Intermittent Fasting Can Lead to Weight Loss, Improvements in Type 2 Diabetes and the Cardiovascular System

Since diet is a key element in weight loss, weight maintenance, and overall health, a lot of research has gone into looking at different types of diets. One diet approach that has received much attention in the past several years is the intermittent fasting (IF) diet. Usually, in the IF diet, an individual follows a very low or zero calorie plan for some period, and a normal eating plan at other times. The diet can lead to weight loss. And IF studies have determined that the IF diets can be effective in glycemic control and cardiovascular improvements.

One study consisted of a control group and two intervention groups. One of the intervention groups followed a protocol using a 600 calorie diet for two days a week, and the other intervention group followed a protocol using a 600 calorie diet for 4 days a week. On the non-calorie-restricted days of the week, the participants in both intervention groups were free to eat anything they wanted.

At the end of the twentieth week, participants in both intervention groups showed a decrease in HbA1c and insulin resistance. Further, a 29% "diabetes remission without ... medication" was seen in both groups.

And another study indicated that the 5:2 IF diet, where a person follows a 500-to-600 calorie diet on two days of the week, and a normal diet on the other days of the week, is a beneficial diet. The diet allows an individual to lose weight and lower the risk of cardiovascular disease. In fact, the study’s investigators “found that following weight loss, participants in the 5:2 group continue to eliminate fats (triglycerides) faster and more effectively than other volunteers. Scientists have also noticed a greater reduction in arterial systolic pressure associated with decreased risk of heart attack and stroke.”

So, healthcare providers might want to add IF to their weight loss tools. Not only could IF enable some patients to lose weight, but the weight loss approach might also lead to improvement in type 2 diabetes and cardiovascular conditions.

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Choose a Healthful Plant-Based Diet

Today, many people are following plant-based diets. These diets appear to be beneficial in combating many chronic diseases, including obesity, high blood pressure, and chronic kidney disease. One study has indicated that a plant-based diet is effective in lowering the risk for coronary heart disease (CHD). However, plant-based diets are most beneficial when the diet is a healthful plant-based diet.

So, first of all, what exactly is a plant-based diet? Depending on who you talk to, a plant-based diet can be anything from a semi-vegetarian diet, consisting of very small portions of animal products, to a vegan diet, consisting of absolutely no animal products. At any rate, compared to diets that include a goodly number of animal products, healthful plant-based diets appear to be significantly helpful in lowering CHD.

So, what is a healthful plant-based diet? Well, a healthful plant-based diet is a diet that is a diet focused on the consumption of foods such as fruits, vegetables, whole grains, nuts legumes and oils. A less healthful plant-based diet, for example, is a diet involving the large consumption of juices, refined grains and french fries.

To determine how a healthful plant-based diet can prevent CHD, in one study, researchers followed over 200,000 participants who had no CHD, stroke or coronary artery surgery. The participants were free of most cancers. The participants were asked to fill out a "questionnaire every 2 years on lifestyle, health behaviors, and mental health ... "

The researchers concluded that individuals that followed a diet, built around healthful plant foods, had a lower risk of CHD than those individuals that followed a diet containing less healthful plant foods.

Indeed, there are indications that the use of a healthful plant-based diet can improve health, in general, and CHD risk factors in particular. The evidence creates an opportunity for cardiologists and other healthcare providers. Therefore, healthcare providers should learn more about healthful plant-based diets and how to counsel patients on the benefits that can be gained from the diets.

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Alpha-Lipoic Acid Plus Probiotics May Improve Weight Loss Maintenance

Alpha-Lipoic acid or ALA is an antioxidant that is made in our bodies. ALA works to protect our cells. Probiotics are bacteria and yeasts that live in our bodies. Although some bacteria that live in our bodies are unhealthy, probiotics improve our health. And one study has shown that the combination of ALA supplements and probiotics supplements may enable individuals to maintain weight loss.

There has not been a lot of research on ALA. But some believe that ALA can treat HIV, diabetes and improve weight loss. Probiotics are thought to “balance your ‘good’ and ‘bad’ bacteria to keep your body working the way it should.”

The above referenced study, which combined ALA with probiotics, consisted of 88 overweight participants. The study was carried out in two phases. The participants were divided into groups, and put on different combinations, using low calorie diets, normal diets, ALA and probiotics.

