Cybermedlife - Therapeutic Actions Dietary Modification - Low Carbohydrate

Prospective Study of Glycemic Load, Glycemic Index, and Carbohydrate Intake in Relation to Risk of Biliary Tract Cancer.

Abstract Title: Prospective Study of Glycemic Load, Glycemic Index, and Carbohydrate Intake in Relation to Risk of Biliary Tract Cancer. Abstract Source: Am J Gastroenterol. 2016 Jun ;111(6):891-6. Epub 2016 Mar 29. PMID: 27021191 Abstract Author(s): Susanna C Larsson, Edward L Giovannucci, Alicja Wolk Article Affiliation: Susanna C Larsson Abstract: OBJECTIVES: Diets that induce a high glycemic response might increase the risk of biliary tract cancer (BTC). We evaluated the hypothesis that diets with high glycemic load (GL) and high glycemic index (GI), which are measures of the glycemic effect of foods, are associated with an increased incidence of BTC. METHODS: We used data from a population-based prospective study of 76,014 Swedish adults (age 45-83 years; 57% men) who were free of cancer and had completed a food-frequency questionnaire in the autumn of 1997. Incident cancer cases were ascertained by linkage with the Swedish Cancer Registry. Data were analyzed using Cox proportional hazards regression models. RESULTS: During a mean follow-up of 13.3 years (1,010,777 person-years), we identified 140 extrahepatic BTC cases (including 77 gallbladder cancers) and 23 intrahepatic BTC cases. A high dietary GL was associated with an increased risk of BTC. The multivariable relative risks for the highest versus lowest quartile of dietary GL were 1.63 (95% confidence interval (95% CI), 1.01-2.63) for extrahepatic BTC, 2.14 (95% CI, 1.06-4.33) for gallbladder cancer, and 3.46 (95% CI, 1.22-9.84) for intrahepatic BTC. Dietary GI was statistically significantly positively associated with risk of extrahepatic BTC and gallbladder cancer. We observed no statistically significant association between carbohydrate intake and BTC risk, although all associations were positive. CONCLUSION: Although these data do not prove a causal relationship, they are consistent with the hypothesis that high-GL and high-GI diets are associated with an increased risk of BTC. Article Published Date : May 31, 2016

Metabolic Correction as a tool to improve diabetes type 2 management.

Abstract Title: Metabolic Correction as a tool to improve diabetes type 2 management. Abstract Source: Bol Asoc Med P R. 2015 Apr-Jun;107(2):54-9. PMID: 26434085 Abstract Author(s): Jorge R Miranda-Massari, Michael J Gonzalez, Alvarez-Soto Fernando, Carlos Cidre, Iván M Paz, Jorge Charvel, Viridiana Martínez, Jorge Duconge, Aileen Aponte, Carlos M Ricart Article Affiliation: Jorge R Miranda-Massari Abstract: Diabetes Mellitus type 2 (DM2) is a metabolic disease that develops by a decrease in sensitivity of insulin receptors as an effect of the disruption certain metabolic functions in the processing of glucose. DM2 patients have, uncontrolled glucose levels, and commonly have problems with obesity and cardiovascular disease. Patients are treated with standard diet, insulin, diabetic oral agents and antihypertensive drugs, but this approach does not completely stops tissue deterioration since it does not address the metabolic root of the disease. Metabolic correction is proposed as a suitable adjunct treatment to improve clinical outcomes. Metabolic correction is based on diet modification, proper hydration and scientific supplementation directed to improve cellular biochemistry and metabolic efficiency. In addition, other possible benefits may include reduction in medication use, disease complications and medical costs. To test the results of a metabolic correction program, 25 patients with DM2 participated in an education program about adequate food consumption that promoted control of blood glucose levels. Anthropometric measurements and blood tests were performed during a 13 week program based on a low carbohydrate diet, proper hydration and magnesium supplementation. The metabolic correction program implemented by a proprietary educational system resulted in significant reductions in glucose, triglycerides, cholesterol, weight and waist circumference. Improvements in these values could represent an important reduction of coronary heart disease risk factors as well as other chronic degenerative diseases. In addition there was medication dosage reduction in one or more medications in 21 of the 25 participating patients, which suggest that the program has the potential to improve health outcomes and reduce health care costs. Article Published Date : Mar 31, 2015

