Months Of Diet Research Articles

Disparities between rural and urban communities: Response to 18-months of diet and exercise versus control for knee osteoarthritis and overweight or obesity.

The study objective was to determine whether the clinical response of older adults with knee osteoarthritis and overweight or obesity to 18 months of diet and exercise or attention control interventions differed between participants from rural versus urban communities. Participants were 823 older adults (mean age, 64.6 years; 77% women) with knee osteoarthritis, overweight or obesity, who resided in rural (N = 410) and urban (N = 413) counties in North Carolina. All were enrolled in the WE-CAN clinical trial that randomly assigned participants to either 18-months of diet and exercise (D+E) or attention control (C) interventions. General linear models were used to examine differences in clinical outcomes between rural and urban groups after adjusting for covariates. The rural group had significant differences (P<.05) at baseline in clinical outcomes, education, comorbidities, medication use, and income compared to the urban dwellers. After adjusting for baseline differences, the group (rural, urban) by treatment (D+E, C) interactions for WOMAC pain (rural: D+E-C= -0.63,95%CI,-1.31 to 0.06; urban: D+E-C= -0.29,95%CI,-0.99 to 0.41;P=.50) and WOMAC function (rural: D+E-C = -4.60,95%CI,-6.89 to -2.31; urban: D+E-C = -1.38,95%CI,-3.73 to 0.94;P=.054) indicated that the groups responded similarly to the interventions. Among participants with knee osteoarthritis and overweight or obesity, diet and exercise compared to attention control led to similar pain outcomes in rural and urban dwellers that favored diet and exercise; the possibility there may be greater differential efficacy in functional outcomes among rural participants needs further study.

Okinawa-Based Nordic Diet Decreases Plasma Levels of IAPP and IgA against IAPP Oligomers in Type 2 Diabetes Patients.

Pancreas-derived islet amyloid polypeptide (IAPP) aggregates and deposits in the pancreas and periphery of Type 2 Diabetes (T2D) patients, contributing to diabetic complications. The excess IAPP can be removed by autoantibodies, and increased levels of immunoglobulin (Ig) G against IAPP have been reported in T2D patients. However, whether other Ig classes are also affected and if the levels can be managed is less known. This pre-post study examines IgA levels against IAPP oligomers (IAPPO-IgA) in T2D patients and assesses the impact of the Okinawa-based Nordic (O-BN) diet-a low-carbohydrate, high-fiber diet-on these levels after following the diet for 3 months. IAPP, IAPPO-IgA, and total IgA levels were measured in plasma and fecal samples from n = 30 T2D patients collected at baseline, after 3 months of diet, and after additional 4 months of unrestricted diets (a clinical follow-up). The IAPP and IAPPO-IgA levels were significantly lower after 3 months, with the latter also being significantly reduced at the clinical follow-up. The reduction in plasma IAPP and IAPPO-IgA levels correlated with reductions in plasma levels of metabolic and inflammatory markers. Hence, following the O-BN diet for at least 3 months is sufficient to reduce circulating IAPP and IAPPO-IgA levels, which may be principal in managing T2D.

Antisense oligonucleotide targeting hepatic Serum Amyloid A limits the progression of angiotensin II-induced abdominal aortic aneurysm formation

Background and aimsObesity increases the risk for abdominal aortic aneurysms (AAA) in humans and enhances angiotensin II (AngII)-induced AAA formation in C57BL/6 mice. We reported that deficiency of Serum Amyloid A (SAA) significantly reduces AngII-induced inflammation and AAA in both hyperlipidemic apoE-deficient and obese C57BL/6 mice. The aim of this study is to investigate whether SAA plays a role in the progression of early AAA in obese C57BL/6 mice. MethodsMale C57BL/6J mice were fed a high-fat diet (60% kcal as fat) throughout the study. After 4 months of diet, the mice were infused with AngII until the end of the study. Mice with at least a 25% increase in the luminal diameter of the abdominal aorta after 4 weeks of AngII infusion were stratified into 2 groups. The first group received a control antisense oligonucleotide (Ctr ASO), and the second group received ASO that suppresses SAA (SAA-ASO) until the end of the study. ResultsPlasma SAA levels were significantly reduced by the SAA ASO treatment. While mice that received the control ASO had continued aortic dilation throughout the AngII infusion periods, the mice that received SAA-ASO had a significant reduction in the progression of aortic dilation, which was associated with significant reductions in matrix metalloprotease activities, decreased macrophage infiltration and decreased elastin breaks in the abdominal aortas. ConclusionsWe demonstrate for the first time that suppression of SAA protects obese C57BL/6 mice from the progression of AngII-induced AAA. Suppression of SAA may be a therapeutic approach to limit AAA progression.

