Regular Diet Group Research Articles

Is it necessary to stop glucagon-like peptide-1 receptor agonists prior to endoscopic procedure? A retrospective study.

Glucagon-like peptide-1 receptor agonists (GLP-1 RA) are effective in diabetes and obesity, reducing hyperglycemia by increasing insulin release and delaying gastric emptying. However, they can cause gastroparesis, raising concerns about aspiration during procedures. Recent guidelines advise discontinuing GLP-1 RA before surgery to reduce the risk of pulmonary aspiration. To evaluate the effect of GLP-1 RAs on gastric residual contents during endoscopic procedures. A retrospective chart review at BronxCare Health System, New York, from January 2019 to October 2023, assessed gastric residue and aspiration in GLP-1 RA patients undergoing endoscopic procedures. Two groups were compared based on dietary status before the procedure. Data included demographics, symptoms of gastroparesis, opiate use, hemoglobin A1c, GLP-1 agonist indication, endoscopic details, and aspiration occurrence. IBM SPSS was used for analysis, calculating means, standard deviations, and applying Pearson's chi-square and t-tests for associations, with P < 0.05 as being significant. During the study, 306 patients were included, with 41.2% on a clear liquid/low residue diet and 58.8% on a regular diet before endoscopy. Most patients (63.1%) were male, with a mean age of 60 ± 12 years. The majority (85.6%) were on GLP-1 RAs for diabetes, and 10.1% reported digestive symptoms before endoscopy. Among those on a clear liquid diet, 1.5% had residual food at endoscopy compared to 10% on a regular diet, which was statistically significant (P = 0.03). Out of 31 patients with digestive symptoms, 13% had residual food, all from the regular diet group (P = 0.130). No complications were reported during or after the procedures. The study reflects a significant rise in GLP-1 RA use for diabetes and obesity. A 24-hour liquid diet seems safe for endoscopic procedures without aspiration. Patients with upper gastrointestinal symptoms might have a higher residual food risk, though not statistically significant. Further research is needed to assess risks based on diabetes duration, gastroparesis, and GLP-1 RA dosing, aiming to minimize interruptions in therapy during procedures.

Anti-obesity effects of potential probiotic Lactobacillus strains isolated from Mongolian fermented dairy products in high-fat diet-induced obese rodent model.

This study aims to investigate the anti-obesity properties of lactic acid bacteria (LAB) isolated from fermented dairy products such as "Airag" and "Khoormog" in Mongolia. These traditional dairy products are widely used in Mongolia and believe in having potential probiotic, anti-diabetes, anti-cancer, and anti-tuberculosis properties and are made from unheated two-humped camel milk and mare milk, respectively. We chose three LAB strains based on their probiotic characteristics, including tolerance of gastric and bile acids. Then we checked the anti-obesity activity of probiotic strains in vivo. An animal model was evaluated in twenty male C57BL/6J mice by inducing obesity with a high-fat diet (HFD), which was divided into five groups: regular diet group (Negative control), HFD group (Positive control), HFD with Lacticaseibacillus paracasei X-1 (X-1), Lacticaseibacillus paracasei X-17 (X-17), and Limosilactobacillus fermentum BM-325 (BM-325). For six weeks, 5 × 109 colony-forming units (CFU) of bacteria were given orally to the LAB-fed groups. Fasting blood glucose (FBG), lipid profiles, organ index, and organ morphology were all measured. The probiotic strains suppressed growth in adipose cell volume, stabilized FBG, reduced liver cell degeneration, and slowed HFD-induced body weight gain. The results suggest that some strains increase general metabolism while lowering body weight.

Intermittent Fasting After ST-Segment-Elevation Myocardial Infarction Improves Left Ventricular Function: The Randomized Controlled INTERFAST-MI Trial.

