 reliable items, the second factor contained 4 items, third factor with 6 items (with Cronbach’s Alpha= 0.669, 0.884, 0.775 respectively) As hypothesized, the QOL was better among patients following Low Carb Diets with higher levels of happiness, more satisfaction with their life and health and also, their biochemical, anthropometric and intake improved. These findings indicate the efficacy of the Low Carb Diet education on QOL and the influence on biochemical, anthropometric and dietary intake parameters was noted. This also shows the efficacy of online consultation and review methods during Pandemic.

Weight reduction in response to unauthorized treatment in a poorly controlled obese woman

This case study highlights the importance of using alternative or herbal medication with no authority or medical prescription. Obesity is a disease that affect human physiological and psychological health and leads to serious complications such as cardiovascular problems. An overweight 41-aged female with a body mass index of 53.9 Kg/m2 with no medical history has self-prescribed a herbal tea of fountain grass aerial parts following herbalist advice. Her obesity is poorly controlled and negatively affect her social, emotional, and overall psychological status. Insulin resistance, lipid profile, and glycosylate hemoglobin were on the highest edges. The patient tried many diet regimes with no avail. After regular intake of the herbal tea for six months in conjugation with a low-carb diet; there was an enhancement in her obesity profile conjugated with significant improvements in her body scores and biochemical profile. Undesirable effects were experienced include loss of appetite, constipation, and mood change. The herbal fountain grass tea has a significant contribution to decrease the patient weight and improve her biochemical readings. Alternative therapy and traditional recipes have to be monitored and investigated thoroughly for clinical evidence. The safety of P. setaceum needs more investigation.

Perioperative Low Carb Diet in a Type 2 Diabetic Prior Duodenopacreatectomy

Background: There is a positive association between various types of cancer and diabetes. Duodenopancreatectomy is the treatment of choice for diabetic patients with duodenal tumors. Pancreatic resections may trigger endocrine insufficiency. There is an association between poor glycemic control and lower survival rates. Low carb diets appears to be an effective approach in the treatment of diabetic patients that require pancreatic resections. Case Presentation: We report the case of a type II diabetic diagnosed with resectable duodenum cancer. At the time of diagnosis he was jaundiced and with decompensated diabetes. The patient was submitted to a low carb diet for three weeks and, having improved its physiological and metabolic parameters, we performed a duodenopancreatectomy. The patient evolved without complications, with easy management of postoperative glycemia. Conclusions: Low carb diets can prove to be a powerful, inexpensive, and safe tool to add to our therapeutic arsenal before pancreatic resections.

Patient activation, self-efficacy and usage of complementary and alternative medicine in cancer patients

Complementary and alternative medicine (CAM) is used by many cancer patients by themselves. Therefore, we conducted a survey regarding the association between CAM, self-efficacy, and patient activation in adult cancer patients. A standardized questionnaire, consisted of the ASKU, the PAM 13-D, and a structured questionnaire on CAM usage from our own working group, was distributed to 880 potential participants. Six hundred and thirty-nine (639) patients (male 32.9%, female 63.2%; gynecological cancer 41%, gastrointestinal 19.2%, urogenital 15.6%) took part. 60% of all patients used CAM in the last 3 months (biological 73%, holistic 63%, mind–body methods 62%). Higher self-efficacy was associated with higher interest in CAM (p = 0.03), but not usage of CAM, compared to patients with lower self-efficacy (p = 0.099). Higher patient activation was associated with higher interest in CAM (p = 0.004) and usage of CAM (p = 0.012). Patients with higher activation significantly more often used homeopathy (p = 0.007), prayer (p = 0.002), yoga, etc. (p = 0.032), meditation (p = 0.002), low carb or ketogenic diets (p < 0.001) (but not vegan or other cancer diets). Higher patient activation is associated with higher usage of CAM. Focusing on patient activation as a goal in patient–physician relationship will help patients to adhere to a healthy lifestyle and to actively participate in the whole treatment process.

