1.
Nutritional intervention for diabetes mellitus with Alzheimer's disease.
Li, Z, Li, S, Xiao, Y, Zhong, T, Yu, X, Wang, L
Frontiers in nutrition. 2022;9:1046726
-
-
-
Free full text
Plain language summary
Diabetes Mellitus (DM) affects more than 463 million people worldwide. Similarly, the number of deaths related to Alzheimer’s disease (AD) has increased by 145%. There are several common risk factors for Type 2 Diabetes and AD, including obesity, insulin resistance, and ageing, as well as common pathological mechanisms, including altered insulin signalling, oxidative stress, neuroinflammation, mitochondrial dysfunction, formation of glycated proteins and metabolic syndrome. This review aims to summarize the therapeutic effects of different nutritional therapy strategies on the reduction of DM and AD risk. Controlling blood sugar levels and reducing calorie intake is crucial to preventing diabetes and Alzheimer's disease. The low-carbohydrate, ketogenic, and Mediterranean diets have been found to improve glucose control in people with Type 2 diabetes (T2D). In addition, MIND (Mediterranean-DASH Diet Intervention for Neurodegenerative Delay) and a ketogenic diet may improve cognition in AD patients. Lactobacillus, Bifidobacterium probiotics, and prebiotics, such as inulin, may inhibit the progression of T2D and AD diseases by suppressing inflammation and modulating gut microbes. In addition, vitamins A, C, D, E, B6, B12, folate, long-chain polyunsaturated fatty acids, zinc, magnesium, and polyphenols may improve cognitive decline, homocysteine levels, and insulin resistance in AD and T2D patients. Healthcare professionals can use the results of this review to understand the beneficial effects of dietary strategies and multi-nutrient supplementation on DM and AD. However, further robust studies are required to investigate the risk factors and underlying mechanisms behind DM-combined AD progression.
Abstract
The combined disease burden of diabetes mellitus (DM) and Alzheimer's disease (AD) is increasing, and the two diseases share some common pathological changes. However, the pharmacotherapeutic approach to this clinical complexity is limited to symptomatic rather than disease-arresting, with the possible exception of metformin. Whether nutritional intervention might extend or synergize with these effects of metformin is of interest. In particular, dietary patterns with an emphasis on dietary diversity shown to affect cognitive function are of growing interest in a range of food cultural settings. This paper presents the association between diabetes and AD. In addition, the cross-cultural nutritional intervention programs with the potential to mitigate both insulin resistance (IR) and hyperglycemia, together with cognitive impairment are also reviewed. Both dietary patterns and nutritional supplementation showed the effects of improving glycemic control and reducing cognitive decline in diabetes associated with AD, but the intervention specificity remained controversial. Multi-nutrient supplements combined with diverse diets may have preventive and therapeutic potential for DM combined with AD, at least as related to the B vitamin group and folate-dependent homocysteine (Hcy). The nutritional intervention has promise in the prevention and management of DM and AD comorbidities, and more clinical studies would be of nutritional scientific merit.
2.
The Effect of an 8 Week Prescribed Exercise and Low-Carbohydrate Diet on Cardiorespiratory Fitness, Body Composition and Cardiometabolic Risk Factors in Obese Individuals: A Randomised Controlled Trial.
Perissiou, M, Borkoles, E, Kobayashi, K, Polman, R
Nutrients. 2020;12(2)
-
-
-
Free full text
Plain language summary
Low carbohydrate (CHO) and ketogenic diets have been shown to be effective for weight loss and improving cardiometabolic risk factors. However, they have also been associated with reduced muscle and bone mass, although this may be ameliorated by exercise. The aim of this randomised trial was to assess the effects of an 8-week exercise programme, comprising resistance and aerobic exercise, alongside a low CHO diet on cardiometabolic factors in overweight and obese people. 85 patients were randomised to the 8-week exercise programme (4x45 minute sessions per week) and either a low CHO diet, with a maximum of 50 grams of CHO per day, or standard dietary advice. The participants in the low CHO had greater improvements in cardiorespiratory fitness, blood glucose levels, triglycerides and C-reactive protein (CRP, an inflammatory marker) than the control group. They lost more fat but also more muscle mass than the control group. The improvements seen in the low CHO group were associated with reaching a state of ketosis, an alternative energy state when glucose levels are low. The authors conclude that the longer-term effects of low CHO diets should be explored further.
