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Carrots Help Prevent Heart Disease, Particularly for Women, Study Finds

Are carrots the key to a healthy heart? A new study found that individuals with a high level of carotenes in their blood are likely to have a lower degree of atherosclerosis in their arteries, consequently reducing the risk of cardiovascular diseases. 

Conducted by researchers from the Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and the Universitat Oberta de Catalunya (UOC), the study focused on carotenes, bioactive compounds that are abundant in yellow, orange, and green fruits and vegetables such as carrots, spinach, tomatoes, and sweet potatoes. 

While the positive impact of diet on cardiovascular health is well-established, previous research on carotenes’ effect on atherosclerosis (a condition where arteries become narrow and hardened) has yielded inconclusive results. 

Surprisingly, studies on carotene supplements have even suggested potential harm.

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Led by Gemma Chiva Blanch, a prominent figure in the IDIBAPS translational research in diabetes, lipids, and obesity group, the research team shed light on the positive correlation between carotenes and cardiovascular health. 

Atherosclerosis, characterized by the accumulation of LDL or “bad” cholesterol on the inner walls of blood vessels, can lead to the formation of atherosclerotic plaques, which narrow the vessel’s diameter and impede blood flow. In some cases, these plaques may rupture and form clots, resulting in heart attacks or ischemic strokes when blood flow to the heart or brain is obstructed.

To investigate this further, the research team examined 200 participants aged 50 to 70 from the Carotid Atherosclerosis in Newly Diagnosed Type 2 Diabetic Individuals (DIABIMCAP) cohort. The participants’ blood samples were analyzed to measure carotene concentrations, while ultrasound imaging was used to assess the presence of atherosclerotic plaques in the carotid artery.

Fruit and vegetables lower cholesterol

The study found that people with atherosclerosis had lower levels of large HDL particles (also known as “good” cholesterol) compared to those without atherosclerosis. The researchers also observed that there were positive connections between α-carotene (a type of antioxidant found in certain fruits and vegetables) and both large and medium HDL particles. 

On the other hand, they noticed that β-carotene (another type of antioxidant) and total carotene were inversely related to LDL and its medium/small particles.

Furthermore, the study revealed that individuals with atherosclerosis had significantly lower levels of total carotene in their blood compared to those without the condition. As the number of atherosclerotic plaques (buildup in the arteries) increased, the concentrations of carotene in the blood decreased. 

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However, when accounting for various other factors, the inverse relationship between β-carotene and total carotene with plaque burden remained significant only in women.

Chiva Blanch, also an associate professor and researcher at the Faculty of Health Sciences of the UOC, emphasized the significance of their findings. “The study concludes that the greater the concentration of carotenes in the blood, the lesser the atherosclerotic burden, particularly in women,” Chiva Blanch said in a statement.

“So, we can confirm that a diet rich in fruit and vegetables and thus in carotenes lowers the risk of suffering from cardiovascular diseases,” Chiva Blanch added.

The findings of the study, published in the medical journal Clinical Nutrition, highlight the potential benefits of incorporating carotene-rich foods into one’s diet to mitigate the risk of developing cardiovascular diseases, emphasizing the importance of a healthy and balanced diet. 

Further research is needed to delve deeper into the mechanisms underlying the protective effects of carotenes and to explore potential strategies for incorporating them into preventive and therapeutic interventions for cardiovascular health.

Plant-based diet and cardiovascular disease

The study serves as a reminder that small changes in dietary habits can have a significant impact on long-term health outcomes, particularly in the context of cardiovascular diseases, which remain a leading cause of mortality worldwide. 

Many studies have shown the benefits of fruit and vegetable consumption when it comes to heart health. One study published earlier this year in the medical journal JAMA Internal Medicine found that a plant-based diet is among several healthy eating patterns linked to a lower risk of death from cardiovascular disease, cancer, or respiratory disease. 

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The study participants were scored based on four dietary pattern indexes: Healthy Eating Index 2015, Alternate Mediterranean Diet, Healthful Plant-based Diet Index, and Alternate Healthy Eating Index. 

According to the study results, sticking closely to at least one of these diets was associated with lower risk of premature death from all causes, and from cardiovascular disease, cancer, and respiratory disease.

 The researchers believe that the reason for the similarity in the associations between diet quality and death is that all four dietary patterns share the key component of being high in plant foods, specifically whole grains, fruits, vegetables, nuts, and legumes.

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Risk of dementia can be reduced with early efforts

Dr. Douglas Preston

Dementia is a progressive decline in mental function, including memory and cognition, that impacts a person’s daily living, caused by degeneration of the brain. Alzheimer’s disease is one form of dementia well known to the public and impacts about 10% of the population over 65 years of age. An additional 20% of people over 65 years of age have some mild cognitive impairment. In these cases, the effects of the loss of memory and thinking ability are less severe but can sometimes indicate a higher risk for developing dementia later in life. This means, in a group of 10 people over 65 years of age, three of them are probably experiencing some difficulty in their cognitive abilities.

