Non-starchy Vegetables Research Articles

Association of a healthy plant-based heart-protective diet with reduced cardiovascular disease incidence and mortality: findings from the UK Biobank Study

Abstract Importance Previous research examining the effects of omnivorous and plant-based diets on CVD outcomes has produced inconsistent findings, and the importance of diet quality is overlooked. Objective To assess the relation between adherence to a healthy plant-based, heart-protective diet and the risk of cardiovascular disease (CVD) events. Design: Prospective cohort study. Methods and Results 192,274 (mean age: 56.3±7.9 years, 43.3% males) participants in UK Biobank without CVD at baseline who completed a 24-hour recall questionnaire. Using data generated by Oxford WebQ, we developed a novel heart-protective diet score (HPDS) based on 22 food groups. Cox proportional hazard models were used to study associations. During a median follow-up of 12.3 years, there were 20,692 CVD events and 1,131 CVD deaths. After adjusting for demographics, Townsend deprivation index, lifestyle factors, and history of chronic diseases, participants in the top quartile of the HPDS were at the lower risk of overall CVD (HR: 0.92, 95% CI: 0.88 to 0.95), ischemic heart disease (HR: 0.88 [95% CI: 0.83 to 0.93]), myocardial infarction (HR: 0.82, 95% CI: 0.74 to 0.90), and heart failure (HR: 0.86, 95% CI: 0.78 to 0.95) than those in the bottom quartile. Participants who adhered closely to a healthy plant-based heart-protective diet had the lowest risk of overall CVD (HR: 0.72, 95% CI: 0.61 to 0.86), ischemic heart disease (HR: 0.68, 95% CI: 0.52 to 0.89), myocardial infarction (HR: 0.65, 95% CI: 0.46 to 0.91), and heart failure (HR: 0.51, 95% CI: 0.30 to 0.85) mortality. Conclusions and relevance: Adherence to a healthy plant-based heart-protective diet rich in non-starchy vegetables, fruits, whole grains, legumes, and fish, is associated with a reduced cardiovascular disease incidence and mortality. Further research in diverse ethnic populations is necessary to validate our findings and enhance their generalizability.

Cancers attributable to diet in Italy.

Cancer burden can be reduced by controlling modifiable risk factors, including diet. We provided an evidence-based assessment of cancer cases and deaths attributable to diet in Italy in 2020. We considered dietary factor-cancer type pairs for which the World Cancer Research Fund/American Institute for Cancer Research - Continuous Update Project reported either 'convincing' or 'probable' evidence of causal association. Relative risks were retrieved from recent meta-analyses and dietary intakes (around 2005) from a national food consumption survey. Sex-specific population attributable fractions (PAFs) were computed by comparing the distribution of dietary intakes in the Italian population against counterfactual scenarios based on dietary recommendations. Using data from national cancer and mortality registries in 2020, we estimated the number of attributable cancer cases and deaths, assuming ~15-year lag period. Unhealthy diet accounted for 6.3% (95% CI: 2.5%-9.9%) of all cancer cases in men and 4.5% (95% CI: 1.7%-7.4%) in women. PAFs of colorectal cancer were 10.5% and 7.0% for any intake of processed meat, 3.3% and 2.0% for high red meat, 4.8% and 4.3% for low dairy products, and 7.9% and 9.0% for low fiber intakes in men and women, respectively. PAFs for low intake of non-starchy vegetables and fruit ranged from 0.8% to 16.5% in men and 0.6%-17.8% in women for cancers of the aerodigestive tract. The estimated cancer burden associated with unfavorable dietary habits in Italy is considerable, but appears lower than for other high-income countries, reflecting the typically Mediterranean diet.

