Thank you to the Editors for the opportunity to respond to Dr. Geoffrey Livesey’s comments regarding the methodology used in the publication (1). At the outset, the authors agree that the field of dietary fibers is quite vast and encompasses a variety of carbohydrates, each with different human health benefits and unique properties such as structure, solubility, and fermentability. The diversity in the types of fibers supports the need to continue conducting robust, high quality scientific research to understand the relationship between biological effects and health benefits. We would like to address key points raised by Dr. Livesey. Use of breath hydrogen as a measure for carbohydrate fermentation and an estimate of caloric value is established in the scientific literature. Other resistant maltodextrins have utilized this methodology (2) as have low and no calorie sweeteners (3). It is also typical to have this study last until the ten-hour time point. We acknowledge Dr. Livesey’s point that there is a possibility of additional fermentation, and therefore breath hydrogen, which could have been produced over the next fourteen hours. To minimize undue burden to the clinical subjects, we decided against this length of study design. It is also important to note that our decision was validated as we saw the breath hydrogen curves returned to baseline at the ten-hour time point. The authors wish to clarify that they did not claim that no breath hydrogen was produced as a result of SCF70 or SCF85B consumption, as can be seen in the original publication figure 2. The authors would also like to highlight that mixtures of different fermentable carbohydrates were not provided to the clinical subjects, as each individual fiber was provided in a beverage on separate occasions. Dr. Livesey did mention that in our study there was not a time for adaptation of colonic microflora to the presence of SCF70 or SCF85B. He is correct in this interpretation of the study design and this aspect of the protocol design was intentional. We did not provide either SCF70 or SCF85B to the participants for a longer duration, in advance of the breath hydrogen collection, to best simulate real world consumption pattern of consumers. In order to address the likelihood of instability of the baseline hydrogen excretion, a low-fiber diet was provided to the subjects the day before the testing as well as the meal provided during the collection of breath hydrogen samples. In Dr. Livesey’s commentary, he references three conventional energy balance studies in animals. It is important to note that one of the studies referenced did not use PROMITORR SCF, but another soluble fiber (4). For the remaining two studies, Dr. Livesey provided values of 1.8 kcal/g SCF70 in pigs (5) and 1.5 kcal/g SCF70 in roosters (5). It must be noted that these values are the kcals per gram of ingredient and not kcal per gram of fiber. Table 3 of Canene-Adams et al presents caloric values for both, per gram fiber level and for per gram ingredient. The total energy per gram of ingredient included the energy obtained from breath hydrogen (representing the fiber portion) and energy from digestible carbohydrate at 4 kcal/g. Energy per g ingredient (kcal/g ingredient) was significantly greater for SCF70 (1.1 kcal per gram of ingredient) compared to SCF85B (0.46 kcal per gram of ingredient) as expected due to the greater portion of non-fiber carbohydrate in SCF70 compared to SCF85B. At the time of these animal studies being performed, the SCF85B ingredient was not yet developed by Tate & Lyle. In Table 3, the average caloric value for SCF70 on an ingredient basis, is 1.1 kcal per gram of ingredient. This value is not dissimilar from the porcine (1.8 kcal per gram of ingredient) and rooster (1.5 kcal per gram of ingredient) studies performed prior and could be due to physiological differences in species, microbiota strain and amounts present, and/or methodology differences. Ultimately, the values determined in humans are the ones most relevant to the caloric calculations performed for Nutrition Facts panels. Authors acknowledge Dr. Livesey’s comment that the human clinical trial to quantify the amount of PROMITORR Soluble Corn Fiber in stool samples has not been performed and would be useful information to obtain and analyze in due course. Nevertheless, the lack of this data does not negate the breath hydrogen results