Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 10.020
Filtrar
1.
Food Chem ; 341(Pt 1): 128148, 2021 Mar 30.
Artículo en Inglés | MEDLINE | ID: mdl-33038776

RESUMEN

The brown seaweed Undaria pinnatifida polysaccharides show various biological activities, but their hypoglycemic activity and the underlying mechanism remain unclear. Here, three fractions of sulfated polysaccharides Up-3, Up-4, and Up-5 were prepared by microwave-assisted extraction from U. pinnatifida. In vitro assays demonstrated that Up-3 and Up-4 had strong α-glucosidase inhibitory activity, and Up-3, Up-4, and Up-5 could improve the glucose uptake in insulin-resistant HepG2 cells without affecting their viability. In vivo studies indicated Up-3 and Up-4 markedly reduced postprandial blood glucose levels. Up-U (a mixture of Up-3, Up-4, and Up-5), reduced fasting blood glucose levels, increased glucose tolerance and alleviated insulin resistance in HFD/STZ-induced hyperglycemic mice. Histopathological observation and hepatic glycogen measurement showed that Up-U alleviated the damage of the pancreas islet cell, reduced hepatic steatosis, and promoted hepatic glycogen synthesis. These findings suggest that Up-U could alleviate postprandial and HFD/STZ-induced hyperglycemia and was a potential agent for diabetes treatment.


Asunto(s)
Hipoglucemiantes/farmacología , Polisacáridos/farmacología , Algas Marinas/química , Undaria/química , Animales , Fraccionamiento Químico , Dieta Alta en Grasa/efectos adversos , Glucosa/metabolismo , Glucosa/farmacocinética , Células Hep G2 , Humanos , Hiperglucemia/tratamiento farmacológico , Hiperglucemia/etiología , Hipoglucemiantes/química , Insulina/farmacología , Resistencia a la Insulina , Masculino , Ratones Endogámicos C57BL , Ratones Endogámicos ICR , Microondas , Polisacáridos/química , Polisacáridos/aislamiento & purificación , Periodo Posprandial , Sulfatos/química
2.
Life Sci ; 264: 118585, 2021 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-33058914

RESUMEN

AIMS: Postprandial lipemia is characterized by an increase in triglyceride-rich lipoproteins after fatty meals. MicroRNAs (miRs) play important roles in lipid and lipoprotein metabolism. The aim of this study was to determine relationship between levels of plasma miR expression and lipoprotein metabolism-related proteins in subjects with normal (NPR) and high postprandial response (HPR) in postprandial period. MATERIALS AND METHODS: The oral fat tolerance test was applied to 22 individuals with NPR and 22 with HPR. KEY FINDINGS: Increased expressions of miR-122 and miR-33a and miR-122/30c ratio and decreased miR-30c expression were observed in fasting and postprandial period of HPR compared with NPR. ROC curve analysis showed that miR-122/30c ratio is a good biomarker for postprandial lipemia (AUC: 0.97, p < 0.001). Levels of TG, MTTP, and Apo B-48 and chylomicron (CM) particle size were significantly higher in HPR than in NPR (p < 0.05). The miR-122/30c ratio at 2 h was positively correlated with CM particle size, and with TG, MTTP and Apo B-48 levels at 4th hour. miR-33a expression decreased in HPR and was negatively correlated with ABCA1 and Apo A-1 levels at 4th hour of the postprandial period in both groups. SIGNIFICANCE: Increased miR-122 and decreased miR-30c expression levels in HPR may play critical roles in elevated or prolonged postprandial lipemia. The miR122/30c ratio exhibited good association with MTTP, Apo B-48 and TG levels, and with CM particle size, and may be a reliable marker for evaluating postprandial lipemia. miR-33a may also play a key role in decreased HDL-C in postprandial lipemia.


Asunto(s)
Hiperlipidemias/sangre , Lipoproteínas/sangre , MicroARNs/sangre , Periodo Posprandial/fisiología , Adulto , Biomarcadores/sangre , Grasas de la Dieta/administración & dosificación , Grasas de la Dieta/efectos adversos , Femenino , Humanos , Hiperlipidemias/inducido químicamente , Lípidos/sangre , Masculino , Persona de Mediana Edad
3.
Med Clin North Am ; 105(1): 19-30, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33246519

RESUMEN

Dyspepsia affects a large percentage of the general population and can lead to lost work productivity and reduced quality of life. Patients with dyspepsia younger than 60 should not routinely undergo endoscopy but instead should pursue Helicobacter pylori test-and-treat approach. For patients 60 and older, endoscopy should be performed. Patients without any identifiable cause for their symptoms are diagnosed with functional dyspepsia. Guideline-based treatment includes H pylori eradication and proton pump inhibitor use. If acid suppression is not adequate, treatment with a tricyclic antidepressant followed by a prokinetic agent and psychological therapy are considered. Complementary therapies are not recommended due to limited evidence.


Asunto(s)
Dispepsia , Antibacterianos/uso terapéutico , Antidepresivos Tricíclicos/uso terapéutico , Terapia Cognitivo-Conductual , Terapias Complementarias , Diagnóstico Diferencial , Dieta , Dispepsia/diagnóstico , Dispepsia/etiología , Dispepsia/fisiopatología , Dispepsia/terapia , Fármacos Gastrointestinales/uso terapéutico , Infecciones por Helicobacter/tratamiento farmacológico , Helicobacter pylori , Humanos , Periodo Posprandial , Prebióticos , Probióticos/uso terapéutico , Inhibidores de la Bomba de Protones/uso terapéutico , Síndrome
4.
PLoS One ; 15(11): e0241847, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33156875

