Effect of Pilates on Body Composition and Some Biochemical Parameters of Women with Type 2 Diabetes on a Low-Carbohydrate or High-Complex-Carbohydrate Diabetic Diet

Background: The prevalence of type 2 diabetes mellitus (T2DM) has increased dramatically in the past 30 years. The World Health Organization has prepared an action plan to stop the increase in diabetes and obesity by 2025. Objectives: This study was conducted to assess the effect of pilates on body composition and some biochemical parameters in women with T2DM on a high-complex-carbohydrate diabetic diet or a low-carbohydrate/high-monounsaturated fatty acids (MUFA) diet. Methods: This experimental study was conducted on 120 woman patients with T2DM, referring to the Fatih Medical Park Hospital’s Internal Medicine Department, Istanbul, Turkey, between December 2018 and June 2019. Participants were divided into 4 groups and were followed up for 12 weeks. The mean participants’ age was 41.67 ± 3.83 years. The first group received a low-carbohydrate and high MUFA (LC, MUFA) diet, the second group received a low-carbohydrate and a high-MUFA diet and did pilates (LC, MUFA + PL), the third group received a higher complex carbohydrate (HCC) diet, and the fourth group took the HCC diet and did pilates (HCC + PL). Results: According to the applied intervention method, there were significant differences between the preliminary and final measurements of body mass index, body fat percentage, muscle mass, and fasting blood glucose, insulin, HbA1c, total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglyceride (TG) values (P < 0.05). In this study, only an increase in body muscle composition of the women in the LC, MUFA + PL group was found significant (P < 0.05). The highest decrease in body fat ratio was determined again in the LC, MUFA + PL group (P < 0.05). HDL levels of the women who did pilates increased significantly than other groups (P < 0.05). Conclusions: In the treatment of diabetes, the patient should be evaluated with a multidisciplinary team. Diet and exercise are important non-pharmacological interventions in the treatment of diabetes.

Effects of a multifactorial ecosustainable isocaloric diet on liver fat in patients with type 2 diabetes: randomized clinical trial

IntroductionTreatment options for non-alcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes (T2D) are still a matter of debate. We compared the effects of a diet including different components versus a proven beneficial diet rich in monounsaturated fatty acids (MUFAs) on liver fat in T2D.Research design and methodsAccording to a parallel design, 49 individuals with T2D, overweight/obese, with high waist circumference, 35–75 years-old, in satisfactory blood glucose control with diet or drugs not affecting liver fat content, were randomly assigned to an 8-week isocaloric intervention with a MUFA diet (n=26) or a multifactorial diet rich in fiber, MUFA, n-6 and n-3 polyunsaturated fatty acids, polyphenols, and vitamins D, E, and C (n=23). Before and after the intervention, liver fat content was evaluated by proton magnetic resonance spectroscopy (1H-MRS). 1H-MRS complete data were available for n=21 (MUFA diet) and n=18 (multifactorial diet) participants.ResultsAdherence to dietary interventions was optimal. No significant differences between groups in body weight reduction, plasma glycated hemoglobin, insulin, glucose, lipids and liver enzymes were observed. Liver fat significantly decreased after both the multifactorial diet (9.18%±7.78% vs 5.22%±4.80%, p=0.003) and the MUFA diet (9.47%±8.89% vs 8.07%±8.52%, p=0.027) with a statistically significant difference between changes either in absolute terms (−4.0%±4.5% vs −1.4%±2.7%, p=0.035) or percent (−40%±33% vs −19%±25%, p=0.030).ConclusionsAn isocaloric multifactorial diet including several beneficial dietary components induced a clinically relevant reduction of liver fat in patients with T2D, more pronounced than that induced by simply replacing saturated fat with MUFA. This suggests that the ‘optimal diet’ for NAFLD treatment in T2D should be based on synergic actions of different dietary components on multiple pathophysiological pathways.Trial registration numberNCT03380416.

A high-MUFA diet alone does not affect ketone body metabolism, but reduces glycated hemoglobin when combined with exercise training in diabetic rats

