1,720,988 research outputs found
A Clinical Perspective of Low Carbohydrate Ketogenic Diets: A Narrative Review
Full text linkLow carbohydrates diets (LCDs), which provide 20–120 g of carbohydrates per day, have long been used as therapeutic options in the treatment of severe obesity, type 2 diabetes mellitus and other morbid conditions, with good results in terms of weight loss and control of the main metabolic parameters, at least in the short and medium term. According to the caloric content and the macronutrient composition, we can classify LCDs in hypocaloric, normoproteic diets [such as the Very Low-Calorie Ketogenic Diet (VLCKD) or the protein-sparing modified fasting (PSMF)], hypocaloric, hyperproteic and hyperlipidic diets (e.g., Atkins, Paleo diets…) and normocaloric, normo-/hyperproteic diets (eucaloric KD), the latter mainly used in patients with brain tumors (gliomas) and refractory epilepsy. In addition to LCD diets, another interesting dietary approach which gained attention in the last few decades is fasting and its beneficial effects in terms of modulation of metabolic pathways, cellular processes and hormonal secretions. Due to the impossibility of using fasting regimens for long periods of time, several alternative strategies have been proposed that can mimic the effects, including calorie restriction, intermittent or alternating fasting, and the so-called fasting mimicking diets (FMDs). Recent preclinical studies have shown positive effects of FMDs in various experimental models of tumors, diabetes, Alzheimer Disease, and other morbid conditions, but to date, the scientific evidence in humans is limited to some opens studies and case reports. The purpose of our narrative review is to offer an overview of the characteristics of the main dietary regimens applied in the treatment of different clinical conditions as well as of the scientific evidence that justifies their use, focusing on low and zero-carb diets and on the different types of fasting
Anti-hypothalamus autoantibodies in anorexia nervosa: a possible new mechanism in neuro-physiological derangement?
No full textPURPOSE: Anorexia nervosa (AN) is a serious and complex mental disorder affecting mainly young adult women. AN patients are characterized by low body weight in combination with self-induced starvation, intense fear of gaining weight, and distortion of body image. AN is a multifactorial disease, linked by recent evidence to a dysregulation of the immune system. METHODS: In this pilot study, 22 blood serums from AN patients were tested for the presence of autoantibodies against primate hypothalamic periventricular neurons by immunofluorescence and by a home-made ELISA assay. Cellular fluorescence suggests the presence of autoantibodies which are able to recognize these neurons (both to body cell and fiber levels). By means of ELISA, these autoantibodies are quantitatively evaluated. In addition, orexigenic and anorexigenic molecules were measured by ELISA. As control, 18 blood serums from healthy age matched woman were analysed. RESULTS: All AN patients showed a reactivity against hypothalamic neurons both by immunofluorescence and ELISA. In addition, ghrelin, pro-opiomelanocortin (POMC), and agouti-related peptide (AGRP) were significantly higher than in control serums (p < 0.0001). In contrast, leptin was significantly lower in AN patients than controls (p < 0.0001). CONCLUSIONS: Immunoreaction and ELISA assays on AN blood serum suggest the presence of autoantibodies AN related. However, it is not easy to determine the action of these antibodies in vivo: they could interact with specific ligands expressed by hypothalamic cells preventing their physiological role, however, it is also possible that they could induce an aspecific stimulation in the target cells leading to an increased secretion of anorexigenic molecules. Further studies are needed to fully understand the involvement of the immune system in AN pathogenesis. LEVEL OF EVIDENCE: V, descriptive study
Effects of the Postoepartive Dietetic/Behavioral Counseling on the Weight Loss After Bariatric Surgery
No full textOBJECTIVE: Weight outcomes after bariatric surgery are due to an adequate adjustment of eating behavior to the new gastrointestinal conditions created by operation. The efficacy of dietary/behavior counseling for promoting weight loss and maintenance in a growing number of bariatric patients was investigated. MATERIAL AND METHODS: One hundred seventy-six non-diabetic obese patients undergoing Roux-en-Y gastric bypass (RYGBP) and sleeve gastrectomy (SG) were investigated. The first group (CO, 88 subjects, 16 male) attended a standard surgical follow-up, while in the second (DIET, 88 subjects, 15 male) the surgeon was supported by a dietitian, and patients received behavioral-dietary sessions on individual request. Data prior to the operation and at 2 years were considered, the weight outcome being regarded as successful when postoperative body mass index (BMI) value was lower than 30 kg/m2. RESULTS: Weight results were better (p < 0.01) in the RYGBP than in the SG patients. In comparison to CO, in the DIET group a greater adherence to the bariatric program was observed (76% vs. 41%, < 0.01), while body weight data and prevalence of successful cases at 2 years (87 ± 23 vs. 83 ± 16 kg and 27% vs.33%, respectively) were similar. CONCLUSIONS: After RYSG and SG, postoperative dietetic/behavioral sessions delivered on patient's request does not influence weight results. The dietetic intervention promotes the adherence to bariatric program and prevents postoperative follow-up loss. In a dietitian/behavioral strategy after RYGBP and SG, a cognitive reinforcement of the compliance to bariatric program and a strengthening of the motivation to changes could promote better weight results