Linear Regression Analysis Results of the CGM Sensor PPG Comparison Between Predicted PPG Data Using the Linear Elastic Glucose Theory (LEGT) and Measured PPG Data During a ~2-year COVID-19 Quarantine Period for a type 2 Diabetes Patient Based on GH-Method: Math-Physical Medicine (No. 540)

Since 5/5/2018, the author has been applying a continuous glucose monitoring (CGM) sensor device on his upper arm that collected and recorded the complete glucose data continuously at 15-minute time intervals on his iPhone. He accumulated 96 glucoses per day over the past ~3.5 years. As a result, over these 1,272 days, he has compiled a total of 122,112 glucose data and stored them in his database where postprandial plasma glucose (PPG) occupies 45,792 data size and 37.5% of the total glucose database. During 2020-2021 COVID-19 quarantine period, he has a strictly managed routine, without any traveling, which allowed him to have an overall healthy lifestyle. Therefore, all of the 19 influential factors of PPG are mainly control by two primary factors: carbs/sugar intake amount (average at 13.1 gram, low-carb diet) and post-meal waking e excise (average of 4,300 steps). Based on this simplified and healthy lifestyle, he can then easily utilize his developed linear elastic glucose theory (LEGT) model to predict his PPG. In his previous research reports, he has applied physics concepts and theories, engineering models and equations, mathematical concepts and formulas, computer big data and artificial intelligence (AI) techniques, as well as some statistical approaches. The majority of published medical papers he has read are mainly based on statistics. As a result, in this article, he selected one of the basic statistical tools, linear regression analysis, to study the comparison between his predicted PPG using LEGT and CGM sensor measured PPG. In conclusion, the linear regression analysis results have provided similar findings with his previous analysis outcomes using other math-physical tools.

Linear Regression Analysis Results of the CGM Sensor PPG Comparison Between Predicted PPG Data Using the Candlestick Model and the LEGT Model Against the Measured Sensor PPG Data During a 2-year COVID-19 Quarantine Period for a Type 2 Diabetes Patient Based on GH-Method: MathPhysical Medicine (No. 541)

Since 5/5/2018, the author has been applying a continuous glucose monitoring (CGM) sensor device on his upper arm that collected and recorded the complete glucose data continuously at 15-minute time intervals on his iPhone. He accumulated 96 glucoses per day over the past ~3.5 years. As a result, over these 1,272 days, he has compiled a total of 122,112 glucose data and stored them in his database where postprandial plasma glucose (PPG) occupies 45,792 data size and 37.5% of the total glucose database. During the 2020-2021 COVID-19 quarantine period, he maintained a strict daily routine, without any travel, allowing him to reach an overall healthy lifestyle. Therefore, all of the 19 influential factors of PPG are mainly control by two primary factors: carbs/sugar intake amount (average at 13.1 gram, low-carb diet) and postmeal walking exercise (average of 4,300 steps). These lifestyle improvements helped reduce his PPG waveform amplitudes, including the four associated PPG data of candlestick (aka K-line) model: opening, maximum, minimum, and closing. Based on the simplified and healthy lifestyle, he can then easily utilize his developed candlestick (aka K-line) model to develop another set of predicted PPG values in addition to the LEGT model results shown in paper No. 540. In previous research reports, he applied physics concepts and theories, engineering models and equations, mathematical concepts and formulas, computer big data and artificial intelligence (AI) techniques, as well as some statistical approaches. However, the majority of published medical papers he read are mainly based on statistics. As a result, in this article, he selected one of the basic statistical tools, linear regression analysis, to study the comparison between his predicted PPG using K-line model and CGM sensor measured PPG. In conclusion, the linear regression analysis results using the K-line model provide more accurate predicted PPG results than using the LEGT model. Actually, both of the maximum PPG and minimum PPG of K-line model are generated through LEGT equation, but the starting PPG of K-line is a measured sensor value instead of the calculation via 0.97*FPG. Moreover, the K-line model contains one extra data point for the closing PPG value. This is why the K-line model has extracted from 4 out of 13 measured sensor PPG data which results in a higher prediction accuracy than the LEGT prediction calculated from carbs/sugar intake grams and post-meal walking steps.

