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Fasting off "The COVID-19".
Mccalmon, S, Galappaththy, SL, Bulchandani, S, Cabandugama, PK
Missouri medicine. 2021;(2):164-167
Abstract
The SARS-CoV-2 outbreak has led to an increase in sedentary lifestyles compounded with the loss of access to public exercise facilities and limited fresh grocery supply. With the multitude of possible diet options available, how do you choose one that works with your lifestyle, financial means, and ultimately proves to be most effective? In this article, we review the medical benefits and challenges of several different types of fasting diets that can be adopted by the general public.
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Weight Loss Strategies and the Risk of Skeletal Muscle Mass Loss.
McCarthy, D, Berg, A
Nutrients. 2021;(7)
Abstract
With energy intake restriction and exercise remaining the key diet and lifestyle approaches to weight loss, this is not without potential negative implications for body composition, metabolic health, and quality and quantity of life. Ideally, weight loss should be derived almost exclusively from the fat mass compartment as this is the main driver of metabolic disease, however, several studies have shown that there is an accompanying loss of tissue from the fat-free compartment, especially skeletal muscle. Population groups including post-menopausal women, the elderly, those with metabolic disease and athletes may be particularly at risk of skeletal muscle loss when following a weight management programme. Research studies that have addressed this issue across a range of population groups are reviewed with a focus upon the contribution of resistance and endurance forms of exercise and a higher intake dietary protein above the current guideline of 0.8 g/kg body weight/day. While findings can be contradictory, overall, the consensus appears that fat-free and skeletal muscle masses can be preserved, albeit to varying degrees by including both forms of exercise (but especially resistance forms) in the weight management intervention. Equally, higher intakes of protein can protect loss of these body compartments, acting either separately or synergistically with exercise. Elderly individuals in particular may benefit most from this approach. Thus, the evidence supports the recommendations for intakes of protein above the current guidelines of 0.8 g/kg body weight/d for the healthy elderly population to also be incorporated into the dietary prescription for weight management in this age group.
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A Review of Recent Findings on Meal Sequence: An Attractive Dietary Approach to Prevention and Management of Type 2 Diabetes.
Kubota, S, Liu, Y, Iizuka, K, Kuwata, H, Seino, Y, Yabe, D
Nutrients. 2020;(9)
Abstract
While adjustment of total energy and nutritional balance is critically important, meal sequence, a relatively simple method of correcting postprandial hyperglycemia, is becoming established as a practical dietary approach for prevention and management of diabetes and obesity. Meal sequence, i.e., consumption of protein and/or fat before carbohydrate, promotes secretion of glucagon-like peptide-1 (GLP-1) from the gut and ameliorates secretions of insulin and glucagon and delays gastric emptying, thereby improving postprandial glucose excursion. GLP-1 is known to suppress appetite by acting on the hypothalamus via the afferent vagus nerve. Thus, enhancement of GLP-1 secretion by meal sequence is expected to reduce body weight. Importantly, consumption of a diet rich in saturated fatty acids such as meat dishes before carbohydrate increases secretions of not only GLP-1 but also glucose-dependent insulinotropic polypeptide (GIP), which promotes energy storage in adipose tissue and may lead to weight gain in the long term. Dietary fiber intake before carbohydrate intake significantly reduces postprandial glucose elevation and may have a weight loss effect, but this dietary strategy does not enhance the secretion of GLP-1. Thus, it is suggested that their combination may have additive effects on postprandial glucose excursion and body weight. Indeed, results of some clinical research supports the idea that ingesting dietary fiber together with meal sequence of protein and/or fat before carbohydrate benefits metabolic conditions of individuals with diabetes and obesity.
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Diet in the Treatment of Epilepsy: What We Know So Far.
