Category: Diet and Nutrition

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Cutting Sugar Intake in Antibiotic Treatment may Help Protect the Gut Microbiome

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Researchers analysed more than 9400 meals and 1000 stool samples, linking sugar-rich foods to greater antibiotic-related microbiome disruption in stem cell transplant patients.

Photo by Patrick Fore on Unsplash

Treatment with antibiotics often causes stomach cramps and diarrhoea, broadly destroying good bacteria in the gut, allowing the overgrowth of harmful microbes. A new study involving City of Hope researchers suggests eating less sugar could protect the microbiome during antibiotic treatment. The study followed patients with blood cancer who were going through an intensive treatment called allogeneic hematopoietic cell transplant, a population at particularly high risk for severe gut microbiome disruption and associated side effects.

Published in Nature, the surprising findings connect to the idea of “food as medicine” during cancer care and the ways diet can help us prevent and recover from illness. The research could lead to new treatment strategies for cancer patients and potentially others taking antibiotics.

“Antibiotics disrupt the diversity of our gut bacteria, or microbiomes, which play an essential role in supporting our immune systems and overall health,” said co-senior author Marcel van den Brink, MD, PhD, president of City of Hope Los Angeles and City of Hope chief physician executive. “Our research supports emerging evidence that avoiding sugary foods during antibiotic treatment may protect the microbiome. Preserving microbiome diversity has previously been linked with improved clinical outcomes for patients with cancer.”

Dr van den Brink, a globally recognised leader in the microbiome, cell transplantation and cancer immunotherapy, collaborated on the research with Jonathan Peled, MD, PhD, at Memorial Sloan Kettering Cancer Center and Jonas Schluter, PhD, at NYU’s Grossman School of Medicine.

A Large Clinical Study With High-Frequency Data

The five-year study, one of the largest of its kind, followed patients who were hospitalised for several weeks to receive intensive chemotherapy, sometimes with radiation, to wipe out their immune systems and then undergo a stem cell transplant. To prevent and treat infections, each patient took at least one antibiotic during their hospital stay, with 80% of them taking one or more of the broad-spectrum antibiotics that exert the strongest effect on the microbiome by targeting many types of bacteria.

The research team tracked 9419 meals eaten by 173 hospitalised patients and profiled the microbiome diversity in stool samples from 158 patients. Microbiome diversity is a key indicator of a healthy microbiome.

Precisely Measuring Food in Real Time and Tracking Effects in the Gut

Each time patients ordered a meal from the hospital kitchen, the tray arrived with a questionnaire asking them to record the amount of each item that they ate and drank.

With this help from the hospital kitchen to track nutritional information for all hospital meals consumed, the scientists recorded more than 40,000 food items, creating an unprecedented dataset with a level of detail that’s rarely possible in nutrition research.

For each patient, the researchers tracked between eight and 128 meals across a period ranging from 12 days before to 49 days after transplantation. The team also analysed more than 1000 patient stool samples to monitor changes in the gut microbiome.

“Unlike past nutrition studies that rely on patients’ memories of what they ate or other imprecise surveys, we had meticulous dietary records collected in real time,” noted Dr van den Brink. “This enabled us to look for patterns that otherwise might be impossible to detect.”

A Striking Discovery: Sugar Upsets the Balance of Gut Bacteria

Using a variety of advanced statistical models, the researchers scoured the data in search of patterns linked to injury to the gut microbiome.

What they found surprised them.

“No matter how we analysed the data, the same strong signal kept appearing,” observed Dr van den Brink. “The patients who consumed more sweets while taking antibiotics were more likely to experience a loss of microbiome diversity as aggressive microbes crowded out other strains of bacteria.”

One organism stood out: Enterococcus. When it takes over the microbiome, patients undergoing transplant face a higher risk of bloodstream infections, graft-versus-host disease and other life-threatening complications.

The combination of high-sugar foods and broad-spectrum antibiotics appeared to multiply injury to the microbiome, leading to a substantial 24% drop in bacterial diversity for every 100-gram increase in sweets (equivalent in sugar content to a large milkshake).

