High-carbohydrate Low-fat Diet Research Articles

Concurrent low-carbohydrate, high-fat diet with/without physical activity does not improve glycaemic control in type 2 diabetics

Aim: This study aimed to determine if a low-carbohydrate, high-fat diet (LCHFD) provides any benefits of glycaemic control in patients with type 2 diabetes mellitus, either alone or in conjunction with physical activity. Methods: Type 2 diabetics (n = 39) were assigned into either a concurrent physical activity and LCHFD group (DiExG), LCHFD only group (DietG) or control group (ConG). Results: No significant (p > 0.05) changes were observed in glycated haemoglobin (HbA1c), glucose and insulin in either the DiExG (HbA1c: p = 0.592; 8.3% decrease, glucose: p = 0.477; 11.1% decrease and insulin: p = 0.367; 44.1% increase) or DietG (HbA1c: p = 0.822; 0% change, glucose: p = 0.108; 11.0% decrease and insulin: p = 0.976; 4.2% decrease) group. Conclusions: In this study, neither an LCHFD alone nor in combination with a physical activity programme succeeded in eliciting improvements in insulin sensitivity in the type 2 diabetics. As such, adoption of a LCHFD, either alone or in combination with physical activity, should not unequivocally be part of the treatment approach for type 2 diabetics. Furthermore, it should carefully be weighed against the benefits of more balanced dietary and/or physical activity interventions.

Effects of a 12-Week Very-Low Carbohydrate High-Fat Diet on Maximal Aerobic Capacity, High-Intensity Intermittent Exercise, and Cardiac Autonomic Regulation: Non-randomized Parallel-Group Study.

PurposeThe aim of this non-randomized parallel group study was to examine the 12 week effects of a very low-carbohydrate high-fat diet (VLCHF) on maximal cardiorespiratory capacity, high-intensity interval training (HIIT) performance, and cardiac autonomic regulation.MethodsTwenty-four recreationally trained participants allocated to either a VLCHF (N = 12) or a habitual diet (HD; N = 12) group completed 12 weeks of a diet and exercise (VLCHF) or an exercise only intervention (HD). Maximal graded exercise tests (GXT) were performed at baseline, after 4, 8, and 12 weeks. A supervised HIIT session and the 30-15 Intermittent Fitness Test (30-15IFT) were conducted once a week.ResultsTotal time to exhaustion (TTE) in both GXT and 30-15IFT largely increased in both VLCHF (p = 0.005, BF10 = 11.30 and p = 0.001, BF10 ≥ 100, respectively) and HD (p = 0.018, BF10 = 3.87 and p = 0.001, BF10 ≥ 100, respectively) groups after 12 weeks. Absolute maximal oxygen uptake (O2max) was not changed in both groups but relative O2max increased in VLCHF in concert with reductions in body mass (66.7 ± 10.2–63.1 ± 8.5 kg). Cardiac autonomic regulation did not reveal any between-group differences after 12 weeks. VLCHF diet induced an increase in β-hydroxybutyrate, which tended to normalize during the intervention period.ConclusionThe 12 week VLCHF diet did not impair high-intensity continuous or intermittent exercise lasting up to 25 min, nor did it impair maximal cardiorespiratory performance or autonomic nervous system (ANS) activity.

The effect of a low-carbohydrate high-fat diet and ethnicity on daily glucose profile in type 2 diabetes determined by continuous glucose monitoring.

Nutrition is an integral part of type 2 diabetes (T2DM) treatment, but the optimal macronutrient composition is still debated and previous studies have not addressed the role of ethnicity in dietary response. The current study aims were to compare the effect of short-term glycemic response to low-carbohydrate high-fat (LC-HF) diet vs. high-carbohydrate low-fat (HC-LF) diet using continuous glucose monitoring (CGM) and to evaluate the response of individuals with T2DM of Yemenite (Y-DM) and non-Yemenite origin (NY-DM). Twenty T2DM males, ten Y-DM and ten NY-DM underwent meal tolerance test and indexes of insulin resistance and secretion were calculated. Subsequently, patients were connected to CGM to assess daily glycemic control and glucose variability in response to isocaloric HC-LF or LC-HF diet, receiving each diet for 2days by providing prepared meals. Daily glucose levels, area under the glucose curve (G-AUC) and parameters of glucose variability [standard deviation (SD), mean amplitude of glycemic excursions (MAGE) and mean absolute glucose (MAG)] were evaluated. The LC-HF resulted in a significantly lower G-AUC (p < 0.001) and in lower variability parameters (p < 0.001) vs. the HC-LF diet. However, Y-DM showed less reduction in glucose variability indices upon diet-switching vs. NY-DM; MAGE decreased, respectively, by 69% vs. 89%, p = 0.043 and MAG by 34% vs. 45%, p = 0.007 in Y-DM compared to NY-DM. These results suggest that LC-HF diet is effective in reducing glycemic fluctuation in T2DM and that ethnicity may have a role in the response to dietary regime.

