Dietary carbohydrate restriction improves insulin sensitivity,blood pressure,microvascular function,and cellular adhesion markers in individuals taking statins

Statins positively impact plasma low-density lipoprotein cholesterol, inflammation and vascular endothelial function (VEF). Carbohydrate restricted diets (CRD) improve atherogenic dyslipidemia, and similar to statins, have been shown to favorably affect markers of inflammation and VEF. No studies have examined whether a CRD provides additional benefit beyond that achieved by habitual statin use. We hypothesized that a CRD (<50 g carbohydrate/d) for 6 weeks would improve lipid profiles and insulin sensitivity, reduce blood pressure, decrease cellular adhesion and inflammatory biomarkers, and augment VEF (flow-mediated dilation and forearm blood flow) in statin users. Participants (n = 21; 59.3 ± 9.3 y, 29.5 ± 3.0 kg/m²) decreased total caloric intake by approximately 415 kcal at 6 weeks (P < .001). Daily nutrient intakes at baseline (46/36/17% carb/fat/pro) and averaged across the intervention (11/58/28% carb/fat/pro) demonstrated dietary compliance, with carbohydrate intake at baseline nearly 5-fold greater than during the intervention (P < .001). Compared to baseline, both systolic and diastolic blood pressure decreased after 3 and 6 weeks (P < .01). Peak forearm blood flow, but not flow-mediated dilation, increased at week 6 compared to baseline and week 3 (P ≤ .03). Serum triglyceride, insulin, soluble E-Selectin and intracellular adhesion molecule-1 decreased (P < .01) from baseline at week 3, and this effect was maintained at week 6. In conclusion, these findings demonstrate that individuals undergoing statin therapy experience additional improvements in metabolic and vascular health from a 6 weeks CRD as evidenced by increased insulin sensitivity and resistance vessel endothelial function, and decreased blood pressure, triglycerides, and adhesion molecules.     

Consuming eggs for breakfast influences plasma glucose and ghrelin,while reducing energy intake during the next 24 hours in adult men

We hypothesized that consuming eggs for breakfast would significantly lower postprandial satiety and energy intake throughout the day. Using a crossover design, 21 men, 20 to 70 years old, consumed 2 isoenergetic test breakfasts, in a random order separated by 1 week. The macronutrient composition of the test breakfasts were as follows: (EGG, % CHO/fat/protein = 22:55:23) and (BAGEL, % CHO/fat/protein = 72:12:16). Fasting blood samples were drawn at baseline before the test breakfast and at 30, 60, 120, and 180 minutes after breakfast. After 180 minutes, subjects were given a buffet lunch and asked to eat until satisfied. Subjects filled out Visual Analog Scales (VAS) during each blood draw and recorded food intake the days before and after the test breakfasts. Plasma glucose, insulin, and appetite hormones were analyzed at each time point. Subjects consumed fewer kilocalories after the EGG breakfast compared with the BAGEL breakfast (P< .01). In addition, subjects consumed more kilocalories in the 24-hour period after the BAGEL compared with the EGG breakfast (P < .05). Based on VAS, subjects were hungrier and less satisfied 3 hours after the BAGEL breakfast compared with the EGG breakfast (P < .01). Participants had higher plasma glucose area under the curve (P < .05) as well as an increased ghrelin and insulin area under the curve with BAGEL (P < .05). These findings suggest that consumption of eggs for breakfast results in less variation of plasma glucose and insulin, a suppressed ghrelin response, and reduced energy intake.     

Consumption of the slow-digesting waxy maize starch leads to blunted plasma glucose and insulin response but does not influence energy expenditure or appetite in humans

Limited research in humans suggests that slowly digestible starch may blunt the postprandial increase and subsequent decline of plasma glucose and insulin concentrations, leading to prolonged energy availability and satiety, compared to more rapidly digestible starch. This study examined the postprandial metabolic and appetitive responses of waxy maize starch (WM), a slow-digestible starch. It was hypothesized that the waxy maize treatment would result in a blunted and more sustained glucose and insulin response, as well as energy expenditure and appetitive responses. Twelve subjects (6 men and 6 women) (age, 23 ± 1 years; body mass index, 22.2 ± 0.7 kg/m²; insulin sensitivity [homeostatic model assessment], 16% ± 2%; physical activity, 556 ± 120 min/wk) consumed, on separate days, 50 g of available carbohydrate as WM, a maltodextrin-sucrose mixture (MS), or white bread (control). Postprandial plasma glucose and insulin, energy expenditure, and appetite (hunger, fullness, desire to eat) were measured over 4 hours. Compared to control, the 4-hour glucose response was not different for MS and WM, and the 4-hour insulin response was higher for MS (P < .005) and lower for WM (P < .05). Compared to MS, WM led to lower 4-hour glucose and insulin responses (P < .001). These differences were driven by blunted glucose and insulin responses during the first hour for WM. Postprandial energy expenditure and appetite were not different among treatments. These results support that WM provides sustained glucose availability in young, insulin-sensitive adults.     