currently presented, nor does it refute the beneficial physiologic health effects seen in multiple human studies. The International Association for Probiotics and Prebiotics (ISAPP) defines a prebiotic as “a substrate that is selectively utilized by host microorganisms conferring a health benefit” (6). This definition states that the prebiotic must be utilized, not limited to fermentation, as in the case of some polyphenolics which have prebiotic related health benefits despite not being fermented (7). The definition of prebiotic also does not state to what extent the fiber must be utilized or fermented. In fact, there are many slightly fermented fibers consumed by humans with established
OBJECTIVE:The present study aimed to assess the bio-functional analysis of camel milk viz. anti-oxidative, anti-inflammatory activities using potent Lactobacillus fermentum (KGL4) strain through fermentation and also to release the bioactive peptides during fermentation.METHOD:The antioxidant and proteolytic activities of the fermented camel milk were studied followed by SDS-PAGE analysis and 2 D PAGE. The separations of the bioactive peptides of water-soluble extract (WSE) of 3 and 10 kDa (Permeates & Retentates) were achieved by RP-HPLC. The purified bioactive peptides were identified and characterized using RPLC/MS and the effect of WSE of camel milk fermented with KGL4 on lipopolysaccharide (LPS)/endotoxin-induced inflammation in RAW 264.7 macrophages were also studied.RESULTS:The maximal activity was observed in ABTS assay (64.03%), then in hydroxyl free radical scavenging assay, and minimal activity was observed in superoxide free radical assay (57.75%). ABTS assay was significantly (P < 0.05) higher than other assays. MTT assay was performed on WSE of camel milk fermented with KGL4 using treated macrophage cells with different concentrations and found the decreasing range of cell viability at 0.25 mg/mL treatment which was non-significant. 7.80 mg/ml peptide production was found after 48 h of fermentation using the OPA method. Further, WSE of fermented camel milk was separated and analyzed their protein profiles using SDS-PAGE and 2 D-PAGE techniques. Here, many new peptides were found in camel milk when fermented with KGL4 strain. Each protein sequence was characterized through bioinformatic tools, including SWISS-PROT & PIR protein databases. Novel bioactive anti-oxidative peptides were found by searching in the BIOPEP database.CONCLUSIONS:The present study suggests that the L. fermentum KGL4 strain could be explored to produce novel antioxidative peptides from fermented camel milk (Indian breed).
Single-point mutation diseases in which substitution of one nucleotide with another in a gene occurs include familial Alzheimer's disease (fAD), familial Parkinson's disease (fPD), and familial Creutzfeldt-Jacob disease (fCJD) as well as Huntington's disease (HD), sickle cell anemia, and hemophilia. Inevitability of occurrence of these diseases is certain. However, the time of appearance of symptoms could be influenced by the diet, environment, and possibly other genetic factors. There are no effective approaches to delay the onset or progression of symptoms of these diseases. The fact that increased oxidative stress and inflammation significantly contribute to the initiation and progression of these point mutation diseases shows that antioxidants could be useful. The major objectives are (a) to present evidence that increased oxidative stress and chronic inflammation are associated with selected single-point mutation diseases, such as fAD, fPD, and fCJD, HD, sickle cell anemia, and hemophilia; (b) to describe limited studies on the role of individual antioxidants in experimental models of some of these diseases; and (c) to discuss a rationale for utilizing a comprehensive mixture of micronutrients, which may delay the development and progression of symptoms of above diseases by simultaneously reducing oxidative and inflammatory damages.Key teaching pointsSelected single-point mutation diseases and their pattern of inheritanceCharacteristics of each selected single-point mutation diseaseEvidence for increased oxidative stress and inflammation in each diseasePotential reasons for failure of single antioxidants in human studiesRationale for using a comprehensive mixture of micronutrients in delaying the onset and progression of single-point mutation diseases.
