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Overeating, overweight and obesity induced by an unpreferred diet.

Rats fed diets containing 50-71% added water (liquid diets) eat more energy and gain more weight than rats fed the same diets without added water (solid diets). The present experiments examined the effects of making a liquid diet less palatable. The first experiment examined the effects of sucrose octaacetate on diet preference. Rats, given a choice of a liquid diet containing 0.5% sucrose octaacetate and a plain solid diet, preferred the plain solid diet for three weeks. When the concentration of sucrose octaacetate was reduced to 0.05%, the rats did not show a reliable preference for either the sucrose octaacetate liquid or plain dry diet. In subsequent experiments, each rat was given only one diet at a time. In the second experiment, rats were fed 0.5% sucrose octaacetate liquid diet for three weeks followed by 0.05% sucrose octaacetate liquid diet for another four weeks. The rats fed the sucrose octaacetate liquid diet overate and became obese compared to the rats fed plain solid diet throughout. In the third experiment, rats fed 0.5% sucrose octaacetate liquid diet for six weeks became obese compared to rats fed plain solid diet throughout. Thus, the overeating and obesity induced by liquid diets cannot be attributed solely to their high palatability.

Animals↗

Diet composition and the plasma levels of some peptides regulating pancreatic secretion in the pig.

The aim of the present work was to study the effect of a modification of diet composition upon the plasma levels of some peptides known to be involved in the hormonal regulation of exocrine pancreas secretion. Six growing Large-White pigs weighing 41 +/- 3.2 kg were fitted with a catheter in a carotid artery; four of these pigs were also fitted with permanent fistulae in the pancreatic duct and duodenum. All the pigs were adapted to a control diet (C) during an 8-day period before surgery. In the 8-day postoperative period and a first experimental period of 4 days, they were fed on the same control diet. Three pigs were then fed the experimental diets in the following sequence: fat-rich diet (F) for 7 days, control diet (C) for 7 days, starch-rich diet (S) for 7 days, whereas the other three pigs were fed the same diets over the same time lengths but in inverse sequence: diet S, diet C, diet F. The three diets were isoproteinic (16% protein) and isocaloric (3,850 cal/kg). The pancreatic secretion and the plasma levels of cholecystokinin (CCK), secretin, pancreatic polypeptide (PP) and somatostatin were analysed during the 4 days of the first experimental period and the last day of each of the other three experimental periods. Total proteins and lipase and amylase activities were determined in pancreatic juice samples collected over the 7 hours following the morning meal. Arterial blood was sampled at 9 h 00 (before meal consumption), 9 h 30, 10 h 00 and every hour until 16 h 00. The results confirm pancreatic adaptation to the diet, i.e. increase of lipase specific activity (x 1.8) when the pigs ingested 6 times more fat (diet S----diet F) per day, and an increase in amylase specific activity (x 2.3) when they ingested 3 times more starch (diet F----diet S) per day. Furthermore, changes in diet composition did not lead to any durable, significant change in plasma peptide levels. In conclusion, CCK, secretin, PP and somatostatin, known to regulate exocrine pancreas secretion, would not be involved in the mechanisms of pancreatic amylase and lipase adaptation to the amount of carbohydrate and fat ingested by pigs.

Animals↗

Energy balances of eight volunteers fed on diets supplemented with either lactitol or saccharose.

1. Complete 24 h energy and nitrogen balances were measured for eight subjects both while consuming a basal diet supplemented with 49 g saccharose/d (diet S) and while consuming the same basal diet but supplemented with 50 g lactitol monohydrate/d (diet L). 2. The subjects ate the two diets for 8 d. Faeces and urine were collected for the final 4 d. Exchange of respiratory gases (oxygen, carbon dioxide, hydrogen and methane) was measured during the final 72 h while the subjects stayed in an open-circuit respiration chamber, 11 m3, and simulated office work. Before eating diet L, subjects ate 50 g lactitol daily for 10 d. 3. On diets L and S, faecal moisture content averaged 0.787 and 0.753 g/g respectively, the difference being significant (P less than 0.05). On diet L, energy and nitrogen digestibilities and energy metabolizability averaged 0.922, 0.836 and 0.881 respectively, and on diet S 0.935, 0.869 and 0.896 respectively; the differences were also significant (P less than 0.05). Urinary energy losses and N balances were not significantly different for the two diets. 4. In all subjects only traces of methane were produced but hydrogen production differed significantly (P less than 0.05) for diets L and S, being 2.3 and 0.4 litres (normal temperature and pressure)/d respectively. 5. Intakes of metabolizable energy (ME) were corrected, within subjects, to energy equilibrium and equal metabolic body-weight. The corrected ME intakes did not show differences between diets. However, when on diet L the subjects were probably less active than when on diet S because differences within subjects of ankle actometer counts between diets showed a high correlation with the corresponding differences in corrected ME intakes (r 0.92). Further correction of ME intake toward equal actometer activity showed a significant (P less than 0.05) difference between diets: for maintaining energy equilibrium 5.6 (SE 0.8; P less than 0.05)% more ME from diet L was needed than from diet S. The reliability of this 5.6% difference depends on whether or not one ankle actometer gives an accurate picture of the subject's physical activity. 6. The energy contribution to the body is clearly smaller from lactitol than from saccharose, certainly due to the effect of lactitol on digestion, and probably also due to the effect on the utilization of ME.