RESUMEN

BACKGROUND: Laparoscopic vertical sleeve gastrectomy (LSG) is a popular bariatric procedure performed in Asia, as obesity continues to be on the rise in our population. A major problem faced is the development of de novo gastroesophageal reflux disease (GERD) after LSG, which can be chronic and debilitating. In this study, we aim to assess the relationship between the presence of small hiatal hernia (HH) and the development of postoperative GERD, as well as to explore the correlation between GERD symptoms after LSG and timing of meals. In doing so, we hope to gain a better understanding about the type of reflux that occurs after LSG and take a step closer towards effectively managing this difficult to treat condition. METHODS: We retrospectively reviewed data collected from patients who underwent LSG in our hospital from Dec 2008 to Dec 2016. All patients underwent preoperative upper GI endoscopy, during which the identification of hiatal hernia takes place. Patients' information and reflux symptoms are recorded using standardized questionnaires, which are administered preoperatively, and again during postoperative follow up visits. RESULTS: Of the 255 patients, 125 patients (74%) developed de novo GERD within 6 months post-sleeve gastrectomy. The rate of de novo GERD was 57.1% in the group with HH, and 76.4% in the group without HH. Adjusted analysis showed no significant association between HH and GERD (RR = 0.682; 95% CI 0.419 to 1.111; P = 0.125). 88% of the patients who developed postoperative GERD reported postprandial symptoms occurring only after meals, and the remaining 12% of patients reported no correlation between the timing of GERD symptoms and meals. CONCLUSION: There is no direct correlation between the presence of small hiatal hernia and GERD symptoms after LSG. Hence, the presence of a small sliding hiatal hernia should not be exclusion for sleeve gastrectomy. Electing not to perform concomitant hiatal hernia repair also does not appear to result in higher rates of postoperative or de novo GERD.


Asunto(s)
Gastrectomía/efectos adversos , Reflujo Gastroesofágico/epidemiología , Hernia Hiatal/cirugía , Adulto , Endoscopía Gastrointestinal , Femenino , Reflujo Gastroesofágico/etiología , Hernia Hiatal/diagnóstico , Humanos , Laparoscopía , Masculino , Persona de Mediana Edad , Periodo Posprandial , Estudios Retrospectivos , Resultado del Tratamiento
5.
Proc Biol Sci ; 287(1938): 20202172, 2020 11 11.
Artículo en Inglés | MEDLINE | ID: mdl-33171081

RESUMEN

Foraging animals must balance benefits of food acquisition with costs induced by a post-prandial reduction in performance. Eating to satiation can lead to a reduction in locomotor and escape performance, which increases risk should a threat subsequently arises, but limiting feeding behaviour may be maladaptive if food intake is unnecessarily reduced in the prediction of threats that do not arise. The efficacy of the trade-off between continued and interrupted feeding therefore relies on information about the future risk, which is imperfect. Here, we find that black carp (Mylopharyngodon piceus) can balance this trade-off using an a posteriori strategy; by eating to satiation but regurgitating already ingested food when a threat arises. While degrees of satiation (DS) equal to or greater than 60% reduce elements of escape performance (turning angle, angular velocity, distance moved, linear velocity), at 40% DS or lower, performance in these tasks approaches levels comparable to that at 0% satiation. After experiencing a chasing event, we find that fish are able to regurgitate already ingested food, thereby changing the amount of food in their gastrointestinal tract to consistent levels that maintain high escape performance. Remarkably, regurgitation results in degrees of satiation between 40 and 60% DS, regardless of whether they had previously fed to 40, 60 or 100% DS. Using this response, fish are able to maximize food intake, but regurgitate extra food to maintain escape performance when they encounter a threat. This novel strategy may be effective for continual grazers and species with imperfect information about the level of threat in their environment.


Asunto(s)
Carpas/fisiología , Animales , Conducta Animal , Cyprinidae , Ingestión de Alimentos , Conducta Alimentaria , Alimentos , Agua Dulce , Periodo Posprandial , Saciedad
6.
JAMA Netw Open ; 3(11): e2025454, 2020 11 02.
Artículo en Inglés | MEDLINE | ID: mdl-33252690

RESUMEN

Importance: Excess body weight and insulin resistance lead to type 2 diabetes and other major health problems. There is an urgent need for dietary interventions to address these conditions. Objective: To measure the effects of a low-fat vegan diet on body weight, insulin resistance, postprandial metabolism, and intramyocellular and hepatocellular lipid levels in overweight adults. Design, Setting, and Participants: This 16-week randomized clinical trial was conducted between January 2017 and February 2019 in Washington, DC. Of 3115 people who responded to flyers in medical offices and newspaper and radio advertisements, 244 met the participation criteria (age 25 to 75 years; body mass index of 28 to 40) after having been screened by telephone. Interventions: Participants were randomized in a 1:1 ratio. The intervention group (n = 122) was asked to follow a low-fat vegan diet and the control group (n = 122) to make no diet changes for 16 weeks. Main Outcomes and Measures: At weeks 0 and 16, body weight was assessed using a calibrated scale. Body composition and visceral fat were measured by dual x-ray absorptiometry. Insulin resistance was assessed with the homeostasis model assessment index and the predicted insulin sensitivity index (PREDIM). Thermic effect of food was measured by indirect calorimetry over 3 hours after a standard liquid breakfast (720 kcal). In a subset of participants (n = 44), hepatocellular and intramyocellular lipids were quantified by proton magnetic resonance spectroscopy. Repeated measure analysis of variance was used for statistical analysis. Results: Among the 244 participants in the study, 211 (87%) were female, 117 (48%) were White, and the mean (SD) age was 54.4 (11.6) years. Over the 16 weeks, body weight decreased in the intervention group by 5.9 kg (95% CI, 5.0-6.7 kg; P < .001). Thermic effect of food increased in the intervention group by 14.1% (95% CI, 6.5-20.4; P < .001). The homeostasis model assessment index decreased (-1.3; 95% CI, -2.2 to -0.3; P < .001) and PREDIM increased (0.9; 95% CI, 0.5-1.2; P < .001) in the intervention group. Hepatocellular lipid levels decreased in the intervention group by 34.4%, from a mean (SD) of 3.2% (2.9%) to 2.4% (2.2%) (P = .002), and intramyocellular lipid levels decreased by 10.4%, from a mean (SD) of 1.6 (1.1) to 1.5 (1.0) (P = .03). None of these variables changed significantly in the control group over the 16 weeks. The change in PREDIM correlated negatively with the change in body weight (r = -0.43; P < .001). Changes in hepatocellular and intramyocellular lipid levels correlated with changes in insulin resistance (both r = 0.51; P = .01). Conclusions and Relevance: A low-fat plant-based dietary intervention reduces body weight by reducing energy intake and increasing postprandial metabolism. The changes are associated with reductions in hepatocellular and intramyocellular fat and increased insulin sensitivity. Trial Registration: ClinicalTrials.gov Identifier: NCT02939638.