Replicating the Results in Mice Supports Human Data

The researchers also tested their hypothesis that sugar exacerbates microbiome injury by giving broad-spectrum antibiotics to healthy mice and feeding them a variety of diets. Mice that ate a high-sucrose diet quickly developed an overgrowth of Enterococcus in their guts. Mice that ate the high-sugar diet without antibiotics, however, maintained normal bacterial diversity.

“The fact that animal studies support associations we found in patient data provides a compelling rationale for future clinical trials to evaluate whether reducing sugar intake during antibiotic use would protect the microbiome,” said Dr van den Brink, the Deana and Steve Campbell Physician Executive Distinguished Chair and the Morgan and Helen Chu Presidential Chair.

What the Findings Could Mean for Patients

“The microbiome is emerging as an important factor in cancer care,” Dr van den Brink said. “The better we understand what supports and disrupts it, the more opportunities we have to reduce treatment side effects while improving how patients respond to and recover from therapy.”

For cancer patients, he noted, the study results reinforce diet as a strong influence on the microbiome and as one of the most practical ways hospitals can support recovery during treatment.

“Many of the foods and drinks we encourage hospitalised patients to consume, like nutritional shakes, smoothies and sports drinks, are high in sugar content,” Dr van den Brink said. “That’s something we’ll need to evaluate when prescribing antibiotics.”

The practical takeaway for physicians, he says, is that antibiotic stewardship matters beyond preventing antibiotic resistance.

“Antibiotic stewardship includes thinking about how different antibiotics affect the microbiome,” Dr van den Brink said. “Our study demonstrates that some antibiotics disrupt beneficial gut bacteria more than others.”

To preserve microbiome health, he encourages patients to ask their healthcare team to ensure antibiotics are thoughtfully chosen from equally effective treatment options for controlling infections.

So, should people cut out sugar while taking antibiotics?

“It’s premature to recommend everyone taking antibiotics avoid sugar,” Dr van den Brink said. “On the other hand, we don’t have strong evidence that probiotics help preserve or restore microbiome diversity and many people choose to take them anyway. There’s no harm in limiting sugar in your diet, and it’s an easy thing to try.”

Original written by Elaine Schmidt

Source: City of Hope

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Major Trial Examines Artificial Sweeteners in Soft Drinks

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Researchers at the University of Liverpool have conducted the longest and most comprehensive randomised controlled trial on non-nutritive sweetened (NNS) soft drinks.

Non-nutritive sweeteners are low- or no-calorie alternatives to sugar used to sweeten foods and drinks. The 104-week clinical trial shows NNS beverages ie, diet beverages are equivalent to water for long term weight management.

Professor Jo Harrold, Dean of Psychology at the University of Liverpool alongside Professor Jason Halford, Professor, Biological Psychology & Health Behaviours at the University of Leeds (formerly of the University of Liverpool) conducted the peer-reviewed research funded by the American Beverage Association. The research team was independent of the funder and had full control over the analysis and reporting of their findings.

The major new study was published in the British Journal of Nutrition and provides long-term clinical evidence that NNS beverages – specifically those containing aspartame, acesulfame potassium (acesulfame‑K), and sucralose – are equivalent to water in supporting weight loss and long‑term weight maintenance.

The SWITCH trial followed 493 adults with overweight or obesity through a structured behavioural weight management programme. Participants were randomised to consume either water or commercially available diet beverages, daily, with sweeteners provided at levels well within established European Food Safety Authority (EFSA) safety thresholds.

Overall, the results do not support concerns that NNS beverages disrupt appetite regulation or have long term metabolic harm.

Key outcomes include:

  • Equivalent weight loss between NNS beverages and water at 104 weeks (−4.8 kg vs −3.7 kg; nonsignificant difference).
  • Sustained weight reduction over two years in both groups, even during the final unassisted year.
  • Decrease in waist and hip circumference and improvement in body composition, and several metabolic biomarkers in both groups.
  • No clinically meaningful difference in effects such as blood pressure and cholesterol, associated with long-term consumption of either aspartame, acesulfame‑K, or sucralose or water.
  • Sugar intake decreased in both groups, with slightly greater reductions in the NNS group.

Importantly, the findings directly address recent World Health Organization (WHO) guidance, which advised against using non-sugar sweeteners for weight control due to uncertainty in observational studies. The SWITCH trial provides long-duration, randomised controlled evidence which can be used to inform global guidelines.

