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Effects of ascorbic acid supplementation on oxidative stress markers in healthy women following a single bout of exercise.
Yimcharoen, M, Kittikunnathum, S, Suknikorn, C, Nak-On, W, Yeethong, P, Anthony, TG, Bunpo, P
Journal of the International Society of Sports Nutrition. 2019;16(1):2
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Moderately intense exercise often causes muscle damage, which initiates an acute inflammatory response. Vitamin C or ascorbic acid is suggested to provide antioxidant protection against oxidative stress. The efficacy of ascorbic acid supplementation on exercise-induced oxidative stress remains unclear. The aim of this crossover study was to determine the effects of ascorbic acid supplementation on circulating biomarkers of oxidative stress and muscle damage in 19 healthy women after a single bout of moderately-intense exercise. Participants performed 30 minutes of cycling after ingesting 1000 mg of ascorbic acid or placebo with a one-week washout period. Blood samples were taken before exercise, immediately after and 30 minutes post-exercise to determine various markers of oxidative stress and muscle damage. This study found ascorbic acid supplementation prior to moderately-intense exercise improves antioxidant capacity but does not prevent muscle damage. The exercise performed in this study did not induce systemic inflammation, only low-grade muscle damage. Based on these results, the authors suggest further investigation of the effects of ascorbic acid supplementation during exercise be done to better understand the molecular interactions of ascorbic acid during exercise.
Abstract
BACKGROUND Ascorbic acid is a water-soluble chain breaking antioxidant. It scavenges free radicals and reactive oxygen species (ROS), which are produced during metabolic pathways. Exercise can produce an imbalance between ROS and antioxidants, leading to oxidative stress-related tissue damages. This study was designed to determine the effects of ascorbic acid supplementation on circulating biomarkers of oxidative stress and muscle damage following a single bout of exercise. METHODS In a crossover design with a 1 wk. wash-out period, 19 healthy women performed 30 min moderate-intensity cycling after ingesting 1000 mg of ascorbic acid (AA) or placebo. Blood samples were taken immediately before, immediately after and 30 min post-exercise to determine plasma albumin, total protein, glucose, oxidative stress and muscle damage markers. RESULTS Plasma albumin and total protein levels increased immediately after exercise in placebo alongside slight reductions in glucose (p = 0.001). These effects were absent in AA cohort. Ferric reducing ability of plasma and vitamin C levels in AA cohort significantly increased after exercise (p < 0.05). Superoxide dismutase activity was significantly elevated after exercise (p = 0.002) in placebo but not AA. Plasma malondialdehyde did not change after exercise in placebo but was significantly decreased in AA (p < 0.05). The exercise protocol promoted slight muscle damage, reflected in significant increases in total creatine kinase in all subjects after exercise. On the other hand, plasma C-reactive protein and lactate dehydrogenase remained unchanged. CONCLUSION Supplementation with ascorbic acid prior exercise improves antioxidant power but does not prevent muscle damage.
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Effects of Tart Cherry Juice on Biomarkers of Inflammation and Oxidative Stress in Older Adults.
Chai, SC, Davis, K, Zhang, Z, Zha, L, Kirschner, KF
Nutrients. 2019;11(2)
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Inflammation and oxidative stress are thought to contribute to the development of heart disease. A previous study suggested that drinking tart cherry juice for 12 weeks lowers blood pressure and cholesterol in older adults. The aim of this study was to investigate the effects of tart cherry juice on blood biomarkers of inflammation and oxidative stress. In this randomised-controlled clinical trial, 37 men and women between the ages of 65 and 80 were randomly assigned to drink 480 mL of tart cherry juice or a control drink daily for 12 weeks. Several blood biomarkers of inflammation and oxidative stress were measured at the beginning of the study and after 12 weeks. Tart cherry juice significantly increased blood levels of DNA repair activity of 8-oxoguanine glycosylase and lowered c-reactive protein (CRP) compared to the control group. Blood levels of CRP decreased by 25%, malondialdehyde (MDA) by 3%, and oxidised low-density lipoprotein (OxLDL) by 11% after 12 weeks of tart cherry juice consumption. The authors of this study suggest that the ability of tart cherry juice to reduce blood pressure and cholesterol, in part, may be due to its anti-oxidative and anti-inflammatory properties. Larger and longer follow-up studies are needed to confirm these findings.
