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Category: nutrition

Published on Leave a comment on Peanut Allergies Can Be Successfully Treated In Young Children

Yes! Treating young children who have peanut allergies with doses of peanut protein (oral immunotherapy or OIT) for one month works in treating the peanut allergies in the overwhelming majority of young children in an important study. Several studies have now shown that early exposure to nuts is important for prevention of nut allergies, and in this study the researchers showed that both lower and higher dose oral immunotherapy works in treating nut allergies in young children (9 to 36 months of age). Note that this is a paradigm change - before this the thinking was avoid, avoid, avoid for the child to not get or to not worsen the allergy (whether nuts or animals), but now it's early exposure is good in preventing and treating allergies. From Futurity:

Can therapy before 3 wipe out a peanut allergy?

Preschool children with a peanut allergy were able to start eating peanuts after taking part in oral immunotherapy, a new study shows. The findings confirm and extend previous results that show oral immunotherapy (OIT) can protect children from potentially life-threatening anaphylaxis caused by peanut exposure.

The phase two clinical trial results, published online in the Journal of Allergy and Clinical Immunology, show that one month after completing the OIT protocol, almost 80 percent of trial participants achieved “sustained unresponsiveness,” the highest rate yet reported.

“These findings, if confirmed in larger studies, could transform the care of peanut-allergic children early in life,” says Brian P. Vickery, lead investigator of the trial and assistant professor of pediatrics at the University of North Carolina at Chapel Hill. Approximately three million people in the United States report having allergies to peanuts and tree nuts. According to a study released in 2013 by the Centers for Disease Control and Prevention, food allergies among children increased approximately 50 percent between 1997 and 2011.

The initial allergic reaction to peanuts commonly occurs within the first year or two of life, and the condition persists in 80 percent of affected patients, placing them at life-long risk of anaphylaxis. Based on other studies suggesting that peanut allergies strengthen over time, researchers enrolled 40 peanut-allergic children aged 9 to 36 months in the trial, the first study to specifically target children under the age of three.

Children were randomly assigned to high-dose peanut OIT with a target daily dose of 3,000 milligrams of peanut protein or a low-dose regimen with a target dose of 300 milligrams. The trial was double-blinded. Participants took 3,000 mg of study protein, but for the low-dose group, 2,700 mg of placebo was added to the OIT medication. As in previous studies, nearly all participants experienced some side effects, most of which were mild and required little or no treatment.

After receiving OIT for 29 months on average, participants abstained from peanut exposure for four weeks before undergoing a final peanut challenge—where participants ingest a small amount of peanut in a controlled setting. If the challenge is successful, then doctors reintroduce normal amounts of peanuts—such as in a peanut butter and jelly sandwich—into the diets of participants. After the four-week period, nearly 80 percent of children in both the high- and low-dose groups consumed peanut with no allergic response and achieved sustained unresponsiveness.

The OIT-treated children were compared with a matched control group of 154 peanut-allergic children who avoided peanut. The OIT-treated children experienced beneficial changes in their immune responses to peanut and were 19 times more likely to successfully incorporate peanut into their diets. 

Published on Leave a comment on Lifestyle Factors Influence Protein Buildups Linked to Alzheimer’s

  Again, another study showing the importance of lifestyle factors in the development of protein buildups in the brain that are associated with the onset of Alzheimer's disease. Specifically, the study found that each one of several lifestyle factors—a healthy body mass index, physical activity and a Mediterranean diet, were linked to lower levels of plaques and tangles on brain scans in people who already had mild memory changes, (but not dementia). Other posts discussing Mediterranean diet and brain health (brain volume, etc.) are here, here, and here. Activity levels and brain health posts are here, here, and here. From Medical Xpress:

Diet and exercise can reduce protein build-ups linked to Alzheimer's

A study by researchers at UCLA's Semel Institute for Neuroscience and Human Behavior has found that a healthy diet, regular physical activity and a normal body mass index can reduce the incidence of protein build-ups that are associated with the onset of Alzheimer's disease.