Synergic chemoprevention with dietary carbohydrate restriction and supplementation of AMPK-activating phytochemicals: the role of SIRT1. 📎

Abstract Title: Synergic chemoprevention with dietary carbohydrate restriction and supplementation of AMPK-activating phytochemicals: the role of SIRT1. Abstract Source: Eur J Cancer Prev. 2015 Mar 19. Epub 2015 Mar 19. PMID: 25747515 Abstract Author(s): Jong Doo Lee, Min-Ah Choi, Simon Weonsang Ro, Woo Ick Yang, Arthur E H Cho, Hye-Lim Ju, Sinhwa Baek, Sook In Chung, Won Jun Kang, Mijin Yun, Jeon Han Park Article Affiliation: Jong Doo Lee Abstract: Calorie restriction or a low-carbohydrate diet (LCD) can increase life span in normal cells while inhibiting carcinogenesis. Various phytochemicals also have calorie restriction-mimetic anticancer properties. We investigated whether an isocaloric carbohydrate-restriction diet and AMP-activated protein kinase (AMPK)-activating phytochemicals induce synergic tumor suppression. We used a mixture of AMPK-activating phytochemical extracts including curcumin, quercetin, catechins, and resveratrol. Survival analysis was carried out in a B16F10 melanoma model fed a control diet (62.14% kcal carbohydrate, 24.65% kcal protein and 13.2% kcal fat), a control diet with multiple phytochemicals (MP), LCD (16.5, 55.2, and 28.3% kcal, respectively), LCD with multiple phytochemicals (LCDmp), a moderate-carbohydrate diet (MCD, 31.9, 62.4, and 5.7% kcal, respectively), or MCD withphytochemicals (MCDmp). Compared with the control group, MP, LCD, or MCD intervention did not produce survival benefit, but LCDmp (22.80±1.58 vs. 28.00±1.64 days, P=0.040) and MCDmp (23.80±1.08 vs. 30.13±2.29 days, P=0.008) increased the median survival time significantly. Suppression of the IGF-1R/PI3K/Akt/mTOR signaling, activation of the AMPK/SIRT1/LKB1pathway, and NF-κB suppression were the critical tumor-suppression mechanisms. In addition, SIRT1 suppressed proliferation of the B16F10 and A375SM cells under a low-glucose condition. Alterations in histone methylation within Pten and FoxO3a were observed after the MCDmp intervention. In the transgenic liver cancer model developed by hydrodynamic transfection of the HrasG12V and shp53, MCDmp and LCDmp interventions induced significant cancer-prevention effects. Microarray analysis showed that PPARα increased with decreased IL-6 and NF-κB within the hepatocytes after an MCDmp intervention. In conclusion, an isocaloric carbohydrate-restriction diet and natural AMPK-activating agents induce synergistic anticancer effects. SIRT1 acts as a tumor suppressor under a low-glucose condition.This is an open-access article distributedunder the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/3.0. Article Published Date : Mar 18, 2015

Effects of a moderate low-carbohydrate diet on preferential abdominal fat loss and cardiovascular risk factors in patients with type 2 diabetes. 📎

