Low Carbohydrate Intake Research Articles

Effects of Dietary Quality on Vaginal Microbiome Composition Throughout Pregnancy in a Multi-Ethnic Cohort.

Background: Vaginal Lactobacillus predominance is associated with improved vaginal health and reduced pregnancy complications. Little is known about how dietary quality may improve vaginal microbial composition or about dietary interventions that may promote Lactobacillus abundance. To understand the host factors affecting vaginal microbiota during pregnancy in a multi-ethnic cohort in Hawai`i. We hypothesize that better diet quality improves vaginal microbial composition, as represented by Lactobacillus abundance and depletion of anaerobic organisms. Methods: We compared comprehensive diet quality, as measured by the Healthy Eating Index-2015 (HEI-2015), to taxonomic classifications of bacteria present within the vagina. Participants of the four predominant ethnic groups in Hawai'i (Japanese, Filipino, Non-Hispanic White and Native Hawaiian) completed Quantitative Food Frequency Questionnaires (QFFQs) and collected vaginal swabs during each trimester. 16s rRNA amplicon sequencing (V2-V9 regions) was performed on vaginal samples. HEI-2015 scores and macro- and micronutrient intake were compared with the predominant species present using the Mann-Whitney-U test, PERMANOVA, and the Pearson correlation coefficient. A mixed-effects logistics regression model was used to predict the depletion of Lactobacillus species while accounting for confounding demographic factors. Results: Matched, longitudinal data for 40 participants demonstrated three predominant Lactobacillus species: L. crispatus, L. iners, and L. gasseri, with another subset of samples with anaerobic abundance. (Primarily, Atopobium vaginae, Prevotella, and Gardnerella vaginalis.) Non-Hispanic White participants had lower amounts of Lactobacillus iners compared to other racial and ethnic groups. HEI scores correlated with the chao index and observed species number primarily in the first trimester (r = 0.25, p < 0.05). Greater carbohydrate intake was associated with a higher abundance of L. crispatus, while lower carbohydrate intake trended towards more L. iners (0.056) and anaerobic species. Conclusions: Increased carbohydrate consumption and improved diet quality may be associated with beneficial vaginal microbial composition in pregnancy.

12201 Ketogenic-diet As A Trigger Of First Episode Diabetic Ketoacidosis In A Woman Living With Type 1 Diabetes Mellitus

Abstract Disclosure: M.E. Chacon Cruz: None. A.N. Gonzalez Bossolo: None. G.J. Mora Osoria: None. A number of dietary patterns have been proposed as an effective method for weight reduction. A keto diet is a strict low-carbohydrate and high-fat diet. The reduction in carbohydrates enables the body to rely on fat as a predominant energy source leading to a state of ketosis. However, a serious but rare complication of the ketogenic diet is ketoacidosis associated with low carbohydrate intake, which should be cautiously monitored in people with a predisposition to the condition, such patient with diabetes mellitus type 1. We report the case of a female patient living with type 1 diabetes mellitus female who developed her first episodes of diabetic ketoacidosis (DKA) as the following the course of ketogenic diet. A 53 y/o Female patient with past medical history diabetes mellitus type 1 and pernicious anemia went emergency department complaining pelvic pain associated with weakness, nausea and vomiting for about 1 day of evolution. Patient also refers that during the past 2 weeks she has been doing a detox and taking some herbal and tea. Other physical examinations were unremarkable except for moderate dehydration. The initial testing revealed patients meet criteria for severe diabetes ketoacidosis (DKA) with a pH: 7.04, CO2 15, serum central bicarbonate in 6 mmol/L and elevated blood glucose in 504 mg/dl and positive urine and serum ketones, C-Peptide less than 0.02 ng/ml. and glycosylated hemoglobin in 8.25%. She was admitted to the intensive care unit and treated with intravenous saline, intravenous insulin infusion, and electrolyte repletion. Blood glucose levels and metabolic acidosis improved. After DKA resolved patient refers that week started with Keto-diet and was restricting carbohydrates. Patient was discharge home with multiple injection insulin and followed by Endocrinologist services in the external clinic for a follow up. This case illustrates the challenges and the importance of dietary history providing clues to the diagnosis. If we had never asked her about her diet, we would not have found the reason that brought her to the DKA. This case demonstrates the development of DKA following ketogenic diet in a patient with type 1 diabetes. It is important for physicians to be aware of this rare potential complication of ketogenic diet which is infrequently reported in literature. Therefore, physicians should be cognizant of the complications and risks, and benefits of the ketogenic diet. Risks and benefits of the ketogenic diet should be discussed with patients before initiation of this diet. The patient was followed in an outpatient clinic with Endocrinologist service for evaluation for an insulin pump. Presentation: 6/1/2024

