scholarly journals Baseline HOMA IR and Circulating FGF21 Levels Predict NAFLD Improvement in Patients Undergoing a Low Carbohydrate Dietary Intervention for Weight Loss: A Prospective Observational Pilot Study

Nutrients ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 2141 ◽  
Author(s):  
Mikiko Watanabe ◽  
Renata Risi ◽  
Elisabetta Camajani ◽  
Savina Contini ◽  
Agnese Persichetti ◽  
...  
Keyword(s):  
Weight Loss ◽  
Liver Disease ◽  
Dietary Intervention ◽  
Fibroblast Growth Factor 21 ◽  
Obese Patients ◽  
Anthropometric Parameters ◽  
Alcoholic Fatty Liver ◽  
Low Carbohydrate Diet ◽  
Ketogenic Diets ◽  
Low Carbohydrate

Background: Non-alcoholic fatty liver disease (NAFLD) is a major cause of liver disease. Very low-calorie ketogenic diets (VLCKD) represent a feasible treatment as they induce profound weight loss and insulin resistance (IR) improvement. Despite the recognized benefits on NAFLD deriving from pharmacological administration of fibroblast growth factor 21 (FGF21), whose endogenous counterpart is a marker of liver injury, little is known about its physiology in humans. Aim: To identify predictors of NAFLD improvement as reflected by the reduction of the non-invasive screening tool hepatic steatosis index (HSI) in obese patients undergoing a weight loss program. Methods: Sixty-five obese patients underwent a 90-day dietary program consisting of a VLCKD followed by a hypocaloric low carbohydrate diet (LCD). Anthropometric parameters, body composition, and blood and urine chemistry were assessed. Results: Unlike most parameters improving mainly during the VLCKD, the deepest HSI change was observed after the LCD (p = 0.02 and p < 0.0001, respectively). Baseline HOMA-IR and serum FGF21 were found to be positive (R = 0.414, p = 0009) and negative (R = 0.364, p = 0.04) independent predictors of HSI reduction, respectively. Conclusions: We suggest that patients with IR and NAFLD derive greater benefit from a VLCKD, and we propose a possible role of human FGF21 in mediating NAFLD amelioration following nutritional manipulation.

scholarly journals A 12-week multi-component dietary intervention improves markers of non-alcoholic fatty liver disease in Irish patients in tertiary care

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Deirdre Ní Fhloinn ◽  
Ciara Wright ◽  
Sara Naimimohasses ◽  
Stephen Finn ◽  
Suzanne Norris ◽  
...  
Keyword(s):  
Weight Loss ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Dietary Intervention ◽  
Tertiary Care ◽  
Intervention Group ◽  
Post Intervention ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease

AbstractNon-alcoholic fatty liver disease (NAFLD) is a significant public health concern closely linked to obesity, affecting an estimated 25% of adults in Europe. Understudied in Ireland, the aim of this research was to examine the effects of a 12-week multi-component dietary intervention on weight loss and markers of liver injury in Irish NAFLD patients in tertiary care. Biopsy confirmed NAFLD patients (n = 27) were recruited from St James’ Hospital in Dublin, Ireland. Consenting participants underwent a 12-week moderate-intensity intervention incorporating weekly group nutritional education, behavioural change and group support, as well as individualised advice and weigh-ins from a trained nutritionist. Control group participants were given routine clinical care. All participants were clinically reviewed before, immediately after, and 3 months post intervention. Individuals (n = 12) with histological evidence of steatohepatitis underwent a repeat liver biopsy on completion of the intervention. Detailed dietary assessment was performed using both a 4-day diet diary (4DDD) and a novel, recently validated, short food frequency questionnaire (SFFQ) designed specifically to assess habitual intakes of food items related to NAFLD. Nutrient intakes were analysed using myFood24TM dietary analysis software, and the Mediterranean diet quality score (MDQS) was used to assess the overall change in dietary patterns. Of the 15 participants who completed the intervention, 80% (n = 12) achieved a weight loss exceeding 5%, with 47% (n = 7) achieving > 7%. There were significant improvements from baseline to week 12 in the intervention group for the majority of clinical parameters including HbA1c (p = 0.0054), liver enzymes (ALT, p = 0.0108; GGT, p = 0.0001) and transient elastography (kPA, p = 0.0308; CAP, p = 0.0081). However, these results failed to maintain significance when analysed compared to controls. The overall dietary pattern was significantly improved after 12 weeks as assessed by the MDQS (p = 0.03), with no apparent compromise in micronutrient intake despite the energy reduction. Reductions in energy, saturated fat, carbohydrate and sugar intakes at 12 weeks, were maintained at three months follow up. Analysis of pre- and post-intervention liver biopsies in the intervention group demonstrated a clinically significant improvement in NAS score (p = 0.0273), attributable to reductions in hepatic steatosis (p = 0.0078). A significant correlation was observed between improvement in liver histology and change in sugar intake (r = 0.7534, p = 0.0093). Although results were somewhat limited by small sample size, nutritional education achieved beneficial dietary changes that persisted after the intervention ceased. Notably, achieving reductions in sugar intakes may be particularly beneficial in reducing the severity of hepatic steatosis in Irish adults with NAFLD.