Disordered eating and weight loss after bariatric surgery
No full textPURPOSES: Aberrant eating patterns are frequently observed in bariatric patients. Since bariatric operations produce alterations in food transit and in appetite/satiety balance, postoperative eating behavior changes are not surprising. METHODS: 88 consecutive obese patients undergoing Roux-en-Y gastric bypass (RYGBP, 50 cases) and Sleeve Gastrectomy (SG, 38 cases) were retrospectively evaluated. Beside anthropometric data measurement, eating behavior was assessed by direct interview prior to the operation and at the first and second postoperative years: patients were considered as eating disordered (ED) when referred habitual occurrence of binge eating and nibbling/grazing. Weight loss was assessed by percent of BMI loss (% Δ BMI). Together with standard follow-up, patients received additional behavioral/dietetic support upon request. RESULTS: Postoperative ED patients showed lower % Δ BMI than the not ED ones at one (30.7% ± 8,5 vs. 26.8% ± 10, p < 0.02) and two (32% ± 10.3 vs. 27.4% ± 12.9, p < 0.05) years after operation, the follow-up rate being 82% and 76%, respectively, without differences between RYGBP and SG group. After RYGBP, an improvement of eating behavior was observed (ED patients from 75 to 28% at 1 year and to 27% at 2 years), while no changes were observed after SG. In SG patients, the number of additional behavioral/dietetic support sessions throughout the follow-up was positively associated with % Δ BMI. DISCUSSION: The postoperative normalization of eating pattern has a role in weight loss after bariatric surgery. Behavioral/dietetic support is indicated in all SG patient, while after RYGBP is useful only when weight loss is unsatisfactory
The real-life use of a protein-sparing modified fast diet by nasogastric tube (ProMoFasT) in obese adults: An open-label randomized controlled trial
No full textSmall RNAs in eucaryotes: new clues for amplifying microRNA benefits
No full textmiRNAs, the smallest nucleotide molecules able to regulate gene expression at post transcriptional level, are found in both animals and plants being involved in fundamental processes for growth and development of living organisms. The number of miRNAs has been hypothesized to increase when some organisms specialized the process of mastication and grinding of food. Further to the vertical transmission, miRNAs can undergo horizontal transmission among different species, in particular between plants and animals. In the last years, an increasing number of studies reported that miRNA passage occurs through feeding, and that in animals, plant miRNAs can survive the gastro intestinal digestion and transferred by blood into host cells, where they can exert their functions modulating gene expression. The present review reports studies on miRNAs during evolution, with particular focus on biogenesis and mechanisms regulating their stability in plants and animals. The different biogenesis and post biogenesis modifications allow to discriminate miRNAs of plant origin from those of animal origin, and make it possible to better clarify the controversial question on whether a possible cross-kingdom miRNA transfer through food does exist. The majority of human medicines and supplements derive from plants and a regular consumption of plant food is suggested for their beneficial effects in the prevention of metabolic diseases, cancers, and dietary related disorders. So far, these beneficial effects have been generally attributed to the content of secondary metabolites, whereas mechanisms regarding other components remain unclear. Therefore, in light of the above reported studies miRNAs could result another component for the medical properties of plants. miRNAs have been mainly studied in mammals characterizing their sequences and molecular targets as available in public databases. The herein presented studies provide evidences that miRNA situation is much more complex than the static situation reported in databases. Indeed, miRNAs may have redundant activities, variable sequences, different methods of biogenesis, and may be differently influenced by external and environmental factors. In-depth knowledge of mechanisms of synthesis, regulation and transfer of plant miRNAs to other species can open new frontiers in the therapy of many human diseases, including cancer
Whey protein, as exclusively nitrogen source, controls food intake and promotes glutathione antioxidant protection in Sprague-Dawley rats