Intermittent fasting has shown positive effects on numerous cardiovascular risk factors. The INTERFAST-MI trial (Intermittent Fasting in Myocardial Infarction) has been designed to study the effects of intermittent fasting on cardiac function after STEM (ST-segment-elevation myocardial infarction) and the feasibility of future multicenter trials. The INTERFAST-MI study was a prospective, randomized, controlled, nonblinded, single-center investigator-initiated trial. From October 1, 2020, to July 15, 2022, 48 patients were randomized to the study groups intermittent fasting or regular diet and followed for 6 months with follow-up visits at 4 weeks and 3 months. In all, 22 of 24 patients in the intermittent fasting group with a mean age of 58.54±12.29 years and 20 of 24 patients in the regular diet group with a mean age of 59.60±13.11 years were included in the intention-to-treat population. The primary efficacy end point (improvement in left ventricular ejection fraction after 4 weeks) was significantly greater in the intermittent fasting group compared with the control group (mean±SD, 6.636±7.122%. versus 1.450±4.828%; P=0.038). This effect was still significant and even more pronounced after 3 and 6 months. The patients in the intermittent fasting group showed a greater reduction in diastolic blood pressure and body weight compared with the control group. The mean adherence of patients in the intermittent fasting group was a median of 83.7% (interquartile range, 69.0%-98.4%) of all days. None of the patients from either group reported dizziness, syncope, or collapse. Our results suggest that intermittent fasting after myocardial infarction may be safe and could improve left ventricular function after STEMI. URL: https://www.drks.de; Unique identifier: DRKS00021784.

Improvement of oral function and its impact on oral food intake in subacute stroke patients: A prospective study with dental intervention.

The association between oral food intake and oral function during the subacute stage of stroke is not well known. To investigate (1) oral function changes in subacute stroke patients and (2) association between oral function and oral intake status at several time points. In a prospective study involving 324 stroke patients at a convalescent rehabilitation unit, four oral function parameters (maximum tongue pressure, MTP; lip-tongue motor function, LTMF; maximum occlusal force, MOF and oral health assessment tool, OHAT) were quantitatively measured upon admission (T0), at 1 month (T1) and 2 months (T2). Oral feeding status was assessed using the Functional Oral Intake Scale (FOIS) and divided based on the FOIS score into the dysphagic and regular diet groups. The changes in oral functions at the three time points were tested using generalized estimating equation analysis. The association between FOIS groups and oral functions at T1 and T2 was analysed by means of logistic regression analysis. All oral function parameters improved significantly over time during the hospital stay (mean differences: 4.9 for MTP, 0.6 for LTMF, 1.1 for MOF and -1.8 for OHAT). The FOIS groups were significantly associated with MTP (p < .05) and OHAT (p < .05) at both T1 and T2. Our findings suggest that oral function significantly improves in patients during subacute stroke rehabilitation and better oral health can be associated with better oral intake. Improved oral function through dental intervention and oral rehabilitation may contribute to gains in oral food intake.

Protective role of Multi-strain Probiotic Bacteria against Eimeria in Broilers

In the present research, two trials were conducted to investigate the potential protective effects of multi-strain probiotic bacteria in broiler chickens experimentally infected with Eimeria brunetti or Eimeria mivati. In the present study, we examined oocysts shedding; antibody immune responses and histopathology differences of broilers fed the commercial probiotic Poultry Star Me (PSM). Day-old Ross 308 broiler chicks were fed either a regular broiler diet or one of two probiotic diets supplemented with 0.1% PSM or 0.2% PSM. Chicks were orally challenged with 5000 or 10000 sporulated oocysts of Eimeria brunetti or with 5000 Eimeria mivati oocysts on day 10 or 12 of age, respectively. In Eimeria brunette and Eimeria mivati-infected birds, the PSM 0.1% group showed reduction in oocyst shedding in birds infected with 5000 Eimeria oocysts as compared with the other two groups. In Eimeria mivati-infected birds, Eimeria-0.05) in the PSM fed groups, especially in the PSM 0.1% birds, compared with the regular diet group. These results demonstrate that this PSM probiotic effectively enhances the immune resistance of birds and protects against the negative growth effects associated with coccidiosis (Eimeria infestation), particularly when supplemented at 0.1% PSM of the diet. Histopathology changes revealed normal architecture and greater vilus height was obtained in ileum with the use of PSM in relation to the control group. Multi-strain probiotic bacteria interfere with the pathogen binding sites and produce antimicrobial peptides and induce host immune responses especially mucosal surfaces immunity, thus enhancing resistance against enteric intestinal pathogens like Eimeria spp.

Changes in oral health status with dental intervention during the acute to subacute stages of stroke.

