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The effect of periodic ketogenic diet on newly diagnosed overweight or obese patients with type 2 diabetes.
Li, S, Lin, G, Chen, J, Chen, Z, Xu, F, Zhu, F, Zhang, J, Yuan, S
BMC endocrine disorders. 2022;22(1):34
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Currently, the ketogenic diet is gaining popularity in managing Type 2 diabetes (T2D). Ketogenic diets replace carbohydrates with fat and include limited carbohydrates and adequate protein. This randomised controlled trial evaluated the effects of the 12-week ketogenic diet on sixty overweight or obese T2D patients. Both the ketogenic and control diabetes diet groups achieved significant reductions in weight, body mass index, waist circumference, triglycerides, total cholesterol, low-density lipoprotein, high-density lipoprotein, fasting blood glucose, fasting insulin, and HbA1c. However, the ketogenic group showed significantly greater reductions in body mass, blood lipids, and blood glucose than the control group. In the ketogenic diet group, serum uric acid levels were higher than those in the control diet group. It was found that the control diet group adhered to the diet for a longer period than the ketogenic diet group, whose willingness to adhere to the diet long-term was weaker. More robust long-term studies are needed to evaluate the long-term effects of a ketogenic diet. In this study, more patients who followed the ketogenic diet experienced hypoglycaemic events during the first four weeks. Healthcare providers should exercise caution when recommending a short term therapeutic ketogenic diet.
Abstract
BACKGROUND The ketogenic diet (KD) is characterized by fat as a substitute of carbohydrates for the primary energy source. There is a large number of overweight or obese people with type 2 diabetes mellitus (T2DM), while this study aims to observe periodic ketogenic diet for effect on overweight or obese patients newly diagnosed as T2DM. METHODS A total of 60 overweight or obese patients newly diagnosed as T2DM were randomized into two groups: KD group, which was given ketogenic diet, and control group, which was given routine diet for diabetes, 30 cases in each group. Both dietary patterns lasted 12 weeks, and during the period, the blood glucose, blood lipid, body weight, insulin, and uric acid before and after intervention, as well as the significance for relevant changes, were observed. RESULTS For both groups, the weight, BMI(body mass index), Waist, TG (triglyceride), TC(cholesterol), LDL (low-density lipoprotein cholesterol), HDL (high-density lipoprotein cholesterol), FBG (fasting glucose), FINS (fasting insulin), HbA1c (glycosylated hemoglobin) were decreased after intervention (P < 0.05), while the decrease rates in the KD group was more significant than the control group. However, UA(serum uric acid) in the KD group showed an upward trend, while in the control group was not changed significantly (P > 0.05).The willingness to adhere to the ketogenic diet over the long term was weaker than to the routine diet for diabetes. CONCLUSION Among the overweight or obese patients newly diagnosed as type 2 diabetes mellitus, periodic ketogenic diet can not only control the body weight, but also control blood glucose and lipid, but long-term persistence is difficult.
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Metabolic Syndrome Features: Is There a Modulation Role by Mineral Water Consumption? A Review.
Costa-Vieira, D, Monteiro, R, Martins, MJ
Nutrients. 2019;11(5)
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Metabolic syndrome, defined as having high blood pressure, triglycerides, blood glucose and being obese, is becoming an increasing worldwide health problem. It’s considered to be a result of modern-day life styles and there is no effective cure other than diet and life style interventions. This review paper looks at the mineral content and the alkalising effects of mineral water when consumed by participants with metabolic syndrome. The minerals within mineral water are thought to be more readily absorbed in the body than when consumed in foods and since Westernised diets are low in mineral content and high in acidity, consuming mineral water could help counteract mineral deficiencies and help to balance pH in those with metabolic syndrome. 20 studies, both animal and human, were selected for evaluation of the effect of mineral water on blood pressure, lipid profile, blood glucose and waist circumference. The authors conclude that mineral water is indeed beneficial to those with metabolic syndrome and can help counteract mineral deficiencies and balance pH. However, it is unclear whether mineral water in high quantities would be detrimental to a person with adequate mineral status and a pH within optimal range. Further studies are needed.