No full textThe inclusion of whey protein concentrates (WPC) in the diet can lead to a decrease in food intake. Considering that excessive food intake and weight gain are correlated with increased oxidative stress and other risk factors, the anorectic action of WPC may have important clinical implications. The aims of the current study were to verify the effects of WPC in comparison with those of casein on food intake, weight, and oxidized glutathione (GSSG) and total glutathione (GSH) concentrations in the blood and liver with or without oxidative stress induced by oral carbon tetrachloride intoxication. Male Sprague-Dawley rats were fed a balanced liquid diet for 3 weeks. Half of the rats received WPC (group P), while the control group received casein (group C). Group P rats ate significantly less than group C rats (p < 0.0001), and their weights decreased significantly. After carbon tetrachloride intoxication, there was a significant increase in GSH in rats of group P compared with the levels in rats of group C both in the liver (GSH group P 4,994 ± 652.6, group C 2,196 ± 323.2 nmol/mg, p < 0.01) and in the blood (GSH group P 1,368 ± 69.56, group C 1,088 ± 48.35 nmol/ml, p < 0.05). These findings indicate that WPC is effective in reducing food intake and preventing weight gain, and it may also play a protective role against oxidative stress by increasing glutathione synthesis in the liver. © 2008 Springer-Verlag 2008
Appetite control and gastrointestinal hormonal behavior (CCK, GLP-1, PYY 1–36) following low doses of a whey protein-rich nutraceutic
No full textPrevalence of Dysphagia and Its Health Implications Among Elderly Residents in Long-Term Care Facilities in the Liguria Region (Italy): An Observational Cohort Study
No full text: Background/Objectives: Dysphagia is a common condition among older adults, associated with significant health risks. This prospective, open-label observational cohort study aimed to determine the prevalence of dysphagia and its impact on nutritional status and clinical outcomes in elderly residents of six long-term care facilities. Methods: Patients aged ≥ 65 years were screened using the 3 oz Water Swallow Test (WST); those with dysphagia were followed for 6 months. Nutritional status was evaluated with the Mini Nutritional Assessment short-form (MNA-SF), the Global Leadership Initiative on Malnutrition (GLIM), and the SARC-F questionnaire. Anthropometric and body composition measurements were also obtained. Results: Among 656 patients screened, 188 (28.6%) had dysphagia (median age 90 years; 89.9% females). Mild dysphagia was present in 34.0%, while 66.0% had moderate-to-severe dysphagia. At baseline, patients with moderate-to-severe dysphagia had significantly lower BMI (18.4 vs. 20.6 kg/m2, p = 0.014), smaller calf circumference (24.0 vs. 28.0 cm, p = 0.005), and higher SARC-F score (8 vs. 7, p = 0.028). Bioimpedance analysis showed lower fat mass (6.7 vs. 12.9 kg, p < 0.001) and fat mass% (14.7 vs. 25.4%, p < 0.001), and higher FFM% (85.3 vs. 74.6%, p < 0.001). At 6 months, BMI, calf circumference, handgrip strength, fat mass, and fat mass% resulted significantly lower in patients with moderate-to-severe dysphagia. A total of 23 participants (12.2%) died during follow-up, with a higher mortality rate in the moderate-to-severe group (HR 2.58, 95% CI 1.20-7.59, p = 0.044); aspiration pneumonia was the leading cause (21.7%). Conclusions: Dysphagia significantly affects nutritional status and survival in elderly residents of long-term care facilities. Early personalized nutritional intervention is pivotal to improve outcomes
Oxidative stress in the animal model: The possible protective role of milk serum protein
No full textIn the field of biology, free radicals which are derived from the incomplete reduction of oxygen take on great importance; they belong to the so called reactive oxygen species, whose production in the organism is an inevitable consequence of various external or internal factors to which it is exposed. Once free radicals are generated they are often capable of giving rise to chain reactions. A lot of biological molecules are susceptible to the attack by free radicals including lipids, proteins, carbohydrates and nucleic acids. Molecular alterations caused by the radical reactions have been frequently studied and are considered as pathogenetically main passages in the development of many diseases and ageing. In order to face a radical attack, living organisms have developed several biological defensive systems against it: the main ones are represented by anti oxidizing molecules and by enzymatic anti oxidizing systems. Among the various defence systems, glutathione stands out as the principal guarantor of homoeostatic intra-cellular oxidation-reduction. One of glutathione's most important functions is to act as cysteine "tank"; this amino acid is extremely unstable in the extra-cellular environment and it rapidly auto-oxidates. Whey proteins (WP) are particularly rich in cysteine (cys) and in glutamine (glu) and therefore potentially capable of increasing the organism's antioxidant defences. It is thought that the principal mechanism which allows WPs to exert their properties is through the contribution of cys and glu, which is rich in these proteins and is used intra-cellularly for the synthesis of glutathione. A diet based on milk serum proteins which supplies a superior quantity of cys, allows for a greater synthesis of hepatic glutathione in oxidative stress conditions. The use of ultra-filtrated WP could represent a useful tool in the control of oxidative stress in numerous pathological situations. © 2010 Springer-Verlag
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