Wednesday, February 23, 2011

Weight loss without dietary restriction: efficacy of different forms of aerobic exercise.

Am J Sports Med. 1987 May-Jun;15(3):275-9.

Weight loss without dietary restriction: efficacy of different forms of aerobic exercise.

Abstract

Since obese patients with orthopaedic disabilities are often advised to undertake swimming as a part of a weight loss program, the effect of swimming on body weight was systematically studied. Minimally to moderately obese, otherwise healthy young women seeking to lose weight through a program of exercise without dietary restrictions were randomly assigned to one of three groups in which only the type of daily exercise was different. The three types of exercise were brisk walking, riding a stationary cycle, and swimming laps in a pool. All women slowly but progressively increased the time spent in daily exercise to 60 minutes. After 6 months or slightly longer, the women assigned to walking lost 10% of initial weight, the women who cycled lost 12%, but the women who swam lost no weight. The thickness of the subcutaneous panniculus over the middle of the extensor surface of the upper arm was measured using a Lang skin-fold caliper (Graham Field Co, New York, NY) and showed equivalent substantial reductions in the walkers and cyclists, but no change in the swimmers. The results of this study show that both walking and cycling are effective methods of reducing body fat, but that swimming is not.

Tuesday, February 22, 2011

Weight change and risk of endometrial cancer.

Int J Epidemiol. 2006 Feb;35(1):151-8. Epub 2005 Nov 8.

Weight change and risk of endometrial cancer.

University of Wisconsin Comprehensive Cancer Center, Madison, Wisconsin 53726, USA. trentham@wisc.edu
Comment in:

Abstract

BACKGROUND: Obesity is an established risk factor for endometrial cancer. Less well understood is the role of weight gain and weight change in determining risk.
METHODS: We analysed data from a population-based case-control study to evaluate the associations of body mass index (BMI), weight gain, and weight cycling with risk of endometrial cancer. Cases (n=740) under age 80 with a new diagnosis of endometrial cancer were identified from Wisconsin's cancer registry. Controls (n=2342) were randomly selected from driver's license lists and Medicare beneficiary files. Body size at three time points and other risk factor information were ascertained by interview in 1992-95.
RESULTS: Endometrial cases were more likely than controls to be nulliparous, have early ages at menarche and late ages at menopause, be diabetic, smoke cigarettes, and use post-menopausal hormones. After adjustment for these factors, increasing BMI was associated with increased risk (P-trend<0.001); women in the top quartile of BMI (>29 kg/m2) had a 3-fold greater risk of endometrial cancer [95% confidence interval (95% CI) 2.4-4.2] compared with women in the lowest quartile (<23 kg/-m2). For each 5 kg weight gain, the odds ratio (OR) for endometrial cancer risk equalled 1.2 (95% CI 1.2-1.3). History of weight cycling modestly increased risk after adjustment for BMI and other factors (OR=1.3; 95% CI 1.0-1.6). In addition, women who reported sustained weight loss had a reduced risk of endometrial cancer (OR=0.7; 95% CI 0.6-0.9).
CONCLUSIONS: These results suggest that weight gain and lack of weight stability are associated with risk of endometrial cancer.

Vitamin D levels may predict weight loss success

Sunday, February 20, 2011

Carbohydrate recommendations for fat loss

To maximally promote fat loss, the release of insulin must be controlled. The practice behind many of today’s popular diets is to lower body fat by decreasing the amount of insulin released. When insulin is elevated above normal fasting levels, fat cells start storing fat and inhibit its release. Carbohydrates increase insulin levels. Lower carbohydrate diets release less insulin than higher carbohydrate diets. That’s one of the main reasons low carbohydrate diets are more successful for long-term weight management and health.

If you’re on a ketogenic diet, carbohydrate selection won’t matter much as you will be eating less than 50 grams of carbohydrates per day. If you’re eating more than 100 grams of carbohydrates per day, then being careful with your dietary sources of carbohydrates will be especially important if you’re trying to lose fat. Your carbohydrate sources and amount will affect your rate of fat loss, your energy levels, appetite, and mood. This can make or break your fat loss efforts.