Adult↗

Studies of women eating diets with different fatty acid composition. I. Plasma lipoproteins and steroid excretion.

Moderate changes in dietary fat composition have been recommended to improve plasma cholesterol status. Such changes have not been studied extensively in women. This research evaluates plasma lipoprotein and steroid excretion changes in young women who consumed a diet similar to US average consumption in 1974 [40 en% fat, polyunsaturated (P) to saturated fatty acid (S) ratio, P/S = 0.3, US74] or a diet modified to contain 30 en% fat, P/S = 1.0 (MOD). Following a preexperimental period of self-selected diets, young women were fed the diets for 28-day periods in a crossover design with 10 women at the University of Nebraska, Lincoln, and 10 at Iowa State University, Ames. Plasma lipoproteins and steroid excretion were quantitated and the compositions determined. Data were analyzed for race (five Chinese, 14 Caucasians) and for diet carryover effects, as well as for primary diet effects. In the Chinese women, the US74 diet raised total and very-low-density lipoprotein (VLDL) cholesterol compared to prior self-selected or modified diets; in the Caucasian women the MOD diet lowered total, low-density lipoprotein (LDL), and VLDL cholesterol. The diet carryover was evident in total high-density lipoprotein (HDL) and HDL3 cholesterol. Total HDL and HDL3 cholesterol in response to the US74 diet were unchanged from the MOD diet when the US74 diet followed the MOD diet, but were lower than modified when the US74 diet followed self-selected diets. The US74 diet resulted in greater neutral sterol excretion than the MOD diet; this response was more marked in the self-selected, US74, MOD sequence than in the self-selected, MOD, US74 sequence.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Evaluation of a carbohydrate-free diet for patients with severe head injury.

Hyperglycemia, which may be caused or exacerbated by conventional diets, may worsen the neurological outcome from severe head injury, especially if secondary ischemic insults occur. The purpose of this study was to evaluate an experimental diet intended to replace systemic caloric and protein requirements without producing hyperglycemia. In initial studies in the laboratory, 5 experimental diets were employed in a middle cerebral artery temporary occlusion model. The effects of the diets on blood biochemistry and on infarction volume were compared in fasted animals and in animals fed a control diet. Animals fed the experimental diets had a significantly lower preischemia blood glucose concentration, a higher blood concentration of ketone bodies, and a smaller infarct volume than the animals fed a control diet. One diet chosen from the laboratory study was then evaluated in a clinical study as a randomized, open-label trial. Twenty severely head-injured patients were randomly assigned to be fed the experimental diet, EN-9305, or the control diet, Osmolyte HN, for the first 2 weeks after injury. Both treatment groups had similar blood glucose concentrations, averaging 6.33 +/- 0.21 mumol/mL (114 +/- 4 mg/dL), on day 1 prior to starting the assigned diet. Blood glucose concentration increased in the control diet group to a peak of 8.37 +/- 0.94 mumol/mL (151 +/- 17 mg/dL) on day 7 as the infusion rate of the diet was increased to the final rate. In the experimental diet group, the blood glucose concentration remained unchanged from fasting levels as the diet was advanced. Blood lactate concentration was lower, and blood ketone body concentrations were higher in the patients fed the experimental diet. Urinary nitrogen balance was better in the experimental diet group, but measures of visceral protein sparing, including serum albumin, plasma retinol binding protein, and total lymphocyte count, were not significantly different in the 2 treatment groups. Measures of cerebral anaerobic metabolism, including CSF lactate concentration and cerebral lactate production, were not significantly different in the 2 treatment groups. These studies suggest that a carbohydrate-free diet such as EN-9305 might have advantages for patients with severe head injury by replacing systemic caloric and protein requirements without producing hyperglycemia.

Adult↗

Effect of ethanol on maternal and offspring characteristics: comparison of three liquid diet formulations fed during gestation.