Professor Joanne Harrold, said: “The University of Liverpool is one of the UK’s leading research-intensive higher education institutions, with a key focus on public health. These latest findings show that concerns about sweeteners disrupting appetite or causing weight gain are not supported when tested in a rigorous, long-term randomised trial. We hope this evidence informs future WHO guidance and public health policy.

The effectS of non-nutritive sWeetened beverages on appetITe during aCtive weigHt loss (SWITCH) trial was conceived and designed by researchers in the context of the need to reduce sugar in the diet and to address questions about the potential effects on appetite regulation of using sweeteners as a substitute. This latest published work continues from previously published evidence in the International Journal of Obesity in 2023.

Professor Jason Halford, University of Leeds and University of Liverpool, concluded: “This study provides the long‑term clinical evidence that has been missing from international discussions. For people trying to manage their weight, non‑nutritive sweetened beverages offer an effective alternative to sugar‑sweetened drinks – and perform equivalently to water over two years.”

Source: University of Liverpool

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Dietary Patterns Linked to Favourable Ageing Biomarkers

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Older adults who follow healthy dietary patterns have blood biomarker levels associated with more favourable biological processes relevant to ageing. This is shown in a study from Karolinska Institutet published in the journal BMC Medicine. The findings may contribute to a better understanding of how dietary habits are related to the body’s ageing processes.

Researchers have long known that diet plays an important role in health later in life, but the biological mechanisms underlying these associations are not yet fully understood. In the current study, researchers cross-sectionally investigated how different dietary patterns are associated with a broad range of blood biomarkers reflecting metabolism, inflammation, vascular health and neurodegenerative processes related to ageing.

The study included 1,769 people aged 60 years and over who participated in the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K). Participants answered questions about their dietary habits over the previous year, and researchers simultaneously analysed 54 different blood biomarkers. 

Three dietary patterns

The researchers examined three dietary patterns that have previously been linked to good health: a Mediterranean-style diet, an index of overall dietary quality, and a measure of the inflammatory potential of the diet. Greater adherence to these dietary patterns was associated with favourable levels of several biomarkers. This included higher folate levels and lower levels of growth differentiation factor 15, which were observed consistently across all three patterns. Additional associations with biomarkers linked to inflammation, metabolism and neurodegenerative processes were specific to individual dietary patterns.

“Our findings suggest that healthy dietary patterns are associated with several biological processes that are important for how we age. This reinforces the view of diet as a modifiable factor that may contribute to healthy ageing,” says Rachel Ann Da Costa, researcher at the Department of Neurobiology, Care Sciences and Society, and first author of the study.

The dietary pattern with lower inflammatory potential showed associations with the greatest number of biomarkers, particularly those linked to inflammation and metabolism. According to the researchers, this may indicate that the inflammatory properties of diet are related to several interconnected biological processes involved in ageing.

More studies needed

As the study examined associations at a single point in time, it cannot establish cause and effect. The researchers also emphasise that participants mainly consisted of older adults from the Stockholm area with relatively high levels of education, which may limit the generalisability of the findings to other populations.

“We now need more longitudinal and intervention studies to investigate whether changes in diet also lead to changes in the biological markers we have studied,” says Adrián Carballo-Casla, researcher at the same department and last author of the study.

The study was conducted in collaboration between researchers at Karolinska Institutet, Stockholm University, KTH Royal Institute of Technology, Stockholm Gerontology Research Center, Universidad Autónoma de Madrid and CIBERESP in Spain, as well as the University of Ljubljana in Slovenia. The study is based on data from SNAC-K. Funding was provided by, among others, the Swedish Research Council, Forte, Karolinska Institutet, the Swedish Alzheimer Foundation, the Dementia Foundation, the Foundation for Geriatric Diseases at Karolinska Institutet, the David and Astrid Hagelén Foundation, and Swedish government departments, regions and municipalities. The researchers report no conflicts of interest.

Three ways of measuring diet quality

Alternative Mediterranean Diet (AMED)

A dietary pattern based on the traditional Mediterranean diet. Higher scores are awarded for a high consumption of vegetables, legumes, fruit, nuts, whole grains and fish. A high proportion of unsaturated fats and moderate alcohol consumption are also scored positively. Lower consumption of red meat and dairy products likewise contributes to a higher score.