Though we understand how dementia changes the brain’s function, researchers are still working hard to develop treatments that might help improve daily symptoms. In the meantime, it is important to focus on the many lifestyle habits that can help decrease the likelihood of dementia and other memory disorders later in life.

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Intermittent fasting and calorie counting about equal for weight loss, according to new study

The traditional approach to weight loss is to count calories and try to reduce the number consumed each day. This is a time-consuming and error-prone process — often with disappointing results. Intermittent fasting — and the popular version known as time-restricted eating — could be a simpler option for people wanting to achieve a healthy weight.

But is intermittent fasting any better than calorie counting for losing weight? A new study, published in the Annals of Internal Medicine, aimed to provide the answer. It showed that the two methods could be equally effective — if undertaken with professional counseling.

In this year-long study, researchers at the University of Illinois Chicago recruited 90 adults with obesity, aged 18 to 65. The participants were randomly allocated to one of three groups:

  • a time-restricted eating group who were required to consume all their calories each day between noon and 8pm
  • a daily calorie restriction group, who were required to reduce their calorie intake by 25% by closely tracking their diet
  • a control group who maintained their normal dietary patterns throughout the study.

The participants lost about 5% of their starting body weight on both diets in the first six months. The diets were then adjusted to help maintain this weight loss over the next six months.

The time-restricted eating group extended their eating window to ten hours (10am to 8pm) and the daily calorie restriction group increased their calorie intake to match their requirements, which was calculated based on their weight, height, age and activity levels. The control group maintained the same eating pattern.  

The researchers hypothesized that participants focusing on reducing the number of hours they ate would achieve and maintain weight loss better than participants focusing on counting calories. The effects of these two diets on body composition (muscle, fat and bone mass), waist circumference and a range of health markers were also assessed.

The study found that restricting the time during which you can eat and restricting the number of calories were equally effective for losing weight. Participants in both groups lost about 4% of their starting body weight after 12 months.

Both diets also reduced waist circumference and fat mass to a similar extent. Diet records revealed that calorie intake was reduced to a similar extent with both diets, despite the different approaches.

Neither diet showed any changes in health markers, such as glucose, insulin or cholesterol levels. One reason for this may be the use of a late time-restricted eating window (12pm to 8pm), which was considered to be more acceptable for participants.

There is evidence an early time-restricted eating window (8am to 4pm, for instance) can achieve greater weight loss and improve blood glucose regulation.

Scientists aren’t certain why this is the case. However, research suggests that our metabolism is more efficient earlier in the day, aligning with our natural waking and sleeping patterns. This means that the body may be better at using nutrients consumed early in the day.

These findings support previous studies that have found similar weight loss when comparing time-restricted eating and other popular versions of intermittent fasting (such as the 5:2 diet), to daily calorie restriction.  

These studies all show that calorie restriction — whether achieved by reducing the time during which people are allowed to eat or counting the number of calories eaten — is the main thing that determines weight loss.

The new study shows that time-restricted eating can lead to weight loss without explicit instruction to reduce calorie intake. Another strength of this study was the racial diversity of the participants (79% were black or Hispanic), meaning these results can be applied more widely than most previous studies.

 

Substantial counseling

However, one important aspect of this study that makes it difficult to conclude that these interventions alone are enough to help people lose weight is the fact that participants in both dietary intervention groups received a lot of counseling during the study.

This included healthy-eating guidance and cognitive behavioral therapy (a type of talk therapy) to reduce impulse eating. This probably helped participants reduce the urge to eat high-calorie food after completing their fasting window.

Whether this study shows that time-restricted eating and daily calorie restriction are equally effective for weight loss or whether professional support with healthy eating helps with weight loss, is debatable.

Interestingly, a recent study found that time-restricted eating without additional support did not lead to weight loss after three months.

There were also substantial differences in weight loss between individual participants on each diet. This suggests there may be factors that allow time-restricted eating or daily calorie restriction to be more effective for some people than others.

Dieting is difficult, regardless of the method used. This new study suggests weight loss can be achieved using intermittent fasting, but some people will probably benefit more than others. Why that is, we don’t currently know.

David Clayton, Senior Lecturer in Nutrition and Exercise Physiology, Nottingham Trent University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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What Is Quercetin? Benefits, Foods And Side Effects – Forbes Health

Quercetin is used for a variety of potential health benefits, from heart and brain health to allergies. Quercetin can be:

Anti-inflammatory. “Studies suggest quercetin may help alleviate inflammation in various conditions, including arthritis, allergies and cardiovascular disease,” says Dr. Schweig. When the body encounters harmful or irritating substances, inflammation occurs as a natural response for protection and recovery. Inflammation doesn’t always indicate an infection, as it can also be the body’s way of healing itself. Quercetin helps regulate inflammation by inhibiting enzymes involved in the inflammatory process.

Cardioprotective. “Quercetin exhibits cardioprotective benefits,” says Costa. In human studies, quercetin is shown to improve artery health by increasing dilation and reducing blood pressure in participants with hypertension (high blood pressure), which can cause artery damage and ultimately result in heart attack or stroke. “Quercetin [can also] counteract oxidation, a process that hardens arteries by altering LDL (bad) cholesterol,” says Dr. Schweig.

