Thursday, December 12, 2013

J Pediatr Endocrinol Metab. 2012;25(7-8):697-704. Metabolic impact of a ketogenic diet compared to a hypocaloric diet in obese children and adolescents. Partsalaki I, Karvela A, Spiliotis BE. BACKGROUND: The effects of carbohydrate-restricted (ketogenic) diets on metabolic parameters in children have been incompletely assessed. OBJECTIVE: To compare the efficacy and metabolic impact of ketogenic and hypocaloric diets in obese children and adolescents. SUBJECTS: Fifty-eight obese subjects were placed on one of the two diets for 6 months. METHODS: Anthropometric measurements, body composition, oral glucose/insulin tolerance test, lipidemic profile, high molecular weight (HMW) adiponectin, whole-body insulin sensitivity index (WBISI), and homeostatic model assessment-insulin resistance (HOMA-IR) were determined before and after each diet. RESULTS: Both groups significantly reduced their weight, fat mass, waist circumference, fasting insulin, and HOMA-IR (p = 0.009 for ketogenic and p = 0.014 for hypocaloric), but the differences were greater in the ketogenic group. Both groups increased WBISI significantly, but only the ketogenic group increased HMW adiponectin significantly (p = 0.025). CONCLUSIONS: The ketogenic diet revealed more pronounced improvements in weight loss and metabolic parameters than the hypocaloric diet and may be a feasible and safe alternative for children's weight loss. Combating insulin resistance is the key, and low carb seems to do this pretty well. I wasn't sure if going low carb only meant you had better responses because your insulin went down, or if your insulin resistance was improved. Seems like the latter.

Ketogenic low-carbohydrate diets have no metabolic advantage over nonketogenic low-carbohydrate diets.

Ketogenic low-carbohydrate diets have no metabolic advantage over nonketogenic low-carbohydrate diets. Am J Clin Nutr. 2006 May;83(5):1055-61. Ketogenic low-carbohydrate diets have no metabolic advantage over nonketogenic low-carbohydrate diets. Johnston CS, Tjonn SL, Swan PD, White A, Hutchins H, Sears B. BACKGROUND: Low-carbohydrate diets may promote greater weight loss than does the conventional low-fat, high-carbohydrate diet. OBJECTIVE: We compared weight loss and biomarker change in adults adhering to a ketogenic low-carbohydrate (KLC) diet or a nonketogenic low-carbohydrate (NLC) diet. DESIGN: Twenty adults [body mass index (in kg/m(2)): 34.4 +/- 1.0] were randomly assigned to the KLC (60% of energy as fat, beginning with approximately 5% of energy as carbohydrate) or NLC (30% of energy as fat; approximately 40% of energy as carbohydrate) diet. During the 6-wk trial, participants were sedentary, and 24-h intakes were strictly controlled. RESULTS: Mean (+/-SE) weight losses (6.3 +/- 0.6 and 7.2 +/- 0.8 kg in KLC and NLC dieters, respectively; P = 0.324) and fat losses (3.4 and 5.5 kg in KLC and NLC dieters, respectively; P = 0.111) did not differ significantly by group after 6 wk. Blood beta-hydroxybutyrate in the KLC dieters was 3.6 times that in the NLC dieters at week 2 (P = 0.018), and LDL cholesterol was directly correlated with blood beta-hydroxybutyrate (r = 0.297, P = 0.025). Overall, insulin sensitivity and resting energy expenditure increased and serum gamma-glutamyltransferase concentrations decreased in both diet groups during the 6-wk trial (P < 0.05). However, inflammatory risk (arachidonic acid:eicosapentaenoic acid ratios in plasma phospholipids) and perceptions of vigor were more adversely affected by the KLC than by the NLC diet. CONCLUSIONS: KLC and NLC diets were equally effective in reducing body weight and insulin resistance, but the KLC diet was associated with several adverse metabolic and emotional effects. The use of ketogenic diets for weight loss is not warranted.

Friday, December 06, 2013

There are still health risks for metabolically healthy obese individuals

There are still health risks for metabolically healthy obese individuals Obese people who are currently metabolically healthy face a higher risk of developing diabetes and cardiovascular disease, according to new research accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism. Research has found conflicting evidence about whether it is possible for some obese people to avoid health complications that increase the risk of metabolic diseases. These complications can include high blood pressure, high blood sugar, insulin resistance and low levels of high-density lipoproteins, the "good" form of cholesterol that reduces heart disease risk. Past studies have found as many as 30 percent of obese people may be metabolically healthy. "Unfortunately, our findings suggest metabolically healthy obesity is not a benign condition," said the study's corresponding author, Carlos Lorenzo, MD, of the University of Texas Health Science Center at San Antonio, Texas. "Regardless of their current metabolic health, people who are obese face an increased risk of developing cardiovascular disease and diabetes in the future." To determine metabolic health, researchers examined whether subjects had elevated blood pressure, elevated triglyceride and blood sugar levels, insulin resistance and decreased HDL cholesterol. People who had none or only one of the characteristics were classified as metabolically healthy. The analysis found that increased body mass index was linked to an elevated risk of developing diabetes. Normal weight people who had multiple metabolic abnormalities also faced an increased risk of developing diabetes. Both groups faced an elevated risk of cardiovascular disease after taking into account demographics and smoking behavior. "Our data demonstrate the importance of continuing to monitor for diabetes and cardiovascular disease in both people with metabolically healthy obesity and those who have metabolically abnormalities despite being a normal weight," Lorenzo said. "If physicians and patients are too complacent about assessing risk, we can miss important opportunities to prevent the development of chronic and even deadly conditions."

Study casts doubt on whether extra vitamin D prevents disease

Study casts doubt on whether extra vitamin D prevents disease By Kate Kelland LONDON (Reuters) - Researchers cast doubt on the prevailing wisdom that vitamin D supplements can prevent conditions like cancer, diabetes and heart disease, saying on Friday low vitamin D may be a consequence, not a cause, of ill health. The findings could have implications for millions of people who take vitamin D pills and other supplements to ward off illness - Americans spend an estimated $600 million a year on them alone. Vitamin D, sometimes known as the "sunshine vitamin" is made in the body when the skin is exposed to sunlight and in found in foods like fish liver oil, eggs and fatty fish such as salmon, herring and mackerel. [...] Researchers led by Philippe Autier of France's International Prevention Research Institute in Lyon analyzed data from several hundred observational studies and clinical trials examining the effects of vitamin D levels on so-called non-bone health - including links to illness such as cancer, diabetes and cardiovascular disease. They found that the benefits of high vitamin D levels seen in observational studies — including reduced risk of cardiovascular events, diabetes and colorectal cancer - were not replicated in randomized trials where participants were given vitamin D to see if it would protect against illness. "What this discrepancy suggests is that decreases in vitamin D levels are a marker of deteriorating health," said Autier. In other words, he explained, serious illness like cancer and diabetes may reduce vitamin D concentrations, but that does not necessarily mean that raising vitamin D levels would prevent the illness from occurring.