Abstract Title: Effects of a moderate low-carbohydrate diet on preferential abdominal fat loss and cardiovascular risk factors in patients with type 2 diabetes. Abstract Source: Diabetes Metab Syndr Obes. 2011 ;4:167-74. Epub 2011 Apr 29. PMID: 21779148 Abstract Author(s): Tae Sasakabe, Hajime Haimoto, Hiroyuki Umegaki, Kenji Wakai Article Affiliation: Department of Clinical Nutrition, Haimoto Clinic, Yayoi, Kasugai, Aichi, Japan; Abstract: BACKGROUND: Reports have shown that visceral adipose tissue (VAT) is more closely linked to cardiovascular risk factors (CRFs) than subcutaneous adipose tissue (SAT). We aimed to elucidate preferential abdominal fat loss and the correlations between abdominal fat reductions and changes in CRFs achieved with a moderate low-carbohydrate diet (LCD) in patients with type 2 diabetes (T2DM). PATIENTS AND METHODS: Fifty-two outpatients (28 men and 24 women, mean age± SD: 60.0 ± 10.5 years) with hemoglobin A(1c) (HbA(lc)) levels ≥ 6.5% were on an LCD for 6 months. Over a 6-month period, we measured their abdominal fat distribution (using CT) and assessed CRFs, including body mass index (BMI), HbA(1c), fasting blood glucose (FBG), serum insulin, high-densitylipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglyceride levels. RESULTS: The patients showed good compliance with the LCD (1812± 375 kcal/day, % carbohydrate:fat:protein = 35:40:19 for men; 1706 ± 323 kcal/day, % carbohydrate:fat:protein = 41:36:21 for women). Significant decreases (P = 0.05) in BMI and HbA(1c) levels were observed, along with an increase in HDL-C (P = 0.021) in men and a decrease in LDL-C (P = 0.001) inwomen. VAT (-21.6 cm(2), P<0.001 in men; -19.6 cm(2), P<0.001 in women) and SAT (-13.5 cm(2), P = 0.004 in men; -19.1 cm(2), P = 0.003 in women) significantly decreased. The loss of VAT (%ΔVAT) was greater than that of SAT (%ΔSAT) in women (P = 0.022). A similar but not significant predominance of VAT loss was detected in men (P = 0.111). In women, the %ΔSAT significantly correlated with changes in FBG (ΔFBG) (r = 0.417) and HDL-C (ΔHDL) (r = -0.720), as was %ΔVAT with changesin triglyceride (ΔTG) (r = 0.591). CONCLUSION: Six months of a moderate LCD resulted in preferential VAT loss only in women, with significant correlations between %ΔSAT and both ΔHDL and ΔFBG, as well as between %ΔVAT and ΔTG. Our results suggest that an LCD has the potential to reduce abdominal fat in patients with T2DM and deterioration of serum lipid profiles. Article Published Date : Jan 01, 2011

Low-carbohydrate diet disrupts the association between insulin resistance and weight gain.

Abstract Title: Low-carbohydrate diet disrupts the association between insulin resistance and weight gain. Abstract Source: Metabolism. 2009 Aug;58(8):1116-22. Epub 2009 Jun 18. PMID: 19439329 Abstract Author(s): Jose O Leite, Ryan DeOgburn, Joseph C Ratliff, Randy Su, Jeff S Volek, Mary M McGrane, Alan Dardik, Maria Luz Fernandez Article Affiliation: Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA. Abstract: The cornerstone to treat metabolic syndrome and insulin resistance is dietary intervention. Both low-carbohydrate diet (LCD) and low-fat diet (LFD) have been reported to induce weight loss and improve these conditions. One of the factors associated with a subject's adherence to the diet is satiety. The aim of this study was to evaluate the effects of LCD and LFD on body weight, appetite hormones, and insulin resistance. Twenty guinea pigs were randomly assigned to LCD or LFD (60%:10%:30% or 20%:55%:25% of energy from fat/carbohydrate/protein, respectively) for 12 weeks. Weight and food intake were recorded every week. After this period, animals were killed and plasma was obtained to measure plasma glucose and insulin, appetite hormones, and ketone bodies. Guinea pigs fed LCD gained more weight than those fed LFD. The daily amount of food intake in grams was not different between groups, suggesting that food density and gastric distension played a role in satiety. There was no difference in leptin levels, which excludes the hypothesis of leptin resistance in the LCD group. However, plasma glucagon-like peptide-1 was 47.1% lower in animals fed LCD (P<.05). Plasma glucose, plasma insulin, and insulin sensitivity were not different between groups. However, the heavier animals that were fed LFD had impairment in insulin sensitivity, which was not observed in those fed LCD. These findings suggest that satiety was dependent on the amount of food ingested. The weight gain in animals fed LCD may be related to their greater caloric intake, lower levels of glucagon-like peptide-1, and higher protein consumption. The adoption of LCD promotes a unique metabolic state that prevents insulin resistance, even in guinea pigs that gained more weight. The association between weight gain and insulin resistance seems to be dependent on high carbohydrate intake. Article Published Date : Aug 01, 2009
Therapeutic Actions DIETARY MODIFICATION Low Carbohydrate

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Improved adherence to Mediterranean Diet in adults with type 1 diabetes mellitus.