Intestinal Pgc1α ablation protects from liver steatosis and fibrosis

The gut-liver axis modulates the progression of metabolic dysfunction-associated steatotic liver disease (MASLD), a spectrum of conditions characterised by hepatic steatosis and a progressive increase of inflammation and fibrosis, culminating in metabolic dysfunction-associated steatohepatitis. Peroxisome proliferator-activated receptor-gamma coactivator 1α (Pgc1α) is a transcriptional co-regulator of mitochondrial activity and lipid metabolism. Here, the intestinal-specific role of Pgc1α was analysed in liver steatosis and fibrosis. We used a mouse model in which Pgc1α was selectively deleted from the intestinal epithelium. We fed these mice and their wild-type littermates a Western diet to recapitulate the major features of liver steatosis (after 2 months of diet) and metabolic dysfunction-associated steatohepatitis (after 4 months of diet). The chow diet was administered as a control diet. In humans and mice, low expression of intestinal Pgc1α is inversely associated with liver steatosis, inflammation, and fibrosis. Intestinal disruption of Pgc1α impairs the transcription of a wide number of genes, including the cholesterol transporter Niemann-Pick C1-like 1 (Npc1l1), thus limiting the uptake of cholesterol from the gut. This results in a lower cholesterol accretion in the liver and a decreased production of new fatty acids, which protect the liver from lipotoxic lipid species accumulation, inflammation, and related fibrotic processes. In humans and mice, intestinal Pgc1α induction during Western diet may be another culprit driving hepatic steatosis and fibrosis. Here, we show that enterocyte-specific Pgc1α ablation protects the liver from steatosis and fibrosis by reducing intestinal cholesterol absorption, with subsequent decrease of cholesterol and de novo fatty acid accumulation in the liver. Liver diseases result from several insults, including signals from the gut. Although the incidence of liver diseases is continuously increasing worldwide, effective drug therapy is still lacking. Here, we showed that the modulation of an intestinal coactivator regulates the liver response to a Western diet, by limiting the uptake of dietary cholesterol. This results in a loweraccumulation of hepatic lipids together with decreased inflammation and fibrosis, thus limiting the progression of liver steatosis and fibrosis towards severe end-stage diseases.

#5541 EVALUATION OF PROTEIN MALNUTRITION IN CKD PATIENTS ON LOW-PROTEIN DIET

Abstract Background and Aims Low-protein diet is considered crucial in patients with chronic kidney disease to slow down kidney function deterioration and control metabolic variables such as serum phosphate, urea and bicarbonate. However, low-protein diet may result in malnutrition if patients do not respect nutritional prescription. Thus, the present study examined the risk of protein malnutrition in CKD patients who started a low-protein diet. Method We analysed anthropometric variables, nutrient intake and body composition in 27 patients with CKD stage 4-5 (M/F 15/12; 69±15 years; 72±18 kg; BMI 27.3±7 kg/m2; serum creatinine 4.9±1.9 mg/dl; GFR 11±4 ml/min; 10 diabetic patients) before and after 3-months of low-protein diet (0.6 g/kg). We estimated nutrient intake with a food frequency questionnaire composed of 37 items and administered by a nutritionist who also prescribed the low-protein diet. We also measured body fat mass (FM) and free-fat mass (FFM) and appendicular skeletal muscle mass using bioimpedentiometry analysis (Akern, Florence). Patients having a protein intake lower than 0.6 g/kg at the nutritional survey was defined as malnourished. Results In the whole sample, after a 3-month diet protein intake decreased from 0.87±0.23 to 0.69±0.18 g/kg (p&amp;lt;0.001; Wilcoxon test). Protein intake was positively correlated with 24-h urine excretion of phosphate at baseline (r = 0.69, p = 0.012) and after 3-monts of diet (r = 0.62, p = 0.02). The diet induced a decrease in body weight (72±18 to 70±17 kg; p = 0.001), BMI (27.3±7 to 26.7±6.8 kg/m2; p = 0.001), FM (24±11 to 21±11 kg; p = 0.006), serum phosphate (1.68±0.33 to 1.52±0.32 mmol/l; p = 0.033) and urea (166±53 to 133±42 mg/dl; p&amp;lt;0.001), whereas FFM, expressed as percentage of body weight, significantly increased (69±9 to 73±8%; p = 0.011). Six patients (22%; 3 diabetic patients) had a protein intake lower than 0.6 g/kg after 3-months of diet. Their protein intake was significantly lower than that in the other 21 patients with protein intake above 0.6 g/kg (0.43±0.1 vs 0.77±0.12 g/kg; p&amp;lt;0.001). These patients had lower FM (14±2 vs 26±11 kg; p = 0.03) and protein intake before starting the low-protein diet than the other 21 patients (0.64±0.06 vs 0.94±21 g/kg; p = 0.003). Patients with protein intake lower than 0.6 g/kg slightly decreased FFM after 3 months of diet compared to the value at baseline (52±7 to 50±7 kg; p = 0.07); conversely the other 21 patients did not change FFM (51±10 to 53±11 kg; p = 0.17), but significantly decreased FM (26±11 to 23±12 kg; p&amp;lt;0.001). Conclusion In conclusion, protein malnutrition may occur during a low-protein diet in CKD patients with a low consumption of proteins before starting this diet. Nutritional analysis is necessary to identify CKD patients at risk of protein malnutrition and to adequately follow up CKD patients on low protein diet.