Now that we know that not all carbohydrate containing foods are created equal, what are some of the considerations we can pay attention to in order to choose the best carbohydrate sources for fat loss, muscle gains, and health? The glycemic index and glycemic load is what you want to consider first. In 1981, researchers from the University of Toronto developed the glycemic index as a way to allow diabetics to measure the effects of carbohydrates on blood sugar levels. Carbohydrates that break down quickly during digestion and release glucose rapidly into the bloodstream have a high GI; carbohydrates that break down more slowly, releasing glucose more gradually into the bloodstream, have a low GI. This is where the “good’ carbs (slow releasing) versus the “bad’ carbs idea originated from. A glycemic index value of below 55 was consider low, 56 to 69 was considered medium, and a glycemic index of 70+ was considered high. The glycemic index was far from perfect and suffered from many flaws. One flaw was that the glycemic index was based on the consumption of 50grams of a single food. Since humans rarely eat 50 grams of one food at a meal, a more sophisticated concept need to be developed, and that lead to the glycemic load. The glycemic load gave us a much better picture of determining the insulin output of a meal. The glycemic load of a meal is calculated by multiplying the glycemic index of a food item by the amount of carbohydrate per serving, and dividing the result by 100. A glycemic load of fewer than 10 is considered low, 11 to 20 are medium, and 20+ is high. Try your best to stay on the low end of the glycemic load scale to best control your blood sugar.

This is just a brief explanation of the way scientist determine the blood sugar response to various foods and meals. Hopefully I haven’t scared you into thinking you must walk around with a glycemic index chart, a food scale, and a calculator to design your diet because you won’t, but I do want you to be aware that you can make better food choices. Eating your steak with a potato and eating a steak with a salad with yield two different blood sugar responses. In my practice I don’t write any meal plans. Instead I determine how much protein and fat the client will need and how much carbohydrates they need in order to lose fat at a respectable speed and coach them on making better food choices

TIP: familiarize yourself with the content of proteins, fat, and carbohydrates in the foods you eat. Be aware of both glycemic index and glycemic load. My advice is not to worry too much as this will just increase you level of anxiety associated with dieting. Losing fat is easier than most people think. Adding stress and confusion during a fat loss cycle will likely cause you to give up the diet entirely. Instead, I recommend people eat vegetables exclusively for their carbohydrate sources instead of starchy carbohydrates like breads, pasta, and potatoes.

In the future I will review studies that compared low versus high glycemic index and load on fat loss and other health issues. If you have any questions or need some assistance with your diet and exercise program please contact me at

workoutsolutionscoach@gmail.com

Fat loss and skipping breakfast

Fat loss and skipping breakfast

It has been suggested that breakfast is the most important meal of the day. This is probably true. Starting each day with breakfast is considered an important habit for health. As the obesity rate continues to increase, physical activity and breakfast consumption has declined. I will present to you some of the negatives associated with skipping breakfast.

• Woman that skipped breakfast had a higher incidence of irregular menses.
• Skipping breakfast is associated with higher incidence of constipation.
• Skipping breakfast is associated with a higher risk of cardiovascular disease.
• Skipping breakfast is associated with being overweight and obese.
• Skipping breakfast is associated with lower dietary fiber intake, micronutrients, and other essential nutrients.
• Skipping breakfast is associated with higher hunger / appetite levels throughout the day, especially in the evening.
• Skipping breakfast is associated with lowered reproductive function.
• Breakfast skipping is associated with insulin resistance and diabetes.
• Skipping breakfast is associated with lower mental health.
• Skipping breakfast is associated with lower academic performance.
• Children with more educated mothers were more prone to skipping breakfast and being overweight.
• Skipping breakfast is associated with high blood pressure.
• Skipping breakfast is associated with reduced physical activity.
• Skipping breakfast is associated with greater consumption of unhealthful snack foods later in the day.
• Skipping breakfast lowers cognitive function related to memory, test grades, and school attendance.
• Skipping breakfast is associated with dysmenorrhea.
• Skipping breakfast is associated with increase in perceived stress.
• Skipping breakfast is associated with body dissatisfaction, dieting, and dieting disorders.
• Skipping breakfast is associated with impaired thermogenesis.