Anti-diabetic. “Quercetin has been studied for its potential benefits in reducing the risk of diabetes,” says Dr. Schweig. A 2022 Biomedicine and Pharmacotherapy review suggests quercetin can decrease high blood sugar and improve antioxidant defense within cells. The same review notes that in a Chinese population, daily consumption of quercetin reduced the prevalence of type 2 diabetes.

Anti-allergic. “Quercetin may act as an antihistamine, reducing the release of histamine and other inflammatory mediators that contribute to allergy symptoms,” says Dr. Schweig. In human studies, a four-week, randomized-controlled trial published in 2022 looked at the effects of quercetin supplementation in Japanese participants with seasonal allergy. Participants who took the quercetin supplement experienced significant improvement in allergy symptoms like itchy eyes, sneezing and nasal discharge compared to the placebo group.

Anti-cancer. “The anti-cancer effects of quercetin may be due in part to its ability to reduce inflammation, prevent DNA damage and induce apoptosis (programmed cell death) in cancer cells,” notes Dr. Schweig. In human studies, quercetin combined with curcumin (a compound in turmeric) reduced the size and number of abnormal growths in patients with familial adenomatous polyposis, a condition in which numerous abnormal growths form in the colon and rectum.

Neuroprotective. “Quercetin can improve brain function and reduce neuroinflammation, key factors in age-related cognitive decline and neurodegenerative diseases like Alzheimer’s disease, Parkinson’s disease and stroke,” says Dr. Schweig. A 40-week randomized-controlled trial published in 2022 studied the effects of regular consumption of a quercetin-containing beverage on Japanese subjects with age-related cognitive decline. The group that consumed the quercetin drink showed significant improvement in reaction time. The study indicates that the quercetin treatment may prevent a decrease in cerebral blood flow and cerebral activity related to stress, although the difference between the treatment and placebo groups wasn’t significant.

Antimicrobial. “Studies indicate that quercetin possesses wide-ranging antimicrobial characteristics,” says Dr. Schweig. In human studies, quercetin’s antiviral effects have been studied in relation to COVID-19, says Dr. Schweig and Costa. However more research is needed to determine its effectiveness, according to the National Institutes of Health (NIH).

Anti-toxin. “Quercetin can also act as a binding agent for pesticides and heavy metals, helping to remove toxins from the body,” says Costa, citing a 2022 Molecules review that summarizes quercetin’s potential to prevent and control toxins caused by food spoilage, fungus and various poisons harmful to plants, animals and humans.

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Plant based Diet Market to Reach $227.2 Billion, Globally, by 2032 at 17.7% CAGR: Allied Market Research

The global plant-based diet market is driven by factors such as rise in vegan population, surge in demand for plant-based food and beverages, and growing animal welfare concerns.

PORTLAND, Ore., June 27, 2023 /PRNewswire/ — Allied Market Research published a report, titled, “Plant based Diet Market by Product Type (Plant based Dairy Products, Plant based Meat Products, and Others), Source (Legumes, Seeds & Nuts, Whole Grains, and Fruits & Vegetables), and Distribution Channel (Supermarkets/hypermarkets, Convenience Stores, Specialty Stores, Online Sales Channel): Global Opportunity Analysis and Industry Forecast, 2023–2032.”. According to the report, the global plant-based diet market was valued at $44.9 billion in 2022, and is projected to reach $227.2 billion by 2032, registering a CAGR of 17.7% from 2023 to 2032.


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Prime determinants of growth

The global plant-based diet market is driven by factors such as rise in vegan population, surge in demand for plant-based food and beverages, and growing animal welfare concerns. However, growing nutritional concerns among consumers and stringent government regulations restain the market growth to some extent. Nevertheless, growing establishment of plant-based or vegan restaurants and a rise in retail sales of plant-based food and beverages are expected to offer prolific growth opportunities in the upcoming years.

Report coverage & details:

Report Coverage

Details

Forecast Period

2023–2032

Base Year

2022

Market Size in 2021

$44.9 billion

Market Size in 2031

$227.2 billion

CAGR

17.7 %

No. of Pages in Report

250

Segments covered

Product Type, Source, Distribution Channel, and Region.

Drivers

Rise in the vegan population

The surge in demand for plant-based food and beverages 

Opportunities

Growing animal welfare concerns

Growing establishment of plant-based or vegan restaurants

Rise in retail sales of plant-based food and beverages

Restraints

Decline in fertility rates in women

Strict safety regulations pertaining to the baby electrolyte

The plant based dairy products segment to maintain its leadership status throughout the forecast period

By product type, the plant based dairy products segment held the highest market share in 2022, accounting for nearly half  of the global plant based diet market revenue and is estimated to maintain its leadership status throughout the forecast period. A wide range of products are now available in the market for plant-based dairy. Innovative flavors, superior textures, and nutrient-rich plant-based substitutes for conventional dairy products are constantly being introduced by manufacturers. The plant based meat products segment, however, would showcase the fastest CAGR of 18.1% during the forecast period. Consumer demand for meat substitutes made from plants has significantly increased. Numerous factors, such as concerns about the effects of animal agriculture on the environment, animal welfare, health considerations, and a rising number of people embracing vegetarian and vegan diets, are behind this desire.