Asunto(s)
Dieta con Restricción de Grasas , Dieta Vegana , Hígado/metabolismo , Músculo Esquelético/metabolismo , Obesidad/dietoterapia , Absorciometría de Fotón , Adulto , Anciano , Glucemia/metabolismo , Composición Corporal , Peso Corporal , Péptido C/metabolismo , Colesterol/metabolismo , HDL-Colesterol/metabolismo , LDL-Colesterol/metabolismo , Ingestión de Energía , Metabolismo Energético , Femenino , Hemoglobina A Glucada/metabolismo , Hepatocitos/metabolismo , Humanos , Insulina/metabolismo , Resistencia a la Insulina , Grasa Intraabdominal/diagnóstico por imagen , Metabolismo de los Lípidos , Hígado/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Fibras Musculares Esqueléticas/metabolismo , Músculo Esquelético/diagnóstico por imagen , Obesidad/metabolismo , Sobrepeso/dietoterapia , Sobrepeso/metabolismo , Periodo Posprandial , Espectroscopía de Protones por Resonancia Magnética , Triglicéridos/metabolismo
7.
Medicine (Baltimore) ; 99(48): e23473, 2020 Nov 25.
Artículo en Inglés | MEDLINE | ID: mdl-33235136

RESUMEN

BACKGROUND: Postprandial distress syndrome (PDS), characterized by the presence of prevalently meal-related early satiation and fullness, is a highly prevalent condition with major socioeconomic and healthcare impact. To date, there is a lack of pharmacological treatment proven value for PDS. Therefore, an ideal strategy to relieve PDS is urgently needed. In recent years, massage therapy has been increasingly accepted by PDS patients due to its lower costs, fewer unwanted side effects and safety for clinical use. In this systematic review, we aim to evaluate the effectiveness and safety of massage therapy for patients with postprandial distress syndrome. METHODS: We will search the following electronic databases for randomized controlled trials to evaluate the effectiveness and safety of massage therapy in treating postprandial distress syndrome: Wanfang and Pubmed Database, CNKI, CENTRAL, CINAHL, and EMBASE. Each database will be searched from inception to October 2020. The entire process will include study selection, data extraction, risk of bias assessment, and meta-analyses. RESULTS: This proposed study will evaluate the effectiveness and safety of massage therapy for patients with postprandial distress syndrome. The outcomes will include changes in PDS relief and adverse effect. CONCLUSIONS: This proposed systematic review will evaluate the existing evidence on the effectiveness and safety of massage therapy for patients with postprandial distress syndrome. DISSEMINATION AND ETHICS: The results of this review will be disseminated through peer-reviewed publication. Because all of the data used in this systematic review and meta-analysis has been published, this review does not require ethical approval. Furthermore, all data will be analyzed anonymously during the review process. OSF REGISTRATION NUMBER: DOI 10.17605/OSF.IO/9WRX8.


Asunto(s)
Dispepsia/terapia , Masaje , Periodo Posprandial , Humanos , Metaanálisis como Asunto , Proyectos de Investigación , Revisiones Sistemáticas como Asunto
8.
Diabetes Res Clin Pract ; 169: 108475, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33002547

RESUMEN

AIMS: To assess the prevalence of undiagnosed diabetes (UDD) and the diagnostic accuracy of the American Diabetes Association (ADA) criteria to detect UDD cases in a Peruvian population. METHODS: Population-based cross-sectional study. UDD was defined using fasting plasma glucose (FPG), 2-hour post-prandial plasma glucose (2 h-PPG), and glycated hemoglobin (HbA1c) traditional cut-offs. Diagnostic accuracy was estimated using areas under the receiver-operating characteristic (ROC) curve, compared with the combination of oral glucose tolerance test (FPG plus 2 h-PPG) plus HbA1c as gold standard. RESULTS: 1609 subjects were evaluated; mean age 48.2 (SD: 10.6) years, 50.3% were women. A total of 179 (11.3%) subjects were classified as having diabetes, 41.3% of them had UDD. Area under the curve for FPG, 2 h-PPG and HbA1c was 86.5% (95% CI: 81.4-91.6%); 87.2% (95% CI: 82.2-92.2%) and 80.4% (95% CI: 74.8-86.0%), respectively. FPG sensitivity was 73.0%, whereas this value was 74.3% for 2 h-PPG and 60.8% for HbA1c. Of 74 UDD cases, 45 were positive for HbA1c, 54 for FPG and 55 for 2 h-PPG. CONCLUSIONS: 41.3% of people with diabetes do not know their diagnosis. Diagnostic accuracy of FPG and 2 h-PPG was higher than HbA1c. The most sensitive combination of two tests to detect UDD cases was FPG plus 2 h-PPG.