In the study, 44 adults ranging in age from 40 to 85 (mean age: 62.6) with mild memory changes but no dementia underwent an experimental type of PET scan to measure the level of plaque and tangles in the brain. Researchers also collected information on participants' body mass index, levels of physical activity, diet and other lifestyle factors. Plaque, deposits of a toxic protein called beta-amyloid in the spaces between nerve cells in the brain; and tangles, knotted threads of the tau protein found within brain cells, are considered the key indicators of Alzheimer's.

The study found that each one of several lifestyle factors—a healthy body mass index, physical activity and a Mediterranean diet—were linked to lower levels of plaques and tangles on the brain scans. (The Mediterranean diet is rich in fruits, vegetables, legumes, cereals and fish and low in meat and dairy, and characterized by a high ratio of monounsaturated to saturated fats, and mild to moderate alcohol consumption.)

"The fact that we could detect this influence of lifestyle at a molecular level before the beginning of serious memory problems surprised us," said Dr. David Merrill, the lead author of the study, which appears in the September issue of the American Journal of Geriatric Psychiatry.

Earlier studies have linked a healthy lifestyle to delays in the onset of Alzheimer's. However, the new study is the first to demonstrate how lifestyle factors directly influence abnormal proteins in people with subtle memory loss who have not yet been diagnosed with dementia, Merrill said. Healthy lifestyle factors also have been shown to be related to reduced shrinking of the brain and lower rates of atrophy in people with Alzheimer's."The study reinforces the importance of living a healthy life to prevent Alzheimer's, even before the development of clinically significant dementia," Merrill said. 

Published on Leave a comment on Tart Cherry Juice May Aid Recovery After Intense Exercise

Image result for cherries wikipedia Another study reporting health benefits of drinking tart cherry juice, specifically in speeding recovery following prolonged, repeat sprint activity (think soccer and rugby). The researchers found that after a prolonged, intermittent sprint activity, the cherry juice significantly lowered levels of Interleukin-6, a marker for inflammation and that there was a decrease in muscle soreness.  The study participants drank the cherry juice (1 oz cherry juice concentrate mixed with 100 ml water) for several days before and several days after the sprint activity. Montmorency tart cherry juice is a polyphenol rich food that is already used by many professional sports teams to aid recovery. From Medical Xpress:

New study: Montmorency tart cherry juice found to aid recovery of soccer players

Montmorency tart cherry juice may be a promising new recovery aid for soccer players following a game or intense practice. A new study published in Nutrients found Montmorency tart cherry juice concentrate aided recovery among eight semi-professional male soccer players following a test that simulated the physical and metabolic demands of a soccer game .The U.K. research team, led by Glyn Howatson at Northumbria University, conducted this double-blind, placebo-controlled study to identify the effects of Montmorency tart cherry juice on recovery among a new population of athletes following prolonged, intermittent exercise..... many teams in professional and international soccer and rugby already use Montmorency tart cherry juice to aid recovery."

The study involved 16 semi-professional male soccer players aged 21 to 29 who were randomly assigned to either a Montmorency tart cherry concentrate group or a placebo control group. Montmorency group participants consumed about 1 ounce (30 ml) of a commercially available Montmorency tart cherry juice concentrate mixed with 100 ml of water twice per day (8 a.m. and 6 p.m.) for seven consecutive days—for four days prior to the simulated trial and for three days after the trial. Following the same schedule, placebo group participants consumed a calorie-matched fruit cordial with less than 5 percent fruit mixed with water and maltodextrin. The 30 ml dosage of Montmorency tart cherry juice concentrate contained a total anthocyanin content of 73.5 mg, or the equivalent of about 90 whole Montmorency tart cherries.

Montmorency tart cherry juice, compared to a placebo, was found to maintain greater functional performance, impact a key marker of inflammation and decrease self-reported muscle soreness among study participants following prolonged activity that mirrors the demands of field-based sports. While additional research is needed, the authors suggest the dampening of the post-exercise inflammatory processes may be responsible.

