Effect of pistachio diet on lipid parameters,endothelial function,inflammation, and oxidative status: A prospective study

ObjectiveRecent studies have suggested that nuts have favorable effects beyond lipid lowering. We aimed to investigate effect of the Antep pistachio (Pistacia vera L.) on blood glucose, lipid parameters, endothelial function, inflammation, and oxidation in healthy young men living in a controlled environment.MethodsA Mediterranean diet was administered to normolipidemic 32 healthy young men (mean age 22 y, range 21–24) for 4 wk. After 4 wk, participants continued to receive the Mediterranean diet but pistachio was added for 4 wk by replacing the monounsaturated fat content constituting ≈20% of daily caloric intake. Fasting blood samples and brachial endothelial function measurements were performed at baseline and after each diet.ResultsCompared with the Mediterranean diet, the pistachio diet decreased glucose (P < 0.001, ?8.8 ± 8.5%), low-density lipoprotein (P < 0.001, ?23.2 ± 11.9%), total cholesterol (P < 0.001, ?21.2 ± 9.9%), and triacylglycerol (P = 0.008, ?13.8 ± 33.8%) significantly and high-density lipoprotein (P = 0.069, ?3.1 ± 11.7%) non-significantly. Total cholesterol/high-density lipoprotein and low-density lipoprotein/high-density lipoprotein ratios decreased significantly (P < 0.001 for both). The pistachio diet significantly improved endothelium-dependent vasodilation (P = 0.002, 30% relative increase), decreased serum interleukin-6, total oxidant status, lipid hydroperoxide, and malondialdehyde and increased superoxide dismutase (P < 0.001 for all), whereas there was no significant change in C-reactive protein and tumor necrosis factor-α levels.ConclusionIn this trial, we demonstrated that a pistachio diet improved blood glucose level, endothelial function, and some indices of inflammation and oxidative status in healthy young men. These findings are in accordance with the idea that nuts, in particular pistachio nuts, have favorable effects beyond lipid lowering that deserve to be evaluated with prospective follow-up studies.     

Anthocyanins in berries exhibited anti-atherogenicity and antiplatelet activities in a metabolic syndrome population

Metabolic syndrome (MetS) is a global challenge for atherosclerosis. It was hypothesized that a four-week consumption of anthocyanin supplements by MetS patients who had three or more risk factors linked with metabolic syndrome would have a greater improvement in cardiometabolic biomarkers and would also reduce the risk of thrombosis. A total of 55 participants in two groups of Normal healthy and MetS (age 25-75y) were given 320 mg anthocyanin supplements twice daily for 4 weeks. Platelet coagulant activities, lipid profiles, fasting blood glucose, and inflammatory and oxidative stress biomarkers were measured before and after supplementation to evaluate the atheroprotective effects of anthocyanins in the study subjects. Four weeks of anthocyanin supplementation significantly decreased cardiometabolic risk factors including the average serum fasting blood glucose (FBG) (by 13.3%, P < .05) and lipid profiles by significant reduction in triglyceride (by 24.9%, P < .05) and LDL-C (by 33.1%, P < .05) in the MetS group. Anthocyanin supplementation also decreased high sensitivity C-reactive protein (hs-CRP) level (by 28%, P < .05) in females. However, no significant differences in serum UA (uric acid) and HDL-C were observed between anthocyanin pre- and post-treatment in both groups. Moreover, Anthocyanin supplements decreased ADP-induced platelet activation configuration expressed as P-selectin by 40% (P < .05). There was a positive correlation between decreased hs-CRP values and the levels of LDL-C and FBG in the MetS group (P < .05). These results support the hypothesis that anthocyanin supplementation exerts anti-atherogenicity effects by improving cardiometabolic risk factors and reducing thrombogenicity in the MetS population.     

Pistachio Nuts Reduce Triglycerides and Body Weight by Comparison to Refined Carbohydrate Snack in Obese Subjects on a 12-Week Weight Loss Program

Objective: There is a widely held view that, due to high fat content, snacking on nuts will lead to weight gain, ultimately causing unhealthy changes in lipid profiles. This study is designed to study the effects of pistachio snack consumption on body weight and lipid levels in obese participants under real-world conditions.

Methods: Participants were randomly assigned to consume 1 of 2 isocaloric weight reduction diets for 12 weeks, with each providing 500 cal per day less than resting metabolic rate. Each diet included an afternoon snack of either 53 g (240 cal) of salted pistachios (n = 31) or 56 g of salted pretzels (220 cal; n = 28).