Maternal blood alcohol levels, weight gain during pregnancy, parturition time, perinatal mortality, and postnatal growth of offspring were compared in groups of pregnant rats fed one of three ethanol-containing liquid diets (Kahn's formula = BSA diet, Revised Wiener's = RA6 diet, and Lieber-DeCarli's high protein 82C diet = LDA diet). The three ethanol diets all contained the same amount of ethanol-derived energy (36% of total energy), but differed in the amount of energy contributed by protein (17, 30, and 25%), fat (36, 24, and 13%), and carbohydrate (12, 10, and 27%), respectively. The experimental design also included dams that were pair-fed isocaloric ethanol-free versions of the three ethanol diets (designated BSP, RP6, and LDA, respectively) and a group of dams fed a pelleted casein-based solid diet (PC diet). All experimental diets were fed ad libitum from gestational day 7 to delivery. The effect of ethanol exposure in utero was most severe in mothers and offspring fed the BSA diet. The feed efficiency ratio (maternal weight gain/total dietary energy consumed) of this low-protein ethanol diet was less than that of RA6 or LDA diets. The feed efficiency ratio calculated for RA6 and LDA diets was not different from that of PC diet. Compared with rats fed RA6 and LDA diets, the rats that were fed BSA diet exhibited deficient maternal weight gain, greater parturition delay, impaired fetal growth, and increased perinatal mortality among the offspring. BSA dams had the highest blood ethanol levels of all groups fed ethanol diets, and exhibited the least difference in blood ethanol concentrations between the day (2 PM) and night (9 PM) periods of the diurnal cycle.(ABSTRACT TRUNCATED AT 250 WORDS)

Alcoholism↗

Role of carbohydrate type on diet selection in neuropeptide Y-stimulated rats.

We tested whether carbohydrate source (corn starch, sucrose, Polycose) influences the choice between a high-fat and high-carbohydrate diet in spontaneously feeding rats and in rats stimulated to eat by neuropeptide Y (NPY) administration or food deprivation. Rats were tested under three diet options: 1) a high-fat diet versus a high-corn starch diet; 2) a high-fat diet versus a high-sucrose diet, and 3) a high-fat diet versus a high-Polycose diet. During daily and stimulated feeding rats ate more of the high-carbohydrate diet than the fat diet when the source of carbohydrate was sucrose or Polycose; however, when corn starch was provided as the carbohydrate source rats ate more of the high-fat diet. Food-deprived rats increased intake of both the high-fat and the high-carbohydrate diets, with the proportion of energy ingested from each of the diets resembling that noted during 3 days of spontaneous feeding. NPY-injected rats ate more of both the high-fat and high-carbohydrate diets during diet options 1 and 3, but not during option 2 when the high-sucrose and high-fat diets were offered concurrently. In that case, rats did not significantly increase their intake of the high-fat diet. Although carbohydrate source and NPY administration each influenced diet selection, altering the source of carbohydrate had a more marked effect.

Animals↗

Influence of three different fiber-supplemented enteral diets on bowel function and short-chain fatty acid production.

BACKGROUND: Dietary fiber is known to influence bowel habit and gastrointestinal mucosal cell morphology and function. large-bowel function is particularly influenced by insoluble, poorly fermentable fiber sources, whereas mucosal function is affected by fiber sources that are soluble and highly fermentable. The aim of the present study was to compare bowel function during consumption of a self-selected diet, a fiber-free enteral diet, and three polymeric enteral diets, each supplemented with a fiber with different fermentation characteristics. The fiber sources used were oat, soy oligosaccharide, and soy polysaccharide. METHODS: Seven healthy subjects consumed four diets in random order for 4 to 7 days. These were a self-selected diet, a 2-L polymeric enteral diet, and a 2-L polymeric enteral diet supplemented with 15 g of total dietary fiber per liter derived from either soy oligosaccharide fiber (75 g/L) or oat fiber (15 g/L). An additional six healthy subjects were randomly assigned to three diets (4 to 7 days): a self-selected diet, a 2-L polymeric enteral diet, or the same 2-L polymeric enteral diet supplemented with 20 g of soy polysaccharide fiber per liter (15 g of total dietary fiber per liter). Bowel function was assessed by measuring whole-gut transit time, mean daily stool wet weights, and bowel movement frequency per day. Fermentation characteristics of the different fiber sources were determined quantitatively and qualitatively by measuring short-chain fatty acids produced during in vitro stool culture. RESULTS: Total short-chain fatty acid and butyric acid production with soy oligosaccharide fiber were significantly higher compared with values observed for soy polysaccharide fiber (p < .003), oat fiber (p < .005), and self-selected (control) diet (p < .003). Compared with the fiber-free diet, consumption of the soy polysaccharide, oat, and soy oligosaccharide-fiber-supplemented enteral diets did not significantly (p > .05) alter whole-gut transit time or stool wet weight. However, bowel frequency was significantly improved by consumption of the soy polysaccharide-fiber-supplemented diet but not the oat fiber or soy oligosaccharide-fiber-supplemented diets. CONCLUSION: Compared with a fiber-free polymeric enteral diet, the daily consumption of an enteral diet supplemented with 30 g of total dietary fiber per day derived from a poorly fermentable oat fiber, a highly fermentable soy oligosaccharide fiber, or a moderately fermentable soy polysaccharide fiber has little impact, if any, on bowel function.