To investigate the changes in oral health status with dental intervention during the acute and subacute stages of stroke and their associations with oral intake status. Oral health may deteriorate easily in patients following a stroke. However, data are scarce on the changes in oral health with dental intervention throughout the acute and subacute stages of stroke recovery. We prospectively recruited 98 stroke patients who were admitted to an acute hospital and referred to a dental team and then could be followed at a subacute rehabilitation unit in the same hospital. Provided dental intervention, including oral health care and other general dental treatments, was recorded. Oral health was assessed with Oral Health Assessment Tool (OHAT), and the changes in OHAT score during the acute and subacute stages were statistically tested. Oral feeding status was examined using Functional Oral Intake Scale (FOIS). The cohort was divided into the non-oral feeding, dysphagia and regular diet groups based on FOIS score. Differences in OHAT among the oral intake groups were statistically tested. Gross OHAT score did not differ among the oral intake groups at the time of admission (mean ± standard deviation score: 6.5 ± 2.8 for non-oral diet, 5.6 ± 2.4 for dysphagia diet and 5.3 ± 2.1 for regular diet), but improved more in the regular diet group (2.4 ± 1.5) than in the other groups (5.8 ± 3.0 for non-oral diet and 4.0 ± 2.1 for dysphagia diet) at the last evaluation. Oral hygiene scores improved significantly in the acute stage, while scores for dentures and natural teeth ameliorated significantly in the subacute stage. Our findings suggest that appropriate dental intervention in the acute and subacute stages of stroke may contribute to improved oral health and oral food intake.

Effects of the Phytocompound Combination against Dysbiosis Induced by AGE-Rich High-fat Diet in Mice

Background and Aims: The composition of the Microbiota can be influenced by various lifestyle and environmental factors, including diet. We designed a study to investigate the improving effects of plant extract, the combination of turmeric, ginger, boswellia, and cat’s claw on the abundance of key members of the gut microbiota, Bacteroidetes, Akkermansia muciniphila (A. muciniphila), Faecalibacterium prausnitzii (F. prausnitzii), Firmicutes and Bifidobacterium in mice treated with advanced glycation end products (AGE) rich high-fat diet (HFD).&#x0D; Materials and Methods: Eighteen 2-month age male C57BL/6 mice were adopted to a regular diet for 1 week and then fed with an HFD or regular diet. After 8 weeks of diet, animals received plant extract concurrently with HFD for 8 weeks. Stools were taken, DNA of stool samples was extracted, and qPCR of 16s rDNA universal primers was performed. Then the effect of plant extract on dysbiosis induced by AGE-rich HFD was accessed.&#x0D; Results: Our results revealed the frequencies of Bacteroidetes (p=0.001), A. muciniphila (p= 0.0005), F. prausnitzii (p&lt;0.0001), and Bifidobacterium (p= 0.0008) were reduced, whereas the frequency of Firmicute was increased in the AGE-rich HFD group. A significant increase in the F/B ratio was observed in the HFD group than in the regular diet group (p= 0.0003). plant extract reduced the F/B ratio and improved gut microbiota homeostasis. &#x0D; Conclusion: Plant extract restored gut microbiota patterns in HFD-treated mice. It seems more studies are required to prove the application of plant extracts for modulating the gut microbiota as a promising new biomarker with potential for therapeutic applications.

1538-P: Brain TGFß Regulates Glucose Tolerance in Male Mice with Metabolic Syndrome

Hypothalamic inflammation contributes to insulin resistance and obesity. Transforming growth factor beta (TGFβ) is among the inflammatory mediators inducing hypothalamic inflammation. In this study, we investigated the role of brain TGFβ on metabolic function. We hypothesized that TGFβ in the brain promotes insulin resistance and reduces glucose tolerance in diabetic and obese mice. C57BL/J male mice were fed either hypercaloric diet (HCD, 52% fat) or regular diet (RD) from weaning. At 3 months age, intraperitoneal glucose tolerance test (GTT), insulin tolerance test (ITT) and weight confirmed the acquisition of metabolic syndrome. Hypothalamic protein expression was assessed for TGFβ receptor 2, phosphorylated SMAD3, SMAD6 and SMAD7, as downstream signal transducer proteins for TGFβ. Compared to RD male mice (n=6), mice on HCD (n=6) showed glucose intolerance (AUC; 60587 ±2460 vs. 30802±1923, p&amp;lt;0.0001), insulin intolerance (AUC; Mean±SEM; 19025836.0 vs.11436±1087, p=0.02) and weight gain (33.67±2.028 vs. 26.89±0.4231 g). HCD mice also exhibited increased protein levels of TGFβR2 (normalized to total protein, Fold Change (FC)±SEM to RD group; 3.54±0.3, p&amp;lt;0.0001), pSMAD3 (FC 2±0.5, p=0.04) while inhibitors for TGFβ signaling such as SMAD6 and SMAD7, were downregulated (FC 0.7±0.1, p=0.03 and 0.8±0.04, p=0.03, respectively). To understand the role of brain TGFβ on metabolic regulation, 3 months HCD mice were subjected to intracerebroventricular (ICV) infusion with either TGFβ neutralizing antibody (nAb, n=4) or IgG control antibody (n=4) using subcutaneous osmotic pumps connected to ICV cannula for 2 weeks. GTT was measured after 2-week infusion. Treatment with TGFβ nAb resulted in lower fasting blood glucose compared to before treatment (166.1 ±6.878 vs. 229.9 ±3.923 mg/dL) and at 120 min time point (229.9 ±28.69 vs. 382.2 ±24.33 mg/dL). In conclusion, brain TGFβ plays a key role in regulating glucose metabolism probably through inflammation-induced insulin resistance. Disclosure M.Elgazzaz: None. K.Miao: None. A.R.Nuzzo: None. L.Restivo: None. K.Moles: None. E.D.Lazartigues: None. Funding American Diabetes Association (1-19-IBS-291 to E.D.L.)