Alternative Healthy Eating Index (AHEI)

A scientifically developed index that measures overall diet quality. Higher scores are awarded for foods such as vegetables, fruit, whole grains, legumes, nuts, fish, healthy fats and moderate alcohol consumption. Lower scores are given for high consumption of red and processed meat, sugar-sweetened beverages, trans fats and sodium.

Empirical Dietary Inflammatory Index (EDII)

A measure that estimates how diet influences inflammation in the body. In this study, a reverse version of the index was used, with higher scores corresponding to a diet with lower inflammatory potential. Components such as leafy green and dark yellow vegetables, fruit juices, coffee and tea receive higher scores, while higher consumption of red and processed meat, refined grain products and sugar-sweetened beverages results in lower scores.

Source: Karolinska Institutet

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GLP-1s Linked to Nutritional Deficiencies in Children

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Risk highest for vitamin D deficiency

Photo by Pavel Danilyuk

Children prescribed GLP-1 medications for weight loss, prediabetes or type 2 diabetes are at risk for nutritional deficiencies – diagnosed in nearly one in six patients (16.8%) within the first year – according to new research from scientists at Northwestern University and Ann & Robert H. Lurie Children’s Hospital of Chicago.

Vitamin D deficiency was the most common, identified in 12.4% of children within one year of GLP-1 treatment, the study found.

“As appropriate paediatric use of GLP-1s becomes more widespread, we need to understand the risks during periods of rapid growth and pubertal development,” said senior author Justin Ryder, associate professor of surgery and paediatrics at Northwestern University Feinberg School of Medicine and vice chair of research for the department of surgery at Lurie Children’s. “Nutrients such as vitamin D, iron and calcium are of particular concern during adolescence, when deficiencies may have lasting implications for skeletal health and overall development.”

The study was published last week in the journal Childhood Obesity.

“Nutritional support needs to play a critical role once treatment with a GLP-1 medication is initiated,” he said. “In our study, however, we found that only 5% of patients received nutritional counselling within 30 days of GLP-1 treatment and less than 25% received nutritional counselling within 6 months.”

The scientists used national administrative claims data from 2017 to 2022 covering over 100 million patients to identify 2,031 GLP-1 users aged 10–17 years who met continuous enrollment criteria and had no prior diagnosis of nutritional deficiency. In this sample, the most prescribed GLP-1s were liraglutide (78.6%), dulaglutide (10.4%) and semaglutide (9.1%).

“We hope that our study findings bring much-needed recognition to the importance of proactive nutritional management when GLP-1s are prescribed to children, as opposed to waiting until a nutritional deficiency is diagnosed,” Ruder said. “Knowing the risks, we are in a much better position to prevent harm to children treated with GLP-1s during a pivotal period in their lives.”

Source: Northwestern University

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Can Vitamin C Improve Outcomes in People with Pre-cancer Blood Disorders?

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Phase 2 trial results warrant further study in a phase 3 trial.

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Vitamin C boosts the activity of cellular proteins called TET enzymes that help control which genes are turned on or off. Because decreased function of TET enzymes is a common driver of certain forms of blood cancer, researchers tested the effects of vitamin C supplements in patients at risk of developing such malignancies. Results of the investigators’ phase 2 clinical trial are published by Wiley online in CANCER, a peer-reviewed journal of the American Cancer Society.

The randomised, double-blind, placebo-controlled EVITA trial enrolled 109 patients in Denmark and the United States who had either a blood condition that can turn cancerous or a low-risk form of blood cancer. At the start of the trial, 55 patients were randomly assigned to receive oral vitamin C (1000mg/day) and 54 were assigned to receive placebo, for a total of 12 months.

Although the primary endpoint (growth rate of precancerous or cancerous cells) was similar between groups, participants who received vitamin C experienced changes in inflammatory signaling that aligns with better outcomes. Also, anaemia, pneumonia, acute aseptic arthritis, and internal bleeding were less frequent (although gastrointestinal problems were more frequent) in patients taking vitamin C compared with those taking placebo.