As you can see from the available research, skipping breakfast is not conducive to your health and fitness goals. My tip today is not to skip breakfast. The main reasons for skipping breakfast was lack of time and not feeling hungry upon wakening. If lack of time represents your situation, I would look to altering your daily scheduled routine and make time. If you have time but don’t feel hungry, this could be a perfect time to do something active for 20-40 minutes. Physical activity can increase your hunger levels, but this is a future article. Also in the future I will show you what macronutrient ratios are best during breakfast for health and fat loss, and other tips and tricks that can be applied to help you lose fat and gain muscle.

If you require assistance with setting up a diet and exercise program, please contact me at workoutsolutionscoach@gmail.com

Fat Loss Tips and Tricks Facebook


http://tinyurl.com/2akebzw

Uneasy about eggs? Let's unscramble the good from the bad. By Jose Antonio

Eggs are the Rodney Dangerfield of foods: They get no respect and, I must say, undeservedly so. Let's face it -- if you want a high-quality protein, eat eggs. Think about it: You're eating an entire animal, a full complement of the essential amino acids. In addition, eggs are a rich source of thiamine, riboflavin, pantothenic acid, folic acid, Vitamin B12, biotin, Vitamin D, Vitamin E and phosphorus. 1 Seems like a complete food, right?

Don't Throw Those Yolks Away!
How often have you cracked those eggshells and daintily dropped the whites into a mixing bowl only to discard the yolks down your kitchen sink faster than you kick dog droppings off your shoes? Why the visceral antipathy toward those bright-yellow orbs? Have we been brainwashed by the "anti-egg lobby"? Well, yes. The old adage that nothing is as bad as the doom-and-gloom dietary crowd makes it out to be is very true in this case.

One of the most extensive studies of egg consumption in the United States examined dietary intake of more than 27,000 individuals and found that the daily nutrient intake of egg consumers was significantly greater than that of non-egg consumers.2 Vitamins B12 , C, E and A were ingested in greater quantities in the egg consumers, and those who ate four or more eggs daily had lower blood cholesterol levels than those who ate one egg or less daily.

Further, in 24 healthy adults (median age 40) who added two boiled eggs to their daily diets for six weeks, HDL (the "good" cholesterol) increased 10%, total cholesterol increased 4% and the total cholesterol/HDL cholesterol ratio didn't change.3 Think something must be wrong with this data? In a sample of 76 bodybuilders who followed an atherogenic (artery-damaging) diet characterized by high fat and high cholesterol, cholesterol intake was due mainly to egg consumption, which ranged from 0-81 eggs per week.4 Interestingly, blood cholesterol levels didn't differ between those who consumed high or low amounts of eggs, and HDL cholesterol concentrations were higher in those who consumed more eggs.

Designer Eggs
Regular chicken eggs aren't as bad as the naysayers have claimed and are, in fact, chock-full of nutrients and protein. But scientists couldn't leave a good thing alone, so along came "designer eggs," which have in some way been fortified with extra Vitamin E, lutein (an antioxidant), selenium and/or omega-3 fatty acids, all of which are good for you. A study in the prestigious European Journal of Clinical Nutrition enlisted 40 healthy men and women to consume either one "normal" egg or one "designer" egg daily for eight weeks. The designer eggs won hands-down; subjects' blood levels of Vitamin E, lutein (more on this later), selenium (a mineral that works with E to fight free radicals) and docosahexaenoic acid (DHA, a type of healthful polyunsaturated fat) were higher.5

Think something cooked up in the lab won't taste as good as the real thing? Seventy-eight volunteers couldn't distinguish the taste or smell of designer vs. regular eggs.6


How many can you consume daily?

Evidence shows that consuming 1-2 whole eggs daily doesn't adversely affect blood lipid parameters.