Related Articles Improved adherence to Mediterranean Diet in adults with type 1 diabetes mellitus. Eur J Nutr. 2018 Jul 17;: Authors: Granado-Casas M, Alcubierre N, Martín M, Real J, Ramírez-Morros AM, Cuadrado M, Alonso N, Falguera M, Hernández M, Aguilera E, Lecube A, Castelblanco E, Puig-Domingo M, Mauricio D Abstract PURPOSE: We aimed to assess food intake and adherence to the Mediterranean Diet in patients with T1D compared with nondiabetic individuals. METHODS: This was an observational, multicenter study in 262 T1D subjects and 254 age- and sex-matched nondiabetic subjects. A validated food-frequency questionnaire was administered. The alternate Mediterranean Diet Score (aMED) and alternate Healthy Eating Index (aHEI) were assessed. The clinical variables were also collected. The analysis of data included comparisons between groups and multivariate models. RESULTS: Compared to the controls, the patients with T1D had a higher intake of dairy products (p < 0.001), processed meat (p = 0.001), fatty fish (p = 0.009), fruits and vegetables (p < 0.001), nuts (p = 0.011), legumes (p < 0.001), potatoes (p = 0.045), and bread (p = 0.045), and a lower intake of seafood (p = 0.011), sweets (p < 0.001), and alcohol drinks (p = 0.025). This intake pattern resulted in a higher consumption of complex carbohydrates (p = 0.049), fiber (p < 0.001), protein (p < 0.001), polyunsaturated fatty acids (PUFA) (p = 0.007), antioxidants (p < 0.001), vitamins (p < 0.001), and minerals (p < 0.001). The frequency of patients with T1D and low aMED score (23.2%) was lower than that of the controls (35.4%; p = 0.019). The overall multivariate analysis showed that, among other factors, being a T1D subject was associated with improved aMED and aHEI scores (p = 0.006 and p < 0.001). In patients with T1D, residing in a nonurban area was associated with improved aMED and aHEI scores (p = 0.001 and p < 0.001). CONCLUSIONS: Adult patients with T1D showed healthier dietary habits and a higher adherence to the Mediterranean Diet than nondiabetic subjects. Residing in a nonurban area is associated with an improved dietary pattern. PMID: 30019088 [PubMed - as supplied by publisher]

Nutrition in the management of gastrointestinal diseases and disorders: the evidence for the low FODMAP diet.

Related Articles Nutrition in the management of gastrointestinal diseases and disorders: the evidence for the low FODMAP diet. Curr Opin Pharmacol. 2017 12;37:151-157 Authors: Eswaran S, Farida JP, Green J, Miller JD, Chey WD Abstract A growing interest from both physicians and patients is fueling research in the interaction of symptoms related to irritable bowel syndrome (IBS) and diet, particularly the low FODMAP diet. Recent studies further define the role of these short-chain fermentable carbohydrates on IBS symptoms and their effects in different parts of the gastrointestinal tract. Mounting evidence supports the use of a low FODMAP diet in the clinical setting, but this dietary approach is not without potential drawbacks. This review illustrates the mechanisms by which the low FODMAP diet leads to improvement in IBS symptoms, summarizes the available clinical evidence, and offers practical advice regarding implementation of this dietary strategy. PMID: 29156449 [PubMed - indexed for MEDLINE]

Low fermentable, oligo-, di-, mono-saccharides and polyol diet in the treatment of irritable bowel syndrome: A systematic review and meta-analysis.

Related Articles Low fermentable, oligo-, di-, mono-saccharides and polyol diet in the treatment of irritable bowel syndrome: A systematic review and meta-analysis. Nutrition. 2018 Jan;45:24-31 Authors: Schumann D, Klose P, Lauche R, Dobos G, Langhorst J, Cramer H Abstract OBJECTIVES: The aim of this review was to systematically assess and meta-analyze the effects of a low fermentable, oligo-, di-, mono-saccharides and polyol (FODMAP) diet (LFD) on the severity of symptoms, quality of life, and safety in patients with irritable bowel syndrome (IBS). METHODS: The MEDLINE/PubMed, Scopus, and Cochrane Library databases were screened through January 19, 2016. Randomized controlled trials (RCTs) that compared LFD to other diets were included if they assessed symptoms of IBS or abdominal pain in patients with IBS. Safety, quality of life, anxiety, depression, and effect on gut microbiota were defined as secondary outcomes. Standardized mean difference (SMD) and 95% confidence interval (CI) were calculated. RESULTS: Nine RCTs with a total of 596 subjects were included. Three RCTs compared LFD with a habitual diet, two RCTs provided all meals and compared LFD with a western diet, one RCT each compared LFD with a diet high in FODMAPs or a sham diet, and two RCTs compared with other diet recommendations for IBS. A meta-analysis revealed significant group differences for LFD compared with other diets with regard to gastrointestinal symptoms (SMD = -0.62; 95% CI = -0.93 to -0.31; P = 0.0001), abdominal pain (SMD = -0.50; 95% CI = -0.77 to -0.22; P = 0.008), and health-related quality of life (SMD = 0.36; 95% CI = 0.10-0.62; P = 0.007). Three studies reported a significant reduction in luminal bifidobacteria after LFD. Adverse events were assessed in three RCTs only and no intervention-related adverse events were reported. CONCLUSIONS: This meta-analysis found evidence of the short-term efficacy and safety of LFD in patients with IBS. However, only a preliminary recommendation for LFD can be made until long-term effects are investigated. PMID: 29129233 [PubMed - indexed for MEDLINE]

