Effects of DASH diet on lipid profiles and biomarkers of oxidative stress in overweight and obese women with polycystic ovary syndrome: A randomized clinical trial

ObjectiveThe aim of this study was to assess the effects of the Dietary Approaches to Stop Hypertension (DASH) diet on lipid profiles and biomarkers of oxidative stress in overweight and obese women with polycystic ovary syndrome (PCOS).MethodsThis randomized controlled clinical trial was conducted with 48 women diagnosed with PCOS. The women were randomly assigned to consume either the control (n = 24) or DASH diet (n = 24) for 8 wk. Both diets were designed to be calorie-restricted. Both diets consisted of 52% carbohydrates, 18% proteins, and 30% total fats. The DASH diet was designed to be rich in fruits, vegetables, whole grains, and low-fat dairy products and to be low in saturated fats, cholesterol, and refined grains. Fasting blood samples were taken at baseline and after 8-wk intervention to measure lipid profiles and biomarkers of oxidative stress including plasma total antioxidant capacity (TAC) and total glutathione (GSH).ResultsAdherence to the DASH diet, compared with the control diet, resulted in a significant decrease in weight (−4.4 versus −1.5 kg; P < 0.001) and body mass index (−1.7 versus −0.6 kg/m²; P < 0.001), decreased serum triglycerides (−10.0 versus +19.2 mg/dL; P interaction = 0.005) and very-low-density lipoprotein cholesterol levels (−2.0 versus +3.9 mg/dL; P interaction = 0.005). Increased concentrations of TAC (+98.6 versus −174.8 mmol/L; P interaction <0.001) and GSH (+66.4 versus −155.6 μmol/L; P interaction = 0.005) also were found in the DASH group compared with the control group.ConclusionConsumption of DASH diet for 8 wk led to a significant reduction in serum insulin, triglycerides and very-low-density lipoprotein cholesterol and a significant increase in TAC and GSH levels.     

The effect of almonds on inflammation and oxidative stress in Chinese patients with type 2 diabetes mellitus: a randomized crossover controlled feeding trial

Purpose

Almond consumption is associated with ameliorations in obesity, hyperlipidemia, hypertension, and hyperglycemia. The hypothesis of this 12-week randomized, crossover, controlled feeding trial was that almond consumption would ameliorate inflammation and oxidative stress in Chinese patients with type 2 diabetes mellitus (T2DM) (9 M, 11 F; 58 years; BMI: 26 kg/m²) with mild hyperlipidemia.

Methods

After a 2-week run-in period, the patients were assigned to either a control NCEP step II diet (control diet) or almond diet for 4 weeks with a 2-week washout period between alternative diets. Almonds approximately at 56 g/day were added to the control diet to replace 20 % of total daily calorie intake.

Results

As compared to the control diet, the almond diet decreased IL-6 by a median 10.3 % (95 % confidence intervals 5.2, 12.6 %), CRP by a median 10.3 % (?24.1, 40.5), and TNF-α by a median 15.7 % (?0.3, 29.9). The almond diet also decreased plasma protein carbonyl by a median 28.2 % (4.7, 38.2) as compared to the C diet but did not alter plasma malondialdehyde. The A diet enhanced the resistance of LDL against Cu²⁺-induced oxidation by a median 16.3 % (7.4, 44.3) as compared to the C diet. Serum intercellular adhesion molecule-1 and vascular adhesion molecule-1 were not changed by both diets.

Conclusions

Our results suggested that incorporation of almonds into a healthy diet could ameliorate inflammation and oxidative stress in patients with T2DM.     

Effect of dairy products on oxidative stress in type 2 diabetic patients: A randomized controlled clinical trial

ObjectiveThe aim of this randomized control trial was to assess the effect of dairy product (milk and yogurt) consumption on oxidative stress biomarkers in diabetic patients.Material and methodsNinety-one diabetic patients were randomly assigned to one of the three following intervention groups: group A (<1 serving of dairy products), group B (2 to 3 servings), and group C (4 to 5 servings). Biomarkers of oxidative stress including, serum total antioxidant capacity, catalase activity, malondialdehyde (MDA) were measured at baseline and after the 8-week intervention.ResultsNo significant difference was found in oxidative stress between groups, except for MDA that significantly decreased in group C.ConclusionsConsumption of dairy products including milk and yogurt, ≥ 4 servings per day, reduced MDA concentration, however consumption ≤ 3 serving per day had no significant effect on oxidative stress among diabetic patients.     