An Eyeful
Clearly, if you can get all the essential amino acids with a truckload of vitamins and minerals from eggs, this is a food you need to incorporate into your diet. Since designer eggs have higher levels of omega-3 fats that are usually found in fish, designer eggs may be the way to go if you live in Nebraska and can't get enough good seafood. Omega-3 fats may lower the incidence of heart disease, arthritis and psoriasis if consumed regularly, and may have an anti-inflammatory role that could benefit injured muscle. Why is this good? Well, inflammation is a normal and necessary component of skeletal muscle adaptation to intense exercise. Take some fish fat or designer eggs and you may just speed up your postexercise recovery process.

Yet another wonderful ingredient found in eggs is lutein, an antioxidant that's important in preventing age-related macular degeneration (a disease of the eye). Certainly, if you value your vision, lutein is a must.

Take-Home Message
You can consume eggs regularly without harm. As said by scientists at the University of Tennessee Health Sciences Center in Memphis, "No association was seen between egg consumption at levels up to 1+ egg per day and the risk of coronary heart disease in non-diabetic men and women."7 So don't waste the precious vitamins, minerals and nutrients in the yolk. Include a yolk or two in your egg-white omelet.


Egg Facts

1 large whole egg
77 calories
6.3 g protein
0.6 g carbohydrate
5.3 g fat

1 large egg white
17 calories
3.5 g protein
0.3 g carbohydrate
0 g fat

Credits:

Jose Antonio, PhD, CSCS, is a fellow of the American College of Sports Medicine. He's an assistant professor at the University of Delaware (Newark) in the department of health and exercise science.

References: Pennington, J.A.T. Food values of portions commonly used. Philadelphia, PA: J.B. Lippincott Co., 1994.

Dietary Cholesterol and Skeletal Muscle Hypertrophy with Resistance Training: A Randomized Placebo-Controlled Trial

Dietary Cholesterol and Skeletal Muscle Hypertrophy with Resistance Training: A Randomized Placebo-Controlled Trial

Steven E Riechman1,2, Chang Woock Lee1, Heath G Gasier1 and Gentle Chikani2
1 Health and Kinesiology
2 Nutrition, Texas A&M University, College Station, TX

ABSTRACT
Background: We recently reported a strong positive association of dietary cholesterol and skeletal muscle responses to resistance training (Riechman, 2007). To confirm these findings we conducted a randomized placebo controlled trial in which we supplemented the diet with whole egg or egg white (control).
Methods: 3 groups of 50–69 year old generally healthy subjects (N=30) underwent 12 weeks of resistance exercise training (RET, 3x/week, 2–3 sets, 8–12 reps, 70% of max strength). Each group consumed 3.5 mg/kg lean/day (<200 mg/day, LC), 7.0 mg/kg lean/day (~400 mg/day, MC), or 14.0 mg/kg lean/day (~800 mg/day, HC) of cholesterol. Subjects were asked to complete 48 food records over the 12 wks to confirm dietary compliance. Body composition (DEXA) and maximal strength tests were conducted before and after the training.
Results: Summary strength gain (chest press +leg press) was increased significantly (P<0.05) with increasing dietary cholesterol (HC=52±8%, MC=38±8%, LC=21±8%). The mean gain in lean mass was 1.7±1.0 kg (3.7%) where subjects also lost 0.5±1.7 kg of fat mass (1.6%). Changes in lean mass and fat mass between groups was not significantly different (P>0.05).
Conclusion: Our results confirm our previous finding that high dietary cholesterol contributes to strength gain with resistance training; however, lean mass gains were inconsistent. Supported by US Poultry and Egg Association.

Saturday, February 19, 2011

Long-term consumption of a carbohydrate-restricted diet does not induce deleterious metabolic effects.

Nutr Res. 2008 Dec;28(12):825-33.

Long-term consumption of a carbohydrate-restricted diet does not induce deleterious metabolic effects.

Department of Experimental Pharmacology, Polish Academy of Sciences Medical Research Center in Warsaw, 02-106 Warsaw, Poland.