Longitudinal comparison of the relationship of energy intake with body composition and physical performance in elite female basketball and volleyball players

Abstract Purpose To maximise sporting success, disciplines such as basketball and volleyball need to improve their methods of analysing the sporting performance and fitness of their athletes. Although energy intake quantities have been established at a theoretical level for women to perform at a sporting level, it has been found that these energy intake levels are not met or followed and that, despite this, the performance of female players is not diminished. Thus, the purpose of this research study was to describe and compare the anthropometric characteristics of these two disciplines and to identify the differences in actual and theoretical energy intake, as well as to observe physical performance in both disciplines. Methods Anthropometric data, continuous quantitative data, training time and characteristics, and energy intake data were collected. Performance tests included upper and lower body strength, speed, agility, and endurance tests. Dietary monitoring showed lower intakes of total energy, carbohydrate and protein than theoretically recommended. However, the athletes experienced overall improvements in performance and body composition. Results The mean total energy intake was 20.2 ± 4.3 kcal·kg−1·day−1. The minimum individual mean intake was 9.8 kcal·kg−1·day−1 and the maximum was 25.95 kcal·kg−1·day−1. Carbohydrates accounted for 54.3% ± 8.8% of the energy intake; 20.3% ± 6.5% from fats; 25.4% ± 5.7% from proteins. Conclusions Current data suggest that, although a cause-effect relationship between dietary intake and BC performance cannot be determined, elite athletes in these sports disciplines may experience beneficial outcomes despite having lower total energy, CHO, protein, and fat intakes than previously recommended in the literature.

A reduced carbohydrate diet improves glycemic regulation in hyperglycemic older people in a retirement home: The SAGE study.

Poor glucose regulation associated with gradual insulin resistance is a significant risk factor in several age-related chronic diseases. An eating plan that promotes a lower carbohydrate intake may have a beneficial effect on glucose metabolism. This study aimed to evaluate how a diet reduced carbohydrate by 32% (RCHO) over a 2-month period would influence the metabolic profile of older individuals (N = 24) living in a retirement home (RH). A continuous glucose monitor was used to measure blood glucose during four periods: the standard diet before (baseline) and after (washout) the intervention, during the 4 initial days of the RCHO diet (RCHO-early), and the final days of the 2-month intervention (RCHO-end). The blood metabolic profile was also measured (glucose, ketones, insulin, triglycerides and cholesterol). RCHO intake decreased average blood glucose compared to the standard diet in hyperglycemic participants: RCHO-early 7.8 ± 1.0 vs 7.5 ± 1.1 mM (p = 0.012) and RCHO-end 7.8 ± 1.0 vs 7.0 ± 0.9 mM (p = 0.050). In the hyperglycemic participants, the percentage of time spent in hyperglycemia (> 10.0 mM) decreased by 50% during the RCHO-early (p = 0.012) and by 66% at RCHO-end (p = 0.021) compared to baseline. Glycated hemoglobin was significantly lower at RCHO-end in both hyperglycemic and normoglycemic participants compared to baseline (p < 0.008). Plasma ketones increased 3-fold in hyperglycemic participants at RCHO-end compared to baseline (p < 0.028). This study shows that an RCHO diet has metabolic health benefits in an older population and confirms its safety, tolerability, and acceptability in a RH. (NCT06022094).

