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1.
Cochrane Database Syst Rev ; 9: CD000280, 2020 09 08.
Artigo em Inglês | MEDLINE | ID: mdl-32898300

RESUMO

BACKGROUND: Preterm infants are born with low glycogen stores and require higher glucose intake to match fetal accretion rates. In spite of the myriad benefits of breast milk for preterm infants, it may not adequately meet the needs of these rapidly growing infants. Supplementing human milk with carbohydrates may help. However, there is a paucity of data on assessment of benefits or harms of carbohydrate supplementation of human milk to promote growth in preterm infants. This is a 2020 update of a Cochrane Review first published in 1999. OBJECTIVES: To determine whether human milk supplemented with carbohydrate compared with unsupplemented human milk fed to preterm infants improves growth, body composition, and cardio-metabolic and neurodevelopmental outcomes without significant adverse effects. SEARCH METHODS: We used the standard search strategy of Cochrane Neonatal to search Cochrane Central Register of Controlled Trials (CENTRAL 2019, Issue 8) in the Cochrane Library and MEDLINE via PubMed on 22 August 2019. We also searched clinical trials databases and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. SELECTION CRITERIA: Published and unpublished controlled trials were eligible if they used random or quasi-random methods to allocate preterm infants in hospital fed human milk to supplementation or no supplementation with additional carbohydrate. DATA COLLECTION AND ANALYSIS: Two review authors independently abstracted data and assessed trial quality and the quality of evidence at the outcome level using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) method. We planned to perform meta-analyses using risk ratios (RRs) for dichotomous data and mean differences (MDs) for continuous data, with their respective 95% confidence intervals (CIs). We planned to use a fixed-effect model and to explore potential causes of heterogeneity via sensitivity analyses. We contacted study authors for additional information. MAIN RESULTS: One unblinded, quasi-randomised controlled trial (RCT) assessing effects of carbohydrate supplementation of human milk in the form of a prebiotic in 75 preterm infants was eligible for inclusion in this review. We identified two publications of the same trial, which reported different methods regarding blinding and randomisation. Study authors confirmed that these publications pertain to the same trial, but they have not yet clarified which method is correct. We were unable to reproduce analyses from the data presented. At 30 days of age, the mean weight of preterm infants in the trial was greater in the prebiotic carbohydrate-supplemented group than in the unsupplemented group (MD 160.4 grams, 95% CI 12.4 to 308.4 grams; one RCT, N = 75; very low-quality evidence). We found no evidence of a clear difference in risk of feeding intolerance (RR 0.64, 95% CI 0.36 to 1.15; one RCT, N = 75 infants; very low-quality evidence) or necrotising enterocolitis (NEC) (RR 0.2, 95% CI 0.02 to 1.3; one RCT, N = 75 infants; very low-quality evidence) between the prebiotic-supplemented group and the unsupplemented group. Duration of hospital stay was shorter in the prebiotic group than in the control group at a median (range) of 16 (9 to 45) days (95% CI 15.34 to 24.09) and 25 (11 to 80) days (95% CI 25.52 to 34.39), respectively. No other data were available for assessing effects of carbohydrate supplementation on short- and long-term growth, body mass index, body composition, and neurodevelopmental or cardio-metabolic outcomes. AUTHORS' CONCLUSIONS: We found insufficient evidence on the short- and long-term effects of carbohydrate supplementation of human milk in preterm infants. The only trial included in this review presented very low-quality evidence, and study authors provided uncertain information about study methods and analysis. The evidence may be limited in its applicability because researchers included a small sample of preterm infants from a single centre. However, the outcomes assessed are common to all preterm infants, and this trial demonstrates the feasibility of prebiotic carbohydrate supplementation in upper-middle-income countries. Future trials should assess the safety and efficacy of different types and concentrations of carbohydrate supplementation for preterm infants fed human milk. Although prebiotic carbohydrate supplementation in preterm infants is currently a topic of active research, we do not envisage that further trials of digestible carbohydrates will be conducted, as this is currently done as a component of multi-nutrient human milk fortification. Hence we do not plan to publish any further updates of this review.