The Effectiveness of Virgin Coconut Oil on the Decrease of Blood Glucose Levels on Gestational Diabetes Mellitus

Gestational Diabetes Mellitus (GDM) was medical complication that occurs during pregnancy and caused preterm labor. Efforts reduce blood glucose levels and improve pancreatic performance must be safe both for mother and fetus. The research aimed to prove VCO can reduce blood glucose levels in GDM. The research design was quasi-experimental with one group pre-test and post-test. The research started on March to September 2020. The population was pregnant mother with GDM from two hospitals in Mojokerto East Java. The sample was 46 respondents with purposive sampling. The treatment given was VCO at a dose of 5 ml, 6 times a day and lowcarb diet. The instrument used to measure the fasting blood glucose was glucose stick. The data was analyzed with paired t-test. The result showed blood glucose levels before intervention average of 155.19 mg/dL and after 153.50 mg/dL. The t-test value 14.442 and p value 0.000 which meant that VCO and low carb diet was more effective in reducing blood glucose levels on GDM. The administration of VCO with a low carb diet is an effort to restrict glucose intake in the body without hypoglycemia. It is safe to use for both mother and fetus as an alternative non-pharmacological therapy on GDM and prevent preterm labor

Eight Weeks of Aerobic Exercise and Prescribed Diet (Low in Carbohydrate and High Protein) Improve Mental Health in Obese Women

Objectives: Although, the association between mental health and obesity has been reported in different studies, the relationship between dietary carbohydrate intake and mental health is not well understood. The aim of this study was to investigate the association of a diet (low in carbohydrate and high protein) along with aerobic exercise on mental health in obese individuals. Methods: In this quasi-experimental study, 30 obese women (20 - 35 years; 80 - 100 kg, 160 ± 5.1 cm and body mass index (above 30) who lived in Qazvin, Iran were selected voluntarily. Dietary intakes during the past one- month was assessed using a quantitative questionnaire on food frequency. Additionally, Beck Anxiety Inventory was used to monitor the rate of depression. Subjects were then randomly divided into experimental and control groups. The experimental group received a balanced diet that was low in carbohydrates and high in protein based on the calculation of their metabolism, while at the same time engaging in aerobic exercise (walking) for 8 weeks with 75% of the maximum heart rate. Control group did not receive any intervention during the study period. The aerobic program was performed for eight weeks (4 sessions per week and 50 minutes per session). Results: The results showed that the rate of depression was significantly improved in experimental group (P = 0.001), however, no significant change was found for control group (P = 0.17) Conclusions: The present study showed that a low carb and high protein diet is positively associated with mental health improvement (anxiety, stress and depression).

Self-Control at Meals in Order Not to Gain Weight and Its Relationship with Food Cravings in Low-Carb Dieters

Aims: This study’s objective was to verify the level of food cravings and cognitive restraint in women who reported having followed a low-carb diet. Methods: The volunteers filled out the binge eating scale, the cognitive restraint subscale, the food cravings trait and state questionnaires, and the food frequency questionnaire. This study has also compared participants according to the self-reported practice of a low-carb diet. Parametric tests were used to compare the groups and Pearson’s correlations between some variables of interest (p &gt; 0.05 adopted). Results: According to the question regarding the practice of the low-carb diet, 39 participants had tried a low-carb diet in the last six months (46.2% of these with binge eating) and 48 did not (16.7% with binge eating). Dieters showed higher levels of binge eating, cognitive restriction, and food cravings (trait and state). Dieters consumed less rice and bread but did not present lower consumption of sweets. Correlations showed that for dieters who ‘Consciously hold back at meals in order not to gain weight’, it was negatively associated with ‘Intention and plans to eat’, ‘positive reinforcement’ and ‘relieving negative states’ and food cravings scores. Conclusions: Despite the higher levels of cognitive restriction in dieters, they are negatively correlated with food craving factors and negatively associated with the consumption of sweets.

Beliefs and Experiences of Individuals Following a Zero-Carb Diet.

The adoption of carbohydrate-restrictive diets to improve health is increasing in popularity, but there is a dearth of research on individuals who choose to severely restrict or entirely exclude carbohydrates. The present study investigated the beliefs and experiences of individuals following a diet that severely limits, or entirely excludes, dietary carbohydrates, colloquially known as a ‘zero-carb’ diet, for at least 6 months. Zero-carb dieters (n = 170) recruited via a social networking site completed an online qualitative survey prompting them to discuss their motives, rationale, and experiences of following a low-carb diet. Transcripts of participants’ responses were analyzed using inductive thematic analysis. Results revealed that participants’ decision to follow a zero-carb diet was driven by health concerns and benefits. Participants expressed a strong social identity and belongingness to online zero-carb communities. Participants reported strong intentions to follow the diet indefinitely. Shortcomings of the diet centered on experienced stigma; lack of support from healthcare providers and significant others; limited access to, and high cost of, foods; and limited scientific data on the diet. Further research into the benefits and shortcomings of zero-carb diets across settings and populations is warranted, and guidelines for healthcare professionals on how to support individuals following a zero-carb diet are needed.