Randomized controlled trial for an effect of green tea consumption on insulin resistance and inflammation markers

To study the effects of the intake of green tea and polyphenols, which are a component of green tea, on insulin resistance and systemic inflammation, a randomized controlled trial was conducted on 66 patients aged 32-73 y (53 males and 13 females) with borderline diabetes or diabetes. Subjects in the intervention group were asked to take a packet of green tea extracts/powder containing 544 mg polyphenols (456 mg catechins) daily, which was a dose that could be taken without difficulty, and were asked to divide the green tea extracts/powder in a packet into 3 or 4 fractions dissolved in hot water everyday and to take a fraction after every meal or snack for 2 mo, in addition to daily food intake. The subjects in the control group were simply followed. To calculate the level of green tea polyphenol intake that the subject usually drank at home, the subject was asked to taste 3 teas of different strengths (1, 2 and 3%) and the tea that was closest to the one that the subject drank at home, was selected by each subject. After 2 mo, the mean daily polyphenol intake in the intervention group was 747 mg, which was significantly higher than that of 469 mg in the control group. In the intervention group, the body weight, BMI, systolic and diastolic blood pressures, blood glucose level, Hb A1c level, insulin level and HOMA index after taking the supplementation for 2 mo, were lower than the respective value before intervention: however, these parameters in the intervention group at 2 mo did not significantly differ from those in the control group. Within the intervention group, changes in insulin level tended to be associated with changes in polyphenol intake. In addition, changes in BMI were associated with changes in blood glucose level and insulin level. In conclusion, the daily supplementary intake of 500 mg green tea polyphenols did not have clear effects on blood glucose level, Hb A1c level, insulin resistance or inflammation markers. The positive correlation between the level of polyphenol intake and insulin level warrants further studies on the effect of green tea on insulin resistance.     

Effect of lipoic acid consumption on oxidative stress among multiple sclerosis patients: A randomized controlled clinical trial

Objectives

Multiple sclerosis is a neurodegenerative and demyelinating disease of central nervous system. High levels of oxidative stress are associated with inflammation and play an important role in pathogenesis of multiple sclerosis. This double-blind, randomized controlled clinical study was carried out to determine the effect of daily consumption of lipoic acid on oxidative stress among multiple sclerosis patients.

Methods

A total of 52 relapsing-remitting multiple sclerosis patients, aged 18–50 years with Expanded Disability Status Scale ≤5.5 were assigned to consume either lipoic acid (1200 mg/day) or placebo capsules for 12 weeks. Fasting blood samples were collected before the first dose taken and 12 hours after the last. Dietary intakes were obtained by using 3-day dietary records.

Results

Consumption of lipoic acid resulted in a significant improvement of total antioxidant capacity (TAC) in comparison to the placebo group (P = 0.004). Although a significant change of TAC (?1511 mmol/L, P = 0.001) was found within lipoic acid group, other markers of oxidative stress including superoxide dismutase activity, glutathione peroxidase activity, and malondialdehyde levels were not affected by lipoic acid consumption.

Discussion

These results suggest that 1200 mg of lipoic acid improves serum TAC among multiple sclerosis patients but does not affect other markers of oxidative stress.     

A randomized, blinded, controlled trial investigating the gastrointestinal health effects of drinking water quality

A double-blinded, randomized, controlled trial was carried out in in Melbourne, Australia, to determine the contribution of drinking water to gastroenteritis. Melbourne is one of the few major cities in the world that draws drinking water from a protected forest catchment with minimal water treatment (chlorination only). Six hundred families were randomly allocated to receive either real or sham water treatment units (WTUs) installed in their kitchen. Real units were designed to remove viruses, bacteria, and protozoa. Study participants completed a weekly health diary reporting gastrointestinal symptoms during the 68-week observation period. There were 2,669 cases of highly credible gastroenteritis (HCG) during the study (0.80 cases/person/year). The ratio of HCG episode rates for the real WTU group compared to the sham WTU group was 0.99 (95% confidence interval, 0.85-1.15, p = 0.85). We collected 795 fecal specimens from participants with gastroenteritis, and pathogens were not more significantly common in the sham WTU group. We found no evidence of waterborne disease in Melbourne. The application of this methodology to other water supplies will provide a better understanding of the relationship between human health and water quality.     