Abstract
Inflammation and oxidative stress are important factors in the development of cardiovascular disease and atherosclerosis. The findings of our previous study suggest that 12 weeks consumption of tart cherry juice lowers the levels of systolic blood pressure (BP) and low-density lipoprotein (LDL) cholesterol in older adults. The present study investigated the effects of tart cherry juice on blood biomarkers of inflammation and oxidative stress. In this randomized-controlled clinical trial, a total of 37 men and women between the ages of 65⁻80 were randomly assigned to consume 480 mL of tart cherry juice or control drink daily for 12 weeks. Several blood biomarkers of inflammation and oxidative stress were assessed at baseline and after 12 weeks intervention. After the 12 weeks intervention, tart cherry juice significantly increased the plasma levels of DNA repair activity of 8-oxoguanine glycosylase (p < 0.0001) and lowered (p = 0.03) the mean c-reactive protein (CRP) level compared to the control group. There was a significant group effect observed for plasma CRP (p = 0.03) and malondialdehyde (MDA) (p = 0.03), and a borderline significant group effect observed for plasma oxidized low-density lipoprotein (OxLDL) (p = 0.07). Within group analysis showed that the plasma levels of CRP, MDA, and OxLDL decreased numerically by 25%, 3%, and 11%, respectively after 12 weeks of tart cherry juice consumption compared with corresponding baseline values. The present study suggests that the ability of tart cherry juice to reduce systolic BP and LDL cholesterol, in part, may be due to its anti-oxidative and anti-inflammatory properties. Larger and longer follow-up studies are needed to confirm these findings.
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A low-dose, 6-week bovine colostrum supplementation maintains performance and attenuates inflammatory indices following a Loughborough Intermittent Shuttle Test in soccer players.
Kotsis, Y, Mikellidi, A, Aresti, C, Persia, E, Sotiropoulos, A, Panagiotakos, DB, Antonopoulou, S, Nomikos, T
European journal of nutrition. 2018;57(3):1181-1195
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In elite athletes, recovery time between matches is often suboptimal. Since exercise-induced muscle damage (EIMD) can determine the duration of the recovery period, several strategies have been explored to reduce recovery time by attenuating EIMD. The aim of this placebo-controlled, double-blind randomised trial was to examine the effect of a long-term, low-dose bovine colostrum (BC) supplementation on EIMD and performance in 18 elite soccer players. To set a baseline, all participants completed the Loughborough Intermittent Shuttle Test (LIST), a fitness test that simulates the activity pattern of a soccer match, and muscle damage indices were monitored for 72 hours post-exercise. Subjects were then randomised to consume either BC or whey as placebo daily for 6 weeks, and complete the LIST post-intervention with the same indices monitored. This study found that BC helped maintain performance and attenuate post-exercise inflammatory markers compared to whey. Based on these results, the authors conclude a low-dose of BC may reduce post-exercise EIMD and help enhance muscle recovery during a soccer match.
Abstract
PURPOSE The aim of the study was to investigate the effect of a 6-week, low-dose bovine colostrum (BC) supplementation on exercise-induced muscle damage (EIMD) and performance decline in soccer players following the Loughborough Intermittent Shuttle Test (LIST) during a competitive season period. METHODS In a double-blind, randomized, placebo-controlled design, two groups of soccer players were allocated to a 3.2 g/day of whey protein (WP, N = 8) or BC (N = 10) and performed a pre- and a post-supplementation LIST. Maximum isometric voluntary contraction, squat jump (SQJ), countermovement jump, muscle soreness, blood cell counts, creatine kinase (CK), C-reactive protein (CRP) and interleukin-6 (IL-6) were monitored for 2, 24, 48, 72 h post-LIST. RESULTS LIST induced transient increases in leukocytes, granulocytes, CK, muscle soreness, CRP, IL-6 and declines in lymphocytes and performance indices. Supplementation resulted in a faster recovery of SQJ, CK and CRP compared to pre-supplementation kinetics (trial × time: p = 0.001, 0.056, 0.014, respectively) and lower incremental area under the curve (iAUC) for IL-6, only in the BC group [pre-: 31.1 (6.78-46.9), post-: 14.0 (-0.16 to 23.5) pg h/ml, p = 0.034]. Direct comparison of the two groups after supplementation demonstrated higher iAUC of SQJ [WP: -195.2 (-229.0 to (-52.5)), BC: -15.8 (-93.2 to 16.8) cm h, p = 0.034], a trend for lower iAUC of CK in the BC group [WP: 18,785 (4651-41,357), BC: 8842 (4807-14,802) U h/L, p = 0.081] and a significant intervention × time interaction for CRP (p = 0.038) in favor of BC. CONCLUSIONS Post-exercise EIMD may be reduced and performance better maintained by a low dose of BC administration following LIST in soccer players.