Background Monounsaturated fat (MUFA) also has glucose-lowering action, but its effect on ketone bodies is unknown. Objectives To examine the effects of high-MUFA diet alone or in combination with exercise training, which can improve glucose and ketone body metabolism, in a rat model of diabetes. Methods Wistar rats were administered streptozotocin to induce diabetes and then randomly divided into five groups: sedentary rats fed a regular diet (1), a high-saturated-fat diet (2), a high-MUFA diet (3); and exercisetrained rats fed a regular diet (4), and a high-MUFA diet (5). Training was by a treadmill twice daily, 5 days/week. At 12 weeks, glucose, glycated hemoglobin (HbA1c), insulin, nonesterified fatty acids (NEFA), and β-hydroxybutyrate levels were measured in cardiac blood. Activity of the overall ketone synthesis pathway was determined in liver and 3-ketoacyl-CoA transferase activity determined in gastrocnemius muscle. Results A high-MUFA diet tended to lower plasma glucose without affecting other biochemical variables. Training did not change glucose metabolism, but significantly reduced serum NEFA. Only the high-MUFA diet plus training significantly decreased HbA1c levels. Hepatic ketone synthesis was decreased and 3-ketoacyl-CoA transferase activity was increased by training alone or in combination with a high-MUFA diet. Changes in NEFA, β-hydroxybutyrate, and the enzymatic activities in response to training plus a high-MUFA diet were comparable to those caused by training alone. Conclusion A high-MUFA diet alone does not alter ketone body metabolism. Combination of a MUFA-rich diet and exercise training is more effective than either MUFA or exercise alone for lowering HbA1c.

The Effect Of Diet Composition On Weight Gain in Obese, Type 2 Diabetes Patients Receiving Intensive Insulin Therapy

This study was conducted to contribute to the limiting existing body of literature about diet and prevention of weight gain when administering intensive insulin therapy. The effects of a high- monounsaturated fatty acid (MUFA) diet compared with a conventional diabetic diet have not been studied in insulin treated patients. A growing body of evidence assessed that diets rich in high-MUFA foods had similar glycemic results, as do low-fat, high carbohydrate diets. However, a high-MUFA diet did not raise triglycerides as suspected. Ros (2003) stated that high-MUFA energy controlled diets do not promote weight gain and are more acceptable for weight loss and/or maintenance. A MUFA diet can be used as an alternate to the conventional American Diabetic Association (ADA) diet when managing obese type 2 diabetes patients treated with intensive insulin therapy. Dietary restriction to 1600 calories in diabetes patients on intensive insulin therapy decreased the A1C value by 1.3 points in the ADA group and 1.5 points in the MUFA group without weight gain and without additional insulin required. In conclusion the total calorie count was more important for preventing weight gain and reducing the A1C in patients on intensive insulin therapy than was dietary composition.

Compared with that of MUFA, a high dietary intake of n-3 PUFA does not reduce the degree of pathology in mdx mice

Duchenne muscular dystrophy (DMD) is a severe muscle disease that affects afflicted males from a young age, and the mdx mouse is an animal model of this disease. Although new drugs are in development, it is also essential to assess potential dietary therapies that could assist in the management of DMD. In the present study, we compared two diets, high-MUFA diet v. high-PUFA diet, in mdx mice. To generate the high-PUFA diet, a portion of dietary MUFA (oleic acid) was replaced with the dietary essential n-3 PUFA α-linolenic acid (ALA). We sought to determine whether ALA, compared with oleic acid, was beneficial in mdx mice. Consumption of the high-PUFA diet resulted in significantly higher n-3 PUFA content and reduced arachidonic acid content in skeletal muscle phospholipids (PL), while the high-MUFA diet led to higher oleate content in PL. Mdx mice on the high-MUFA diet exhibited 2-fold lower serum creatine kinase activity than those on the high-PUFA diet (P< 0·05) as well as a lower body fat percentage (P< 0·05), but no significant difference in skeletal muscle histopathology results. There was no significant difference between the dietary groups with regard to phosphorylated p65 (an inflammatory marker) in skeletal muscle. In conclusion, alteration of PL fatty acid (FA) composition by the high-PUFA diet made mdx muscle more susceptible to sarcolemmal leakiness, while the high-MUFA diet exhibited a more favourable impact. These results may be important for designing dietary treatments for DMD patients, and future work on dietary FA profiles, such as comparing other FA classes and dose effects, is needed.

Adding MUFA to a dietary portfolio of cholesterol-lowering foods reduces apoAI fractional catabolic rate in subjects with dyslipidaemia