A Mediterranean-style, low-glycemic-load diet reduces the expression of 3-hydroxy-3-methylglutaryl-coenzyme A reductase in mononuclear cells and plasma insulin in women with metabolic syndrome

We evaluated changes in low-density lipoprotein (LDL) receptor and 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase gene expression in women with metabolic syndrome and elevated plasma LDL cholesterol (LDL-C). We hypothesized that expression of these 2 genes would be modulated by our dietary intervention. Twenty-five women were instructed to follow a Mediterranean-style low-glycemic-load diet for 12 weeks. Quantitative real-time polymerase chain reaction was used to measure messenger RNA (mRNA) abundance of the LDL receptor and HMG-CoA reductase in mononuclear cells, which were used as a proxy of liver expression of these 2 genes. All women experienced favorable impacts on metabolic syndrome variables, with decreases in waist circumference (P < .001), plasma triglycerides (P < .05), and systolic blood pressure (P < .05) compared with baseline. Furthermore, participants had reductions in LDL-C (P < .01), plasma insulin (P < .001), and homeostatic model assessment score for insulin resistance (P < .001) over time. In addition, significant decreases were found in plasma tumor necrosis factor α (P < .01), which might have contributed to the improvements observed in insulin resistance. Although no changes in LDL-receptor mRNA levels were observed, HMG-CoA-reductase gene expression was reduced (P < .001) after 12 weeks. The reductions in plasma insulin correlated with changes in HMG-CoA-reductase mRNA levels (r = 0.45, P < .01). In conclusion, the observed reductions in plasma insulin may have affected the expression of a key regulatory gene of cholesterol synthesis, HMG-CoA reductase. The decreased HMG-CoA-reductase expression may be related to lower secretion of very low density lipoprotein (VLDL)-cholesterol, which, in turn, would account for the reductions in LDL-C.     

Olive leaf extract suppresses messenger RNA expression of proinflammatory cytokines and enhances insulin receptor substrate 1 expression in the rats with streptozotocin and high-fat diet–induced diabetes

Type 2 diabetes, characterized by hyperglycemia and hyperlipidemia, is a metabolic disease resulting from defects in both insulin secretion and insulin resistance. Recently, olive leaf has been reported as an anti-inflammatory, antioxidant, and antidiabetic agent. This study sought to investigate whether olive leaf extract can improve the insulin resistance and inflammation response in rats with type 2 diabetes induced by high-fat diet and streptozotocin. After administering olive leaf extract for 8 weeks (200 and 400 mg/kg body weight), rats given the higher dose showed significantly lower blood glucose, serum total cholesterol, and triglyceride levels compared with those of diabetic control rats (P < .05). Results of oral glucose tolerance tests, homeostasis model assessment of insulin resistance, and messenger RNA (mRNA) expression of tumor necrosis factor α and interleukin (IL) 6 in the liver show significantly decreased glucose level in rats given either dose of olive leaf extract (P < .05). Both olive leaf extract–treated groups showed significantly increased insulin receptor substrate 1 expression (P < .05). Tumor necrosis factor α, IL-6 and IL-1β mRNA expressions in epididymis adipose tissue were significantly lower in rats that received higher dose of olive leaf extract (P < .05). Lymphocyte infiltration was not observed in these rats. The results suggest that olive leaf extract may attenuate insulin resistance by suppressing mRNA expression of proinflammatory cytokines and elevating of insulin receptor substrate 1 expression.     