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The legumes segment to maintain its leadership status throughout the forecast period

By source, the legumes segment held the highest market share in 2022, accounting for nearly two fifths of the global plant based diet market share and is estimated to maintain its leadership status throughout the forecast period. Legumes are an important part of plant-based eating habits because they are valued sources of plant-based protein, dietary fiber, and critical elements. The whole grains segment would showcase the fastest CAGR of 18.4% during the forecast period. Whole grains are becoming more widely acknowledged as key components of a nutrient-dense and balanced diet as plant-based diets gain popularity.

The specialty stores segment to maintain its leadership status throughout the forecast period

By distribution channel, the specialty stores segment held the highest market share in 2022, accounting for more than one-third of the global plant based diet market share and is estimated to maintain its leadership status throughout the forecast period. Specialty stores provide high service quality and detailed product specification & expert guidance to the consumers, which boost the sale of these products. The online sales channel segment would showcase the fastest CAGR of 20.0% during the forecast period. Consumers currently prefer to purchase plant based diet products online since it is easy and offers a wide variety of brands that are not accessible in stores.

Europe to maintain its dominance by 2032

By region, Europe held the highest market share, accounting for more than one-third of the global market revenue in terms of revenue in 2022 and is likely to dominate the market during the forecast period. Consumers in Europe are embracing the idea of flexitarianism by eating less meat and increasing their intake of plant-based cuisine. However, North America is expected to witness the fastest CAGR of 18.4% from 2023 to 2032. Consumer demand for plant-based food options has significantly increased in North America. Health issues, environmental awareness, animal welfare concerns, and the desire for a diverse culinary experience are some of the elements that are driving this trend.

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Leading Market Players: –

  • Atlantic Natural Foods LLC
  • Beyond Meat, Inc.
  • Califia Farms, LLC
  • Conagra Brands, Inc
  • Danone S.A.
  • Royal DSM N.V.
  • Glanbia PLC
  • Harmless Harvest
  • Impossible Foods Inc.
  • Lightlife Foods Inc (Maple Leaf Foods Inc.)
  • Nestle S.A., Noumi Ltd.
  • SunOpta Inc.
  • The Hain Celestial Group, Inc.
  • Tyson Foods Inc.

 The report provides a detailed analysis of these key players in the global plant based diet market. The report is valuable in highlighting business performance, operating segments, product portfolio, and strategic moves of market players to showcase the competitive scenario.

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Allied Market Research (AMR) is a full-service market research and business-consulting wing of Allied Analytics LLP based in Portland, Oregon. Allied Market Research provides global enterprises as well as medium and small businesses with unmatched quality of “Market Research Reports” and “Business Intelligence Solutions.” AMR has a targeted view to provide business insights and consulting to assist its clients to make strategic business decisions and achieve sustainable growth in their respective market domain.

We are in professional corporate relations with various companies and this helps us in digging out market data that helps us generate accurate research data tables and confirms utmost accuracy in our market forecasting. Allied Market Research CEO Pawan Kumar is instrumental in inspiring and encouraging everyone associated with the company to maintain high quality of data and help clients in every way possible to achieve success. Each and every data presented in the reports published by us is extracted through primary interviews with top officials from leading companies of domain concerned. Our secondary data procurement methodology includes deep online and offline research and discussion with knowledgeable professionals and analysts in the industry.

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Raisin polyphenols improve cognitive scores in elderly

Specifically, scores for tests assessing orientation, visuospatial/executive and language, and recall were all improved when compared to the placebo. In addition, scores for quality of life and functional capacity also saw increases following supplementation.

“Therefore, the consumption of 50g of raisins produces a slight improvement in cognitive performance, quality of life, and functional activities in the elderly,” the ‘Nutrients’ published report concludes.

The researchers add: “This study can also affirm that flavonoids, present in raisins, may be related to better cognitive performance.”

Polyphenol power

It has been observed​ that diets rich in fruit and vegetables can result in a reduced prevalence of inflammatory and neurodegenerative diseases, due to their high phenolic contents. Such compounds, including polyphenols, are known to have potent anti-inflammatory and antioxidant activities.

Following this, studies​ have suggested that nutritional interventions with phenolic compounds may prevent cognitive decline associated with age, due to their influence on the pathological mechanisms underlying cognitive degeneration.

Grapes are noted to be particularly rich in such polyphenols, containing a diverse array of anthocyanins, flavanols, hydroxycinnamic acid, and flavonols, with previous studies​ noting the neuroprotective properties associated with their consumption.

Raisins offer a low glycaemic index alternative whilst providing satiety, yet little research has been conducted into their supplementation with regards to the effects on cognitive health. Thus, the researchers sought to investigate this potential relationship.

