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  #1   ^
Old Tue, Jul-11-17, 06:36
teaser's Avatar
teaser teaser is offline
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Default Fasting blood sugar, fasting insulin identified as new biomarkers for weight loss

A personalized diet approach could lead to greater weight loss and maintenance success, report researchers. Their study identifies fasting blood sugar and/or fasting insulin as new biomarkers for weight loss in people with prediabetes or diabetes.

Researchers from the Department of Nutrition, Exercise and Sports at the University of Copenhagen today announced the findings from a weight loss biomarker study published in the American Journal of Clinical Nutrition (AJCN). The study, "Pretreatment fasting plasma glucose and insulin modify dietary weight loss success: results from 3 randomized clinical trials," found that fasting blood sugar and/or fasting insulin can be used to select the optimal diet and to predict weight loss, particularly for people with prediabetes or diabetes.

The research analyzed data from three diet clinical trials which collectively looked at more than 1,200 individuals -- Diet, Obesity, and Genes (DiOGenes); the OPUS Supermarket intervention (SHOPUS); and the Nutrient-gene interactions in human obesity (NUGENOB). The findings suggest that for most people with prediabetes, a diet rich with vegetables fruits and wholegrains should be recommended for weight loss and could potentially improve diabetes markers. For people with type 2 diabetes, the analysis found that a diet rich in healthy fats from plant sources would be effective for achieving weight loss. These diets could also be effective independent of caloric restriction.

Two simple biomarkers with a large effect

"Recognizing fasting plasma glucose as a key biomarker enables a new interpretation of the data from many previous studies, which could potentially lead to a breakthrough in personalized nutrition," said Arne Astrup, M.D., Head of Department of Nutrition, Exercise and Sports at University of Copenhagen. "The beauty of this concept is its simplicity. While we are looking into other biomarkers, it is quite amazing how much more we can do for our patients just by using those two simple biomarkers. We will continue to participate in and support research to explore additional biomarkers such as gut microbiota and genomics approaches, which may offer more insights and help to more effectively customize the right diet for specific individuals."

The latest findings, as reported in AJCN, have garnered international support with further analysis conducted by researchers from the University of Colorado, Tufts University, and Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBER OBN). Presented at the American Diabetes Association's 77th Scientific Sessions on June 11, 2017, the additional research includes an examination of patients in the Prevencion Dieta Mediterranea (PREDIMED Study), a Randomized Trial of a Low-CHO Diet for Obesity (CHO Study), and The Healthy Weight for Living Study. The different studies (six in total) employed a variety of nutrition strategies, including caloric restriction and ad libitum diets, varying the contributions of carbohydrate and fat, and increasing fiber intake.

The study was inspired by a finding in an early trial of Gelesis100, a novel hydrogel which demonstrated pronounced weight loss in people with prediabetes. The latest findings, as published in AJCN, concluded that a personalized nutritional approach based on an individual's biomarkers will lead to improved weight loss and maintenance success. The University of Copenhagen will continue to collaborate with the study's authors and other experts to advance this research and help find solutions for people around the world who struggle with weight loss.

If the pitch here was that lowering glycemic load and downright low carb diets could be useful where obesity comes with elevated insulin and blood glucose, that might be fine. But they make a distinction--type II's ought to eat plant-rich low carb (not what the science says, most of the promising research into low carb doesn't avoid animal fat), prediabetics ought to eat healthywholegrain "low glycemic." And the basis?


Background: Which diet is optimal for weight loss and maintenance remains controversial and implies that no diet fits all patients.

Objective: We studied concentrations of fasting plasma glucose (FPG) and fasting insulin (FI) as prognostic markers for successful weight loss and maintenance through diets with different glycemic loads or different fiber and whole-grain content, assessed in 3 randomized trials of overweight participants.

Design: After an 8-wk weight loss, participants in the DiOGenes (Diet, Obesity, and Genes) trial consumed ad libitum for 26 wk a diet with either a high or a low glycemic load. Participants in the Optimal well-being, development and health for Danish children through a healthy New Nordic Diet (OPUS) Supermarket intervention (SHOPUS) trial consumed ad libitum for 26 wk the New Nordic Diet, which is high in fiber and whole grains, or a control diet. Participants in the NUGENOB (Nutrient-Gene Interactions in Human Obesity) trial consumed a hypocaloric low-fat and high-carbohydrate or a high-fat and low-carbohydrate diet for 10 wk. On the basis of FPG before treatment, participants were categorized as normoglycemic (FPG <5.6 mmol/L), prediabetic (FPG 5.6–6.9 mmol/L), or diabetic (FPG ≥7.0 mmol/L). Modifications of the dietary effects of FPG and FI before treatment were examined with linear mixed models.

Results: In the DiOGenes trial, prediabetic individuals regained a mean of 5.83 kg (95% CI: 3.34, 8.32 kg; P < 0.001) more on the high– than on the low–glycemic load diet, whereas normoglycemic individuals regained a mean of 1.44 kg (95% CI: 0.48, 2.41 kg; P = 0.003) more [mean group difference: 4.39 kg (95% CI: 1.76, 7.02 kg); P = 0.001]. In SHOPUS, prediabetic individuals lost a mean of 6.04 kg (95% CI: 4.05, 8.02 kg; P < 0.001) more on the New Nordic Diet than on the control diet, whereas normoglycemic individuals lost a mean of 2.20 kg (95% CI: 1.21, 3.18 kg; P < 0.001) more [mean group difference: 3.84 kg (95% CI: 1.62, 6.06 kg); P = 0.001]. In NUGENOB, diabetic individuals lost a mean of 2.04 kg (95% CI: −0.20, 4.28 kg; P = 0.07) more on the high-fat and low-carbohydrate diet than on the low-fat and high-carbohydrate diet, whereas normoglycemic individuals lost a mean of 0.43 kg (95% CI: 0.03, 0.83 kg; P = 0.03) more on the low-fat and high-carbohydrate diet [mean group difference: 2.47 kg (95% CI: 0.20, 4.75 kg); P = 0.03]. The addition of FI strengthened these associations.

Conclusion: Elevated FPG before treatment indicates success with dietary weight loss and maintenance among overweight patients consuming diets with a low glycemic load or with large amounts of fiber and whole grains.

They are comparing dietary effects across trials, no single trial compares dietary effects on diabetic vs. prediabetic, no trial looks at the effects of a low carbohydrate diet on people with prediabetes. Maybe people with a lesser current disease status can benefit from a less rigorous program, these studies weren't designed to even ask that question, let alone answer it. I don't know what point there even is to this paper, other than maybe rescuing the status quo. I don't even care what the numbers are, putting them together in this way makes no sense.
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  #2   ^
Old Tue, Jul-11-17, 10:47
GRB5111's Avatar
GRB5111 GRB5111 is offline
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Plan: Ketogenic (LCHFKD)
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I agree, good observations on the whole. I don't understand why they'd even find this exercise meaningful. In fact, it appears to be a transparent play to buoy high carb, high fiber with a low glycemic approach without including animal proteins or fats. We know that there are people who respond positively to this protocol, but many, depending on how advanced their path is to T2 and IR, will not. Nothing new!
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