Ultramarathon Comprehensive Injury Prevention

This paper aims to review injury prevention for ultramarathon runners during training, race day, and recovery. Injury prevention starts with a training plan that emphasizes a gradual increase in distance interspersed with speed work, long runs, strength training, and active recovery. Pre-race training environment that mirrors race day terrain and climate is preferred. Customized nutrition and hydration strategies are recommended. Further research is needed regarding various carbohydrate/fat nutrition strategies. There are numerous reviews of ultramarathon running-related injuries, which often include discussion on symptoms, treatment options, and how to improve race day performance. This review rather focuses on recent findings in ultramarathon injury prevention including pre-participation screening, training recommendations, shoe selection, foot strike patterns, blisters, and environmental issues. Pre-race and race day nutrition is highlighted with a discussion on high-carbohydrate low-fat diet vs. low-carbohydrate high-fat diets. Prevention of gastrointestinal distress and exercise-associated hyponatremia are also reviewed.

Food choice motivations: Profiling low-carbohydrate, high-fat dieters

We sought to determine the motivational profile of low-carbohydrate, high-fat (LCHF) dieters compared to other-dieter and non-dieter groups, in terms of both absolute food choice motivations (FCMs) and relative FCMs (how one motivation is prioritised against others). Participants (N = 330, 287 female, 43 male) completed a 12-scale food choice questionnaire online. Results showed that all three groups prioritised the FCM of health highly. Differences between the dietary groups (adjusting for age) showed that the “LCHF diet” and “other-diet” group rated FCM's weight control and natural content (absolute and relative motivation scores) significantly higher than those in the “no-diet” group. Whereas, FCM's price and convenience (absolute and relative motivation scores) were rated significantly lower than the “no-diet” group. Importantly, FCM Natural content was the top priority for the “LCHF diet” group, and its level of importance significantly differed from the “other-diet” group, who scored natural content significantly lower in both absolute and relative terms. In contrast, the “LCHF diet” group scored significantly lower on relative animal welfare as compared to both other groups. The pattern of both absolute and relative food choice motivation scores between each group is discussed. These results show a novel profile of differences for absolute and relative FCMs between LCHF dieters, other-dieters and non-dieters.

Acute Carbohydrate Consumption On The Iron-regulatory Response To Exercise In Elite Keto-adapted Endurance Athletes

PURPOSE: To investigate the impact of CHO re-introduction in athletes previously adapted to a LCHF diet on subsequent inflammatory and hepcidin responses to exercise. METHODS: In the three weeks prior to the exercise trials, twenty-three elite race walkers adhered to either a CHO-rich (n=14) or LCHF diet (n=9). A 19-25 km race walking protocol was performed while the race walkers were still adhering to their allocated dietary intervention (Adapt). A second exercise test was performed three days later, where the LCHF consumed CHO 2 h prior to, and during the exercise protocol (in line with sports nutrition guidelines) for the first time in 3.5 weeks (CHO Restoration). Venous blood samples were collected pre-, post- and 3 h post-exercise and analysed for serum ferritin, interleukin-6 (IL-6) and hepcidin-25. RESULTS: Serum ferritin concentration was similar between trials (p=0.48) and dietary groups (p=0.93). The post-exercise IL-6 increase was greater in LCHF (p<0.001) during both Adapt (LCHF: 13.1-fold increase; CHO: 8.0-fold increase) and CHO Restoration (LCHF: 18.5-fold increase, CHO: 6.3-fold increase); outcomes were not different between trials (p=0.84). Hepcidin-25 levels increased 3 h post-exercise (p<0.001), however, they did not differ between trials (p=0.46) or diets (p=0.84). CONCLUSIONS: Strenuous exercise undertaken following chronic adaptation to a LCHF diet is associated with a greater post-exercise IL-6 response than when exercise is undertaken with high CHO availability. The elevated IL-6 response in athletes adapted to a LCHF diet is not attenuated by an acute increase in exogenous CHO availability. Despite diet-induced differences in IL-6 responses, no differences in hepcidin levels were evident, suggesting IL-6 is likely not the primary factor determining the magnitude of post-exercise hepcidin levels. Baseline iron status may be a more dominant factor regulating this response. Increased IL-6 levels may negatively influence other body processes, and the long-term impact of adhering to LCHF on other health outcomes warrants further investigation.