Asunto(s)
Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiología , Adulto , Glucemia/análisis , Estudios Transversales , Diagnóstico Tardío/estadística & datos numéricos , Diabetes Mellitus/sangre , Ayuno/sangre , Femenino , Prueba de Tolerancia a la Glucosa , Hemoglobina A Glucada/análisis , Humanos , Masculino , Tamizaje Masivo/métodos , Tamizaje Masivo/normas , Persona de Mediana Edad , Perú , Periodo Posprandial , Prevalencia , Curva ROC , Sensibilidad y Especificidad
9.
Arterioscler Thromb Vasc Biol ; 40(12): 2953-2964, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-32998517

RESUMEN

OBJECTIVE: Compare the postprandial fatty acid metabolism of isotopically labeled stearate (U-13C18:0) and oleate (U-13C18:1). Approach and Results: In conjunction with a randomized-controlled crossover trial, 6 hypercholesterolemic postmenopausal women (≥50 years; body mass index: 25.6±3.0 kg/m2; LDL [low-density lipoprotein]-cholesterol ≥110 mg/dL) consumed isocaloric diets enriched in 18:0 or 18:1 (10%-15% E) for 5 weeks each. On day 1 of week 5, following a 12-hour fast, participants receive their experimental diet divided into 13 hourly meals beginning at 8 am. U-13C18:0 or U-13C18:1 was incorporated into the 1:00 pm meal (1.0 mg/kg body weight). Serial blood and breath samples were collected over 12 hours and fasting samples at 24 and 48 hours. Plasma and lipid subfraction fatty acid profiles were assessed by gas chromatography-flame ionization detector, isotope-enrichment by liquid chromatography time-of-flight mass spectrometry, and fatty acid oxidation rate (expired 13CO2) by isotope ratio mass spectrometry. Both diets resulted in similar plasma LDL-cholesterol concentrations. Kinetic curves showed that U-13C18:0 had a higher plasma area under the curve (66%), lower plasma clearance rate (-46%), and a lower cumulative oxidation rate (-34%) than U-13C18:1. Three labeled plasma metabolites of U-13C18:0 were detected: 13C16:0, 13C16:1, and 13C18:1. No plasma metabolites of U-13C18:1 were detected within the study time-frame. Higher incorporation of 18:0 in cholesteryl ester and triglyceride fractions was observed on the 18:0 compared with the 18:1 diet. CONCLUSIONS: The neutrality of 18:0 on plasma LDL-cholesterol concentrations is not attributable to a single factor. Compared with 18:1, 18:0 had higher plasma area under the curve because of lower clearance and oxidation rates, underwent both a direct and a multistage conversion to 18:1, and was preferentially incorporated into cholesteryl esters and triglycerides.


Asunto(s)
Hipercolesterolemia/dietoterapia , Ácido Oléico/sangre , Posmenopausia/sangre , Periodo Posprandial , Ácidos Esteáricos/sangre , Anciano , Anciano de 80 o más Años , Isótopos de Carbono , Ésteres del Colesterol/sangre , LDL-Colesterol/sangre , Estudios Cruzados , Femenino , Absorción Gastrointestinal , Humanos , Hipercolesterolemia/sangre , Hipercolesterolemia/diagnóstico , Persona de Mediana Edad , Ácido Oléico/administración & dosificación , Ácido Oléico/farmacocinética , Oxidación-Reducción , Ácidos Esteáricos/administración & dosificación , Ácidos Esteáricos/farmacocinética , Triglicéridos/sangre
10.
Postgrad Med ; 132(8): 727-736, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33108957

RESUMEN

OBJECTIVE: To understand physicians' reasons for prescribing Insulin Lispro 200 units/ml (IL200) and their experience with IL200 treatment in Germany. METHODS: The survey consisted of 28 questions on physician's profile, average IL200 patients' characteristics and rationales for prescribing IL200. Questions were rated on a scale of 0 ('not at all important'/'strongly disagree') to 4 ('absolutely important'/'strongly agree'). RESULTS: The surveyed physicians had a mean (SD) experience of 18.1 (7.0) years managing diabetes, consulted an average of 226.8 patients with diabetes/month and prescribed IL200 to 56.1% of their patients on mealtime insulin (MTI). About 80.0% of IL200 patients had type 2 diabetes mellitus, were overweight/obese, and received >20 units/day of MTI. More than 70.0% of physicians rated patient's insulin dose, pattern of self-measured glucose levels, hemoglobin A1c (HbA1c) (clinical); adherence, hypoglycemia knowledge, motivation to improve lifestyle, desire to reduce injection volume and emotional struggle with controlling HbA1c (behavioral) as 'very important'/'absolutely important' factors when prescribing IL200. CONCLUSION: Physicians considered IL200 a promising treatment option that reduces the injection burden for patients on MTI. Physicians adopted a patient-centered perspective by aligning IL200 prescribing decisions with each patient's medical needs and non-clinical preferences, with an aim to encourage treatment adherence through resorting to IL200's advantageous attributes.


Asunto(s)
Diabetes Mellitus Tipo 2/tratamiento farmacológico , Diabetes Mellitus Tipo 2/epidemiología , Hipoglucemiantes/uso terapéutico , Insulina Lispro/uso terapéutico , Sobrepeso/epidemiología , Médicos/psicología , Adulto , Glucemia , Automonitorización de la Glucosa Sanguínea , Estudios Transversales , Femenino , Hemoglobina A Glucada , Conocimientos, Actitudes y Práctica en Salud , Humanos , Hipoglucemia/inducido químicamente , Hipoglucemiantes/administración & dosificación , Hipoglucemiantes/efectos adversos , Insulina Lispro/administración & dosificación , Insulina Lispro/efectos adversos , Masculino , Cumplimiento de la Medicación , Persona de Mediana Edad , Motivación , Obesidad/epidemiología , Periodo Posprandial , Pautas de la Práctica en Medicina
11.
Diabetes Res Clin Pract ; 169: 108464, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-32971156