Results: Both groups lost weight during the 12-week study (time trend, p < 0.001), but there were significant differences in the changes in body mass index between the pretzel and pistachio groups (pistachio, 30.1 ± 0.4 to 28.8 ± 0.4 vs. pretzel, 30.9 ± 0.4 to 30.3 ± 0.5). At 6 and 12 weeks, triglycerides were significantly lower in the pistachio group compared with the pretzel group (88.04 ± 9.80 mg/dL vs. 144.56 ± 18.86 mg/dL, p = 0.01 at 6 weeks and 88.10 ± 6.78 mg/dL vs. 132.15 ± 16.76 mg/dL, p = 0.02 at 12 weeks), and there was a time trend difference between the 2 groups over the 12 weeks (p < 0.01). There were no significant differences in total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, insulin, or glucose between the 2 groups.

Conclusion: Pistachios can be consumed as a portion-controlled snack for individuals restricting calories to lose weight without concern that pistachios will cause weight gain. By comparison to refined carbohydrate snacks such as pretzels, pistachios may have beneficial effects on triglycerides as well.     

Enhancement of a modified Mediterranean-style, low glycemic load diet with specific phytochemicals improves cardiometabolic risk factors in subjects with metabolic syndrome and hypercholesterolemia in a randomized trial

Background

As the worldwide dietary pattern becomes more westernized, the metabolic syndrome is reaching epidemic proportions. Lifestyle modifications including diet and exercise are recommended as first-line intervention for treating metabolic syndrome. Previously, we reported that a modified Mediterranean-style, low glycemic load diet with soy protein and phytosterols had a more favorable impact than the American Heart Association Step 1 diet on cardiovascular disease (CVD) risk factors. Subsequently, we screened for phytochemicals with a history of safe use that were capable of increasing insulin sensitivity through modulation of protein kinases, and identified hops rho iso-alpha acid and acacia proanthocyanidins. The objective of this study was to investigate whether enhancement of a modified Mediterranean-style, low glycemic load diet (MED) with specific phytochemicals (soy protein, phytosterols, rho iso-alpha acids and proanthocyanidins; PED) could improve cardiometabolic risk factors in subjects with metabolic syndrome and hypercholesterolemia.

Methods

Forty-nine subjects with metabolic syndrome and hypercholesterolemia, aged 25–80, entered a randomized, 2-arm, 12-week intervention trial; 23 randomized to the MED arm; 26 to the PED arm. Forty-four subjects completed at least 8 weeks [MED (n = 19); PED (n = 25)]. All subjects were instructed to follow the same aerobic exercise program. Three-day diet diaries and 7-day exercise diaries were assessed at each visit. Fasting blood samples were collected at baseline, 8 and 12 weeks for analysis.

Results

Both arms experienced equal weight loss (MED: -5.7 kg; PED: -5.9 kg). However, at 12 weeks, the PED arm experienced greater reductions (P < 0.05) in cholesterol, non-HDL cholesterol, triglycerides (TG), cholesterol/HDL and TG/HDL compared with the MED arm. Only the PED arm experienced increased HDL (P < 0.05) and decreased TG/HDL (P < 0.01), and continued reduction in apo B/apo A-I from 8 to 12 weeks. Furthermore, 43% of PED subjects vs. only 22% of MED subjects had net resolution of metabolic syndrome. The Framingham 10-year CVD risk score decreased by 5.6% in the PED arm (P < 0.01) and 2.9% in the MED arm (P < 0.05).

Conclusion

These results demonstrate that specific phytochemical supplementation increased the effectiveness of the modified Mediterranean-style low glycemic load dietary program on variables associated with metabolic syndrome and CVD.     

Regular aerobic exercise activates PDGF-BB/PDGFR-β signaling and modulates the inflammatory-anti-inflammatory balance in diet-induced obese mice

ObjectiveRegular aerobic exercise induces cardioprotection by counteracting the obesity-associated inflammatory response, dyslipidemia. PDGF-BB/PDGFR-β signaling is established as a crucial mechanism of endothelial cell-cardiomyocyte communication and cardioprotection, but its physiological roles in response to obesity and regular aerobic exercise are unknown.MethodsThirty C57BL/6 mice were divided into three groups: a normal diet group, a high-fat diet group, and a high-fat diet plus aerobic exercise group. Glucose metabolic parameters, inflammation-related indicators, and blood lipids indicators were detected. In addition, gene expression levels of the inflammatory factors, PDGF-BB, PDGFR-β, PI3K, Akt, eNOS, and P53 in cardiac tissue were quantified. Morphological analysis was also used to quantify the magnitude of inflammation.ResultsHigh-fat diet (HFD) feeding resulted in adiposity, dyslipidemia, and low levels of cardioprotective factors such as APN and eNOS (P < 0.05), which were improved significantly by 8 weeks of aerobic exercise (P < 0.05). HFD feeding increased the gene expression levels of proinflammatory cytokines and decreased the gene expression levels of anti-inflammatory cytokines in cardiac tissue (P < 0.05), which was reversed by regular aerobic exercise (P < 0.05). In addition, HFD feeding suppressed the levels of the cardioprotective factors PDGF-BB and eNOS through PDGF-BB/PDGFR-β/PI3K/Akt/eNOS signaling in cardiac tissue, while regular aerobic exercise activated PDGF-BB/PDGFR-β/PI3K/Akt/eNOS signaling.ConclusionRegular aerobic exercise improved adiposity, dyslipidemia induced by HFD feeding. Regular aerobic exercise exerted a prominent role in modulating the inflammatory-anti-inflammatory balance and activating the levels of the cardioprotective factors eNOS and PDGF-BB through PDGF-BB/PDGFR-β signaling.     