Adult↗

Comparison of energy-restricted very low-carbohydrate and low-fat diets on weight loss and body composition in overweight men and women.

OBJECTIVE: To compare the effects of isocaloric, energy-restricted very low-carbohydrate ketogenic (VLCK) and low-fat (LF) diets on weight loss, body composition, trunk fat mass, and resting energy expenditure (REE) in overweight/obese men and women. DESIGN: Randomized, balanced, two diet period clinical intervention study. Subjects were prescribed two energy-restricted (-500 kcal/day) diets: a VLCK diet with a goal to decrease carbohydrate levels below 10% of energy and induce ketosis and a LF diet with a goal similar to national recommendations (%carbohydrate:fat:protein = ~60:25:15%). SUBJECTS: 15 healthy, overweight/obese men (mean +/- s.e.m.: age 33.2 +/- 2.9 y, body mass 109.1 +/- 4.6 kg, body mass index 34.1 +/- 1.1 kg/m2) and 13 premenopausal women (age 34.0 +/- 2.4 y, body mass 76.3 +/- 3.6 kg, body mass index 29.6 +/- 1.1 kg/m2). MEASUREMENTS: Weight loss, body composition, trunk fat (by dual-energy X-ray absorptiometry), and resting energy expenditure (REE) were determined at baseline and after each diet intervention. Data were analyzed for between group differences considering the first diet phase only and within group differences considering the response to both diets within each person. RESULTS: Actual nutrient intakes from food records during the VLCK (%carbohydrate:fat:protein = ~9:63:28%) and the LF (~58:22:20%) were significantly different. Dietary energy was restricted, but was slightly higher during the VLCK (1855 kcal/day) compared to the LF (1562 kcal/day) diet for men. Both between and within group comparisons revealed a distinct advantage of a VLCK over a LF diet for weight loss, total fat loss, and trunk fat loss for men (despite significantly greater energy intake). The majority of women also responded more favorably to the VLCK diet, especially in terms of trunk fat loss. The greater reduction in trunk fat was not merely due to the greater total fat loss, because the ratio of trunk fat/total fat was also significantly reduced during the VLCK diet in men and women. Absolute REE (kcal/day) was decreased with both diets as expected, but REE expressed relative to body mass (kcal/kg), was better maintained on the VLCK diet for men only. Individual responses clearly show the majority of men and women experience greater weight and fat loss on a VLCK than a LF diet. CONCLUSION: This study shows a clear benefit of a VLCK over LF diet for short-term body weight and fat loss, especially in men. A preferential loss of fat in the trunk region with a VLCK diet is novel and potentially clinically significant but requires further validation. These data provide additional support for the concept of metabolic advantage with diets representing extremes in macronutrient distribution.

Journal Article↗

Effects of feeding growing cattle high-concentrate diets at a restricted intake on feedlot performance.

Three trials were conducted to compare effects of restricted intake of high-concentrate diets vs ad libitum intake of corn silage diets during the growing phase on feedlot cattle performance. In Trial 1, 120 steers (initial BW, 246 kg) were fed 1) a corn silage-based diet ad libitum, 2) a high-moisture corn-corn silage-based diet with intake restricted to a level 20% less than that of the corn silage diet or 3) a high-moisture corn-based diet with intake restricted to a level 30% less than that of the corn silage diet. Steers fed the 20% restricted corn-corn silage-based diet tended (P = .07) to gain slower than those fed the corn silage or 30% restricted high-concentrate diet. Feed efficiency and diet digestibility were greatest for steers fed the 30% restricted-intake, high-concentrate diet (P less than .01). Performance of steers during the subsequent 118-d finishing period was not affected (P greater than .65) by source of energy during the growing period. In Trial 2, ADG of steers fed the 30% intake-restricted, high-concentrate diet was lower (P less than .01) than that of steers with ad libitum access to corn silage. During the 84-d growing period, steers fed supplemental blood meal had 8.3% greater gains and a 6% greater efficiency of feed use than those fed supplemental soybean meal (P less than .01). Monensin did not affect (P = .82) performance of steers fed 30% restricted-intake diets. During the 76-d finishing period, gains and feed conversion were improved (P less than .01) for steers fed the restricted-intake diet in the growing period compared with those given ad libitum access to corn silage. During the growing period in Trial 3, ADG of steers restricted-fed an all-concentrate diet were slightly greater (P less than .10) than ADG of those given ad libitum access to corn silage. Gains did not differ (P = .37) during the subsequent finishing period when steers were switched to 85 or 100% concentrate diets. We concluded that intake of all concentrate diets can be restricted to achieve gains equal to those of steers given ad libitum access to corn silage-based diets without detrimental effects on finishing performance.

Animal Feed↗

Utilization of spray-dried blood cells and crystalline isoleucine in nursery pig diets.