Analysis of the Effects of Dietary Pattern on the Oral Microbiome of Elite Endurance Athletes.

Although the oral microbiota is known to play a crucial role in human health, there are few studies of diet x oral microbiota interactions, and none in elite athletes who may manipulate their intakes of macronutrients to achieve different metabolic adaptations in pursuit of optimal endurance performance. The aim of this study was to investigate the shifts in the oral microbiome of elite male endurance race walkers from Europe, Asia, the Americas and Australia, in response to one of three dietary patterns often used by athletes during a period of intensified training: a High Carbohydrate (HCHO; n = 9; with 60% energy intake from carbohydrates; ~8.5 g kg−1 day−1 carbohydrate, ~2.1 g kg−1 day−1 protein, 1.2 g kg−1 day−1 fat) diet, a Periodised Carbohydrate (PCHO; n = 10; same macronutrient composition as HCHO, but the intake of carbohydrates is different across the day and throughout the week to support training sessions with high or low carbohydrate availability) diet or a ketogenic Low Carbohydrate High Fat (LCHF; n = 10; 0.5 g kg−1 day−1 carbohydrate; 78% energy as fat; 2.1 g kg−1 day−1 protein) diet. Saliva samples were collected both before (Baseline; BL) and after the three-week period (Post treatment; PT) and the oral microbiota profiles for each athlete were produced by 16S rRNA gene amplicon sequencing. Principal coordinates analysis of the oral microbiota profiles based on the weighted UniFrac distance measure did not reveal any specific clustering with respect to diet or athlete ethnic origin, either at baseline (BL) or following the diet-training period. However, discriminant analyses of the oral microbiota profiles by Linear Discriminant Analysis (LDA) Effect Size (LEfSe) and sparse Partial Least Squares Discriminant Analysis (sPLS-DA) did reveal changes in the relative abundance of specific bacterial taxa, and, particularly, when comparing the microbiota profiles following consumption of the carbohydrate-based diets with the LCHF diet. These analyses showed that following consumption of the LCHF diet the relative abundances of Haemophilus, Neisseria and Prevotella spp. were decreased, and the relative abundance of Streptococcus spp. was increased. Such findings suggest that diet, and, in particular, the LCHF diet can induce changes in the oral microbiota of elite endurance walkers.

Three days of a eucaloric, low-carbohydrate/high-fat diet increases insulin clearance in healthy non-obese Japanese men

Metabolic clearance rate of insulin (MCRI) is thought to help maintain glucose homeostasis even in healthy subjects. However, the effect of a low carbohydrate/high fat (LCHF) diet on MCRI in healthy subject remains unclear. To investigate the effect of a 3-day eucaloric LCHF diet on MCRI in healthy subjects, we studied 42 healthy non-obese Japanese men. Each subject consumed a eucaloric LCHF diet for 3 days. Before and after the LCHF diet, intramyocellular lipid (IMCL) levels were measured using 1H-magnetic resonance spectroscopy, and glucose infusion rate (GIR) and MCRI were evaluated with a euglycemic hyperinsulinemic clamp. The LCHF diet increased MCRI by 10% and decreased steady state serum insulin (SSSI) and GIR during glucose clamp by 10% and 6%, respectively. To further investigate the role of MCRI, we divided subjects into high-responder (HR) and low-responder (LR) groups based on the median %change in MCRI. The LCHF diet increased IMCL and decreased SSSI during glucose clamp in the HR group, while those were not altered in the LR group. Our results suggested that a 3-day eucaloric LCHF diet increases MCRI in healthy non-obese Japanese men. This change seemed to be beneficial in terms of maintaining euglycemia during low carbohydrate availability.

Nutrition for Ultramarathon Running: Trail, Track, and Road.