RESUMEN

AIMS: This study aimed to investigate whether supplemental soluble fiber, oat ß-glucan, has any effect on glycemic control and variability of adolescents with type 1 diabetes mellitus. METHODS: This study was conducted in 30 adolescents with type 1 diabetes mellitus and it consisted of three phases lasting one week. At Phase I, all subjects followed a standard diet program. For Phase II and Phase III, the subjects continued their standard diet program and added natural oat flakes containing 3 g/day and 6 g/day ß-glucan, respectively. Glucose levels were monitored by continuous glucose monitoring (CGM). The maximal, minimal, mean and daytime and night blood glucose levels, percentages of glucose values in a target range and below and above a target values were calculated for each of the phases. Premeal, postmeal, peak blood glucose values and peak times of meals were evaluated for each of the phases. Glycemic variability was measured via SD, CV, MAGE, IQR, MODD, LBGI, HBGI, and CONGA parameters. RESULTS: The maximal, mean and daytime and night blood glucose levels were the lowest at Phase III (p < 0.05). Minimal blood glucose levels were the highest at Phase III (p < 0.05). Phase I, II, and III showed similar durations elapsed for Level 2 and Level 1 hypoglycemia, euglycemia, Level 1 and Level 2 hyperglycemia (p > 0.05). Premeal and postmeal blood glucose levels were lowest at Phase III for breakfast, lunch, and overall (p < 0.05). The lowest peak blood glucose levels were detected at Phase III for breakfast, lunch, dinner and overall (p < 0.05). Phase III also showed delayed peaks for all time-points (p < 0.05 for each) compared to other phases. Phase III had significantly lower levels of SD, CV, LBGI, and CONGA levels than those in either Phase I or Phase II (p < 0.05 for each). CONCLUSION: 6 g/day oat ß-glucan have favorable outcomes in glycemic control and variability in adolescents with type 1 diabetes mellitus.


Asunto(s)
Avena , Diabetes Mellitus Tipo 1/dietoterapia , Fibras de la Dieta/administración & dosificación , beta-Glucanos/administración & dosificación , Adolescente , Glucemia/análisis , Automonitorización de la Glucosa Sanguínea , Diabetes Mellitus Tipo 1/sangre , Femenino , Humanos , Hiperglucemia/epidemiología , Hipoglucemia/epidemiología , Masculino , Comidas , Periodo Posprandial
12.
PLoS One ; 15(9): e0238648, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32947608

RESUMEN

Elevated postprandial plasma glucose is a risk factor for development of type 2 diabetes and cardiovascular disease. We hypothesized that the inter-individual postprandial plasma glucose response varies partly depending on the intestinal microbiome composition and function. We analyzed data from Danish adults (n = 106), who were self-reported healthy and attended the baseline visit of two previously reported randomized controlled cross-over trials within the Gut, Grain and Greens project. Plasma glucose concentrations at five time points were measured before and during three hours after a standardized breakfast. Based on these data, we devised machine learning algorithms integrating bio-clinical, as well as shotgun-sequencing-derived taxa and functional potentials of the intestinal microbiome to predict individual postprandial glucose excursions. In this post hoc study, we found microbial and clinical features, which predicted up to 48% of the inter-individual variance of postprandial plasma glucose responses (Pearson correlation coefficient of measured vs. predicted values, R = 0.69, 95% CI: 0.45 to 0.84, p<0.001). The features were age, fasting serum triglycerides, systolic blood pressure, BMI, fasting total serum cholesterol, abundance of Bifidobacterium genus, richness of metagenomics species and abundance of a metagenomic species annotated to Clostridiales at order level. A model based only on microbial features predicted up to 14% of the variance in postprandial plasma glucose excursions (R = 0.37, 95% CI: 0.02 to 0.64, p = 0.04). Adding fasting glycaemic measures to the model including microbial and bio-clinical features increased the predictive power to R = 0.78 (95% CI: 0.59 to 0.89, p<0.001), explaining more than 60% of the inter-individual variance of postprandial plasma glucose concentrations. The outcome of the study points to a potential role of the taxa and functional potentials of the intestinal microbiome. If validated in larger studies our findings may be included in future algorithms attempting to develop personalized nutrition, especially for prediction of individual blood glucose excursions in dys-glycaemic individuals.


Asunto(s)
Glucemia/metabolismo , Microbioma Gastrointestinal , Periodo Posprandial , Algoritmos , Ayuno/sangre , Femenino , Humanos , Estilo de Vida , Masculino , Persona de Mediana Edad , Modelos Biológicos , Fenómica
13.
Intern Med ; 59(18): 2229-2235, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32938850

RESUMEN

Objective The measurement of C-peptide immunoreactivity (CPR) is essential for evaluating the pancreatic ß-cell function and selecting appropriate therapeutic agents in patients with diabetes mellitus. The meal tolerance test (MTT) is simple to administer physiological insulin-stimulating test. Previous studies have reported that several CPR-related indices are useful markers for predicting insulin requirement in type 2 diabetes. In the present study, we investigated the serum CPR response during the MTT in hospitalized patients with type 2 diabetes mellitus in order to clarify the clinical utility of the MTT. Methods We performed the MTT using a test meal with timed measurements of the serum CPR level based on the oral glucose tolerance test over 180 minutes and tested the correlation of various CPR-related indices and clinical factors in patients with type 2 diabetes mellitus. Patients The subjects were patients with type 2 diabetes mellitus who had been admitted to our hospital for diabetes management and education. The final study population consisted of 68 patients. Results The fasting CPR level was correlated with the 24-hour urinary CPR excretion and body mass index. The serum CPR level at 120 minutes in the MTT was strongly correlated with the area under the curve of CPR during the MTT. The patients who needed insulin therapy at 6 months after hospitalization showed a significant lower incremental CPR value from 0 to 120 minutes in the MTT than those who did not need insulin therapy. Conclusion The plasma C-peptide levels at 0 and 120 minutes in the MTT provide essential information for the clinical management of patients with type 2 diabetes mellitus.