Across every performance measure, including maximal voluntary isometric contraction, countermovement jump height, 20 m sprint time, knee extensors, 5-0-5 agility, the Montmorency group showed better performance than the placebo group. Additionally, the Montmorency group showed significantly lower levels of Interleukin-6, a marker for inflammation, particularly immediately post-trial. Ratings for muscle soreness (DOMS) were significantly lower in the Montmorency group across the 72-hour post-trial period. No significant effects in muscle damage or oxidative stress were observed in either the Montmorency group or the placebo group. These data support previous research showing similar results for athletes performing marathon running, high-intensity strength training, cycling, and metabolic exercise. 

Published on Leave a comment on Twin Study Finds Being Overweight Not Linked To Early Death or Heart Attack

Another interesting study looking at whether being overweight is linked to premature death, heart attacks, and diabetes. This study looked at sets of twins, in which one is heavier than the other, and followed them long-term (average 12.4 years) and found that NO - being overweight or obese (as measured by Body Mass Index or BMI) is NOT associated with premature death or heart attack (myocardial infarction), but it is associated with higher rates of type 2 diabetes. These results are in contrast with what a large study recently found. From Science Daily:

Higher BMI not associated with increased risk of heart attack or early death, twin study shows

A study of 4,046 genetically identical twin pairs with different amounts of body fat shows that twin siblings with a higher Body Mass Index, as a measure of obesity, do not have an increased risk of heart attack or mortality. The study, conducted by researchers at Umeå University in Sweden, also shows that a higher BMI is associated with an increased risk of type 2 diabetes...."The results suggest that lifestyle changes that reduce levels of obesity do not have an effect on the risk of death and heart attack, which contradicts conventional understandings of obesity-related health risks," says Peter Nordström, researcher at the Department of Community Medicine and Rehabilitation at Umeå University.

In the cohort study, Peter Nordström and research colleagues at Umeå University compared health data from 4,046 monozygotic twin pairs. All twins in the study had different levels of body fat, as measured in BMI....During a follow-up period of on average 12.4 years, differences between the twins were compared when it comes to incidents of mortality, heart attack and type 2 diabetes. The results clearly showed that twin siblings with a higher BMI did not have an increased risk of mortality or heart attack compared to their thinner counterparts. However, twins with a higher BMI did have an increased risk of developing type 2 diabetes.

The results showed that: - Among twin siblings with a higher BMI (mean value 25.1), there were 203 heart attacks (5 %) and 550 deaths (13.6 %) during the follow-up period. - Among twin siblings with a lower BMI (mean value 23.9), there were 209 heart attacks (5.2 %) and 633 deaths (15.6 %) during the same period. - Among the 65 twin pairs in the study who had a BMI difference of 7 or higher, and where the larger twin siblings had a BMI of 30 or higher, there were still no noticeably increased risk of mortality or heart attack associated with a higher BMI.

The study, described in the article Risks of Myocardinal Infarction, Death, and Diabetes in Identical Twin Pairs With Different Body Mass Index, is based on the Swedish Twin Registry, the largest of its kind in the world. The median age of the twins in the study was 57.5 and participants' ages ranged from 42-92. The cohort study was conducted between 1998 and 2003, with follow-ups regarding incident of mortality, heart attack and diabetes during a 10 year period until 2013. One study limitation was that weight and length (used to calculate BMI) was self-reported.

Published on Leave a comment on Frequent Nut Consumption Has Health Benefits

Studies have found that increased nut consumption has been associated with reduced risk of cardiovascular disease and type 2 diabetes. A newly published study looked at large groups of people to see if this was due to nuts reducing systemic inflammation throughout the body - which can be measured by inflammatory biomarkers such as C-reactive protein (CRP) and  interleukin 6 (IL6).

The researchers found that nut consumption was inversely associated with concentrations of biomarkers CRP and IL-6 - that is, the more nuts eaten weekly, the lower the inflammatory biomarkers. They also found that substituting nuts for red meat, processed meat, eggs, refined grains, potatoes, or potato chips was associated with a healthier inflammatory biomarker profile. In the study, one serving of nuts was equivalent to 28 g (1 oz) of peanuts or other nuts. What's in nuts? Unsaturated fatty acids, high quality plant protein, fiber, minerals, vitamins, bioactive compounds such as phytosterols, antioxidants, magnesium, etc. Bottom line: eat a serving of nuts at least several times a week. From Science Daily:

Frequent nut consumption associated with less inflammation

In a study of more than 5,000 people, investigators from Brigham and Women's Hospital have found that greater intake of nuts was associated with lower levels of biomarkers of inflammation, a finding that may help explain the health benefits of nuts. The results of the study appear July 27 in the American Journal of Clinical Nutrition.