Ultramarathon running events and participation numbers have increased progressively over the past three decades. Besides the exertion of prolonged running with or without a loaded pack, such events are often associated with challenging topography, environmental conditions, acute transient lifestyle discomforts, and/or event-related health complications. These factors create a scenario for greater nutritional needs, while predisposing ultramarathon runners to multiple nutritional intake barriers. The current review aims to explore the physiological and nutritional demands of ultramarathon running and provide general guidance on nutritional requirements for ultramarathon training and competition, including aspects of race nutrition logistics. Research outcomes suggest that daily dietary carbohydrates (up to 12g·kg-1·day-1) and multiple-transportable carbohydrate intake (∼90g·hr-1 for running distances ≥3hr) during exercise support endurance training adaptations and enhance real-time endurance performance. Whether these intake rates are tolerable during ultramarathon competition is questionable from a practical and gastrointestinal perspective. Dietary protocols, such as glycogen manipulation or low-carbohydrate high-fat diets, are currently popular among ultramarathon runners. Despite the latter dietary manipulation showing increased total fat oxidation rates during submaximal exercise, the role in enhancing ultramarathon running performance is currently not supported. Ultramarathon runners may develop varying degrees of both hypohydration and hyperhydration (with accompanying exercise-associated hyponatremia), dependent on event duration, and environmental conditions. To avoid these two extremes, euhydration can generally be maintained through "drinking to thirst." A well practiced and individualized nutrition strategy is required to optimize training and competition performance in ultramarathon running events, whether they are single stage or multistage.

Short-Term Low-Carbohydrate High-Fat Diet in Healthy Young Males Renders the Endothelium Susceptible to Hyperglycemia-Induced Damage, An Exploratory Analysis.

Postprandial hyperglycemia has been linked to elevated risk of cardiovascular disease. Endothelial dysfunction and/or damage may be one of the mechanisms through which this occurs. In this exploratory study, we determined whether acute glucose ingestion would increase markers of endothelial damage/activation and impair endothelial function before and after a short-term low-carbohydrate high-fat diet (HFD) designed to induce relative glucose intolerance. Nine healthy young males (body mass index 23.2 ± 2 kg/m2) consumed a 75 g glucose drink before and <24 hours after consuming seven days of an iso-energetic HFD consisting of ~70% energy from fat, ~10% energy from carbohydrates, and ~20% energy from protein. CD31+/CD42b- and CD62E+ endothelial microparticles (EMPs) were enumerated at fasting, 1 hour (1 h), and 2 hours (2 h) post-consumption of the glucose drink. Flow-mediated dilation (FMD), arterial stiffness, and diameter, velocity, and flow of the common and internal carotid, and vertebral arteries were assessed in the fasting state and 1 h post glucose consumption. After the HFD, CD31+/CD42b- EMPs were elevated at 1 h compared to 2 h (p = 0.037), with a tendency for an increase above fasting (p = 0.06) only post-HFD. CD62E EMPs followed the same pattern with increased concentration at 1 h compared to 2 h (p = 0.005) post-HFD, with a tendency to be increased above fasting levels (p = 0.078). FMD was reduced at 1 h post glucose consumption both pre- (p = 0.01) and post-HFD (p = 0.005). There was also a reduction in FMD in the fasting state following the HFD (p = 0.02). In conclusion, one week of low-carbohydrate high-fat feeding that leads to a relative impairment in glucose homeostasis in healthy young adults may predispose the endothelium to hyperglycemia-induced damage.

FDG atrial uptake is associated with an increased prevalence of stroke in patients with atrial fibrillation.

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and is associated with an increased risk of stroke. Indeed, silent AF is frequently identified in unexplained ischemic stroke. 18F-FDG-PET/CT is a powerful tool for assessing myocardial metabolic shift and inflammation, both potentially at stake in AF. This case-control study investigated whether AF could promote FDG uptake in atria after physiological myocardial glucose uptake suppression, and the potential relationship between FDG atrial uptake and prevalence of stroke. We retrospectively enrolled 128 patients (64 consecutive patients with AF and 64 without AF as the control group, matched for age and sex) who underwent 18F-FDG-PET/CT after a high-fat low-carbohydrate diet. We analyzed visual and quantitative FDG uptake parameters of the right and left atria (RA/LA) and the right and left appendages (RAA/LAA), and selected clinical features including history of stroke. Diffuse right atrial uptake was present in a third of patients with AF and only two patients in the control group. FDG uptake intensity of both atria was significantly associated with the underlying heart rhythm. The occurrence of stroke was strongly associated with detectable atrial uptake in multivariate analysis, with an odds ratio superior to that of other known risk factors. This study shows a significant correlation between FDG atrial uptake and AF. While inconsistent, this pattern seems to be associated with an increased prevalence of cardioembolic stroke.