scholarly journals Halo effect of a weight-loss trial on spouses: the DIRECT-Spouse study

2009 ◽  
Vol 13 (4) ◽  
pp. 544-549 ◽  
Author(s):  
Rachel Golan ◽  
Dan Schwarzfuchs ◽  
Meir J Stampfer ◽  
Iris Shai
Keyword(s):  
Weight Loss ◽  
Weight Change ◽  
Dietary Intervention ◽  
Controlled Trial ◽  
Halo Effect ◽  
Research Centre ◽  
Food Groups ◽  
Low Fat ◽  
Low Carbohydrate Diet ◽  
Low Carbohydrate

AbstractObjectiveWe examined the halo effect of a 2-year weight-loss diet trial, the Dietary Intervention Randomized Controlled Trial (DIRECT), on the weight and nutritional patterns of participants' spouses.DesignDIRECT participants in a research centre workplace were randomly assigned to one of three diets: Low-fat, Mediterranean or Low-carbohydrate. A sample of wives of the DIRECT participants, who attended support update meetings specific to their husband's diet during the first 6 months, were followed for 2 years.SettingSouth Israel.SubjectsSeventy-four women (mean age = 51 years, mean BMI =26·6 kg/m2).ResultsAmong the wives of husbands randomised to the Low-fat, Mediterranean and Low-carbohydrate diet, self-reported weight change was respectively −1·48 kg, −2·30 kg and −4·62 kg after 6 months, and +0·39 kg, −3·00 kg and −2·30 kg after 2 years. Weight loss among wives whose husbands were in the alternative diet groups combined (Mediterranean+Low-carbohydrate) was significantly greater than among wives whose husbands were in the Low-fat group after 6 months (P = 0·031) and 2 years (P = 0·034). Overweight wives experienced more weight loss. The weight change of couples was significantly correlated (r = 0·42, P < 0·001). Across all dietary groups, wives had significant improvement in their dietary patterns in all food groups according to their husbands' diets, mainly by a larger significant decrease in carbohydrate consumption in the Low-carbohydrate group (P = 0·013 compared to Low-fat). Six-month weight change among the seventy-four DIRECT participants whose wives took part in the group support sessions was −5·2 kg, compared to −3·5 kg among the 248 DIRECT participants whose wives did not take part in these sessions (P = 0·020).ConclusionsFocusing on the couple as a unit could provide a cost-effective approach to weight-loss programmes.

Interim analysis of a prospective randomized trial of dietary carbohydrate restriction for men with a rising PSA after failed primary treatment: Carbohydrate and Prostate Study 2 (CAPS2).

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 382-382
Author(s):  
Stephen J. Freedland ◽  
Jenifer Allen ◽  
Andrew J. Armstrong ◽  
Judd W. Moul ◽  
Howard M. Sandler ◽  
...  
Keyword(s):  
Weight Loss ◽  
Interim Analysis ◽  
Dietary Intervention ◽  
Local Treatment ◽  
Carbohydrate Restriction ◽  
Dietary Carbohydrate ◽  
Carbohydrate Diet ◽  
Curative Intent ◽  
Low Carbohydrate Diet ◽  
Low Carbohydrate