Insulin resistance is not strictly associated with energy intake or dietary macronutrient composition in women with polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is a heterogeneous disorder characterized by hyperandrogenism and chronic anovulation. Around 60% of PCOS patients are obese. Weight loss has consistently been shown to improve the clinical status of women with PCOS. We hypothesized that dietary factors are associated with the hormonal and metabolic abnormalities of PCOS. This case-control study included 43 women with PCOS and 37 ovulatory, nonhirsute controls matched to the study group by body mass index. Age ranged from 14 to 38 years. Both groups underwent anthropometric, laboratory, and nutritional assessment. End points included diet composition, body fat, and hormonal and metabolic variables related to insulin resistance. The groups had similar intake of energy, carbohydrate (53.51% ± 8.36% vs 51.83% ± 10.06%), protein (15% [12-18] vs 16% [13-19]), and total fat (30.51% ± 7.90% vs 30.80% ± 7.97%). Total body fat, sum of trunk skinfold measurements, and waist circumference were higher in the PCOS group (P < .05). Sex hormone-binding globulin was lower in PCOS patients than in controls, whereas total testosterone, free androgen index, postprandial glucose, fasting and postprandial insulin, homeostatic model assessment index, triglycerides, and total and low-density lipoprotein cholesterol (P < .050) were higher. Homeostatic model assessment index was correlated with central obesity in PCOS patients and controls alike. No association was detected between androgen status and macronutrient intake. In conclusion, central obesity and insulin resistance were not strictly associated with energy intake or dietary macronutrient composition in women with PCOS.     

Dietary intake of medium- and long-chain triacylglycerols ameliorates insulin resistance in rats fed a high-fat diet

Objective

Excessive accumulation of visceral fat is strongly associated with insulin resistance. The present investigation examined the effects of dietary intake of medium- and long-chain triacylglycerols (MLCTs), which have been shown to induce significantly lower visceral fat accumulation in rats and humans, on high-fat diet-induced obesity and insulin resistance in rats. These effects were then compared with those observed in long-chain triacylglycerol (LCT)-fed rats.

Methods

After an 8-wk feeding of a high-fat diet, which induced severe whole-body insulin resistance, male Sprague-Dawley rats were fed a standard diet containing LCTs or MLCTs for 6 wk. After the dietary treatment, an oral glucose tolerance test was performed.

Results

Although body weight and total intra-abdominal fat mass did not differ between the two groups, mesenteric fat weight in the MLCT-fed group was significantly lower than that in the LCT group (P < 0.05). The increase in plasma insulin concentrations, but not in glucose, after glucose administration (area under the curve) was significantly smaller in the MLCT group than in the LCT group (P < 0.01) and was significantly associated with mesenteric fat weight (P < 0.05). MLCT-fed rats had significantly higher plasma adiponectin concentrations compared with LCT rats (P < 0.05). Adiponectin concentrations were negatively correlated with the area under the curve for plasma insulin (P < 0.05) and tended to be inversely related to mesenteric fat weight (P = 0.08).

Conclusion

These results suggest that dietary intake of MLCTs may improve insulin resistance in rats fed a high-fat diet, at least in part through increased adiponectin concentrations caused by a lower mesenteric fat mass.     

Weight loss is coupled with improvements to affective state in obese participants engaged in behavior change therapy based on incremental, self-selected “Small Changes”

The aim of this study was to investigate the effects of a group behavior change intervention involving self-selected, contextualized, and mediated goal setting on anthropometric, affective, and dietary markers of health. It was hypothesized that the intervention would elicit changes consistent with accepted health recommendations for obese individuals. A rolling program of 12-week “Small Changes” interventions during 24 months recruited 71 participants; each program accommodated 10 to 13 adults (body mass index [BMI] ≥30 kg/m²). Fifty-eight participants completed Small Changes. Repeated measures were made at baseline, 6 and 12 weeks. Anthropometric measures included height and weight (to calculate BMI), body composition, waist circumference, and blood pressure. Affective state was monitored using relevant validated questionnaires. Dietary assessment used 3-day household measures food diaries with Schofield equations to monitor underreporting. Relevant blood measures were recorded throughout. Across the measurement period, Small Changes elicited a significant reduction in body weight (baseline, 102.95 ± 15.47 vs 12 weeks 100.09 ± 16.01 kg, P < .0005), coupled with associated significant improvements in BMI, body fat percentage, and waist circumference measures. There were additional significant positive changes in measures of affective state including general well-being (baseline, 58.92 ± 21.22 vs 12 weeks 78.04 ± 14.60, P < .0005) and total mood disturbance (baseline, 31.19 ± 34.03 vs 12 weeks 2.67 ± 24.96, P < .0005). Dietary changes that occurred were largely consistent with evidenced-based recommendations for weight management and included significant reductions in total energy intake and in fat and saturated fat as a proportion of energy. The Small Changes approach can elicit a range of health-orientated benefits for obese participants, and although further work is needed to ascertain the longevity of such effects, the outcomes from Small Changes are likely to help inform health professionals when framing the future of weight management. Long-term follow-up of Small Changes is warranted.     