Investigating the impact of dietary guidelines transition on cardiometabolic risk profile: a forensic analysis using diet quality metrics

Evaluating dietary guidelines using diet quality (DQ) offers valuable insights into the healthfulness of a population’s diet. We conducted a forensic analysis using DQ metrics to compare the Malaysian Dietary Guidelines (MDG-2020) with its former version (MDG-2010) in relation to cardiometabolic risk (CMR) for an adult Malaysian population. A DQ analysis of cross-sectional data from the Malaysia Lipid Study (MLS) cohort (n = 577, age: 20-65yrs) was performed using the healthy eating index-2015 (HEI-2015) framework in conformation with MDG-2020 (MHEI2020) and MDG-2010 (MHEI2010). Of 13 dietary components, recommended servings for whole grain, refined grain, beans and legumes, total protein, and dairy differed between MDGs. DQ score associations with CMR, dietary patterns and sociodemographic factors were examined. Out of 100, total DQ scores of MLS participants were ‘poor’ for both MHEI2020 (37.1 ± 10.3) and MHEI2010 (39.1 ± 10.4), especially among young adults, males, Malays, and those frequently ‘eating out’ as well as those with greatest adherence to Sugar-Sweetened Beverages pattern and lowest adherence to Food Plant pattern. Both metrics shared similar correlations with CMR markers, with MHEI2020 exhibiting stronger correlations with WC, BF%, TG, insulin, HOMA2-IR, and smallLDL than MHEI2010, primarily attributed to reduced refined grain serving. Notably, participants with the highest adherence to MHEI2020 scores exhibited significantly reduced odds for elevated TG (AOR 0.44, 95% CI 0.21–0.93, p = 0.030), HOMA2-IR (AOR 0.44, 95% CI 0.21–0.88, p = 0.022), and hsCRP (AOR 0.54, 95% CI 0.31–0.96, p = 0.040, compared to those with the lowest adherence. Each 5-unit increase in MHEI2020 scores reduced odds for elevated BMI (− 14%), WC (− 9%), LDL-C (− 32%), TG (− 15%), HOMA2-IR (− 9%) and hsCRP (− 12%). While MHEI2020 scores demonstrated better calibration with CMR indicators, the overall sub-optimally ‘poor’ DQ scores of this population call for health promotion activities to target the public to achieve adequate intake of healthful fruits, non-starchy vegetables and whole grain, and moderate intake of refinedgrain, added sugar and saturated fat.

The Other Side of the Perfect Cup: Coffee-Derived Non-Polyphenols and Their Roles in Mitigating Factors Affecting the Pathogenesis of Type 2 Diabetes.

The global prevalence of type 2 diabetes (T2D) is 10.5% among adults in the age range of 20-79 years. The primary marker of T2D is persistent fasting hyperglycemia, resulting from insulin resistance and β-cell dysfunction. Multiple factors can promote the development of T2D, including obesity, inflammation, and oxidative stress. In contrast, dietary choices have been shown to prevent the onset of T2D. Oatmeal, lean proteins, fruits, and non-starchy vegetables have all been reported to decrease the likelihood of T2D onset. One of the most widely consumed beverages in the world, coffee, has also demonstrated an impressive ability to reduce T2D risk. Coffee contains a diverse array of bioactive molecules. The antidiabetic effects of coffee-derived polyphenols have been thoroughly described and recently reviewed; however, several non-polyphenolic molecules are less prominent but still elicit potent physiological actions. This review summarizes the effects of select coffee-derived non-polyphenols on various aspects of T2D pathogenesis.

The effects of specific vegetable subtypes on constipation incidence in the general United States population.

While the intake of larger quantities of vegetables has been linked to a reduction in constipation risk, which vegetables in particular underlie this risk reduction remains incompletely understood. As such, the present study was developed to explore correlations between the intake of particular vegetable types and the risk of constipation. This cross-sectional analysis was based on data from the National Health and Nutrition Examination Survey (NHANES) collected from 2005-2010. Classifications and intake assessments for different vegetables were assessed with the Food Patterns Equivalents Database (FPED), while stool frequency or stool consistency was used to define constipation. Relationships between the intake of particular vegetable components and constipation were assessed through a weighted logistic regression approach. Subgroup and restricted cubic spline (RCS) regression analyses were further employed to explore associations between specific vegetable subtypes and constipation. This study included 13,860 eligible subjects, of whom 1,405 and 12,455 were respectively classified into the constipated and non-constipated groups. Following multivariate adjustment, the intake of non-starchy vegetables including orange, red, dark green, and other vegetables was found to be positively associated with a reduction in constipation risk. In contrast, constipation was unrelated to total starchy vegetable or potato intake. Tomatoes, in particular, were associated with a marked decrease in constipation risk (odds ratios: 0.80, 95% confidence interval: 0.71-0.91). These results were confirmed through RCS and subgroup analyses. Non-starchy vegetables, particularly tomatoes, were found to be associated with a pronounced reduction in constipation risk, which was unaffected by the intake of potatoes or starchy vegetables.