Asunto(s)
Péptido C/sangre , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Técnicas de Diagnóstico Endocrino , Hipoglucemiantes/uso terapéutico , Insulina/uso terapéutico , Adulto , Biomarcadores/sangre , Glucemia/metabolismo , Índice de Masa Corporal , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/fisiopatología , Femenino , Prueba de Tolerancia a la Glucosa , Humanos , Insulina/sangre , Células Secretoras de Insulina/fisiología , Masculino , Comidas , Carne , Persona de Mediana Edad , Periodo Posprandial
14.
Nutr Metab Cardiovasc Dis ; 30(11): 1954-1960, 2020 10 30.
Artículo en Inglés | MEDLINE | ID: mdl-32807631

RESUMEN

BACKGROUND AND AIMS: Although the use of Continuous Glucose Monitoring (CGM) is rapidly extending, little evidence is currently available on daily glycemic excursions after different bariatric procedures. We assessed glycemic patterns after sleeve gastrectomy (SG) and roux-en-Y gastric bypass (RYGB) using CGM. METHODS AND RESULTS: Cross-sectional study in subjects who had undergone RYGB (n = 22) or SG (n = 29) since at least 1 year, without pre-surgery or in current diabetes (T2DM) remission. All subjects underwent 7 day-CGM (Dexcom G4 PLATINUM), which provides glucose variability (GV), number and time spent in hypoglycemia, hypoglycemia patterns (postprandial, nocturnal or mixed). All indexes of GV were higher after RYGB than after SG (p < 0.001). Twenty-eight (55%) subjects experienced hypoglycemia. The number of events was higher after RYGB than SG (p = 0.017) while it did not differ in subjects with or without pre-surgery T2DM (p = 0.129). Overall, 9 (32%) subjects presented hypoglycemia exclusively during the postprandial period, 8 (29%) an exclusively nocturnal pattern and 11 (39%) a mixed pattern. The nocturnal pattern was more frequent after SG than RYGB (53.8% vs 6.7%, p = 0.036) while no difference was observed in subjects with or without pre-surgery T2DM (p = 0.697). Hypoglycemia symptoms were more frequent in subjects with postprandial than in those with nocturnal pattern (77.8% vs 12.5%, p = 0.015). CONCLUSIONS: RYGB is characterized by a greater GV and a higher number of hypoglycemia events mostly post-prandial and symptomatic, while SG is associated with nocturnal and often asymptomatic hypoglycemia. These findings suggest that post-bariatric hypoglycemia is a more complex, not exclusively, postprandial phenomenon.


Asunto(s)
Análisis Químico de la Sangre , Glucemia/metabolismo , Ritmo Circadiano , Gastrectomía/efectos adversos , Derivación Gástrica/efectos adversos , Hiperglucemia/diagnóstico , Hipoglucemia/diagnóstico , Monitoreo Ambulatorio , Cuidados Posoperatorios , Adulto , Biomarcadores/sangre , Estudios Transversales , Femenino , Humanos , Hiperglucemia/sangre , Hiperglucemia/etiología , Hipoglucemia/sangre , Hipoglucemia/etiología , Masculino , Persona de Mediana Edad , Periodo Posprandial , Valor Predictivo de las Pruebas , Factores de Tiempo , Resultado del Tratamiento
15.
Nutr Metab Cardiovasc Dis ; 30(11): 1967-1972, 2020 10 30.
Artículo en Inglés | MEDLINE | ID: mdl-32811738

RESUMEN

BACKGROUND AND AIMS: Postprandial blood glucose (PBG) is an independent predictor of disease and mortality risk. To date, the shortest, single, moderate-intensity exercise intervention to reduce PBG is a 1 min bout of stair stepping during an oral glucose tolerance test. Whether this effect translates to real meal consumption is unknown. METHODS AND RESULTS: Subjects (N = 30) participated in a randomized controlled crossover trial performing 0 min (seated control), 1 min, 3 min or 10 min of stair climbing and descending bouts (SCD) at a self-selected pace after consumption of a mixed meal on four separate visits. Compared to control, all SCD reduced PBG at least one timepoint: at 30-min the 3 min (-10.8 (-18.7 to -2.8) mg/dL, p = 0.010) and 10 min (-36.3 (-46.4 to -26.3) mg/dL), p < .001), and at 45-min the 1 min (-7.3 (-13.9 to -0.7) mg/dL, p = 0.030, 3 min (-8.7 (-13.9 to -3.6) mg/dL, p = 0.002 and 10 min SCD (-12.2 (-18.2 to -6.1)mg/dL, p < 0.000) reduced PBG. The area under the curve (AUC) for PBG was lower following the 3 min (-4.4% (-7.5 to -1.4%), p = 0.006) and 10 min (-8.9% (-12.4 to -5.3%), p < 0.001), while the incremental AUC (iAUC) was reduced only following the 10 min (-38.0% (-63.7 to -12.3%), p = 0.005) SCD. All SCD were rated by subjects as very light to light intensity. CONCLUSIONS: Single, subjectively "light" intensity stair climbing and descending bouts as short as 1 min in duration attenuate the postprandial glucose response in normal weight individuals following consumption of a mixed meal. More pronounced effects require longer bouts in a dose-dependent manner.