"Population studies have consistently supported a protective role of nuts against cardiometabolic disorders such as cardiovascular disease and type 2 diabetes, and we know that inflammation is a key process in the development of these diseases," said corresponding author Ying Bao, MD, ScD, an epidemiologist in BWH's Channing Division of Network Medicine. "Our new work suggests that nuts may exert their beneficial effects in part by reducing systemic inflammation."

Previously Bao and her colleagues observed an association between increased nut consumption and reduced risk of major chronic diseases and even death, but few prospective cohort studies had examined the link between nut intake and inflammation. In the current study, the research team performed a cross-sectional analysis of data from the Nurses' Health Study, which includes more than 120,000 female registered nurses, and from the Health Professionals Follow-Up Study, which includes more than 50,000 male health professionals.... looked at the levels of certain telltale proteins known as biomarkers in blood samples collected from the study participants. They measured three well-established biomarkers of inflammation: C-reactive protein (CRP), interleukin 6 (IL6) and tumor necrosis factor receptor 2 (TNFR2).

After adjusting for age, medical history, lifestyle and other variables, they found that participants who had consumed five or more servings of nuts per week had lower levels of CRP and IL6 than those who never or almost never ate nuts. In addition, people who substituted three servings per week of nuts in place of red meat, processed meat, eggs or refined grains had significantly lower levels of CRP and IL6.

Peanuts and tree nuts contain a number of healthful components including magnesium, fiber, L-arginine, antioxidants and unsaturated fatty acids such as α-linolenic acid. Researchers have not yet determined which of these components, or if the combination of all of them, may offer protection against inflammation, but Bao and her colleagues are interested in exploring this further through clinical trials that would regulate and monitor diet.

Published on Leave a comment on Are Foods Containing Nanoparticles Safe To Eat?

 Did you know that some foods have nanoparticles added to them? Which foods? Nanoparticles in foods are ingredients so small that they are measured in nanometers or billionths of one meter. The most common nanoingredients are: titanium dioxide, silicon dioxide, and zinc oxide. What, if anything, do nanoingredients do to humans? That is, are there any effects from ingesting them? No one really knows. However, several articles in the past year raise a number of concerns, especially because so much is still unknown. Meanwhile the use of nanoingredients is unregulated in the U.S., and the number of foods with nanoingredients is growing rapidly.

Nanoparticles are typically used in foods as additives, flavorings, coloring, or even anti-bacterial coatings for packaging. It is thought that nanocoatings are being used on some fruits and vegetables. Even though ingredients such as titanium dioxide are considered to be "generally recognized as safe" (GRAS) before they're made into nanoparticles, the question is whether they’re safe in their nanoparticle form. This is because nanoparticles can exhibit new or altered properties at nanoscale dimensions. Some concerns about nanoparticles are that they are small enough to penetrate the skin, lungs, digestive system, and perhaps pass through the blood-brain barrier and placental-fetal barrier, and cause damage.

A 2016 report by Friends of The Earth reported finding nanoparticles in various brands of baby formulas. None listed nanoparticles as ingredients, but independent laboratory testing found the baby formulas to contain them. The Medscape article (below) reported on recent research  that suggested that nanoingredients can cause problems such as intestinal inflammation, especially for certain groups, such as those with intestinal bowel disease (IBD). According to the Science News article (below): "Tests show that on average more than one-third of the titanium dioxide in foods is in the form of nano-sized particles."

