u/HelenEk7

Conclusions: In adults with hyperlipidemia, daily egg consumption as part of a heart-healthy diet did not compromise cardio-metabolic health indicators.

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Abstract

Background: Despite dietary cholesterol not being considered a nutrient of concern, dietary guidelines still recommend that people with elevated LDL cholesterol limit their intake of egg yolks.

Objective: We examined the effects of the daily consumption of eggs in the context of the Dietary Approach to Stop Hypertension (DASH) diet for 8 weeks on cardio-metabolic risk factors in adults with hyperlipidemia.

Methods: The study was a randomized, controlled, single-blind, crossover trial involving 45 adults (mean age 59.5 years; 35 females, 10 males; 42 Caucasian, two African American, one Asian) with hyperlipidemia. Participants were randomly allocated to one of the two possible sequence permutations of two treatments: the DASH diet with eggs (I) and the DASH without eggs (C). There was a 4-week run-in phase before treatments and an 8-week washout period between treatments. Participants received menus and guidance from the study dietitian on adhering to the DASH diet. They also received advice to exclude or include two whole eggs daily for 8 weeks in their DASH diet while displacing other foods based on instructions to maintain an isocaloric intake. Primary outcome measures were LDL cholesterol and endothelial function assessed as flow-mediated dilation. Secondary outcome measures included insulin sensitivity, other lipids, blood pressure, C-reactive protein, and dietary intake. Data were analyzed using repeated measures ANOVA.

Results: Daily addition of eggs to the DASH (ΔI) compared with DASH without eggs (ΔC) did not negatively affect endothelial function (ΔI: 2.7 ± 10.8% versus ΔC: 3.7 ± 19.9% versus ΔI - ΔC = -1.1, p = 0.767) or LDL cholesterol (ΔI: 13.0 ± 23.5 mg/dL versus ΔC: 8.9 ± 19.6 mg/dL; ΔI - ΔC = 4.2, p = 0.317). The DASH diet with eggs compared with the DASH without eggs relatively increased the consumption of choline (ΔI: -29.6 ± 136.8 mg/d versus ΔC: -148.2 ± 146.3 mg/d; ΔI - ΔC = 118.6, p = 0.002) while the intake of carbohydrates decreased (ΔI: -26.4 ± 327.3 kcal/d versus ΔC: 147.7 ± 282.3 kcal/d; ΔI - ΔC = -174.1, p = 0.032). Compared with DASH diet without eggs, the addition of 2 eggs per day in the DASH did not impact other cardio-metabolic risk factors (blood pressure, other lipid profiles, CRP, and glycemic control).

Conclusions: In adults with hyperlipidemia, daily egg consumption as part of a heart-healthy diet did not compromise cardio-metabolic health indicators.

https://pubmed.ncbi.nlm.nih.gov/40957619/

Conclusions

The prevalence of plant-based diets remains relatively low. Individuals who adhered to plant-based diets were generally younger, female, single and had higher education levels and household incomes. Self-perceived general health and lifestyle factors, such as tobacco consumption, hazardous drinking and physical activity, were similar to those of individuals following omnivorous diets with similar socio-demographic profiles. These findings highlight the importance of prioritising healthy behaviours over specific dietary patterns when addressing patient concerns regarding dietary patterns and personal well-being.

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Abstract

Objective: To determine the prevalence and characteristics of plant-based patterns in the Spanish population and assess their potential impact on individuals with similar socio-demographic backgrounds.

Design: We estimated vegetarian and vegan individuals’ national and regional prevalence and analysed their socio-demographic characteristics and weekly dietary intake patterns. Individuals with a plant-based dietary pattern were matched to a control group (1:4) with similar socio-demographic characteristics. Associations with the prevalence risk of common chronic diseases, self-reported health status, lifestyle and healthcare use were analysed with unadjusted and adjusted logistic regression models.

Setting: A population-based survey of individuals residing in Spain.

Participants: Data from 22 072 participants were examined.

Results: The prevalence of plant-based diets was 5·62‰ (95 % CI: 4·33, 7·28), and adherents were female (68·6 %), single (62·3 %) and university-educated 41·8 %) (P < 0·001). They reported higher rates of ‘never’ consuming snacks (50 % v. 35 %), fast food (58 % v. 36 %) and sweets (33 % v. 14 %). Lifestyle factors did not differ between the plant-based and omnivorous groups; however, adherence to plant-based diets was associated with a prevalence risk of depressive symptoms (OR 2·58, 95 % CI: 1·00, 6·65), stroke (OR 7·08, 95 % CI: 1·27, 39·46) and increased consultations for mental health and complementary medicine (OR 3·21, 95 % CI: 1·38, 7·43).

Conclusions: Plant-based diets are uncommon and are associated with specific socio-demographic profiles, particularly sex. When comparing individuals with similar socio-demographic characteristics, individuals with plant-based diets and omnivores had similar lifestyles. Addressing patient concerns regarding diet and personal well-being might prioritise healthy behaviours over specific dietary patterns.

https://pmc.ncbi.nlm.nih.gov/articles/PMC12465083/

An escaped North Korean from the hostile class interviews a former North Korea diplomat in the UK. Comparing their two stories is quite interesting since they were brought up on the oposite ends of the class system. The former diplomat also went to Denmark and Sweden, and described how his worldview were completely shattered when being in the capital of Denmark realizing that he had been lied to all along. Its not North Korea that's the paradise - its rather Denmark that's the paradise! Clean streets with no homeless people, all children goes to public school, all citizens having access to public healthcare, and everyone being relatively wealthy. (Part of his job back in North Korea was taking representatives from humanitarian organisations to the North Korean countryside, so he was well aware of the level of poverty there.)

TL;DR:

All of the subjects who were taking antihypertensive medication at entry (6.3% of the total sample) successfully discontinued the use of medication.

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Abstract

Background: Hypertension-related diseases are the leading cause of morbidity and mortality in industrially developed societies. Although antihypertensive drugs are extensively used, dietary and lifestyle modifications also are effective in the treatment of patients with hypertension. One such lifestyle intervention is the use of medically supervised, water-only fasting as a safe and effective means of normalizing blood pressure and initiating health-promoting behavioral changes.

Methods: One hundred seventy-four consecutive hypertensive patients with blood pressure in excess of 140 mm Hg systolic, 90 mm Hg diastolic (140/90 mm Hg), or both were treated in an inpatient setting under medical supervision. The treatment program consisted of a short prefasting period (approximately 2 to 3 days on average) during which food consumption was limited to fruits and vegetables, followed by medically supervised water-only fasting (approximately 10 to 11 days on average) and a refeeding period (approximately 6 to 7 days on average) introducing a low-fat, low-sodium, vegan diet.

Results: Almost 90% of the subjects achieved blood pressure less than 140/90 mm Hg by the end of the treatment program. The average reduction in blood pressure was 37/13 mm Hg, with the greatest decrease being observed for subjects with the most severe hypertension. Patients with stage 3 hypertension (those with systolic blood pressure greater than 180 mg Hg, diastolic blood pressure greater than 110 mg Hg, or both) had an average reduction of 60/17 mm Hg at the conclusion of treatment. All of the subjects who were taking antihypertensive medication at entry (6.3% of the total sample) successfully discontinued the use of medication.

Conclusion: Medically supervised water-only fasting appears to be a safe and effective means of normalizing blood pressure and may assist in motivating health-promoting diet and lifestyle changes.

https://pubmed.ncbi.nlm.nih.gov/11416824/

What is already known on this topic

• The idea of drug-free remission of type 2 diabetes (T2D) gives hope to many and can be achieved in different ways.

• Sugary and starchy foods worsen blood glucose control so a low-carbohydrate diet is a logical first step.

What this study adds

• Advice and ongoing guidance on a low-carbohydrate diet in primary care can achieve improved diabetic control for 97% of those interested in the approach, sustained for an average of 33 months.

• Those patients who started with ‘younger’ diabetes and lower HbA1c were far more likely to achieve remission.

• Those in the non-remission, ‘mitigation’ group achieved unexpectedly greater, clinically important improvements in diabetic control with the diet

How this study might affect research, practice or policy

• Seventy-seven per cent of those adopting a low-carbohydrate approach in the first year of their T2D achieved remission. This represents an important ‘window of opportunity’ for further investigation.

• People with established long-term T2D, which may be poorly controlled could benefit from looking carefully at reducing sugar and starchy carbohydrates.

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Abstract

Background: Type 2 diabetes (T2D) is often regarded as a progressive, lifelong disease requiring an increasing number of drugs. Sustained remission of T2D is now well established, but is not yet routinely practised. Norwood surgery has used a low-carbohydrate programme aiming to achieve remission since 2013.

Methods: Advice on a lower carbohydrate diet and weight loss was offered routinely to people with T2D between 2013 and 2021, in a suburban practice with 9800 patients. Conventional ‘one-to-one’ GP consultations were used, supplemented by group consultations and personal phone calls as necessary. Those interested in participating were computer coded for ongoing audit to compare ‘baseline’ with ‘latest follow-up’ for relevant parameters.

Results The cohort who chose the low-carbohydrate approach (n=186) equalled 39% of the practice T2D register. After an average of 33 months median (IQR) weight fell from 97 (84–109) to 86 (76–99) kg, giving a mean (SD) weight loss of −10 (8.9)kg. Median (IQR) HbA1c fell from 63 (54–80) to 46 (42–53) mmol/mol. Remission of diabetes was achieved in 77% with T2D duration less than 1 year, falling to 20% for duration greater than 15 years. Overall, remission was achieved in 51% of the cohort. Mean LDL cholesterol decreased by 0.5 mmol/L, mean triglyceride by 0.9 mmol/L and mean systolic blood pressure by 12 mm Hg. There were major prescribing savings; average Norwood surgery spend was £4.94 per patient per year on drugs for diabetes compared with £11.30 for local practices. In the year ending January 2022, Norwood surgery spent £68 353 per year less than the area average.

Conclusions: A practical primary care-based method to achieve remission of T2D is described. A low-carbohydrate diet-based approach was able to achieve major weight loss with substantial health and financial benefit. It resulted in 20% of the entire practice T2D population achieving remission. It appears that T2D duration <1 year represents an important window of opportunity for achieving drug-free remission of diabetes. The approach can also give hope to those with poorly controlled T2D who may not achieve remission, this group had the greatest improvements in diabetic control as represented by HbA1c.

https://nutrition.bmj.com/content/6/1/46

Plain language summary

Anorexia nervosa is a serious mental health condition marked by food restriction and low body weight. Even after weight restoration, many individuals continue to struggle with intense fears about eating, dissatisfaction with their body, and ongoing worries about weight and shape. This study explored whether a special, fat-based diet could be a safe and effective treatment for adults with anorexia nervosa. Participants tolerated the diet well, with no evidence of worsening of symptoms. Instead, participants showed significant improvements in eating disorder symptoms, including reduced dietary restraint, less concern about food and body shape, and improved mood. By the end of the study, nearly three-quarters of participants had scores within the normal range for both eating disorder and depression symptoms. These findings suggest that a ketogenic diet may be a safe and promising approach to help reduce core symptoms of anorexia nervosa.

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Abstract

Background: Anorexia nervosa (AN) is a severe psychiatric disorder characterized by food restriction and significantly low body weight. Even after weight restoration, core symptoms such as body dissatisfaction, intense fear of eating, and preoccupation with body shape and weight often persist, contributing to a high risk of relapse.

Methods: This study evaluated the feasibility and safety of a weight-maintaining ketogenic dietary therapy administered over 14 weeks in adults with anorexia nervosa who were either mildly underweight or weight-restored. The study also examined whether ketogenic therapy could reduce eating disorder symptoms. Twenty-two individuals participated, and eighteen (82%) completed the trial.

Results: Repeated-measures MANCOVA (intent-to-treat; comorbidity and medication included in the model) reveals significant overall treatment effects (Wilk’s λ = 0.165, F = 2.383, p < 0.001), and symptom score decreases over time on the Eating Disorder Examination Questionnaire (EDE-Q) subscales Restraint, Eating Concern, Shape Concern, and Weight Concern, as well as for depression scores. At study completion, 72% of participants show EDE-Q and depression scores within the normal range. At three-month follow-up, 39% of completers continue ketogenic dietary therapy, of whom 28% show an increase in EDE-Q Global scores, while among those not maintaining ketogenic therapy, 64% present with an elevation in EDE-Q scores. Ketogenic dietary therapy does not precipitate worsening of symptoms or clinically significant weight loss.

Conclusions: The ketogenic dietary therapy is well-tolerated and demonstrates potential efficacy in reducing core symptoms of AN among adults who are mildly underweight or weight-restored. These findings support the further investigation of ketogenic dietary therapy as a potential intervention for this population.

https://www.nature.com/articles/s43856-026-01644-0

TL;DR:

n = 1

Analysis revealed a total Agatston calcium score of 0 across all coronary artery territories. These findings indicate an absence of detectable coronary artery calcification

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Abstract

Adults with type 1 diabetes (T1D) are at a higher risk for cardiovascular disease (CVD) compared with the general population. HbA1c is the primary modifiable risk factor for CVD in T1D. However, fewer than 1% of patients achieve euglycemia (<5.7% HbA1c). Ketogenic diets (KD; ≤50g carbohydrate/day) could improve glycemia and reduce CVD risk in T1D by reducing HbA1c and insulin load. One gold-standard cardiovascular assessment - coronary artery calcification - has not yet been reported among individuals with T1D undergoing a KD. In T1D, 30–70% of males between the ages of 30–39 years old have CAC >1, which rapidly progresses to 70–90% between the ages of 40–49 years old, with male sex and elevated low-density lipoprotein (LDL-C) as predictors of CAC progression. Therefore, this case report aims to provide CAC scores from an individual who followed a KD for over 10 years for the first time. We collected this medical history information from the 33-year-old male case study participant with T1D following the KD for over 10 years without use of lipid-lowering medication. The participant achieved euglycemia with an HbA1c of 5.5%. High-resolution computed tomography (CT) imaging of the chest was performed, focusing on the coronary arteries. Scans were obtained using a 64-slice CT scanner equipped with coronary calcium quantification software. Analysis revealed a total Agatston calcium score of 0 across all coronary artery territories. These findings indicate an absence of detectable coronary artery calcification, suggesting the absence of atherosclerotic plaque formation despite concern about the long-term cardiovascular consequences of a KD.

https://pmc.ncbi.nlm.nih.gov/articles/PMC12742286/

TL;DR:

Food system models overlook nutrient bioavailability, which can lead to misleading results.

Abstract

The advocated shift from diets high in animal-source food toward healthy, plant-based diets has raised concerns for adequate nutrient intake, especially for those nutrients that are more bioavailable in animal-source foods compared to plant-source foods. To date, global food system optimization models have not accounted for differences in nutrient bioavailability, which could lead to an overestimation of nutrient availability in healthy, plant-based diets. We used the results of an existing food system optimization model – the Circular Food Systems (CiFoS) model – to assess the impact of accounting for the bioavailability of iron, calcium and zinc. Nutrient content of individual food items in the model were recalculated based on bioavailability fractions, while also accounting for bioavailability in the nutrient requirements used as model constraints. Using bioavailable nutrient content affected i) the quantity of foods that need to be produced and consumed, ii) the types of foods within food groups, and iii) the environmental impact of the food system. The dietary amount of animal-source protein was not affected by using bioavailable nutrient content, and any emerging nutrient gaps were filled mainly by grains and vegetables. Finally, meeting the nutrient requirement constraints was the largest driver for food system changes, with tighter model constraints for nutrient requirements leading to an environmental trade-off due to an increase in crop production. These results highlight the relevance of accounting for bioavailability when studying sustainable healthy diets, while acknowledging the methodological challenges of doing so in global food system models.

https://www.sciencedirect.com/science/article/pii/S3050835526000215

Hi there from Norway. I have a son who was diagnosed with epilepsy at 9 months, and Dravet at 5 years old.

I would like to know your experience with the ketogenic diet for epilepsy - if your child has tried that. Did it effect the amount of seizures? Severity of seizures? Any cognitive improvements? And if your child has not done keto, were this option given to you at any point?

Just finished 'The Crash', and it left me somewhat uneasy. Not so much because of the girl, but because of her parents. What are your thoughts?

ABSTRACT

Background

Previous meta-analyses reported inconsistent results on the effect of vitamin D on depression because of different baseline concentrations of 25-hydroxyvitamin D [25(OH)D], highlighting the need for a more accurate subgroup analysis of previously published findings. The goal of the present study was to evaluate the effect of vitamin D supplementation on depression in adults.

Methods

A systematic search in numerous databases including PubMed, Embase, and Web of Science was performed. Randomized-controlled trials comparing the effect of vitamin D on depression in adults were selected.

Results

Eighteen studies met the inclusion criteria in the retrieved citations. The meta-analysis showed that vitamin D supplementation had a significant effect on overall reduction in depression symptom scores (SMD = −0.15, 95 % CI [−0.26, −0.04]). Sub-group analysis showed that vitamin D supplementation significantly reduced depressive symptom scores in patients with serum 25(OH)D levels higher than 50 nmol/L (SMD = −0.38, 95 % CI [−0.68, −0.08]).

Conclusions

Vitamin D supplementation has a benefit on improving depressive symptoms in adults with primary depression and 25(OH)D levels higher than 50 nmol/L but has no effect on improving depressive symptoms in adults with primary depression and 25(OH)D levels lower than 50 nmol/L. Relatively high levels of 25(OH)D maybe required for alleviating depression.

Limitations

The randomized studies included in this study were designed and completed at different times and countries, the variability in duration and dose of vitamin D supplementation may have introduced significant heterogeneity and have militated against observation of the effects of vitamin D supplementation on depression.

https://www.sciencedirect.com/science/article/abs/pii/S0165032723012260?via%3Dihub

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I frequently say that I hate our winters. But I honestly think I would miss them if they were gone.