Asunto(s)
Glucemia/metabolismo , Terapia por Ejercicio , Hiperglucemia/prevención & control , Subida de Escaleras , Adulto , Biomarcadores/sangre , California , Estudios Cruzados , Regulación hacia Abajo , Femenino , Humanos , Hiperglucemia/sangre , Hiperglucemia/diagnóstico , Hiperglucemia/etiología , Masculino , Periodo Posprandial , Factores de Tiempo , Resultado del Tratamiento , Adulto Joven
16.
Am J Clin Nutr ; 112(4): 1114-1119, 2020 10 01.
Artículo en Inglés | MEDLINE | ID: mdl-32766882

RESUMEN

BACKGROUND: High postprandial glucose excursions may increase risk for disease. Individuals have widely varying glucose responses to different meals, and precision nutrition approaches often seek to personalize diets to minimize postprandial glycemic responses as measured by continuous glucose monitors (CGMs). However, it is unknown whether different CGM devices result in concordant meal rankings according to postprandial glycemic excursions. OBJECTIVE: We explored whether meal rankings according to postprandial glycemic excursions differ between 2 simultaneously worn CGMs. METHODS: We collected 27,489 simultaneous measurements from Dexcom G4 Platinum and Abbott Freestyle Libre Pro CGMs during 28 inpatient days in 16 adults without diabetes. Simultaneous glucose measurements obtained for 2 h following 760 ad libitum meals were used to compare within-subject meal rankings between the CGM devices according to their incremental glucose response. RESULTS: Postprandial responses to ad libitum meals were highly variable, with the Abbott and Dexcom systems resulting in within-subject incremental mean ± SD glucose CVs of 91.7 ± 1.9% and 94.2 ± 2.7%, respectively. Within-subject meal rankings for incremental glycemic responses were relatively discordant between CGMs, with a mean Kendall rank correlation coefficient of 0.43 ± 0.05. Meals in the bottom compared with those in the top half of incremental glycemic responses ranked by Abbott resulted in 50 ± 10% (P = 0.0002) less glycemic reduction as measured by Dexcom, and vice versa. The missing glycemic reduction by eating meals ranked according to the discordant CGM was inversely correlated with each subject's Kendall rank correlation coefficient (r = -0.95; P < 0.0001). CONCLUSIONS: Precision nutrition approaches that use CGMs to personalize meal recommendations for minimizing glycemic excursions may be premature given the discordance of within-subject meal rankings between simultaneous CGM devices. More research is needed to clarify the source of this imprecision. This trial was registered at clinicaltrials.gov as NCT03407053.


Asunto(s)
Glucemia/análisis , Estado Nutricional , Periodo Posprandial/fisiología , Medicina de Precisión , Adulto , Femenino , Humanos , Masculino , Comidas , Ciencias de la Nutrición
17.
Am J Physiol Heart Circ Physiol ; 319(4): H808-H813, 2020 10 01.
Artículo en Inglés | MEDLINE | ID: mdl-32857602

RESUMEN

In univentricular (Fontan) physiology, peripheral and splanchnic vascular tone may be raised to counteract reduced cardiac output (CO) and elevated central venous pressure and thus maintain vital organ perfusion. This could negatively affect the normal cardiovascular response to food ingestion, where mesenteric vasodilation and a concurrent rise in CO are central. We sought to elucidate this using rapid cardiovascular MRI. Thirty fasting subjects (50% controls, 40% women and 60% men) ingested a standardized meal. Responses over ~50 min in mean arterial pressure (MAP), CO, and blood flow in all major aortic branches were measured, and regional vascular impedance (Z0) was calculated. Differences from baseline and between groups were assessed by repeated-measures mixed models. Compared with the control group, the Fontan patient group had greater fasting Z0 of the legs and kidneys, resulting in greater systemic Z0 and similar MAP. They further had similar blood flow to the digestive organs at baseline, despite larger variation in mesenteric resistance. Postprandially, blood flow to the legs decreased in the control group but not in the Fontan patient group. Increases in CO and superior mesenteric blood flow were similar in both groups, but the celiac response was blunted in the Fontan patient group. No significant differences in MAP responses were observed. In conclusion, alterations in vascular tone to counteract adverse hemodynamics and raised hepatic afterload may blunt vasoreactivity in the legs and the celiac axis in Fontan physiology. Further study is needed to determine whether blunted celiac or mesenteric vasoreactivity is linked to deteriorating hemodynamics and poor prognosis in Fontan patients.NEW & NOTEWORTHY Novel data on cardiovascular physiology in response to a meal in Fontan patients are presented. Using a previously validated dynamic MRI protocol, we demonstrated that the usual increase in cardiac output and the dilation of the superior mesenteric artery are preserved in clinically well Fontan patients. In contrast, vasoconstriction of the legs may have prevented redistribution of blood flow from this region in response to the meal. This may also affect responses to other types of stress. Celiac vasodilation was also absent in Fontan patients. This may be due to abnormal hepatic circulation. The proposed protocol may be used to study Fontan complications secondary to abnormal regional hemodynamics.


Asunto(s)
Ingestión de Alimentos , Procedimiento de Fontan , Cardiopatías Congénitas/cirugía , Hemodinámica , Imagen por Resonancia Magnética , Circulación Esplácnica , Adolescente , Adulto , Estudios de Casos y Controles , Femenino , Cardiopatías Congénitas/diagnóstico por imagen , Cardiopatías Congénitas/fisiopatología , Humanos , Masculino , Periodo Posprandial , Valor Predictivo de las Pruebas , Factores de Tiempo , Resultado del Tratamiento , Adulto Joven
18.
J Anim Sci ; 98(9)2020 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-32835365

