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Effects of intermittent very-low calorie diet on glycemic control and cardiovascular risk factors in obese patients with type 2 diabetes mellitus: A randomized controlled trial.
Umphonsathien, M, Rattanasian, P, Lokattachariya, S, Suansawang, W, Boonyasuppayakorn, K, Khovidhunkit, W
Journal of diabetes investigation. 2022;13(1):156-166
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Various studies have shown that intermittent low-calorie diets are effective in reducing weight and improving glycaemic control. In this randomized controlled trial, two intermittent very-low calorie diets (2 days per week and 4 days per week) were evaluated against a control group with respect to achieving diabetes remission, improving glycemic control, metabolic parameters, and quality of life in Type 2 diabetic patients. There was a significant reduction in HbA1c and insulin resistance in the 2 days/week and 4 days/week intermittent very-low calorie groups at week 20. Both the intervention groups achieved diabetes remission with 29% of participants not requiring glucose-lowering medications at week 20. Both intervention groups also showed a significant reduction in serum triglycerides, body weight, body mass index, and fat mass. Aspartate transaminase and alanine aminotransferase levels, as well as blood pressure, decreased significantly with a 4 day/week intermittent low-calorie diet. Both intervention groups experienced improved quality of life at week 10 and the interventions were generally well tolerated. To generalise the results, longer-term, robust studies are required. These results can help healthcare providers understand the clinical relevance of intermittent very-low calorie diets in managing Type 2 diabetes and obesity.
Abstract
AIMS/INTRODUCTION Very few studies assess the effectiveness of different protocols of intermittent very-low calorie diet (VLCD) in patients with diabetes. This study was designed to compare the effects of 2 days/week and 4 days/week of intermittent VLCD on glycemic control, diabetes remission, metabolic parameters and quality of life in patients with type 2 diabetes and obesity. MATERIALS AND METHODS Participants with obesity and type 2 diabetes were recruited and randomly assigned to three groups, consisting of control, 2 days/week and 4 days/week of intermittent VLCD. In the intermittent VLCD groups, participants received a 600-kcal diet per day on restricted days and ad libitum food consumption on non-restricted days. Glycemic control, rate of diabetes remission, metabolic parameters and quality of life were evaluated at baseline, weeks 2, 10 and 20. RESULTS A total of 40 participants were enrolled. The mean body mass index was 30.1 ± 5.9 kg/m2 , and the mean glycated hemoglobin was 7.4 ± 1.2%. At week 20, there was an improvement in glycemic control in both intermittent VLCD groups with significant decreases in glycated hemoglobin levels and insulin resistance index throughout the study periods. Diabetes remission without the need for medications was equally found in 29% of participants in both intermittent VLCD groups. Serum triglyceride, bodyweight, body mass index and fat mass were also significantly decreased in both VLCD groups. No serious adverse events were encountered. CONCLUSION Intermittent VLCD was highly effective in achieving optimal glycemic control. The effects of 2 days/week and 4 days/week of intermittent VLCD on diabetes remission were relatively similar.
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Meta-Analysis of Effects of Nutritional Intervention Combined with Calcium Carbonate D3 Tablets on Bone Mineral Density, Bone Metabolism, and Curative Effect in Patients with Osteoporosis.
Ni, H, Zhang, S, Niu, X, Dai, S
Contrast media & molecular imaging. 2022;2022:3670007
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Osteoporosis is characterised by reduced bone mineral density and changes in bone metabolism, which may increase the risk of bone fractures. Elderly people are more at risk of developing osteoporosis. A calcium carbonate D3 tablet combined with nutritional intervention is commonly recommended by health professionals for the treatment of osteoporosis in the elderly. In this meta-analysis, 10 Chinese literature, 7 high-quality literature and 3 low-quality research were examined to determine the effect of nutritional intervention with calcium carbonate D3 tablets on changes in bone mineral density and bone metabolism in osteoporosis patients. Nutritional intervention in combination with calcium carbonate tablet supplementation showed significant efficacy compared to the use of a single drug. In the combined intervention group, osteocalcin levels, serum alkaline phosphatase levels, serum calcium levels, blood phosphorus levels, and bone mineral density were significantly higher than those in the monotherapy group. This study provides healthcare professionals with an opportunity to gain a better understanding of the efficacy of nutritional intervention coupled with calcium carbonate D3 supplementation on osteocalcin levels, serum alkaline phosphatase levels, serum calcium levels, blood phosphorus levels, and bone mineral density in osteoporosis patients. The validity of the data and the clinical utility of different combinations of therapeutic strategies require further robust research.