Unhealthy dietary practices have increased among college students in South Asia. Higher intakes of energy-dense foods may increase health risks such as weight gain in college students. The purpose of the study was to gather evidence on fast food consumption patterns and factors that influenced fast food consumption among college students in South Asia. Electronic databases (CINAHL, PsycINFO, PubMed, and ScienceDirect) were used to find relevant potential English-written articles. We followed the standard process of identification, screening, eligibility assessment, study quality assessment, and data extraction from the included articles in this review. In total, data were synthesized from 28 articles. Factors such as gender, being younger, higher socio-economic class, higher body mass index (being overweight or obese), study groups such as students from Humanities, low nutrition knowledge, and the internet addiction played the roles as positive determinants (all P values < 0.05) of consuming fast food frequently. Furthermore, taste, brand reputation, accessibility, location, price, ambiance, hygiene practice, variety, promotional offers, and timely service significantly (all P values < 0.05) increased intakes of fast food in college students. Engaged institutional nutrition education intervention and multisectoral approaches are necessary to reduce fast food consumption in college students along with enabling them to make healthy food choices.Key teaching pointsFrequency of fast food consumption (daily to several times a week) has increased among college students in recent years in South Asia.This systematic review shows that a number of socio-economic, physiological, and behavioral factors influence fast food consumption in college students.Commonly, male students and persons with higher body mass index consume fast food more often. Taste, price, and convenience, accessibility, availability, ambiance, and location also promote fast food consumption in college students.Nutrition interventions are needed to promote healthy dietary intake behavior among college students in South Asia.
Measurements in humans of their breath hydrogen is sometimes used to assess the availability, fermentability, and food energy value of carbohydrates that, to an unknown extent, resists small intestinal digestion and fermentation in the large intestine. Here I outline that the method is utterly flawed and conclude that it is unsuitable for making claims as to the availability, fermentability, and food energy value of carbohydrates. More traditional methods, although more demanding of time and effort, can be used. Otherwise further development of methodology is essential to avoid undue risk of bias.
Objective: Beef protein extracts are growing in popularity in recent years due to their purported anabolic effects as well as to their potential benefits on hematological variables. The present randomized, controlled, double-blind, cross-over study aimed to analyze the effects of beef protein supplementation on a group of male elite triathletes (Spanish National Team). Methods: Six elite triathletes (age, 21 +/- 3 years; VO2max, 71.5 +/- 3.0 ml center dot kg center dot min(-1)) were randomly assigned to consume daily either 25 g of a beef supplement (BEEF) or an isoenergetic carbohydrates (CHO) supplement for 8 weeks, with both conditions being separated by a 5-week washout period. Outcomes, including blood analyses and anthropometrical measurements, were assessed before and after each 8-week intervention. Results: No effects of supplement condition were observed on body mass nor on skinfold thicknesses, but BEEF induced significant and large benefits over CHO in the thigh cross-sectional area (3.02%, 95%CI = 1.33 to 4.71%; p = 0.028, d = 1.22). Contrary to CHO, BEEF presented a significant increase in vastus lateralis muscle thickness (p = 0.046), but differences between conditions were not significant (p = 0.173, d = 0.87). Although a significantly more favorable testosterone-to-cortisol ratio (TCR) was observed for BEEF over CHO (37%, 95% CI = 5 to 68%; p = 0.028, d = 1.29), no significant differences were found for the hematological variables (i.e., iron, ferritin, red blood cell count, hemoglobin or hematocrit). Conclusion: Beef protein supplementation seems to facilitate a more favorable anabolic environment (i.e., increased TCR and muscle mass) in male elite triathletes, with no impact on hematological variables.
The major aim of this randomized, placebo-controlled, triple-blind clinical trial was to evaluate the efficacy of cinnamon as an adjuvant treatment in reducing glycemic levels in people with type 2 diabetes, compared to a placebo. The study was conducted between August and December 2019, with 160 people with type 2 diabetes, in five Primary Health Units, in Parnaíba, Brazil. Inclusion criteria were: persons of both genders using oral antidiabetic agents, with glycated hemoglobin ≥ 6.0%, and between 18 and 80 years of age. The primary outcome was change in glycated hemoglobin levels after 90 days of intervention. Other biomarkers evaluated were fasting blood glucose, insulin level, and HOMA-IR index. Participants were divided equally into two groups of 80 individuals each, and were given 3 g capsules of either cinnamon or placebo to be taken in combination with their usual oral antidiabetic agents. After 90 days, participants in the cinnamon group had statistically significant reductions of 0.2% of glycated hemoglobin and 0.55 mmol/L of fasting venous glucose, when compared with the placebo group. Cinnamon reduced the glycemic measures of persons with type 2 diabetes, albeit with modest reductions. TRIAL: RBR-2KKB6D.