The ketogenic diet: history, mechanism of action, indications and contraindications

Low-carb diets have been successfully used to alleviate a number of severe neurological diseases for about 100 years. The publication of the results of new studies suggesting that this type of diet may play a therapeutic role in other pathologies such as diabetes, obesity, polycystic ovary syndrome, and oncology is of particular interest for both doctors and the public. However, the long-term safety of using a low-carb or ketogenic diet, as well as its impact, primarily on the risks of developing cardiovascular diseases, remains poorly studied. This article presents the results of observation of patients against the background of a low-carbohydrate diet, both in the short-term perspective as well as provides an assessment of its long-term consequences.

Effect and Mechanism of Low Carb High Protein Diet on Nonalcoholic Fatty Liver Disease

Effect and Mechanism of Low Carb High Protein Diet on Nonalcoholic Fatty Liver Disease

Changes in Quantity and Sources of Dietary Fiber from Adopting Healthy Low-Fat vs. Healthy Low-Carb Weight Loss Diets: Secondary Analysis of DIETFITS Weight Loss Diet Study.

The daily intake of dietary fiber is well below the recommended levels in the US. The effect of adopting a low-fat vs. a low-carbohydrate weight loss diet on fiber intake is of interest but not well-documented, especially when both approaches promote high-quality food choices. The objective of this paper is to compare the quantity and sources of dietary fiber between a healthy low-fat (HLF) vs. healthy low-carbohydrate (HLC) diet group when consumed over 12 months in a weight loss diet study. In this secondary analysis of the Diet Intervention Examining The Factors Interacting with Treatment Success (DIETFITS) study, the amount and sources of dietary fiber were examined in generally healthy adults, 18–50 years of age, Body Mass Index (BMI) 28–40 kg/m2, randomized to HLF or HLC for 12 months, who had available 24-h recalls at 0 (n = 609), 3 (n = 549), 6 (n = 491), and 12 (n = 449) months. The dietary intake was estimated by the Nutrition Data System for Research (NDS-R). The sources of fiber were determined for the major food groups. Significantly more total dietary fiber was consumed by HLF at every post-randomization time point, and, at 12 m, was 23.04 ± 9.43 g vs. 18.61 ± 8.12 g for HLF vs. HLC, respectively, p < 0.0001. In both diet groups at 12 months, the highest amount of dietary fiber came from non-starchy vegetables (4.13 ± 3.05 g and 5.13 ± 3.59 g). The other primary sources of fiber at 12 months for the HLF group were from whole grains (3.90 ± 3.13 g) and fruits (3.40 ± 2.87 g), and, for the HLC group, were from plant protein and fat sources, such as nuts and seeds, their butters, and avocados (2.64 ± 2.64 g). In the DIETFITS study, the difference in the total fiber intake for the HLF vs. HLC groups was more modest than expected. The HLC group consumed reasonably high amounts of fiber from high-protein and high fat plant-based sources.

The Low Carb Program for people with type 2 diabetes and pre-diabetes: a mixed methods feasibility study of signposting from general practice.

BackgroundEvidence shows type 2 diabetes mellitus (T2DM) can be effectively treated with a reduced-carbohydrate diet to support weight loss. Digital apps are increasingly used to support weight loss, yet little is known about their use as part of general practice diabetes care.AimDetermine the feasibility of signposting from routine NHS general practice to a digital weight management tool (Low Carb Program) for patients with T2DM and pre-diabetes.Design & settingMixed-methods feasibility study implemented within routine general practice consultations at four practices in the Midlands, England.MethodGeneral practices offered signposting to eligible patients attending consultations of any type during a 4-week recruitment period. Rates of offering and accepting signposting were recorded, with program registration, program completion, and self-reported health outcomes (weight, haemoglobin A1C [HbA1c]).ResultsSignposting was offered to 351 patients; 160 (45.6%) accepted, 103 (29.3%) registered with the intervention and 43 (26.9% of patients accepting signposting) completed the programme. GPs reported that signposting added between 1–4 minutes to the consultation length. Patients completing the programme reported greater weight loss (7.2kg versus 1.6kg, P<0.001) and HbA1c improvements (-9.1mmol/mol versus 1.7mmol/mol, P<0.001) compared to those who did not, and were more likely to reduce the number of prescribed diabetes medications in general practice.ConclusionsSignposting from real-world general practice to the Low Carb Program is feasible and can potentially improve diabetes outcomes. Further research should explore whether the process of signposting can be enhanced to increase registration, identify whether additional practice-led support leads to increased programme completion, and confirm the intervention’s clinical and cost-effectiveness.