Abstract

Carbohydrate (CHO)-restricted diets have been recommended for weight loss and to prevent obesity, but their long-term effects have not been fully elucidated. This study was designed to evaluate the effect of long-term (>1 year) consumption of a low-CHO high-fat diet ("The optimal diet," developed by Dr Kwaśniewski referenced herein) on lipid profile, glycemic control, and cardiovascular disease risk factors in healthy subjects. Of 31 "optimal" dieters enrolled in the study (17 women and 14 men, aged 51.7+/-16.6 years), 22 declared adherence to the diet for more than 3 years. Average energy intake and principal nutrients consumed were assessed from 6-day dietary records provided by the participants. In most dieters, concentrations of beta-hydroxybutyrate, free fatty acids, total cholesterol, and low-density lipoprotein cholesterol exceeded the upper limits of the reference ranges for nonstarved subjects. The metabolic profiles of most subjects were positive for several indicators, including relatively low concentrations of triacylglycerols, high levels of high-density lipoprotein cholesterol (HDL-C), and normal ratios of low-density lipoprotein cholesterol/HDL-C and total cholesterol/HDL-C. In most subjects, plasma concentrations of glucose, insulin, glucagon, cortisol, homocysteine, glycerol, and C-reactive protein were within reference ranges. Notably, in all but one subject, the homeostasis model assessment index of insulin resistance remained below the threshold for diagnosis of insulin resistance. These results indicate that long-term (>1 year) compliance with a low-CHO high-fat "optimal diet" does not induce deleterious metabolic effects and does not increase the risk for cardiovascular disease, as evidenced by maintenance of adequate glycemic control and relatively low values for conventional cardiovascular risk factors.

Carbohydrate restriction (with or without additional dietary cholesterol provided by eggs) reduces insulin resistance and plasma leptin without modifying appetite hormones in adult men.

Nutr Res. 2009 Apr;29(4):262-8.

Carbohydrate restriction (with or without additional dietary cholesterol provided by eggs) reduces insulin resistance and plasma leptin without modifying appetite hormones in adult men.

Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA.

Abstract

Carbohydrate-restricted diets (CRDs) have been shown to reduce body weight, whereas whole egg intake has been associated with increased satiety. The purpose of this study was to evaluate the effects of additional dietary cholesterol and protein provided by whole eggs while following a CRD on insulin resistance and appetite hormones. Using a randomized blind parallel design, subjects were allocated to an egg (640 mg/d additional dietary cholesterol) or placebo (0 mg/d additional dietary cholesterol) group for 12 weeks while following a CRD. There were significant reductions in fasting insulin (P < .025) and fasting leptin concentrations (P < .01) for both groups, which were correlated with the reductions in body weight and body fat (P < .05 and P < .01, respectively). Both groups reduced insulin resistance as measured by the homeostatic model assessment of insulin resistance (P < .025). There was a significant decrease in serum glucose levels observed after the intervention. We did not observe the expected increases in plasma ghrelin levels associated with weight loss, suggesting a mechanism by which subjects do not increase appetite with CRD. To confirm these results, the subjective measures of satiety using visual analog scale showed that both groups felt more "full" (P < .05), "satisfied" (P < .001), and "wanted to eat less" (P < .001) after the intervention. These results indicate that inclusion of eggs in the diet (additional dietary cholesterol) did not modify the multiple beneficial effects of CRD on insulin resistance and appetite hormones.

Egg consumption as part of an energy-restricted high-protein diet improves blood lipid and blood glucose profiles in individuals with type 2 diabetes.

Br J Nutr. 2011 Feb;105(4):584-92. Epub 2010 Dec 7.

Egg consumption as part of an energy-restricted high-protein diet improves blood lipid and blood glucose profiles in individuals with type 2 diabetes.

Commonwealth Scientific and Industrial Research Organization (CSIRO), Food and Nutritional Sciences, Adelaide, SA 5000, Australia.