Dietary intake, energy availability, and power in men collegiate gymnasts.

The purpose was to examine the prevalence of low energy availability (LEA), explore dietary behaviors in men collegiate gymnasts (n = 14), and investigate the relationships between energy availability (EA), body composition, and plyometric performance. Body composition was measured using air displacement plethysmography. Lower- and upper-body peak power (PWRpeak) and modified reactive strength index (RSImod) were calculated from countermovement jump (CMJ) and plyometric push-up (PP) assessments. Energy expenditure was tracked over 3 days, while daily energy and macronutrient intake were recorded. EA was calculated and used to categorize athletes into LEA and non-LEA groups. Pearson correlation coefficients were used to examine relationships between EA, body composition, and performance metrics. 85.7% of athletes (n = 12) exhibited LEA (20.98 ± 5.2 kcals/kg FFM), with non-LEA athletes (n = 2) marginally surpassing the <30 kcal/kg of fat-free mass (FFM) threshold (30.58 ± 0.2 kcals/kg FFM). The cohort (n = 14) consumed insufficient energy (30.5 ± 4.5 kcal/kg/day) and carbohydrates (3.7 ± 1.1 g/kg/day), resulting in LEA (22.36 ± 5.9 kcal/kg/FFM). EA was not correlated with body composition or performance metrics. A high prevalence of LEA may exist in men gymnasts, largely due to a low relative energy and carbohydrate intake.

Dietary Macronutrient and Micronutrient Intake Among Corporate Employees Aged 30 to 40 Years Residing in Mumbai, India

The rising burden of non-communicable diseases (NCDs) in India necessitates more studies on nutritional intake and dietary behaviour. While data exists on low-income groups, rural populations and the population at large, limited information exists on that of urban, working professionals – a demographic that has the means and access to make informed choices, and yet, have a disproportionately high risk of NCDs. The aim of this study was to investigate nutrient intake in Indian professionals. A cross-sectional study was conducted on 214 working professionals (aged 30-40 years; 69 females and 145 males) in Mumbai. Habitual food intake was investigated by two 24-hour recalls and a semi-quantitative food frequency questionnaire. Nutrient adequacy ratios were calculated in comparison to Indian estimated average requirements. Compared to recommendations, a lower total energy and carbohydrate intake, while a higher protein and fat intake was observed among the participants. However, the intake of omega-3 fats, and overall fruit and vegetable intake was poor. A significantly higher energy from proteins and fats was observed among non-vegetarians, while vegetarians consumed more energy from carbohydrates. Insufficient intake of vitamins and minerals was prevalent with over 50% of study participants consuming &lt;50% of their required intake of Vitamin A, B12, folate, riboflavin, zinc and potassium. Intake of copper, pyridoxine and iron were also suboptimal. To conclude, the insufficient intake of micronutrient and macronutrient imbalances in the studied population, highlights the urgency of targeted nutritional interventions and education in urban, corporate populations in India, to mitigate the risk of NCDs.

Impact of a ketogenic diet on intestinal microbiota, cardiometabolic, and glycemic control parameters in patients with Type 2 diabetes mellitus.

Abstract. A ketogenic diet (KD), characterized by high fat and low carbo-hydrate intake, has been proposed as a therapeutic option for Type 2 Diabetes Mellitus (T2DM). One hundred individuals with T2DM were selected and divid-ed into a control group (CG) and an observation (OG) group, with 50 patients in each group, to investigate the effects of a KD on the intestinal flora, Gluca-gon Like Peptide-1 (GLP-1), and HbA1c levels in T2DM patients. Individuals in the CG were given standard treatment and diet, while patients in the OG were given a KD based on the CG. The blood glucose index, blood lipid index, HbA1c, GLP-1 levels, physical examination, and intestinal flora were compared in both groups. The FPG, HbA1c, two h PG, HOMA-IR TG, TC, and LDL -C levels in the two groups were reduced when compared to those before treatment (p&lt;0.05), and the decreases in the OG were more significant than in the CG (p&lt;0.05), while the levels of GLP-1 in the two groups were increased compared to those before treatment, those in the OG were significantly increased when compared to the CG (p&lt;0.05). After treatment, waist circumference, BMI, body mass, and the levels of Enterococcus faecalis (E. faecalis) and Escherichia coli (E. coli) of the two groups were reduced compared to indicators before treatment (p&lt;0.05), and those in the OG were even lower than those in the CG (p&lt;0.05). In conclusion, these findings underscore the KD’s potential to act as an effica-cious dietary strategy in managing T2DM.