At a median follow-up of 33.6 months (nearly 3 years) in the intention-to-treat population, 35 deaths were recorded, including 24 in the placebo group and 11 in the vitamin C group. An exploratory analysis of these data found that participants in the vitamin C group were more likely to survive during follow-up than those in the placebo group. This finding requires confirmation in a larger phase 3 clinical trial.

“The EVITA trial gives us a strong rationale to continue exploring if and how vitamin C might benefit people with certain pre-cancer or early-stage blood cancers. More work is needed but we are cautiously optimistic that these findings could inform future strategies to intercept leukemia development,” said co–senior author Peter A. Jones, PhD, DSc (hon), of Van Andel Institute, in Grand Rapids, Michigan. Jones is co-leader of the Van Andel Institute–Stand Up To Cancer (VAI–SU2C) Epigenetics Dream Team, which led the EVITA trial.

“We are encouraged by our findings and what they ultimately could mean for people with these early-stage blood disorders. Although it is too soon to make recommendations based on our results, we are hopeful that a larger study will give us more definitive answers,” added co–senior author Kirsten Grønbæk, MD, PhD, of Rigshospitalet, Copenhagen University Hospital in Denmark. Grønbæk is a longtime member of the VAI–SU2C Epigenetics Dream Team.

Source: Wiley

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Healthy Eating Associated with Slower Biological Aging – But No One Diet is Best

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A study by DZNE finds that healthy eating is associated with slower biological aging – and that there is more than one way to eat healthily. The researchers examined ten dietary patterns considered healthy, including the Mediterranean, Nordic, and a plant-based diet, as well as the DASH diet, which is designed to help lower blood pressure. All were linked with slower biological aging, with age-related changes in the DNA serving as markers. These results, based on data from DZNE’s Rhineland Study and confirmed with data from an independent study, are published in the journal Nature Communications. 

“Our study suggests that healthy eating goes hand in hand with slower biological aging. The effects are not massive, but they are measurable and relevant for prevention. By slowing the aging process, the risk of age-related diseases such as dementia or cardiovascular disorders can be reduced. Thus, healthy eating contributes to healthy aging,” says Prof. Monique Breteler, Director of Population Health Sciences at DZNE and head of the Rhineland Study. “Importantly, there is probably no single ‘correct’ diet. According to our data, various dietary patterns are associated with slower aging, some more, some less. That is an encouraging finding, because it leaves room to tailor healthy eating to personal and cultural preferences, budget and taste.” 

Molecular Aging Measures 

For their analysis, the researchers evaluated blood samples and dietary habits from about 7500 women and men: This included 6470 participants of DZNE’s Rhineland Study in Bonn – where the findings were initially made – and 1034 participants of the EPIC-Potsdam Study of the German Institute of Human Nutrition Potsdam-Rehbrücke (DIfE), where the key results were independently confirmed.  

From blood, the team determined chemical modifications in the DNA, known as “DNA methylation patterns”, which influence gene activity and thus biological mechanisms. Since these molecular markers change systematically over the course of life, they are considered indicators of biological aging. 

“We applied three different approaches, so-called epigenetic clocks, to read biological aging from DNA methylation,” explains Juliana Tavares, a doctoral researcher at DZNE and lead author of the current publication. “To this end, we leveraged state-of-the-art technology, which allowed us to cover about 850 000 sites in the DNA. This is roughly twice as many as in most previous studies.” 

Healthy Eating: Different for Everyone 

The researchers also matched every participant’s eating habits against the recommendations of each of the ten diets studied. Adherence was quantified and graded using a scoring system based on how closely individuals followed each dietary pattern. “One and the same person could therefore rank high on one diet score and low on another. In other words: People who ate healthily by one standard were often not the same people who ate healthily by another. According to our data, hardly anyone counts as a healthy eater by every standard at once,” says Tavares. 

However, across the board, higher diet quality was associated with slower biological aging. This applied to all of the ten diets examined. “While there are measurably differences between the diets, they are modest in absolute terms. It’s the big picture what matters,” says Tavares. “In summary: When it comes to slowing down the aging process, there isn’t just one healthy diet, but indeed a whole repertoire of possible diets with a positive effect.”  

One result was particularly noteworthy: the association between diet quality and slower biological aging was most pronounced in smokers, even though smokers were by no means eating healthier than non-smokers. The biological explanation is still open. “Smoking is very harmful to health,” says Tavares, “One explanation for our findings might be that there is just more health benefit to gain for smokers by eating healthy because of the enormous detrimental effects of smoking.” 