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Are a high-refined carbohydrate diet and the alterations resulting from its intake linked to small intestine changes?

In a recent study published in Nutrition, researchers investigated whether a high-refined carbohydrate (HC) diet and associated metabolic alterations could cause small intestinal dysregulation.

Study: Effect of high-refined carbohydrate diet on intestinal integrity. Image Credit: Oleksandra Naumenko/Shutterstock.com
Study: Effect of high-refined carbohydrate diet on intestinal integrity. Image Credit: Oleksandra Naumenko/Shutterstock.com

Background

Excessive nutrient intake is a leading cause of adiposity or obesity, marked by the expansion of adipose tissues, metabolic changes, and immunological dysfunctions. High-fat diets reportedly result in obesity with altered gut health; however, similar effects have not been extensively investigated in mild-obesity murine models fed HC diets.

The intestinal barrier comprises epithelial cells, tight junctions, mucus, immunological cells, and the microbiome. The gut is vulnerable to dysfunction caused by excessive dietary intake via increased intestinal permeability and the translocation of intestinal bacteria-derived lipopolysaccharides (LPS) within and beyond the intestines to various organs.

About the study

In the present study, researchers evaluated the effects of HC diets on gut integrity using a murine model.

Ten eight-week-old BALB/c murine animals were randomly allocated to receive either a diet rich in high-refined carbohydrates (the intervention group) or a chow diet (control animals) for eight weeks. The high-refined carbohydrate diet comprised 10.0% refined sugar, 45.0% condensed-type milk, and 45.0% chow, consisting of 30% refined sugar (mainly sucrose).

Body weight and food consumption were measured once and twice weekly, respectively. The animals were sacrificed, and samples of their serum, mesenteric lymphatic nodes, small intestines, and adipose tissues from visceral regions were obtained for further evaluation. The distal portions of the ileum and jejunum were utilized to extract messenger ribonucleic acid (mRNA) and determine myeloperoxidase (MPO) levels. Adiposity index scores were calculated as the proportion of the mesenteric, retroperitoneal, and epididymal adipose tissues by weight to body mass.

Gut permeability and bacterial translocation (BT) assays were assessed. The tissues sampled were inserted into tubes to determine 99m technetium (Tc)-Escherichia coli radioactivity. Oral glucose tolerance tests (OGTTs) were performed. Intestinal (jejunum and ileum) and epididymal adipose tissue samples underwent histopathological examination. MPO levels were monitored using colorimetric assays to measure neutrophil infiltration in the small intestines indirectly.

Further, serological fasting glucose, total cholesterol (TC), triacylglyceride (TG), and leptin levels were also measured. Further, RNA expression of tight junctions in the ileum and jejunum and inflammatory mediators was assessed using reverse transcription polymerase chain reaction (RT-PCR). In addition, the levels of claudin 4 (Cldn4), zonula occludens-1 (Zo1), interferon-gamma (IFN-γ), and tumor necrosis factor-alpha (TNF-α) genes were assessed, and flow cytometry (FC) was performed to analyze mesenteric lymph node samples.

Results

Energy intake and body weight did not significantly differ among the groups; nevertheless, HC-fed mice exhibited mild obesity characterized by increased visceral adiposity in the epididymal, retroperitoneal, and mesenteric tissues in relation to metabolic changes such as increased TC, TG, leptin, and fasting blood glucose levels with reduced glucose tolerance in the HC group compared to controls.

MPO and IFN-γ levels in the ileum were elevated within the small intestines of HC-fed mice, indicating local inflammation. However, the length of intestinal villi, tight junction (Cldn4 and Zo1) expression, TNF-α levels, and intraepithelial lymphocytic proportion in the jejunum and ileum were not significantly different among the two groups. In addition, there were no differences in permeability or BT in the intestines, blood, spleen, liver, lungs, mesenteric adipose tissue (MAT), or mesenteric lymph nodes of HC-fed animals.

Further, no significant changes were observed in the population of neutrophils, macrophages, natural killer (NK) lymphocytes, cytotoxic [cluster of differentiation 8+ (CD8+)] T lymphocytes, T helper (Th)-1, 2, and 17 lymphocytes, regulatory T (Treg) cells, and TNF+ cells in the mesenteric lymph nodes. Only the eosinophilic count was significantly lowered in the HC group.

Conclusions

Overall, the study findings showed that HC diets (comprising mainly sucrose) could induce metabolic changes resulting in mild obesity (increased adiposity with no excessive weight gain) and metabolic dysfunction without significant alterations in gut morphology, integrity, or immune function.

The small intestines showed elevated IFN-γ expression and neutrophil counts without any inflammatory signs, as indicated by the unaltered inflammatory cell counts within the mesenteric lymphatic nodes.

An increase in adiposity could predispose to metabolic changes since adipose tissues are endocrinal organs involved in metabolic control and energy metabolism. A sugar-dense diet can promote metabolic disorders with insulin signaling impairments.