A randomized controlled clinical trial investigating the effect of DASH diet on insulin resistance,inflammation, and oxidative stress in gestational diabetes

ObjectiveTo our knowledge, no reports are available indicating the effects of the Dietary Approaches to Stop Hypertension (DASH) eating plan on insulin resistance, inflammation, and oxidative stress among pregnant women with gestational diabetes mellitus (GDM).This study was designed to investigate the effects of the DASH diet on insulin resistance, serum high-sensitivity C-reactive protein (hs-CRP) and biomarkers of oxidative stress among pregnant women with GDM.MethodsThis randomized controlled clinical trial was performed with 32 pregnant women diagnosed with GDM at 24 to 28 wk gestation. Participants were randomly assigned to consume either the control (n = 16) or DASH diet (n = 16) for 4 wk. The DASH diet was rich in fruits, vegetables, whole grains, and low-fat dairy products and was low in saturated fats, total fats, cholesterol, refined grains, and sweets, with a total of 2400 mg/d of sodium. The control diet contained 40% to 55% of its energy as carbohydrates, 10% to 20% as proteins, and 25% to 30% as total fats. Fasting blood samples were taken at baseline and after 4 wk of intervention to measure fasting plasma glucose (FPG), serum insulin, and hs-CRP, Homeostasis Model of Assessment—Insulin Resistance (HOMA-IR), plasma total antioxidant capacity (TAC), and total glutathione levels (GSH).ResultsConsumption of the DASH diet compared with the control diet resulted in decreased FPG (–7.62 versus 3.68 mg/dL; P = 0.02), serum insulin levels (–2.62 versus 4.32 μIU/mL, P = 0.03), and HOMA-IR score (–0.8 versus 1.1; P = 0.03). Increased concentrations of plasma TAC (45.2 versus –159.2 mmol/L; P < 0.0001) and GSH (108.1 versus –150.9 μmol/L; P < 0.0001) also were seen in the DASH group compared with control group. We failed to find a significant difference in mean changes of serum hs-CRP levels between the two diets. Within-group comparisons revealed significant reductions in plasma TAC and GSH levels in the control diet, while a significant increase in these biomarkers in the DASH diet.ConclusionConsumption of the DASH diet in pregnant women with GDM had beneficial effects on FPG, serum insulin levels, HOMA-IR score, plasma TAC, and total GSH levels. The effects of this dietary pattern on pregnancy outcomes need to be investigated in future studies.     

The relationship between body composition and selected metabolic syndrome markers in black adolescents in South Africa: The PLAY study

ObjectiveTo determine the relationship between body composition and selected markers of the metabolic syndrome in black adolescents.MethodsThe group consisted of 232 adolescent boys and girls aged 15–19 y attending two secondary schools in a low socio-economic status area of Potchefstroom, South Africa. Body mass (kg), stature (cm), and waist (WC) and hip circumferences were measured using standard methods. Body mass index and waist:hip ratio were calculated. Percentage body fat and lean body mass were measured by air displacement plethysmography. Fasting plasma insulin, fasting glucose, homeostasis model assessment of insulin resistance (HOMA-IR), systolic blood pressure (SBP), and diastolic blood pressure were measured.ResultsChildren with a high body fat percentage (boys >20%, girls >25%) had significantly higher serum leptin concentration than children with normal body fat percentage (boys, P = 0.005; girls, P < 0.0001). Girls with a high body fat percentage also reported significantly higher SBP (P = 0.004), diastolic blood pressure (P = 0.03), plasma insulin (P = 0.004), and HOMA-IR (P = 0.004) than girls with normal body fat percentage. Body fat percentage had a significant positive association with HOMA-IR (P = 0.02) and SBP (P = 0.02), respectively. A significant positive correlation was also found between plasma leptin concentration and body mass index (P < 0.0001), WC (P < 0.0001), body fat percentage (P < 0.0001), and fat:height index (P < 0.001).ConclusionA significant positive association was found between body fat percentage and both SBP and HOMA-IR, respectively. Girls with a high body fat percentage had significantly higher BP, plasma insulin, and HOMA-IR than girls with normal body fat percentage, indicating risk of non-communicable diseases.     