Three experiments were conducted to evaluate spray-dried blood cells (SDBC) and crystalline isoleucine in nursery pigs. In Exp. 1, 120 pigs were used to evaluate 0, 2, 4, and 6% SDBC (as-fed basis) in a sorghum-based diet. There were six replicates of each treatment and five pigs per pen, with treatments imposed at an initial BW of 9.3 kg and continued for 16 d. Increasing SDBC from 0 to 4% had no effect on ADG, ADFI, and G:F. Pigs fed the 6% SDBC diet had decreased ADG (P < 0.01) and G:F (P = 0.06) compared with pigs fed diets containing 0, 2, or 4% SDBC. In Exp. 2, 936 pigs were used to test diets containing 2.5 or 5% SDBC (as-fed basis) vs. two control diets. There were six replicates of each treatment at industry (20 pigs per pen) and university (six pigs per pen) locations. Treatments were imposed at an initial BW of 5.9 and 8.1 kg at the industry and the university locations, respectively, and continued for 16 d. Little effect on pig performance was noted by supplementing 2.5% SDBC, with or without crystalline Ile, in nursery diets. Pigs fed the 5% SDBC diet without crystalline Ile had decreased ADG (P < 0.01), ADFI (P < or = 0.10), and G:F (P < 0.05) compared with pigs fed the control diets. Supplementation of Ile restored ADG, ADFI, and G:F to levels that were not different from that of pigs fed the control diets. In Exp. 3, 1,050 pigs were used to test diets containing 5, 7.5, or 9% SDBC (as-fed basis) vs. a control diet. There were six replicates of each treatment at the industry (20 pigs per pen) location and five replicates at the university (six pigs per pen) locations. Treatments were imposed at an initial BW of 6.3 and 7.0 kg at the industry and university locations, respectively, and continued for 16 d. Supplementation of 5% SDBC without crystalline Ile decreased ADG and G:F (P < 0.01) compared with pigs fed the control diet, but addition of Ile increased ADG (P < 0.01) to a level not different from that of pigs fed the control diet. The decreased ADG, ADFI, and G:F noted in pigs fed the 7.5% SDBC diet was improved by addition of Ile (P < 0.01), such that ADG and ADFI did not differ from those of pigs fed the control diet. Pigs fed diets containing 9.5% SDBC exhibited decreased ADG, ADFI, and G:F (P < 0.01), all of which were improved by Ile addition (P < 0.01); however, ADG (P < 0.05) and G:F (P = 0.09) remained lower than for pigs fed the control diet. These data indicate that SDBC can be supplemented at relatively high levels to nursery diets, provided that Ile requirements are met.

Animal Feed↗

[Effects of high carbohydrate and high fat diet on plasma apolipoproteins AI, AII, B100, CI, CII, CIII and E in normal and hypertriglyceridemic humans].

Effects of high carbohydrate (CHO) and high fat diet on plasma apolipoproteins (apo) AI, AII, B100, CI, CII, CIII and E were assessed in 10 healthy subjects and 10 patients with endogenous hypertriglyceridemia. High CHO diet consisted of 80% CHO, 5% fat and 15% protein of total calories, and high fat diet consisted of 40% CHO, 45% fat and 15% protein. After 5 days normal diet (60% of total calories from CHO, 25% from from fat and 15% from protein), the subjects studied received sequentially high CHO diet and normal diet for 5 days and high fat diet and normal diet for 5 days. Fasting blood samples were drawn on days 1, 3, and 5 of high CHO and high fat diet period, and 5 days after taking normal diet. Results showed that fasting plasma apo AI slightly decreased (P less than 0.01) on day 3 of the high CHO diet period and slightly increased (P less than 0.01) on day 3 of the high fat diet period, plasma apo AII increased after intake of high CHO diet, but no changes were observed after the subjects were placed on high fat diet. Fasting plasma apo B100 decreased (P less than 0.001) in hypertriglyceridemics on the 3rd day of the high CHO diet, but no differences were noted in normal subjects on the same diet. On the 3rd day of the high fat diet period, apo B100 increased (P less than 0.01) in normal subjects, but no changes were found in hypertriglyceridemics. Apo CII and CIII levels declined during the high CHO diet period but increased in normal subjects after intake of high fat died.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Mediterranean diet improves low density lipoprotein susceptibility to oxidative modifications].

