LOGI, Flexicarb und Leberfasten - Das Ernährungsforum von Nicolai Worm

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Barclay C, et al.Can type 2 diabetes be prevented in UK general practice? A lifestyle-change feasibility study. British Journal of General Practice, Volume 58, Number 553, August 2008 , pp. e1-e7(1)

Abstract

Background: The increasing incidence of type 2 diabetes mellitus is attributed to increasing weight, reduced physical activity, and poor diet quality. Lifestyle change in patients with pre-diabetes can reduce progression to diabetes but this is difficult to achieve in practice.
Aim: To study the effectiveness of a lifestyle-change intervention for pre-diabetes in general practice.
Design: A feasibility study.
Setting: A medium-sized general practice in Sheffield.
Method: Participants were 33 patients with pre-diabetes. The intervention was a 6-month delayed entry comparison of usual treatment with a lifestyle-change programme: increased exercise and diet change, either reduction in glycaemic load, or reduced-fat diet. The main outcome measures were weight, body mass index (BMI), waist circumference, fasting glucose, lipid profile, and nutrition.
Results: A statistically significant difference was observed between control and intervention groups in three markers for risk of progression to diabetes (weight (P<0.03), BMI (P<0.03), and waist circumference (P<0.001)). No significant differences in fasting glucose or lipid profiles were seen. Aggregated data showed a statistically non-significant improvement in all the measures of metabolic risk of progression to diabetes in the low-glycaemic-load group when compared with a low-fat-diet group (P>0.05). Significant total energy, fat, and carbohydrate intake reduction was achieved and maintained in both groups.
Conclusion: A lifestyle-change intervention feasibility programme for pre-diabetic patients was implemented in general clinical practice. The potential of a low-glycaemic-load diet to be more effective than a low-fat diet in promoting change in the features associated with progression to diabetes is worthy of further investigation.
Keywords: lifestyle; motivation; prediabetic state

DOI: 10.3399/bjgp08X319701
Affiliations: 1: School of Health and Related Research (ScHARR), University of Sheffield, Sheffield 2: Division of Epidemiology & Biostatistics, University of Leeds, Leeds 3: Academic Unit of Primary Medical Care, University of Sheffield, Sheffield

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Haimoto H, Iwata M, Wakai K, Umegaki H. Long-term effects of a diet loosely restricting carbohydrates on HbA1c levels, BMI and tapering of sulfonylureas in type 2 diabetes: a 2-year follow-up study. Diabetes Res Clin Pract 2008;79:350-6.

The aim was to assess the long-term effect of a loose restriction of carbohydrate intake (carbohydrate-reduced diet: CARD) compared to a conventional diet (CD) in type 2 diabetes. One hundred and thirty-three type 2 diabetic outpatients followed the CD (n=57, 1734+/-410 kcal, carbohydrate:protein:fat ratio=57:16:26) or CARD (n=76, 1773+/-441 kcal, carbohydrate:protein:fat ratio=45:18:33) according to their own will, and were followed up for 2 years. Glycemic control, body mass index (BMI), serum cholesterols and dose of antidiabetic drugs were assessed at baseline and after 1 and 2 years. At baseline, hemoglobin A1c (HbA1c) and BMI levels were 7.1+/-1.0% and 24.2+/-2.9, respectively, in the CD group, and 7.4+/-1.1% and 25.1+/-3.4 in the CARD group, showing no significant differences. During the 2-year follow-up period, HbA1c levels were significantly improved in the CARD group (CD: 7.5+/-1.3%, CARD: 6.7+/-0.6%, P<0.001), and BMI decreased more significantly in the CARD group (CD: 23.8+/-3.0, CARD: 23.8+/-3.5, P<0.001). The doses of sulfonylureas clearly tapered, and serum cholesterol profiles improved significantly with the CARD. Our results warrant a long-term and large-scale randomized study of the diet for type 2 diabetes.

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Abete I, et al. Effects of two energy-restricted diets differing in the carbohydrate/protein ratio on weight loss and
oxidative changes of obese men. International Journal of Food Sciences and Nutrition
2008, 1 13, iFirst article, ISSN 0963-7486 print/ISSN 1465-3478 online.

Department of Food Sciences, Physiology and Toxicology, University of Navarra, Pamplona,
Spain

Abstract
Introduction: Low-carbohydrate, high-protein diets are a current challenge in the nutritional
treatment of obesity.
Objective: To compare the effect of a low-carbohydrate high-protein diet with a traditional
hypocaloric diet on weight loss and mitochondrial oxidative metabolism.
Subjects and methods: Nineteen obese men (age 3696 years; body mass index 3492 kg/m2)
were randomized to follow one of the two diets: control diet (15% protein; 30% lipids;
55% carbohydrates) or high-protein diet (30% protein; 30% lipids; 40% carbohydrates) over
an 8-week period. Anthropometry, biochemical variables, resting energy expenditure and
mitochondrial oxidation were measured at the start and at the end of the intervention.
Results: The high-protein diet produced a greater weight loss ( 8.391.2% versus 5.59
2.5%, P 0.012) than the control diet. Interestingly, an activation in the mitochondrial
oxidation was found in the high-protein-fed group. This stimulation was positively correlated
with the final resting energy expenditure and negatively associated with the final fat mass
content.
Conclusion: Low-carbohydrate high-protein diets could involve specific changes in mitochondrial
oxidation that could be related to a higher weight loss.

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Morgan LM, et al. Comparison of the effects of four commercially available weight-loss programmes on lipid-based cardiovascular risk factors. Public Health Nutr. 2008 Jul 23:1-9.

OBJECTIVE: To investigate the relative efficacy of four popular weight-loss programmes on plasma lipids and lipoproteins as measures of CVD risk. DESIGN: A multi-centred, randomised, controlled trial of four diets - Dr Atkins' New Diet Revolution, The Slim-Fast Plan, Weight Watchers Pure Points programme and Rosemary Conley's 'Eat yourself Slim' Diet and Fitness Plan - against a control diet, in parallel for 6 months.Setting and subjectsThe trial was conducted at five universities across the UK (Surrey, Nottingham, Ulster (Coleraine), Bristol and Edinburgh (Queen Margaret University College)) and involved the participation of 300 overweight and obese males and females aged 21-60 years in a community setting. RESULTS: Significant weight loss was achieved by all dieting groups (5-9 kg at 6 months) but no significant difference was observed between diets at 6 months. The Weight Watchers and Rosemary Conley (low-fat) diets were followed by significant reductions in plasma LDL cholesterol (both -12.2 % after 6 months, P < 0.01), whereas the Atkins (low-carbohydrate) and Weight Watchers diets were followed by marked reductions in plasma TAG (-38.2 % and -22.6 % at 6 months respectively, P < 0.01). These latter two diets were associated with an increase in LDL particle size, a change that has been linked to reduced CVD risk. CONCLUSIONS: Overall, these results demonstrate the favourable effects of weight loss on lipid-mediated CVD risk factors that can be achieved through commercially available weight-loss programmes. No detrimental effects on lipid-based CVD risk factors were observed in participants consuming a low-carbohydrate diet.