Acute carbohydrate ingestion does not influence the post-exercise iron-regulatory response in elite keto-adapted race walkers

ObjectivesAdhering to a low carbohydrate (CHO) high fat (LCHF) diet can alter markers of iron metabolism in endurance athletes. This investigation examined the re-introduction of CHO prior to, and during exercise on the iron-regulatory response to exercise in a homogenous (in regard to serum ferritin concentration) group of athletes adapted to a LCHF diet. DesignParallel groups design. MethodsThree weeks prior to the exercise trials, twenty-three elite race walkers adhered to either a CHO-rich (n=14) or LCHF diet (n=9). A standardised 19–25km race walk was performed while athletes were still adhering to their allocated dietary intervention (Adapt). A second test was performed three days later, where all athletes were placed on a high CHO diet (CHO Restoration). Venous blood samples were collected pre-, post- and 3h post-exercise and measured for interleukin-6 (IL-6) and hepcidin-25. ResultsThe post-exercise IL-6 increase was greater in LCHF (p<0.001) during both the Adapt (LCHF: 13.1-fold increase; 95% CI: 5.6–23.0, CHO: 8.0-fold increase; 5.1–11.1) and CHO Restoration trials (LCHF: 18.5-fold increase; 10.9–28.9, CHO: 6.3-fold increase; 3.9–9.5); outcomes were not different between trials (p=0.84). Hepcidin-25 concentrations increased 3h post-exercise (p<0.001), however, they did not differ between trials (p=0.46) or diets (p=0.84). ConclusionsThe elevated IL-6 response in athletes adapted to a LCHF diet was not attenuated by an acute increase in exogenous CHO availability. Despite diet-induced differences in IL-6 response to exercise, post-exercise hepcidin levels were similar between diets and trials, indicating CHO availability has minimal influence on post-exercise iron metabolism.

Implications of Low-Carbohydrate-High Fat Diet on Weight Management

The leading concern in terms of public health today is primarily obesity or weight management. Because of the fact, people in the countries being obese there is a rise in a number of weight loss diets programs. Especially, the low carbohydrate diets were attracted by public as-the results in this particular diet are rapid. Evidence indicates the advent of media today is not letting the public to take appointment with the registered dieticians. Public through audio-visual aids are trying to participate in veeramachaneni low carbohydratehigh fat diet. The diet is resulting in reduction of weight (in kgs). In this article we discuss the current practical implications on the efficacy of high-fat, low-carbohydrate dietary patterns for weight loss, and their potential action in execution of the diets further.

Benefits of resistance training on body composition and glucose clearance are inhibited by long-term low carbohydrate diet in rats.

Background/ObjectivesRegular exercise training is effective to altering many markers of metabolic syndrome and its effects are strongly influenced by the type of consumed diet. Nowadays, resistance training (RT) has been frequently associated with low-carbohydrate high-fat diet (LCD). After long term these diets causes body weight (BW) regain with deleterious effects on body composition and metabolic risk factors. The effects of RT associated with long-term LCD on these parameters remain unexplored. We aimed to investigate the effects of RT when associated with long-term LCD on BW, feed efficiency, body composition, glucose homeostasis, liver parameters and serum biochemical parameters during BW regain period in rats.Subjects/MethodsMale Sprague–Dawley rats were fed with LCD (LC groups) or standard diet (STD) (ST groups). After 10 weeks-diet animals were separated into sedentary (Sed-LC and Sed-ST) and resistance-trained (RT-LC and RT-ST) groups (N = 8/group). RT groups performed an 11-week climbing program on a ladder with progressive load. Dual x-ray absorptiometry, glucose tolerance tests and insulin tolerance tests were performed at weeks 10 and 20. Liver and serum were collected at week 21.ResultsRT reduced feed efficiency, BW gain, liver fat and total and LDL cholesterol, and improved body composition and glucose clearance in animals fed on STD. In those fed with LCD, RT reduced caloric intake, BW regain, liver fat and serum triglycerides levels. However, improvement in body composition was inhibited and bone mineral density and glucose clearance was further impaired in this association.ConclusionsThe LCD nullifies the beneficial effects of RT on body composition, glucose homeostasis and impairs some health parameters. Our results do not support the association of RT with LCD in a long term period.