382 Background: Nearly one third of men treated with curative intent for localized prostate cancer (PC) will develop a rising PSA. The rate of PSA rise (PSA doubling time aka PSASDT) is a predictor metastases and PC death. In laboratory mice, an extreme low carbohydrate diet slows PC growth. We tested whether this diet could slow PSADT in men with recurrent PC. Methods: We are conducting a 6-month multi-center randomized phase II trial of dietary carbohydrate restriction vs. no diet intervention control. Men had to have a BMI ≥24 kg/m2, received radical prostatectomy or definitive local radiation for PC, had a PSA 0.4-20.0 ng/ml (3-20 if prior radiation therapy) within the past 3 months, and current PSADT 3-36 months. The intervention arm was instructed to eat < 20 grams/carbs/day with no other limits. The control arm was told to make no diet. In this interim analysis, we present the efficacy of the dietary intervention with regards to weight loss. Arms were compared using rank-sum. Total anticipated enrollment is 60. The primary outcome is differences in PSADT between arms. Secondary outcomes include weight loss, and dietary make-up. Results: To date, 28 patients (14 in each study arm) have completed the study. Characteristics were well-balanced at baseline. At the 6-month dietary assessment, calorie consumption was similar between the two study arms (p = 0.090) among the 16 patients (7 low-carb, 9 control) with diet information. Subjects in the low-carb arm ate fewer carbs (29 vs. 188 g, p = 0.008) and more protein (125 vs. 73 g, p = 0.044) but similar amounts of fat (75 vs. 67 g, p = 0.672) vs. subjects in the control arm. Six months on the low carb diet resulted in greater weight loss (median: 31.7 vs. 0.8 lbs, p < 0.001), lower BMI (24.4 vs. 29.6 kg/m2, p < 0.001), and smaller waist circumference (95.7 vs. 108.9 cm, p = 0.002). Conclusions: In this interim analysis of an on-going dietary study for men with a rising PSA after definitive local treatment, an extreme low carbohydrate diet results in dramatic weight loss in 6 months. Whether this weight loss slows PC growth is an on-going question. Clinical trial information: NCT01763944.

scholarly journals Surgically induced weight loss by gastric bypass improves non alcoholic fatty liver disease in morbid obese patients

2012 ◽  
Vol 4 (12) ◽  
pp. 382 ◽  
Author(s):  
Víctor Vargas ◽  
Helena Allende ◽  
Albert Lecube ◽  
Maria Teresa Salcedo ◽  
Juan A Baena-Fustegueras ◽  
...  
Keyword(s):  
Weight Loss ◽  
Gastric Bypass ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Obese Patients ◽  
Alcoholic Fatty Liver ◽  
Morbid Obese ◽  
Surgically Induced ◽  
Alcoholic Fatty Liver Disease

scholarly journals Very Low-Carbohydrate Ketogenic Diet for the Treatment of Severe Obesity and Associated Non-Alcoholic Fatty Liver Disease: The Role of Sex Differences

Nutrients ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2748 ◽  
Author(s):  
Marco D’Abbondanza ◽  
Stefano Ministrini ◽  
Giacomo Pucci ◽  
Elisa Nulli Migliola ◽  
Eva-Edvige Martorelli ◽  
...  
Keyword(s):  
Weight Loss ◽  
Sex Differences ◽  
Liver Disease ◽  
Fatty Liver Disease ◽  
Severe Obesity ◽  
Menopausal Status ◽  
Alcoholic Fatty Liver ◽  
Significant Difference ◽  
Low Carbohydrate ◽  
Alcoholic Fatty Liver Disease

Very low-carbohydrate ketogenic diets (VLCKDs) are an emerging nutritional treatment for severe obesity and are associated with a significant improvement in non-alcoholic fatty liver disease (NAFLD). Little is known about the effect of sex differences on weight loss induced by following a VLCKD. The aim of this study was to investigate the effects of sex differences on weight loss and NAFLD improvement in patients with severe obesity undergoing a VLCKD. Forty-two females and 28 males with severe obesity underwent a 25-day VLCKD. Anthropometric parameters, bioimpedentiometry, degree of liver steatosis measured by ultrasonography, liver function tests, and glucose homeostasis were measured before and after the VLCKD. Males experienced a significantly larger excess body weight loss (EBWL) and a greater reduction in γ-glutamyl transferase (γGT) than females. Dividing the female group by menopausal status, a significant difference between males and pre-menopausal females was found for both EBWL and γGT. No significant difference between groups was observed for improvement in the Edmonton stage or in the degree of steatosis. We conclude that the efficacy of following a VLCKD in severe obesity is affected by sex differences and, for females, by menopausal status. Males seem to experience larger benefits than females in terms of EBWL and NAFLD improvement. These differences are attenuated after menopause, probably because of changes in hormonal profile and body composition.

scholarly journals Very Low-Calorie Ketogenic Diet: A Safe and Effective Tool for Weight Loss in Patients with Obesity and Mild Kidney Failure