Eating behavior influences diet,weight, and central obesity in women after pregnancy

ObjectiveThe aim of this study was to explore whether type of eating behavior is related to diet and overweight in women after childbirth.MethodsIn a prospective mother–infant study, women's (N = 189) eating behavior, dietary intake from food diaries, weight, and waist circumference (WC) were measured at 6, 12, 24, and 48 mo after giving birth. Three aspects of eating behavior were measured by the validated Three Factor Eating Questionnaire-18: cognitive restraint (CR; restricting of eating without associated hunger or fullness), emotional eating (EE; overeating due to negative feelings), and uncontrolled eating (UE; overeating irrespective of physiologic need).ResultsHigh scores in CR associated with the lowest tertile of fat intake (% of energy [E%], P = 0.045). High UE scores associated with the highest tertiles of intakes of energy (kcal; P < 0.001), fiber (g; P < 0.001) and sucrose (E%; P < 0.001). High EE scores (P = 0.003) linked with overweight (body mass index ≥ 25 kg/m²), whereas UE (P < 0.001) linked with central obesity (WC ≥ 80 cm).ConclusionsWe demonstrated that certain types of eating behavior related to both energy-dense diet and weight and central adiposity. We propose that measuring eating behavior by the simple questionnaire could be a helpful tool in dietary counseling that aids in identifying women who are likely at risk for unhealthy dietary patterns and for developing overweight.     

Dietary Patterns in Asian Indians in the United States: An Analysis of the Metabolic Syndrome and Atherosclerosis in South Asians Living in America Study

Dietary patterns contribute to cardiovascular disease (CVD) risk. Asian Indians have earlier onset, more severe, and more prevalent CVD than many other racial/ethnic groups. We aimed to characterize dietary patterns in Asian Indians living in the United States and examine associations with cardiometabolic risk factors. One hundred fifty Asian Indians, aged 45 to 84 years, without known CVD, living in the San Francisco Bay, CA, area between August 2006 and October 2007 were enrolled into the Metabolic syndrome and Atherosclerosis in South Asians Living in America study. A food frequency questionnaire validated in Asian Indians, fasting blood samples, and computed tomography scans were obtained for all participants. Principal component analysis with varimax rotation was used to determine prevalent dietary patterns. Linear regression analyses were performed for associations between dietary patterns and metabolic factors, adjusting initially for age and sex, then additionally for BMI, income, education, metabolic equivalent of task-minutes of exercise, alcohol consumption, and smoking. Two distinct dietary patterns were identified that we termed “Western,” and “Vegetarian.” Compared with the Western diet, the Vegetarian diet was associated with lower homeostasis model of assessment-insulin resistance (−1.12 mmol/L×mU/L; P=0.05) and lower high-density lipoprotein cholesterol (−4.77 mg/dL; P=0.09). Given that the Western and Vegetarian dietary patterns were each associated with adverse metabolic changes, healthful diet choices may help Asian Indians improve risk factors for CVD.     

Impact of weight loss and maintenance with ad libitum diets varying in protein and glycemic index content on metabolic syndrome

ObjectivesWe investigated the effects of weight loss and maintenance with diets that varied with regard to protein content and glycemic index (GI) on metabolic syndrome (MetSyn) status.MethodsSecondary analyses were performed within the Diet, Obesity and Genes (DiOGenes) study (2006–2008), a randomized controlled dietary intervention. Nine hundred and thirty-eight overweight and obese adults from eight European countries entered an 8-wk low-calorie-diet period. Seven hundred and seventy-three adults who lost at least 8% of their body weights were randomized to one of five ad libitum diets for 6 mo: 1) low-protein (LP)/low-GI (LGI); 2) LP/high-GI (HGI); 3) high-protein (HP)/LGI; 4) HP/HGI; and 5) control diet. MetSyn prevalence and a standardized MetSyn score were assessed at baseline, after the low-calorie diet, and after the intervention.ResultsWeight loss among participants while on the low-calorie diet significantly reduced MetSyn prevalence (33.9% versus 15.9%; P < 0.001) and MetSyn score (−1.48 versus −4.45; P < 0.001). During weight maintenance, significant changes in MetSyn score were observed between the groups, with the highest increase detected in the LP/HGI group (P = 0.039, partial η² = 0.023). Protein, GI, and their interaction did not have isolated effects on study outcomes.ConclusionsNeither protein nor GI affected MetSyn status in this sample of European overweight and obese adults. However, a diet with a combination of an increased protein-to-carbohydrate ratio with low-GI foods had beneficial effects on MetSyn factors.     