Dietary cholesterol from eggs increases plasma HDL cholesterol in overweight men consuming a carbohydrate-restricted diet

Carbohydrate-restricted diets (CRD) significantly decrease body weight and independently improve plasma triglycerides (TG) and HDL cholesterol (HDL-C). Increasing intake of dietary cholesterol from eggs in the context of a low-fat diet maintains the LDL cholesterol (LDL-C)/HDL-C for both hyper- and hypo-responders to dietary cholesterol. In this study, 28 overweight/obese male subjects (BMI = 25-37 kg/m2) aged 40-70 y were recruited to evaluate the contribution of dietary cholesterol from eggs in a CRD. Subjects were counseled to consume a CRD (10-15% energy from carbohydrate) and they were randomly allocated to the EGG group [intake of 3 eggs per day (640 mg/d additional dietary cholesterol)] or SUB group [equivalent amount of egg substitute (0 dietary cholesterol) per day]. Energy intake decreased in both groups from 10,243 +/- 4040 to 7968 +/- 2401 kJ (P < 0.05) compared with baseline. All subjects irrespective of their assigned group had reduced body weight and waist circumference (P < 0.0001). Similarly, the plasma TG concentration was reduced from 1.34 +/- 0.66 to 0.83 +/- 0.30 mmol/L after 12 wk (P < 0.001) in all subjects. The plasma LDL-C concentration, as well as the LDL-C:HDL-C ratio, did not change during the intervention. In contrast, plasma HDL-C concentration increased in the EGG group from 1.23 +/- 0.39 to 1.47 +/- 0.38 mmol/L (P < 0.01), whereas HDL-C did not change in the SUB group. Plasma glucose concentrations in fasting subjects did not change. Eighteen subjects were classified as having the metabolic syndrome (MetS) at the beginning of the study, whereas 3 subjects had that classification at the end. These results suggest that including eggs in a CRD results in increased HDL-C while decreasing the risk factors associated with MetS.     

White button mushroom (Agaricus bisporus) lowers blood glucose and cholesterol levels in diabetic and hypercholesterolemic rats

Agaricus bisporus (white button mushroom; WBM) contains high levels of dietary fibers and antioxidants including vitamin C, D, and B₁₂; folates; and polyphenols that may provide beneficial effects on cardiovascular and diabetic diseases. The objective of this study was to examine the hypothesis that intake of the fruiting bodies of WBM regulates anticholesterolemic and antiglycemic responses in rats fed a hypercholesterolemic diet (0.5% cholesterol; 14% fat) and rats with type 2 diabetes induced by injection of streptozotocin (STZ) (50 mg/kg body weight), respectively. The STZ-induced diabetic male Sprague-Dawley rats fed the Agaricus bisporus powder (ABP; 200 mg/kg of body weight) for 3 weeks had significantly reduced plasma glucose and triglyceride (TG) concentrations (24.7% and 39.1%, respectively), liver enzyme activities, alanine aminotransferase and aspartate aminotransferase (11.7% and 15.7%, respectively), and liver weight gain (P < .05). In hypercholesterolemic rats, oral feeding of ABP for 4 weeks resulted in a significant decrease in plasma total cholesterol (TC) and low-density lipoprotein (LDL) (22.8% and 33.1%, respectively) (P < .05). A similar significant decrease in hepatic cholesterol and TG concentrations was observed (36.2% and 20.8%, respectively) (P < .05). Decrease in TC, LDL, and TG concentrations was accompanied by a significant increase in plasma high-density lipoprotein concentrations. It was concluded that A bisporus mushroom had both hypoglycemic and hypolipidemic activity in rats.     