The Center For Food Safety states: "Bulk scale titanium dioxide is used as a food coloring agent, often to make foods look whiter or brighter, but the FDA has not set exposure limits yet for its use at the nano scale in the US. Moreover, the largest review of nano titanium dioxide studies show that many basic questions have not been answered. Candies like M&M’s, processed cheeses, and chewing gum have all been found to contain nano titanium dioxide.  Nano titanium dioxide is small enough to cross through the intestine and into organs where it can damage DNA and disrupt cell function." They have established a searchable data base of foods containing nanoparticles. The list is incomplete, but some popular foods containing nanoingredients (may not be on ingredient list, but lab tests found them) include: M&Ms, Lindt chocolate, Dannon Greek Plain Yogurt, Cadbury Milk Chocolate bars, Nabisco Chips Ahoy cookies, and Nabisco Oreos.

From Medscape [UPDATE: The Medscape link no longer works. Link to original study and to a discussion of the research in The Rheumatologist.]:  Titanium Dioxide Additives May Boost Intestinal Inflammation

Murine [mice] and other studies suggest that titanium dioxide (TiO2) nanoparticles, widely used as food additives and in drug formulations, may be involved in intestinal inflammation, according to Swiss researchers..... "It seems that titanium dioxide nanoparticles are not harmful for a healthy person with a normal intestinal barrier. But this may be different in an individual with impaired intestinal barrier function such as patients with inflammatory bowel disease (IBD).".... IBD is increasing in many nations undergoing westernization. Among possible causes are microparticles of agents such as Ti02, which are used to improve the appearance of products including food.

The researchers go on to point out that there is increasing evidence that exposure to TiO2 "can cause adverse effects, including the production of reactive oxygen species (ROS) inflammatory responses and tumor formation.".....Finally, wrote the investigators, "An increase of titanium burden in blood of patients with ulcerative colitis having active disease was found, evidencing an impaired barrier function and suggesting that TiO2 nanoparticles could pose a specific risk to patients with IBD." ...continue reading "Are Foods Containing Nanoparticles Safe To Eat?"

Published on Leave a comment on Weight Loss As Cancer Prevention Method?

Another excellent reason to lose weight if you are overweight or obese: losing weight (through diet or through combined diet and exercise) significantly lowers levels of proteins in the blood that help cancerous tumors grow. In other words, reducing weight could turn out to be a cancer prevention method in overweight and obese persons. Exercise alone did not lower the levels of these cancer-associated proteins.

The study enrolled 439 overweight or obese women (aged 50 to 75 years old) from the Seattle area who were randomly placed into one of four groups for 12 months: exercise only, diet only, exercise plus diet, or no change to health habits. Researchers measured three proteins in blood samples - VEGF, PAI-1 and PEDF – that flow through the body and help in the formation of new blood vessels, a process called angiogenesis. Angiogenesis can occur during such processes as wound healing, but it also occurs during the growth of tumors. Since the three measured proteins are involved in nurturing the growth and survival of tumor cells, this is a great reason to lose weight - to lower their levels in the blood. From Science Daily:

Losing weight lowered levels of proteins associated with tumor growth

Overweight or obese women who lost weight through diet or a combination of diet and exercise also significantly lowered levels of proteins in the blood that help certain tumors grow, according to a Fred Hutchinson Cancer Research Center study published July 14 in Cancer Research, a journal of the American Association for Cancer Research.

The study: Measured three proteins that are known to enhance tumor-related angiogenesis -- the formation of blood vessels that feed tumors and enable them to grow. Was intended to see how cancer-promoting proteins changed when overweight, sedentary, postmenopausal women lost weight through diet or diet and exercise over the course of a year. Enrolled 439 healthy women (they did not have cancer), placing each participant in one of four study arms: 1) Calorie- and fat-restricted diet. 2) Aerobic exercise five days a week. 3) Combined diet and exercise. 4) Control (no intervention).

Found that women in the diet arm and the diet and exercise arm lost more weight and had significantly lower levels of angiogenesis-related proteins, compared with women in the exercise-only arm and the control arm.

This study shows that weight loss may be a safe and effective way to improve the "angiogenic profile" of healthy individuals, meaning they would have lower blood levels of cancer-promoting proteins. Although the researchers cannot say for certain that this would impact the growth of tumors, they believe there could be an association between reduced protein levels and a less favorable environment for tumor growth.