Abstract

The role of dietary cholesterol in people with diabetes has been little studied. We investigated the effect of a hypoenergetic high-protein high-cholesterol (HPHchol) diet compared to a similar amount of animal protein (high-protein low-cholesterol, HPLchol) on plasma lipids, glycaemic control and cardiovascular risk markers in individuals with type 2 diabetes. A total of sixty-five participants with type 2 diabetes or impaired glucose tolerance (age 54·4 (sd 8·2) years; BMI 34·1 (sd 4·8) kg/m2; LDL-cholesterol (LDL-C) 2·67 (sd 0·10) mmol/l) were randomised to either HPHchol or HPLchol. Both hypoenergetic dietary interventions (6-7 MJ; 1·4-1·7 Mcal) and total carbohydrate:protein:fat ratio of 40:30:30 % were similar but differed in cholesterol content (HPHchol, 590 mg cholesterol; HPLchol, 213 mg cholesterol). HPHchol participants consumed two eggs per d, whereas HPHchol participants replaced the eggs with 100 g of lean animal protein. After 12 weeks, weight loss was 6·0 (sd 0·4) kg (P < 0·001). LDL-C and homocysteine remained unchanged. All the subjects reduced total cholesterol ( - 0·3 (sd 0·1) mmol/l, P < 0·001), TAG ( - 0·4 (sd 0·1) mmol/l, P < 0·001), non-HDL-cholesterol (HDL-C, - 0·4 (sd 0·1) mmol/l, P < 0·001), apo-B ( - 0·04 (sd 0·02) mmol/l, P < 0·01), HbA1c ( - 0·6 (sd 0·1) %, P < 0·001), fasting blood glucose ( - 0·5 (sd 0·2) mmol/l, P < 0·01), fasting insulin ( - 1·7 (sd 0·7) mIU/l, P < 0·01), systolic blood pressure ( - 7·6 (sd 1·7) mmHg, P < 0·001) and diastolic blood pressure ( - 4·6 (sd 1·0) mmHg; P < 0·001). Significance was not altered by diet, sex, medication or amount of weight loss. HDL-C increased on HPHchol (+0·02 (sd 0·02) mmol/l) and decreased on HPLchol ( - 0·07 (sd 0·03) mmol/l, P < 0·05). Plasma folate and lutein increased more on HPHchol (P < 0·05). These results suggest that a high-protein energy-restricted diet high in cholesterol from eggs improved glycaemic and lipid profiles, blood pressure and apo-B in individuals with type 2 diabetes.

Don't Skip the Fat Burning Eggs

Dr. Richard Bernstein On High-Fat, Low-Carb Diets & Diabetes

Thursday, February 17, 2011

Fructose: a highly lipogenic nutrient implicated in insulin resistance, hepatic steatosis, and the metabolic syndrome.

Am J Physiol Endocrinol Metab. 2010 Nov;299(5):E685-94. Epub 2010 Sep 7.

Fructose: a highly lipogenic nutrient implicated in insulin resistance, hepatic steatosis, and the metabolic syndrome.

Research Institute, The Hospital for Sick Children, University of Toronto, Ontario, Canada.

Abstract

As dietary exposure to fructose has increased over the past 40 years, there is growing concern that high fructose consumption in humans may be in part responsible for the rising incidence of obesity worldwide. Obesity is associated with a host of metabolic challenges, collectively termed the metabolic syndrome. Fructose is a highly lipogenic sugar that has profound metabolic effects in the liver and has been associated with many of the components of the metabolic syndrome (insulin resistance, elevated waist circumference, dyslipidemia, and hypertension). Recent evidence has also uncovered effects of fructose in other tissues, including adipose tissue, the brain, and the gastrointestinal system, that may provide new insight into the metabolic consequences of high-fructose diets. Fructose feeding has now been shown to alter gene expression patterns (such as peroxisome proliferator-activated receptor-γ coactivator-1α/β in the liver), alter satiety factors in the brain, increase inflammation, reactive oxygen species, and portal endotoxin concentrations via Toll-like receptors, and induce leptin resistance. This review highlights recent findings in fructose feeding studies in both human and animal models with a focus on the molecular and biochemical mechanisms that underlie the development of insulin resistance, hepatic steatosis, and the metabolic syndrome.