Green tea extract reduces blood pressure,inflammatory biomarkers,and oxidative stress and improves parameters associated with insulin resistance in obese,hypertensive patients

Green tea (GT) consumption is known to be associated with enhanced cardiovascular and metabolic health. The purpose of this study is to examine the hypothesis that supplementation with GT alters insulin resistance and associated cardiovascular risk factors in obese, hypertensive patients. In a double-blind, placebo-controlled trial, 56 obese, hypertensive subjects were randomized to receive a daily supplement of 1 capsule that contained either 379 mg of GT extract (GTE) or a matching placebo, for 3 months. At baseline and after 3 months of treatment, the anthropometric parameters, blood pressure, plasma lipid levels, glucose levels, creatinine levels, tumor necrosis factor α levels, C-reactive protein levels, total antioxidant status, and insulin levels were assessed. Insulin resistance was evaluated according to the homeostasis model assessment–insulin resistance protocol. After 3 months of supplementation, both systolic and diastolic blood pressures had significantly decreased in the GTE group as compared with the placebo group (P < .01). Considerable (P < .01) reductions in fasting serum glucose and insulin levels and insulin resistance were observed in the GTE group when compared with the placebo group. Serum tumor necrosis factor α and C-reactive protein were significantly lower, whereas total antioxidant status increased in the GTE group compared with the placebo (P < .05). Supplementation also contributed to significant (P < .05) decreases in the total and low-density lipoprotein cholesterol and triglycerides, but an increase in high-density lipoprotein cholesterol. In conclusion, daily supplementation with 379 mg of GTE favorably influences blood pressure, insulin resistance, inflammation and oxidative stress, and lipid profile in patients with obesity-related hypertension.     

Chitosan improves insulin sensitivity as determined by the euglycemic-hyperinsulinemic clamp technique in obese subjects

In accordance with obesity is associated with insulin resistance and dyslipidemia and chitosan decrease weight and lipids, but its effect on insulin sensitivity is unknown. Our hypothesis for the research was that chitosan improves insulin sensitivity estimated with the euglycemic-hyperinsulinemic clamp technique in obesity. We undertook this study with the objective to determine the effect of chitosan on insulin sensitivity using the euglycemic-hyperinsulinemic clamp technique in obese patients during a 3-month period. A randomized, double-blind clinical trial was carried out in 12 obese adults without diabetes mellitus. During a 3-month period, 6 patients received chitosan (750 mg, 3 times per day) 30 minutes before meals, and the other 6 subjects received placebo. Serum glucose, total cholesterol, high-density lipoprotein cholesterol, and triglycerides (TG) were measured. Insulin sensitivity was estimated with the euglycemic-hyperinsulinemic clamp technique before and after the intervention. Insulin sensitivity increased significantly with the administration of chitosan (2.4 ± 1.4 vs 3.6 ± 1.4 mg kg⁻¹ min⁻¹; P = .043). In addition, there was a decrease in weight (90.7 ± 14.2 vs 84.7 ± 13.7 kg; P = .027), body mass index (34.3 ± 2.7 vs 31.6 ± 2.2 kg/m²; P = .028), waist circumference (106 ± 12 vs 99 ± 9 cm; P = .028) and TG (2.4 ± 0.9 vs 1.6 ± 0.9 mmol/L; P = .028) in the chitosan group. In conclusion, 3-month administration of chitosan increased insulin sensitivity in obese patients and demonstrated a decrease in weight, body mass index, waist circumference, and TG.     

Mild weight loss reduces inflammatory cytokines,leukocyte count,and oxidative stress in overweight and moderately obese participants treated for 3 years with dietary modification