Published on

Yup, according to a new mega-study, being overweight or obese is linked to higher risk of dying prematurely than being normal weight.  And the more you weigh, the greater the risk. This mega-study that looked at data from many studies and countries, also found that being underweight is linked to a higher risk of premature death. What's the best weight to be? A BMI of 22.5-<25 kg/m2 is considered a healthy weight range, and had the lowest mortality risk in the study. Being overweight was linked to higher rates of death from "all causes", and also from 4 major causes: coronary heart disease, stroke, respiratory disease, and cancer.

However, note that while other studies also agree that being underweight or obese increases the rate of dying prematurely, there is still some debate over whether being just overweight with BMI 25–<30 kg/m2 , really has a higher risk of dying prematurely. This was pointed out in the accompanying editorial in the journal Lancet (but not mentioned below). From Science Daily:

As overweight and obesity increase, so does risk of dying prematurely: Major study

Being overweight or obese is associated with a higher risk of dying prematurely than being normal weight -- and the risk increases with additional pounds, according to a large international collaborative study led by researchers at the Harvard T.H. Chan School of Public Health and the University of Cambridge, UK. The findings contradict recent reports that suggest a survival advantage to being overweight -- the so-called "obesity paradox."

The deleterious effects of excess body weight on chronic disease have been well documented. Recent studies suggesting otherwise have resulted in confusion among the public about what is a healthy weight. According to the authors of the new study, those prior studies had serious methodological limitations. One common problem is called reverse causation, in which a low body weight is the result of underlying or preclinical illness rather than the cause. Another problem is confounding by smoking because smokers tend to weigh less than nonsmokers but have much higher mortality rates.....Hu stressed that doctors should continue to counsel patients regarding the deleterious effects of excess body weight, which include a higher risk of diabetes, cardiovascular disease, and cancer.

For the new study, consortium researchers looked at data from more than 10.6 million participants from 239 large studies, conducted between 1970 and 2015, in 32 countries. A combined 1.6 million deaths were recorded across these studies, in which participants were followed for an average of 14 years. For the primary analyses, to address potential biases caused by smoking and preexisting diseases, the researchers excluded participants who were current or former smokers, those who had chronic diseases at the beginning of the study, and any who died in the first five years of follow-up, so that the group they analyzed included 4 million adults. They looked at participants' body mass index (BMI) -- an indicator of body fat calculated by dividing a person's weight in kilograms by their height in meters squared (kg/m2).

The results showed that participants with BMI of 22.5-<25 kg/m2 (considered a healthy weight range) had the lowest mortality risk during the time they were followed. The risk of mortality increased significantly throughout the overweight range: a BMI of 25-<27.5 kg/m2 was associated with a 7% higher risk of mortality; a BMI of 27.5-<30 kg/m2 was associated with a 20% higher risk; a BMI of 30.0-<35.0 kg/m2 was associated with a 45% higher risk; a BMI of 35.0-<40.0 kg/m2 was associated with a 94% higher risk; and a BMI of 40.0-<60.0 kg/m2 was associated with a nearly three-fold risk. Every 5 units higher BMI above 25 kg/m2 was associated with about 31% higher risk of premature death. Participants who were underweight also had a higher mortality risk.

Looking at specific causes of death, the study found that, for each 5-unit increase in BMI above 25 kg/m2, the corresponding increases in risk were 49% for cardiovascular mortality, 38% for respiratory disease mortality, and 19% for cancer mortality. Researchers also found that the hazards of excess body weight were greater in younger than in older people and in men than in women.

Published on Leave a comment on Gut Bacteria Imbalance and Diabetes

Another view of  type 2 diabetes - that the gut microbiome is involved, specifically two gut bacteria: Prevotella copri and Bacteroides vulgatus. View them as the bad guys. The researchers point out "... the majority of overweight and obese individuals are insulin resistant and it is well known that dietary shifts to less calorie-dense eating and increased daily intake of any kind of vegetables and less intake of food rich in animal fat tend to normalize imbalances of gut microbiota and simultaneously improve insulin sensitivity of the host." In other words, eat more vegetables and fewer calories (if you're overweight or obese) to improve the gut microbes. This is similar to yesterday's post of research that viewed type 2 diabetes as "a response to overnutrition" and potentially reversible. From Medical Express:

Gut bacteria imbalance increases diabetes risk

Currently, scientists think the major contributors to insulin resistance are excess weight and physical inactivity, yet ground-breaking new research by an EU funded European-Chinese team of investigators called MetaHit have discovered that specific imbalances in the gut bacteria can cause insulin resistance, which confers an increased risk of health disorders like type 2 diabetes.