Effect of Low vs. High Carbohydrate Intake after Glycogen-Depleting Workout on Subsequent 1500 m Run Performance in High-Level Runners.

Carbohydrate (CHO) metabolism is crucial for short-duration, high-intensity exercise performance, but the effects of variations in glycogen availability have not been investigated in field trials of trained athletes. This study was designed to test how 1500 m time trial (TT) performance is affected by the manipulation of pre-race glycogen reserves. Competitive middle-distance runners (n = 11 (4 females)) completed a 1500 m individually paced indoor TT after abundant (high, >5 g/kg/d) or restricted (low, <1.5 g/kg/d) dietary CHO intake for 2 days after a glycogen-depleting session. Stride pattern, heart rate (HR), capillary blood lactate, and glucose and plasma malondialdehyde (MDA) response were determined. The TT was slower in low vs. high condition by 4.5 (4.5) s (~2%; p < 0.01), with a tendency toward shorter stride length. Blood lactate and glucose were lower before the TT in low vs. high condition (1.8 (0.5) vs. 2.2 (0.7) mmol/L and 5.4 (0.7) vs. 5.9 (0.8) mmol/L, p = 0.022 and 0.007, respectively), and peak lactate was higher in high vs. low condition (16.8 (3.1) vs. 14.5 (4.2) mmol/L, p = 0.039). Plasma MDA was the same before the TT, and 15 min after the TT, it increased similarly by 15% in low (p = 0.032) and high (p = 0.005) conditions. The restriction of pre-test CHO intake impaired 1500 m TT performance and reduced baseline and peak blood lactate concentrations but not blood glucose or MDA response.

Exploring the ketogenic diet's potential in reducing neuroinflammation and modulating immune responses.

The ketogenic diet (KD) is marked by a substantial decrease in carbohydrate intake and an elevated consumption of fats and proteins, leading to a metabolic state referred to as "ketosis," where fats become the primary source of energy. Recent research has underscored the potential advantages of the KD in mitigating the risk of various illnesses, including type 2 diabetes, hyperlipidemia, heart disease, and cancer. The macronutrient distribution in the KD typically entails high lipid intake, moderate protein consumption, and low carbohydrate intake. Restricting carbohydrates to below 50 g/day induces a catabolic state, prompting metabolic alterations such as gluconeogenesis and ketogenesis. Ketogenesis diminishes fat and glucose accumulation as energy reserves, stimulating the production of fatty acids. Neurodegenerative diseases, encompassing Alzheimer's disease, Parkinson's disease are hallmarked by persistent neuroinflammation. Evolving evidence indicates that immune activation and neuroinflammation play a significant role in the pathogenesis of these diseases. The protective effects of the KD are linked to the generation of ketone bodies (KB), which play a pivotal role in this dietary protocol. Considering these findings, this narrative review seeks to delve into the potential effects of the KD in neuroinflammation by modulating the immune response. Grasping the immunomodulatory effects of the KD on the central nervous system could offer valuable insights into innovative therapeutic approaches for these incapacitating conditions.

Efficacy of anti-seizure medications and alternative therapies (ketogenic diet, CBD, and quinidine) in KCNT1-related epilepsy: A systematic review.