Taurine alleviated hepatic steatosis in oleic acid-treated-HepG2 cells and rats fed a high-fat diet

Taurine has been proven in many trials to alleviate the symptoms of metabolic associated fatty liver disease. Here its protective effect for hepatic steatosis and modulation of AMP-activated protein kinase and insulin signaling pathway were investigated. Steatotic HepG2 cell established with oleic acid (0.05 mmol/L), treated with taurine (5 mmol/L), dorsomorphin (10 μmol/L) for 24 h. Sprague Dawley rats were divided into regular and high-fat diet (HFD) groups, and their corresponding taurine (70 or 350 mg/kg BW/d) groups, fed for 8 weeks. In steatotic cell, taurine reduced the TG concentration and SREBP-1c, PPARγ, FAS, ACC, SCD1 protein levels, decreased phosphorylation of mTOR, IRS1 (Ser302), increased phosphorylation of AMPKα, LKB1, PI3K, Akt, ACC. While dorsomorphin eliminated taurine's TG-lowering effect. In HFD-fed rats, taurine reduced liver TG, serum TG, ALT, AST, IL-1β, IL-4, TNF-α. The effects of taurine on the main factors of fatty acid synthesis were mostly consistent with cell experiments, and the reduction of microRNAs (451, 33, 291b) was aligned with the improvement in LKB1 and AMPK expression in HFD rats. Taurine alleviated steatosis-induced inhibition of IRS1-PI3K-Akt pathway, but suppressed its positively regulated downstream factor mTOR. In parallel, taurine reduced steatosis by activating LKB1-AMPKα pathway via phosphorylation and no-phosphorylation manner, then inhibiting SREBP-1c directly or by suppressing mTOR phosphorylation.

Lupus pathogenesis and autoimmunity are exacerbated by high fat diet-induced obesity in MRL/lpr mice

ObjectiveSLE is an autoimmune disease characterised by persistent inflammation and autoantibody production. Genetic predisposition and environmental factors such as a high-fat diet (HFD) may contribute to lupus development. However, the...

Impact of metabolic substrate modification on myocardial efficiency in a rat model of obesity and diabetes

