Cybermedlife - Therapeutic Actions Dietary Modification - Low Glycemic Diet

Mediterranean diet and nonalcoholic fatty liver disease: molecular mechanisms of protection.

Abstract Title: Mediterranean diet and nonalcoholic fatty liver disease: molecular mechanisms of protection. Abstract Source: Int J Food Sci Nutr. 2016 Aug 2:1-10. Epub 2016 Aug 2. PMID: 27484357 Abstract Author(s): Justyna Godos, Alessandro Federico, Marcello Dallio, Francesca Scazzina Article Affiliation: Justyna Godos Abstract: Nutritional habits modifications have shown an important impact in preventing and ameliorating metabolic alterations, such as nonalcoholic fatty liver disease (NAFLD). Among several dietary approaches that exert positive effects in NAFLD patients, the Mediterranean dietary pattern has shown notable benefits. This review explores the molecular mechanisms through which the Mediterranean diet would improve risk factors associated with metabolic syndrome and NAFLD. The main features of the Mediterranean diet acting on metabolism are represented by its whole-grain and low glycemic index cereal-based items, its fatty acid profile, and its content in phytochemical compounds. Carbohydrate-rich foods high in dietary fiber inducing low glycemic response are able to interact with glucose and insulin metabolism. Unsaturated fatty acids are associated with better hepatic lipid metabolism. Finally, phytochemical compounds, such as dietary polyphenols, are thought to ameliorate inflammation, which is considered one of the mechanisms through which NALFD may evolve into nonalcoholic steatohepatitis (NASH). Article Published Date : Aug 01, 2016

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

Effect of a low glycemic load on body composition and Homeostasis Model Assessment (HOMA) in overweight and obese subjects. 📎

Abstract Title: Effect of a low glycemic load on body composition and Homeostasis Model Assessment (HOMA) in overweight and obese subjects. Abstract Source: Nutr Hosp. 2011 Feb;26(1):170-175. PMID: 21519744 Abstract Author(s): A L Armendáriz-Anguiano, A Jiménez-Cruz, M Bacardí-Gascón, L Hurtado-Ayala Article Affiliation: Medicine and Psychology School, Universidad Auntónoma de Baja California, Tijuana, Baja California, Mexico. Abstract: Objective: The aim of this study was to compare the effects of different glycemic load diets on biochemical data and body composition, in overweight and obese subjects, during a 6-month period. Research design and methods: This study was an experimental, randomized, parallel design. Anthropo-metric measurements and biochemical data were measured at baseline at 3 and at 6 months. All subjects completed 3-day dietary intake diaries at the baseline period and during the third and the sixth months. At the sixth month, LGL group had a mean intake of 1,360± 300 kcal/day and the high glycemic load group (HGL) had a mean intake of 1,544 ± 595 kcal/day. Results: LGL group obtained a weight reduction of 4.5% (p = 0.006) and the HGL group of 3.0% (p = 0.18). Significant reductions in waist circumference (5%, p = 0.001) of the LGL group were observed, 10% of body fat percentage (p = 0.001), 4.3 kg (13%) of body fat (p = 0.001), 14% of total cholesterol (p=0.007), 35% of high-density lipoproteins (HDL) (p = 0.001), and 10% of HOMA (p = 0.009). In the HGL group, reductions of 4.5% of waist circumference (p = 0.02), 37% of HDL (p = 0.002), and an increase of 8 % of LDL (p = 0.04) were observed. Conclusions: These results suggest that long term LGL diets are more effective for reducing body mass index, body fat, waist circumference and HOMA and, therefore, may contribute in the prevention of diabetes. Article Published Date : Feb 01, 2011

Improvement of dietary quality with the aid of a low glycemic index diet in Asian patients with type 2 diabetes mellitus.

Abstract Title: Improvement of dietary quality with the aid of a low glycemic index diet in Asian patients with type 2 diabetes mellitus. Abstract Source: J Am Coll Nutr. 2010 Jun;29(3):161-70. PMID: 20833988 Abstract Author(s): Mohd Yusof Barakatun Nisak, Abd Talib Ruzita, A Karim Norimah, Heather Gilbertson, Kamaruddin Nor Azmi Article Affiliation: Department of Nutrition&Dietetics, Faculty of Medicine&Health Sciences, University Putra Malaysia, Serdang, Selangor, Malaysia. Abstract: OBJECTIVES: This randomized controlled study was conducted to determine the effect of low glycemic index (GI) dietary advice on eating patterns and dietary quality in Asian patients with type 2 diabetes (T2DM). METHODS: Asian patients with T2DM (N =  104) were randomized into 2 groups that received either low GI or conventional carbohydrate exchange (CCE) dietary advice for 12 weeks. Nutritional prescriptions were based on the medical nutrition therapy for T2DM, with the difference being in the GI component of the carbohydrates. Dietaryintake and food choices were assessed with the use of a 3-day food record. RESULTS: At week 12, both groups achieved the recommendations for carbohydrate (52 ± 4% and 54 ± 4% of energy) and fat (30 ± 4% and 28 ± 5% of energy) intake. There were no significant differences in the reported macronutrient intake in both groups. With the low GI diet, crude fiber and dietary calcium intake increased, while the dietary GI reduced. Subjects in the lowest dietary glycemic index/glycemic load (GI/GL) quartile consumed more parboiled/basmati rice, pasta, milk/dairy products, fruits, and dough, which are foods from the low GI category. There was a significant reduction in the hemoglobin A(1c) level at week 12 for patients in the lowest GI/GL quartile (Δ  =  -0.7 ± 0.1%) compared with those in the highest GI/GL quartile (Δ  =  -0.1 ± 0.2%). CONCLUSIONS: These results demonstrate the ability of low GI dietary advice to improve the dietary quality of Asian patients with T2DM. Article Published Date : Jun 01, 2010