Multicentre, controlled, randomized clinical trial to compare the efficacy and safety of ambulatory treatment of mild acute diverticulitis without antibiotics with the standard treatment with antibiotics.

Related Articles Multicentre, controlled, randomized clinical trial to compare the efficacy and safety of ambulatory treatment of mild acute diverticulitis without antibiotics with the standard treatment with antibiotics. Int J Colorectal Dis. 2017 Oct;32(10):1509-1516 Authors: Mora Lopez L, Ruiz-Edo N, Serra Pla S, Pallisera Llovera A, Navarro Soto S, Serra-Aracil X, Diverticulitis Study Group Abstract PURPOSE: Acute diverticulitis (AD) is a highly prevalent disease in Spain. Its chronic-recurrent appearance and high rate of relapse mean that it has a major epidemiological and economic impact on our health system. In spite of this, it has not been studied in any great depth. Reassessing its etiopathology, recent studies have observed that it is an inflammatory disease-not, as classic theories had postulated, an infectious one. In the light of these findings, the suitability of antibiotics for its treatment has been reconsidered. At present, however, the evidence for incorporating these findings into clinical practice guidelines remains insufficient. METHODS: This study was designed to analyse the safety and efficacy of a non-antibiotic treatment for mild AD. Patients with mild AD (grade 0 in the modified Neff classification) who meet the inclusion criteria will be randomly assigned to one of two outpatient treatment strategies: (a) classical treatment (antibiotics, anti-inflammatories and low-fibre diet) or (b) experimental treatment (anti-inflammatories and low-fibre diet). Clinical controls will be performed at 2, 7, 30, and 90 days. We will determine whether there are any differences in the clinical outcome between groups. The main objective is to demonstrate that antibiotics neither accelerate the resolution of the disease nor decrease the number of complications and/or recurrences in these patients, suggesting that their use may be unnecessary. CONCLUSIONS: The results of this trial will help to optimize and homogenize the treatment of this highly prevalent disease. However, more studies are required before firm changes can be introduced in international clinical practice guidelines. TRIAL REGISTRATION: The trial has been registered at the ClinicalTrials.gov database (ID: NCT02785549) and the EU Clinical Trials Register database (EudraCT number: 2016-001596-75). PMID: 28808771 [PubMed - indexed for MEDLINE]

Treatment of gestational diabetes mellitus with myo-inositol: analyzing the cutting edge starting from a peculiar case.