INTRODUCTION:With a well-established role in inflammation and immune function, vitamin D status has emerged as a potential factor for coronavirus disease-2019 (COVID-19).OBJECTIVE:The purpose of this study was to evaluate the moderating effect of race on the relationship between vitamin D status and the risk of COVID-19 test positivity, and to compare propensity score (PS) model results to those obtained from classical bivariate and multivariable models, which have primarily comprised the literature to date.METHODS:Electronic health record (EHR) data from TriNetX (unmatched n = 21,629; matched n = 16,602) were used to investigate the effect of vitamin D status, as measured by 25-hydroxyvitamin D [25(OH)D], on the odds of experiencing a positive COVID-19 test using multivariable logistic regression models with and without PS methodology.RESULTS:Having normal (≥ 30 ng/mL) versus inadequate 25(OH)D (< 30 ng/mL) was not associated with COVID-19 positivity overall (OR = 0.913, p = 0.18), in White individuals (OR = 0.920, p = 0.31), or in Black individuals (OR = 1.006, p = 0.96). When 25(OH)D was analyzed on a continuum, a 10 ng/mL increase in 25(OH)D lowered the odds of having a positive COVID-19 test overall (OR = 0.949, p = 0.003) and among White (OR = 0.935, p = 0.003), but not Black individuals (OR = 0.994, p = 0.75).CONCLUSIONS:Models which use weighting and matching methods resulted in smaller estimated effect sizes than models which do not use weighting or matching. These findings suggest a minimal protective effect of vitamin D status on COVID-19 test positivity in White individuals and no protective effect in Black individuals.
Abstract Objective We investigated the effects of acute ingestion of Maytenus ilicifolia extract on metabolic and cardiopulmonary responses during a high-intensity interval exercise (HIIE), and its consequence on neuromuscular fatigue. Methods Ten healthy men underwent a HIIE (4 x 4 min, 3 min recovery) one hour after ingesting 400 mg of Maytenus ilicifolia extract (MIE) or placebo. Oxygen uptake ( O2), dioxide carbon production ( CO2), ventilation ( E) and heart rate (HR) were measured throughout the HIIE. Maximal voluntary contraction (MVC), voluntary activation (VA), and evoked 1, 10 and 100 Hz force twitch were measured before supplementation (baseline), and before (pre-HIIE) and after the HIIE (post-HIIE). Results The O2, E, E/ O2 ratio and HR increased progressively throughout the HIIE under both conditions (p < 0.05). MIE increased HR, however, at bouts 1 and 2 and mean O2 during HIIE. The mean respiratory exchange ratio during recovery was also reduced with MIE (p < 0.05). MVC and evoked force at 1, 10 and 100 Hz declined similarly after HIIE, regardless of the condition (MIE: −18 ± 17%, −50 ± 15%, −61 ± 13% and −34 ± 10% vs. placebo: −19 ± 15%, −48 ± 16%, −58 ± 12 and −29 ± 11%, respectively, p < 0.05). There was no effect of exercise or MIE on VA (p > 0.05). Conclusion MIE increases heart rate in the first bouts and mean oxygen uptake during HIIE without changes in neuromuscular fatigue development.
Abstract Objective Nonalcoholic steatohepatitis (NASH) has become a prominent liver disease in contemporary society because of the changing dieting styles. Complicated syndromes often accompanied by obesity and diabetes makes no standard treatment for NASH. Therefore, we investigated the potential role of Antrodia cinnamomea mycelium (ACM) as nutraceutical supplementation in the treatment of NASH in this 6-month randomized, double-blind, placebo-controlled study. Method 28 Participants were treated with three capsules per day containing either 420 mg of ACM or 420 mg of starch as a placebo. The participants were required to follow a predetermined regular visit to hospital every three months during the intervention period (6 months). During each study visit, subjects underwent anthropometric measurements and blood testing for biochemical analysis, immune function assay, inflammatory cytokines assay, and FibroMax test. Results The ACM supplemented group had a significant improvement in steatosis and decreased in the inflammatory marker of TNF-α after three and six months. NASH patients who received ACM showed a significant decrease in the SteatoTest mean value from 0.66 at baseline to 0.49 at 6 months (p < 0.029) and the ActiTest mean value decreased from 0.46 at baseline to 0.30 at 6 months (p < 0.029). Conclusion This is the first clinical investigation that explores the hepatoprotective effect of A. cinnamomea mycelium in patients with NASH. No participants experienced any adverse events during the study, which suggested that ACM is a safe alternative treatment for NASH.