KCNT1-related epilepsies encompass three main phenotypes: (i) epilepsy of infancy with migrating focal seizures (EIMFS), (ii) autosomal dominant or sporadic sleep-related hypermotor epilepsy [(AD)SHE], and (iii) different types of developmental and epileptic encephalopathies (DEE). Many patients present with drug-resistant seizures and global developmental delays. In addition to conventional anti-seizure medications (ASM), multiple alternative therapies have been tested including the ketogenic diet (KD), cannabidiol (CBD-including Epidyolex © and other CBD derivatives) and quinidine (QUIN). We aimed to clarify the current state of the art concerning the benefits of those therapies administered to the three groups of patients. We performed a literature review on PubMed and EMBase with the keyword "KCNT1" and selected articles reporting qualitative and/or quantitative information on responses to these treatments. A treatment was considered beneficial if it improved seizure frequency and/or intensity and/or quality of life. Patients were grouped by phenotype. A total of 43 studies including 197 patients were reviewed. For EIMFS patients (32 studies, 135 patients), KD resulted in benefit in 62.5% (25/40), all types of CBD resulted in benefit in 50% (6/12), and QUIN resulted in benefit in 44.6% (25/56). For (AD)SHE patients (10 studies, 32 patients), we found only one report of treatment with KD, with no benefit noted. QUIN was trialed in 8 patients with no reported benefit. For DEE patients (10 studies, 30 patients), KD resulted in benefit for 4/7, CBD for 1/2, and QUIN for 6/9. In all groups, conventional ASM are rarely reported as beneficial (in 5%-25% of patients). Ketogenic diet, CBD, and QUIN treatments appear to be beneficial in a subset of patient with drug-resistant epilepsy. The KD and CBD are reasonable to trial in patients with KCNT1-related epilepsy. Further studies are needed to identify optimal treatment strategies and to establish predictive response factors. We performed an extensive review of scientific articles providing information about the therapeutic management of epilepsy in patients with epilepsy linked to a mutation in the KCNT1 gene. Conventional anti-seizure treatments were rarely reported to be beneficial. The ketogenic diet (a medical diet with very high fat, adequate protein and very low carbohydrate intake) and cannabidiol appeared to be useful, but larger studies are needed to reach a conclusion.

Ketogenic Diet and Its Potential Role in Preventing Type 2 Diabetes Mellitus and Its Complications: A Narrative Review of Randomized Controlled Trials.

Diabetes mellitus is a global health crisis affecting millions. Nutrition plays a vital role in its management and prevention. While carbohydrate reduction is beneficial for glycemic control, various dietary approaches exist. The ketogenic diet, characterized by very low carbohydrate intake, has shown promise in weight management and blood sugar control. However, its potential for preventing type 2 diabetes mellitus (T2DM) remains largely unexplored. To evaluate the ketogenic diet's potential in preventing T2DM, this review searched the PubMed database for studies published between 2013 and 2023. Findings suggest that the diet can effectively aid weight loss and improve blood glucose levels. Some evidence indicates reduced reliance on diabetes medications. However, effects on cholesterol levels are inconsistent, and long-term adherence challenges exist. Additionally, potential micronutrient deficiencies and safety concerns require careful consideration. While the ketogenic diet offers potential benefits, further research is needed to establish its efficacy and safety as a long-term prevention strategy for T2DM. However, the results of the present study indicate the need for further research in this area, utilizing rigorous methodology.

A Mobile-Based Nutrition Tracker App Enhanced Dietitian-Guided 2:1:1 Diet-Induced Weight Loss: An 8-Week Retrospective Cohort Study in Taiwan.