Abstract
To investigate the changes in bone mineral density, bone metabolism, and efficacy of nutritional intervention combined with calcium carbonate D3 tablets in patients with osteoporosis, a RevMan 5.2 software meta-analysis was conducted in this study. According to the therapeutic direction of nutritional intervention combined with calcium carbonate D3 tablets for osteoporosis patients, relevant literature were searched in Wanfang Medical, CNKI, VIP, and PubMed literature databases at home and abroad. Keywords included bone mineral density, bone metabolism, blood calcium (Ca), blood phosphorus (P), osteocalcin (OC), bone mineral density (BMD), serum alkaline phosphatase (ALP), efficacy, osteoporosis, and nutritional intervention. Literature that met the criteria were deleted, and meta-analysis was performed using RevMan 5.2 software. The results indicate that a total of 10 Chinese literature were included. Compared with the monotherapy group, the clinical efficacy, osteocalcin, BMD, alkaline phosphatase, calcium, and phosphorus were significantly higher in the combination group (P < 0.05). Based on calcium carbonate D3, treatment combined with nutritional intervention can enhance the clinical efficacy, bone metabolism, and bone mineral density of patients with osteoporosis, and nutritional intervention combined with calcium carbonate D3 tablets is a feasible program to promote the recovery of patients with osteoporosis.
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The effect of cinnamon supplementation on liver enzymes in adults: A systematic review and meta-analysis of randomized controlled trials.
Shekarchizadeh-Esfahani, P, Heydarpour, F, Izadi, F, Jalili, C
Complementary therapies in medicine. 2021;58:102699
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Non-alcoholic fatty liver disease (NAFLD) is known to be the most prevalent hepatic disorder that is characterised by the accumulation of lipids within the hepatocytes exceeding 5% of the liver weight in the absence of excessive alcohol intake and secondary causes of liver diseases. Currently, the primary treatment for NAFLD is weight loss by lifestyle therapy involving diet and exercise. The aim of this study was to summarise the available evidence of randomised controlled trials to establish the effect of cinnamon supplementation on changes in liver enzymes among adults. This study is a meta-analysis of seven randomised controlled trials with nine treatment arms. In total, 266 participants were enrolled in selected articles, of which 133 individuals allocated to cinnamon supplementation group and 133 subjects to the control group. Results show that cinnamon cannot effectively reduce the liver enzymes - aspartate aminotransferase, alanine aminotransferase (ALT) and alkaline phosphatase levels. However, subgroup analyses showed that the effect of cinnamon supplementation on ALT levels was significant at dosages of <1500 mg/day, in trials lasting >12 weeks and in trials conducted of both genders. Authors conclude that due to limited availability of studies with NAFLD participants and relatively small sample sizes, well designed trials with adequate sample sizes aimed at NAFLD patients are recommended.
Abstract
AIMS: The aim of this study was to perform a systematic review and meta-analysis of randomized controlled trials (RCTs) to examine the effect of cinnamon supplementation on liver enzymes. METHODS A systematic search was performed in electronic databases including PubMed-Medline, Scopus, and ISI Web of Science up to November 2020. We used a random effects model to estimate pooled effect size of alanine aminotransferase (ALT), alkaline phosphatase (ALP), and aspartate aminotransferase (AST) levels. RESULTS Seven RCTs (9 treatment arms) fulfilled the eligibility criteria of the present meta-analysis. Overall, meta-analysis could not show any beneficial effect of cinnamon supplementation on AST, ALT, and ALP. Subgroup analyses showed that the effect of cinnamon supplementation on ALT was significant at the dosages of <1500 mg/day (Hedges's: -0.61; 95 % CI: -1.11, -0.10; P = 0.002), in trials lasting>12 weeks (Hedges's: -0.83; 95 % CI: -1.36, -0.30; P = 0.01), and in trials conducted of both gender (Hedges's: -0.72; 95 % CI: -1.45, -0.01; P = 0.04). CONCLUSION In summary, cinnamon supplementation had no significant effect on liver enzymes in adults. However, the effect of cinnamon on ALT levels was significant at the dosages of <1500 mg/day, in trials lasting>12 weeks, and in trials conducted of both gender. Nevertheless, further studies should be performed to confirm our results.