Abstract Background Congenic leptin receptor deficient rat generated by introgression of the Koletsky leptin receptor mutation into BioBreeding Diabetes Resistant rat (BBDR.lepr−/−) is a novel animal model combining obesity, systemic insulin resistance and diabetes. Systemic insulin resistance is associated with reduced myocardial glucose utilization, but its effect on myocardial external efficiency, i.e. the ability of the myocardium to convert energy into external stroke work, remains uncertain. Purpose To characterize cardiac energy metabolism and function in BBDR.lepr−/− rats and to study the effect of dipeptidyl peptidase 4 (DPP-4) inhibitor linagliptin in this model. Methods Cardiac phenotype was evaluated in six-month-old male BBDR.lepr−/− rats (n=11) and age-matched male non-diabetic lean control littermates (BBDR.lepr+/− or BBDR.lepr+/+ rats, n=14). Of these, 7 BBDR.lepr−/− rats and 6 controls underwent cardiac ultrasound, 2-deoxy-2-[18F]fluoro-D-glucose ([18F]FDG) positron emission tomography/computed tomography (PET/CT), and [11C]acetate PET in order to evaluate cardiac structure and function as well as glucose and oxidative metabolism. In the remaining rats, fatty acid metabolism was evaluated by [18F]fluorothia-6-heptadecanoic acid ([18F]FTHA) PET/CT. In the linagliptin intervention study, 25 BBDR.lepr−/− male rats were randomly divided into control group (n=11) that received regular chow diet and linagliptin group (n=14) that received linagliptin (10mg/kg/d) mixed in the chow diet for three months. After the intervention, the rats underwent cardiac ultrasound, [18F]FDG PET/CT, and [11C]acetate PET. Results Compared with controls, BBDR.lepr−/− rats showed increased left ventricle (LV) mass (∼40%, p&amp;gt;0.001) and higher systolic blood pressure (∼10%, p=0.02). However, fractional shortening and cardiac output were similar in both groups. Myocardial fractional uptake rate of glucose measured with [18F]FDG PET was significantly reduced (∼86%, p=0.004) (Fig. 1A, E), whereas myocardial fatty acid uptake measured by [18F]FTHA PET was not significantly increased (free fatty acid (FFA) corrected standardized uptake value (SUV) ∼21%, p=0.54) (Fig. 1B) in BBDR.lepr−/− compared to controls. Myocardial oxygen consumption assessed by [11C]acetate PET was similar in both groups (Fig. 1C, E), but LV work per gram of myocardium was reduced (∼28%, p=0.001) resulting in reduced myocardial external efficiency (∼21%, p=0.03) (Fig. 1D) in BBDR.lepr−/− compared to controls. Treatment with linagliptin significantly enhanced myocardial fractional uptake rate of glucose (∼166%, p=0.006) (Fig. 2A, C), but had no effect on efficiency of cardiac work (Fig. 2B). Conclusions Obese and diabetic BBDR.lepr−/− rats demonstrate LV hypertrophy and markedly reduced myocardial glucose utilization associated with impaired myocardial external efficiency despite normal LV systolic function. Enhancement of myocardial glucose uptake by linagliptin did not improve efficiency of cardiac work. Funding Acknowledgement Type of funding sources: Public grant(s) – EU funding. Main funding source(s): IMI-SUMMIT

Protective effect of fish oil targeting hadhaa (3-ketoacyl-CoA thiolase, alpha subunit a and hadhb (3-ketoacyl-CoA thiolase, beta subunit) against high cholesterol diet (HCD) induced atherosclerosis on Zebrafish

Currently a high mortality rate is observed due to heart diseases such as atherosclerosis and myocardial infarction, which are mainly caused due to high cholesterol. More novel drugs are needed to replace the currently available drugs to reduce the side effects. Zebrafish are an effective model for lipid metabolism studies in vertebrates. Because it shares 80% of diseases related genes similarity with humans. Zebrafish (Male) were fed with high cholesterol diet to induce atherosclerosis and the cholesterol levels of the Zebrafish are measured. Further, the m RNA expression of hadhaa and hadhb genes in the liver, intestine, and skeletal muscle of Zebrafish are studied. Finally, the atherosclerotic protective effects of fish oil are studied using fluorescence imaging of EGPF Zebrafish larvae and using nail red staining. In this study, we evaluated the effect of a fish oil-rich diet, dietary lipids reported having anti-obesity effects in animals, or cholesterol build-up in Zebrafish. Zebrafish were fed a high cholesterol diet containing 20% (w/w) fish oil. Zebrafish in the fish oil-fed group has 40% less cholesterol build-up than in the regular diet group. The genes encoding beta oxidases such as hadhaa and hadhb are expressed 2 fold higher in the gut of the fish oil treated group. Thiolase/enoyl coenzyme A-hydrates were 20% higher in the test (fish oil) diet group than in the normal diet (pellets) group (p < 0.05). The expression of the fatty acid synthesis gene (fasn) in the liver was considerably reduced in the fish oil group compared to the normal diet group (p < 0.05). These results show that fish oil may reduce cholesterol accumulation and might be used as an effective tool for anti-atherosclerotic drug development and on functional foods with further research. • In this research article we have discussed the possible effect of fish oil over HCD fed Zebrafish. • We have observed a positive effect on fish oil fed Zebrafish. • We suggest that the fish oil may have ability to reduce cholesterol accumulation and blood cholesterol level reduction. • All fishes subjected to the study are male Zebrafish.