循环训练对肥胖女大学生身体成分体适能和代谢综合征危险因素的影响

探讨12周循环训练对肥胖女大学生身体成分、体适能以及代谢综合征危险因素的影响,为针对肥胖女大学生相应干预措施的制定提供参考.方法 将某高校60名肥胖女大学生随机分为对照组和运动组各30名.对照组保持日常生活习惯不变,运动组进行3次/周、共12周的循环训练.分别于干预前后测定身体成分[身高、体重、体质量指数(BMI)、体脂百分比(percentage of body fat,PBF)和瘦体重(lean body mass,LBM)]、健康体适能(背肌力量、仰卧起坐、坐位体前屈和1600m跑成绩)和代谢综合征危险因素[腰围(waist circumference,WC)、空腹血糖(fasting blood glucose,FBG)、三酰甘油(triglyceride,TG)、总胆固醇(total cholesterol,TC)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)和低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)]相关参数.结果 与干预前比较,干预后运动组体重、BMI、PBF下降,背肌力量、仰卧起坐、坐位体前屈和1600m跑成绩提高(t值分别为2.14,2.21,2.48,-7.21,-7.69,-7.01,4.83,P值均<0.05),WC、TG、TC下降(t值分别为2.89,4.54,2.71,P值均<0.05);对照组所有参数干预前后比较差异均无统计学意义(P值均>0.05).结论 规律循环训练能够改善肥胖女大学生身体成分、提高体适能水平,并可能有助于预防代谢性疾病发生.     

A Novel Fortified Dairy Product and Sarcopenia Measures in Sarcopenic Older Adults: A Double-Blind Randomized Controlled Trial

ObjectivesTo evaluate the efficacy of daily consumption of fortified yogurt with beta-Hydroxy beta-Methyl Butyrate (HMB) and vitamins D and C on measures of sarcopenia, inflammation, and quality of life in sarcopenic older adults.DesignIn this 12-week randomized double-blind controlled trial, participants received either yogurt fortified with 3 g HMB, 1000 IU vitamin D, and 500 mg vitamin C in the intervention group (n = 33) or plain yogurt in the control group (n = 33).Setting and ParticipantsA total of 66 older adults with sarcopenia recruited from the community in Shiraz, Iran.MeasuresBody composition, muscle strength, and functionality were measured using Dual-energy-X-ray Absorptiometry (DXA), hydraulic handgrip dynamometer, and usual gait speed, respectively. Serum concentrations of vitamin D, insulin-like growth factor-1 (IGF-1), C-reactive protein (hs-CRP), malondialdehyde, and insulin were measured at baseline and after 12 weeks. Health-related quality of life (HRQoL) was also evaluated using SF-12 questionnaire.ResultsConsumption of fortified yogurt was associated with improvement in handgrip strength [mean change (95% confidence interval) 4.36 (3.35–5.37) vs. 0.97 (?0.04 to 1.99)] and gait speed [0.10 (0.07–0.13) vs. 0.01 (0.00–0.04)] in the intervention group compared with the control group (P < .001). In addition, the results revealed a significant increase in vitamin D and IGF-1 levels in the intervention group (P < .001). The nutritional intervention significantly prevented any increase in the serum concentration of hs-CRP compared with the control group (P = .033). The results also showed a more significant decrease in the malondialdehyde level in the intervention group compared with the control (P = .008). Moreover, there were significant differences between the 2 groups regarding physical aspects of HRQoL (P = .035).Conclusions and ImplicationsA novel dairy product fortified with HMB, vitamin D, and vitamin C not only could enhance muscle strength and functionality, but also modulate anabolic and inflammatory conditions as well as quality of life. This study suggested that specific nutritional interventions alone could be beneficial, especially for those who are unable to exercise.     

Metabolic effects of aloe vera gel complex in obese prediabetes and early non-treated diabetic patients: Randomized controlled trial

ObjectiveThe metabolic effects of an aloe vera gel complex (Aloe QDM complex) on people with prediabetes or early diabetes mellitus (DM) are unknown. The goal of this study was to determine the effects of Aloe QDM complex on body weight, body fat mass (BFM), fasting blood glucose (FBG), fasting serum insulin, and Homeostasis Model of Assessment - Insulin Resistance (HOMA-IR) in obese individuals with prediabetes or early DM who were not on diabetes medications.MethodsParticipants (n = 136) were randomly assigned to an intervention or a control group and evaluated at baseline and at 4 and 8 wk.ResultsThe study lost six participants in the control group and eight in the intervention group. At 8 wk, body weight (P = 0.02) and BFM (P = 0.03) were significantly lower in the intervention group. At 4 wk, serum insulin level (P = 0.04) and HOMA-IR (P = 0.047) were lower in the intervention group; they also were lower at 8 wk but with borderline significance (P = 0.09; P = 0.08, respectively). At 8 wk, FBG tended to decrease in the intervention group (P = 0.02), but the between-group difference was not significant (P = 0.16).ConclusionIn obese individuals with prediabetes or early untreated DM, Aloe QDM complex reduced body weight, BFM, and insulin resistance.     