Background A gradual upward progression of blood pressure (BP) occurs regularly in most humans during aging. This is unfortunate, because it is generally recognized that elevation of BP, even when relatively mild, is eventually detrimental to human health. Accordingly, considerably more understanding of the pathophysiology behind such a phenomenon is important in order to institute the correct remedies. Two components of the ubiquitous metabolic syndrome (MS) with nutritional implications, elevated insulin resistance (IR) and excess body fat mass (FM), are often postulated to be critical driving forces behind the elevated BP that is common with aging. The current study, therefore, focuses on the presence and importance of IR and/or body FM in BP regulation of non-diabetics over the lifespan. Methodology In cross sectional analyses, baseline data obtained from healthy, non-diabetic volunteers involved in prior clinical studies were analyzed by examining links between FBG measurements used as a surrogate for IR and body FM through their individual and combined effects on BP. Results A significant positive correlation was found between FBG and FM and also between each employed individually as independent variables to the dependent BP and heart rate (HR) variables. In volunteers with higher body FM compared to lower, average systolic BP (SBP) values are increased to some extent at the same FBG measurement suggesting that other factors related to FM in addition to IR are the basis for slight pressure differences. Considering quartiles based upon levels of FM and FBG, low FM-low FBG display significantly reduced average SBP, diastolic blood pressure (DBP), and HR compared to the upper FM-FBG quartiles. While readings of FBG and FM display a decline in elderly subjects after age 70 years (aging paradox), such does not occur with SBP. Conclusions IR is a major driving force behind BP regulation even in non-diabetics. FM influences BP substantially through its relationship with IR and also via other mechanisms directly linked to FM.
Objective:To investigate the association between sociodemographic characteristics and changes in dietary intake in patients with ischemic heart disease who were following a cardiac rehabilitation program. Methods:Longitudinal study among patients with first-time admission to outpatient cardiac rehabilitation after ST-elevation myocardial infarction, non-ST-elevation myocardial infarction, unstable angina pectoris or stable angina pectoris. We used a validated self-administered food frequency questionnaire to assess the dietary intake before rehabilitation, post rehabilitation and 6 months after baseline. The intake was summarized into a fat and fish-fruit-vegetable score for both sexes. To assess the within-patient differences in dietary scores, a paired t-test was applied. Regression analyses were performed to assess the association between sociodemographic characteristics and changes in diet. Results:186 patients completed two measurements, 157 patients completed all three measurements. Fat and fish-fruit-vegetable scores increased statistically significantly and improvements remained statistically significant at follow-up. Fat scores increased less in employed men than in retired men (-11 (95% CI -17; -5)). Fish-fruit-vegetable scores increased less in men with a bachelor degree than in men with a vocational education (-8 (95% CI -13; -3)) as well as in retired women compared with employed women (-18 (95% CI -32; -4)). Conclusions:Patients statistically significantly improved their dietary intake and improvements remained at follow-up. Dietary improvements were sensitive to marital status, living arrangements and employment status. Unemployed and retired women did not seem to improve their diet as much as employed women. Additional dietary intervention may become relevant in some patient groups defined by sociodemographic characteristics. (250)
Survivors of breast cancer (BC) are at increased risk of chronic diseases due to factors such as low bone mineral density (BMD) and loss of muscle mass (MM) coupled with increased fat mass (FM). It is important to know that healthy behaviors can mitigate the risk of these complications. A narrative review was performed using PubMed and ScienceDirect to identify diet and physical activity (PA) interventions aimed at improving BMD, MM, and/or FM in female BC survivors. Data from 2000 to 2018 were used and 17 diet and/or PA interventions were identified. The duration of interventions was from 3 weeks until 24 months, the smallest sample was 26 women, and the largest was 223. The ranging age of participants was from 46 to 64 years. Studies with a longer duration, in-person modality and/or that used behavioral models showed better results. In BMD, the best results in spine were observed at 24 months in a face-to-face intervention (increase of 