Shared Biological Pathways 

Although each dietary pattern was associated with its own distinct set of DNA methylation sites, the biological mechanisms involved showed substantial overlap. “More than 70 percent of the affected biological pathways were shared across all diets. These involve cell structure, cell signalling and metabolism – processes central to aging and chronic disease. Therefore, it is understandable that the dietary patterns we examined were all linked with a slowing of biological aging,” says Tavares. “A few pathways were diet-specific, and they matched each diet’s main objectives: heart-related pathways were unique to the DASH diet, and pathways related to cognition and memory were unique to the so-called MIND diet, which aims to support brain health. You don’t need a perfect diet – that may be the most practical message here. But moving forward, the diet-specific pathways point to future research on targeted dietary interventions. This could be helpful in designing targeted health recommendations.” 

Source: DZNE

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Keto Diet Delivers Added Liver Benefits Beyond Weight Loss

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WashU Medicine researchers led a clinical trial testing three diets with different proportions of carbohydrates, fats and proteins and found all of them improved metabolic health, but a very low-carb ketogenic diet had additional benefits for liver health and blood sugar control. Credit: Katie Gertler/WashU Medicine

There is no shortage of popular diets to try, and they can generally produce weight loss if followed to the letter. But are all diet plans created equal in terms of reducing the cardiometabolic risks that come with obesity, such as Type 2 diabetes and liver disease?

A randomised clinical trial from Washington University School of Medicine in St. Louis suggests they aren’t, even when they lead to identical amounts of weight loss. Comparing three commonly recommended diet plans, the researchers found that losing weight on any of them improved overall metabolic health in adults with obesity who also had elevated blood sugar and excess fat in their liver – which are important risk factors for developing diabetes. But limiting carbohydrates through a ketogenic diet offered additional benefits for liver health and blood sugar control.

The findings appear August 27 in Cell Metabolism.

“For patients with obesity, prediabetes and fatty liver disease, weight loss induced by a very low-carbohydrate diet provides additional therapeutic effects on glucose and lipid metabolism that should further help prevent the progression to more severe metabolic diseases than weight loss alone,” said Samuel Klein, MD, the Danforth Professor of Medicine and Nutritional Science at WashU Medicine and the study’s senior author. “But all three diets – despite vastly different macronutrient makeups, from very low carbohydrates to very high carbohydrates – successfully improved metabolic health through weight loss alone.”

Which diet best improves metabolic and liver health?

Obesity affects roughly four in 10 Americans, most of whom also face metabolic health risks, including insulin resistance, which leads to prediabetes, and fat buildup in the liver. If left untreated, these problems can progress to Type 2 diabetes, chronic liver disease and cardiovascular events, among other irreversible conditions. While weight loss is the gold standard for reducing obesity-related health risks, it hasn’t been clear which type of diet, in terms of its protein, fat and carb content, works best to improve metabolic health.

To explore that question, the researchers, including first author Max C. Petersen, MD, PhD, an assistant professor of medicine in the John T. Milliken Department of Medicine at WashU Medicine, and Gordon I. Smith, PhD, an associate professor of medicine in the department, randomly assigned 55 adults with metabolically unhealthy obesity – meaning obesity with prediabetes and fatty liver – to follow one of three diets for around five months: a low-carbohydrate, high-fat ketogenic diet; a high-carbohydrate, low-fat, plant-forward diet; or a Mediterranean diet balanced between the two. Participants received 100% of their food throughout the study and attended weekly meetings with a study dietitian to support adherence to the assigned diet.

Across all three groups, participants lost an equal amount of weight, shedding about 10% of their total starting weight, and boosted insulin sensitivity in muscle cells by roughly 50% from baseline. The comparable restoration of insulin sensitivity across diet groups suggests that the weight loss itself was the important factor in combatting muscle insulin resistance – not the combination of fat and carbohydrates used to get there.

“Many metabolically unhealthy patients also are candidates for GLP-1 medicines, which have been very useful tools for helping people lose weight. But our results show that choice of diet remains important because it has an impact on specific health outcomes that go beyond weight loss alone.”