The impact of immunonutrition on pancreaticoduodenectomy outcomes

Malnutrition is a significant risk factor for decreased survival in cancer patients undergoing a pancreaticoduodenectomy (PD). Our study aims to investigate the impact of immunonutrition on length of stay (LOS), infection rates, postoperative pancreatic fistula (POPF), and delayed gastric emptying (DGE). This study retrospectively reviewed 344 patients who underwent PD between 2007 and 2018. Patients were on a regular diet or 5 days of preoperative immunonutrition. Statistical analyses were done via t -test and chi-square test with a significance cutoff of p < 0.05. Immunonutrition was associated with increased intraabdominal infection (13% vs. 23%, p = 0.021), POPF (6% vs. 19%, p = 0.001), and decreased DGE (17% vs. 8%, p = 0.013). When patients were stratified by pathology, immunonutrition was not associated with POPF or infection rates in the pancreatic adenocarcinoma (PDAC) group. In the non-PDAC group, immunonutrition was associated with longer LOS (12.4 vs. 9.9 days, p = 0.02) and higher rates of intraabdominal infection (26% vs. 10%, p = 0.02) compared to the regular diet group. In PDAC patients undergoing PD, preoperative immunonutrition did not have an impact on LOS, infections, POPF, or DGE. In non-PDAC patients, immunonutrition was associated with longer LOS and higher intraabdominal infections. Additional studies are needed to validate the routine use of immunonutrition in this patient population

A pilot dynamic analysis of formative factors of nephrolithiasis related to metabolic syndrome: evidence in a rat model

Introduction and objective To examine the dynamic changes in the formative factors of nephrolithiasis and the final micromorphological changes in an obesity-initiated metabolic syndrome (MS) rat model. Methods Forty five-week-old male Sprague–Dawley (SD) rats were randomly divided into four groups: the regular diet group (RD), high-fat diet group (HFD), regular diet with drug (ethylene glycol and ammonium chloride) group (RDD), and high-fat diet with drug group (HFDD). A dynamic assessment of MS components (body weight (BW), body length (BL), Lee’s index (LI), blood glucose (BG), total cholesterol (TC), and triglycerides (TGs)) and stone-forming factors (urinary pH, urinary calcium, and urinary oxalate acid) was carried out. In addition, the levels of oxidative stress (OS) markers (CAT, SOD, TAC, GSH-PX, and MDA) were measured, and histological analysis was carried out at the end of 16 weeks. Results MS-related parameters, such as BW, LI, BG, TC, and TG, were significantly higher in HFD-fed rats than in RD-fed rats (p < 0.001). In the HFDD group, significantly lower urinary pH, hyperoxaluria, and hypocalciuria were noted in the dynamic assessment of stone-forming factors (p < 0.001). CAT, TAC, and MDA were notably changed in the HFD-fed groups, particularly the HFDD rats. Histological analysis showed that the renal tubules of HFDD rats had the highest scores for both inflammation and renal crystallization deposition (p < 0.05). Conclusions Our results suggest that male SD rats with MS are prone to developing nephrolithiasis. Validation in an in vivo model may lead to an understanding of the underlying pathophysiological mechanisms of action of MS-related nephrolithiasis in humans. Key messages Male SD rats with metabolic syndrome are more prone to developing calcium oxalate nephrolithiasis after treatment with ethylene glycol and ammonium chloride compared to control lean rats. MS-related nephrolithiasis in rats induced by ethylene glycol and ammonium chloride is mainly related to increased hyperoxaluria and inflammation and decreased antioxidant levels. High-fat diet-fed SD rats treated with ethylene glycol and ammonium chloride are a stable and valid in vivo model for understanding the potential mechanism of action of MS-related nephrolithiasis.

Clinical (BMI and MRI) and Biochemical (Adiponectin, Leptin, TNF-α, and IL-6) Effects of High-Intensity Aerobic Training with High-Protein Diet in Children with Obesity Following COVID-19 Infection.