Nutrients ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 333 ◽  
Author(s):  
Adriano Bruci ◽  
Dario Tuccinardi ◽  
Rossella Tozzi ◽  
Angela Balena ◽  
Silvia Santucci ◽  
...  
Keyword(s):  
Weight Loss ◽  
Kidney Function ◽  
Kidney Failure ◽  
Dietary Intervention ◽  
Real Life ◽  
Average Weight ◽  
Efficacy And Safety ◽  
Anthropometric Parameters ◽  
Low Calorie ◽  
Ketogenic Diets

Very low-calorie ketogenic diets (VLCKD) are an effective and increasingly used tool for weight loss. Traditionally considered high protein, ketogenic diets are often looked at with concern by clinicians due to the potential harm they pose to kidney function. We herein evaluated the efficacy and safety of a VLCKD in patients with obesity and mild kidney failure. A prospective observational real-life study was conducted on ninety-two patients following a VLCKD for approximately 3 months. Thirty-eight had mild kidney failure and fifty-four had no renal condition and were therefore designated as control. Anthropometric parameters, bioelectrical impedance and biochemistry data were collected before and at the end of the dietary intervention. The average weight loss was nearly 20% of initial weight, with a significant reduction in fat mass. We report an improvement of metabolic parameters and no clinically relevant variation regarding liver and kidney function. Upon stratification based on kidney function, no differences in the efficacy and safety outcomes were found. Interestingly, 27.7% of patients with mild renal failure reported normalization of glomerular filtrate after dietary intervention. We conclude that, when conducted under the supervision of healthcare professionals, a VLCKD is an effective and safe treatment for weight loss in patients with obesity, including those affected by mild kidney failure.

Multidisciplinary Weight Loss Programs Lead to Statistically Significant Reductions in Liver Enzyme Levels in Obese Patients with Non-Alcoholic Fatty Liver Disease

2017 ◽  
Vol 152 (5) ◽  
pp. S687
Author(s):  
Tiffany E. Schwasinger-Schmidt ◽  
Bobbie Paull-Forney ◽  
Milan Bimali ◽  
Nathan Tofteland ◽  
William Salyers ◽  
...  
Keyword(s):  
Weight Loss ◽  
Liver Disease ◽  
Fatty Liver ◽  
Liver Enzyme ◽  
Fatty Liver Disease ◽  
Obese Patients ◽  
Alcoholic Fatty Liver ◽  
Weight Loss Programs ◽  
Alcoholic Fatty Liver Disease

scholarly journals The Potential Roles of Very Low Calorie, Very Low Calorie Ketogenic Diets and Very Low Carbohydrate Diets on the Gut Microbiota Composition

2021 ◽  
Vol 12 ◽  
Author(s):  
Mariangela Rondanelli ◽  
Clara Gasparri ◽  
Gabriella Peroni ◽  
Milena Anna Faliva ◽  
Maurizio Naso ◽  
...  
Keyword(s):  
Weight Loss ◽  
Gut Microbiota ◽  
Fecal Microbiota ◽  
Microbiota Composition ◽  
Fecal Microbiome ◽  
Low Calorie ◽  
Low Carbohydrate Diet ◽  
Ketogenic Diets ◽  
Low Carbohydrate ◽  
Gut Microbiota Composition

Several studies have described a strong correlation between diet, weight loss, and gut microbiota composition. The aim of this review was to evaluate the potential effects of energy-restricted diets, namely very low calorie diets (VLCDs), very low calorie ketogenic diets (VLCKDs), and very low carbohydrate diets (VLCarbDs), on the composition of the gut microbiota in humans. We performed a literature search using the following terms (with their abbreviations or acronyms): “very low calorie diet”, “very low calorie ketogenic diet”, “very low carbohydrate diet”, and “gut microbiota”. Our search strategy retrieved nine eligible studies. Overall, VLCDs and VLCarbDs affected the Bacteroidetes to Firmicutes ratio in obese patients, leading to a reduction in short-chain fatty acid production by fecal microbiota associated with Clostridial cluster XIVa. This reduction particularly affected Roseburia and Eubacterium rectale, the two most abundant butyrate-producing bacteria in human feces. VLCKDs preserved the core fecal microbiome, but altered the composition of fecal microbial populations in relation to the plasma metabolome and fecal bile acid composition. In particular, VLCKD-induced weight loss resulted in a reduction in E. rectale and Roseburia, an increase in Christensenellaceae and Akkermansia while not all studies show a decrease in Faecalibacterium prausnitzii. Although very few studies have analyzed the effects of VLCarbDs and VLCDs on gut microbiota, significant diet-induced changes in fecal microbiota composition have been observed. Further studies are needed.

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