Effective weight management interventions involve a combination of behavioral strategies focusing on dietary changes. Tracing the change through mobile apps has been proven to be a valuable platform for facilitating weight management in many countries. However, the effectiveness of mobile app-based dietary intervention on weight management in Taiwan remains to be determined. By using the designated mobile app, this study aimed to assess the efficacy of the diet intervention, which is based on a 2:1:1 portion control plate and a flexible low-carbohydrate (FLC) diet. This 8-week retrospective cohort study involved 10,297 participants who were divided into two groups: the intervention group (joined an 8-week diet intervention program with the daily diet record assessed by registered dietitians) and the control group (voluntarily using the app without instructional materials or coaching). After eight weeks of intervention, the intervention group showed a higher weight loss percentage (-4.78% vs. -1.54%), body mass index (BMI) (-1.26 kg/m2 vs. 0.69 kg/m2), and diet record completeness (73.52% vs. 28.91%) compared with the control group. With respect to gender, male participants showed higher baseline weight and higher weight loss (-6.02%) in the intervention group. In the intervention group, 2871 participants (33.4%) lost less than 4% of their weight, 5071 participants (58.9%) lost 4-8% of their body weight, and 662 participants (7.7%) lost >8% of their weight. Compared to the low-effectiveness group (weight lost <4%), the high-effectiveness group (weight lost >8%) had a significantly higher diet record completeness (91.61 ± 15.99 vs. 55.81 ± 32.92), dietary compliance (green light %) (88.93 ± 9.9 vs. 77.75 ±17.5), protein intake % (26.34 ± 2.85 vs. 23.49 ± 3.56), and fat intake % (49.66 ± 6.36 vs. 44.05 ± 7.37). Most importantly, the high-effectiveness group had a lower carbohydrate intake % (24.1 ± 7.86 vs. 32.46 ± 9.61). The results remained significant after being stratified by gender. This study found that the use of online applications plus the intervention of dietitians is beneficial for short-term weight loss. The composition of nutrients and dietary compliance also significantly impacted weight loss.

Dietary patterns to promote cardiometabolic health.

Multiple professional societies recommend the Mediterranean and/or Dietary Approaches to Stop Hypertension dietary patterns in their cardiovascular disease prevention guidelines because these diets can improve cardiometabolic health and reduce the risk of cardiovascular events. Furthermore, low sodium intake can be particularly beneficial for patients with hypertension. Carbohydrate restriction, with an emphasis on including high-quality carbohydrates and limiting refined starches and foods and beverages with added sugars, can promote weight loss and cardiometabolic benefits in the short term, compared with higher carbohydrate intake. Evidence is lacking for sustained, long-term effects of low carbohydrate and very low carbohydrate intake on cardiometabolic risk and cardiovascular outcomes. Time-restricted eating, in the context of an overall healthy dietary pattern, can promote cardiometabolic health by aligning food intake with the circadian rhythm, although its effect on hard clinical outcomes remains to be proven. Although there is no one dietary pattern that is appropriate for all patients, engaging in shared decision-making with patients, utilizing behaviour-change principles and engaging members of the health-care team, such as registered dietitian nutritionists, can lead to substantial improvement in the lifestyle and overall health trajectory of a patient. Emphasizing the similarities, rather than differences, of recommended dietary patterns, which include an emphasis on vegetables, fruits, legumes, nuts, whole grains and minimally processed protein foods, such as fatty fish or plant-based proteins, can simplify the process for both patients and clinicians alike.

Eating habits in recreational athletes

Aim: Physical activity (PA) is an important factor in maintaining health, and combined with a balanced diet, it forms the basis of a healthy lifestyle. A diet not aligned with proper nutritional guidelines and the intensity of PA can affect the body's functioning, hinder recovery after training, and increase the risk of injury. This study examines the PA among recreational athletes and explores their eating habits. Methods: An observational study was conducted using Metabolic Equivalent Task (MET) minutes/week to determine the level of PA. Dietary data were collected using a Food Frequency Questionnaire (FFQ). Results: The study involved 62 respondents, categorized into groups of moderately, intensively, and very intensively active recreational athletes and despite recognizing the importance of PA recreational athletes exhibited inadequate dietary habits. Higher intake of fats, cholesterol, and saturated fatty acids was observed, as well as lower intake of carbohydrates than recommended. Most vitamins and some mineral intakes exceeded recommendations. Significant differences between groups were noted only for folate and saturated fatty acid intake. Conclusion: Nutritional education by professional nutritionists is essential for recreational athletes to correct improper eating habits. The findings of this study can be applied in similar socioeconomic-cultural regions.