We show that specific imbalances in the gut microbiota are essential contributors to insulin resistance, a forerunner state of widespread disorders like type 2 diabetes, hypertension and atherosclerotic cardiovascular diseases, which are in epidemic growth," says Professor Oluf Pedersen, Metabolism Center, University of Copenhagen, and senior lead author of the paper.

In the Danish study of 277 non-diabetic individuals and 75 type 2 diabetic patients, there was close collaboration between the University of Copenhagen and the Technical University of Denmark with extensive international participation from a team of investigators, who performed analyses of the action of the insulin hormone. They monitored the concentrations of more than 1200 metabolites in blood and did advanced DNA-based studies of hundreds of bacteria in the human intestinal tract to explore if certain imbalances in gut microbiota are involved in the causation of common metabolic and cardiovascular disorders.

The researchers observed that people who had a decreased capacity of insulin action, and therefore were insulin resistant, had elevated blood levels of a subgroup of amino acids called branched-chain amino acids (BCAAs). Importantly, the rise of BCAAs levels in blood was related to specific changes in the gut microbiota composition and function.

The main drivers behind the gut bacterial biosynthesis of BCAAs turned out to be the two bacteria Prevotella copri and Bacteroides vulgatus. To test mechanistically if gut bacteria were a true cause of insulin resistance, the researchers fed mice with the Prevotella copri bacteria for 3 weeks. Compared with sham fed mice the Prevotella copi fed mice developed increased blood levels of BCAAs, insulin resistance and intolerance to glucose.

"Most people with insulin resistance do not know that they have it. However, it is known that the majority of overweight and obese individuals are insulin resistant and it is well known that dietary shifts to less calorie-dense eating and increased daily intake of any kind of vegetables and less intake of food rich in animal fat tend to normalize imbalances of gut microbiota and simultaneously improve insulin sensitivity of the host," adds Pedersen. (Original study)

Published on Leave a comment on Type 2 Diabetes May Be Reversible

This study gives hope to those with type 2 diabetes that it may be reversible - even if they've had it for up to 10 years. Researchers demonstrated that in 40% of the 30 study participants on a very low calorie diet (VLCD) of 600 to 700 calories daily for 8 weeks achieved remission of their diabetes for as long as 6 months (the length of the study). They returned to nondiabetic blood glucose levels, had improvement in acute insulin secretion, normalization of liver fat content and insulin sensitivity, and were off all diabetes medicine. The average weight loss was 31 pounds and they maintained this weight loss over the length of the study, even though most remained obese or overweight. The researchers mention that there is already evidence that diabetes reversal lasts for at least 3 years, as long as weight is not regained.

What they did: A) 3 diet shakes per day and 240 grams (1 cup or 1/2 pound) of non-starchy vegetables taking in between 600 and 700 calories per day for 8 weeks, B) volunteers then gradually returned to eating normal food over the next two weeks with very careful instruction on how much to eat, C) volunteers were seen once a month and supported with an individualized weight maintenance program over the next 6 months, D) to keep weight steady after the weight loss, they were eating around one third less than before the study.

Overall, 12 patients who had had diabetes for less than 10 years reversed their condition, and 6 months later they remained diabetes free. In fact, after 6 months a thirteenth patient had reversed their diabetes. The 30 people with diabetes in the study had it between 0.5 and 23 years. The best results were in those who had it for a shorter time. Thus, while 40% of study participants overall reversed their diabetes, 60% of those with short-duration of diabetes (under 10 years) reversed their diabetes. These are fantastic results!