Assuntos
Carboidratos da Dieta/administração & dosagem , Suplementos Nutricionais , Fenômenos Fisiológicos da Nutrição do Lactente , Recém-Nascido Prematuro/crescimento & desenvolvimento , Leite Humano , Prebióticos , Peso Corporal , Enterocolite Necrosante/epidemiologia , Intolerância Alimentar/epidemiologia , Humanos , Recém-Nascido , Tempo de Internação , Leite Humano/química , Oligossacarídeos/administração & dosagem
2.
Cochrane Database Syst Rev ; 8: CD011737, 2020 08 21.
Artigo em Inglês | MEDLINE | ID: mdl-32827219

RESUMO

BACKGROUND: Reducing saturated fat reduces serum cholesterol, but effects on other intermediate outcomes may be less clear. Additionally, it is unclear whether the energy from saturated fats eliminated from the diet are more helpfully replaced by polyunsaturated fats, monounsaturated fats, carbohydrate or protein. OBJECTIVES: To assess the effect of reducing saturated fat intake and replacing it with carbohydrate (CHO), polyunsaturated (PUFA), monounsaturated fat (MUFA) and/or protein on mortality and cardiovascular morbidity, using all available randomised clinical trials. SEARCH METHODS: We updated our searches of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (Ovid) and Embase (Ovid) on 15 October 2019, and searched Clinicaltrials.gov and WHO International Clinical Trials Registry Platform (ICTRP) on 17 October 2019. SELECTION CRITERIA: Included trials fulfilled the following criteria: 1) randomised; 2) intention to reduce saturated fat intake OR intention to alter dietary fats and achieving a reduction in saturated fat; 3) compared with higher saturated fat intake or usual diet; 4) not multifactorial; 5) in adult humans with or without cardiovascular disease (but not acutely ill, pregnant or breastfeeding); 6) intervention duration at least 24 months; 7) mortality or cardiovascular morbidity data available. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed inclusion, extracted study data and assessed risk of bias. We performed random-effects meta-analyses, meta-regression, subgrouping, sensitivity analyses, funnel plots and GRADE assessment. MAIN RESULTS: We included 15 randomised controlled trials (RCTs) (16 comparisons, 56,675 participants), that used a variety of interventions from providing all food to advice on reducing saturated fat. The included long-term trials suggested that reducing dietary saturated fat reduced the risk of combined cardiovascular events by 17% (risk ratio (RR) 0.83; 95% confidence interval (CI) 0.70 to 0.98, 12 trials, 53,758 participants of whom 8% had a cardiovascular event, I² = 67%, GRADE moderate-quality evidence). Meta-regression suggested that greater reductions in saturated fat (reflected in greater reductions in serum cholesterol) resulted in greater reductions in risk of CVD events, explaining most heterogeneity between trials. The number needed to treat for an additional beneficial outcome (NNTB) was 56 in primary prevention trials, so 56 people need to reduce their saturated fat intake for ~four years for one person to avoid experiencing a CVD event. In secondary prevention trials, the NNTB was 53. Subgrouping did not suggest significant differences between replacement of saturated fat calories with polyunsaturated fat or carbohydrate, and data on replacement with monounsaturated fat and protein was very limited. We found little or no effect of reducing saturated fat on all-cause mortality (RR 0.96; 95% CI 0.90 to 1.03; 11 trials, 55,858 participants) or cardiovascular mortality (RR 0.95; 95% CI 0.80 to 1.12, 10 trials, 53,421 participants), both with GRADE moderate-quality evidence. There was little or no effect of reducing saturated fats on non-fatal myocardial infarction (RR 0.97, 95% CI 0.87 to 1.07) or CHD mortality (RR 0.97, 95% CI 0.82 to 1.16, both low-quality evidence), but effects on total (fatal or non-fatal) myocardial infarction, stroke and CHD events (fatal or non-fatal) were all unclear as the evidence was of very low quality. There was little or no effect on cancer mortality, cancer diagnoses, diabetes diagnosis, HDL cholesterol, serum triglycerides or blood pressure, and small reductions in weight, serum total cholesterol, LDL cholesterol and BMI. There was no evidence of harmful effects of reducing saturated fat intakes. AUTHORS' CONCLUSIONS: The findings of this updated review suggest that reducing saturated fat intake for at least two years causes a potentially important reduction in combined cardiovascular events. Replacing the energy from saturated fat with polyunsaturated fat or carbohydrate appear to be useful strategies, while effects of replacement with monounsaturated fat are unclear. The reduction in combined cardiovascular events resulting from reducing saturated fat did not alter by study duration, sex or baseline level of cardiovascular risk, but greater reduction in saturated fat caused greater reductions in cardiovascular events.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Gorduras na Dieta/administração & dosagem , Ácidos Graxos/administração & dosagem , Adulto , Doenças Cardiovasculares/mortalidade , Causas de Morte , Colesterol/sangue , Carboidratos da Dieta/administração & dosagem , Gorduras Insaturadas na Dieta/administração & dosagem , Proteínas na Dieta/administração & dosagem , Ingestão de Energia , Feminino , Humanos , Masculino , Infarto do Miocárdio/mortalidade , Infarto do Miocárdio/prevenção & controle , Ensaios Clínicos Controlados Aleatórios como Assunto , Acidente Vascular Cerebral/prevenção & controle
3.
Cochrane Database Syst Rev ; 6: CD001903, 2020 06 24.
Artigo em Inglês | MEDLINE | ID: mdl-32588435