The Replacement of Only One Portion of Starchy Carbohydrates with Green Leafy Vegetables Regresses Mid and Advanced Stages of NAFLD: Results from a Prospective Pilot Study.

The gold standard treatment for NAFLD is weight loss and lifestyle interventions, which require a diet enriched in fiber and reduced in sugars and saturated fats. Fibres may be advantageous for NAFLD patients since they reduce and slow the absorption of carbohydrates, lipids, and proteins, lowering the energy density of the meal and increasing their sense of satiety. Furthermore, the polyphenol content and other bioactive compounds of vegetables have antioxidant and anti-inflammatory properties preventing disease progression. The aim of this study is to ascertain the effects of a diet enriched by green leafy vegetables and with a moderate restriction of carbohydrate intake in patients with NAFLD over a three month period. Among the forty patients screened, twenty four patients completed the clinical trial consisting of swapping one portion of carbohydrate-rich food for one portion of green leafy vegetables, and liver and metabolic markers of NAFLD were evaluated. All patients underwent routine blood tests, anthropometric measurements, bioelectrical impedance analysis, fibroscan, and fatty liver index (FLI) evaluation before and at the end of the study. The population under study (n = 24) had a median age of 47.5 (41.5-52.5) years and included mainly women (70.8%). We found that FLI, which is used to predict fatty liver (73 (33-89) vs. 85 (54-95), p < 0.0001) and the FAST score, which is a fibroscan-derived parameter identifying patients at risk of progressive NASH (0.03 (0.02-0.09) vs. 0.05 (0.02-0.15), p = 0.007), were both improved after changes in diet. The BMI (33.3 (28.6-37.3) vs. 35.3 (31.2-39.0), p < 0.0001), WC (106.5 (95.0-112.5) vs. 110.0 (103.0-124.0), p < 0.0001), neck circumference (38.0 (35.0-41.5) vs. 39.5 (38.0-42.5), p < 0.0001), fat mass (32.3 (23.4-40.7) vs. 37.9 (27.7-43.5), p < 0.0001), and extracellular water (17.3 (15.2-20.8) vs. 18.3 (15.9-22.7), p = 0.03) were also all significantly lower after three months of diet. Metabolic parameters linked to NAFLD decreased: HbA1c (36.0 (33.5-39.0) vs. 38.0 (34.0-40.5), p = 0.01), triglycerides (72 (62-90) vs. 90 (64-132), p = 0.03), and the liver markers AST (17 (14-19) vs. 18 (15-27), p = 0.01) and γGT (16 (13-20) vs. 16 (14-27), p = 0.02). In conclusion, replacing only one portion of starchy carbohydrates with one portion of vegetables for a three month period is sufficient to regress, at least in part, both mid and advanced stages of NAFLD. This moderate adjustment of lifestyle habits is easily achievable.

Combination of a Glucagon-Like Peptide 1 Analog and a Sodium-Glucose Cotransporter 2 Inhibitor Improves Lipid Metabolism Compared to the Monotherapies in Experimental Metabolic Syndrome

Background: Obesity is a risk factor for insulin resistance, dyslipidemia, fatty liver disease, and all disorders associated with metabolic syndrome. Here we evaluated the association of the glucagon-like peptide 1 (GLP-1) analog, liraglutide, and the sodium-glucose cotransporter-2 (SGLT-2) inhibitor, canagliflozin, on the improvement of metabolic syndrome symptoms in a high-fat diet (HFD)-induced obesity rat model. Methods: Male Wistar rats received either a control diet or HFD ad libitum for 5 months. After 4 months of diet, HFD rats were randomly divided into four experimental groups (HFD, HFD + liraglutide, HFD + canagliflozin, and HFD + liraglutide + canagliflozin). Treatment groups received liraglutide (100 µg/kg) and/or canagliflozin (10 mg/kg) once daily for one month. Body mass and food intake were monitored throughout the experiment. An oral glucose tolerance test, biochemical parameters, epididymal and liver fat, and adipocyte morphology were assessed after the treatment period. Results: Rats on the HFD developed obesity, glucose intolerance, dyslipidemia, and fatty liver. Liraglutide reduced food intake and body weight, normalized the lipid profile, and reduced abdominal and liver fat. Canagliflozin slightly reduced body mass and improved glucose tolerance and dyslipidemia. The combination therapy was more effective than the monotherapies in normalizing the lipid profile. Conclusions: The combination of liraglutide and canagliflozin was more effective than the monotherapies in improving dyslipidemia and liver fat. These results indicate that the combination of GLP-1 receptor agonists and SGLT-2 inhibitors is a promising therapeutic strategy to treat dyslipidemia, and possibly prevent fatty liver disease in metabolic syndrome and obese patients. J Endocrinol Metab. 2022;12(6):168-177 doi: https://doi.org/10.14740/jem843