In the first phase, one group was put on an isocaloric diet plus 500 mg of probiotics, one group was put on an isocaloric diet with ALA plus 600 mg of probiotics, one group was put on an isocaloric diet with ALA, and one group was put on an isocaloric diet with a placebo. And during phase 2, the participants were put on normal diets with ALA and probiotics supplements.

Measurements such as weight, BMI, hip circumference and waist circumference were taken and monitored. At the end of the study, the groups on ALA plus probiotics lost significantly more weight than the other groups. The ALA plus probiotics groups also were able to maintain weight loss better than the groups not on the ALA plus probiotics combination.

Of course, more research is needed to determine how the ALA plus probiotics combination works. Indeed, more research into ALA is also needed. But the ALA plus probiotics combination could, potentially, be another weapon in the weight loss and weight maintenance toolbox. The combination could be especially helpful in weight maintenance, since weight maintenance is considered to be more difficult than weight loss. At any rate, healthcare providers should consider the combination of ALA plus probiotics.

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The DASH Diet Might Lower Breast Cancer Risk

The DASH diet's name stands for “Dietary Approaches to Stop Hypertension.” As the name implies, the diets' objective is to lower high blood pressure. And, in general, the diet is considered to be a healthy pattern of eating that can lower blood pressure. The DASH diet or eating pattern may also lower the risk of breast cancer, according to one study.

The DASH diet puts a special focus on eating fruits, vegetables and whole grains. The diet also emphasizes protein from fish, poultry and nuts. These foods are high in calcium, protein, potassium and fiber. These nutrients are known to help lower blood pressure. Further, after looking at the top diets in use in 2021, the U.S.News rated the DASH diet as the second best overall diet. The U.S.News indicated that the diet puts limitations on saturated fats and salt. And that individuals who follow the DASH diet will eventually lower their salt consumption to about 1500 mg per day.

For the DASH-breast-cancer study mentioned above, researchers established two groups: one group consisted of 477 participants with breast cancer and the other group consisted of 507 healthy participants. The healthy participants were the control group. The study was done at the Cancer Institute of Iran between 2014 and 2016. The researchers indicated that the DASH diet reduced the risk of breast cancer.

Specifically, the researchers concluded that “adherence to the DASH dietary pattern could be associated with an approximately 30% reduction in risk of breast cancer.”

While more studies are necessary to determine if the DASH diet is as effective as the study indicates, with respect to breast cancer risk, the DASH diet has been shown to promote health. The diet is known to be a healthful diet. Therefore, healthcare providers should include the diet in their diet-counseling sessions for appropriate patients. The possibility of lowering breast cancer risk, as well as blood pressure, is a strong incentive to give advice on the DASH diet.

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Prediabetes Raises the Risk of Heart Failure

Prediabetes is associated with cardiovascular disease, kidney problems and, of course, diabetes. Prediabetes is a precursor to type 2 diabetes. And diabetes is highly associated with heart failure (HF). In fact, one report indicated that the risk of heart failure in persons with diabetes is about double the risk compared to those with normoglycaemia. However, there remains doubt as to whether prediabetes raises the risk of heart failure. So, one study was done to determine if there is a relationship between prediabetes and HF, such that those with prediabetes are at a higher risk of HF.

The study was a meta-analysis consisting of 15 studies. The studies included 9,827,430 individuals. The researchers used definitions of prediabetes established by  the American Diabetes Association (ADA), the World Health Organization (WHO), and the International Expert Committee (IEC). For their definitions, the organizations used ranges of measurements for impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and elevated HbA1c.

The researchers determined that when an individual had prediabetes as defined by the above mentioned organizations, there was an increased risk of heart failure when compared with normoglycaemia.

The researchers concluded that “Prediabetes is associated with an increased risk of HF. Future studies are needed to evaluate effective treatments for prediabetes to prevent the development and progression of HF.”

Since the National Diabetes Prevention Program Lifestyle Change Program (National DPP LCP) can delay or prevent type 2 diabetes, it may be prudent to determine if the program can delay of prevent HF.