Changes in Food and Nutrient Intake and Diet Quality on a Low-Fat Vegan Diet Are Associated with Changes in Body Weight,Body Composition,and Insulin Sensitivity in Overweight Adults: A Randomized Clinical Trial

BackgroundConsuming different food groups and nutrients can have differential effects on body weight, body composition, and insulin sensitivity.ObjectiveThe aim was to identify how food group, nutrient intake, and diet quality change relative to usual-diet controls after 16 weeks on a low-fat vegan diet and what associations those changes have with changes in body weight, body composition, and measures of metabolic health.DesignSecondary analysis of a randomized clinical trial conducted between October 2016 and December 2018 in four replications.Participants/settingParticipants included in this analysis were 219 healthy, community-based adults in the Washington, DC, area, with a body mass index (BMI) between 28 and 40, who were randomly assigned to either follow a low-fat vegan diet or make no diet changes.InterventionA low-fat, vegan diet deriving approximately 10% of energy from fat, with weekly classes including dietary instruction, group discussion, and education on the health effects of plant-based nutrition. Control group participants continued their usual diets.Main outcome measuresChanges in food group intake, macronutrient and micronutrient intake, and dietary quality as measured by Alternate Healthy Eating Index-2010 (AHEI-2010), analyzed from 3-day diet records, and associations with changes in body weight, body composition, and insulin sensitivity were assessed.Statistical analyses performedA repeated-measure analysis of variance model that included the factors group, subject, and time was used to test the between-group differences throughout the 16-week study. Interaction between group and time was calculated for each variable. Within each diet group, paired comparison t tests were calculated to identify significant changes from baseline to 16 weeks. Spearman correlations were calculated for the relationship between changes in food group intake, nutrient intake, AHEI-2010 score, and changes in body weight, body composition, and insulin sensitivity. The relative contribution of food groups and nutrients to weight loss was evaluated using linear regression.ResultsFruit, vegetable, legume, meat alternative, and whole grain intake significantly increased in the vegan group. Intake of meat, fish, and poultry; dairy products; eggs; nuts and seeds; and added fats decreased. Decreased weight was most associated with increased intake of legumes (r = ?0.38; P < 0.0001) and decreased intake of total meat, fish, and poultry (r = +0.43; P < 0.0001). Those consuming a low-fat vegan diet also increased their intake of carbohydrates, fiber, and several micronutrients and decreased fat intake. Reduced fat intake was associated with reduced body weight (r = +0.15; P = 0.02) and, after adjustment for changes in BMI and energy intake, with reduced fat mass (r = +0.14; P = 0.04). The intervention group’s AHEI-2010 increased by 6.0 points on average, in contrast to no significant change in the control group (treatment effect, +7.2 [95% CI +3.7 to +10.7]; P < 0.001). Increase in AHEI-2010 correlated with reduction in body weight (r = 0.14; P = 0.04), fat mass (r = ?0.14; P = 0.03), and insulin resistance as measured by the Homeostasis Model Assessment (HOMA-IR; r = ?0.17; P = 0.02), after adjustment for changes in energy intake.ConclusionsWhen compared with participants’ usual diets, intake of plant foods increased, and consumption of animal foods, nuts and seeds, and added fats decreased on a low-fat vegan diet. Increased legume intake was the best single food group predictor of weight loss. Diet quality as measured by AHEI-2010 improved on the low-fat vegan diet, which was associated with improvements in weight and metabolic outcomes. These data suggest that increasing low-fat plant foods and minimizing high-fat and animal foods is associated with decreased body weight and fat loss, and that a low-fat vegan diet can improve measures of diet quality and metabolic health.     

Impact of advanced and basic carbohydrate counting methods on metabolic control in patients with type 1 diabetes

ObjectiveDiets based on carbohydrate counting remain a key strategy for improving glycemic control in patients with type 1 diabetes. However, these diets may promote weight gain because of the flexibility in food choices. The aim of this study was to compare carbohydrate counting methods regarding anthropometric, biochemical, and dietary variables in individuals with type 1 diabetes, as well as to evaluate their knowledge about nutrition.MethodsParticipants were allocated in basic or advanced groups. After 3 mo of the nutritional counseling, dietary intake, anthropometric variables, lipemia, and glycemic control were compared between groups. A questionnaire regarding carbohydrate counting, sucrose intake, nutritional knowledge, and diabetes and nutrition taboos also was administered.ResultsTen (30%) participants had already used advanced carbohydrate counting before the nutritional counseling and these individuals had a higher body mass index (BMI) (P < 0.01) and waist circumference (WC) (P = 0.01) than others (n = 23; 69.7%). After 3 mo of follow-up, although participants in the advanced group (n = 17; 51.52%) presented higher BMI (P < 0.01) and WC (P = 0.03), those in the basic group (n = 16; 48.48%) showed a higher fat intake (P < 0.01). The majority of participants reported no difficulty in following carbohydrate counting (62.5% and 88% for basic and advanced groups, respectively) and a greater flexibility in terms of food choices (>90% with both methods).ConclusionsAdvanced carbohydrate counting did not affect lipemic and glycemic control in individuals with type 1 diabetes, however, it may increase food intake, and consequently the BMI and WC, when compared to basic carbohydrate counting. Furthermore, carbohydrate counting promoted greater food flexibility.     