Effect of two carbohydrate-modified tube-feeding formulas on metabolic responses in patients with type 2 diabetes.

Abstract Title: Effect of two carbohydrate-modified tube-feeding formulas on metabolic responses in patients with type 2 diabetes. Abstract Source: Nutrition. 2008 Oct;24(10):990-7. Epub 2008 Aug 21. PMID: 18718737 Abstract Author(s): Anne Coble Voss, Kevin C Maki, W Timothy Garvey, Deborah S Hustead, Carolyn Alish, Brenda Fix, Vikkie A Mustad Article Affiliation: Abbott Nutrition, Abbott Laboratories, Columbus, Ohio, USA. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: OBJECTIVES: This study evaluated the glycemic, insulinemic, and glucagon-like peptide-1 (GLP-1) responses of subjects with type 2 diabetes mellitus to consumption of two diabetes-specific tube-feeding formulas (slowly digested carbohydrate formula [SDC] and diabetes-specific formula [DSF]) and one formula intended for individuals without diabetes (standard formula [STND]). METHODS: Forty-eight subjects controlled with diet and/or oral antihyperglycemic medications received the SDC, DSF, and STND. Postprandial glucose, insulin, and GLP-1 were measured on three occasions after an overnight fast in a double-blinded, randomized, three-treatment, crossover design. RESULTS: The positive area under the curve for glucose and insulin with the STND was higher (P<0.001) compared with the SDC and DSF. The adjusted GLP-1 concentration at 60 min was higher for the SDC compared with the DSF and STND (P<0.05). CONCLUSION: Both lower-carbohydrate diabetes-specific formulas resulted in a lower postprandial blood glucose response compared with the STND. The formula also rich in slowly digested carbohydrate and monounsaturated and omega-3 fatty acids (SDC) produced significantly lower blood glucose and insulin responses and higher levels of GLP-1 in the presence of significantly lower insulin concentrations. These results support the view that the quantity and quality of carbohydrate and fat may play important roles in the management of patients with type 2 diabetes mellitus and could result in improved beta-cell function over the long term. Article Published Date : Oct 01, 2008
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Therapeutic Actions DIETARY MODIFICATION Low Glycemic Diet

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The Effect of Dietary Glycaemic Index on Glycaemia in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Related Articles The Effect of Dietary Glycaemic Index on Glycaemia in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients. 2018 Mar 19;10(3): Authors: Ojo O, Ojo OO, Adebowale F, Wang XH Abstract BACKGROUND: The increasing prevalence of diabetes in the United Kingdom and worldwide calls for new approaches to its management, and diets with low glycaemic index have been proposed as a useful means for managing glucose response. However, there are conflicting reports and differences in the results of studies in terms of their effectiveness. Furthermore, the impact of low-glycaemic index diets and their long-term use in patients with type 2 diabetes remains unclear. OBJECTIVES: The objective of this study was to conduct a systematic review and meta-analysis of the effect of low-glycaemic index diets in patients with type 2 diabetes. METHODS: Search methods: Randomised controlled studies were selected from a number of databases (EBSCOHost with links to Health Research databases, PubMed, and grey literature) based on the Population, Intervention, Comparator, Outcomes and Study designs (PICOS) framework. The search terms included synonyms and Medical Subject Headings (MeSH) and involved the use of Boolean operators (AND/OR) which allowed the combination of words and search terms. SELECTION CRITERIA: As per the selection criteria, the following types of articles were selected: studies on randomised controlled trials, with year of publication between 2008 and 2018, including patients with type 2 diabetes. Thus, studies involving patients with gestational and type 1 diabetes were excluded, as were observational studies. Nine articles which met the inclusion criteria were selected for the systematic review, whereas only six articles which met the criteria were included in the meta-analysis. DATA COLLECTION AND ANALYSIS: Studies were evaluated for quality and risk of bias. In addition, heterogeneity, meta-analysis, and sensitivity tests of the extracted data were carried out using Review Manager 5.3 (Review Manager, 2014). RESULTS: The findings of the systematic review showed that the low-glycaemic index (low-GI) diet resulted in a significant improvement (<0.05) in glycated haemoglobin (HbA1c) in two studies: low-GI diet Δ = -0.5% (95% CI, -0.61% to -0.39%) vs. high-cereal fibre diet Δ = -0.18% (95% CI, -0.29% to -0.07%); and low-GI legume diet Δ = -0.5% (95%, -0.6% to -0.4%) vs. high-wheat fibre diet Δ = -0.3% (95% Cl, -0.4 to -0.2%). There was a slight improvement in one study (low glycaemic response = 6.5% (6.3-7.1) vs. control = 6.6% (6.3-7.0) and no significant difference (p > 0.05) in four studies compared with the control diet. Four studies showed improvements in fasting blood glucose in low-GI diets compared to higher-GI diets or control: low-GI diet = 150.8 ± 8.7 vs. higher-GI diet = 157.8 ± 10.4 mg/dL, mean ± SD p = 0.43; low-GI diet = 127.7 vs. high-cereal fibre diet = 136.8 mg/dL, p = 0.02; low-GI diet = 6.5 (5.6-8.4) vs. standard diabetic diet = 6.7 (6.1-7.5) mmol/L, median and interquartile range p > 0.05; and low-GI diet = 7.3 ± 0.3 vs. conventional carbohydrate exchange diet = 7.7 ± 0.4 mmol/L, mean ± SEM (Standard Error of Mean) p < 0.05. The results of the meta-analysis and sensitivity tests demonstrated significant differences (p < 0.001 and p < 0.001, respectively) between the low-GI diet and the higher-GI diet or control diet in relation to glycated haemoglobin. Differences between the low-GI diet and higher-GI diet or control were significant (p < 0.05) with respect to the fasting blood glucose following meta-analysis. CONCLUSION: The low-GI diet is more effective in controlling glycated haemoglobin and fasting blood glucose compared with a higher-GI diet or control in patients with type 2 diabetes. PMID: 29562676 [PubMed - indexed for MEDLINE]