Objective: To find the clinical and biochemical effects of high-intensity aerobic training with a high-protein diet in children with obesity following COVID-19 infection. Methods: By using the block randomization method, the eligible participants were randomized into two groups. The first group received high-intensity aerobic training with a high-protein diet (Group A; n = 38) and the second group were allowed to do regular physical activities and eat a regular diet (Group B; n = 38) for 8 weeks. Clinical (basal metabolic index (BMI) and muscle-mass-cross-sectional area (CSA)) and biochemical (Adiponectin, leptin, TNF-α, and IL-6) measures were measured at baseline, on the 8th week, and at 6-months follow-up. Results: Baseline demographic and clinical attributes show homogenous presentation among the study groups (p > 0.05). After eight weeks of intervention, and at the end of 6-months follow-up, the basal metabolic index (BMI) (6.3) (CI 95% 4.71 to 7.88), mid-arm CSA (17) (CI 95% 14.70 to 19.29), mid-thigh CSA (13.10) (CI 95% 10.60 to 15.59), mid-calf CSA (11.3) (CI 95% 9.30 to 13.29), adiponectin (−1.9) (CI 95% −2.13 to −1.66), leptin (5.64) (CI 95% 5.50 to 5.77), TNF-α (0.5) (CI 95% 0.42 to 0.57), and IL-6 (0.21) (CI 95% 0.18 to 0.23) showed more improvement (p < 0.001) in Group A than Group B (p > 0.05). Conclusion: Overall, this trial found that high-intensity aerobic training with a high-protein diet decreased the BMI percentile and muscle mass (arm, thigh, and calf), and positively altered the biochemical variables in children with obesity.

1327-P: Loss of Exocrine Pancreas Improves Glucose Tolerance and Insulin Secretion in Diet-Induced Hyperglycemia

There are two intra-pancreatic axes of communication between the endocrine and exocrine pancreas (insular-acinar &amp; acinar-insular axes) yet the study of the endocrine and exocrine pancreas have generally been conducted separately. We previously showed that loss of acinar cells improved glucose homeostasis in wild type mice. Here, we examined the effect of loss of acinar cells on diet-induced hyperglycemia.We used a genetic mouse model (ElaCreERT2; R26DTR) , wherein diphtheria toxin (DT) ablates acinar cells, allowing for the study of β-cell function in the absence of acinar cells. We included 3 groups [ElaCreERT2; R26DTR + high fat diet (HFD) ], [R26DTR + HFD], and [R26DTR + regular diet (RD) ]. These groups were on their respective diets for 12 weeks, then underwent glucose tolerance testing (GTT) and glucose stimulated insulin secretion (GSIS) after DT injection. Four days post-DT, the ElaCreERT2; R26DTR+HFD mice had a significantly improved glucose tolerance compared to R26DTR + HFD (AUC p=0.0003) . Importantly, the ElaCreERT2; R26DTR + HFD were not different from R26DTR+RD, indicating complete reversal of the hyperglycemia. GSIS done during GTT showed significantly lower insulin secretion in ElaCreERT2; R26DTR + HFD compared to R26DTR + HFD (AUC p=0.0388) , but similar to R26DTR+ RD, again indicating normalization. Islets were isolated from the 3 groups for in vitro GSIS, which showed no difference in the insulin secretion between ElaCreERT2; R26DTR + HFD and R26DTR + RD, but both had increased insulin secretion compared to R26DTR + HFD. Four weeks post-DT, when full regeneration of acinar cells from duct cells takes place, repeat GTT in the same animals showed that HFD groups had worse glucose tolerance compared to the RD group, suggesting that it was specifically the loss of the acinar cells that improved glucose tolerance. We conclude that the acute ablation of exocrine pancreas improves glucose tolerance and reverses HFD-induced hyperglycemia by enhancing insulin secretion. Disclosure S.Abi raad: None. M.Saleh: None. G.Gittes: None.

Factors Affecting Hospitalization and Death of Older Patients Who Need Long-Term Care-The Necessity of the Support for Dysphagia in Home Dental Care.

The demand for home dental care is increasing, but how it should be involved in the continuation of life at home for elderly people who need care has not been examined. Therefore, we examined whether items examined by dentists can affect hospitalization and death. The study included 239 patients with oral intake. They were divided into regular and non-regular diet groups, and ages, nutritional statuses, activities of daily living (ADLs), Charlson Comorbidity Indexes (CCI) and swallowing functions were compared. The nutritional statuses and ADLs of the three groups at the first visit and after one year were compared. The groups included those with stable, declined and improved diet forms. Factors influencing hospitalization and death over three years were examined. Nutritional status, swallowing function, CCI and ADLs were worse in the non-regular diet group. The declined diet form group had lower ADL levels and nutritional statuses at the first visit. A proportional hazards analysis showed significant differences in the changes in diet form for the stable and declined groups related to hospitalization (hazard ratio (HR): 6.53) and death (HR: 3.76). Changes in diet form were thought to affect hospitalization and death, and it is worthwhile to assess swallowing function in home dental care.

Effects of a Mediterranean Diet Compared with the Low-Fat Diet on Patients with Knee Osteoarthritis: A Randomized Feeding Trial.