The Effect of Convergence Gamification Training in Community-Dwelling Older People: A Multicenter,Randomized Controlled Trial

ObjectivesIt is necessary to improve the health of older adults through exercise, but there is no concrete way to implement it or an environment in which they can exercise continuously. Our objective was to confirm the safety and efficacy of information technology (IT) convergence gamification exercise equipment for older adults. We tried to demonstrate equivalence to conventional exercise by comparing the functional improvement.DesignRandomized controlled trial, with 8-week-long IT convergence exercises 3 times a week vs conventional exercise.Setting and Participants40 community-dwelling participants aged 60-85 years.MethodParticipants were randomly divided into a conventional exercise group (group 1) and an IT convergence exercise group (group 2). Both groups were trained for 8 weeks, and functional assessment was performed before training (pre-evaluation), after training, and after 4 weeks of rest.ResultsThere were functional improvements in both groups. A comparison of the differences in the functional assessment between pre-evaluation and after 8 weeks of training yielded the following results. In group 1, the mean Five Times Sit to Stand Test–30 seconds was scored as 3.60 ± 2.56 (P < .015); Five Times Sit to Stand Test–5 times, ?1.75 ± 2.04 s (P < .015); Berg Balance Scale, 1.05 ± 1.39 (P < .015); Timed Up-and-Go test, ?0.64 ± 0.64 s (P < .015); and 10-m Walking Test, ?0.35 ± 0.47 s (P < .015). And in group 2, the mean Five Times Sit to Stand Test–30 seconds (s) was scored as 3.70 ± 2.62 (P < .015), Five Times Sit to Stand Test–5 times, ?1.65 ± 1.59 s (P < .015); Berg Balance Scale, 1.05 ± 1.00 (P < .015); Timed Up-and-Go test, ?0.93 ± 0.68 s (P < .015); 10-m Walking Test, ?0.41 ± 0.489 s (P < .015); Chair Sit and Reach test, 2.23 ± 3.19 cm (P < .015); and Korean version of the Falls Efficacy Scale–International, ?1.05 ± 1.43 (P < .015).Conclusion and ImplicationsThe results of this study suggest that the IT convergence gamification exercise equipment such as balpro110 has exercise effects similar to conventional exercise and also has advantages as an alternative to exercise for older adults in the next generation.     

生活方式干预对代谢综合征患者动脉血管早期病变检测指标的影响

目的探讨生活方式干预对非糖尿病代谢综合征（MS）患者动脉血管早期病变检测指标的影响。方法入选非糖尿病MS患者87例,随机分为干预组（47例）和对照组（40例）。干预组实施健康管理,包括健康教育、合理膳食、规律运动、纠正不良习惯等生活方式干预。对照组未行健康管理干预。随访9个月,所有患者随访前后均进行体重指数（BMI）、腰围（WC）、收缩压（SBP）、舒张压（DBP）、三酰甘油（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL—C）、低密度脂蛋白胆固醇（LDL—C）、空腹血糖（FPG）、糖化血红蛋白（HbAlc）、空腹胰岛素（FINS）、胰岛素抵抗指数（HOMA—IR）、高敏C反应蛋白（hs—CRP）、颈动脉内膜中层厚度（IMT）、臂踝脉搏波速度（baPWV）、踝臂指数（ABI）的测定。结果（1）干预组BMI、WC、SBP、TG、FIDL—C、FPG、HbAlc、FINS、HOMA—IR和hs—CRP在干预后6个月、9个月与干预前相比均显著改善,差异有统计学意义（P〈0．05）,并且HDL—C、FPG、HbAlc、FINS、HOMA-IR和hs—CRP在干预后9个月与干预后6个月相比又进一步改善,差异有统计学意义（P〈0．05）。与对照组相比,干预后9个月干预组BMI、WC、HDL—C、FPG、HbAlc、FINS、HOMA—IR和hs—CRP有改善,差异有统计学意义（P〈0．05）。（2）干预组baPWV和ABI在干预后6个月、干预后9个月与干预前相比有改善,差异有统计学意义（F值分别为：32．98,45．81;P〈0．05）。与对照组相比,干预后9个月干预组baPWV和ABI有改善,差异有统计学意义（t值分别为：-5．62,5．99;P〈0．05）。（3）干预组baPWV在干预后9个月的异常率为44．68％,与干预前（68．09％）相比有改善,差异有统计学意义（X。=5．23,P〈0．05）。（4）baPWV与hs—CRP、HOMA—IR相关（OR值分别为：0．436,0．565）;ABI与hs—CRP、HOMA—IR相关（OR值分别为：0．543,0．502）。结论对MS患者实施健康管理,加强生活方式的调控,能明显改善非糖尿病MS患者的胰岛素抵抗,调节糖脂代谢,减轻炎症反应,并在一定程度上能延缓动脉粥样硬化的进程。     

