[Basic principles of diet therapy and a general diet for the sick].
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Diet↗
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[Diet therapy of multiple sclerosis. Case report and epicrisis of my first multiple sclerosis patients cured by diet therapy after an observation of 20 years and report on my other 9000 dietetically treated multiple sclerosis patients].
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Adolescent↗
United Kingdom Prospective Diabetes Study 24: a 6-year, randomized, controlled trial comparing sulfonylurea, insulin, and metformin therapy in patients with newly diagnosed type 2 diabetes that could not be controlled with diet therapy. United Kingdom Prospective Diabetes Study Group.
BACKGROUND: Uncertainty exists about the suitability of oral hypoglycemic drugs and insulin therapy for patients with newly diagnosed type 2 diabetes. OBJECTIVE: To assess and compare response to sulfonylurea, insulin, or metformin over 6 years in patients with newly diagnosed type 2 diabetes in whom disease could and could not be controlled with diet therapy alone. DESIGN: Multicenter, randomized, controlled trial. SETTING: Outpatient diabetes clinics of 15 hospitals in the United Kingdom. INTERVENTION: Sulfonylurea (chlorpropamide or glyburide), insulin, or metformin (if patients were obese). PATIENTS: 458 patients with newly diagnosed type 2 diabetes that could not be controlled with diet and had hyperglycemic symptoms or fasting plasma glucose levels greater than 15 mmol/L during the initial 3 months of diet therapy (primary diet failure group) and 1620 patients in whom disease was controlled by diet therapy and who had fasting plasma glucose levels of 6 to 15 mmol/L and no hyperglycemic symptoms while receiving diet therapy alone. MEASUREMENTS: Fasting plasma levels of glucose and insulin, hemoglobin A1c concentrations, body weight, and therapy required. RESULTS: Compared with the diet-controlled group, the primary diet failure group was younger and less obese and had more retinopathy, lower fasting plasma insulin levels, and reduced beta-cell function. At 6 years, patients allocated to insulin had lower fasting plasma glucose levels than did patients allocated to oral agents, but hemoglobin A1c concentrations were similar. Forty-eight percent (95% CI, 37% to 58%) of patients in the primary diet failure group maintained hemoglobin A1c concentrations less than 0.08. By 6 years, 51% of patients (CI, 42% to 62%) allocated to ultralente insulin required additional short-acting insulin and 66% of patients (CI, 58% to 73%) allocated to sulfonylurea required additional therapy with metformin or insulin to control symptoms and maintain fasting plasma glucose levels less than 15 mmol/L. Patients allocated to insulin gained more weight and had more hypoglycemic attacks than did patients allocated to sulfonylurea. Obese patients allocated to metformin gained the least weight and had the fewest hypoglycemic attacks. For all therapies, control achieved at 6 years was worse in the primary diet failure group than in the diet-controlled group. CONCLUSIONS: Because initial insulin therapy induced more hypoglycemic reactions and weight gain without necessarily providing better control, it may be reasonable to start with oral agents and change to insulin if goals for glycemic levels are not achieved.
Adult↗
PKU-related dysgammaglobulinaemia: the effect of diet therapy on IgE and allergic sensitization.
The effect of diet on the development of immunoallergic signs and symptoms in children with phenylketonuria (PKU) was evaluated. Immunological indices of 58 children with PKU treated with diets were compared to the immunological indices of 58 healthy (non-PKU) children. In the PKU group, 39 children had been placed on diet therapy within the first month of life; 19 children had been placed on diet therapy after 6 months of age. Total circulating lymphocytes; CD3+, CD4+, CD8+ circulating lymphocytes; and serum IgA, IgM, IgG and total IgE levels were measured for each child. Skin prick tests were performed for common inhalant and food allergens. Every 3 months over the 2-year period of this study, the signs and symptoms of eczema, allergic rhinitis and asthma were recorded. The PKU group had lower IgG levels (p = 0.004) and higher total IgE levels (p = 0.0001) than the control group. Significantly lower IgE levels were found in children started on diet therapy within the first month of life compared with those started on diet therapy after 6 months of age (p = 0.0001). Allergic sensitization was significantly more frequent in the PKU group (24/58 vs 13/58, z = 2.00, p < 0.05), but no significant difference in the incidence of eczema and allergic rhinitis was found. Asthma was less frequent in the PKU group than in the control group (5/58 vs 14/58, z = 2.09, p < 0.05). Thus, diet appeared to prevent the development of immunoallergic signs and symptoms.
Adolescent↗
[Usefulness of the low protein rice on the diet therapy in patients with chronic renal failure].