Related Articles Treatment of gestational diabetes mellitus with myo-inositol: analyzing the cutting edge starting from a peculiar case. Eur Rev Med Pharmacol Sci. 2017 Jun;21(2 Suppl):73-76 Authors: Costabile L, Unfer V Abstract OBJECTIVE: The robust data about myo-inositol (Myo-Ins) safety profile and effectiveness opened a new scenario for the treatment and prevention of Gestational Diabetes Mellitus (GDM). We report our experience about a case of GDM successfully treated with Myo-Ins. PATIENTS AND METHODS: An overweight 29-year-old Caucasian pregnant woman, nulliparous, affected by GDM, according to the National Institute for Health and Care Excellence (NICE) Guideline. After diagnosis, the patient underwent regular glycemia checks: mean fasting blood glucose value was 103.63 ± 1.46 mg/dl, whereas 1-hour and 2-hours after-meal values were 122.74 ± 11.14 mg/dl and 110.74 ± 10.70 mg/dl, respectively. We decided to prescribe a low-calorie diet and oral treatment with 4 g of Myo-Ins, 3 times per day for 3 weeks. RESULTS: After the treatment, mean fasting value was 90.74 ± 5.30 mg/dl, whereas 1-hour after and 2-hours after-meal values were 108.11 ± 6.05 mg/dl and 101.21 ± 4.78 mg/dl, respectively. DISCUSSION: We reported a significant decrease of glycemia in a faster and steady way at fasting, 1-hour and 2-hours after-meal post oral treatment with 4 g of Myo-Ins 3 times per day, in a patient affected by GDM. CONCLUSIONS: On the one hand, we could confirm the safety profile of the molecule also at this high dosage, free from any side effects; on the other hand, our experience highlighted the faster glucose-lowering effect due to a higher dose of Myo-Ins. This outcome may open a new scenario in the treatment of GDM. PMID: 28724184 [PubMed - indexed for MEDLINE]

Products of chickpea processing as texture improvers in gluten-free bread.

Related Articles Products of chickpea processing as texture improvers in gluten-free bread. Food Sci Technol Int. 2017 Dec;23(8):690-698 Authors: Bird LG, Pilkington CL, Saputra A, Serventi L Abstract Recent market developments raised the need for alternatives to hydrocolloids as texture improver in gluten-free bread. Chickpea exerts several physicochemical properties (water- and oil-binding, emulsifying and foaming) that might address this need. Therefore, the effect of processing on chickpea functionality was tested on low ingredient dose, comparably to that of common hydrocolloids. Control bread was small, hard and with low gas retention ability as shown by microscopy, depicting holes inside crumb pores. Addition of chickpea flour in low dose (2% w/w) enhanced loaf volume by 20% and reduced crumb hardness by 40%, due to increased gas retention (no holes within pores) and superior homogeneity of the starch-protein network. On the contrary, chickpea paste deleteriously affected bread quality due to loss of solubility upon cooking. Interestingly, both soaking and cooking water significantly reduced crumb hardness, although to a lower extent than the flour. More homogeneous crumb structure and gas retention were observed in the micrographs, possibly due to the emulsifying activity of flavonoids and saponins (soaking) and insoluble fibre (cooking). Chickpea ingredients are promising substitute of hydrocolloids such as xanthan gum for texture improvement of gluten-free bread, although acting with different mechanisms. PMID: 28658964 [PubMed - indexed for MEDLINE]

Effects of acute dietary weight loss on postprandial plasma bile acid responses in obese insulin resistant subjects.

Related Articles Effects of acute dietary weight loss on postprandial plasma bile acid responses in obese insulin resistant subjects. Clin Nutr. 2017 12;36(6):1615-1620 Authors: van Nierop FS, Kulik W, Endert E, Schaap FG, Olde Damink SW, Romijn JA, Soeters MR Abstract BACKGROUND & AIMS: Bile acids (BA) are pleiotropic hormones affecting glucose and lipid metabolism. The physiochemical properties of different BA species affect their enterohepatic dynamics and their affinity for bile acid receptors. The BA pool composition is altered in patients with type 2 diabetes and obesity. In this study we used a 2-week very-low-calorie diet (VLCD) to investigate the effects of weight loss on BA pool composition and postprandial dynamics. METHODS: We performed mixed meal tests in obese, insulin resistant subjects before and after the VLCD. We measured postprandial plasma levels of glucose, insulin, BA and the BA-induced enterokine fibroblast growth factor 19 (FGF19). RESULTS: The VLCD decreased weight by 4.5 ± 2.3 kg (p < 0.0001) within 14 days. Weight loss increased peak postprandial deoxycholate (DCA) levels (median [IQR]: 0.90 [0.90] vs. 1.25 [1.35] μmol/L; p = 0.045*). Other BA species, glucose, insulin and FGF19 levels and prandial excursions were not significantly affected. The VLCD decreased resting and postprandial energy expenditure by 7 and 11% respectively. CONCLUSIONS: VLCD induced weight loss increased postprandial DCA peak levels and decreased resting energy expenditure in obese insulin resistant subjects. PMID: 27773549 [PubMed - indexed for MEDLINE]