Exercise-induced reduction in obesity and insulin resistance in women: a randomized controlled trial

OBJECTIVES: To determine the effects of equivalent diet- or exercise-induced weight loss and exercise without weight loss on subcutaneous fat, visceral fat, and insulin sensitivity in obese women. RESEARCH METHODS AND PROCEDURES: Fifty-four premenopausal women with abdominal obesity [waist circumference 110.1 +/- 5.8 cm (mean +/- SD)] (BMI 31.3 +/- 2.0 kg/m2) were randomly assigned to one of four groups: diet weight loss (n = 15), exercise weight loss (n = 17), exercise without weight loss (n = 12), and a weight-stable control group (n = 10). All groups underwent a 14-week intervention. RESULTS: Body weight decreased by approximately 6.5% within both weight loss groups and was unchanged in the exercise without weight loss and control groups. In comparison with controls, cardiorespiratory fitness improved within the exercise groups only (p < 0.01). Reduction in total, abdominal, and abdominal subcutaneous fat within the exercise weight loss group was greater (p < 0.001) than within all other groups. The reduction in total and abdominal fat within the diet weight loss and exercise without weight loss groups was greater than within controls (p < 0.001) but not different from each other (p > 0.05). Visceral fat decreased within all treatment groups (p < 0.008), and these changes were not different from each other. In comparison with the control group, insulin sensitivity improved within the exercise weight loss group alone (p < 0.001). DISCUSSION: Daily exercise without caloric restriction was associated with substantial reductions in total fat, abdominal fat, visceral fat, and insulin resistance in women. Exercise without weight loss was also associated with a substantial reduction in total and abdominal obesity.     

Efficacy and safety of very-low-calorie diet in Taiwanese: A multicenter randomized, controlled trial

ObjectiveVery-low-calorie diets (VLCDs) are an effective method for weight reduction in Caucasians. This study investigated the efficacy and safety of two different VLCDs (450 or 800 kcal/d) in obese Taiwanese.Methods132 participants with BMI ≥30 kg/m² were randomized to two VLCD groups for body weight reduction for 12 weeks. Each group had 66 participants. Anthropometric and metabolic parameters were measured.ResultsThe intention-to-treat analysis revealed that the percentage change in body weight over the 12-week treatment period was –9.14% in the VLCD-450 group and –8.98% in the VLCD-800 group. A total of 27 (40.9%) participants in the VLCD-450 group and 29 (43.9%) participants in the VLCD-800 group achieved 10% or more weight loss at the end of treatment. The body weight, waist circumference, hip circumference, fat mass, blood pressure, triglycerides, and blood glucose were statistically improved from baseline but not between the two groups. The improvement rate of nonalcoholic fatty liver disease (NAFLD) was 41.5% in the VLCD-450 group and 50.0% in the VLCD-800 group. The incidence of adverse events did not differ significantly between the groups and no serious adverse events were reported in either group.ConclusionBoth the VLCD-450 and 800 kcal/d can effectively and safely reduce body weight and improve NAFLD in 12 weeks in obese Taiwanese participants. However, there is no additional benefit in prescribing the more restrictive diet intervention in Taiwanese.     

门冬胰岛素和生物合成人胰岛素治疗妊娠期糖尿病的临床疗效观察

目的:探究临床有效治疗妊娠期糖尿病的可靠方法.方法:对84例妊娠期糖尿病患者随机分为观察组(采用门冬胰岛素诺和锐进行治疗)和对照组(采用生物合成人胰岛素诺和灵R进行治疗)各42例,观察比较两组患者临床治疗后FPG、2Hppg、HbAlc、胰岛素用量和达标时间.结果:在FPG、2Hppg、HbAlc、胰岛素用量、达标时间等5项指标上观察组均明显的优于对照组,差异有统计学意义(P＜0.05);总低血糖发生率观察组显著的低于对照组,差异有统计学意义(P＜0.01).结论:在临床针对妊娠期糖尿病患者采用门冬胰岛素进行治疗的临床优势明显,相关患者的临床指标水平更好,不良反应发生水平更低,是临床治疗妊娠期糖尿病的理想选择.     