Evaluating recommendation-based dietary and physical activity strategies for prostate cancer prevention: a target trial emulation in the Health Professionals Follow-up Study.

The 2018 World Cancer Research Fund/American Institute for Cancer Research recommends sustained strategies of physical activity and diet for cancer prevention, but evidence for long-term prostate cancer risk is limited. Using observational data from 27,859 men in the Health Professionals Follow-up Study, we emulated a target trial of recommendation-based physical activity and dietary strategies and 26-year risks of prostate cancer, adjusting for risk factors via the parametric g-formula. Compared with no intervention, limiting sugar-sweetened beverages showed a 0.4% (0.0-0.9%) lower risk of lethal (metastatic or fatal) disease and 0.5% (0.1-0.9%) lower risk of fatal disease. Restricting consumption of processed foods showed a 0.4-0.9% higher risk of all prostate cancer outcomes. Estimated risk differences for clinically significant disease were close to null for strategies involving fruits and non-starchy vegetables, whole grains and legumes, red meat, and processed meat, as well as under a joint strategy of physical activity and diet. Compared with a "low adherence" strategy, maintaining recommended physical activity levels showed a 0.4% (0.1-0.8%) lower risk of lethal and 0.5% (0.2-0.8%) lower risk of fatal disease. Adhering to specific components of current physical activity and dietary recommendations may help to prevent lethal and fatal prostate cancer over 26 years.

Cross-cultural differences in diet and quality of life between Taiwanese and American women during breast cancer treatment.

e23187 Background: Limited research has examined the role of different food types (vegetables, fruits, meat, fat, and whole grains) on quality of life (QoL) among cancer patients undergoing active treatment. This study aimed to examine what different food intakes are associated with QoL among American and Taiwanese women who are newly diagnosed with breast cancer (BC). Methods: This ongoing observational study enrolled 77 American (Black, Latina, and non-Hispanic White) adult women from MedStar Georgetown University Hospital and 79 Taiwanese women from National Taiwan University Hospital. They were diagnosed with stage 0-III primary BC within six months prior to enrollment, were undergoing surgery, chemotherapy, and radiation, with no other cancers. Patient-reported overall health and QoL were assessed using the two global health items from the EORTC-QLQ30. Three random 24-hour diet recalls (two weekdays and one weekend) were administered using the NIH-developed ASA24 program. Linear regression was conducted to examine the associations between food categories and QoL outcome, adjusting for nationality, age, cancer stage, treatment type, body mass index, physical activities, financial problems, and appetite loss. Results: American and Taiwanese patients displayed differing food intake during BC treatment. Taiwanese patients consumed less starchy vegetables and total fat (both p < .01) than American patients, on average. Multivariate results indicated that QoL was positively associated with higher total vegetable intake (excluding starchy vegetables and legumes; β = 5.38, 95% CI: 0.22, 1.20), controlling for other food types and covariates. Starchy vegetables and legumes showed non-significant negative effects on QoL. QoL was positively associated with total fat intake (β = 0.11, 95% CI: 0.02, 0.21). Total meat, fruit, and whole grain intakes were not significantly associated with QoL. Conclusions: The associations between food intakes and QoL were not affected by nationality, regardless of food type. Non-starchy vegetables and adequate total fat intakes may support BC patients undergoing treatments. More research is needed to verify the identified associations and explore how cancer treatment affects the digestion of certain food types and their potential impact on QoL. This study provides cross-cultural insights into potential nutritional influence on QoL among patients undergoing cancer treatment.

A Narrative Review of the Significance of Popular Diets in Diabetes Mellitus Management.

Diabetes mellitus is a collection of metabolic disorders marked by elevated levels of glucose in the blood due to irregularities in the generation or functioning of insulin. Medical nutrition therapy and weight loss are crucial elements in the management of diabetes and the prevention of complications. Several diets have become popular over time for the goal of achieving weight loss, but their popularity has declined due to a lack of reliable scientific evidence. This study classifies popular diets into three categories: diets that manage the composition of macronutrients, diets that restrict specific foods or food groups, and diets that manipulate meal timing. The review includes research studiesthat investigated the effects of popular diets on the prevention, management, and complications of diabetes. It is clear that different popular diets can have positive effects on both preventing and treating diabetes and preventing and treating complications related to diabetes. However, it is not practical to determine which diet is the most effective option for preventing or controlling diabetes. Thus, the main focus should be on common underlying factors that support well-being, such as decreasing the intake of refined grains and added sugar, choosing non-starchy vegetables, and giving priority to whole foods over processed foods whenever possible, until there is stronger evidence supporting the specific benefits of different dietary patterns.

Fresh start with high hopes: a qualitative evaluation of experiences of the Total Diet Replacement phase of the NHS Low Calorie Diet Programme pilot

Background: The National Health Service (NHS) Low Calorie Diet (LCD) programme in England aims to support people with type 2 diabetes (T2DM) to lose weight, improve glycaemic parameters and potentially achieve diabetes remission. The programme pilot launched in 2020 using three different delivery models: one-to-one, group and digital via an App. Service users begin the programme with 12 weeks of Total Diet Replacement (TDR). This study aims to understand the experience of this TDR phase from the service user perspective. Methods: This was a co-produced qualitative longitudinal and cross-sectional study, underpinned by a realist informed approach using semi-structured interviews and photovoice techniques. Service users (n=45) from the NHS LCD programme were recruited across the three delivery models and 21 pilot sites in England. Data were analysed using a thematic approach. Results: Participant demographics were representative of the overall LCD pilot population sample and included experiences from a mix of delivery models and providers. Three themes were presented chronologically. 1) life pre-LCD: the LCD programme was viewed as an opportunity to reset eating behaviours and improve quality of life; 2) experience of TDR: flexibility in allowing supplementary non-starchy vegetables and adapting the flavour and texture of TDR products supported adherence; 3) looking ahead to food reintroduction: at the end of the TDR phase, weight and glycaemia had reduced, while subjective energy levels and mobility improved. Some participants were concerned about progressing to the food reintroduction phase and the possibility of weight regain. Conclusions: The paper reports insight from the TDR phase of the LCD programme. The co-production of this work has resulted in several recommendations for policy and practice which have informed the national roll out of the programme.

Abstract P189: Optimal Measures of Carbohydrate Quality to Reduce the Risk of Type 2 Diabetes

Introduction: A plethora of indices have been investigated as optimal measures of carbohydrate quality in relation to risk of type 2 diabetes (T2D), but a systematic comparison has not been conducted. Hypothesis: We hypothesized that not all carbohydrate quality indices are equally associated with the risk of T2D. Methods: We investigated associations between twenty-two carbohydrate quality variables and T2D risk among 212,883 US adults with up to 32y of follow-up in the ongoing Nurses’ Health Study (NHS), NHS II, and the Health Professionals Follow-up Study. We used multivariable and BMI-adjusted Cox proportional hazards regression models. Results: Cereal fiber (comparing extreme quintiles of intake, RR:0.82, 95% CI:0.78, 0.87), whole fruit carbohydrates (RR:0.82, 95% CI:0.78, 0.87), glycemic index (RR:1.18, 95% CI:1.12, 1.24), and sugar-sweetened beverage (SSB) sugar (RR:1.23, 95% CI:1.17, 1.29) had the largest observed risk estimates of T2D (all P-trend<0.001). In addition, dietary glycemic load, starch, starchy vegetables, and potato and legume carbohydrates were positively associated (RR’s= 1.07 - 1.14), while whole grain carbohydrate intake was inversely associated with risk of T2D (RR= 0.94). Total and refined grain carbohydrates, added sugar, and non-starchy vegetables were not associated with risk of T2D. Ratios of carbohydrate or starch to total fiber or cereal fiber were all positively associated with risk of T2D (RR’s=1.11 - 1.33). The alternate Carbohydrate Quality Index (aCQI) (RR:0.73, 95% CI:0.69, 0.77) was more strongly associated with risk of T2D than the original CQI (RR:0.90, 95% CI:0.85, 0.95; both P-trend<0.001). Conclusion: Although many indices were associated with risk of T2D, higher intakes of cereal fiber and whole fruit carbohydrates, and lower intakes of glycemic index and sugar-sweetened beverage sugar had the lowest risk of T2D. The aCQI, comprising these four dietary variables and whole-grain carbohydrates, was strongly associated with risk of T2D and warrants further investigation.

Food insecurity is associated with low diet quality and unhealthy cooking and eating habits in Iranian women

BackgroundFood insecurity affects diet and nutrition intakes. We explored the relationship between food insecurity and dietary intakes in a group of Iranian women.MethodsThe cross-sectional study was performed on 190 healthy females aged 20–55 years attending primary healthcare centers in Shiraz. Food insecurity was evaluated by Household Food Insecurity Access Scale, which is a validated tool for assessing food insecurity in developing countries. Diet was assessed using a food frequency questionnaire. The association of dietary patterns and food insecurity was assessed by linear regression.ResultsAssessment of dietary intakes revealed that consumption of red meat, poultry, fish, dairy, fruits, non-starchy vegetables, and nuts decreased whereas that of grains, processed meats, potato, and sugary foods increased with increasing food insecurity. Among nutrients, carbohydrates, fiber, vitamin A, vitamin C, folic acid, potassium, calcium, and magnesium decreased while fat and sodium increased as food insecurity increased. Three major dietary patterns were detected. Healthy dietary patterns showed inverse associations with food insecurity in the crude (β = -0.422 and − 0.435, P < 0.001) and adjusted (adjusted for age, marital status, and educational level) (β = -0.475 and − 0.341, P < 0.001) models of regression analysis but unhealthy pattern did not show an association with food insecurity. Compared to food secure participants, a higher percentage of food insecure individuals indicated unhealthy eating habits, such as skipping breakfast, lower snack ingestion, more fast and fried food consumption, and using unhealthy cooking methods.ConclusionOverall, this study showed that food insecurity was associated with less healthy diet and unhealthy cooking and eating habits.

Food groups consumption and urinary metal mixtures in women from Northern Mexico

ObjectiveWe aimed to evaluate the association between food groups and mixtures of urinary metal concentrations in a sample of women; as well as identify the most important metals within each mixture. MethodsThis is a cross-sectional analysis between food groups consumption and mixtures of various metals in urine from 439 women, ≥18 years old, from Northen Mexico. We estimated the dietary intake of 20 food groups through a validated semi-quantitative food frequency questionnaire. Urinary metal concentration of aluminum, antimony, arsenic, barium, cadmium, cesium, chromium, cobalt, copper, lead, manganese, magnesium, molybdenum, nickel, selenium, thallium, tin, vanadium, and zinc, were measured by inductively coupled plasma triple quad. We used weighted quantile sum (WQS) regression with binomial family specification to assess the association of food groups and metal mixtures, as well as to identify the most important ones. ResultsWe identified tin, lead, and antimony as the most important metals, in the metal mixtures that were positively associated with the consumption of eggs, non-starchy vegetables, fruits, seafood, corn, oil seeds, chicken, soda, legumes, red and/or processed meats, as well as negatively with the consumption of alliums, corn tortillas and/or vegetable oils. ConclusionOur findings suggest that food consumption is related to more than one metal in the study sample, and highlights the presence of some of them. Further research is required to identify the possible sources of metals in food, as well as the chronic adverse health effects attributed to their simultaneous presence.

The relationship between weight status and food environments, peer influence and dietary intake among high-school students: a case-control study

Purpose The purpose of this study is to evaluate the relationship between weight status and food environments, peer influence and dietary intake among high-school students in Shiraz, Iran. Design/methodology/approach Applying a case-control design, 406 adolescents (n = 203 overweight or obese and n = 203 normal weight) aged 14–18 years were selected using a multistage cluster random sampling method. Demographic information, physical activity level and anthropometric indices were collected. Dietary intake was determined using a 147-item food frequency questionnaire. Food environment (home and out of home) and peer influence were determined by a validated questionnaire. Findings The type of food purchased using pocket money was different between adolescents with overweight or obesity and normal weight adolescents (p &lt; 0.001). The out-of-home food environment score was not different between groups, but the home food environment score (p = 0.004) and the peer influence score (p = 0.001) were higher in normal weight adolescents. Adolescents with overweight or obesity consumed higher amounts of carbohydrate (p = 0.006) and lower amounts of protein (p = 0.01) and more sweet junk foods (p = 0.01), nonstarchy vegetables (p = 0.03) and fruits (p = 0.01) compared to the normal weight group. Originality/value Home food environment, peer influence, differences in macronutrient intake and dietary patterns may be contributing factors to adolescent weight status.

Factors affecting chemical and textural properties of dried tuber, fruit and vegetable

The chemical components and cell structure of fruit and vegetable tissues are the main factors affecting the textural properties of fruit and vegetable crisps, while the pore structure formed inside the crisps determines their specific crispness. This study investigated the factors influencing the textural properties of different fruit and vegetable crisps by examining the differences between the chemical components, cell structures, pore-forming structures of six different fruits and vegetables. The results showed that there were large differences between the chemical components, cellular structure and pore structure among different fruits and vegetables. The chemical components in the raw materials of fruits and vegetables were the main factors affecting the textural properties of fruit and vegetable crisps, while the cellular structure was a secondary factor. The starch in starchy fruits and vegetables supported the structure of the product, which in turn increased its firmness. The chelating pectin (CSP) content of non-starchy fruits and vegetables was the main factor influencing hardness, cell wall material (CWM) content was the primary element affecting crispness. The pore structure of different fruit and vegetable crisps was mainly dominated by connected pores, with pore diameters mainly distributed between 20 and 150 μm. The isolated pores in the pore structure were the major elements impacting the textural properties of the product, followed by porosity.

A Randomized Controlled Pilot Study of the Food Order Behavioral Intervention in Prediabetes.

(1) Background: Prior research in individuals with overweight/obesity and prediabetes or type 2 diabetes has shown that the ingestion of protein-rich food and non-starchy vegetables before concentrated carbohydrates (a carbohydrate-last food order) led to lower postprandial glucose excursions over 180 min, compared to eating the same foods in the reverse order. To expand upon this research, we sought to examine the feasibility and impact of carbohydrate-last food order behavioral intervention on glucose tolerance (GT), HbA1c, weight, and nutrient intake in adults with prediabetes in the real world over a 16-week span. (2) Methods: A total of 45 adults with overweight/obesity and prediabetes were randomized to receive 4-monthly standard nutritional counseling (C) or standard nutritional counseling plus carbohydrate-last food order counseling (FO) sessions (NCT# NCT03896360). (3) Results: The FO group decreased in body weight (-3.6 ± 5.7 lbs, p = 0.017), and trended toward lower HbA1c (-0.1 ± 0.2, p = 0.054). The C group weight trended lower (-2.6 ± 6.8 lbs, p = 0.102) without altering HbA1c (-0.03 ± 0.3, p = 0.605). GT was unchanged in both groups after 16 weeks. Changes in weight, HbA1c, and GT were similar between groups. Sensitivity analysis of pre-COVID participants showed significant weight loss in the FO group (-5.9 ± 5.3 lbs, p = 0.003) but not in C group (-1.0 ± 6.8 lbs, p = 0.608). After 16 weeks, the C group significantly reduced its daily intake of calories, fat, protein, and grains whereas the FO group increased its daily intake of vegetables and protein. There were 17 (94%) FO participants that reported high intervention adherence and 13 (72%) reported it was easy to eat protein/vegetables before carbohydrates. (4) Conclusions: A carbohydrate-last food order is a feasible behavioral strategy in individuals with prediabetes that improves diet quality, notably increasing protein and vegetable intake.

SAT679 Telehealth And Metabolic Health: Unraveling The Effects Of A 12-week Low-starch Diet On Homa2B IR In Overweight Women

Abstract Disclosure: G. Erta: None. G. Gersone: None. P. Tretjakovs: None. Background: Telehealth has emerged as a promising approach for delivering health care interventions remotely, allowing increased access and convenience, especially in the context of lifestyle interventions for metabolic health. In this study, our aim was to investigate the effects of a 12-week low-starch diet on HOMA2B IR (Homeostatic Model As-sessment for Beta Cell Function Insulin Resistance) in overweight women using tele-health consultations. Methods: A prospective single arm intervention study was conducted among 14 overweight women aged 18-48 years with a body mass index (BMI) of 25-29,9 kg/m^2. Participants received weekly telehealth consultations via video conference with an endocrinologist and were prescribed a low-starch diet for 12 weeks. The dietary intervention focused on reducing the intake of high-starch foods, such as refined grains, potatoes, and bread, while promoting the consumption of non-starchy vegetables, lean protein, and healthy fats. HOMA2B IR, a widely used surrogate marker of insulin resistance, was measured at baseline and after 12 weeks. Results: After 12 weeks of the low-starch diet intervention, there was a significant reduction in HOMA2B IR in overweight women (Mean ± SD: Baseline HOMA2B IR data (2.126 ± 1.909) improved to 1.522 ± 1.468 at 12 weeks (p &amp;lt; 0.05)), indicating improved beta cell function and decreased insulin resistance. Participants also showed reductions in bodyweight, waist circumference, and fasting blood glucose levels. The compliance with the low starch diet was generally high. Conclusion: Our findings suggest that a 12-week low-starch diet administered through telehealth consultations may have positive effects on HOMA2B IR, as well as bodyweight and fasting blood glucose levels, in overweight women. These results highlight the potential of telehealth as a convenient and effective mode of delivering lifestyle interventions to improve metabolic health. More research with larger sample sizes and longer follow-up periods is warranted to confirm these findings and explore the long-term effects of telehealth-based interventions on metabolic health outcomes. Presentation: Saturday, June 17, 2023

Association between changes in carbohydrate intake and long term weight changes: prospective cohort study.

To comprehensively examine the associations between changes in carbohydrate intake and weight change at four year intervals. Prospective cohort study. Nurses' Health Study (1986-2010), Nurses' Health Study II (1991-2015), and Health Professionals Follow-Up Study (1986-2014). 136 432 men and women aged 65 years or younger and free of diabetes, cancer, cardiovascular disease, respiratory disease, neurodegenerative disorders, gastric conditions, chronic kidney disease, and systemic lupus erythematosus before baseline. Weight change within a four year period. The final analyses included 46 722 women in the Nurses' Health Study, 67 186 women in the Nurses' Health Study II, and 22 524 men in the Health Professionals Follow-up Study. On average, participants gained 1.5 kg (5th to 95th centile -6.8 to 10.0) every four years, amounting to 8.8 kg on average over 24 years. Among men and women, increases in glycemic index and glycemic load were positively associated with weight gain. For example, a 100 g/day increase in starch or added sugar was associated with 1.5 kg and 0.9 kg greater weight gain over four years, respectively, whereas a 10 g/day increase in fiber was associated with 0.8 kg less weight gain. Increased carbohydrate intake from whole grains (0.4 kg less weight gain per 100 g/day increase), fruit (1.6 kg less weight gain per 100 g/day increase), and non-starchy vegetables (3.0 kg less weight gain per 100 g/day increase) was inversely associated with weight gain, whereas increased intake from refined grains (0.8 kg more weight gain per 100 g/day increase) and starchy vegetables (peas, corn, and potatoes) (2.6 kg more weight gain per 100 g/day increase) was positively associated with weight gain. In substitution analyses, replacing refined grains, starchy vegetables, and sugar sweetened beverages with equal servings of whole grains, fruit, and non-starchy vegetables was associated with less weight gain. The magnitude of these associations was stronger among participants with overweight or obesity compared with those with normal weight (P<0.001 for interaction). Most of these associations were also stronger among women. The findings of this study highlight the potential importance of carbohydrate quality and source for long term weight management, especially for people with excessive body weight. Limiting added sugar, sugar sweetened beverages, refined grains, and starchy vegetables in favor of whole grains, fruit, and non-starchy vegetables may support efforts to control weight.

The immediate impact of a balanced, very low-calorie diet on the metabolic health of Indian subjects - A prospective longitudinal study

Problems consideredGlobal challenges posed by obesity, type 2 diabetes mellitus (T2DM), hypertension, and related metabolic diseases necessitate effective interventions. Pharmacotherapy often falls short, leading to a demand for innovative approaches. This study delves into the effects of an organized diet featuring a readily available food substitute blend over an eight-week span. MethodsThe study implemented a low-calorie diet (800–830 calories), comprising three shakes, non-starchy vegetables, soups, reduced buttermilk, and limited fat. Assessments covered NCDs like T2DM, hypertension, dyslipidemia, and non-alcoholic fatty liver disease. WHO STEPS protocol guided anthropometric measures and blood pressure readings, while INBODY 230 Analyser determined body composition. SPSS 16 software facilitated analysis of baseline and two-month follow-up data. ResultsParticipants with an average baseline BMI of 31.9 kg/m2 witnessed substantial improvements. Weight, BMI, waist and hip circumferences, neck, arm, and thigh circumferences, and body fat percentage registered significant decreases. Positive changes were observed in diabetes indicators, including reduced HbA1c (7.2%–6.1%) and fasting/post-prandial blood glucose (p < 0.001). Noteworthy enhancements extended to blood pressure, triglycerides, and NAFLD markers (p < 0.001), indicating favorable shifts in obesity-related markers and metabolic irregularities. ConclusionThe study underscores the potential of reversal diet in real-world clinical settings, offering promise in ameliorating metabolic disorders linked to obesity. Intriguingly, these benefits extended to individuals of South Asian region, accentuating its broad relevance. However, sustaining these improvements necessitates further exploration through extended interventions with larger participant cohorts. The findings kindle optimism in addressing mounting burden of metabolic diseases on a global scale.

Association of carbohydrate intake from different sources with all-cause and cardiovascular mortality among chronic kidney disease populations: assessment of 1999–2018 National Health and Nutrition Examination Survey participation

This study analysed the data from the NHANES (1999–2018) to examine how different sources of carbohydrate intake affected the all-cause and cardiovascular mortality of 11,302 chronic kidney disease (CKD) patients. The data were adjusted for other factors using various methods. The results showed that CKD patients (stages 1-2 and 3-5) who consumed more carbohydrates from whole grains, fruits, vegetables and less carbohydrates from fruit juice or sauces had lower mortality rates. Replacing fat intake with carbohydrates from whole grains (HR = 0.86[0.78–0.95]), fruits (raw) (HR = 0.79[0.70–0.88]) and non-starchy vegetables (HR = 0.82[0.70–0.96]), but not protein intake, was linked to lower all-cause mortality. The fibre content in carbohydrates might partly account for the benefits of selected carbohydrate intake. This study provided practical recommendations for optimising the carbohydrate sources in CKD patients.

Associations of starchy and non-starchy vegetables with risk of metabolic syndrome: evidence from the NHANES 1999–2018

BackgroundHigher dietary quality, including increased vegetable consumption, was associated with a reduced risk of metabolic syndrome (MetS). However, specific vegetable consumption in the development of MetS remains obscure. Our study aimed to investigate the correlation between starchy and non-starchy vegetables and MetS.MethodsSecondary data analysis from the National Health and Nutrition Examination Survey (NHANES 1999–2018). MetS was defined by National Cholesterol Education Program-Adult treatment Panel III (NCEP ATPIII) and dietary consumption was assessed by trained staff using two 24-h diet recall methods. Weighted logistic regression analysis was carried out to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Subgroup analyses and restricted cubic spline (RCS) regression were performed to further investigate specific vegetable subtypes and MetS.ResultsThis research enrolled 24,646 individuals (11,725 females and 12,921 males), with an average age of 45.84 ± 0.23 years. Approximately 15,828(64.22%) participants were defined to be with non-MetS and 8818(35.78%) were with MetS. Both total starchy vegetables and potatoes were associated with increased MetS risk, with the corresponding OR per standard deviation (SD) (95%CI, p-trend) being 1.06(1.02–1.11, p-trend = 0.028) and 1.08(1.04–1.13, p-trend = 0.011), respectively. However, an inverse correlation was found between dark-green vegetables and MetS, and the OR per SD (95%CI, p-trend) was 0.93(0.90–0.97, p-trend = 0.010). Subgroup analyses showed that the positive associations of starchy vegetables and potatoes on MetS risk were stronger in non-Hispanic White participants (p for interaction < 0.050).ConclusionTotal starchy vegetables and white potatoes were both associated with an increased risk of MetS, while consumption of dark-green vegetables was negatively associated with MetS risk. These findings might provide a promising and healthy dietary strategy for preventing MetS.