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Brief intervention of low carbohydrate dietary advice: clinic results and a review of the literature
Purpose of review The purpose of the review is to assess the efficacy of a brief intervention of low carbohydrate dietary advice for weight loss in patients with a raised body mass index (BMI) (>25 kg/m2) during routine patient appointments in primary care. Recent findings Brief interventions in primary care have been shown to be a valuable tool in supporting patients to make lifestyle changes. Low carbohydrate diets have been successful in helping patients lose weight. The authors carried out a retrospective observational study based on the electronic records from a single general practitioner surgery with...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - September 9, 2021 Category: Endocrinology Tags: OBESITY AND NUTRITION: Edited by Eric C. Westman Source Type: research

Ketogenic diet as an advanced option for the management of pediatric obesity
Purpose of review The Duke Healthy Lifestyles Program (HL), established in 2006, has treated over 15,000 pediatric patients with obesity. A subset of patients with obesity do not respond to dietary and lifestyle changes. Development of the Staged Transitional Eating Plan (STEP) in 2012 provided a ketogenic advanced dietary option for these specific patients. Recent findings The goal of STEP is to facilitate weight loss, while assuring adequacy and the promotion of health through the abundant inclusion of vegetables, fatty fish, nuts, olive oil, and other foods consistent with the Mediterranean Diet. STEP is a th...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - September 9, 2021 Category: Endocrinology Tags: OBESITY AND NUTRITION: Edited by Eric C. Westman Source Type: research

Retrospective cohort study of changes in estimated glomerular filtration rate for patients prescribed a low carb diet
In this study, for patients with mildly reduced and moderately to severely reduced kidney function who were prescribed an LCD, their estimated glomerular filtration rate (eGFR) was either unchanged or improved. For those with normal or elevated eGFR, their kidney function was slightly decreased. For those without diabetes, greater weight loss was associated with improved eGFR. Future studies should prospectively measure low carbohydrate dietary adherence and physical activity and directly measure changes in GFR and albuminuria for participants with CKD before and during that diet. (Source: Current Opinion in Endocrinology,...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - September 9, 2021 Category: Endocrinology Tags: OBESITY AND NUTRITION: Edited by Eric C. Westman Source Type: research

Renal function in patients following a low carbohydrate diet for type 2 diabetes: a review of the literature and analysis of routine clinical data from a primary care service over 7 years
Purpose of review People with T2 Diabetes (T2D) who follow a low carbohydrate diet (LCD) may increase their dietary protein intake. Dietary protein can modulate renal function so there is debate about its role in renal disease. There is concern that higher protein intakes may promote renal damage, and that LCDs themselves may impact on cardiovascular risk. We review the evidence around LCDs, renal and cardiovascular risk factors and compare to results obtained in a real-world, primary care setting. Recent findings Chronic kidney disease (CKD) is a well-recognised microvascular complication of T2D caused in part ...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - September 9, 2021 Category: Endocrinology Tags: OBESITY AND NUTRITION: Edited by Eric C. Westman Source Type: research

Effect of low carbohydrate diets on insulin resistance and the metabolic syndrome
Purpose of review This review outlines recent research in the application of low carbohydrate diets (LCD) for insulin resistance (IR) and metabolic syndrome (MetS). Recent findings Studies included in this review explore how a LCD can be used in the management of patients with IR and MetS. LCDs have been shown to result in Type 2 Diabetes Mellitus (T2DM) remission, improve lipid profiles and dramatically reduce intrahepatic fat. Summary The field of nutritional science is notoriously complex. The LCD has a simple narrative, which can easily and safely be applied in clinical practice. Current guidelines re...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - September 9, 2021 Category: Endocrinology Tags: OBESITY AND NUTRITION: Edited by Eric C. Westman Source Type: research

Nutritional ketosis is well-tolerated, even in type 1 diabetes: the ZeroFive100 Project; a proof-of-concept study
The objective of this study was to test the feasibility of exercising over a 5-day period while fasting, in those with and without type 1 diabetes mellitus (T1DM). Eight individuals, ages 29--62 years, two with T1DM, walked/ran around 20 miles per day for five consecutive days while only consuming water. All eight individuals completed the project with no physical injuries or problems with diabetes control. The blood glucose levels ranged from less than 3 mmol/l to 7 mmol/l in those without T1D, and less than 3 mmol/l to 9 mmol/l in those with T1D. The continuous glucose traces in those with T1D showed little ...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - September 9, 2021 Category: Endocrinology Tags: OBESITY AND NUTRITION: Edited by Eric C. Westman Source Type: research

A case study of overfeeding 3 different diets
This study reports a case study of an individual who ate 5800 Calories per day of 3 different diets for 21 days at a time. The 3 different diets were low-carb, low-fat, and very-low-fat vegan. The weight gain over 21 days was 1.3 kg for low-carb, 7.1 kg for low-fat, and 4.7 kg for very-low-fat vegan. Summary In this n-of-1 study, consuming 5800 Calories/day of 3 different diets for 21 days did not lead to the same amount of weight gain. Further research should be conducted on how the human body gains weight with an emphasis on how different foods affect physiology. If these findings are replicated, there...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - September 9, 2021 Category: Endocrinology Tags: OBESITY AND NUTRITION: Edited by Eric C. Westman Source Type: research