A follow-on study based on the original Diabetes Prevention Program study has shown that participation in the study did lower blood pressure. Perhaps, collecting blood pressure measurements and other cardiovascular data in DPP clinical settings could lead to a tweaking of the DPP program that could cause a delay or prevent HF in program participants.

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Flaxseed, C-Reactive Protein and Central Obesity

"Flaxseeds are a good source of dietary fiber and omega-3 fatty acids." And flaxseed may be beneficial in other ways. One study has shown that flaxseed consumption may aid in reducing the amount of C-reactive protein (CRP) in the blood. And another study has shown that flaxseed consumption may also aid in the reduction of central obesity.

According to one of the studies mentioned above, CRP is related to inflammation or swelling of the arteries. And this swelling is associated with cardiovascular problems. In the study, which was a Harvard  women's study consisting of 18,000 subjects, researchers noticed that CRP appeared to be more indicative of cardiovascular risk than cholesterol levels. In fact, a high CRP level could increase the risk of cardiovascular problems by a factor of three.

And flaxseed, which contains a large amount of dietary fiber, has been shown to lower the levels of CRP in the blood. In one study, consisting of 27 men who had cardiovascular risk factors, there was a decrease in CRP after the men were given flaxseed. The researchers indicated that "a decrease in inflammatory markers (CRP and TNF-alpha) was observed after flaxseed intake." The researchers suggested "that flaxseed added to a weight loss diet could be an important nutritional strategy to reduce inflammation markers..."

Furthermore, flaxseed added to a diet may reduce central obesity. In a 12 week flaxseed study, 60 overweight and obese women were randomized into two groups. Both groups were put on a balanced diet. However, the control group consumed 30 g/day of milled rice, while the treatment group consumed 30 g/day of milled flaxseed. At the end of the 12 week intervention, the researchers found that "there was [a] significantly higher reduction rate in waist circumference (WC) and waist to hip ratio (WHR) ... in the flaxseed consuming group compared to the control group."

Healthcare providers often look for ways to enable a person to improve his or her health through diet. Using flaxseed as part of a healthy diet may be a way to do that. Therefore, the use of flaxseed may be something healthcare providers might want to consider.

 

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More Rigid Criteria for Prediabetes May Be in Order in the National Diabetes Prevention Program

To delay or prevent type 2 diabetes, the CDC’s National Diabetes Prevention Program Lifestyle Change Program (National DPP LCP) treats individuals with prediabetes. Prediabetes is a condition where a person's blood glucose is elevated, but not elevated enough to be called diabetes. Prediabetes is often a precursor to type 2 diabetes. The prediabetes criteria used by the National DPP to admit persons into its prevention program are the same criteria used by the American Diabetes Association (ADA) and the CDC. However, those criteria allow individuals into the program who may be at a very low risk of contracting type 2 diabetes. So, looking at the probability of contracting diabetes at different points in the ADA's prediabetes criteria range may be beneficial. And one study has done the analysis.

The ADA uses the following criteria for prediabetes: a fasting plasma glucose (FPG) greater than or equal to 100 mg/dL and less than or equal to 125 mg/dL; an impaired glucose tolerance (IGT) where the glucose is greater than or equal to 140 mg/dL and less than or equal to 200 mg/dL; and an HbA1c greater than or equal to 5.7% and less than or equal to 6.4%.

The study mentioned above was done in Spain. There were 1184 participants in the study. And the participants in the study group satisfied two of the ADA's prediabetes criteria. These criteria were FPG between 100 mg/dL and 125 mg/dL and  HbA1c between 5.7% and 6.4%. The mean follow-up for the group was 4.2 years.

The researchers found that individuals at the lower ends of the prediabetes criteria ranges had a lower probability of advancing to type 2 diabetes. Specifically, the researchers stated that "The lowest incidence rate of diabetes was observed in the prediabetes category for isolated FPG 100–109 mg/dL; and the highest, in individuals with FPG within 110–125 mg/dL plus HbA1c 6.0–6.4%. As for reversion to normoglycemia, the highest rate was in the group with isolated HbA1c 5.7–5.9%, and the lowest in the category with FPG 110–125 mg/dL plus HbA1c 6.0–6.4%."

Therefore, focusing on individuals with prediabetes at the higher levels of blood glucose within the ADA's prediabetes criteria ranges may be a better use of resources.

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