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Effect of bilberry juice on indices of muscle damage and inflammation in runners completing a half-marathon: a randomised, placebo-controlled trial.
Lynn, A, Garner, S, Nelson, N, Simper, TN, Hall, AC, Ranchordas, MK
Journal of the International Society of Sports Nutrition. 2018;15:22
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There is a growing interest in identifying alternative approaches for reducing inflammation and lessening recovery time among long distance runners. This type of exercise causes inflammation and muscle soreness which impacts performance and ability to train. Recent studies have shown that various plant-derived polyphenols can counter exercise-induced inflammation and muscle soreness. The aim of this single blind, randomised, parallel study was to investigate whether supplementation of bilberry juice (BJ), a polyphenol-rich fruit, would reduce inflammation and muscle soreness in 19 runners completing a half marathon. Participants were randomised to consume BJ or a placebo fruit drink for 5 days prior to the half marathon, on the day of the race and for two days after the race. Blood samples were collected at baseline, pre-race, post-race, 1 day post-race and 2 days post-race and markers of muscle soreness and damage were measured. Contrary to hypothesis, this study found evidence that BJ produced possibly harmful effects on muscle soreness and inflammatory markers compared to placebo. Based on these results, the authors recommend a larger study to confirm the findings and further explore the underlying cause of the observed detrimental changes.
Abstract
BACKGROUND Emerging evidence indicates that fruits rich in polyphenols may attenuate exercise-induced muscle damage and associated markers of inflammation and soreness. This study was conducted to determine whether bilberry juice (BJ), which is particularly rich in polyphenols, reduces markers of muscle damage in runners completing a half marathon. METHODS A total of 21 recreationally trained runners (age 30.9 ± 10.4 y; mass 71.6 ± 11.0 kg; M = 16; F = 5) were recruited to a single blind, randomised, placebo-controlled, parallel study. Participants were block randomised to consume 2 × 200 ml of BJ or energy-matched control drink (PLA) for 5 d before the Sheffield Half Marathon, on race day, and for 2 days post-race. Measurements of delayed onset muscle soreness (DOMS), muscle damage (creatine kinase; CK) and inflammation (c-reactive protein; CRP) were taken at baseline, pre-race, post-race, 24 h post-race and 48 h post-race. The effect of treatment on outcome measures was analysed using magnitude-based inferences based on data from 19 participants; 2 participants were excluded from the analyses because they did not provide samples for all time points. RESULTS The half marathon caused elevations in DOMS, CRP and CK. BJ had a possibly harmful effect on DOMS from pre-race to immediately post-race (11.6%, 90% CI ± 14.7%), a likely harmful effect on CRP from pre-race to 24 h post-race (mean difference ES 0.56, 90% CI ± 0.72) and a possibly harmful effect on CRP from pre-race to 48 h post-race (ES 0.12, 90% CI ± 0.69). At other time points, the differences between the BJ and PLA groups in DOMS and CRP were unclear, possibly trivial or likely trivial. Differences in the changes in CK between BJ and PLA were unclear at every time point other than from baseline to pre-race, where BJ had a possibly harmful effect on reducing muscle damage (ES 0.23, 90% CI ± 0.57). CONCLUSION Despite being a rich source of antioxidant and anti-inflammatory phytochemicals, BJ evoked small to moderate increases in exercise-induced DOMS and CRP. Further larger studies are required to confirm these unexpected preliminary results.
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Effects of n-3 fatty acids and exercise on oxidative stress parameters in type 2 diabetic: a randomized clinical trial.