The researchers say that the study results "...supports our theory of a Personal Fat Threshold. If a person gains more weight than they personally can tolerate, then diabetes is triggered, but if they then lose that amount of weight then they go back to normal. Individuals vary in how much weight they can carry without it seeming to affect their metabolism -- don't forget that 70% of severely obese people do not have diabetes." The researchers say type 2 diabetes can now be understood to be a metabolic syndrome that is potentially reversible by substantial weight loss, and that this is an important paradigm shift. They also comment that studies and population data indicate that type 2 diabetes is solely a response to overnutrition.

Excerpts from Diabetes Care:  Very Low-Calorie Diet and 6 Months of Weight Stability in Type 2 Diabetes: Pathophysiological Changes in Responders and Nonresponders.

Type 2 diabetes mellitus (T2DM) is generally regarded as an irreversible chronic condition. Because a very low-calorie diet (VLCD) can bring about acute return to normal glucose control in some people with T2DM, this study tested the potential durability of this normalization. The underlying mechanisms were defined.

People with a T2DM duration of 0.5-23 years (n = 30) followed a VLCD for 8 weeks. All oral agents or insulins were stopped at baseline.....Weight fell (98.0 ± 2.6 to 83.8 ± 2.4 kg) and remained stable over 6 months (84.7 ± 2.5 kg). Twelve of 30 participants achieved fasting plasma glucose <7 mmol/L after return to isocaloric diet (responders), and 13 of 30 after 6 months. Responders had a shorter duration of diabetes and a higher initial fasting plasma insulin level....A robust and sustainable weight loss program achieved continuing remission of diabetes for at least 6 months in the 40% who responded to a VLCD by achieving fasting plasma glucose of <7 mmol/L. T2DM is a potentially reversible condition.

However, restoration of normal glucose control is possible after weight loss in some individuals with T2DM . Although most commonly seen after bariatric surgery, reversal of diabetes can occur after any sharp decrease in calorie intake. In short-duration T2DM, fasting plasma glucose becomes normal within days on a very-low-calorie diet (VLCD) because of a rapid decrease in liver fat and return of normal hepatic insulin sensitivity, and normal b-cell function returns over 8 weeks.

This prospective, longitudinal, single center study comprised three phases: VLCD for 8 weeks; a stepped return to isocaloric intake of normal food over 2 weeks; and a structured, individualized weight maintenance program over 6 months. Assessments were carried out before the VLCD, after return to isocaloric eating, and at the end of the 6-month follow-up. The primary outcome measure was fasting blood glucose at 6 months in the group achieving nondiabetic levels after VLCD and return to normal eating, and the primary comparison was the change between post– weight loss and 6 months in responders.

We demonstrate that in 40% of study participants who responded to a VLCD by achieving fasting plasma glucose ,7 mmol/L, remission of T2DM lasts for at least 6 months. Return to nondiabetic blood glucose levels was characterized by improvement in acute insulin secretion, and this was sustained while off all hypoglycemic agents. Hepatic insulin sensitivity improved in both responders and nonresponders....Weight loss brought about normalization of liver fat content and insulin sensitivity in both responders and nonresponders. Of note, no redistribution of fat was seen to the liver from the subcutaneous or other deposits over 6 months of weight stability, even though the participants remained obese or overweight.

The present demonstration of ongoing reversal of T2DM (in 41% of the cohort overall or 60% of individuals with short-duration diabetes) is reflected in population data that indicate that T2DM is solely a response to overnutrition. Ready access to low-cost food is uniformly accompanied by high rates of T2DM, and when food supply becomes limited for any reason, the prevalence of T2DM falls.....The present data confirm reversal of T2DM for at least 6 months in those who achieve nondiabetic plasma glucose levels after VLCD. However, the critical question for health-care delivery is whether truly long-term reversal of T2DM can be achieved in primary care.

The likelihood of VLCD responders remaining free of diabetes indefinitely must be considered. After media coverage of our earlier study, many people with T2DM reversed their own diabetes (37). For such motivated individuals who avoid weight regain, maintenance of normoglycemia for up to 3 years has been reported.... Because progression of longterm complications of diabetes relates to ambient blood glucose control, durable reversal of diabetes would be expected to be associated with longterm health. T2DM can now be understood to be a metabolic syndrome potentially reversible by substantial weight loss, and this is an important paradigm shift.