The effects of intermittent fasting on nighttime blood pressure levels

Hypertension, a preventable disease with a high prevalence, is frequently seen in obese patients with cardiovascular risk factors. Our study aimed to investigate the effect of an intermittent fasting regimen on nighttime blood pressure levels. Patients who applied to Karabuk University Faculty of Medicine Training and Research Hospital Cardiology and Family Medicine Polyclinic between January and March 2021 and were followed up for 24 hours on an outpatient basis were included in this self-controlled interventional study. Patients underwent a second 24-hour Holter blood pressure follow-up after one month of diet, and the results were compared. The study was conducted with 30 subjects who adhered to a one-month intermittent fasting regimen. 63.3% of the patients were male, and the mean age was 54.60 ± 9.71 years. One month later, 13 patients whose nighttime blood pressure improved were assigned to Group 1 and 17 patients to Group 2. There was no important variance between the groups in terms of gender, age, height, waist circumference and BMI (p=0.609, p=0.105 and p=0.087, in order of). Mean VA and BSA were considerably lower in Group 2 (p=0.027 and p=0.045, in order of). HT duration was longer in Group 1 (p=0.001). There was no important variance between the groups in terms of smoking, alcohol use, average daily sleep time, salt intake awareness and exercise habits. The rate of snacking habits in Group 2 was statistically considerably higher (p=0.033). Intermittent fasting may be beneficial in preventing nocturnal hypertension.

The Effect of Gluten-Free Diet Duration on Body Mass Index of Iranian Patients with Celiac Disease.

Background: A gluten-free diet (GFD) is the only effective treatment of celiac disease (CD) that is associated with body mass index (BMI) changes. This study aimed to determine how GFD duration affects the BMI of Iranian patients with CD. Methods: In this prospective study, 215 patients with CD, who were on a GFD, were categorized into three groups according to the duration of compliance to GFD: 1. patients with less than 6 months of diet, 2. Patients who had a diet for 6 months to 2 years, and 3. patients with more than 2 years of diet. The BMI changes were assessed before and after adherence to the GFD. Results: Most patients' weight remains in the same BMI category during different courses of GFD adherence. Patients who were underweight showed significant changes in their BMI following the diet in less than 6 months (P=0.033) and more than 2 years (P<0.001), and the number of weight gain cases increased over time. Conclusion: There is a need for careful, updated, and personalized nutrition management of patients with CD in different periods of the diet. Conducting similar studies with larger sample sizes in different regions can lead to providing expert dietary counseling for patients with CD.

Preventive Effects of Long-Term Intake of Plant Oils With Different Linoleic Acid/Alpha-Linolenic Acid Ratios on Acute Colitis Mouse Model.

ObjectiveTo investigate the preventive effects of plant oils with different linoleic acid/alpha-linolenic acid (LA/ALA) ratios against colitis symptoms, and dysbiosis of gut microbiota in acute colitis mouse model.MethodsSixty male C57BL/6 mice were assigned into six groups (n = 10): three groups were fed low-fat diets with low, medium, and high LA/ALA ratios; and three groups were fed with high-fat diets with low, medium, and high LA/ALA ratios. After 3 months of diet, the mice were exposed to dextran sodium sulfate solution to induce acute colitis. The severity of colitis was estimated by disease activity index (DAI) and histopathological examination. 16S rRNA gene sequencing was used for the analysis of gut microbiota.ResultsPlant oils with a lower LA/ALA ratio showed higher alleviating effects on the symptoms of colitis, which were accompanied by the better prebiotic characteristics manifested as effectively inhibiting the abnormal expansion of phylum Proteobacteria and genus Escherichia-Shigella in the gut microbiota of colitis mouse models.ConclusionA potential IBD prevention strategy of reducing the LA/ALA ratio in the daily consumed plant oils was proposed in this study. Furthermore, based on the optimized LA/ALA ratio, this preventive effect might not be weakened by the high intake of plant oils.

Effect of diet and physical exercise on weight, body composition, and resting metabolic rate in obese chilean adults.