3.08%). Regarding MM, the greatest increase was at 26 weeks under Cognitive Behavioral Therapy (CBT) in person (43.8 ± 8.7 to 44.7 ± 8.4 kg, p = 0.04). This approach also showed the greatest decrease in FM from 36.7 to 31.2 kg in 4 months (p ≤ 0.01). Improving BMD and MM and preventing the increase of FM is a challenge for public health. More studies are needed to improve BMD among BC survivors and consider strategies that have yielded better results to promote healthy changes.Key teaching pointsBreast cancer survivors are at increased risk for low bone mineral density, loss of muscle mass, and increased fat mass due to the treatments received; the adoption of a healthy diet and physical activity can mitigate these complications.Of the 17 studies included, 8 used the face-to-face modality, 7 combined face-to-face with phone calls and two studies used only phone calls and email; studies that used the face-to-face modality showed better results.For bone mineral density, the best results were observed in spine at 24 months (increase of 3.08%) in a face-to-face intervention.The greatest increase in muscle mass (43.8 to 44.7 kg) was at 26 weeks in a physical activity intervention; the larger amount of fat mass loss was 5.5 kg in a diet and physical activity intervention. Both results were obtained using the Cognitive Behavioral Therapy (CBT) in person.Lifestyle interventions to maintain or improve bone mineral density, muscle mass and fat mass are effective at least for one of these three variables.
The lack of prevention of noncommunicable diseases (NCDs) has caused an increase in the mortality rate including conditions such as chronic kidney disease (CKD) and liver disease (LD). The high complexity of CKD and LD results in alterations in the metabolism of carbohydrates, proteins, and lipids. One of the changes observed in CKD and LD is the decrease in albumin, elevation of PO4−3, K+, creatinine, urea, and transaminase enzymes. The pharmacological treatment is expensive. Nowadays, phytotherapy is an option to treat NCDs. Aqueous, ethanolic, methanolic, and ethyl acetate extracts of Cnidoscolus aconitifolius have shown nephroprotective and hepatoprotective potential and can be an alternative to prevent and treat CKD and LD. C. aconitifolius, known as Chaya by Mayas in Yucatán, is a shrub that is consumed in Mexico and in the world, has a low cost, it is very accessible, and can growth in extreme weather. The aim of this review is to show the potential biological effects of C. aconitifolius extracts, and the association of the phytochemicals in the extract. It is known that different solvents result in the uptake of different phytochemicals. These have shown various effects such as hypoglycemic, hypotensive, hypolipidemic, and antioxidant, being a natural alternative to the treatment of NCDs.Key teaching pointsPhytotherapy is a proposal to treat NCDs.Cnidoscolus aconitifolius extracts have a hypotensive effect.Cnidoscolus aconitifolius extracts reduce blood sugar in diabetic rats.Chaya extracts are no toxic for renal and hepatic cells.
Objective It was aimed at comparing the glycating capacities of glucose and ribose in bovine serum albumin (BSA) and anti-glycation activity of pomegranate mesocarp extract (PME). The protective mechanism of PME against ribosylated BSA (BSA(RIB))-induced toxicity was also investigated. Methods BSA was incubated with glucose or ribose in the presence or absence of PME for 15 days. In preadipocytes pretreated with PME, cell viability, ROS production, lipid peroxidation and mitochondrial membrane potential were investigated following 1, 6, 12, 18 and 24 h exposure to BSA(RIB). Nuclear translocation of NF kappa B was assessed at 1 h and 24 h of BSA(RIB) insult. Accumulation of oxidized proteins, activities of intrinsic antioxidant enzymes and IL-6 secretion were also determined after 24 h exposure to BSA(RIB). Results Ribose was a harsher glycating agent as compared to glucose and PME showed strong anti-glycation activity by suppressing (P < 0.05) the increase in levels of fluorescent AGEs, Amadori products, protein carbonyl and advanced oxidation protein products (AOPP). In preadipocytes, BSA(RIB) potentiated pro-apoptotic activity by inhibiting the nuclear translocation of NF kappa B. BSA(RIB) induced a time dependent decrease in cell viability, which was significantly suppressed (P < 0.05) by PME. The extract also significantly reduced (P < 0.05) the time dependent increase in ROS level and associated lipid peroxidation as well as loss in mitochondrial membrane potential caused by BSA(RIB). PME also counteracted the BSA(RIB)-induced accumulation of oxidized proteins, decrease in intrinsic antioxidant activity and IL-6 over-secretion. Conclusions PME showed anti-glycation activity and afforded protection against BSA(RIB)-induced toxicity, oxidative stress and inflammation in preadipocytes.