UNLABELLED: Most experts, specially from Anglo-Saxon countries, recommend a low fat diet in order to prevent cardiovascular diseases. However, mortality rate by ischemic cardiopathy is low in Mediterranean countries, probably because of the consumption of a Mediterranean diet, with a high level of monounsaturated fats provided by the olive oil. We have conducted this study in order to investigate the possible influence of this kind of diet on the oxidation of LDL in vitro, the key element for the development of atherosclerosis. PATIENTS AND METHODS: 41 healthy male subjects were submitted to three consecutive 4-week diets. The first was a saturated fat-rich diet (SAT diet, 38% fat, 20% saturated). This was followed by a low fat diet (NCEP-I, 28% fat, 10% saturated) and after that a Mediterranean diet (38% fat, 22% monounsaturated fat). Plasma levels of total cholesterol, LDL-c, HDL-c, triglycerides, apolipoproteins A-I and B, -tocopherol, and the in vitro susceptibility to oxidation of LDL particles. Both hypolipidemic diets produced a significant decrease in total cholesterol, LDL-c, and apo-B plasma levels. However, it was only the NCEP-I diet that revealed a decrease in the HDL-c. The shift from a saturated fat-rich diet, or a diet rich in carbohydrates, to a Mediterranean diet increased the resistance of LDL particles to oxidation increasing the lag time period (p < 0.038), and decreasing (p < 0.001) the progression rate of the curve of oxidation of LDL. Our results point out two positive consequences of the consumption of a Mediterranean diet by healthy young males, compared with the low fat diet recommended by most Anglo-Saxon experts. On the one hand, the Mediterranean diet increases HDL-c plasma levels, and on the other hand, it decreases the susceptibility of LDL to oxidation. This is why the Mediterranean diet must be recommended in order to prevent cardiovascular diseases.

Adult↗

Effects of a Mediterranean-style diet on cardiovascular risk factors: a randomized trial.

BACKGROUND: The Mediterranean diet has been shown to have beneficial effects on cardiovascular risk factors. OBJECTIVE: To compare the short-term effects of 2 Mediterranean diets versus those of a low-fat diet on intermediate markers of cardiovascular risk. DESIGN: Substudy of a multicenter, randomized, primary prevention trial of cardiovascular disease (Prevención con Dieta Mediterránea [PREDIMED] Study). SETTING: Primary care centers affiliated with 10 teaching hospitals. PARTICIPANTS: 772 asymptomatic persons 55 to 80 years of age at high cardiovascular risk who were recruited from October 2003 to March 2004. INTERVENTIONS: Participants were assigned to a low-fat diet (n = 257) or to 1 of 2 Mediterranean diets. Those allocated to Mediterranean diets received nutritional education and either free virgin olive oil, 1 liter per week (n = 257), or free nuts, 30 g/d (n = 258). The authors evaluated outcome changes at 3 months. MEASUREMENTS: Body weight, blood pressure, lipid profile, glucose levels, and inflammatory molecules. RESULTS: The completion rate was 99.6%. Compared with the low-fat diet, the 2 Mediterranean diets produced beneficial changes in most outcomes. Compared with the low-fat diet, the mean changes in the Mediterranean diet with olive oil group and the Mediterranean diet with nuts group were -0.39 mmol/L (95% CI, -0.70 to -0.07 mmol/L) and -0.30 mmol/L (CI, -0.58 to -0.01 mmol/L), respectively, for plasma glucose levels; -5.9 mm Hg (CI, -8.7 to -3.1 mm Hg) and -7.1 mm Hg (CI, -10.0 to -4.1 mm Hg), respectively, for systolic blood pressure; and -0.38 (CI, -0.55 to -0.22) and - 0.26 (CI, -0.42 to -0.10), respectively, for the cholesterol-high-density lipoprotein cholesterol ratio. The Mediterranean diet with olive oil reduced C-reactive protein levels by 0.54 mg/L (CI, 1.04 to 0.03 mg/L) compared with the low-fat diet. LIMITATIONS: This short-term study did not focus on clinical outcomes. Nutritional education about low-fat diet was less intense than education about Mediterranean diets. CONCLUSION: Compared with a low-fat diet, Mediterranean diets supplemented with olive oil or nuts have beneficial effects on cardiovascular risk factors.

Aged↗

Efficacy and safety of low-carbohydrate diets: a systematic review.