Diet and exercise are the mainstay of weight reduction programs. To evaluate the effect of diet and exercise on body weight and composition and resting metabolic rate (RMR) in obese adults. Twenty-eight obese adults aged 22 to 61 years (18 women) completed four months of diet and exercise. They attended monthly nutritional consultations, and two-three weekly exercise sessions. At baseline and the end of the intervention, anthropometry, body composition by bioimpedance and RMR by indirect calorimetry (IC) were measured. Metabolic adaptation, defined as a decrease in thermogenesis to an extent greater than predicted based on the change in body weight and composition, was calculated. Significant reductions in body weight and fat mass were observed in both genders. Fat-free mass decreased in women and remained unchanged in men. RMR remained stable. Metabolic adaptation was observed in 11/27 participants. Fat mass change in participants with and without metabolic adaptation was 8 Kg and 4,4 kg, respectively (p = 0,018). In the linear regression analysis, male sex accounted for a higher RMR (247.80 Kcal, p = 0,006) than females. For each kg of fat and fat free mass, the RMR varies 7.25 Kcal, (p = 0.02) and 9.79 Kcal (p = 0,006), respectively. The intervention reduced body weight and fat mass and maintained RMR. Fat free mass decreased in women. Participants with metabolic adaptation showed greater changes in fat mass.

Healthy and Chronic Kidney Disease (CKD) Dogs Have Differences in Serum Metabolomics and Renal Diet May Have Slowed Disease Progression.

Chronic kidney disease (CKD) is highly prevalent in dogs, and metabolomics investigation has been recently introduced for a better understanding of the role of diet in CKD. This study aimed to compare the serum metabolomic profile of healthy dogs (CG) and dogs with CKD (CKD-T0 and CKD-T6) to evaluate whether the diet would affect metabolites. Six dogs (5 females; 1 male; 7.47 ± 2.31 years old) with CKD stage 3 or 4 (IRIS) were included. CG consisted of 10 healthy female dogs (5.89 ± 2.57 years old) fed a maintenance diet. Serum metabolites were analyzed by 1H nuclear magnetic resonance (1H NMR) spectra. Principal component analysis (PCA) and partial least squares discriminant analysis (PLS-DA) were performed to assess differences in metabolomic profiles between groups and before (CKD-T0) and after renal diet (CKD-T6). Data analysis was performed on SIMCA-P software. Dogs with CKD showed an altered metabolic profile with increased urea, creatinine, creatine, citrate, and lipids. Lactate, branched-chain amino acids (BCAAs), and glutamine were decreased in the CKD group. However, after 6 months of diet, the metabolite profiles of CKD-T0 and CKD-T6 were similar. Metabolomics profile may be useful to evaluate and recognize metabolic dysfunction and progression of CKD, and the diet may have helped maintain and retard the progression of CKD.

Characterization and Pharmacological Validation of a Preclinical Model of NASH in Göttingen Minipigs

Nonalcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease, which is associated with features of metabolic syndrome. NAFLD may progress in a subset of patients into nonalcoholic steatohepatitis (NASH) with liver injury resulting ultimately in cirrhosis and potentially hepatocellular carcinoma. Today, there is no approved treatment for NASH due to, at least in part, the lack of preclinical models recapitulating features of human disease. Here, we report the development of a dietary model of NASH in the Göttingen minipig. First, we performed a longitudinal characterization of diet-induced NASH and fibrosis using biochemical, histological, and transcriptional analyses. We then evaluated the pharmacological response to Obeticholic acid (OCA) treatment for 8 weeks at 2.5mg/kg/d, a dose matching its active clinical exposure. Serial histological examinations revealed a rapid installation of NASH driven by massive steatosis and inflammation, including evidence of ballooning. Furthermore, we found the progressive development of both perisinusoidal and portal fibrosis reaching fibrotic septa after 6 months of diet. Histological changes were mechanistically supported by well-defined gene signatures identified by RNA Seq analysis. While treatment with OCA was well tolerated throughout the study, it did not improve liver dysfunction nor NASH progression. By contrast, OCA treatment resulted in a significant reduction in diet-induced fibrosis in this model. These results, taken together, indicate that the diet-induced NASH in the Göttingen minipig recapitulates most of the features of human NASH and may be a model with improved translational value to prioritize drug candidates toward clinical development.