The lowered eosinophil count in the gut of HC-fed animals may have led to mucosal immunoglobulin (Ig)A dysregulation and subsequent changes in innate immunological responses; however, the effects of lowered eosinophilic counts in the mesenteric lymph nodes require further research.

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Rethinking What it Means to Exercise with Ankylosing Spondylitis

Alexander Levine, a 34-year-old owner and operator of a virtual personal training business, Alex Levine Fitness LLC, has always held a deep passion for fitness. 

His regimen once centered around traditional strength training exercises like deadlifts, squats, and bench presses, while pursuing a career in sports medicine. However, his trajectory took an unexpected turn at age 21 when he began experiencing intense pain.  

Symptoms including sciatica, mid-back tightness, and intense postural compression began to disrupt Alex’s daily life. Despite numerous doctor visits, no one was able to tell him what was wrong. Physical therapy, however, provided some relief from his shoulder and hip tightness and back pain.   

Pain from Playing Sports or Something Else?

People thought it was a sports injury, with normal aches and pains. At the age of 26, a soccer-related hip injury led to an X-ray that finally revealed the root cause of his pain — inflammation in the sacroiliac (SI) joints. He had bilateral sacroiliitis. This condition is commonly associated with ankylosing spondylitis (AS). The discovery of the HLA-B27 gene in his DNA, a marker strongly linked to AS, confirmed his diagnosis.  

The diagnosis caused Alex to worry about what the future would hold. “My whole career has been in health and fitness,” says Alex. “I wondered if I could continue in my career. My life is sports medicine. Some people told me I wouldn’t make it.” 

He also recalls anxiety over how AS can affect the heart and the lungs — scary things to think about when you’re in your 20s. To help calm his nerves and better understand the condition, he began to research and learn more about AS  

Exercise (As He Knew It) Became Painful

When Alex attempted to resume his traditional exercise routine, it caused too much pain. He was unable to perform his favorite workouts, like lifting weights and playing pick-up basketball, and grappled during the first few years following his diagnosis about how to maintain an active lifestyle. He wondered, “How can I find a way to keep moving? With spondylitis, the less you move, the harder it becomes to get up.” 

How Alex Shifted His Mindset About Exercise

Alex admits to having a particular vision of what exercise meant to him — with strength training at the core — and so he had to shift his thinking to find ways to keep moving. That meant taking an individualized approach, which included using yoga and physical therapy techniques.  

“I changed my whole mindset on what it meant to exercise and what it meant to be physical and strong,” says Alex. 

He discovered that he could gradually reintroduce the exercises he loved pre-AS by modifying his workout techniques. He began utilizing more resistance machines and resistance bands, essentially trying to “hack fitness” to devise a personalized routine that suited his body. 

The exercises Alex chooses are deliberately planned, with a focus on maintaining proper form. If he’s dealing with back tightness or sciatica, he opts for resistance machines over weight training. “There are moments when rest is necessary,” he admits. “My workouts are dictated by the pain. That’s why my routines vary on a weekly basis.” 

At the heart of his journey, Alex is dedicated to keeping active in any way possible — even if it’s just through stretches. He has learned to adapt his workouts to stay fit. This experience reminds us that being strong is about more than just lifting weights — it’s also about resilience and the readiness to change when necessary. 

Tips for Exercising with Ankylosing Spondylitis

As a certified personal trainer, fitness nutrition specialist, and senior fitness specialist via the National Academy of Sports Medicine, Alex dedicates his expertise to providing one-on-one personal training for individuals living with chronic conditions across the globe. Here, he shares his valuable insights on exercising with AS.  

Set reasonable goals.

It is important to create smaller, reasonable goals. Find a couple of minutes every day to exercise so you feel better afterward. Working out for too long can cause stiffness the next day. “I’m working toward strength, flexibility, or cardio, but I’m not going to push the limit to where I’m too sore and too fatigued. I’m going to find that balance,” says Alex.  

Listen to your body.

By doing a couple of minutes of exercise daily, you can really pay attention to how your body feels over time. Alex says it’s important to pay attention to how you feel before and after the exercise. You may feel great during the workout then feel terrible the next day. Find comfortable positions like the wall or a chair to give your body support while you exercise. Remember, it’s important to consult your doctor before starting any new exercise regimen.   

Modify workouts to meet your needs.

When considering chronic conditions like AS, it’s important to note that there are a million ways to work out. The length of the workout, the type of the workout can be adjusted. If one thing doesn’t work, try adjusting one thing like the tools you are using. Even the smallest change can take you where you want to be over time.  

Don’t give up.

Alex believes in having patience and fortitude. “Don’t give up if one thing doesn’t work,” he advises. “Don’t give up if 10 things don’t work.”  

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Whole-food, plant-based diet linked to type 2 diabetes remission

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Incorporating more vegetables into one’s diet could help with insulin resistance. coldsnowstorm/Getty Images
  • New research shows that lifestyle intervention, including eating a whole-food, plant-predominant diet, could result in type 2 diabetes remission.
  • Plant-predominant diets may help with the reversal of insulin resistance.
  • Along with adopting healthier eating habits, weight loss, exercise, stress reduction, and avoiding alcohol can help treat diabetes.