Fayh, APT, Borges, K, Cunha, GS, Krause, M, Rocha, R, de Bittencourt, PIH, Moreira, JCF, Friedman, R, da Silva Rossato, J, Fernandes, JR, et al
Journal of the International Society of Sports Nutrition. 2018;15:18
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An elevated blood glucose level is one of the key metabolic abnormalities associated with complications in type 2 diabetes. Literature shows that individuals with type 2 diabetes have higher inflammatory levels than those with normal blood glucose tolerance. The aim of this study was to examine if omega-3 polyunsaturated fatty acid (PUFA) supplementation can reduce the inflammatory response associated with high-intensity exercise in type 2 diabetic individuals. This was a randomised, double-blind controlled study, which recruited 30 type 2 diabetic men and women aged between 30 and 60 years. Results indicate that after 8 weeks, omega-3 PUFA supplementation diminished the concentration of the total reactive antioxidant potential and triglyceride levels after high intensity exercise, however did not reduce the inflammatory response.
Abstract
BACKGROUND The relationship between diabetes and oxidative stress has been previously reported. Exercise represents a useful non-pharmacological strategy for the treatment in type 2 diabetic (T2DM) patients, but high intensity exercise can induce a transient inflammatory state and increase oxidative stress. Nutritional strategies that may contribute to the reduction of oxidative stress induced by acute exercise are necessary. The aim of this study was to examine if n-3 PUFA supplementation intervention can attenuate the inflammatory response and oxidative stress associated with high intensity exercise in this population. As a primary outcome, lipoperoxidation measurements (TBARS and F2-isoprostanes) were selected. METHODS Thirty T2DM patients, without chronic complications, were randomly allocated into two groups: placebo (gelatin capsules) or n-3 PUFA (capsules containing 180 mg of eicosapentaenoic acid and 120 mg of docosahexaenoic acid). Blood samples were collected fasting before and after 8 weeks supplementation. In the beginning and at the end of protocol, an acute exercise was performed (treadmill), and new blood samples were collected before and immediately after the exercise for measurements of oxidative stress and high-sensitivity C-reactive protein (hs-CRP). RESULTS After the supplementation period, a decrease in triglycerides levels was observed only in n-3 PUFA supplementation group (mean difference and 95% CI of 0.002 (0.000-0.004), p = 0.005). Supplementation also significantly reduced TRAP levels after exercise (mean difference and 95% CI to 9641 (- 20,068-39,351) for - 33,884 (- 56,976 - -10,793), p = 0.004, Cohen's d effect size = 1.12), but no significant difference was observed in n-3 PUFA supplementation group in lipoperoxidation parameters as TBARS (mean difference and 95% CI to - 3.8 (- 10-2.4) for - 2.9 (- 1.6-7.4) or F2-isoprostanes (mean difference and 95% CI -0.05 (- 0.19-0.10) for - 0.02 (- 0.19-0.16), p > 0.05 for both. CONCLUSION PUFA n-3 supplementation reduced triglycerides as well as TRAP levels after exercise, without a significant effect on inflammatory and oxidative stress markers.This study is registered at ClinicalTrials.gov with the registration number of NCT03182712.
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Vitamin D3 repletion versus placebo as adjunctive treatment of heart failure patient quality of life and hormonal indices: a randomized, double-blind, placebo-controlled trial.
Moretti, HD, Colucci, VJ, Berry, BD
BMC cardiovascular disorders. 2017;17(1):274
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A vitamin D deficiency in patients with heart failure (HF) seems to be associated with less favourable outcomes. Vitamin D status may influence several of the hormones that are important to keep the heart working normally. The objective of this study was to determine if vitamin D3 supplementation would replete vitamin D stores, improve the hormones b-type natriuretic peptide (BNP) and parathyroid hormone (PTH), improve heart and lung function, reduce inflammation, and improve quality of life (QOL) in HF patients. This was a 6 month randomised controlled trial, using a dose of 10,000 IU of vitamin D3 daily or a placebo, in 40 vitamin D deficient or insufficient (≤ 32 ng/ml) patients with stable HF. All variables were measured at baseline and 6 months. The change in BNP from baseline was +30pg/ml in the vitamin D group vs. +400pg/ml in the placebo group (p = 0.003). Vitamin D blood levels rose by 49ng/ml in the treatment group vs 4ng/ml in the placebo group (p < 0.001). Other measures of heart function were unchanged. The inflammatory marker high sensitivity C-reactive protein (hsCRP) remained unchanged for women, but modestly improved for men in the group given vitamin D. QOL scores significantly improved in the vitamin D group compared to placebo. The authors concluded that repletion of vitamin D may improve quality of life in heart failure patients and may help to normalise b-type natriuretic peptide, parathyroid hormone and high sensitivity C-reactive protein.