Higher fibre and lower carbohydrate intake are associated with favourable CGM metrics in a cross-sectional cohort of 470 individuals with type 1 diabetes

Aims/hypothesisThe aim of this work was to investigate the association between macronutrient intakes and continuous glucose monitoring (CGM) metrics in individuals with type 1 diabetes.MethodsIn 470 individuals with type 1 diabetes of the GUTDM1 cohort (65% female, median age 40 [IQR 28–53] years, median diabetes duration 15 [IQR 6–29] years), we used logistic regression to establish associations between macronutrient intakes and the CGM metrics time in range (TIR, time spent between 3.9–10.0 mmol/l blood glucose, optimally set at ≥70%) and time below range (TBR, <3.9 mmol/l blood glucose, optimally set at <4%). ORs were expressed per 1 SD intake of nutrient and were adjusted for other macronutrient intakes, age, sex, socioeconomic status, BMI, duration of type 1 diabetes, pump use, insulin dose and alcohol intake.ResultsThe median (IQR) TIR was 67 (51–80)% and TBR was 2 (1–4)%; the mean ± SD energy intake was 6879±2001 kJ, fat intake 75±31 g, carbohydrate intake 162±63 g, fibre intake 20±9 g and protein intake 70±24 g. A higher fibre intake and a lower carbohydrate intake were associated with higher odds of having a TIR≥70% (OR [95% CI] 1.64 [1.22, 2.24] and 0.67 [0.51, 0.87], respectively), whereas solely a higher carbohydrate intake was associated with TBR<4% (OR 1.34 [95% CI 1.02, 1.78]).Conclusions/interpretationA higher fibre intake is independently associated with a higher TIR. A higher carbohydrate intake is associated with less time spent in hypoglycaemia, a lower TIR and a higher time above range. These findings warrant confirmatory (interventional) investigations and may impact current nutritional guidelines for type 1 diabetes.Graphical

Measurement ofenergy availability in highly trained male endurance athletes and examination of its associations with bone health and endocrine function.

Despite the introduction of Relative Energy Deficiency in Sport (RED-s) in 2014, there is evidence to suggest that male endurance athletes still present with a high prevalence of low energy availability (LEA). Previous findings suggest that energy availability (EA) status is strongly correlated with impairments in endocrine function such as reduced leptin, triiodothyronine (T3), and insulin, and elevated bone loss. This study aimed to report the current EA status, endocrine function and bone health of highly trained Irish male endurance athletes. In this cross-sectional study, participants (n = 3 triathletes; n = 10 runners) completed a 7-day testing period during the competition season using lab-based measures, to ascertain EA status, hormone level and rates of bone metabolism. Serum blood samples were obtained to assess hormone levels and markers of bone metabolism. Mean EA was < 30kcal/kg lean body mass (LBM)/day in 76.9% of athletes. There was a strong association between LEA and low carbohydrate intake, and lower LBM. Mean levels of insulin, IGF-1 and leptin were significantly lower than their reference ranges. Elevated mean concentrations of β-CTX and a mean P1NP: β-CTX ratio < 100, indicated a state of bone resorption. The EA level, carbohydrate intake, hormone status and bone metabolism status of highly trained male endurance athletes are a concern. Based on the findings of this study, more frequent assessment of EA across a season is recommended to monitor the status of male endurance athletes, in conjunction with nutritional education specific to EA and the associated risks.

Effect of a Mediterranean Dietary Pattern Providing Higher or Lower Carbohydrate Intake on Physical Performance and Biochemical Markers in Non-professional Athletes

Effect of a Mediterranean Dietary Pattern Providing Higher or Lower Carbohydrate Intake on Physical Performance and Biochemical Markers in Non-professional Athletes