Growing evidence supports the benefits of a whole-food, plant-based diet, which includes reduced blood pressure, lower cholesterol, improved heart health, and diabetes outcomes.

According to a new study published in the American Journal of Lifestyle Medicine, following a lifestyle intervention that involved adopting a whole-food, plant-predominant diet, patients showed potential to achieve type 2 diabetes remission.

The researchers examined the health records of 59 type 2 diabetes patients from a cardiac wellness program between 2007 and 2021, who followed a whole-food, plant-based eating pattern. The average age of the patients was 71.5 years, ranging from 41 to 89 years.

These patients demonstrated noticeable improvements in blood glucose control, and 37% of the individuals in the study achieved full diabetes remission.

Additionally, the study showed an average reduction of glucose-lowering medications among patients who implemented these changes in their lifestyles.

“This study demonstrates that high-fiber, low-fat plant-based diets can help achieve remission from [type 2 diabetes mellitus] in patients already receiving standard-of-care treatment. The study was unique because it did not require caloric restriction or fasting and had a primary endpoint of remission rather than improvement of diabetes.”
— Dr. Caroline Messer, an endocrinologist at Northwell Lenox Hill Hospital, who was not involved in this study, speaking to Medical News Today

Foods high in fiber make you feel fuller longer, which decreases the likelihood of experiencing cravings and overeating.

“High-fiber foods can help slow down the spikes in blood sugar,” Dr. Mary Vouyiouklis Kellis, an endocrinologist at Cleveland Clinic, told MNT.

“High-fiber foods move slowly through the stomach and can help you feel full for longer. This, in turn, may make you less likely to reach for other foods or snacks, for example,” she explained.

Plant-predominant diets may also contribute to the reversal of insulin resistance.

“By avoiding meat, plant-based diets are often hypocaloric and therefore associated with improved insulin sensitivity. Some studies show that individuals following plant-based diets experience improved satiety and are therefore more likely to adhere to these diets,” Dr. Messer explained.

Additionally, plant-based diets are lower in saturated fats, which are thought to harm pancreatic B-cell function.

“A whole grain high fiber diet may improve insulin resistivity. Fiber may attenuate the glycemic response to oral carbohydrates by slowing the absorption of nutrients,“ said Dr. Messer.

“Whole grains and legumes reduce postprandial blood sugars; whole grain foods may be fermented by bacteria in the small intestine, thereby producing fatty acids which improve insulin sensitivity after passing through the liver. In addition, whole grains contain high levels of micronutrients such as vitamin D, magnesium, antioxidants, etc., which all potentially improve insulin sensitivity.“
— Dr. Caroline Messer

Previous studies have shown that whole-food, plant-predominant eating patterns can improve diabetes outcomes. However, the research mainly involved significant calorie restriction, often including fasting or liquid meal replacements.

“Liquid meal replacements are not a long term solution and not typically recommended unless used for certain situations such as, for example, in preparation for bariatric surgery,” explained Dr. Kellis.

“Healthy lifestyle dietary choices are most important. A balanced diet of high fiber foods, lean proteins, fruits, and vegetables as well as complex carbohydrates while avoiding refined sugars can help to improve blood glucose levels,” she advised.

Along with adopting healthier eating habits, weight loss, exercise, stress reduction, and avoiding alcohol can help treat diabetes.

“Weight loss is a very important factor. Exercise can play a role in helping improve blood glucose. Both strength or resistance training and cardio have been found to be helpful in patients with type 2 diabetes,” Dr. Kellis stressed.

”Aim for a goal of 150 minutes of exercise a week. Stress reduction and healthy sleep habits are also important. In addition, avoid alcohol,” she said.

To incorporate more whole and plant-based foods into their diet, it may be helpful to plan meals in advance, the experts interviewed by MNT suggested.

“Meal planning will help you stick to a change. Make a grocery list and you can use this to help you make good choices when you are food shopping,” explained Dr. Kellis.

Mackenzie Burgess, a registered dietitian nutritionist and recipe developer at Cheerful Choices, who was not involved in the study, also highlighted the importance of meal preparation.

“It can be a helpful strategy to prepare large quantities of individual whole food ingredients at a time,” Burgess said.

Here are a few examples of foods Burgess recommended preparing at the weekends and storing in the fridge:

  • cooked grains (rice, quinoa, farro)
  • cooked pulses (beans, lentils, chickpeas)
  • other types of cooked plant proteins (air-fried tofu, sautéed tempeh, microwaved edamame)
  • cooked or chopped vegetables (roasted broccoli, caramelized mushrooms, bell pepper slices)
  • washed and chopped fruits (berries, apple slices, peeled oranges).

Secondly, the experts advised, it may be helpful to make protein a priority.

“Oftentimes when someone starts eating a more plant-forward diet, they make the mistake of not getting enough protein,” Burgess explained.