Effect of soy product kinako and fish oil on serum lipids and glucose metabolism in women with metabolic syndrome

ObjectivesAt the doses typically used to treat hypertriacylglycerolemia, fish oil may increase low-density lipoprotein (LDL) cholesterol and blood glucose levels. The aim of the present study was to verify whether soy could attenuate the effects of fish oil on blood lipids and carbohydrate metabolism in patients with metabolic syndrome.MethodsSixty-five women (47.9 ± 9.98 y) were studied with the use of a parallel, randomized design. The control group maintained the usual diet; the second group received 29.14 g/d of soy (kinako); the third group received 3 g/d of fish oil n-3 fatty acids; and the fourth group received fish oil (3 g/d) and kinako (29.14 g/d). Assessments were performed at baseline and after 45 and 90 d.ResultsIn relation to baseline values, fish oil increased (P < 0.05) total and LDL cholesterol, glucose, insulin, and homeostasis model assessment of insulin resistance levels after 90 d. Comparisons among groups demonstrated a decrease (P < 0.05) in total cholesterol in the fish oil and kinako group after 90 d as compared with the fish oil group. LDL cholesterol decreased (P < 0.01) in the kinako group as compared with the fish oil group. Blood glucose and homeostasis model assessment of insulin resistance levels decreased after 90 d (P < 0.01 and P < 0.05, respectively) and insulin levels decreased (P < 0.05) after 45 d when the kinako group was compared with the fish oil group.ConclusionsThe present study showed that kinako moderates the adverse effects of high doses of fish oil on LDL cholesterol, total cholesterol, and glucose metabolism levels.     

Bioaccessibility of pistachio polyphenols,xanthophylls, and tocopherols during simulated human digestion

ObjectiveThe bioaccessibility of bioactives from pistachios has not been previously evaluated. In the present study we quantified the release of polyphenols, xanthophylls (lutein), and tocopherols from pistachios (raw pistachios, roasted salted pistachios, and muffins made with raw pistachios) during simulated human digestion.MethodsA dynamic gastric model of digestion that provides a realistic and predictive simulation of the physical and chemical processing and accurately mimics the residence time and the luminal environment within the human stomach was used for the digestion studies.ResultsMore than 90% of the polyphenols were released in the gastric compartment, with virtually total release in the duodenal phase. No significant differences were observed between raw shelled and roasted salted pistachio. The presence of a food matrix (muffin) decreased the bioaccessibility of protocatechuic acid (78%) and luteolin (36%). Almost 100% bioaccessibility of lutein and tocopherols was found after duodenal digestion, with no difference among the three samples.ConclusionThe rapid release of the assayed bioactives in the stomach maximizes the potential for absorption in the duodenum and contributes to the beneficial relation between pistachio consumption and health-related outcomes.     

Effects of Dietary Approaches to Stop Hypertension (DASH) diet on some risk for developing type 2 diabetes: A systematic review and meta-analysis on controlled clinical trials

ObjectiveType 2 diabetes is a major public health problem. The Dietary Approaches to Stop Hypertension (DASH) eating pattern may contribute to managing risk factors of type 2 diabetes. The objective of this study was to conduct a systematic review and meta-analysis on randomized controlled trials (RCTs) that examine the effects of DASH diet consumption on the indices of glycemic control such as fasting blood glucose (FBG), serum fasting insulin level, and Homeostatic Model Assessment insulin resistance (HOMA-IR).MethodsWe searched Pubmed, EMBASE, Science direct, ISI web of science, and Google Scholar for RCTs until July 2012. In total we found 20 articles that examine the effect of DASH diet on FBG (n = 9), fasting insulin (n = 7) and HOMA-IR (n = 4) met the inclusion criteria, respectively.ResultsMeta-analysis showed that the DASH diet can significantly reduce fasting insulin concentration (mean difference ?0.15; 95% confidence interval [CI], ?0.22 to ?0.08; P < 0.001). Subgroup analysis based on the study period showed that the DASH diet could significantly reduce fasting insulin levels when prescribed for more than 16 wk (mean difference ?0.16; 95% CI, ?0.23 to ?0.08; P < 0.001). Meta-analysis could not show a beneficial effect of the DASH diet on FBG (mean difference ?0.26; 95% CI, ?0.56 to 0.05; P = 0.1), and HOMA-IR (mean difference ?0.26; 95% CI, ?0.56 to 0.05; P = 0.1).ConclusionsThe DASH dietary pattern may lead to an improvement in insulin sensitivity independent of weight loss. The DASH diet may play an important role in glycemic control in long- term interventions. Additional prospective studies regarding the association between DASH diet and risks for type 2 diabetes are necessary.