Objective We evaluated the nutrient adequacy of a well-planned supplemented whole-food plant-based (WFPB) diet as a component of an ongoing community lifestyle optimization program. We investigated the contributions of nutrients from foods and supplements and plant-based meal replacement (SMR) separately (foods, SMR) and combined (vs recommendations) as well as food group intake, both according to sex. Method Our cross-sectional study included 151 healthy, active participants (aged 39.6 years) who were on a Western-type diet when they voluntarily joined our WFPB lifestyle program (0.5-10 years ago). We assessed diet using 3-day weighed dietary records (foods, S, and MR). After we standardized nutrient intake to 2000 kcal/d, we calculated the contribution of macro- and micronutrients from foods and SMR separately and combined (foods + SMR) (vs central European Recommendations), as well as food group intake, both according to sex. Results All macro- and micronutrient intake (total: from foods plus SMR) exceeded the reference values, except for calcium (95% and 82% in females and males) and vitamin D (both sexes, in summertime). Compared with male participants, female participants consumed (i.e., from foods and SMR together) significantly larger amounts of 23 (/25) micronutrients (8 [/25] from foods and 22 [/25] from SMR). The diet was primarily composed of the following (by mass in descending order): unprocessed vegetables/fruits, whole grains, legumes, potatoes, nuts/seeds, MR, and spices/herbs. Conclusions Participants in our WFPB lifestyle program ingested a nutrient-rich WFPB diet and targeted supplementation. The presented ongoing community WFPB lifestyle program ensures a healthy, balanced, and environment-friendly dietary pattern for participants who are compliant.
Objective: To investigate the feasibility of a modified MCT-based ketogenic diet and its impact on plasma beta-hydroxybutyrate and MS outcomes compared to a modified Paleolithic diet and usual diet in people with Multiple Sclerosis (MS). Methods: Fifteen individuals with MS were randomized to 3 groups: 1) modified Paleolithic diet (Paleo; n = 6); 2) medium-chain triglyceride (MCT)-based ketogenic diet that included coconut as a fat source (Keto; n = 5); or 3) usual diet (Control; n = 4). Participants had blood drawn every 4 weeks to monitor nutritional ketosis. Participants completed 4-day weighed food records, measures of disability, fatigue, quality of life (QoL), cognitive function, and physical function at baseline and 12-weeks. Results: Macronutrient intake significantly shifted toward a ratio indicative of a ketogenic diet in the Keto group at 12 weeks. Similarly, plasma beta-hydroxybutyrate indicated nutritional ketosis in the Keto group, whereas neither macronutrient intake nor plasma beta-hydroxybutyrate indicated nutritional ketosis in the Paleo and Control groups. The Paleo group had significant within group reductions in fatigue scores and maintained cognitive function scores compared to the Control group. The Keto group had significant reductions in fasting glucose and insulin compared to baseline values; however, no clinical outcomes significantly changed. Conclusions: Participants consuming the MCT-based ketogenic diet achieved nutritional ketosis; however, it was not associated with significant clinical improvement in this study whereas the modified Paleolithic diet was associated with significant clinical improvements. Larger randomized controlled trials are needed to determine the safety and efficacy of the modified Paleolithic and MCT-based ketogenic diets on MS.