Diet therapy for patients with chronic renal failure is based on low protein and high energy. To achieve strict diet therapy, it is necessary to use specially formulated low protein foods. Previously, rice with a low content of protein was not available, but recently, a low protein rice (LGC-1: low glutelin content-1) has been developed. LGC-1 was found to have a low content of glutelin in its seed protein compared to other ordinary rice. Glutelin is the major digestive protein in the rice grain. We studied the usefulness of LGC-1 in the diet therapy of patients with chronic renal failure. Twenty-three patients were placed on the low protein diet (0.6-0.9 g/kg/day) during the pre-study period (a mean of 10 months). Subsequently they were followed with the same diet using LGC-1 for the staple foods during the study period (mean of 7 months). Protein intake and the slope of the reciprocal of serum creatinine did not differ between each study period in all patients. Among the 23 patients, 9 consumed rice mainly as the staple food (120-180 g/day as polished rice: rice group), according to the results of a questionnaire. In the rice group, protein intake decreased (from 47 +/- 9 to 42 +/- 9 g/day, p < 0.05), and the slope of the reciprocal of serum creatinine reduced (from -4.59 +/- 4.33 to -1.47 +/- 3.51 x 10(-4) dl/mg/day, p < 0.05) during the study period, compared with the pre-study period. We conclude that LGC-1 is a useful and effective food for a low protein diet in patients with chronic renal failure, especially, for those who consume rice mainly as their staple food.
Aged↗
Diet therapy--a forgotten art?
This study evaluated paediatric nursing students' knowledge of diet therapy to establish whether it was sufficient to prepare them for practice. A questionnaire sampled 19 1st-year and nine 4th-year students' diet therapy knowledge in relation to chronic renal failure, cystic fibrosis, juvenile diabetes mellitus and liver disease. The knowledge of 1st and 4th-year students was compared and then evaluated against criteria, devised by the researcher to measure whether this knowledge level was sufficient for practice. The Mann-Whitney Utest showed a significant difference between the 1st and 4th-years' diet therapy knowledge. The mean score for overall diet therapy knowledge of 4th-year students was 46 per cent. The results suggest that knowledge of diet therapy is insufficient to prepare nursing students for practice and that this topic needs further emphasis in paediatric nurse education.
Child↗
[Natural nutrition and diet therapy].
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Biological Factors↗
[Vitamin and diet therapy in the combined treatment of periodontal disease].
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Combined Modality Therapy↗
[Diet therapy in peptic ulcer (diets Nos. 1a, 1b and 1)].
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Chronic Disease↗
[Assessment of diet therapy effect on blood pressure of obese persons with and without antihypertensive therapy].
BACKGROUND: Arterial hypertension is a multicausal chronic disease often accompanied by obesity. The aim of this investigation was to examine the effect of diet therapy in the treatment of obese hypertensives with and without antihypertensive therapy. METHODS: The investigation was conducted at the Department of Nutrition on a sample of 110 obese hypertensive patients on diet therapy. Subjects were divided into two groups: the group on diet therapy with antihypertensive drugs E1 (n=78), and the group on diet therapy without pharmacotherapy E2 (n=32). Nourishment state i.e., obesity level was assessed by body mass index (BMI). All the patients belonged to the obese group--BMI > 30 kg/m2. Besides blood pressure values, the following parameters were monitored: serum cholesterol, trygliceride levels and BMI. RESULTS: The obtained results in the group with diet therapy combined with antihypertensive therapy showed highly significant decrease of anthropometrical parameters: body weight (99.14 kg vs. 90.16 kg) (p<0.001) and BMI (37.32 vs. 34.09) (p<0.001); percent body fat (41.97 vs. 38.78) (p<0.001); systolic (154.81 vs. 141.91) (p<0.001), and diastolic pressures (95.42 vs. 87.36) (p<0.001); cholesterol (6.39 vs. 5.99) (p<0.002), and triglycerides concentration (2.69 vs. 2.21) (p<0.019). In the group on single diet therapy, highly significant decrease of body mass (99.33 vs. 90.18) (p<0.001), BMI (34.79 vs. 31.58) (p<0.001), percent body fat (39.27 vs. 36.70) (p<0.001), systolic (148.44 vs. 132.74) (p<0.001), and diastolic pressures (93.97 vs. 82.90) (p<0.001), was achieved, while the differences between initial and final cholesterol and triglyceride concentrations, although observed, were not statistically significant. CONCLUSION: The obtained results implicated that diet therapy significantly helped the normoregulation of both systolic and diastolic blood pressure. Considering this, during physicians' routine practice in the treatment of hypertension, attention should be paid on the reduction of the corresponding level of obesity.
Antihypertensive Agents↗
[Clinical, metabolic and hormonal changes in patients with obesity on low-calorie diet therapy].