Obesity-induced oxidative stress and inflammation are involved in the pathogenesis of cardiovascular disease. We investigated whether diet-induced, long-term, mild weight loss improved proinflammatory cytokine levels, leukocyte count, and oxidative stress. Overweight/obese participants (25 ≤ body mass index < 34 kg/m², N = 122, 30-59 years) joined a 3-year-long clinical intervention involving daily 100-kcal calorie deficits. Successful weight loss was defined as a reduction in initial body weight equal to 2 kg after the clinical intervention period. Body weight in the successful mild weight loss group (SWL, n = 50) changed 5.4% (−4.16 ± 0.31 kg) compared to 0.05 ± 0.14 kg in the unsuccessful weight loss group (n = 49). After 3 years, SWL participants exhibited significantly reduced insulin, triglycerides, total and low-density lipoprotein cholesterol, free fatty acids, and leukocyte count (P = .030). Furthermore, in the SWL group, serum interleukin (IL)-1β, IL-6, and urinary 8-epi-prostaglandin (PG)F_2α were significantly reduced (45%, 30%, and 14%, respectively). In contrast, the unsuccessful weight loss group exhibited significant increases in percentage of body fat, waist circumference, oxidized low-density lipoprotein, and tumor necrosis factor–α, as well as a significant decrease in high-density lipoprotein cholesterol. After adjusting for baseline values, the 2 groups demonstrated significantly different percentage of body fat, waist circumference, leukocyte count (P = .018), insulin, IL-6 (P = .031), IL-1β (P < .001), and tumor necrosis factor–α (P < .001), as well as urinary 8-epi-PGF_2α (P = .036). A positive correlation existed between IL-1β and urinary 8-epi-PGF_2α (r = 0.435, P < .001) and between changes in IL-6 and urinary 8-epi-PGF_2α (r = 0.393, P < .001). Long-term mild weight loss reduces inflammatory cytokine levels, leukocyte counts, and oxidative stress and may reverse the elevated oxidative stress induced by inflammatory mediators in the overweight and obese.     

Dietary selenium intake is negatively associated with serum sialic acid and metabolic syndrome features in healthy young adults

Low-grade and chronic inflammation related to excessive body weight can increase the risk for type 2 diabetes and cardiovascular disease, whereas the intake of antioxidant nutrients appears to produce anti-inflammatory effects. The purpose of this observational study was to assess the potential relationships between serum SA levels, metabolic syndrome features, and dietary selenium intake to test the hypothesis that this antioxidant micronutrient may also have anti-inflammatory properties in healthy young adults. Forty-three healthy participants with a mean age of 18.0 ± 0.93 years and a mean body mass index of 22.2 ± 2.7 kg/m² were enrolled. Anthropometric, body composition, and blood pressure determinations were measured as well as serum lipid profile, glucose, insulin, and SA concentrations. Nutritional intake was estimated by a computerized, validated semiquantitative food frequency questionnaire. The findings included a positive correlation between SA and triacylglycerol levels (r = 0.317, P = .038) and a trend to significance with the homeostatic model assessment of insulin resistance index (r = 0.297, P = .053). Moreover, subjects with higher dietary selenium intake showed statistically lower SA levels compared with subjects with lower dietary selenium intake (1.8 ± 0.4 vs 2.1 ± 0.4 mmol/L, P = .037), while dietary selenium negatively correlated with SA (r = −0.331, P = .030) and triacylglycerol levels (r = −0.312, P = .041). It can be concluded that a relationship of SA, an inflammatory marker, with metabolic syndrome features such as lipid profile impairment and insulin resistance has been envisaged. In addition, we report (apparently for the first time) a negative association between SA and selenium intake, a recognized antioxidant trace element, in healthy young subjects, reinforcing the view of selenium as a potential anti-inflammatory nutrient.     

Antihypercholesterolemic effect of Chinese black tea extract in human subjects with borderline hypercholesterolemia

A water-soluble extract of a traditional Chinese black tea (Pu-Ehr) has been shown to precipitate mixed bile salt micelles in foods. In addition, long-term ingestion of this black tea extract (BTE) significantly reduces blood cholesterol levels in rats. We investigated the effects of BTE tablets (a formula designed to enhance compliance) as a dietary supplement in a 3-month double-blind randomized group comparison study in borderline hypercholesterolemic human subjects (n = 47). All subjects ingested BTE tablets (333 mg) or placebo 3 times daily before meals for 3 months. In the BTE-treated group, the initial mean blood total (6.14 ± 0.14 mol/L) and low-density lipoprotein (LDL) cholesterol (4.32 ± 0.14 mol/L) levels decreased with time and were significantly (P < .01) lower (total cholesterol, 5.62 ± 0.11; LDL cholesterol, 3.81 ± 0.13 mol/L) after 3 months of ingestion. Furthermore, the mean body weights (P < .05) and triacylglycerol levels (P < .01) were also significantly reduced after 3 months of BTE intake compared with the baseline levels. Significant improvements in the mean LDL cholesterol, body weight, and triacylglycerol values were not accompanied with undesirable changes in other biochemical parameters measured in the subjects. None of the subjects complained of any adverse effects (eg, abdominal distension). The results indicate that BTE intake elicited a significant antihypercholesterolemic effect and might be useful for improving blood cholesterol levels in subjects at risk for heart disease or obesity.     