Abstract
BACKGROUND Low-carbohydrate (LC) diets are an effective method for treating obesity and reducing cardiometabolic risk. However, exposure to LC diets is associated with reductions in muscle mass and increased osteoporosis risk in obese individuals. The combination of exercise with a LC diet appears to attenuate muscle mass loss induced by LC diets alone, and to further improve cardiometabolic profile. However, evidence to date in obese individuals is limited. We assessed the effect of LC diet in combination with supervised exercise on cardiorespiratory fitness, body composition and cardiometabolic risk factors in obese individuals. Methods: Male and female participants in the experimental (EX-LC; structured supervised exercise program + low-carbohydrate meals; n = 33; 35.3 years) and control (EX-CO; structured supervised exercise program + standard dietary advice; n = 31; 34.2 years) conditions underwent measurements of cardiorespiratory fitness (VO2peak), body fat, lean muscle mass (LMM), and cardiometabolic biomarkers before and after an 8 week intervention. Results: Participants in the EX-LC condition demonstrated greater improvements in VO2peak (p = 0.002) and fat mass index (FMI, p = 0.001) compared to the EX-CO condition. Achieving a ketogenic state (β-hydroxybutyrate, βHB ≥0.3 mmol/L) was associated with greater reductions in total body fat (p = 0.011), visceral adipose tissue (p = 0.025), FMI (p = 0.002) and C-reactive protein (CRP, p = 0.041) but also with greater reductions in LMM (p = 0.042). Conclusion: Short-term LC diet combined with prescribed exercise enhanced cardiorespiratory fitness and the cardiometabolic profile of obese individuals but was also associated with greater muscle mass loss compared to similar exercise training and standard dietary advice. The long-term effects of the LC diet should be further explored in future studies.
3.
Efficacy of ketogenic diet on body composition during resistance training in trained men: a randomized controlled trial.
Vargas, S, Romance, R, Petro, JL, Bonilla, DA, Galancho, I, Espinar, S, Kreider, RB, Benítez-Porres, J
Journal of the International Society of Sports Nutrition. 2018;15(1):31
-
-
-
Free full text
Plain language summary
This randomised controlled trial investigated the effects of a ketogenic diet on body composition in bodybuilders. 24 healthy body-builders were randomised to either a ketogenic diet (KD), non-ketogenic diet (NKD) or to control group (CG). During the trial period, both the KD and the NKD group received a surplus of calories and the same amount of protein, 2g/kg body weight per day to promote anabolic activity. Macronutrient ratios were carbohydrate 55%, protein 20% and fat 25% in the NKD group versus <10% carbohydrate, 20% protein and 70% fat in the KD group. Participants could eat when and how often they wanted to and both groups carried out the same training programme. After eight weeks the KD group showed significantly lower total fat mass and visceral (abdominal) fat, but no gain in either total body weight or lean mass. The NKD group, on the other hand, gained lean mass and body weight, but saw no changes in total or visceral fat mass. No significant changes in body composition were observed in the CG.
Abstract
BACKGROUND Ketogenic diets (KD) have become a popular method of promoting weight loss. More recently, some have recommended that athletes adhere to ketogenic diets in order to optimize changes in body composition during training. This study evaluated the efficacy of an 8-week ketogenic diet (KD) during energy surplus and resistance training (RT) protocol on body composition in trained men. METHODS Twenty-four healthy men (age 30 ± 4.7 years; weight 76.7 ± 8.2 kg; height 174.3 ± 19.7 cm) performed an 8-week RT program. Participants were randomly assigned to a KD group (n = 9), non-KD group (n = 10, NKD), and control group (n = 5, CG) in hyperenergetic condition. Body composition changes were measured by dual energy X-ray absorptiometry (DXA). Compliance with the ketosis state was monitored by measuring urinary ketones weekly. Data were analyzed using a univariate, multivariate and repeated measures general linear model (GLM) statistics. RESULTS There was a significant reduction in fat mass (mean change, 95% CI; p-value; Cohen's d effect size [ES]; - 0.8 [- 1.6, - 0.1] kg; p < 0.05; ES = - 0.46) and visceral adipose tissue (- 96.5 [- 159.0, - 34.0] g; p < 0.05; ES = - 0.84), while no significant changes were observed in the NKD and CG in fat mass (- 0,5 [- 1.2, 0.3] kg; p > 0.05; ES = - 0.17 and - 0,5 [- 2.4, 1.3] kg; p > 0.05; ES = - 0.12, respectively) or visceral adipose tissue (- 33.8 [- 90.4, 22.8]; p > 0.5; ES = - 0.17 and 1.7 [- 133.3, 136.7]; p > 0.05; ES = 0.01, respectively). No significant increases were observed in total body weight (- 0.9 [- 2.3, 0.6]; p > 0.05; ES = [- 0.18]) and muscle mass (- 0.1 [- 1.1,1.0]; p > 0,05; ES = - 0.04) in the KD group, but the NKD group showed increases in these parameters (0.9 [0.3, 1.5] kg; p < 0.05; ES = 0.18 and (1.3[0.5, 2.2] kg; p < 0,05; ES = 0.31, respectively). There were no changes neither in total body weight nor lean body mass (0.3 [- 1.2, 1.9]; p > 0.05; ES = 0.05 and 0.8 [- 0.4, 2.1]; p > 0.05; ES = 0.26, respectively) in the CG. CONCLUSION Our results suggest that a KD might be an alternative dietary approach to decrease fat mass and visceral adipose tissue without decreasing lean body mass; however, it might not be useful to increase muscle mass during positive energy balance in men undergoing RT for 8 weeks.