Low-calorie diet therapy (LCDT) was used to treat obesity in 74 females aged 18-49 in four regimens: short-term (up to 7 days), of middle duration (10-14 days), long-term (up to 21-24 days) and fractionated. Middle duration of LCDT proved most favourable. Long-term fasting may bring unstable effects or complications. LCDT results in electrolyte unbalance, hypokalemia, hypokaligestia. Relevant correction is necessary on the diet day 5-6. Red cell count, blood levels of sugar and protein, lipidogram, nitrogenous metabolism, coagulation activity changed insignificantly. Obese patients on LCDT exhibited reduced hyperinsulinism responsible for body mass decrease, hyperproduction of hydrocortisone and prolactin enhancing fat synthesis. They also developed T3-hypothyrosis reducing thermogenesis. The changes in the body mass depended on these factors.
Adolescent↗
Diet therapy in the U.S. in the past 200 years. A Bicentennial study.
Although diet therapy is a concept of the twentieth century, its foundations were laid by such men as Sanctorius in the sixteenth century, Lavoisier in the eighteenth century, and Beaumont in the nineteenth century, whose detailed notes reflected amazingly accurate observations. With the advent of scientific medicine, research provided the knowledge on which diet therapy was built. Data on food composition, which began to be available around the turn of the century, was important to the therapeutic dietitian, and, at mid-century, formed the basis for the development of the first Exchange Lists (only revised this year). Diets early in the century involved rigid routines, in contrast with the trend today to consider the individual. World War I marked the emergence of the trained dietitian and changes in diet therapy, as knowledge of the biologic sciences and the practice of medium expanded. Research on metabolism led to control of hemoglobin and the red cell anemias, while growing knowledge of the role of pancreatic secretions in metabolism made near-normal lives possible for those with diabetes. The dietitian today finds herself in the position of interpreter of scientific findings, developing meal patterns which not only correct poor food habits but are acceptable to patients. More recently, she has been concerned with problems in modification of fat intake in the interest of possible prevention of cardiovascular disease. Obesity and its prevention remain problems. The practice of diet therapy is subject to vogues, as is science, but the challenge to the dietitian remains: that of serving each patient through the best possible use of her education, skill, and sensitivity.
Adult↗
[Diet therapy].
The effect of diet therapy on borderline type was discussed here. First the effect of calorie restriction on preventing the development of diabetes, using OLETF rat model was shown. Second, the influence of sucrose and ethanol on insulin secretion and insulin sensitivity was studied. Third, the relation between fat and diabetes was discussed. Especially the importance of difference in the quality of fat was emphasized. Fourth, the significance of the idea of glycemic index for preventing the absorption of carbohydrate was explained. Fifth, the application of dietary fiber for preventing diabetes was shown, using WBN/Kob rat model.
Animals↗
Diet therapy and food exchange lists for diabetic patients.
The present situation of diet therapy for diabetes in Japan is described in this chapter. The diabetic diet in Japan is based on Japanese traditional food and eating habits. So far, it has effectively contributed to the treatment of diabetes. The aim of diet therapy for the diabetic regimen in Japan is, as in other countries, firstly, to supply energy for maintaining adequate body weight and healthy social activities, and secondly, to attain glycemic control as close as possible to that of a non-diabetic person to prevent the occurrence of diabetic complications. The Japan Diabetes Society has elucidated the following principles of diet therapy for the accomplishment of the above purposes. (1) The proper amount of daily energy intake means the amount which affords physical activities. (2) The proportion of the 3 main nutrients should be: 60% as carbohydrate, 15-20% protein and 20-25% fat. (3) As to vitamins and minerals, an appropriate amount to meet the average requirement should be supplied daily. (4) It is recommended that a proper amount of fiber be taken. Furthermore, with regard to patient education, which is the most important aspect of adhering to diet therapy, an outline of the latest (1993) edition of the 'Food Exchange Lists', having been first edited in 1965 by the Japan Diabetes Society, is introduced together with its use.
Diabetes Mellitus↗
Effect of apolipoprotein E4 allele on plasma LDL cholesterol response to diet therapy in type 2 diabetic patients.