Effects of pomegranate juice consumption on oxidative stress in patients with type 2 diabetes: a single-blind,randomized clinical trial

Increased free radicals production due to hyperglycemia produces oxidative stress in patients with diabetes. Pomegranate juice (PJ) has antioxidant properties. This study was conducted to determine the effects of PJ consumption in oxidative stress in type 2 diabetic patients.

This study was a randomized clinical trial performed on 60, 40–65 years old diabetic patients.

The patients were randomly allocated either to PJ consumption group or control. Patients in PJ group consumed 200?ml of PJ daily for six weeks. Sex distribution and the mean age were not different between two groups. After six weeks intervention, oxidized LDL and anti-oxidized LDL antibodies decreased and total serum antioxidant capacity and arylesterase activity of paraoxonase increased significantly in the PJ-treated group compared to the control group. Our data have shown that six weeks supplementation of PJ could have favorable effects on oxidative stress in patients with type 2 diabetes (T2D).     

胰岛素抵抗在妊娠期糖尿病发病机制中的作用

目的: 探讨胰岛素抵抗(IR) 在妊娠期糖尿病(GDM) 发病机制中的作用。方法: 应用放射免疫法测量32例GDM妇女、30例正常糖耐量妊娠妇女(NGT) 的空腹胰岛素及C肽水平和75g葡萄糖耐量试验(OGTT) 后2h的胰岛素水平。应用稳态模型胰岛素抵抗指数(HOMA-IR) 及胰岛分泌功能指数(HBCI), 比较两组HOMA-IR及HBCI的差异。结果: GDM组HOMA-IR (2. 3±0. 3) 高于NGT组(1. 4±0 .4), 有显著差异(P<0 .01); 两组间HBCI比较差异不显著(P>0. 05)。结论: 妊娠期存在生理性IR, 妊娠期IR程度增加, 可能是GDM主要的发病机制之一。     

真实世界研究与随机对照试验、单病例随机对照试验在临床治疗性研究中的关系比较

真实世界研究、随机对照试验及单病例随机对照试验在设计及具体的实施环节上存在明显不同.随机对照试验属于新治疗措施实施前的研究,真实世界研究属于新治疗措施实施后的研究.两者不是对同一个问题的平行论证,而是承启关系.精心设计的随机对照试验是临床上任何干预措施效果评价的基础,其结果需要真实世界研究的进一步验证及拓展补充,综合考虑二者才是最佳的选择.单病例随机对照试验更易在短时间内获得一些特殊病例的信息,是随机对照试验结果的良好补充,也是一定条件下最经济的真实世界研究.临床工作及其研究是十分复杂的过程.不同个体虽患同种疾病,但临床表现互有差异,且临床反应的变化也不尽相同.因此,无法获得同一干预措施下不同个体的相同治疗效果;加之有的治疗措施缺乏真实性和实用价值,从而使得疗效评价成为一个难题.近些年来,普遍采用试验性的研究结果作为证据指导临床实践活动,其中以随机对照试验(RCT)最为受到重视,但由于RCT属于药物面市前研究,对研究对象的选择、治疗措施的应用等均有严格的限定.     

诺和锐特充治疗妊娠期糖尿病的临床疗效

目的研究应用诺和锐特充治疗妊娠期糖尿病患者的临床疗效及安全性,为改善妊娠结局,降低妊娠并发症提供理论依据。方法抽取2015年1月-2016年12月在该院接受治疗的妊娠期糖尿病患者60例进行研究,随机分为观察组和对照组,每组各30例。对照组给予诺和灵R进行治疗,用药4周;观察组给予诺和锐特充治疗,用药4周。比较两组患者的血糖、胰岛素抵抗指数变化情况,分析母婴结局与新生儿低血糖发生率。结果治疗后,观察组患者的空腹血糖与餐后2 h血糖均较治疗前明显下降,且降幅较对照组明显(P0.05);HOMA-IR明显低于治疗前与对照组治疗后(P0.05);观察组中新生儿低血糖比例、妊娠期高血压疾病比例、羊水过多以及新生儿呼吸窘迫综合征比例均明显低于对照组(P0.05);两组患者低血糖发生率比较差异无统计学意义(P0.05)。结论应用诺和锐特充治疗妊娠期糖尿病可对患者的血糖水平进行有效控制,改善母婴结局,用药安全。