Low Carb Program Health App Within a Hospital-Based Obesity Setting: Observational Service Evaluation.

BackgroundObesity underlies much chronic disease. Digitalization of obesity management provides an opportunity to innovate our traditional model of health care delivery within this setting, and to transform its scalability potentially to the population level.ObjectiveThe objective was to assess the feasibility and effectiveness of the Low Carb Program app for weight loss, applied within our hospital-based (tier 3) obesity service. Due to the disrupting effects of the COVID-19 pandemic on our obesity service, we compared the clinical outcomes from the Low Carb Program app applied in the context of remote patient appointments over the telephone with the prepandemic traditional standard of care.MethodsWe invited patients who attended our hospital-based obesity service to engage with the Low Carb Program smartphone app. We combined this approach with remote delivery (over the telephone) of obesity management from medical and psychology members of our obesity team during the COVID-19 pandemic. Outcome variables included changes in body weight and changes in HbA1c as a marker of glycemic control. We compared data from the Low Carb Program group with a retrospective control group (n=126) that had received traditional face-to-face obesity management from our team without concomitant use of the Low Carb Program app in the pre–COVID-19 era. T test comparisons were employed, with P<.05 considered significant.ResultsThe mean weight of participants (n=105) was 130.2 kg, with 59% (n=62) females and a mean age of 48.8 years. Most participants (90/105, 86%) completed the Low Carb Program app registration process and engaged with the Low Carb Program app program; at follow-up, most participants (88/105, 84%) had actively engaged with the Low Carb Program app within the prior 30 days. The majority of participants (58/105, 55%) self-reported outcomes within the app. Mean duration of clinical follow-up for recruited participants who received the app was 7.4 months. Paired data were available for 48 participants for body weight and 41 participants for HbA1c. Paired sample t test analysis revealed a statistically significant mean loss of body weight of 2.7 kg (P=.001) and improvement in HbA1c of 3.3 mmol/mol (P=.01). The mean weight of control group patients (n=126) was 137.1 kg, with 74% (93/126) females and a mean age of 44.4 years. The mean follow-up for this group was 6 months. Data comparisons between the app user group and the pre–COVID-19 retrospective control group revealed equivalence for loss of body weight and change in HbA1c between the two groups.ConclusionsWe provide evidence to support the feasibility of implementing the Low Carb Program app combined with remote management; this is the first proof of concept for digitalized management within a hospital-based (tier 3) obesity service. We demonstrate the potential clinical efficacy of the approach in terms of improvements in body weight and glycemic control.

Evaluation of the Low Carb Program Digital Intervention for the Self-Management of Type 2 Diabetes and Prediabetes in an NHS England General Practice: Single-Arm Prospective Study.