Verrotti, A, Iapadre, G, Di Francesco, L, Zagaroli, L, Farello, G
Nutrients. 2020;(9)
Abstract
Epilepsy is a chronic and debilitating neurological disorder, with a worldwide prevalence of 0.5-1% and a lifetime incidence of 1-3%. An estimated 30% of epileptic patients continue to experience seizures throughout life, despite adequate drug therapy or surgery, with a major impact on society and global health. In recent decades, dietary regimens have been used effectively in the treatment of drug-resistant epilepsy, following the path of a non-pharmacological approach. The ketogenic diet and its variants (e.g., the modified Atkins diet) have an established role in contrasting epileptogenesis through the production of a series of cascading events induced by physiological ketosis. Other dietary regimens, such as caloric restriction and a gluten free diet, can also exert beneficial effects on neuroprotection and, therefore, on refractory epilepsy. The purpose of this review was to analyze the evidence from the literature about the possible efficacy of different dietary regimens on epilepsy, focusing on the underlying pathophysiological mechanisms, safety, and tolerability both in pediatric and adult population. We believe that a better knowledge of the cellular and molecular biochemical processes behind the anticonvulsant effects of alimentary therapies may lead to the development of personalized dietary intervention protocols.
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5.
Weight Loss-Induced Reduction of Bone Mineral Density in Older Adults with Obesity.
Jiang, BC, Villareal, DT
Journal of nutrition in gerontology and geriatrics. 2019;(1):100-114
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Abstract
Obesity in older adults is a growing public health problem, yet the appropriate treatment remains controversial partly due to evidence that weight loss reduces bone mass and may increase fracture risk. The purpose of this review is to summarize the research to date on the effects of diet-induced weight loss on bone health in obese (body mass index 30 kg/m2 and above) older (aged 65 years or older) adults. Observational studies have shown that weight loss in this population decreases total hip bone mineral density and increases the risk of frailty fractures (composite of proximal femur, pelvis, and proximal humerus fractures). Randomized controlled trials have largely confirmed these earlier observations but have also shown that exercise, particularly progressive resistance training, can attenuate or even alleviate this bone loss. Further research incorporating outcomes concerning bone quality and mass are needed to identify the optimal exercise and nutritional regimens to counteract the bone loss.
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A new clinical perspective: Treating obesity with nutritional coaching versus energy-restricted diets.
Dayan, PH, Sforzo, G, Boisseau, N, Pereira-Lancha, LO, Lancha, AH
Nutrition (Burbank, Los Angeles County, Calif.). 2019;:147-151
Abstract
Although current guidelines for obesity treatment endorse lifestyle modifications to achieve weight loss, energy-restricted diets are still the most commonly used method for the management of overweight. Diet restriction, however, not only is ineffective in promoting long-term weight loss but also may have more costs than benefits, predisposing the individual to fat regain. Several physiological and psychological mechanisms protect the body against starvation and explain how food restriction can promote paradoxically the opposite of what it is planned to achieve, triggering changes in energy metabolism, endocrine function and, thus, body composition. New approaches that focus on behavioral treatment without diet restriction, such as nutritional coaching, are showing strong growth that arises as an innovative way to create sustainable and effective lifestyle changes.
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Effects of Exercise and Nutritional Intervention on Body Composition, Metabolic Health, and Physical Performance in Adults with Sarcopenic Obesity: A Meta-Analysis.
Hsu, KJ, Liao, CD, Tsai, MW, Chen, CN
Nutrients. 2019;(9)
Abstract
People with sarcopenic obesity (SO) are characterized by both low muscle mass (sarcopenia) and high body fat (obesity); they have greater risks of metabolic diseases and physical disability than people with sarcopenia or obesity alone. Exercise and nutrition have been reported to be effective for both obesity and sarcopenia management. Thus, we aimed to investigate the effects of exercise and nutrition on body composition, metabolic health, and physical performance in individuals with SO. Studies investigating the effects of exercise and nutrition on body composition, metabolic health, and physical performance in SO individuals were searched from electronic databases up to April 2019. Fifteen studies were included in the meta-analysis. Aerobic exercise decreased body weight and fat mass (FM). Resistance exercise (RE) decreased FM and improved grip strength. The combination of aerobic exercise and RE decreased FM and improved walking speed. Nutritional intervention, especially low-calorie high-protein (LCHP) diet, decreased FM but did not affect muscle mass and grip strength. In addition to exercise training, nutrition did not provide extra benefits in outcome. Exercise, especially RE, is essential to improve body composition and physical performance in individuals with SO. Nutritional intervention with LCHP decreases FM but does not improve physical performance.