Max C. Petersen, MD, PhD, WashU Medicine

But this wasn’t the case for liver health. The researchers found that sensitivity to insulin in liver cells – which regulates how well the liver suppresses glucose production – improved two to three times more on the ketogenic diet compared with the other diets, though all three groups saw improvement. They also found that the ketogenic diet reduced fat inside the liver by 67% compared to 45% for the other two diets after five months.

“Fatty liver disease affects about 75% of adults with obesity worldwide and has become the fastest-growing cause of chronic liver disease and liver cirrhosis,” said Petersen. “Our study shows that for people with obesity and fatty liver disease, a low-carbohydrate ketogenic diet could help reduce that statistic.”

The ketogenic diet also provided greater improvements in blood sugar control than the other plans did, lowering 24-hour blood glucose measurements by 20% from baseline compared to 8% on the other diets. Insulin levels in the blood throughout the day also decreased by 74% on the low-carbohydrate diet compared to 44% and 27% on the Mediterranean and high-carbohydrate diets, respectively. This sharp decline in insulin reflects the decreased need for insulin to regulate blood glucose when consuming a very-low carbohydrate diet, so the pancreas doesn’t need to overproduce insulin to get a response.

Half of the participants on the low-carbohydrate diet reversed their prediabetes, compared to 29% of participants on the Mediterranean diet and 7% on the high-carbohydrate diet.

“Weight loss – even just a moderate amount – is universally beneficial in people who are metabolically unhealthy,” said Petersen. “Many metabolically unhealthy patients also are candidates for GLP-1 medicines, which have been very useful tools for helping people lose weight. But our results show that choice of diet remains important because it has an impact on specific health outcomes that go beyond weight loss alone.”

In future studies, the researchers are interested in understanding the fundamental mechanisms responsible for the metabolic benefits of weight loss, including the effects of GLP-1 medicines.

Abeeha Shamshad contributed to this story.

Source: University of Washington Medicine

Categories : Ageing Diet and NutritionTags :

Longer Meal Intervals Linked to Faster Disease Accumulation in Older Adults

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Older adults who typically had longer intervals between meals accumulated chronic diseases more rapidly over time than those with shorter intervals, according to a study from Karolinska Institutet published in the Journal of Internal Medicine. The association was most pronounced among people aged 78 years and older.

Interest in fasting has increased in recent years, but relatively little is known about how meal timing affects health in older adults. In this new study, researchers investigated whether the duration of the longest daily interval between meals was associated with the accumulation of chronic diseases over time. 

The researchers used data from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K), which includes 2,981 people in Stockholm who were aged 60 years or older at the start of the study. Participants were followed for up to 15 years. The duration of intervals between meals was estimated from participants’ self-reported information about when they typically ate during a 24-hour period. 

Association seen across disease types

Longer intervals between meals were associated with faster accumulation of chronic diseases over time. In particular, people whose longest interval between meals during a typical day was 14 to 24 hours accumulated chronic diseases more rapidly than those whose longest interval was 6 to 11.5 hours. The association was observed for the total number of chronic diseases, as well as for cardiovascular and neuropsychiatric diseases, but not for musculoskeletal diseases. 

“Much of the research on fasting has been conducted in younger or middle-aged populations. Our findings suggest that the associations may be different in older adults, particularly among the oldest age groups”, says Adrián Carballo Casla, last author of the study and postdoctoral researcher at the Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet.

The researchers emphasise that the study cannot determine cause and effect. Although longer intervals between meals were linked to faster disease accumulation, the study cannot establish whether the fasting pattern independently contributed to this outcome.

For information on funding and any potential conflicts of interest, please see the study.

Source: Karolinska Institutet

Categories : Cancer Diet and NutritionTags :

Can Antioxidant Foods Help Prevent Cervical Cancer?

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Cervical cancer. Credit: Scientific Animations CC4.0

In research published in the International Journal of Gynecology & Obstetrics, a diet high in antioxidants was linked with a lower risk of cervical cancer in women.

In the study, investigators analysed 2003–2018 data from 1044 US women participating in the National Health and Examination Survey: 174 with and 870 without cervical cancer. With these data, the team looked for an association between cervical cancer and the Composite Dietary Antioxidant Index (CDAI) – a validated composite score that reflects an individual’s intake level of dietary antioxidants, based on dietary recall interviews.