OBJECTIVE: The aim of this study was to investigate the effect of apolipoprotein (apo)E4 allele on plasma LDL cholesterol response to calorie-restricted diet therapy in type 2 diabetic patients. RESEARCH DESIGN AND METHODS: Twenty-four diabetic patients with the apoE3/3 genotype and 11 diabetic patients with the apoE4/3 genotype were recruited. Participants were hospitalized for calorie-restricted diet therapy (25.0 kcal. kg body wt(-1). day(-1)) for 14 days. Body weight, fasting plasma glucose (FPG) levels, and plasma lipid levels on hospital days 1 and 14 were compared between the two apoE genotype groups. RESULTS: There were no significant differences in baseline FPG levels, HbA(1c) levels, BMI, and plasma levels of total cholesterol, triglyceride, and HDL cholesterol between the two apoE genotype groups, but baseline plasma levels of LDL cholesterol were significantly higher in the apoE4/3 group than in the apoE3/3 group. Body weight decreased slightly and FPG levels decreased significantly after diet therapy in both apoE genotype groups. In the apoE3/3 group, only plasma levels of triglyceride decreased significantly after diet therapy, whereas in the apoE4/3 group, plasma levels of triglyceride, total cholesterol, and LDL cholesterol decreased significantly after diet therapy. The decrease (percentage of change) in total cholesterol (-16.3 vs. -6.6%) and LDL cholesterol (-15.6 vs. -0.7%) after diet therapy was significantly greater in the apoE4/3 group than in the apoE3/3 group. CONCLUSIONS: Calorie-restricted diet therapy is more effective in reducing plasma LDL cholesterol in type 2 diabetic patients with the apoE4 allele.
Apolipoprotein E4↗
Unproven diet therapies in the treatment of the chronic fatigue syndrome.
This report is a review of the unproven diet therapies recommended for individuals with chronic fatigue syndrome (CFS). Diet therapies promoted for the relief of CFS symptoms by the authors of five CSF self-help books were evaluated on the basis of nutritional adequacy and scientific rationale. Unproven diet therapies for patients with CFS include megavitamin/mineral supplements; royal jelly and other dietary supplements; and elimination, avoidance, and rotation diets. Claims that these therapies relieve CFS symptoms and promote recovery are anecdotal and have not been substantiated by clinical research. The yeast-avoidance and sugar-free diets, both promoted to combat Candida albicans overgrowth, are of questionable value in treating patients with CFS. The rotation diet is not balanced and does not meet the current recommended dietary intake levels. Diet strategies that call for the avoidance of food additives, preservatives, sweeteners, and other ingredients are not supported by available evidence and are not practical for patients with CFS. A diet plan for patients with CFS should be based on sound nutritional principles and common sense. Until the results of studies demonstrating the benefits of particular diet therapies in the management of CFS are available, patients with CFS are advised to eat a varied diet selected from among and within the basic food groups to ensure an adequate nutrient intake and to reach and maintain a reasonable body weight.
Diet↗
[Experience in using acupuncture reflexotherapy combined with weight-reducing diet therapy in hypertension].
AIM: To study the effectiveness of acupuncture in combination with unload diet against hypertension. MATERIALS AND METHODS: 137 patients with mild hypertension have undergone unload diet therapy or therapeutic fasting in combination with acupuncture. Acupuncture therapy was carried out according to the physiological model. The unload diet therapy was performed according to the method of Iu. S. Nikolaev and consisted of voluntary fasting. RESULTS: The treatment resulted in a decrease of cholesterol levels and blood pressure, positive trend in ECG. For 3 years 20 patients with mild hypertension had normal blood pressure. They kept on diet, had short-term courses of fasting, exercised in free-choice regimen. CONCLUSION: Acupuncture in combination with diet therapy are recommended for treatment of blood hypertension. They can be used alone or in combination with drug therapy.
Acupuncture Points↗
Effects of apolipoprotein E phenotype on serum cholesterol level and cholesterol response to diet therapy in patients with hypercholesterolemia.
We investigated the association of the apolipoprotein (apo) E isoform phenotype with the basal serum cholesterol level and cholesterol response to diet therapy in outpatients with primary hypercholesterolemia. The basal levels of serum cholesterol, triglyceride and HDL-cholesterol in the 132 subjects were 286 +/- 26 mg/dl, 154 +/- 83 mg/dl and 54 +/- 14 mg/dl, respectively. The frequencies of apo E 3/2, 3/3, 4/2, 4/3 and 4/4 were 1, 104, 2, 24 and 1, respectively. There were no differences in serum lipids between subjects with the two most common apo E phenotypes, i.e., apoE 3/3 (n = 104) and apoE 4/3 (n = 24). The serum cholesterol response to diet therapy was evaluated by measuring the serum lipids of 52 participants before and 2-3 months after diet therapy. After dietary counselling, serum cholesterol values were reduced significantly from 293 +/- 27 to 256 +/- 36 mg/dl (P < 0.01) in the total group of study subjects. There was no significant difference in serum cholesterol reduction in response to diet therapy between subjects with apoE4 (E4/2, E4/3 and E4/4, n = 12) and without apoE4 (E3/3 and E3/2, n = 40). Following dietary counselling, patients who lost a large amount of body weight (BM I > or = 1.0) exhibited a greater reduction in serum cholesterol than those who showed less weight loss. In conclusion, the results of our study demonstrated the primary importance of diet therapy in the treatment of hypercholesterolemia, although other investigators have suggested that apo E phenotypes influence the response of serum cholesterol to dietary changes.
Adult↗