Magazine: Core Values - NYTimes.com/Video

Monday, February 14, 2011

Phytochemicals and regulation of the adipocyte life cycle.

J Nutr Biochem. 2008 Nov;19(11):717-26. Epub 2008 May 20.

Phytochemicals and regulation of the adipocyte life cycle.

Department of Animal and Dairy Science, University of Georgia, Athens, GA 30602, USA.

Abstract

Natural products have potential for inducing apoptosis, inhibiting adipogenesis and stimulating lipolysis in adipocytes. The objective of this review is to discuss the adipocyte life cycle and various dietary bioactives that target different stages of adipocyte life cycle. Different stages of adipocyte development include preadipocytes, maturing preadipocytes and mature adipocytes. Various dietary bioactives like genistein, conjugated linoleic acid (CLA), docosahexaenoic acid, epigallocatechin gallate, quercetin, resveratrol and ajoene affect adipocytes during specific stages of development, resulting in either inhibition of adipogenesis or induction of apoptosis. Although numerous molecular targets that can be used for both treatment and prevention of obesity have been identified, targeted monotherapy has resulted in lack of success. Thus, targeting several signal transduction pathways simultaneously with multiple natural products to achieve additive or synergistic effects might be an appropriate approach to address obesity. We have previously reported two such combinations, namely, ajoene+CLA and vitamin D+genistein. CLA enhanced ajoene-induced apoptosis in mature 3T3-L1 adipocytes by synergistically increasing the expression of several proapoptotic factors. Similarly, genistein potentiated vitamin D's inhibition of adipogenesis and induction of apoptosis in maturing preadipocytes by an enhanced expression of VDR (vitamin D receptor) protein. These two examples indicate that combination therapy employing compounds that target different stages of the adipocyte life cycle might prove beneficial for decreasing adipose tissue volume by inducing apoptosis or by inhibiting adipogenesis or both.

Efficacy and tolerability of the Modified Atkins Diet in adults with pharmacoresistant epilepsy: A prospective observational study.

Epilepsia. 2011 Jan 26. doi: 10.1111/j.1528-1167.2010.02941.x. [Epub ahead of print]

Efficacy and tolerability of the Modified Atkins Diet in adults with pharmacoresistant epilepsy: A prospective observational study.

Schulich School of Medicine, University of Western Ontario, London, Ontario, Canada Krembil Neuroscience Program, University Health Network & Neurology Department, University of Toronto, Toronto, Ontario, Canada Krembil Neuroscience Program, University of Toronto, Toronto, Ontario, Canada.

Abstract

Purpose:  Evidence from the pediatric population exists for the efficacy of ketogenic diets in reducing seizure frequency in patients with intractable epilepsy. Recent evidence suggests that a Modified Atkins Diet may be a beneficial form of cotherapy for adult patients with pharmacoresistant epilepsy. Methods:  A prospective, open-label study was performed of adults >18 years of age with pharmacoresistant epilepsy. Carbohydrates were restricted to 20 g/day. Fluids and calories from protein and fat were allowed ad libitum. Key Findings:  Eighteen patients, ages 18-55 years, were initially enrolled. Using an intent-to-treat analysis, 12% had a >50% seizure reduction after 3 months; 28% after 6 months, and 21% after 12 months. Response at 3 months predicted response at 12 months in 79% of patients. The mean decrease in weight was 10.9 kg and the mean decrease in body mass index (BMI) was 3.8, p = 0.01. Fourteen of 18 patients (78%) completed 12 months of this diet. Patients experienced a decrease in triglycerides from (mean) 1.22 to 0.9 mm (p = 0.02). Significance:  The Modified Atkins Diet demonstrates modest efficacy as cotherapy for some adults with pharmacoresistant epilepsy and may be also helpful for weight loss. Financial and logistical barriers were significant factors for those who declined enrollment and for those who discontinued the study.