IJERPH, Vol. 17, Pages 2557: Low-Carbohydrate Diets in the Management of Obesity and Type 2 Diabetes: A Review from Clinicians using the Approach in Practice

We describe the mechanistic basis for the clinical benefits associated with nutritional ketosis and identify areas of practice where the evidence base could be improved. We summarize the key principles which inform our approach to treating patients with low-carbohydrate diets. The scientific controversy relating to these diets is real but is consistent with the known challenges of any dietary interventions and also the limitations of nutritional epidemiology. Secondly, notwithstanding any controversy, international guidelines now recognize the validity and endorse the use of these diets as a therapeutic nutritional approach, in appropriate patients. Thirdly, we have found that early de-prescription of diabetes medications is essential, in particular insulin, sulphonylureas, and sodium-glucose cotransporter (SGLT2) inhibitors. Fourthly, we encourage patients to eat ad libitum to satiety, rather than calorie counting per se. Furthermore, we monitor cardiovascular risk factors frequently, as with all patients with obesity or diabetes, but we do not necessarily consider an increase in low-density lipoprotein (LDL)-cholesterol as an absolute indication to stop these diets, as this is usually related to large LDL particles, which are not associated with increased cardiovascular risk. In the absence of large randomized controlled trials with cardiovascular and other hard endpoints, adopting a low-carbohydrate diet is a legitimate and potentially effective treatment option for patien...
Source: International Journal of Environmental Research and Public Health - Category: Environmental Health Authors: Tags: Review Source Type: research

Related Links:

AbstractHeart failure with preserved ejection fraction (HFpEF) is a complex heterogeneous disease for which our pathophysiological understanding is still limited and specific prevention and treatment strategies are lacking. HFpEF is characterised by diastolic dysfunction and cardiac remodelling (fibrosis, inflammation, and hypertrophy). Recently, microvascular dysfunction and chronic low-grade inflammation have been proposed to participate in HFpEF development. Furthermore, several recent studies demonstrated the occurrence of generalized lymphatic dysfunction in experimental models of risk factors for HFpEF, including obe...
Source: Basic Research in Cardiology - Category: Cardiology Source Type: research
AbstractBackgroundObesity and metabolic syndrome (MetS) are key risk factors for type 2 diabetes and cardiovascular disease. Little information exists on the prevalence of obesity and MetS in Latin America and specifically in Ecuador. We aimed to estimate the prevalence of overweight, obesity, and MetS among adults in Ecuador.MethodsWe analyzed data from a nation-wide population-based survey in Ecuador (ENSANUT-ECU) among 10,318 participants (3684 men, 6634 women; age range: 18 –59 years) conducted in 2012. Data related to residential location (urban versus rural), altitude (  1500 m above sea level ...
Source: Journal of Endocrinological Investigation - Category: Endocrinology Source Type: research
;mez-Huelgas María Rosa Bernal-López The aim of this study was to analyze the utility of liver function tests (LFT) and fatty liver index (FLI), a surrogate marker of non-alcoholic fatty liver disease, in the categorization of metabolic phenotypes in a Mediterranean population. A cross-sectional study was performed on a random representative sample of 2233 adults assigned to a health center in Málaga, Spain. The metabolic phenotypes were determined based on body mass index (BMI) categorization and the presence or absence of two or more cardiometabolic abnormalities (high blood pressure, low h...
Source: International Journal of Environmental Research and Public Health - Category: Environmental Health Authors: Tags: Article Source Type: research
This study provides direct evidence for the contribution of gut microbiota to the cognitive decline during normal aging and suggests that restoring microbiota homeostasis in the elderly may improve cognitive function. On Nutraceutical Senolytics https://www.fightaging.org/archives/2020/05/on-nutraceutical-senolytics/ Nutraceuticals are compounds derived from foods, usually plants. In principle one can find useful therapies in the natural world, taking the approach of identifying interesting molecules and refining them to a greater potency than naturally occurs in order to produce a usefully large therape...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
Abstract Multiple myeloma (MM) is a haematological malignancy arising from monoclonal proliferation of plasma cells in the bone marrow, resulting in the presence of paraproteins or M-protein in serum. The involvement of paraproteins produced by malignant plasma cells in the development of hyperlipidaemia and low-HDL cholesterol has been described, as has an association with MM and obesity, hypertension, and type 2 diabetes mellitus, and insulin resistance, that is, features of the metabolic syndrome (MS). There is an association between MS components, inflammatory cytokines, and the development of MM, and some dru...
Source: Acta Haematologica - Category: Hematology Authors: Tags: Acta Haematol Source Type: research
Nanotechnology has the capacity to revolutionize numerous fields and processes, however, exposure-induced health effects are of concern. The majority of nanoparticle (NP) safety evaluations have been performed utilizing healthy models and have demonstrated the potential for pulmonary toxicity. A growing proportion of individuals suffer diseases that may enhance their susceptibility to exposures. Specifically, metabolic syndrome (MetS) is increasingly prevalent and is a risk factor for the development of chronic diseases including type-2 diabetes, cardiovascular disease, and cancer. MetS is a combination of conditions which...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
DISCUSSION: Eleven articles met the inclusion criteria, which characterised Opuntia spp. products as either PP (n = 6), CLD (n = 4) or commercial products' (n=1). Effects were investigated in healthy and obese populations as well as those with metabolic illnesses, specifically type 2 diabetes and metabolic syndrome. PP consumption was associated with significant reductions in TC (p 
Source: Complementary Therapies in Medicine - Category: Complementary Medicine Authors: Tags: Complement Ther Med Source Type: research
Abstract OBJECTIVES: Since, the main cause of death in Rheumatoid arthritis (RA) patients is the presence of type 2 diabetes, abnormal increase in blood lipids, blood pressure and obesity, the aim of this study was to assess the effects of Barberry on the anthropometric indices and metabolic profile in patients with RA. DESIGN: present study was a double-blinded, placebo-controlled randomized clinical trial. SETTING: 70 active RA patients were randomly allocated into intervention or placebo group INTERVENTION: Participants received 6 capsules of 500 mg barberry extract or placebo for 3 months. MAIN ...
Source: Complementary Therapies in Medicine - Category: Complementary Medicine Authors: Tags: Complement Ther Med Source Type: research
We reported findings from the first 8-month pilot phase of the South African diabetes prevention program. The study was conducted across eight townships (four black and four mixed-ancestry communities) in Cape Town, South Africa, between August 2017 and March 2018. Participants were recruited using both random and self-selected sampling techniques because the former approach proved to be ineffective; <10% of randomly selected individuals consented to participate. Non-laboratory-based diabetes risk screening, using the African diabetes risk score, and based on targeted population specific cut-offs, identified potenti...
Source: International Journal of Environmental Research and Public Health - Category: Environmental Health Authors: Tags: Article Source Type: research
Obesity is a serious, chronic, treatable, and global disease epidemic. Over 98 million people currently have the disease of obesity, and in a recent New England Journal of Medicine article, Harvard researchers predicted that by 2030, 50% of the population in the United States will have the disease of obesity. Type 2 diabetes (T2D) is significantly associated with obesity. While many people with obesity do not have diabetes, most people with T2D have the disease of obesity. Excess adiposity (body fat storage), which is present in obesity, contributes to many chronic diseases beyond T2D. These include high blood pressure, he...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Diabetes Diet and Weight Loss Health Heart Health Surgery Source Type: blogs
More News: Carbohydrates | Cardiology | Cardiovascular | Cholesterol | Diabetes | Diabetes Type 2 | Diets | Eating Disorders & Weight Management | Endocrinology | Environmental Health | Epidemiology | Heart | Insulin | International Medicine & Public Health | Nutrition | Obesity | SGLT2 Inhibitors | Sodium