BackgroundType 2 diabetes mellitus has serious health consequences, including blindness, amputation, and stroke. Researchers and clinicians are increasingly in agreement that type 2 diabetes may be effectively treated with a carbohydrate-reduced diet. Digital apps are increasingly used as an adjunct to traditional health care provisions to support remote self-management of long-term health conditions.ObjectiveOur objective was to evaluate the real-world 12-month outcomes of patients prescribed the Low Carb Program digital health intervention at a primary care National Health Service (NHS) site. The Low Carb Program is a nutritionally focused, 12-session, digitally delivered, educational behavior change intervention for glycemic control and weight loss for adults with prediabetes and type 2 diabetes. The program educates and supports sustainable dietary changes focused on carbohydrate restriction by utilizing behavior change techniques, including goal setting, peer support, and behavioral self-monitoring, as well as personalized downloadable resources, including recipes and meal plans tailored to ethnicity, weekly shopping budget, and dietary preferences.MethodsThis study evaluated the real-world outcomes of patients recruited to the Low Carb Program at an NHS general practice in Southport, United Kingdom. All of the NHS patients recruited to the program were diagnosed with type 2 diabetes or prediabetes and were given access to the program at no cost. A total of 45 participants, with a mean age of 54.8 years (SD 13.2), were included in the study. Women made up 42% (19/45) of the sample. The mean hemoglobin A1c (HbA1c) of the sample was 56.7 mmol/mol (SD 16.95) and the mean body weight was 89.4 kg (SD 13.8).ResultsOf the 45 study participants recruited to the program, all of them (100%) activated their accounts and 37 (82%) individuals reported outcomes at 12 months. All 45 (100%) patients completed at least 40% of the lessons and 32 (71%) individuals completed more than nine out of 12 core lessons of the program. Glycemic control and weight loss improved, particularly for participants who completed more than nine core lessons in the program over 12 months. The mean HbA1c went from 58.8 mmol/mol at baseline to 54.0 mmol/mol, representing a mean reduction of 4.78 mmol/mol (SD 4.60; t31=5.87; P<.001). Results showed an average total body weight reduction of 4.17%, with an average weight reduction of 3.85 kg (SD 2.49; t31=9.27; P<.001) at the 12-month follow-up point.ConclusionsA digital app prescribed to adults with type 2 diabetes and prediabetes in a primary care setting supporting a transition to a low-carbohydrate diet has been shown to be effective in improving glycemic control and enabling weight loss. Further research to understand more about factors affecting engagement with the app and further positive health implications would be valuable.

Caloric Restriction per se Rather Than Dietary Macronutrient Distribution Plays a Primary Role in Metabolic Health and Body Composition Improvements in Obese Mice.

Caloric restriction (CR) is of key importance in combating obesity and its associated diseases. We aimed to examine effects of dietary macronutrient distribution on weight loss and metabolic health in obese mice exposed to CR. Male C57BL/6J mice underwent diet-induced obesity for 18 weeks. Thereafter mice were exposed to a 6-week CR for up to 40% on either low-fat diet (LFD; 20, 60, 20% kcal from protein, carbohydrate, fat), low-carb diet (LCD; 20, 20, 60% kcal, respectively) or high-pro diet (HPD; 35, 35, 30% kcal, respectively) (n = 16 each). Ten mice on the obesogenic diet served as age-matched controls. Body composition was evaluated by tissue dissections. Glucose tolerance, bloods lipids and energy metabolism were measured. CR-induced weight loss was similar for LFD and LCD while HPD was associated with a greater weight loss than LCD. The diet groups did not differ from obese controls in hindlimb muscle mass, but showed a substantial decrease in body fat without differences between them. Glucose tolerance and blood total cholesterol were weight-loss dependent and mostly improved in LFD and HPD groups during CR. Blood triacylglycerol was lowered only in LCD group compared to obese controls. Thus, CR rather than macronutrient distribution in the diet plays the major role for improvements in body composition and glucose control in obese mice. Low-carbohydrate-high-fat diet more successfully reduces triacylglycerol but not cholesterol levels compared to isocaloric high-carbohydrate-low-fat weight loss diets.

Dietary starch is weight reducing when distally digested in the small intestine

Nowadays, carbohydrate-based foods have a negative consumer connotation and low carb diets have become a popular way to lose weight. Here, we show how digestible starch and flavonoids can be used as a dietary approach to manage food intake and weight gain through elevation of glucagon-like peptide-1 (GLP-1) secretion for gut-brain axis communication. This was achieved by extending the digestion of cooked starch to the distal small intestine using luteolin or quercetin as α-amylase-specific inhibitors with competitive inhibition mechanism. In a mouse model, extended and complete digestion produced a signature blunted glycemic profile that induced elevation of GLP-1 and positive regulation of hypothalamic neuropeptides with significantly reduced food intake and weight gain (p < 0.05). These findings represent a shift in paradigm of dietary carbohydrates from weight increasing to reducing, and have implications for industry and public health related to the design of carbohydrate-based foods/ingredients for managing obesity and diabetes.