Abstract P101: Suppression Of Serum Amyloid A Limits Progression Of Obesity Associated Abdominal Aortic Aneurysms

Obesity increases the risk for abdominal aortic aneurysms (AAA) in humans, and enhances angiotensin II (AngII)-induced AAA formation in C57BL/6 mice. Obesity is also associated with increases in serum amyloid A (SAA). We previously reported that deficiency of SAA significantly reduces AngII-induced inflammation and AAA in apoE-deficient mice. In this study we investigated whether SAA plays a role in progression of an established AAA in obese C57BL/6 mice. Approach and Results: Male C57BL/6 mice were fed a high fat diet (60% kcal as fat) throughout the study. After 4 months of diet the mice were infused with angiotensin II (AngII) at 1000ng/kg/min until the end of the study. Ultrasound (US) was performed in all mice before and after 28 days of AngII infusion, and mice that had at least a 25% increase in the luminal diameter of the abdominal aorta were stratified by luminal diameter into 3 groups. Group 1 was killed to establish baseline AAA. Groups 2 and 3 continued to receive AngII for a further 8 weeks along with an antisense oligonucleotide (ASO) that suppresses all 3 acute phase SAA isoforms (SAA-ASO), or a control ASO (5 mg/kg/wk). US was repeated at study end to assess AAA progression. Plasma SAA at the end of the experiment was 89.2±83.2 mg/L in the control ASO group, and 18.6±0.7 mg/L in the SAA-ASO group (mean±SD , p=0.008). There was no impact of SAA suppression on body weight, body fat, or blood pressure. After the first 4 weeks of AngII infusion, the average luminal diameter in all mice was 1.81±0.40 mm (mean±SD). Mice that received the control ASO had continued aortic dilation (average luminal aortic diameter 2.06±0.42 mm), whereas the mice that received the SAA-ASO had a significant reduction in progression of aortic dilation (average luminal diameter 1.64±0.43 mm, p=0.0015 for interaction between time and group). Conclusions: We demonstrate for the first time that suppression of SAA protects obese C57BL/6 mice from progression of AngII-induced AAA. Suppression of SAA may be a therapeutic approach to limit AAA progression.

155-LB: Counterregulatory Response to Hypoglycemia after Short-Term Use of Low and Very Low Carbohydrate Diets in Children with Type 1 Diabetes (T1D)

Background: Low carbohydrate (CHO) diets are used to improve diabetes control, but the safety of these diets has not been studied in children. We assessed counterregulatory response to hypoglycemia after short-term low (LC) or very low (VLC) CHO diets in children with T1D. Methods: Epinephrine (epi), norepinephrine (NE), glucagon (gluc), and beta-hydroxybutyrate (BOHB) were measured before and immediately after becoming hypoglycemic at baseline and after 3 months on a LC or VLC diet (CHO made up 30-39% or 20-29% of total daily calories, respectively). 13 children were enrolled, mean (±SE) A1c 7.8±0.2%, diabetes duration 6.3±1.0 yrs. Participants were given sufficient insulin to decrease glucose to &amp;lt;60 mg/dL (&amp;lt;3.3 mmol/L). Continuous glucose monitoring (Dexcom® G5 or G6) was used to monitor glucose trends. Hypoglycemia was confirmed using a plasma glucose analyzer. Results: Mean age (±SE) for LC and VLC, 10.5±1.7 (n=7) and 15.0±0.6 yrs (n=6), respectively. Epi increased in response to hypoglycemia at baseline in both groups (mean±SE increase, pg/mL) (LC 130.9±60.1, p=0.072; VLC 412.6±84.0, p= 0.008). At 3 mos Epi increased in LC (181.6±66.7, p=0.053) but not significantly in VLC (100.2±67.9, p=0.214). The change in Epi in response to hypoglycemia was significantly less at 3 mos vs. baseline in VLC (100.2±67.9 vs. 412.6±84.0, p=0.019) but not in LC (181.6±66.7 vs. 191.4±61.7, p=0.935). Change in NE, gluc and BOHB during hypoglycemia was similar in both groups when comparing 3 months of diet with baseline. There was no effect of diet when comparing baseline and 3-month changes in Epi, NE, gluc and BOHB in response to hypoglycemia. Conclusion: Short-term use of a diet very low in CHO in children with T1D may adversely affect counterregulatory response to hypoglycemia, whereas LC diet did not affect response. Further studies are needed to confirm these findings and to assess whether these diets affect growth and development in young children. Disclosure L. Fox: None. J. W. Permuy: None. D. Perez santiago: None. M. Fox: None. M. Hossain: None. Funding Nemours Research Programs; Dexcom, Inc.