CONTEXT: Low-carbohydrate diets have been popularized without detailed evidence of their efficacy or safety. The literature has no clear consensus as to what amount of carbohydrates per day constitutes a low-carbohydrate diet. OBJECTIVE: To evaluate changes in weight, serum lipids, fasting serum glucose, and fasting serum insulin levels, and blood pressure among adults using low-carbohydrate diets in the outpatient setting. DATA SOURCES: We performed MEDLINE and bibliographic searches for English-language studies published between January 1, 1966, and February 15, 2003, with key words such as low carbohydrate, ketogenic, and diet. STUDY SELECTION: We included articles describing adult, outpatient recipients of low-carbohydrate diets of 4 days or more in duration and 500 kcal/d or more, and which reported both carbohydrate content and total calories consumed. Literature searches identified 2609 potentially relevant articles of low-carbohydrate diets. We included 107 articles describing 94 dietary interventions reporting data for 3268 participants; 663 participants received diets of 60 g/d or less of carbohydrates--of whom only 71 received 20 g/d or less of carbohydrates. Study variables (eg, number of participants, design of dietary evaluation), participant variables (eg, age, sex, baseline weight, fasting serum glucose level), diet variables (eg, carbohydrate content, caloric content, duration) were abstracted from each study. DATA EXTRACTION: Two authors independently reviewed articles meeting inclusion criteria and abstracted data onto pretested abstraction forms. DATA SYNTHESIS: The included studies were highly heterogeneous with respect to design, carbohydrate content (range, 0-901 g/d), total caloric content (range, 525-4629 kcal/d), diet duration (range, 4-365 days), and participant characteristics (eg, baseline weight range, 57-217 kg). No study evaluated diets of 60 g/d or less of carbohydrates in participants with a mean age older than 53.1 years. Only 5 studies (nonrandomized and no comparison groups) evaluated these diets for more than 90 days. Among obese patients, weight loss was associated with longer diet duration (P =.002), restriction of calorie intake (P =.03), but not with reduced carbohydrate content (P =.90). Low-carbohydrate diets had no significant adverse effect on serum lipid, fasting serum glucose, and fasting serum insulin levels, or blood pressure. CONCLUSIONS: There is insufficient evidence to make recommendations for or against the use of low-carbohydrate diets, particularly among participants older than age 50 years, for use longer than 90 days, or for diets of 20 g/d or less of carbohydrates. Among the published studies, participant weight loss while using low-carbohydrate diets was principally associated with decreased caloric intake and increased diet duration but not with reduced carbohydrate content.

Blood Glucose↗

Diet design for a multicenter controlled feeding trial: the DELTA program. Delta Research Group.

OBJECTIVE: To describe the process and results of diet standardization, diet validation, and monitoring of diet composition, which were key components of protocol 1 of Dietary Effects on Lipoproteins and Thrombogenic Activity (DELTA-1), the initial protocol in a program of multicenter human feeding studies designed to evaluate the effects of amount and type of fat on lipoproteins and hemostasis parameters in various demographic groups. DESIGN: DELTA-1 was based on a randomized, blinded, crossover experimental design. Three diets were fed for 8 weeks to 103 healthy men and women aged 22 to 67 years at 4 field centers. Diet A, an average American diet, was designed to provide 37% of energy from fat, 16% of energy from saturated fatty acids (SFAs); diet B (step 1 diet) was designed to provide 30% of energy from fat, 9% of energy from SFA; and diet C (low SFA diet) was designed to provide 26% of energy from fat, 5% of energy from SFA. Key features of diet standardization included central procurement of fat-containing foods, inclusion of standard ingredients, precision weighing of foods--especially sources of fat and cholesterol--and use of standardized written procedures. SETTING: For menu validation, a set of 12 menus for each diet was prepared in duplicate and chemically assayed. For monitoring of diet composition during the study, an 8-day diet cycle (6 weekday and 2 weekend menus) was sampled by every field center twice during each of 3 feeding periods. STATISTICAL ANALYSES: Means (+/- standard error) were calculated and compared with target nutrient specifications. RESULTS: DELTA-1 was able to provide a standardized diet that met nutrient specifications across 4 field centers over 24 weeks of participant feeding spanning a total of 8 months. APPLICATIONS: Prestudy chemical validation of menus and continuous sampling and assay of diets throughout the study are essential to standardize experimental diets and to ensure that nutrient target goals are met and maintained throughout a controlled multicenter feeding study.

Adult↗

Enhancement of hepatocarcinogenesis initiated with diethylnitrosamine or N-nitrosobis(2-hydroxypropyl)amine by a choline-deficient, L-amino acid-defined diet administered prior to the carcinogen exposure in rats.