Abstract
BACKGROUND Vitamin D status may influence heart failure (HF) patient outcomes by affecting b-type natriuretic peptide (BNP), parathyroid hormone (PTH), and enhancing cardiac contractility. Vitamin D deficiency is associated with morbidity and mortality in HF patients. The objective of this study was to determine if vitamin D3 at a comparatively high dose would replete 25-hydroxyvitamin D (25(OH)D) stores, improve BNP, PTH, cardiopulmonary function, reduce inflammatory markers, and improve quality of life (QOL) in HF patients. METHODS This was a 6 month, parallel group, double-blind, placebo-controlled, single clinic center, randomized trial of supplemental vitamin D3 using a dose of 10,000 IU daily or placebo in 40 vitamin D deficient or insufficient (25(OH)D level ≤ 32 ng/ml) patients with stable New York Heart Association Class II-III HF in a specialty cardiology clinic. All variables were measured at baseline and 6 months. Values between the two treatment groups were assessed using Student's t-test or Mann-Whitney Test. Univariate analysis of covariance was conducted to adjust for variance in baseline 25(OH)D. RESULTS All results were adjusted for baseline 25(OH)D. The change in BNP from baseline was ∆ +30 ± 950 pg/ml for treatment vs. placebo ∆ +400 ± 1900 pg/ml, p = 0.003. 25(OH)D serum levels rose by 49 ± 32 ng/ml in the treatment group vs 4 ± 10 ng/ml in the placebo group, p < 0.001. PTH and exercise chronotropic response index improved in the treatment group vs placebo group, respectively, but both were attenuated by adjustment ((∆-20 ± 20 pg/ml vs ∆ + 7 ± 53 pg/ml respectively (p = 0.01, adjusted p = 0.07)) and (∆ + 0.13 ± 0.26 vs. ∆-0.03 ± 02.9 respectively, p < 0.01, adjusted p = 0.17)). Other measured cardiopulmonary parameters remained unchanged. High sensitivity C-reactive protein (hsCRP) remained unchanged for women, but improved for men (∆-2 ± 4 treatment versus ∆2 ± 5 mg/L placebo, p = 0.05). QOL scores, including composite overall and clinical summary scores significantly improved in treatment compared to placebo (∆ + 10 ± 15 versus -6 ± 15, p < 0.01 and ∆ + 8 ± 14 versus -8 ± 18, p = 0.01, respectively). CONCLUSIONS Repletion of 25(OH)D may improve QOL in HF patients and may help to normalize BNP, PTH, and hsCRP. TRIAL REGISTRATION Clinicaltrials.gov, Trial Registration Number: NCT01636570 , First registered 3 July 2012.
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Effects of daily almond consumption on cardiometabolic risk and abdominal adiposity in healthy adults with elevated LDL-cholesterol: a randomized controlled trial.
Berryman, CE, West, SG, Fleming, JA, Bordi, PL, Kris-Etherton, PM
Journal of the American Heart Association. 2015;4(1):e000993
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Research has shown that almond consumption has a positive impact on cardiovascular risk factors and markers for inflammation. The aim of this randomised controlled trial was to compare a cholesterol lowering diet with almonds (1.5oz./day) with the same diet but substituting almonds with a calorie-matched food (i.e. a muffin) in a controlled-feeding setting. The study concluded that almonds reduce non high density lipoproteins, low-density lipoproteins and central adiposity in healthy individuals. The researchers suggest that it is likely to be almonds unique fatty acid profile and in particular, oleic acid that offers these cardiovascular protective effects. It recommended a daily intake of 1.5oz of almonds to replace high carbohydrate snacks.