The present randomised parallel study assessed the impact of adding MUFA to a dietary portfolio of cholesterol-lowering foods on the intravascular kinetics of apoAI- and apoB-containing lipoproteins in subjects with dyslipidaemia. A sample of sixteen men and postmenopausal women consumed a run-in stabilisation diet for 4 weeks. Subjects were then randomly assigned to an experimental dietary portfolio either high or low in MUFA for another 4 weeks. MUFA substituted 13·0 % of total energy from carbohydrate (CHO) in the high-MUFA dietary portfolio. Lipoprotein kinetics were assessed after the run-in and portfolio diets using a primed, constant infusion of [2H3]leucine and multicompartmental modelling. The high-MUFA dietary portfolio resulted in higher apoAI pool size (PS) compared with the low-MUFA dietary portfolio (15·9 % between-diet difference, P= 0·03). This difference appeared to be mainly attributable to a reduction in apoAI fractional catabolic rate (FCR) after the high-MUFA diet ( − 5·6 %, P= 0·02 v. pre-diet values), with no significant change in production rate. The high-MUFA dietary portfolio tended to reduce LDL apoB100 PS compared with the low-MUFA dietary portfolio ( − 28·5 % between-diet difference, P= 0·09), predominantly through an increase in LDL apoB100 FCR (23·2 % between-diet difference, P= 0·04). These data suggest that adding MUFA to a dietary portfolio of cholesterol-lowering foods provides the added advantage of raising HDL primarily through a reduction in HDL clearance rate. Replacing CHO with MUFA in a dietary portfolio may also lead to reductions in LDL apoB100 concentrations primarily by increasing LDL clearance rate, thus potentiating further the well-known cholesterol-lowering effect of this diet.

Effect of a high monounsaturated fatty acid diet alone or with combined vitamin E and C, or lycopene intake on oxidative stress in patients with type 2 diabetes mellitus

The aims of this study were to investigate the effect of a high monounsaturated fatty acid (MUFA) diet alone or with combined vitamin E and C, or lycopene intake on oxidative stress in type 2 diabetes in Saudi Arabia. Forty-eight type 2 diabetic patients consumed a high MUFA diet for 16 weeks. After four weeks of high MUFA diet alone, supplements of vitamins E (400 mg) and C (1,000 mg) were taken for four weeks, followed by a four-week washout period. In the final four weeks, subjects consumed a high MUFA diet with tomato paste (equivalent to 12 mg lycopene). Plasma samples were tested for vitamin E and C, lycopene, malondialdehyde (MDA), total antioxidant status, fasting plasma glucose and glycated haemoglobin A1c (HbA1c). A high-MUFA diet with vitamins E and C or lycopene caused significant elevation of plasma vitamins E, C and lycopene compared to a high-MUFA diet alone. Plasma MDA was reduced with vitamins, but not lycopene supplementation. The total antioxidant status increased significantly following a high-MUFA diet and with vitamin and lycopene supplementations. Fasting glucose was not affected whereas HbA1c decreased significantly after vitamin supplementation compared to baseline. A high-MUFA diet supplemented with vitamin E and C, or lycopene improves antioxidant status in type 2 diabetes.

Effect of interaction between PPARG, PPARA and ADIPOQ gene variants and dietary fatty acids on plasma lipid profile and adiponectin concentration in a large intervention study

Unsaturated fatty acids are ligands of PPAR-γ, which up-regulates genes involved in fatty acid transport and TAG synthesis and the insulin-sensitising adipokine adiponectin, which activates fatty acid β-oxidation via PPAR-α action in liver. We investigated the effect of dietary fatty acid interaction with PPARG, PPARA and ADIPOQ gene variants on plasma lipid and adiponectin concentrations in the Reading Imperial Surrey Cambridge King's study, a five-centre, parallel design, randomised controlled trial of 466 subjects at increased cardiometabolic risk. After a 4-week run-in to baseline, SFA was replaced by MUFA or carbohydrate (low fat) in isoenergetic diets for 24 weeks. Habitual dietary PUFA:SFA ratio×PPARG Pro12Ala genotype interaction influenced plasma total cholesterol (P=0·02), LDL-cholesterol (P=0·002) and TAG (P=0·02) concentrations in White subjects. PPARA Val162Leu×PPARG Pro12Ala genotype interaction influenced total cholesterol (P=0·04) and TAG (P=0·03) concentrations at baseline. After high-MUFA and low-fat diets, total cholesterol and LDL-cholesterol were reduced (P<0·001) and gene×gene interaction determined LDL-cholesterol (P=0·003) and small dense LDL as a proportion of LDL (P=0·012). At baseline, ADIPOQ −10066 G/A A-allele was associated with lower serum adiponectin (n 360; P=0·03) in White subjects. After the high-MUFA diet, serum adiponectin increased in GG subjects and decreased in A-allele carriers (P=0·006 for difference). In GG, adiponectin increased with age after the high MUFA and decreased after the low-fat diet (P=0·003 for difference at 60 years). In conclusion, in Whites, high dietary PUFA:SFA would help to reduce plasma cholesterol and TAG in PPARG Ala12 carriers. In ADIPOQ −10066 GG homozygotes, a high-MUFA diet may help to increase adiponectin with advancing age.