After adjusting for other factors that might affect cancer risk, the researchers found that each 1-unit increase in the CDAI was associated with a 11.4% lower prevalence of cervical cancer. Participants in the highest CDAI tertile had a 55.8% lower prevalence of cervical cancer than those in the lowest tertile. Additional analyses indicated a linear inverse association between the CDAI and the prevalence of cervical cancer.

“These findings suggest that dietary antioxidant intake may play a potential role in the prevention of cervical cancer. However, further prospective studies are needed to confirm this association and clarify the underlying mechanisms,” the authors wrote.

Source: Wiley

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Ultra-Processed Foods Linked to Notably Higher Prostate Cancer Risks

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Photo by Erik Mclean

Growing evidence links higher consumption of ultra-processed foods (UPFs) to a range of health problems. Research has identified several potential biological pathways through which UPFs may contribute to cancer. These include metabolic disruption, inflammation, oxidative stress, and changes to the gut microbiome. However, data are sparse about whether men who consume high amounts of UPFs have greater risks of prostate cancer.

Now, new research from Florida Atlantic University’s Charles E. Schmidt College of Medicine provides evidence that men with higher consumption of UPFs have increased risks of prostate cancer. Published in The American Journal of Medicine, the study analyses a large and nationally representative survey from 17 024 US adults males from 2003 through 2023. Researchers used two 24-hour dietary recalls to calculate the percentage of daily calories participants consumed from UPFs. Using the validated and widely used NOVA classification system, they divided participants into four groups, ranging from less than about 20% of calories from UPFs to more than 44%.

Men in the three higher-consumption groups of UPFs had a 29% greater risk of prostate cancer, while those in the two highest-consumption groups had a 30% greater risk, compared to those in the lowest consumption group. After adjustments for age, race and ethnicity, smoking, and poverty status, the increased risk remained significant, ranging from 24% to 31%. Men with the highest UPF intake alone had a possible 34% higher risk, although the finding did not reach statistical significance, potentially reflecting the smaller number of prostate cancer cases in that group.

“Among adult men in this nationally representative US population, those who consumed higher amounts of UPFs had significantly higher risks of the subsequent development of prostate cancer,” said Charles H. Hennekens, MD, FACPM, FACC, senior author and the First Sir Richard Doll Professor of Medicine and Preventive Medicine in the Department of Medicine and the Department of Population Health at FAU’s College of Medicine. “These findings add to emerging evidence that UPFs have major adverse health effects and underscore the need for large-scale observational studies and randomised trials to adequately test the hypothesis.”

Previous studies have shown that people who consume larger amounts of UPFs have higher risks of overweight and obesity, metabolic disease, markers of inflammation, cardiovascular disease, principally heart attacks and strokes, as well as premature death.

This original research adds to the armamentaria of a major battle in which the priorities of the food  industry do not align with the needs of the U.S. public. The authors opine that just as the dangers of tobacco began to emerge during the middle of the prior century, decades passed before the preponderance of evidence and the efforts of forward-thinking health officials prompted policy changes to discourage cigarette use. The authors believe that this is likely to be a similar path for UPFs.

“Reducing consumption of UPFs is a complex public health challenge, particularly given how prevalent and accessible these products are,” said co-author Timothy De Ver Dye, PhD, professor and chair of FAU’s Department of Population Health. “Healthcare providers should recognise that many patients face barriers to accessing and affording healthier food options. Addressing these challenges will require efforts that extend beyond individual choices to support greater access to nutritious, minimally processed foods.”

According to the International Agency for Research on Cancer, nearly 1.5 million men worldwide were diagnosed with prostate cancer in 2022, and nearly 400 000 died from the disease.

“All healthcare professionals should encourage patients to adopt healthy lifestyle practices and evidence-based therapies, while also helping them reduce their consumption of ultra-processed foods,” Hennekens said. “Patients and their healthcare providers should consider this finding as part of broader efforts to promote healthier dietary choices.”

Study co-authors are FAU medical students Hunter Scott and John Dunn as well as Yanna Willett, a doctoral student at the University of Oxford in the United Kingdom.

Source: Florida Atlantic University