Effects of a 15-Day Low Carbohydrate, High-Fat Diet in Resistance-Trained Men.

Waldman, HS, Krings, BM, Basham, SA, Smith, JW, Fountain, BJ, and McAllister, MJ. Effects of a 15-day low carbohydrate, high-fat diet in resistance-trained men. J Strength Cond Res 32(11): 3103-3111, 2018-This study examined the effects of a 15-day isocaloric low carbohydrate (<25% E), high-fat (>50% E) (LCHF) diet on physiological and metabolic alterations in resistance-trained (RT) men. College-aged RT men (n = 11) completed 4 V[Combining Dot Above]O2max tests using treadmill every 5 days during the 15-day trial. Blood was drawn intravenously pre-exercise across each experimental trial for insulin, cortisol, and glucose. Pulmonary data were collected and substrate oxidation (OXI) was calculated during exercise. Body mass decreased (p < 0.04) with no further changes in anthropometric measures. Time to exhaustion was not affected across each day. Insulin dropped below baseline values (p < 0.0005). Cortisol increased from baseline to day 5 (p < 0.004) but returned back to near baseline at day 10, whereas glucose remained within normal range throughout the duration of the study. Carbohydrate (CHO) OXI dropped (p < 0.001) from baseline to day 5, and fat OXI increased from baseline to day 5 (p < 0.0001). Heart rate decreased from baseline to day 5 (p < 0.001) and again from day 10 to 15 (p < 0.02). Oxygen uptake (V[Combining Dot Above]O2) decreased from day 5 to 10 (p < 0.0001). A nonketo LCHF diet appears to favor RT men by altering metabolic markers without decrements in aerobic performance and be a potential diet intervention used by coaches. However, the reported cardiorespiratory responses should be interpreted reasonably because of the possibility the subjects running economy improved over experimental trials.

Cardiac mitochondrial respiration following a low-carbohydrate, high-fat diet in apolipoprotein E-deficient mice.

Low-carbohydrate diets are considered to be an effective approach to weight loss and have, subsequently, grown in popularity. Despite the apparent health benefits that these diets may provide for insulin resistance, hypertension, and dyslipidemia, their implications on cardiomyocyte oxidative capacity have yet to be investigated. To evaluate the adaptations induced by a 6-week low-carbohydrate, high-fat (LCHF) diet on mitochondrial respiration, two groups of male mice were investigated: Apolipoprotein E-deficient mice on a LCHF diet (L-DIET) and apolipoprotein E-deficient mice on a regular rodent diet (CON). Heart tissue was extracted and used for high-resolution respirometry (HRR), while immunoblotting was performed to quantify mitochondrial density and complexes. The results demonstrate increased expression of all five mitochondrial subunits in the L-DIET group compared to control condition. Furthermore, HRR revealed increased efficiency of substrate consumption, implying augmented oxidative capacity in the L-DIET group. These findings further support the notion that cardiomyocytes prefer lipids as a primary fuel source, by demonstrating that the shift in metabolism caused by a LCHF diet facilitates such an environment. This provides important information regarding the effects of a LCHF on cardiomyocytes, especially when considering free radical production and heart dysfunction.

Effect of low carbohydrate high fat diet on LDL cholesterol and gene expression in normal-weight, young adults: A randomized controlled study