Can the ketogenic diet improve the hamstring muscle rupture? A narrative review

The ketogenic diet has garnered significant attention for its potential benefits in various health areas, including weight loss, neurological conditions, and metabolic diseases. Characterized by high fat, moderate protein, and low carbohydrate intake, the ketogenic diet induces a state of ketosis, where the body shifts its primary energy source from glucose to ketones derived from fat. This metabolic shift leads to numerous physiological changes, some of which may benefit muscle health and recovery. Hamstring muscle ruptures, common among athletes and physically active individuals, require a combination of rest, physical therapy, and nutritional interventions to reduce inflammation, promote muscle repair, and enhance overall recovery outcomes. Given the known anti-inflammatory and muscle-sparing effects of the ketogenic diet, there is growing interest in exploring its potential role in the recovery of hamstring muscle ruptures. The primary objective of this research is to investigate and potentially validate the ketogenic diet's potential benefits in improving hamstring muscle rupture recovery. This article will explore the underlying mechanisms through which the ketogenic diet may influence muscle healing, review existing studies and clinical evidence, and discuss the potential benefits and challenges of integrating the ketogenic diet into rehabilitation protocols for muscle injuries.

Beta-Hydroxybutyrate Promotes Basal Insulin Secretion While Decreasing Glucagon Secretion in Mouse and Human Islets.

Dietary carbohydrates raise blood glucose levels, and limiting carbohydrate intake improves glycemia in patients with type 2 diabetes. Low carbohydrate intake (< 25 g) allows the body to utilize fat as its primary fuel. As a consequence of increased fatty acid oxidation, the liver produces ketones to serve as an alternative energy source. β-Hydroxybutyrate (βHB) is the most abundant ketone. While βHB has a wide range of functions outside of the pancreas, its direct effects on islet cell function remain understudied. We examined human islet secretory response to acute racemic βHB treatment and observed increased insulin secretion at a low glucose concentration of 3 mM. Because βHB is a chiral molecule, existing as both R and S forms, we further studied insulin and glucagon secretion following acute treatment with individual βHB enantiomers in human and C57BL/6J mouse islets. We found that acute treatment with R-βHB increased insulin secretion and decreased glucagon secretion at physiological glucose concentrations in both human and mouse islets. Proteomic analysis of human islets treated with R-βHB over 72 hours showed altered abundance of proteins that may promote islet cell health and survival. Collectively, our data show that physiological concentrations of βHB influence hormone secretion and signaling within pancreatic islets.

Daily standing time, dietary fiber, and intake of unsaturated fatty acids are beneficially associated with hepatic insulin sensitivity in adults with metabolic syndrome.

Obesity is associated with impaired glucose metabolism and hepatic insulin resistance. The aim was to investigate the associations of hepatic glucose uptake (HGU) and endogenous glucose production (EGP) to sedentary behavior (SB), physical activity (PA), cardiorespiratory fitness, dietary factors, and metabolic risk markers. Forty-four adults with metabolic syndrome (mean age 58 [SD 7] years, BMI ranging from 25-40kg/; 25 females) were included. HGU was measured by positron emission tomography during the hyperinsulinemic-euglycemic clamp. EGP was calculated by subtracting the glucose infusion rate during clamp from the glucose rate of disappearance. SB and PA were measured with hip-worn accelerometers (26 [SD3] days). Fitness was assessed by maximal bicycle ergometry with respiratory gas measurements and dietary intake of nutrients by 4-day food diaries. HGU was not associated with fitness or any of the SB or PA measures. When adjusted for sex, age, and body fat-%, HGU was associated with whole-body insulin sensitivity (β=0.58), water-insoluble dietary fiber (β=0.29), energy percent (E%) of carbohydrates (β=-0.32), saccharose (β=-0.32), mono- and polyunsaturated fatty acids (β=0.35, β=0.41, respectively). EGP was associated with whole-body insulin sensitivity (β=-0.53), and low-density lipoprotein cholesterol [β=-0.31], and when further adjusted for accelerometry wear time, EGP was associated with standing [β=-0.43]. (p-value for all< 0.05). Standing more, consuming a diet rich in fiber and unsaturated fatty acids, and a lower intake of carbohydrates, especially sugar, associate beneficially with hepatic insulin sensitivity. Habitual SB, PA, or fitness may not be the primary modulators of HGU and EGP. However, these associations need to be confirmed with intervention studies.