Preservation of a traditional Korean dietary pattern and emergence of a fruit and dairy dietary pattern among adults in South Korea: secular transitions in dietary patterns of a prospective study from 1998 to 2010

Transitions in nutrition patterns tend to emerge through industrialization and economic development. We hypothesized that the dietary patterns among South Korean adults who were 20 years or older have changed significantly from 1998 to 2010. Herein, a repeated cross-sectional analysis of data was followed for 140 601 adults. We noted changes in consumption, after adjusting for age, sex, body mass index, and exercise, and tested the trends across the study period. Factor and cluster analyses were used to derive dietary patterns. A decrease in traditional Korean food consumption, including cereals, vegetables (252-176 g), and Kimchi (127-82 g), occurred, whereas fruit (172-252 g), egg, and fried food intakes increased (P < .05). Total daily energy intake declined steadily from 1931 in 1998 to 1691 kcal in 2010. Carbohydrate intakes were unchanged over the study period; however, fat-derived energy intake increased slightly from 19.7% to 20.0% (P < .05). Our factor and cluster analyses identified 3 dietary patterns: “Korean” diet (rice, vegetables, and Kimchi), “Western” diet (soda, eggs, and oil), and “New” diet (low sugar and high fruit and dairy product intakes). Compared to 1998, approximately 40% of participants still followed a Korean diet in 2010. Interestingly, the popularity of the Western diet fell by approximately 20%, whereas the new diet pattern increased 2-fold over the study period. Overall, these data show secular trends in dietary patterns that included a preservation of the traditional Korean diet and the emergence of a new diet pattern, and it demonstrated a unique transition in food and nutrient intakes in Korea.     

A high isoflavone diet decreases 5′ adenosine monophosphate–activated protein kinase activation and does not correct selenium-induced elevations in fasting blood glucose in mice

Selenium (Se) has been implicated as a micronutrient that decreases adenosine monophosphate–activated protein kinase (AMPK) signaling and may increase diabetes risk by reducing insulin sensitivity. Soy isoflavones (IF) are estrogen-like compounds that have been shown to attenuate insulin resistance, hyperglycemia, adiposity, and increased AMPK activation. We hypothesized that a high IF (HIF) diet would prevent the poor metabolic profile associated with high Se intake. The purpose of this study was to examine changes in basal glucose metabolism and AMPK signaling in response to an HIF diet and/or supplemental Se in a mouse model. Male FVB mice were divided into groups receiving either a control diet with minimal IF (low IF) or an HIF diet. Each dietary group was further subdivided into groups receiving either water or Se at a dose of 3 mg Se/kg body weight daily, as Se-methylselenocysteine (SMSC). After 5 months, mice receiving SMSC had elevated fasting glucose (P < .05) and a tendency for glucose intolerance (P = .08). The increase in dietary IF did not result in improved fasting blood glucose. Interestingly, after 6 months, HIF-fed mice had decreased basal AMPK activation in liver and skeletal muscle tissue (P < .05). Basal glucose metabolism was changed by SMSC supplementation as evidenced by increased fasting blood glucose and glucose intolerance. High dietary IF levels did not protect against aberrant blood glucose. In FVB mice, decreased basal AMPK activation is not the mechanism through which Se exerts its effect. These results suggest that more research must be done to elucidate the role of Se and IF in glucose metabolism.     

Fructose consumption during pregnancy and lactation induces fatty liver and glucose intolerance in rats