Abstract
Metabolic syndrome (MetSyn) promotes, among others, the development of atherosclerotic cardiovascular disease and diabetes. Its prevalence increases with age, highlighting the relevance of promoting precocious MetSyn primary prevention and treatment with easy-to-implement lifestyle interventions. MetSyn features modulation through mineral water consumption was reviewed on Pubmed, Scopus and Google Scholar databases, using the following keywords: metabolic syndrome, hypertension, blood pressure (BP), cholesterol, triglycerides, apolipoprotein, chylomicron, very low-density lipoprotein, low-density lipoprotein, high-density lipoprotein (HDL), glucose, insulin, body weight, body mass index, waist circumference (WC), obesity and mineral(-rich) water. Twenty studies were selected: 12 evaluated BP, 13 assessed total-triglycerides and/or HDL-cholesterol, 10 analysed glucose and/or 3 measured WC. Mineral waters were tested in diverse protocols regarding type and composition of water, amount consumed, diet and type and duration of the study. Human and animal studies were performed in populations with different sizes and characteristics. Distinct sets of five studies showed beneficial effects upon BP, total-triglycerides, HDL-cholesterol and glucose. WC modulation was not reported. Minerals/elements and active ions/molecules present in mineral waters (and their pH) are crucial to counterbalance their inadequate intake and body status as well as metabolic dysfunction and increased diet-induced acid-load observed in MetSyn. Study characteristics and molecular/physiologic mechanisms that could explain the different effects observed are discussed. Further studies are warranted for determining the mechanisms involved in the putative protective action of mineral water consumption against MetSyn features.
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Effects of Three Commercially Available Sports Drinks on Substrate Metabolism and Subsequent Endurance Performance in a Postprandial State.
Qin, L, Wang, QR, Fang, ZL, Wang, T, Yu, AQ, Zhou, YJ, Zheng, Y, Yi, MQ
Nutrients. 2017;9(4)
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The depletion of stored glucose and the reduction of the availability of carbohydrates can contribute to fatigue during moderate-to-high intensity exercise. Studies have shown that carbohydrate consumption can reduce the depletion of stored energy and that the combination of protein and carbohydrate supplementation resulted in greater replenishment during intense exercise. Nowadays, most commercial sports beverages contain both carbohydrates and proteins. The present study looked at the postprandial effects of commercially available beverages on carbohydrate and fat metabolism and exercise performance. Ten healthy male participants with a history of running or cycling exercise participated in two studies in a double-blinded, counterbalanced manner. Commercially available beverages with low carbohydrate, high carbohydrate, and a combination of proteins and carbohydrates were tested, and it was found that a beverage containing both proteins and carbohydrates maintained insulin levels and provided greater energy during endurance exercise. It is important to conduct future studies on athletes with higher fitness levels to evaluate the benefits of commercially available beverages. Based on the findings of this study, healthcare professionals can learn more about the benefits of commercially available beverages that combine carbohydrates and proteins and have a low carbohydrate content.
Abstract
Purpose: To examine the effects of commercially available sports beverages with various components on substrate metabolism and subsequent performance. Methods: Two studies were conducted in a double-blinded, counterbalanced manner. Study I was designed to determine the glycemic index, while study II determined the utilization of substrates and subsequent exercise performance. Ten healthy male participants (age 21.70 ± 2.41 years, height 176.60 ± 5.23 cm, weight 66.58 ± 5.38 kg, V̇O2max 48.1 ± 8.4 mL/kg/min) participated in both study I and study II. Three types of commercially available sports beverage powders were used. The powders consisted primarily of oligosaccharides (low molecular weight carbohydrates, L-CHO), hydrolyzed starch (high molecular weight CHO, H-CHO), and whey protein powder with carbohydrate (CHO-PRO). They were dissolved in purified water with identical CHO concentration of 8% (w/v). In study I, each participant underwent two oral glucose tolerance tests (OGTT) and one glycemic response test for each sports drink. In study II, participants cycled for 60 min at 70% V̇O2max, one hour after consuming a standardized breakfast. One of four prescribed beverages (L-CHO, H-CHO, CHO-PRO, and Placebo control, PLA) was served at 0, 15, 30, 45 min during the exercise. Six hours after the first exercise session, participants came back for a "time to exhaustion test" (TTE). Blood samples were drawn at 0, 30, and 60 min in the first exercise session, while arterial blood gas analysis was conducted at 0, 30, and 60 min in both sessions. Subjective feelings (rating of perceived exertion and abdominal discomfort) were also evaluated every 30 min during exercise. Results: Compared to the reference standardized glucose solution, the glycemic index of the L-CHO beverage was 117.70 ± 14.25, while H-CHO was 105.50 ± 12.82, and CHO-PRO was 67.23 ± 5.88. During the exercise test, the insulin level at 30 and 60 min was significantly lower than baseline following the treatment of L-CHO, H-CHO, and PLA (p < 0.05). The CHO oxidation rate at 60 min in the first exercise session was significantly higher than that at 60 min in the second exercise session following the L-CHO treatment (p < 0.05). Time to exhaustion was not significantly different (p > 0.05). Conclusion: The CHO sports beverage with additional PRO maintains insulin production during endurance cycling at 70% V̇O2max in the postprandial state. L-CHO sports beverage suppresses fat utilization during the subsequent exercise performance test. The subsequent exercise performance (as evaluated by TTE) was not influenced by the type of CHO or the addition of PRO in the commercially available sports beverages used in the present study.