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Dietary Management of Obesity: Cornerstones of Healthy Eating Patterns.
Smethers, AD, Rolls, BJ
The Medical clinics of North America. 2018;(1):107-124
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Abstract
Several dietary patterns, both macronutrient and food based, can lead to weight loss. A key strategy for weight management that can be applied across dietary patterns is to reduce energy density. Clinical trials show that reducing energy density is effective for weight loss and weight loss maintenance. A variety of practical strategies and tools can help facilitate successful weight management by reducing energy density, providing portion control, and improving diet quality. The flexibility of energy density gives patients options to tailor and personalize their dietary pattern to reduce energy intake for sustainable weight loss.
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Weight-Loss Outcomes: A Systematic Review and Meta-Analysis of Intermittent Energy Restriction Trials Lasting a Minimum of 6 Months.
Headland, M, Clifton, PM, Carter, S, Keogh, JB
Nutrients. 2016;(6)
Abstract
The aim of this systematic review and meta-analysis is to summarise the effects of intermittent energy restriction on weight and biological markers in long term intervention studies of >6 months duration. An electronic search was performed using the MEDLINE, EMBASE and the Cochrane Library databases for intervention trials lasting 6 months or longer investigating the effects of intermittent energy restriction. A total of nine studies were identified as meeting the pre-specified criteria. All studies included an intermittent energy restriction arm, with six being directly compared to continuous energy restriction. A total of 981 subjects were enrolled and randomised, with weight loss observed in all intermittent energy restriction arms regardless of study duration or follow up length. Eight interventions in six trials were used for the meta-analyses, with results indicating neither intermittent or continuous energy restriction being superior with respect to weight loss, 0.084 ± 0.114 (overall mean difference between groups ± standard error; p = 0.458). The effects of intermittent energy restriction in the long term remain unclear. The number of long term studies conducted is very limited, and participant numbers typically small (less than 50 completers), indicating the need for larger, long term trials of 12 months or more, to be conducted in order to understand the impact of intermittent energy restriction on weight loss and long term weight management. Blood lipid concentrations, glucose, and insulin were not altered by intermittent energy expenditure in values greater than those seen with continuous energy restriction.
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The Energy Content and Composition of Meals Consumed after an Overnight Fast and Their Effects on Diet Induced Thermogenesis: A Systematic Review, Meta-Analyses and Meta-Regressions.
Quatela, A, Callister, R, Patterson, A, MacDonald-Wicks, L
Nutrients. 2016;(11)
Abstract
This systematic review investigated the effects of differing energy intakes, macronutrient compositions, and eating patterns of meals consumed after an overnight fast on Diet Induced Thermogenesis (DIT). The initial search identified 2482 records; 26 papers remained once duplicates were removed and inclusion criteria were applied. Studies (n = 27) in the analyses were randomized crossover designs comparing the effects of two or more eating events on DIT. Higher energy intake increased DIT; in a mixed model meta-regression, for every 100 kJ increase in energy intake, DIT increased by 1.1 kJ/h (p < 0.001). Meals with a high protein or carbohydrate content had a higher DIT than high fat, although this effect was not always significant. Meals with medium chain triglycerides had a significantly higher DIT than long chain triglycerides (meta-analysis, p = 0.002). Consuming the same meal as a single bolus eating event compared to multiple small meals or snacks was associated with a significantly higher DIT (meta-analysis, p = 0.02). Unclear or inconsistent findings were found by comparing the consumption of meals quickly or slowly, and palatability was not significantly associated with DIT. These findings indicate that the magnitude of the increase in DIT is influenced by the energy intake, macronutrient composition, and eating pattern of the meal.