MO165CANCER, KIDNEY AND DIET: THE NUTRITIONAL MANAGEMENT IN ONCO-NEPHROLOGICAL PATIENTS. A SINGLE CENTER EXPERIENCE

Abstract Background and Aims Controlled low-normal protein (LNP) diet in CKD patient is effective in controlling the progression of renal impairment. Oncological guidelines explain how a high protein level should be always required in patients (pts) affected by malignancies in order to compensate the cancer derived metabolism and avoid catabolism. But what about the onco-nephrological pts? Aim of our study is to investigate the metabolic impact of a low-normal protein diet in a consecutive cohort of 103 nephrological pts affected or not by urological non-metastatic malignancies. Method A consecutive cohort of 103 pts was enrolled in the Urological Department at San Raffaele Scientific Institute between 2018-2020. Inclusion criteria were: Age (&amp;gt;18 years old), eGFR (&amp;lt; 90 ml/min/1.73), Malnutritional Screening Tool (MTS&amp;lt;2), Urological Cancer aggressiveness (no metastatic process), Informed consent (signed). We divided the total cohort in 2 matched subgroups; case (CS: onco-nephrological pts with urological malignancies) and control (CT: nephrological pts) with a 2.1 ratio. Each patient underwent an initial nephrological and nutritional evaluation and was subsequently subjected to a conventional CKD LNP-diet (0,7-1 g/Kg/die: calories: 30-35 kcal per kg body weight/die) for a period of 6 months (+/- 2 moths). The diet was based on the estimated Glomerular Filtration Rate (CKD-EPI 2012 formula), comorbidities, nutritional status and hypermetabolic conditions. LNP-diets were integrated with aproteic food to maintain a relevant amount of high–biological value proteins, especially for oncological and advanced CKD pts. MTS, Body Mass Index (BMI), Phase Angle (PA), Fat Mass percentage (FM%), Fat-Free Mass Index (FFMI), body cell mass index (BCMI), extracellular:intracellular water ratio (ECW/ICW), waist circumference (WC), lab test exams and clinical variables were examined at baseline and after 6 months. Statistical analysis: Kruskal-Wallis rank sum test; Data analysis: R programming language and RStudio integrated development environment. Results Population divided as follows: average age: 69.8 (+/- 10.3); ♂ : ♀ ratio: 2.4; Hypertension: 57.28%; Diabetes: 19,41%; CKD classification: 3,88% stage 2, 87,37% above stage 3. At time zero no pts were underweight and 51 % were overweight or obese with difference condition of FM percentage (FM % average: 24.3 % ♀ and 18.1 % ♂for CS pts vs 31.6 % ♀ and 18.2 % ♂for CT pts). Only 2.1% of pts had a PA of less than 4°, considered a negative prognostic index (PA average: 5.6° for CS pts vs 5.5° for CT pts) and 6.3 % of pts had a value of cell mass less than 8 kg/m2 indicative of reduced lean mass (BCMI average: 10.4 kg / m2 for CS pts vs 11 kg / m2 for CT pts). An increase in ECW/ICW ratio greater than 1 was more present in CT pts in respect to CS pts (41.6 % vs 22.8 % and ECW/ICW average: 1.01 for CT pts vs 0.93 for CS pts) as well as WC measurement associated with increased cardiovascular risk (WC average: 87 cm ♀ and 99 cm ♂ for CS pts vs 97 cm ♀ and 104 cm ♂ for CT pts). After 6 months of diet, we observed a similar behavior between the CS and the CT cohorts in terms of renal metabolites and eGFR profile. In fact, the 65% of onco-nephrological and the 55% of nephrological pts displayed a significative decrease in urea plasmatic levels (- 27,76 mg/dl) and eGFR improvement (+ 6,27 ml/min/1,73). The nutritional status, as assessed by the MST, was preserved in both groups during the study. In addition, all pts had an improvement in BMI (CS: 2.8 kg/m2; CT :1.3 kg/m2) PA (CS: 2.8°; CT: 1.3°), BCMI (CS: 1.31 kg / m2; CT :0.38 kg / m2) and FFMI (CS; 0.1 ♀ and 0.1 ♂; CT; 2.9 ♀ and 1.1 ♂) and a decrease of WC (CS: - 1.3 cm; CT– 1,65), FM percentage (CS: 0 %; CT – 2.7) and ECW/ICW (CS: 0.02; CT 0.03). Conclusion Our study suggests that LNP high calorie diet ameliorates the nephrological scenarios, the metabolic complications, and the nutritional perspective in uro-oncological pts with stage 2-5 CKD. A larger prospective study to validate these results is on-going.