Nutritional insults during pregnancy and lactation are health risks for mother and offspring. Both fructose (FR) and low-protein (LP) diets are linked to hepatic steatosis and insulin resistance in nonpregnant animals. We hypothesized that dietary FR or LP intake during pregnancy may exacerbate the already compromised glucose homeostasis to induce gestational diabetes and fatty liver. Therefore, we investigated and compared the effects of LP or FR intake on hepatic steatosis and insulin resistance in unmated controls (CTs) and pregnant and lactating rats. Sprague-Dawley rats were fed a CT, or a 63% FR, or an 8% LP diet. Glucose tolerance test at day 17 of the study revealed greater (P < .05) blood glucose at 10 (75.6 mg/dL vs 64.0 ± 4.8 mg/dL) minutes and 20 (72.4 mg/dL vs 58.6 ± 4.0 mg/dL) minutes after glucose dose and greater area under the curve (4302.3 mg?dL^− 1? min^− 1 vs 3763.4 ± 263.6 mg?dL^− 1? min^− 1) for FR-fed dams compared with CT-fed dams. The rats were euthanized at 21 days postpartum. Both the FR- and LP-fed dams had enlarged (P < .05) livers (9.3%, 7.1% body weight vs 4.8% ± 0.2% body weight) and elevated (P < .05) liver triacylglycerol (216.0, 130.0 mg/g vs 19.9 ± 12.6 mg/g liver weight) compared with CT-fed dams. Fructose induced fatty liver and glucose intolerance in pregnant and lactating rats, but not unmated CT rats. The data demonstrate a unique physiological status response to diet resulting in the development of gestational diabetes coupled with hepatic steatosis in FR-fed dams, which is more severe than an LP diet.     

Optimizing dietary fat in a weight-loss trial requires advice based on a structured “whole-of-diet” model

Dietary trials may link macronutrient intakes to health outcomes, but adherence to dietary targets requires advice based on an understanding of food composition and consumption patterns. Using data from a weight loss trial, we hypothesized that structured advice would be required for significant fat modification to occur. We compared participants' food choice patterns in response to advice based on a structured “whole-of-diet” model vs a general approach to healthy eating. Overweight participants (n = 122) were randomized to 2 advice arms (saturated fat [SFA] < 10% energy [E]): (1) general low fat (LF) control—(a) isoenergy, (b) −2000 kJ; and (2) structured LF high polyunsaturated fat (PUFA) (∼10% energy PUFA; PUFA to SFA ratio ≥1) (LF-PUFA)—(a) isoenergy, (b) −2000 kJ. Intakes of E and fat and fat from food groups (percentage of total fat intake) were compared at baseline, 3 months, P < .05. Baseline diets were similar, with most fat from high-SFA foods (59%): meat and milk-based staple meals and high-fat snacks. By 3 months, all groups reduced E and met the SFA target. Polyunsaturated fat targets were met by the LF-PUFA groups only (P < .001), enabling targeted between-group differences. In response to general advice, LF groups simply switched to LF alternatives of the same foods (P < .05). In comparison, LF-PUFA groups shifted fat intake to high-PUFA choices (54%), consuming more fat than controls from nuts (P < .001), whole grains (P < .001), and oils and spreads (P < .05). Significant reductions in E were achieved regardless of advice, but significant shifts in dietary fat profile relied on structured whole-of-diet advice on a range of meal and snack food sources of fat subtypes.     

Effects of pistachio nuts on body composition,metabolic, inflammatory and oxidative stress parameters in Asian Indians with metabolic syndrome: A 24-wk,randomized control trial

ObjectiveThe aim of this study was to evaluate the effects of pistachio nuts as an adjunct to diet and exercise on body composition, metabolic, inflammatory, and oxidative stress parameters in Asian Indians with metabolic syndrome.MethodsIn this 24-wk randomized control trial, 60 individuals with the metabolic syndrome were randomized to either pistachio (intervention group) or control group (diet as per weight and physical activity profile, modulated according to dietary guidelines for Asian Indians) after 3 wk of a diet and exercise run in. In the first group, unsalted pistachios (20% energy) were given daily. A standard diet and exercise protocol was followed for both groups. Body weight, waist circumference (WC), magnetic resonance imaging estimation of intraabdominal adipose tissue and subcutaneous abdominal adipose tissue, fasting blood glucose (FBG), fasting serum insulin, glycosylated hemoglobin, lipid profile, high-sensitivity C-reactive protein (hs-CRP), adiponectin, free fatty acids (FFAs), tumor necrosis factor (TNF)-α, leptin, and thiobarbituric acid reactive substances (TBARS) were assessed before and after the intervention.ResultsStatistically significant improvement in mean values for various parameters in the intervention group compared with control group were as follows: WC (P < 0.02), FBG (P < 0.04), total cholesterol (P < 0.02), low-density lipoprotein cholesterol (P < 0.006), hs-CRP (P < 0.05), TNF-α (P < 0.03), FFAs (P < 0.001), TBARS (P < 0.01), and adiponectin levels (P < 0.001).ConclusionA single food intervention with pistachios leads to beneficial effects on the cardiometabolic profile of Asian Indians with metabolic syndrome.