RESUMEN

Activation of the mechanistic target of rapamycin (mTOR)-controlled anabolic signaling pathways in skeletal muscle of rodents and humans is responsive to the level of dietary protein supply, with maximal activation and rates of protein synthesis achieved with 0.2 to 0.4 g protein/kg body weight (BW). In horses, few data are available on the required level of dietary protein to maximize protein synthesis for maintenance and growth of skeletal muscle. To evaluate the effect of dietary protein level on muscle mTOR pathway activation, five mares received different amounts of a protein supplement that provided 0, 0.06, 0.125, 0.25, or 0.5 g of crude protein (CP)/kg BW per meal in a 5 × 5 Latin square design. On each sample day, horses were fasted overnight and were fed only their protein meal the following morning. A preprandial (0 min) and postprandial (90 min) blood sample was collected and a gluteus medius muscle sample was obtained 90 min after feeding the protein meal. Blood samples were analyzed for glucose, insulin, and amino acid concentrations. Activation of mTOR pathway components (mTOR and ribosomal protein S6 [rpS6]) in the muscle samples was measured by Western immunoblot analysis. Postprandial plasma glucose (P = 0.007) and insulin (P = 0.09) showed a quadratic increase, while total essential amino acid (P < 0.0001) concentrations increased linearly with the graded intake of the protein supplement. Activation of mTOR (P = 0.02) and its downstream target, rpS6 (P = 0.0008), increased quadratically and linearly in relation to the level of protein intake, respectively. Comparisons of individual doses showed no differences (P > 0.05) between the 0.25 and 0.5 g of protein intake for either mTOR or rpS6 activation, indicating that protein synthesis may have reached near maximal capacity around 0.25 g CP/kg BW. This is the first study to show that the activation of muscle protein synthetic pathways in horses is dose-dependent on the level of protein intake. Consumption of a moderate dose of high-quality protein resulted in near maximal muscle mTOR pathway activation in mature, sedentary horses.


Asunto(s)
Proteínas en la Dieta/análisis , Suplementos Dietéticos/análisis , Caballos/fisiología , Biosíntesis de Proteínas/efectos de los fármacos , Transducción de Señal/efectos de los fármacos , Serina-Treonina Quinasas TOR/metabolismo , Animales , Glucemia/análisis , Dieta/veterinaria , Ayuno , Femenino , Insulina/sangre , Proteínas Musculares/metabolismo , Músculo Esquelético/efectos de los fármacos , Periodo Posprandial/efectos de los fármacos , Distribución Aleatoria
19.
An Acad Bras Cienc ; 92(2): e20191085, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32813861

RESUMEN

OBJECTIVE: To elucidate the acute effect of different high-fat meals accompanied by water or orange juice on subjective appetite sensations. METHODS: This acute, postprandial study included 39 healthy women (aged 20 to 40 years): 22 participants received a high-monounsaturated fat meal (MUFA) (≈1000 kcal, 56.3% Energy from MUFA) and 17 participants received a high-saturated fat meal (SFA) (≈1000 kcal, 37.6% Energy from SFA). Both interventions were accompanied by 500 ml of water or orange juice. The subjective appetite sensations were evaluated before (fasting) and 1, 2, 3, 4, and 5 hours after the meal intake using the visual analog scale. RESULTS: The subjective area under curve (AUC) appetite sensations and AUC appetite scores were equal after the consumption of high-fat meals from SFA and MUFA. Moreover, the consumption of a high-SFA meal raises the prospective desire to eat something fatty. In addition, the high-SFA meal consumption reduces subjective AUC appetite sensations and AUC appetite scores along the time, compared to a high-MUFA meal, when orange juice consumption followed those meals. CONCLUSION: Our results demonstrate that high-MUFA meal consumption decreased the desire to intake something fatty, and the high-SFA meal, when followed by orange juice intake, has postprandial appetite sensations suppressed.


Asunto(s)
Apetito , Citrus sinensis , Adulto , Ácidos Grasos Monoinsaturados , Femenino , Humanos , Periodo Posprandial , Estudios Prospectivos , Sensación , Adulto Joven
20.
Am J Clin Nutr ; 112(6): 1468-1484, 2020 12 10.
Artículo en Inglés | MEDLINE | ID: mdl-32710741

RESUMEN

BACKGROUND: Efficacy of protein absorption and subsequent amino acid utilization may be reduced in the elderly. Higher protein intakes have been suggested to counteract this. OBJECTIVES: We aimed to elucidate how habituated amounts of protein intake affect the fasted state of, and the stimulatory effect of a protein-rich meal on, protein absorption, whole-body protein turnover, and splanchnic amino acid metabolism. METHODS: Twelve men (65-70 y) were included in a double-blinded crossover intervention study, consisting of a 20-d habituation period to a protein intake at the RDA or a high amount [1.1 g · kg lean body mass (LBM)-1 · d-1 or >2.1 g · kg LBM-1 · d-1, respectively], each followed by an experimental trial with a primed, constant infusion of D8-phenylalanine and D2-tyrosine. Arterial and hepatic venous blood samples were obtained after an overnight fast and repeatedly 4 h after a standardized meal including intrinsically labeled whey protein concentrate and calcium-caseinate proteins. Blood was analyzed for amino acid concentrations and phenylalanine and tyrosine tracer enrichments from which whole-body and splanchnic amino acid and protein kinetics were calculated. RESULTS: High (compared with the recommended amount of) protein intake resulted in a higher fasting whole-body protein turnover with a resultant mean ± SEM 0.03 ± 0.01 µmol · kg LBM-1 · min-1 lower net balance (P < 0.05), which was not rescued by the intake of a protein-dense meal. The mean ± SEM plasma protein fractional synthesis rate was 0.13 ± 0.06%/h lower (P < 0.05) after habituation to high protein. Furthermore, higher fasting and postprandial amino acid removal were observed after habituation to high protein, yielding higher urea excretion and increased phenylalanine oxidation rates (P < 0.01). CONCLUSIONS: Three weeks of habituation to high protein intake (>2.1 g protein · kg LBM-1 · d-1) led to a significantly higher net protein loss in the fasted state. This was not compensated for in the 4-h postprandial period after intake of a meal high in protein.This trial was registered at clinicaltrials.gov as NCT02587156.


Asunto(s)
Aminoácidos/sangre , Proteínas en la Dieta/administración & dosificación , Privación de Alimentos , Periodo Posprandial , Proteínas/metabolismo , Anciano , Aminoácidos/metabolismo , Aminoácidos/orina , Estudios Cruzados , Método Doble Ciego , Humanos , Masculino , Nitrógeno/metabolismo , Nitrógeno/orina , Circulación Esplácnica/fisiología
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA