Preparatory Diet Research Articles

The Relationship between a High Carbohydrate Diet and Oral Glucose Tolerance Test in Pregnancy.

The aim of this study is to examine the impact of carbohydrate ratios in the diet consumed one day prior to the 75-g oral glucose screening test on both the screening test values and the diagnosis of gestational diabetes mellitus in the unselective pregnant population. 83 pregnant women who were under observation in the antenatal clinic of our hospital and underwent glucose tolerance tests were included in the study. The patients were given training by a dietitian to keep nutrition records of the day prior to glucose loading during their previous visits before any glucose loading. A carbohydrate intake of 40-60% was considered as the normal range in terms of the percentage of carbohydrates in the diet. A carbohydrate percentage above 60% was considered to be a high carbohydrate intake. The carbohydrate percentages in their diet over the past 24 hours was compared with the effect on the glucose tolerance test. Out of the 83 pregnant women included in the study, 40 of them had a high carbohydrate diet (HCD) prior to the oral glucose tolerance test (OGTT), and the average carbohydrate percentage of this diet was found to be 62%. The remaining 43 patients had an average carbohydrate percentage of 49% and belonged to the group that had a normal carbohydrate diet (NCD). Out of the 83 pregnant women, 33 of them were at high risk for gestational diabetes mellitus (GDM). In the high-risk patient group, 16 patients had an NCD intake, while 17 patients had a HCD intake. It was determined that a high carbohydrate diet had no significant effect on fasting, first-hour, and second-hour glucose levels, as well as the diagnosis of gestational diabetes mellitus (GDM), in both the unselective population and the high-risk patient population. In our study, we concluded that the high carbohydrate ratios in the diets of pregnant women one day prior did not affect the OGTT results or the GDM ratios. This indicates that there is no need for a preparatory diet prior to the OGTT in women with normal dietary habits.

Carbohydrate Intake and Oral Glucose Tolerance Test Results in the Postpartum Period.

The American Diabetes Association (ADA) recommends a 3-day preparatory diet prior to a diagnostic oral glucose tolerance test (OGTT), a test often recommended in postpartum individuals with a history of gestational diabetes (GDM). Evaluate the relationship between carbohydrate intake and OGTT glucose in 2 cohorts of postpartum individuals. We performed analyses of postpartum individuals from 2 prospective studies with recent GDM (Balance after Baby Intervention, BABI, n = 177) or risk factors for GDM (Study of Pregnancy Regulation of INsulin and Glucose, SPRING, n = 104) .We measured carbohydrate intake using 24-hour dietary recalls (SPRING) or Food Frequency Questionnaire (BABI) and performed 2-hour 75-g OGTTs. The main outcome measure was 120-minute post-OGTT glucose. There was no relationship between carbohydrate intake and 120-minute post-OGTT glucose level in either study population (SPRING: β = 0.03, [-5.5, 5.5] mg/dL, P = .99; BABI: β = -3.1, [-9.5, 3.4] mg/dL, P = .35). Adding breastfeeding status to the model did not change results (SPRING β = -0.14, [-5.7, 5.5] mg/dL, P = .95; BABI β = -3.9, [-10.4, 2.7] mg/dL, P = .25). There was, however, an inverse relationship between glycemic index and 120-minute post OGTT glucose (BABI: β = -1.1, [-2.2, -0.03] mg/dL, P = .04). Carbohydrate intake is not associated with post-OGTT glucose levels among postpartum individuals. Dietary preparation prior to the OGTT may not be necessary in this population.

The Effect of Pollen Diet Composition and Quantity on Diapause Survival and Performance in an Annual Pollinator (Bombus Impatiens).

Most pollination services are provided by annual bees that go through a winter diapause, during which they are exposed to extreme temperatures, pathogens, and starvation. The ability of bees to successfully face these stressors during diapause and subsequently initiate a nest depends on their overall nutritional state and an adequate preparatory diet. Here, we used queens of the common eastern bumble bee, Bombus impatiens, to examine how pollen diets varying in their protein to lipid ratio and total nutrient amounts affected queen performance during and after diapause. We compared diapause survival and reproductive performance post-diapause across different diets and found that queen survival was highest when pollen had a nutritional ratio of approximately 5:1 (protein to lipid). This diet is significantly enriched in proteins compared to the pollen fed to bumble bees in the lab (1:1) or commonly available in agricultural landscapes. Altering the quantity of macronutrients within this ratio did not improve survival or performance. Our results emphasize the importance of adequate nutrition for diapause performance in bees with annual life cycles and the importance of providing annual bees with floral provisioning based on their individual nutritional targets.

1050 Normal imaging findings after aortic valve implantation on 18f-fluorodeoxyglucose positron emission tomography with computed tomography and computed tomography angiography

Abstract Purpose Although 18F-Fluorodeoxyglucose (18F-FDG) Positron Emission Tomography (PET) with computed tomography (CT) and cardiac computed tomography angiography (CTA) are essential tools in diagnosing prosthetic heart valve (PHV) endocarditis, the normal imaging findings in the first year after PHV implantation on 18F-FDG-PET/CT and CTA have not been studied prospectively. We prospectively assessed the perivalvular FDG uptake at different time points after aortic PHV implantation and assessed the normal imaging findings on CTA. Materials and methods Patients who had undergone uncomplicated aortic PHV implantation were included and underwent 18F-FDG PET/CT and CTA at 5(±1) weeks (group 1), 12(±2) weeks (group 2) or 52(±8) weeks (group 3) after implantation. After a preparatory diet to suppress normal myocardial glucose uptake, FDG uptake in the myocardium as well as around the PHV was scored using the Qualification Visual Score for Hypermetabolism (QVSH) as "none" (< mediastinum), "low" (> mediastinum but < liver), "intermediate" (> liver), or "high" (intense uptake) and quantitative analysis was performed with maximum Standardized Uptake Value (SUVmax) and target to background ratio (SUVratio) on standardized European Association of Nuclear Medicine Research Ltd. (EARL) reconstructions by an experienced nuclear medicine physician. CTA was analysed for image quality, artefacts and stranding of the peri-aortic fat by a cardiac radiologist. Results In total 37 patients (group 1: n = 12, group 2: n = 12, group 3: n = 13) (age 66 ± 8 years) were included. Myocardial FDG uptake was intermediate or less in 29/37 scans (78%). QVSH around the PHV was 8/12(67%) low and 4/12(33%) intermediate in group 1, 7/12(58%) low and 5/12(42%) intermediate in group 2 and 8/13(62%) low and 5/13(38%) intermediate in group 3 (p = 0.91). No scan was scored as "none" or "high". EARL SUVmax was 3.48 ± 0.57, 3.50 ± 0.59 and 3.34 ± 0.55 (mean ± SD, p = 0.77) and EARL SUVratio was 2.00 ± 0.29, 1.96 ± 0.41 and 1.71 ± 0.26 (mean ± SD, p = 0.07) for groups 1, 2 and 3, respectively. One patient in group 3 refused to undergo the additional CTA and one CTA in group 3 could not be analysed for image quality and artefacts due to techniqual difficulties. Overall CTA image quality was "good" or "excellent" with an artefact score of "virtually none" or "mild" in most cases (n = 33, 94%). Stranding of peri-aortic fat was seen in 27/35 (77%) of these patients (group 1: n = 11; group 2: n = 9; group 3: n = 7) with no signs of FDG uptake on PET/CT scan. Conclusion Baseline FDG uptake around aortic PHV at 5, 12 and 52 weeks after implantation is similar and mild in the majority of cases with an overall mean SUVmax and SUVratio of 3.44 ± 0.56 and 1.89 ± 0.34 respectively. CTA revealed baseline post-surgical findings in the first year after PHV implantation.

Nourishing the Spirit: Exploratory Research on Ayahuasca Experiences along the Continuum of Recovery from Eating Disorders

ABSTRACTEating disorders (EDs) are serious health conditions that are among the most difficult to treat. Innovative treatments are needed and modalities from across cultures must be considered. Ayahuasca is a psychoactive plant-based tea originally used by Amazonian indigenous groups. A growing body of research points to its promise in the healing of various mental health issues. This study explored the potential therapeutic value of ayahuasca in the context of EDs, including the perceived impact of the preparatory diet and the ayahuasca purge. Sixteen individuals previously diagnosed with an ED participated in a semi-structured interview relating to their experiences with ceremonial ayahuasca drinking. Interviews were analyzed using thematic analysis. Themes presented relate to the reduction or cessation of ED and mental health symptoms, shifts in body perception, and the importance of a ceremonial setting and after-care. For some, the preparatory diet resulted in familiar patterns of concern; however, none felt triggered by the purge in ayahuasca. Ceremonial ayahuasca drinking shows promise in the healing of EDs and warrants further research.

No influence of high- and low-carbohydrate diet on the oral glucose tolerance test in pregnancy

Objective: Our objective was to determine the influence of the carbohydrate content of the diet preceding the oral glucose tolerance test (OGTT) in pregnancy on the test results and to evaluate the necessity of the recommended preparatory high-carbohydrate diet. Study design: Thirty-four women from our outpatient clinic were enrolled in this prospective study. After giving informed consent, each women underwent a 90-min lesson (supervised by a dietary assistant) covering the carbohydrate, protein and fat content of different foods. Women were then randomized and in a crossover design started a diet with either a low or a high carbohydrate content. We were aiming at a carbohydrate intake of 40% in the low-carbohydrate week (LCH) and 50% in the high-carbohydrate week (HCH). Compliance was monitored by a detailed food diary which the women kept and which included the weight of the foods they consumed. Results: The actual dietary intakes as calculated from the food diaries showed that the mean caloric intake was 1801 ± 314 kcal in the LCH and 2118 ± 312 kcal in the HCH week (<0.001). During the LCH diet, CH intake was 39 ± 6.1% and 49 ± 6.6% in the HCH week ( P < 0.001). The carbohydrate intake per kilogram bodyweight was 30 ± 5.3 kcal vs. 35 ± 5.2 kcal ( P < 0.001). The number of patients diagnosed with gestational diabetes was two in the LCH and three in the HCH week (not significant). The sum of the OGTT values (fasting, 1 h and 2 h) after the LCH was 18.9 ± 2.1 mmol/l vs. 18.8 ± 2.1 mmol/l after the HCH ( P = 0.51). No differences could be found in both groups regarding the fasting, 1-h, or 2-h glucose values. Including patients with a CH difference of at least 5%, 10%, and 15% carbohydrate between the weeks, we still did not observe any differences in the OGTT sum. We also looked at a possible influence of the CH content of the diet on the day before the test and of the last meal before the OGTT results and observed there was none. Conclusion: This is the first study which has observed the influence of the previous day's meal on the test results. We conclude from our results that the carbohydrate percentage of the preparatory diet did not influence the results of an OGTT, even when we increased the difference in carbohydrate intake stepwise up to 15%. This might indicate that a preparatory diet before the OGTT is not necessary for women with normal nutritional behavior.

Oral glucose tolerance test and the preparatory diet

Objective: A 3-day diet containing at least 150 g carbohydrate per day has been used in many centers in preparation for the oral glucose tolerance test. The preparatory diet is thought to reduce false-positive diagnoses of gestational diabetes. The purpose of this study was to evaluate the necessity of a 3-day preparatory diet containing ≥150 g carbohydrate in otherwise healthy pregnant patients. Study Design: Twenty healthy obstetric patients with abnormal results on a 1-hour glucose challenge test (≥140 mg/dL) were enrolled in this prospective pilot study. Two oral glucose tolerance tests were administered. The first was with no dietary restrictions, and the second test was performed after a 3-day diet containing at least 150 g carbohydrate. Patients were given a 3-day dietary supplement, which contained 150 g carbohydrate per day. A food diary verified compliance with the diet and indicated other food intake. Results: There was no difference in the number of oral glucose tolerance tests with abnormal results, with or without the diet (5 in each group). Additionally, no significant difference was found in the mean glucose values in the diet versus no-diet groups. Conclusion: A preparatory diet does not significantly alter the results of an oral glucose tolerance test administered to healthy pregnant women. The diet unnecessarily delays the diagnosis of gestational diabetes. (Am J Obstet Gynecol 2000;182:1052-4.)

Does a high carbohydrate preparatory diet affect the 3‐hour oral glucose tolerance test in pregnancy?

The aim of this study was to determine the effect of a high carbohydrate preparatory diet on the performance of the 3-hour oral glucose tolerance test (GTT) in pregnancy. This prospective clinical trial was performed at a university hospital outpatient obstetric clinic. Gravidas who had an abnormal blood sugar screening test were asked to ingest one of two preparatory diets: ≥ 150g/day of carbohydrate for 3 days (Carbo) or six Snickers™ candy bars per day for 3 days (Candy), or to remain on their usual diet (Ad lib) prior to the GTT. A 100g oral GTT was performed after an overnight fast, and blood glucose values were determined at 1, 2, and 3 hours. Patients with either a fasting whole blood glucose >120 mg/dl or ≥ two abnormal values on the GTT were considered to have gestational diabetes mellitus and received diet therapy. Women who failed diet therapy also received insulin. Our primary outcome parameter was the intergroup incidence of gestational diabetes mellitus. Other parameters included the mean 1-, 2-, and 3-hour glucose values and the rates of both cesarean delivery and large-for-gestational age infants. Of the 354 women studied, 108 entered the Carbo group, 105 entered the Candy group, and 141 comprised the Ad Lib group. The three groups were comparable with regard to historic and demographic risk factors for gestational diabetes mellitus. After the GTT, 29% of the Carbo group were considered to have gestational diabetes mellitus vs. 28% in both the Ad lib and Candy groups (P = 0.98). Additionally, both the mean intergroup fasting, 1-hour, 2-hour, and 3-hour whole blood glucose values and selected clinical outcomes were similar (P = 0.35–0.99). Compared to usual dietary intake, recommending a high carbohydrate diet had a negligible effect on the 100g oral GTT in pregnancy. J. Matern.–Fetal Med. 7:68–71, 1998. © 1998 Wiley-Liss, Inc.

Does a High Carbohydrate Preparatory Diet Affect the 3-Hour Oral Glucose Tolerance Test in Pregnancy?

The aim of this study was to determine the effect of a high carbohydrate preparatory diet on the performance of the 3-hour oral glucose tolerance test (OTT) in pregnancy. This prospective clinical trial was performed at a university hospital outpatient obstetric clinic. Gravidas who had an abnormal blood sugar screening test were asked to ingest one of two preparatory diets: ≥ 150g/day of carbohydrate for 3 days (Carbo) or six Snickers™ candy bars per day for 3 days (Candy), or to remain on their usual diet (Ad lib) prior to the GTT. A 100g oral OTT was performed after an overnight fast, and blood glucose values were determined at 1, 2, and 3 hours. Patients with either a fasting whole blood glucose > 120 mg/dl or ≥ two abnormal values on the GTT were considered to have gestational diabetes mellitus and received diet therapy. Women who failed diet therapy also received insulin. Our primary outcome parameter was the intergroup incidence of gestational diabetes mellitus. Other parameters included the mean 1-, 2-, and 3-hour glucose values and the rates of both cesarean delivery and large-for-gestational age infants. Of the 354 women studied, 108 entered the Carbo group, 105 entered the Candy group, and 141 comprised the Ad Lib group. The three groups were comparable with regard to historic and demographic risk factors for gestational diabetes mellitus. After the OTT, 29% of the Carbo group were considered to have gestational diabetes mellitus vs. 28% in both the Ad lib and Candy groups (P = 0.98). Additionally, both the mean intergroup fasting, 1-hour, 2-hour, and 3-hour whole blood glucose values and selected clinical outcomes were similar (P = 0.35–0.99). Compared to usual dietary intake, recommending a high carbohydrate diet had a negligible effect on the 100g oral OTT in pregnancy.

Reproducibility of the oral glucose tolerance test in pregnancy

This prospective investigation evaluated the reproducibility of the 100 gm oral glucose tolerance test. Sixty-four obstetric patients with ≥ 135 mg/dl on the 50 gm oral glucose screening test were scheduled for the 100 gm test. All patients repeated the oral glucose tolerance test in 1 to 2 weeks. Both tests included a preparatory diet, and testing conditions were identical. There were no significant differences in the mean test values at each testing interval when the entire study population was considered. Patients were then divided into four groups according to the outcome of the two tests. Forty-eight of 64 (75%) had normal results at each testing period (group 1); 11 of 64 (17%) had initially normal results and abnormal results on retest (group 2); 3 of 64 (5%) had initially abnormal results and normal results on retest (group 3); 2 of 64 (3%) had abnormal results at both testing phases (group 4). There were no significant differences between oral glucose tolerance test results within groups 1 and 4. However, significant differences occurred within groups 2 and 3 between the two tests. Group 2 patients had a greater frequency of an abnormal 1-hour value on the test than group 1 patients ( p = 0.001). Overall, the reproducibility of the oral glucose tolerance test was 78% (50 of 64). We recommend the oral glucose tolerance test be repeated when the 1-hour value is abnormal or when the fasting blood sugar, 1-hour, and 2-hour values are near the upper end of the normal range.

Reproducibility of the oral glucose tolerance test in pregnancy

This prospective investigation evaluated the reproducibility of the 100 gm oral glucose tolerance test. Sixty-four obstetric patients with greater than or equal to 135 mg/dl on the 50 gm oral glucose screening test were scheduled for the 100 gm test. All patients repeated the oral glucose tolerance test in 1 to 2 weeks. Both tests included a preparatory diet, and testing conditions were identical. There were no significant differences in the mean test values at each testing interval when the entire study population was considered. Patients were then divided into four groups according to the outcome of the two tests. Forty-eight of 64 (75%) had normal results at each testing period (group 1); 11 of 64 (17%) had initially normal results and abnormal results on retest (group 2); 3 of 64 (5%) had initially abnormal results and normal results on retest (group 3); 2 of 64 (3%) had abnormal results at both testing phases (group 4). There were no significant differences between oral glucose tolerance test results within groups 1 and 4. However, significant differences occurred within groups 2 and 3 between the two tests. Group 2 patients had a greater frequency of an abnormal 1-hour value on the test than group 1 patients (p = 0.001). Overall, the reproducibility of the oral glucose tolerance test was 78% (50 of 64). We recommend the oral glucose tolerance test be repeated when the 1-hour value is abnormal or when the fasting blood sugar, 1-hour, and 2-hour values are near the upper end of the normal range.

Amino acids and control of nucleolar size, the activity of RNA polymerase I, and DNA synthesis in liver.

The volume of nucleolar material per nucleus and the activity of RNA polymerase I (RNA nucleotidyltransferase I) become doubled in the liver cells of rats that are fed for several days a diet that lacks essential amino acids. Omission of methionine from a fully supplemented diet is equivalent to leaving out all the amino acids, and the responses to a deficiency of tryptophan are about 40% as great. Deprivation of one of the remaining essential amino acids gives either small responses or none at all. Supplementation of the methionine-free diet with cystine blocks the nucleolar enlargement and the enhancement of the polymerase activity that would otherwise take place, but the dispensable amino acid does not affect the responses to a deprivation of one of the other essential amino acids. After deprivation of all the essential amino acids or only methionine, hepatocytes make DNA when the rat is fed a meal with protein. A preparatory diet lacking in tryptophan is much less effective; a deficiency in any of the other indispensable compounds tested fails to prepare the liver for DNA synthesis. The results give hope that elucidation of the means by which methionine deprivation affects the nucleolus will also provide information on the regulation of nuclear DNA replication in liver. One attractive possibility is that the amino acid deficiency acts by producing some imbalance in protein metabolism.

Postural augmentation of plasma renin activity and aldosterone excretion in normal people.

Peripheral plasma renin activity and aldosterone excretion rates have been measured in normal people during recumbency, recumbent exercise, tilting, and continuous ambulation. Upright posture induces a prompt elevation in peripheral plasma renin activity beginning in 15 minutes and peaking between 60 and 120 minutes. Aldosterone excretion is increased during 120 minutes of upright posture and correlates directly with the elevation in renin activity. Upright posture induces increased plasma renin activity regardless of the level of sodium intake in the preparatory diet. Concomitant measurements of endogenous creatinine clearance and the rates of excretion of sodium and potassium suggest that a fall in renal arterial perfusion resulting from upright posture induces increased release of renin and the subsequent secondary stimulation of aldosterone secretion. Our data indicate that the changes in plasma renin activity are due to changes in the amount of the enzyme rather than to changes in other elements of the reninangiotensin systm. This report discusses the physiologic importance of postural augmentation of renin production, emphasizing that for proper interpretation of values of plasma renin activity, posture as well as dietary factors must be considered and controlled.

The early recognition of diabetes mellitus.

Progressively earlier recognition of the diabetic state is vital if progress is to be made toward the eventual control and prevention of the disease. The presence of mild diabetes mellitus may remain unrecognized in a large number of individuals for many years unless diagnostic laboratory procedures are freely employed in groups of individuals in whom experience has shown a high incidence of latent diabetes. Dependable diagnostic criteria are now available that make it possible to detect these previously unsuspected diabetic individuals. In addition, it is hoped that other means for detection of the diabetic state will be discovered that will give earlier evidence of its existence than is possible by present methods of testing. This discussion has two purposes, first, to consider the use and the criteria for the interpretation of the standard oral glucose tolerance test employed for the early detection of diabetes and second, to consider experience with the cortisone-glucose tolerance test as used for the possible prediction of future diabetes mellitus. The early recognition of diabetes mellitus depends upon the use and interpretation of proper laboratory procedures. In some cases the presence of latent diabetes will be recognized by routine performance of urinalysis and the determination of a single blood sugar level. In the mildest forms of the disease these procedures may be of little aid. In these cases the earliest recognizable abnormality may be a diminished ability to utilize a carbohydrate load as demonstrated by a glucose tolerance test. We have used the oral glucose tolerance test in our studies. For a t least 3 days preceding the test the subjects ingest a diet containing approximately 300 gm. carbohydrate per day plus maintenance calories.' Although the ingestion of smaller amounts of carbohydrate is sufficient to prevent abnormal tests in normal subjects, a standardized high-carbohydrate preparatory diet is advised to ensure the reproducibility of the test. The loading dose of glucose used is 1.75 gm./kg. of ideal body weight. Blood sugar levels are determined in venous blood by the Somogyi-Nelson technique. The criteria that we employ for the interpretation of the standard oral glucose tolerance test are illustrated in FIGURE 1.2 Carbohydrate tolerance is considered to be normal when the peak blood sugar value is less than 160 mg./ 100 ml. and the 2-hour value is less than 110 mg./100 ml. We regard the combination of an 1-hour value of 160 mg./100 ml. or above plus a 2-hour value of 120 mg./100 ml. or above as diagnostic of the existence of the diabetic state. In borderline curves the level a t 1% hours is required to be 140 mg./100 ml. or above to be diagnostic. This restriction eliminates a false diagnosis of

Criteria for and interpretation of normal glucose tolerance tests.

Excerpt The old dictum that every diabetic has a high prolonged glucose tolerance curve, but that every high prolonged curve is not indicative of diabetes, still holds true. The lack of specificity...

Congenital Malformations Induced in Rats by Maternal Vitamin A Deficiency: II. Effect of Varying the Preparatory Diet Upon the Yield of Abnormal Young: Four Figures

Congenital Malformations Induced in Rats by Maternal Vitamin A Deficiency: II. Effect of Varying the Preparatory Diet Upon the Yield of Abnormal Young: Four Figures