International patient group harnesses social media to help inform rare disease research: use of a low carbohydrate ketogenic diet in McArdle disease
Purpose of review To highlight the benefits of a partnership between patient advocacy organizations (PAO) and clinical researchers in order to clinically study the prior anecdotal patient experience of utilizing a low-carbohydrate ketogenic diet (LCKD) to manage McArdle disease. Recent findings The bedside-to-bench and back again method of translational research is well suited to explore anecdotal patient experiences, particularly for rare diseases. In McArdle disease, patients have explored the use of a LCKD to address the ubiquitous occurrence of physical activity intolerance and minimize associated adverse ev...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - September 9, 2021 Category: Endocrinology Tags: OBESITY AND NUTRITION: Edited by Eric C. Westman Source Type: research

Carbohydrate-restricted diets and Type 1 diabetes mellitus: research considerations
Purpose of review Type 1 diabetes mellitus (T1DM) is managed via careful control of blood glucose, exogenous insulin, diet, exercise, and other physiologic factors. Interestingly, the dietary recommendations for T1DM have had very little systematic research. Many clinical observations, as well as emerging research studies, have noted that a carbohydrate-restricted diet can lead to normalization of blood glucoses with reduction in hypoglycemic reactions among motivated individuals. Recent findings In this paper, we review observations of carbohydrate restriction and propose a series of studies to test two levels ...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - September 9, 2021 Category: Endocrinology Tags: OBESITY AND NUTRITION: Edited by Eric C. Westman Source Type: research

Editorial: Carbohydrate restriction: from the ‘bedside’ to the ‘bench’
No abstract available (Source: Current Opinion in Endocrinology, Diabetes and Obesity)
Source: Current Opinion in Endocrinology, Diabetes and Obesity - September 9, 2021 Category: Endocrinology Tags: OBESITY AND NUTRITION: Edited by Eric C. Westman Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Endocrinology, Diabetes and Obesity)
Source: Current Opinion in Endocrinology, Diabetes and Obesity - September 9, 2021 Category: Endocrinology Tags: EDITORIAL INTRODUCTIONS Source Type: research

Hypophysitis from immune checkpoint inhibitors: challenges in diagnosis and management
Purpose of review This review will summarize the most recent and pertinent evidence regarding immune checkpoint inhibitor (ICI)-induced hypophysitis to describe diagnostic and management algorithm with the help of a case report. Recent findings Hypophysitis is the most common endocrine adverse event from CTLA-4 inhibitors and much less with PD-1/PD-L1 inhibitors. Its pathophysiology appears to be lymphocytic, predominantly affecting the anterior pituitary. The utility of high-dose glucocorticoids for treatment has been questioned, as they do not influence recovery of hypopituitarism and may reduce survival. A su...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - July 15, 2021 Category: Endocrinology Tags: NEUROENDOCRINOLOGY: Edited by Emory Hsu Source Type: research

Acromegaly: achieving timely diagnosis and improving outcomes by personalized care
Purpose of review Discuss recent literature regarding clinical manifestations and comorbidities in acromegaly, with focus on early diagnosis and customized care. Recent findings The mean interval between onset of clinical manifestations and diagnosis is currently 3–5 years. Women, especially younger than 50 years of age, experience longer delays, have lower insulin-like growth factor 1 (IGF-1) levels and larger tumors than men. Development of comorbidities usually precedes the diagnosis and is influenced by age, sex, and biochemical disease activity. Comorbidities other than irreversible osteoarticular struc...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - July 15, 2021 Category: Endocrinology Tags: NEUROENDOCRINOLOGY: Edited by Emory Hsu Source Type: research

Current state of antigen-specific immunotherapy for type 1 diabetes
Purpose of review Update on antigen-specific immunotherapy (ASIT) in type 1 diabetes (T1D) with focus on deoxyribonucleic acid (DNA)-induced immunization and the current obstacles to further research and clinical realization. Recent findings In T1D, immune system imbalances together with malfunctioning islet-specific processes cause autoreactive immune cells to destroy beta cells in the islets. ASIT may restore self-tolerance; however, the approach has yet to fully meet its promise and may require co-administration of antigen (preproinsulin) and suitable immune response modifiers. Summary A self-tolerant ...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - July 15, 2021 Category: Endocrinology Tags: DIABETES AND ENDOCRINE PANCREAS II: Edited by Peter Gottlieb Source Type: research

Novel delivery mechanisms for antigen-specific immunotherapy
Purpose of review Current therapies for autoimmune disorders often employ broad suppression of the immune system. Antigen-specific immunotherapy (ASI) seeks to overcome the side-effects of immunosuppressive therapy by specifically targeting only disease-related autoreactive T and B cells. Although it has been in development for several decades, ASI still is not in use clinically to treat autoimmunity. Novel ways to deliver antigen may be effective in inducing ASI. Here we review recent innovations in antigen delivery Recent findings New ways to deliver antigen include particle and nonparticle approaches. One mai...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - July 15, 2021 Category: Endocrinology Tags: DIABETES AND ENDOCRINE PANCREAS II: Edited by Peter Gottlieb Source Type: research