Abstract
BACKGROUND Evidence consistently shows that almond consumption beneficially affects lipids and lipoproteins. Almonds, however, have not been evaluated in a controlled-feeding setting using a diet design with only a single, calorie-matched food substitution to assess their specific effects on cardiometabolic risk factors. METHODS AND RESULTS In a randomized, 2-period (6 week/period), crossover, controlled-feeding study of 48 individuals with elevated LDL-C (149±3 mg/dL), a cholesterol-lowering diet with almonds (1.5 oz. of almonds/day) was compared to an identical diet with an isocaloric muffin substitution (no almonds/day). Differences in the nutrient profiles of the control (58% CHO, 15% PRO, 26% total fat) and almond (51% CHO, 16% PRO, 32% total fat) diets were due to nutrients inherent to each snack; diets did not differ in saturated fat or cholesterol. The almond diet, compared with the control diet, decreased non-HDL-C (-6.9±2.4 mg/dL; P=0.01) and LDL-C (-5.3±1.9 mg/dL; P=0.01); furthermore, the control diet decreased HDL-C (-1.7±0.6 mg/dL; P<0.01). Almond consumption also reduced abdominal fat (-0.07±0.03 kg; P=0.02) and leg fat (-0.12±0.05 kg; P=0.02), despite no differences in total body weight. CONCLUSIONS Almonds reduced non-HDL-C, LDL-C, and central adiposity, important risk factors for cardiometabolic dysfunction, while maintaining HDL-C concentrations. Therefore, daily consumption of almonds (1.5 oz.), substituted for a high-carbohydrate snack, may be a simple dietary strategy to prevent the onset of cardiometabolic diseases in healthy individuals. CLINICAL TRIAL REGISTRATION URL www.clinicaltrials.gov; Unique Identifier: NCT01101230.
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A decline in inflammation is associated with less depressive symptoms after a dietary intervention in metabolic syndrome patients: a longitudinal study.
Perez-Cornago, A, de la Iglesia, R, Lopez-Legarrea, P, Abete, I, Navas-Carretero, S, Lacunza, CI, Lahortiga, F, Martinez-Gonzalez, MA, Martinez, JA, Zulet, MA
Nutrition journal. 2014;13:36
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Metabolic syndrome (defined as a cluster of cardiovascular risk factors including central obesity, glucose intolerance, hypertension and lipid disorders) is rising rapidly worldwide. Certain features of metabolic syndrome including adiposity, glucose intolerance and lipid disorders have also been linked to depression, another burden on healthcare worldwide. The exact pathways linking these diseases are unclear but appear to be bidirectional and dependent on biological and behaviour factors. This study hypothesises that hypo caloric treatment may have a positive impact on both metabolic syndrome and depression, and explores the possible mechanisms for this effect. The sample included 60 subjects with a BMI of at least 36.1 and aged over 50 years. These were a subsample of the RESMENA-S study which involved a 6 month weight loss intervention (either RESMANA-S or a control both with the same energy restrictions). This study found a reduction in depressive symptoms, alongside a reduction in CRP and leptin following the diet. Previous research has found a relationship between weight loss and reduced depression, but this study specifically found the decrease in CRP and leptin with a reduction of depression. The precise mechanism between CRP and depression remains unclear but the authors suggest that inflammation may be responsible. Theoretically, the association between leptin and depression may be related to its metabolic properties and neurobiological activity (it may relate to mood and cognition).
Abstract
BACKGROUND Metabolic syndrome (MetS) and depression have become two prevalent diseases worldwide, whose interaction needs further investigation. Dietary treatment for weight loss in patients with MetS may improve depressive manifestations, however, the precise interactive pathways remain uncertain. Therefore, the aim of this study was to examine the effects of a hypocaloric diet designed to reduce MetS features on self-perceived depression and the possible underlying factors. METHODS Sixty subjects (Age: 50 ± 1 y; BMI: 36.1 ± 0.6 kg/m(2)) with MetS were selected from the RESMENA study (control and intervention) after they completed the 6-months hypocaloric treatment and rated for depressive symptoms using the Beck Depression Inventory (BDI). Anthropometric and biochemical measurements including leptin, C-reactive protein (CRP) and insulin levels were evaluated. RESULTS Depressive symptoms decreased during the weight loss intervention, with no differences between both dietary groups (control group -4.2 ± 0.8 vs RESMENA group -3.2 ± 0.6, P = 0.490). The number of criteria of the MetS was higher among subjects with more somatic-related depressive symptoms at baseline (B = 1.032, P-trend = 0.017). After six months of dietary treatment, body weight decreased in all subjects (-8.7%; confidence interval (95% CI) = 7.0-9.7) and also self-perceived depression (-37.9%; 95% CI = 2.7-4.9), as well as circulating leptin (-20.1%; 95% CI = 1.8-6.8), CRP (-42.8%; 95% CI = 0.6-3.0) and insulin (-37.7%; 95% CI = 4.1-7.2) concentrations. The decrease in BDI was significantly associated with declines in body fat mass (B = 0.34, 95% CI = 0.11-0.56) and also with the decrease in leptin (B = 0.16, 95% CI = 0.04-0.28) and CRP (B = 0.24, 95% CI = 0.01-0.46) concentrations. CONCLUSIONS The decrease in depressive manifestations after a weight loss intervention was related with adiposity, CRP and leptin in subjects with MetS. TRIAL REGISTRATION ClinicalTrials.gov: NCT01087086.