Effects of pre-administration of a choline-deficient, L-amino acid-defined (CDAA) diet on hepatocarcinogenesis initiated with diethylnitrosamine (DEN) or N-nitrosobis(2-hydroxypropyl)amine (BHP) in rats were investigated. A pre-administrating period was set as 1 week, because CDAA diet induces liver injuries by this time-point. In a time-course study, male Fischer 344 rats, 6 weeks old, received a 1-week pre-administration of choline-supplemented, L-amino acid-defined (CSAA) or CDAA diet, DEN at a dose of 100 mg/kg body weight by a single intraperitoneal injection, then CSAA or CDAA diet for up to 8 weeks, and were sacrificed 4, 6 and 8 weeks after DEN. CDAA diet administered only after DEN significantly increased the numbers of glutathione S-transferase placental form (GST-P)-positive lesions 4, 6 and 8 weeks after DEN and their sizes 6 and 8 weeks after DEN. CDAA diet administered both before and after DEN similarly increased the numbers and sizes of GST-P-positive lesions, but with a significantly greater degree than obtained by the diet administered only after DEN. In a dose response study, rats received vechicle or DEN, at a dose of 0.001, 0.01, 0.1, 1, 10, 20, 50, 100 or 200 mg/kg body weight, 1 week after the commencement of CSAA or CDAA diet, and sacrificed 8 weeks after vehicle or DEN. The significant increases of the numbers of GST-P-positive lesions were obtained after 50-200 mg/kg body weight of DEN under the CSAA diet administration, whereas those were detected after 10-200 mg/kg under CDAA diet administration. Sizes became significantly larger with only 200 mg/kg body weight of DEN in the CSAA case but with 50-200 mg/kg in the CDAA case. Male Wistar rats received a 1-week pre-administration of CSAA or CDAA diet, vehicle or BHP, at a dose of 600 or 1200 mg/kg body weight, by a single intraperitoneal injection, then CSAA or CDAA diet for 8 weeks, and were then sacrificed. The numbers of GST-P-positive lesions demonstrated significant increment with 1200 mg/kg body weight of BHP by CDAA diet administered only after BHP and, to a significantly greater degree, by the diet administered both before and after BHP. While CDAA diet administered only after BHP did not alter the sizes of GST-P-positive lesions, the diet administered both before and after 600 and 1200 mg/kg body weight of BHP significantly increased the sizes of the lesions. These results indicate that the pre- plus post-administration of CDAA diet enhances hepatocarcinogenesis initiated with DEN or BHP, more than the post-administration only, thus providing a sensitive model to detect weak liver carcinogenic potency of environmental chemicals.

Amino Acids↗

Effect of a low-glycaemic index--low-fat--high protein diet on the atherogenic metabolic risk profile of abdominally obese men.

It has been suggested that the current dietary recommendations (low-fat-high-carbohydrate diet) may promote the intake of sugar and highly refined starches which could have adverse effects on the metabolic risk profile. We have investigated the short-term (6-d) nutritional and metabolic effects of an ad libitum low-glycaemic index-low-fat-high-protein diet (prepared according to the Montignac method) compared with the American Heart Association (AHA) phase I diet consumed ad libitum as well as with a pair-fed session consisting of the same daily energy intake as the former but with the same macronutrient composition as the AHA phase I diet. Twelve overweight men (BMI 33.0 (sd 3.5) kg/m2) without other diseases were involved in three experimental conditions with a minimal washout period of 2 weeks separating each intervention. By protocol design, the first two conditions were administered randomly whereas the pair-fed session had to be administered last. During the ad libitum version of the AHA diet, subjects consumed 11695.0 (sd 1163.0) kJ/d and this diet induced a 28 % increase in plasma triacylglycerol levels (1.77 (sd 0.79) v. 2.27 (sd 0.92) mmol/l, P<0.05) and a 10 % reduction in plasma HDL-cholesterol concentrations (0.92 (sd 0.16) v. 0.83 (sd 0.09) mmol/l, P<0.01) which contributed to a significant increase in cholesterol:HDL-cholesterol ratio (P<0.05), this lipid index being commonly used to assess the risk of coronary heart disease. In contrast, the low-glycaemic index-low-fat-high-protein diet consumed ad libitum resulted in a spontaneous 25 % decrease (P<0.001) in total energy intake which averaged 8815.0 (sd 738.0) kJ/d. As opposed to the AHA diet, the low-glycaemic index-low-fat-high-protein diet produced a substantial decrease (-35 %) in plasma triacylglycerol levels (2.00 (sd 0.83) v. 1.31 (sd 0.38) mmol/l, P<0.0005), a significant increase (+1.6 %) in LDL peak particle diameter (251 (sd 5) v. 255 (sd 5) A, P<0.02) and marked decreases in plasma insulin levels measured either in the fasting state, over daytime and following a 75 g oral glucose load. During the pair-fed session, in which subjects were exposed to a diet with the same macronutrient composition as the AHA diet but restricted to the same energy intake as during the low-glycaemic index-low-fat-high-protein diet, there was a trend for a decrease in plasma HDL-cholesterol levels which contributed to the significant increase in cholesterol:HDL-cholesterol ratio noted with this condition. Furthermore, a marked increase in hunger (P<0.0002) and a significant decrease in satiety (P<0.007) were also noted with this energy-restricted diet. Finally, favourable changes in the metabolic risk profile noted with the ad libitum consumption of the low-glycaemic index-low-fat-high-protein diet (decreases in triacyglycerols, lack of increase in cholesterol:HDL-cholesterol ratio, increase in LDL particle size) were significantly different from the response of these variables to the AHA phase I diet. Thus, a low-glycaemic index-low-fat-high-protein content diet may have unique beneficial effects compared with the conventional AHA diet for the treatment of the atherogenic metabolic risk profile of abdominally obese patients. However, the present study was a short-term intervention and additional trials are clearly needed to document the long-term efficacy of this dietary approach with regard to compliance and effects on the metabolic risk profile.

Analysis of Variance↗