Effects of Chungkukjang Diet on the Eyebrows of Middle-aged Women in Their 40s and 60s

This study was conducted to see the effect on the eyebrows of middle-aged women when taking Cheonggukjang. Middle-aged women in their 40s and 60s were divided into 10 test groups and 10 control groups. And the test group consumed 50g of cheonggukjang every day for 3 months before breakfast. In addition, each group measured the length, thickness, number, density, and absorbance of eyebrows before and 3 months after the start of diet. As a result, after 3 months of diet, unlike the control group, the eyebrow length of the test group increased by 9.13% (p<.001), the eyebrow thickness increased by 41.97% (p<.01), and the degree of damage seen by absorbance decreased by 42.82% (p<.05). In the case of eyebrow thickening, which has the greatest effect on the actual image, the test group increased by 8.28% (p<.01). And the number of eyebrows did not change. As a result, the cheonggukjang diet had a positive effect on the eyebrow development and growth of middle-aged women. Keywords: Aging; Cheonggukjanggukjang; Eyebrows; Middle-aged women

PARKINSONIA ACULEATA AS A POTENTIAL PHYTOTHERAPIC FACTOR IN THE INFLAMMATORY AND DYSLIPIDEMIC CONTROL OF WISTAR RATS

Objective: The study evaluated the hypolipidemic and anti-inflammatory potential of the hydroalcoholic extract of P. Aculeata (HEPa/EtOAC) in Wistar rats fed with Westernized diet. Methods: The experiment was approved by the Ethics Committee (Federal University of Pernambuco-23076.027165 / 2010-21). The hydroalcoholic extract (HEPa/EtOAc) was obtained from the aerial parts of P. Aculeata and portioned by acetate/ethanol in different concentrations. 36 male Wistar rats were initially divided into two groups: Control (C, n = 6), fed a commercial diet (26g / 100g of protein; 63g / 100g of carbohydrates; 11g / 100g of lipids) and Westernized (W; n = 30) – fed an experimental diet (15g / 100g of protein; 51g / 100g of carbohydrates; 34 g/100g of lipids) receving water ad libitum. After 4 months of diet, W group was arbitrarily redistributed into six subgroups according to water supplementation, or different extracts concentrations: (n = 6 animals/group): W- distilled water (1mL/kg; po); WG – genfibrozil (140 mg/kg; p.o.); W35- 35 mg/kg; W70 – 70 mg /kg; p.o. and W140- 140 mg/kg; p.o for 30 days. The lipid profile and pro-inflammatory cytokines were analyzed. Results: The westernized diet caused dyslipidemia and the treatment with HEPa-EtOAc (140mg / kg), promoted a significant reduction in the concentration of pro-inflammatory cytokines, in total cholesterol, in the LDLc and serum triglycerides. Conclusion: The reduction of dyslipidemia and pro-inflammatory cytokines from the of P. Aculeata extract corroborate the ethnopharmacological potential of the plant, already used by the population for hypoglycemic purposes.

The influence of diets on plasma homocysteine levels in felines

Epidemiological and clinical studies in humans established the relationship between homocysteine (Hcy) level in plasma and cardiovascular, kidney and liver diseases. In veterinary medicine, the results regarding Hcy are questionable due to conflicting and rare data. The relationship between the metabolism of Hcy and the nutritional principles of different diets can lead in the future to a real prevention of cardiovascular diseases by simply managing the food of predisposed and elderly animals. The present study aims at comparing two types of diets over a period of 9 months (commercial CD and homemade HMD) on the feline plasma Hcy. Analyzing comparatively the results obtained from the determination of serum Hcy values on the initial diets (t0) and after 9 months of diet (t1), we can observe the decrease of these values both in group test I, which switched from a CD to a HMD, as well as in group test 2, which maintained a CD but switched from a lower quality food to a higher quality one. This fact demonstrates not only the benefits of a home-made diet, but also the need to diversify and combine the commercial one to satisfy the nutritional requirements of the feline organism.

Low serum sodium concentrations in patients with obesity normalizes with weight loss.

Obesity is associated with higher extracellular fluid (ECF) compared to intracellular fluid (ICF) volume and this dysregulation is associated with hypertension and abdominal obesity, associated with metabolic syndrome. As sodium is predominantly an extracellular cation, a higher ECF/ICF ratio will lower serum sodium concentration. The aim of the study was to see whether weight loss, due to dieting and bariatric surgery, had any impact on serum sodium concentrations in patients with severe obesity. Patients with a BMI ≥35kg/m2 admitted for bariatric surgery at Innlandet Hospital Trust, Norway during 2012-14 were included in the study (n=119). Clinical data and blood samples were recorded at inclusion, after mean six months of dieting, as well as six and 12 months after bariatric surgery. At inclusion, mean serum sodium was in the lower normal range, 138.3 (SD 2.4) mmol/L, but increased to 141.8 (SD 1.9) mmol/L after weight loss. The increase was significantly correlated to total weight loss (rho: 0.29, p=0.007). Twelve months after surgery, serum sodium was significantly higher in patients with a normal BMI (<25kg/m2) compared to patients with overweight. Obesity and hypertension are associated with body fluid dysregulation affecting serum sodium concentrations. As mild hyponatremia, even within the normal sodium range, is associated with increased total mortality and major cardiovascular disease events, serum sodium might be a potential risk marker in patients with obesity.