“This can leave you feeling unsatisfied and less likely to stick with it. I recommend stocking your kitchen with go-to plant protein sources like nuts, seeds, and pulses. Pulses include beans, lentils, and peas and they’re packed with important nutrients like protein, fiber, potassium, and iron,” she said.

“Healthy lifestyle choices are definitely important,” Dr. Kellis said.

“However,“ she cautioned, “sometimes, despite this, it may be hard to achieve type 2 diabetes remission. This can be due in part to genetics, worsening insulin resistance as we age, or long history of type 2 diabetes.“

“After many years of diabetes, there sometimes can be beta cell insufficiency, which means the pancreas sometimes may have trouble secreting enough insulin to improve blood glucose,” she explained.

The endocrinologist also cautioned that the current study faced certain limitations, so further research could help consolidate its findings.

“A big limitation of this study was that it was a case series, and there was no control group,” Dr. Kellis pointed out. “Also, the data may not be generalizable to other healthcare settings.”

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Study shows lifestyle intervention promoting whole-food, plant-predominant eating pattern can achieve type 2 diabetes remission

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This case series further supports the effectiveness of a whole-food, plant-predominant eating pattern as a primary intervention to achieve remission.

A lifestyle-based treatment intervention promoting adherence to a whole-food, plant-predominant eating pattern and integrated into routine care can successfully achieve type 2 diabetes remission, according to a research study published in the American Journal of Lifestyle Medicine.

The case series determined that a sample of 59 patients from a cardiac wellness program, who also had type 2 diabetes, achieved significant improvements in blood glucose control, and in 37 percent of cases, full remission of their diabetes. The patients were treated with a low-fat, whole-food, plant-predominant dietary pattern while also receiving standard medical treatment at a wellness center in Virginia. Improvements in glucose control were accompanied by significant reductions in BMI.

Previous studies have demonstrated that whole-food, plant-predominant eating patterns can improve diabetes outcomes but that research primarily involved substantial calorie restriction, often relying on liquid meal replacements, or fasting. This study, published in collaboration with the American College of Lifestyle Medicine (ACLM), is unique in its assessment of remission as a primary outcome and contributes novel information on the feasibility of achieving remission simply by eating healthy food.

“The prevalence of diabetes is growing, as is recognition in the health care community that diet as the primary intervention can achieve lasting remission in individuals with type 2 diabetes,” said Gunadhar Panigrahi, MD, FACC, DipABLM, the first author of the study. “This case series further supports the effectiveness of a whole-food, plant-predominant eating pattern as a primary intervention to achieve remission as well as the need for increased education for both clinicians and patients on the successful application of lifestyle medicine principles and dietary interventions in everyday medical practice.”

Researchers reviewed electronic health records of patients treated at the wellness clinic between 2007 and 2021 to identify those who adopted a whole-food, plant-predominant eating pattern and achieved meaningful improvements in HbA1c or blood glucose control, as well as remission of type 2 diabetes. Data points were extracted from the periods immediately before the lifestyle intervention and the most recent post intervention.

The study used the 2022 consensus definition of remission published by ACLM of HbA1c less than 6.5% for at least three months without surgery, devices, or active pharmacologic therapy to lower blood glucose. That expert consensus statement was endorsed by the American Association of Clinical Endocrinology, supported by the Academy of Nutrition and Dietetics and co-sponsored by the Endocrine Society.

The mean age of the patients was 71.5 years and ranged in age from 41 to 89 years. Twenty-two of the 59 patients met the criteria for type 2 diabetes remission. The study also reported an average de-escalation of glucose-lowering medications among patients following lifestyle change. The reduction in glucose-lowering medications was consistent with that mentioned in a recent qualitative case series that provided the first published examples of protocols to help guide clinical decision making on when and how to deprescribe medications following lifestyle intervention. Medication deprescribing is a process that is supervised by a physician when a medication is no longer benefiting a patient.

The study highlighted that many patients did not first self-select into a lifestyle medicine treatment program for type 2 diabetes, but were rather educated on the merits of a whole-food, plant-predominant dietary pattern and regular physical activity as part of their routine care at the wellness center.

“There is a perception that many patients may not accept the idea of adopting a whole-food, plant predominant eating pattern but there is a growing abundance of research that in fact shows adherence to a plant-predominant dietary pattern is feasible, and even enjoyable,” said Micaela Karlsen, ACLM Senior Director of Research. “Although full remission may not be possible for every patient, our research shows that every patient deserves to know that it may be possible through the adopting of appropriately dosed therapeutic lifestyle change.”

Future research should measure the proportion of patients in typical medical practices who are willing to consider lifestyle changes as part of routine treatment and examine the factors leading to successful implementation of a plant-predominant dietary intervention, the authors said.

ABOUT ACLM

The American College of Lifestyle Medicine is the nation’s medical professional society advancing lifestyle medicine as the foundation for a redesigned, value-based and equitable healthcare delivery system, leading to whole person health. ACLM educates, equips, empowers and supports its members through quality, evidence-based education, certification and research to identify and eradicate the root cause of chronic disease, with a clinical outcome goal of health restoration as opposed to disease management.

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