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Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet.
Shai, I, Schwarzfuchs, D, Henkin, Y, Shahar, DR, Witkow, S, Greenberg, I, Golan, R, Fraser, D, Bolotin, A, Vardi, H, et al
The New England journal of medicine. 2008;359(3):229-41
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Most trials comparing the effectiveness of weight-loss regimes are carried out over short durations. This trial explored the effectiveness of three dietary protocols (low carbohydrate, Mediterranean diet and low fat) on weight loss over 2 years. The study randomly allocated 322 moderately obese subjects to one of the three dietary regimes. The mean weight loss for the 272 people completing the study after 2 years was significantly different between the groups; 3.3kg for the low fat group, 4.6kg for the Mediterranean diet group and 5.5kg for the low carbohydrate group. Diabetic subjects in the Mediterranean group achieved more favourable fasting blood sugar and insulin levels compared to the low fat group. The low carbohydrate group achieved the most favourable outcomes in terms of their lipid profiles compared to the other groups. The authors concluded that the Mediterranean diet and low carbohydrate diets may be effective alternatives to low fat regimes; they achieved weight-loss and also some metabolic benefits.
Abstract
BACKGROUND Trials comparing the effectiveness and safety of weight-loss diets are frequently limited by short follow-up times and high dropout rates. METHODS In this 2-year trial, we randomly assigned 322 moderately obese subjects (mean age, 52 years; mean body-mass index [the weight in kilograms divided by the square of the height in meters], 31; male sex, 86%) to one of three diets: low-fat, restricted-calorie; Mediterranean, restricted-calorie; or low-carbohydrate, non-restricted-calorie. RESULTS The rate of adherence to a study diet was 95.4% at 1 year and 84.6% at 2 years. The Mediterranean-diet group consumed the largest amounts of dietary fiber and had the highest ratio of monounsaturated to saturated fat (P<0.05 for all comparisons among treatment groups). The low-carbohydrate group consumed the smallest amount of carbohydrates and the largest amounts of fat, protein, and cholesterol and had the highest percentage of participants with detectable urinary ketones (P<0.05 for all comparisons among treatment groups). The mean weight loss was 2.9 kg for the low-fat group, 4.4 kg for the Mediterranean-diet group, and 4.7 kg for the low-carbohydrate group (P<0.001 for the interaction between diet group and time); among the 272 participants who completed the intervention, the mean weight losses were 3.3 kg, 4.6 kg, and 5.5 kg, respectively. The relative reduction in the ratio of total cholesterol to high-density lipoprotein cholesterol was 20% in the low-carbohydrate group and 12% in the low-fat group (P=0.01). Among the 36 subjects with diabetes, changes in fasting plasma glucose and insulin levels were more favorable among those assigned to the Mediterranean diet than among those assigned to the low-fat diet (P<0.001 for the interaction among diabetes and Mediterranean diet and time with respect to fasting glucose levels). CONCLUSIONS Mediterranean and low-carbohydrate diets may be effective alternatives to low-fat diets. The more favorable effects on lipids (with the low-carbohydrate diet) and on glycemic control (with the Mediterranean diet) suggest that personal preferences and metabolic considerations might inform individualized tailoring of dietary interventions. (ClinicalTrials.gov number, NCT00160108.)