N-3 polyunsaturated fatty acids improve lipoprotein particle size and concentration in Japanese patients with type 2 diabetes and hypertriglyceridemia: a pilot study.

Related Articles N-3 polyunsaturated fatty acids improve lipoprotein particle size and concentration in Japanese patients with type 2 diabetes and hypertriglyceridemia: a pilot study. Lipids Health Dis. 2018 Mar 15;17(1):51 Authors: Ide K, Koshizaka M, Tokuyama H, Tokuyama T, Ishikawa T, Maezawa Y, Takemoto M, Yokote K Abstract BACKGROUND: Patients with type 2 diabetes are at high risk for cardiovascular disease. Although hydroxymethylglutaryl-CoA reductase inhibitors (statins) can reduce cardiovascular events, residual risk remains even after target low-density lipoprotein cholesterol (LDL-C) levels have been achieved. Lipoprotein particle size and fraction changes are thought to contribute to such risks. The purpose of this study was to evaluate the effects of n-3 polyunsaturated fatty acids (n-3 PUFAs), predominantly eicosapentaenoic acid and docosahexaenoic acid, on lipoprotein particle size, concentration, and glycemic control in Japanese patients with type 2 diabetes and hypertriglyceridemia. METHODS: This was a multicenter, prospective, open-label, single arm study. We enrolled 14 patients with type 2 diabetes and hypertriglyceridemia treated with statins and dipeptidyl peptidase-4 inhibitors with glycated hemoglobin (HbA1c) < 8.0%, LDL-C < 120 mg/dL, and fasting triglyceride ≥150 mg/dL. After a 12-week observation period, they were treated with 4 g/day n-3 PUFAs for 12 weeks. Lipoprotein particle sizes, concentrations, lipoprotein insulin resistance (LPIR) scores, lipid profiles, HbA1c, and fasting plasma glucose (FPG) were measured before and after treatment. Lipoprotein profiles were measured by nuclear magnetic resonance spectroscopy. Data were analyzed using Wilcoxon signed-rank tests. RESULTS: Concentrations of total cholesterol (P < 0.001), LDL-C (P = 0.003), and triglyceride (P < 0.001) decreased following n-3 PUFA administration. N-3 PUFAs decreased the size of very low-density lipoprotein (VLDL; P < 0.001) particles, but did not affect LDL or high-density lipoprotein (HDL) particles. The concentration of large LDL increased, whereas small LDL decreased, causing the large to small LDL ratio to increase significantly (P = 0.042). Large VLDL and chylomicron concentrations significantly decreased, as did the large to small VLDL ratio (all P < 0.001). FPG levels unchanged, whereas HbA1c levels slightly increased. LPIR scores improved significantly (P = 0.001). CONCLUSIONS: N-3 PUFAs partly improved atherogenic lipoprotein particle size and concentration, and produced less atherogenic lipoprotein subclass ratios in patients that achieved target LDL-C levels and glycemic control. These results suggest that n-3 PUFAs may reduce residual cardiovascular risk factors in statin-treated patients with type 2 diabetes and hypertriglyceridemia. TRIAL REGISTRATION: The study was registered at UMIN-ID: UMIN000013776 . PMID: 29544483 [PubMed - indexed for MEDLINE]