Background and aimsThe effects of a low carbohydrate/high fat (LCHF) diet on health are debated. This study aims to explore the effects of a diet with less than 20 g carbohydrates per day (LCHF) on plasma low density lipoprotein cholesterol (LDL-C) in young and healthy adults. The secondary aim is the assessment of lipid profile and peripheral blood mononuclear cells (PBMC) gene expression. MethodsThis was a randomized controlled parallel-designed intervention study. Participants were either assigned to a three-week LCHF diet or a control group continuing habitual diet ad libitum, in both groups. ResultsIn total, 30 healthy normal weight participants completed the study. Nine subjects did not complete it due to adverse events or withdrawn consent. In the LCHF diet group (n = 15), plasma LDL-C increased from (mean ± SD) 2.2 ± 0.4 mmol/l before intervention to 3.1 ± 0.8 after, while in the control group (n = 15), LDL-C remained unchanged: 2.5 ± 0.8 mmol/l (p < 0.001 between groups). There was a significant increase in apolipoprotein B, total cholesterol, high-density lipoprotein cholesterol, free fatty acids, uric acid and urea in the LCHF group versus controls. Plasma levels of triglycerides, lipoprotein (a), glucose, C-peptide or C-reactive protein (CRP), blood pressure, body weight or body composition did not differ between the groups. PBMC gene expression of sterol regulator element binding protein 1 (SREBP-1) was increased in the LCHF group versus controls (p ≤ 0.01). The individual increase in LDL-C from baseline varied between 5 and 107% in the LCHF group. ConclusionsAn LCHF diet for three weeks increased LDL-C with 44% versus controls. The individual response on LCHF varied profoundly.

A Systematic Review of Low-Carbohydrate High-Fat Diets: Does the Research Evidence Support Practice?

A Systematic Review of Low-Carbohydrate High-Fat Diets: Does the Research Evidence Support Practice?

Dietary Therapies: Emerging Paradigms in Therapy of Drug Resistant Epilepsy in Children : Based on 6th Dr. I. C. Verma Excellence in Research Award Oration.

About one-third of childhood epilepsy ultimately becomes drug resistant epilepsy. Only about one-third of drug resistant epilepsy is amenable for epilepsy surgery. Epilepsy surgery and vagal nerve stimulation is still beyond the reach of huge proportion of children with pharmacoresistant epilepsy. Ketogenic diet (KD) has been in use for almost a century now all over the world for drug resistant epilepsy, although in between there was a decline in its popularity with advent of newer antiepileptic drugs like valproate, phenytoin and carbamazepine. Again from 1990s there was resurgence of interest in KD for pharmacoresistant epilepsy and in the last two decades several randomized controlled trials and systemic reviews have proved its efficacy beyond any suspicion. Ketogenic diet is a high fat low carbohydrate and low protein diet, which has been found to reduce epileptogenesis in body most probably by production of ketone bodies. Modified Atkin's Diet (MAD) first introduced in 2003 and Low Glycemic Index Treatment (LGIT) first introduced in 2005 are another two dietary therapies, which are less restrictive, more palatable with fewer adverse effects and comparable efficacy. MAD is also a high fat, low carbohydrate diet, in which high sugar foods are discouraged and protein and fluids are unrestricted. In LGIT, only carbohydrates with Glycemic Index <50 are allowed and carbohydrate intake is restricted to 40-60g per day. Medium Chain Triglyceride KD (MCT KD) is another alternative, in which there are more food choices as compared to classic KD, with comparable efficacy.

The impact of chronic carbohydrate manipulation on mucosal immunity in elite endurance athletes

ABSTRACTCarbohydrate (CHO) availability could alter mucosal immune responses to exercise. This study compared the effect of three dietary approaches to CHO availability on resting and post-exercise s-IgA levels. Elite race walkers (n = 26) adhered to a high CHO diet (HCHO), periodised CHO availability (PCHO) or a low CHO/high fat diet (LCHF) for 3 weeks while completing an intensified training program. HCHO and PCHO groups consumed 8.0–8.5 g.kg−1 CHO daily, with timing of ingestion manipulated to alter CHO availability around key training sessions. The LCHF diet comprised 80% fat and restricted CHO to < 50 g.day−1. A race walk test protocol (19 km females, 25 km males) was completed at baseline, after adaptation, and following CHO restoration. On each occasion, saliva samples were obtained pre- and post-exercise to quantify s-IgA levels. Resting s-IgA secretion rate substantially increased ~ two-fold post-intervention in all groups (HCHO: 2.2 ± 2.2, PCHO: 2.8 ± 3.2, LCHF: 1.6 ± 1.6; fold-change± 95% confidence limits), however, no substantial differences between dietary treatments were evident. Post-exercise, substantial 20–130% increases in s-IgA concentration and 43–64% reductions in flow rate occurred in all dietary treatments, with trivial differences evident between groups. It appears that high volume training overrides any effect of manipulating CHO availability on mucosal immunity in elite athletes.