Objectives Knee osteoarthritis is a common global problem, especially in overweight and obese people. It is not clear that weight loss is a factor for pain reduction in these patients or dietary components are important. Herein, we compared the effects of Mediterranean (MD) and low-fat diet on pain, stiffness, and physical function in patients with knee osteoarthritis. Subjects/Methods In this randomized feeding trial, 129 patients with knee osteoarthritis were enrolled. Participants were randomly allocated to the MD (n = 43), low-fat diet (n = 43), and control group (regular diet) (n = 43) for 12 weeks by the blocked randomization method. Total Western Ontario and McMaster Universities Arthritis Index (WOMAC) score and its subscales and anthropometric indices were compared among the groups at the baseline and end of the study. Results Weight and waist circumference reduction was significantly higher in the MD and low-fat diet groups compared with the regular group (p < 0.001 and p < 0.001, respectively), but there was no significant difference between the MD and low-fat diet groups (p = 0.2). Pain was significantly decreased in the Mediterranean-style compared with the low-fat (p = 0.04) and regular (p = 0.002) diet groups. Physical function was significantly improved in the MD compared with the regular diet group (p = 0.01), but had no significant difference with the low-fat one. Stiffness had no significant difference among the dietary groups. Conclusions Pain severity was reduced in the MD group, but no significant change was reported in patients on low-fat and regular diets. It seems that dietary components in the MD, regardless of weight loss effect, are effective on pain reduction in patients with KOA. The present study was registered in the IRCT under the code of IRCT20200929048876N1.

Regular diet is non-inferior to restricted diet after polypectomy with decreased hospitalization length of stay and cost: a randomized–controlled trial

BackgroundThere are no data comparing a regular diet with a restricted diet after endoscopic polypectomy in patients with colorectal polyps. The current guidelines also did not provide the detailed information of dietary patterns after polypectomy. In this study, we aimed to evaluate the safety and efficacy of different diets on post-polypectomy outcomes.MethodsA total of 302 patients with colorectal polyps who underwent polypectomy were prospectively enrolled between March 2019 and December 2019 in Nanfang Hospital (Guangzhou, China). Enrolled patients were then randomly assigned to a regular diet group or a restricted diet group after polypectomy. The study is a non-inferior design and the primary end point was the post-operative adverse events (AE) rate. Secondary end points included length of stay (LOS) and hospitalization cost.ResultsAmong all the included patients, 148 patients received a restricted diet and 154 patients received a regular diet after polypectomy. A total of 376 polyps were removed, with 183 polyps in the restricted diet group and 193 polyps in the regular diet group. Shorter LOS (4.0 ± 1.4 vs 4.8 ± 1.7, P < 0.001) and lower hospitalization costs (7,701.63 ± 2,579.07 vs 8,656.05 ± 3,138.53, P = 0.001) were observed in the regular diet group. In particular, there was no significant difference in 3-day AE rates between the restricted diet and the regular diet group (1.35% [2/148] vs 2.60% [4/154], P = 0.685). Subgroup analysis looking at the number of polyps removed in each patient and different treatment modalities also showed similar findings.ConclusionRegular diet should be recommended after polypectomy for polyps <20 mm as it can shorten LOS and save hospitalization costs.

Texture-Modified Diets Need to be Improved in Vietnamese Hospitals.

Purpose : The aim of this study is to compare the nutritional status of older adult inpatients consuming Texture-Modified Diets (TMD) to older adult inpatients consuming a regular diet. Methods : The study was designed as cross-sectional and was conducted in three large hospitals in northern Vietnam. The data for 344 older adult inpatients were collected in 2021 by dietitians. Results : The result showed 104 subjects were prescribed TMD. The textures of hospital diets have still not been adequately developed. In particular, the hospitals had not yet developed pureed meals. All older adult inpatients (74.7 ± 6.8 years old, 52.9% female) had 28.8% malnutrition by the GLIM criteria. The TMD group had a malnutrition prevalence two times higher than the regular diet group. Total energy intake from hospital meal and outside snacks in the regular diet group was higher than in the TMD group, about 150 kcal. Although energy provided from the hospital diet in both groups was similar, hospital meal wastage in the TMD group was higher than in the regular diet group. Conclusion : The older adult inpatients on TMD may have a nutritional status worse than those consuming a regular diet. Hospital diets need to be improved in texture and quality. J. Med. Invest. 69 : 230-236, August, 2022.