Reversal of severe hypertriglyceridemia with intermittent fasting and a very-low-carbohydrate ketogenic diet: a case series

2020 ◽  
Vol 27 (5) ◽  
pp. 308-311
Author(s):  
Subrat Das ◽  
Jordan McCreary ◽  
Shariq Shamim ◽  
Tro Kalayjian
2021 ◽  
Vol 25 (2) ◽  
pp. 139-151
Author(s):  
Megan W. Arbour ◽  
Melissa Stec ◽  
Kelly C. Walker ◽  
Judith C. Wika

2021 ◽  
Vol 8 ◽  
Author(s):  
Kristen Gavidia ◽  
Tro Kalayjian

Prediabetes and diabetes are leading causes of morbidity and mortality in the United States and are growing in prevalence up to 45% of the population over the past 50 years. Current guidelines from the ADA recommend focusing on energy balance, portion sizes, and weight loss while cautioning that no ideal macronutrient composition has been determined. The guidelines also do not recommend intermittent fasting. In contrast, we report three cases of a substantial reduction in A1C without clinically significant weight loss using a unique, patient-centered program that utilizes low carbohydrate diets with intermittent fasting. These results call into question the role of weight reduction in the management of diabetes while highlighting the unique importance of carbohydrate restriction and intermittent fasting. In this study, we demonstrate a case series of three patients with a substantial reduction in A1C and significantly reducing the need for pharmacotherapy without clinically significant weight loss. Although anecdotal, these results call into question the emphasis of ADA on weight reduction and energy intake reduction for the management of diabetes.


2006 ◽  
Vol 252 ◽  
pp. 1-3

In a nutshellProducing ketosis by high fat and low carbohydrate intake appears to significantly reduce seizure frequency in 2/3rds of epileptics unresponsive to conventional drugs.Side-effects need to be watched for, and data on long-term complications is lacking. Since the evidence is mostly case-series rather than RCTs, caution in implementation alongwith expert dietetic support is appropriate.


Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 611
Author(s):  
Sihui Ma ◽  
Jiao Yang ◽  
Takaki Tominaga ◽  
Chunhong Liu ◽  
Katsuhiko Suzuki

The low-carbohydrate ketogenic diet (LCKD) is a dietary approach characterized by the intake of high amounts of fat, a balanced amount of protein, and low carbohydrates, which is insufficient for metabolic demands. Previous studies have shown that an LCKD alone may contribute to fatty acid oxidation capacity, along with endurance. In the present study, we combined a 10-week LCKD with an 8-week forced treadmill running program to determine whether training in conjunction with LCKD enhanced fatty acid oxidation capacity, as well as whether the maximal exercise capacity would be affected by an LCKD or training in a mice model. We found that the lipid pool and fatty acid oxidation capacity were both enhanced following the 10-week LCKD. Further, key fatty acid oxidation related genes were upregulated. In contrast, the 8-week training regimen had no effect on fatty acid and ketone body oxidation. Key genes involved in carbohydrate utilization were downregulated in the LCKD groups. However, the improved fatty acid oxidation capacity did not translate into an enhanced maximal exercise capacity. In summary, while favoring the fatty acid oxidation system, an LCKD, alone or combined with training, had no beneficial effects in our intensive exercise-evaluation model. Therefore, an LCKD may be promising to improve endurance in low- to moderate-intensity exercise, and may not be an optimal choice for those partaking in high-intensity exercise.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Michael Albosta ◽  
Jesse Bakke

Abstract Background Type 2 Diabetes is a metabolic disorder characterized by hyperglycemia that causes numerous complications with significant long-term morbidity and mortality. The disorder is primarily due to insulin resistance particularly in liver, skeletal muscle, and adipose tissue. In this review, we detail the hormonal mechanisms leading to the development of diabetes and discuss whether intermittent fasting should be considered as an alternative, non-medicinal treatment option for patients with this disorder. Methods We searched PubMed, Ovid MEDLINE, and Google Scholar databases for review articles, clinical trials, and case series related to type 2 diabetes, insulin resistance, and intermittent fasting. Articles were carefully reviewed and included based on relevance to our topic. We excluded abstracts and any non-English articles. Results The majority of the available research demonstrates that intermittent fasting is effective at reducing body weight, decreasing fasting glucose, decreasing fasting insulin, reducing insulin resistance, decreasing levels of leptin, and increasing levels of adiponectin. Some studies found that patients were able to reverse their need for insulin therapy during therapeutic intermittent fasting protocols with supervision by their physician. Conclusion Current evidence suggests that intermittent fasting is an effective non-medicinal treatment option for type 2 diabetes. More research is needed to delineate the effects of intermittent fasting from weight loss. Physicians should consider educating themselves regarding the benefits of intermittent fasting. Diabetic patients should consult their physician prior to beginning an intermittent fasting regimen in order to allow for appropriate oversight and titration of the patients medication regimen during periods of fasting.


2021 ◽  
Vol 20 ◽  
pp. 153473542110322
Author(s):  
Tahj Blow ◽  
Parker N. Hyde ◽  
John N. Falcone ◽  
Aaron Neinstein ◽  
Neil Vasan ◽  
...  

Alpelisib is a α-selective phosphatidylinositol 3-kinase (PI3K) inhibitor approved for treatment of postmenopausal women, and men, with hormone receptor positive (HR+), human epidermal growth factor receptor 2 negative (HER2–), PIK3CA-mutated, advanced breast cancer (ABC). Hyperglycemia is a common, on-target adverse effect that impairs treatment efficacy and increases the rate of treatment delays, dose reductions, and discontinuation. Currently, there are no clear guidelines on how to manage hyperglycemia due to alpelisib when metformin is not effective. In this case series, we review 3 subjects with ABC that developed hyperglycemia during alpelisib-fulvestrant therapy and were successfully managed with dietary and pharmacologic interventions. These cases provide anecdotal evidence to support the use of sodium-glucose co-transporter-2 inhibitors (SGLT2i) and very low carbohydrate diets to minimize hyperglycemia during alpelisib therapy.


Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 374
Author(s):  
Antonio Paoli ◽  
Lorenzo Cenci ◽  
PierLuigi Pompei ◽  
Nese Sahin ◽  
Antonino Bianco ◽  
...  

Background: Ketogenic diet (KD) is a nutritional approach that restricts daily carbohydrates, replacing most of the reduced energy with fat, while maintaining an adequate quantity of protein. Despite the widespread use of KD in weight loss in athletes, there are still many concerns about its use in sports requiring muscle mass accrual. Thus, the present study sought to investigate the influence of a KD in competitive natural body builders. Methods: Nineteen volunteers (27.4 ± 10.5 years) were randomly assigned to ketogenic diet (KD) or to a western diet (WD). Body composition, muscle strength and basal metabolic rate were measured before and after two months of intervention. Standard blood biochemistry, testosterone, IGF-1, brain-derived neurotrophic factor (BDNF) and inflammatory cytokines (IL6, IL1β, TNFα) were also measured. Results: Body fat significantly decreased in KD (p = 0.030); whilst lean mass increased significantly only in WD (p < 0.001). Maximal strength increased similarly in both groups. KD showed a significant decrease of blood triglycerides (p < 0.001), glucose (p = 0.001), insulin (p < 0.001) and inflammatory cytokines compared to WD whilst BDNF increased in both groups with significant greater changes in KD (p < 0.001). Conclusions: KD may be used during body building preparation for health and leaning purposes but with the caution that hypertrophic muscle response could be blunted.


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