RESUMO

BACKGROUND: Ketogenic diets (KDs) are high in fat and low in carbohydrates and have been suggested to reduce seizure frequency in people with epilepsy. Such diets may be beneficial for children with drug-resistant epilepsy. This is an update of a review first published in 2003, and last updated in 2018. OBJECTIVES: To assess the effects of ketogenic diets for people with drug-resistant epilepsy. SEARCH METHODS: For this update, we searched the Cochrane Register of Studies (CRS Web) and MEDLINE (Ovid, 1946 to 26 April 2019) on 29 April 2019. The Cochrane Register of Studies includes the Cochrane Epilepsy Group Specialized Register, the Cochrane Central Register of Controlled Trials (CENTRAL), and randomised controlled trials (RCTs) from Embase, ClinicalTrials.gov and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP). We imposed no language restrictions. We checked the reference lists of retrieved studies for additional relevant studies. SELECTION CRITERIA: RCTs or quasi-RCTs of KDs for people of any age with drug-resistant epilepsy. DATA COLLECTION AND ANALYSIS: Two review authors independently applied predefined criteria to extract data and evaluated study quality. We assessed the outcomes: seizure freedom, seizure reduction (50% or greater reduction in seizure frequency), adverse effects, cognition and behaviour, quality of life, and attrition rate. We incorporated a meta-analysis. We utilised an intention-to-treat (ITT) population for all primary analyses. We presented the results as risk ratios (RRs) with 95% confidence intervals (CIs). MAIN RESULTS: We identified 13 studies with 932 participants; 711 children (4 months to 18 years) and 221 adults (16 years and over). We assessed all 13 studies to be at high risk of performance and detection bias, due to lack of blinding. Assessments varied from low to high risk of bias for all other domains. We rated the evidence for all outcomes as low to very low certainty. Ketogenic diets versus usual care for children Seizure freedom (RR 3.16, 95% CI 1.20 to 8.35; P = 0.02; 4 studies, 385 participants; very low-certainty evidence) and seizure reduction (RR 5.80, 95% CI 3.48 to 9.65; P < 0.001; 4 studies, 385 participants; low-certainty evidence) favoured KDs (including: classic KD, medium-chain triglyceride (MCT) KD combined, MCT KD only, simplified modified Atkins diet (MAD) compared to usual care for children. We are not confident that these estimated effects are accurate. The most commonly reported adverse effects were vomiting, constipation and diarrhoea for both the intervention and usual care group, but the true effect could be substantially different (low-certainty evidence). Ketogenic diet versus usual care for adults In adults, no participants experienced seizure freedom. Seizure reduction favoured KDs (MAD only) over usual care but, again, we are not confident that the effect estimated is accurate (RR 5.03, 95% CI 0.26 to 97.68; P = 0.29; 2 studies, 141 participants; very low-certainty evidence). Adults receiving MAD most commonly reported vomiting, constipation and diarrhoea (very low-certainty evidence). One study reported a reduction in body mass index (BMI) plus increased cholesterol in the MAD group. The other reported weight loss. The true effect could be substantially different to that reported. Ketogenic diet versus ketogenic diet for children Up to 55% of children achieved seizure freedom with a classical 4:1 KD after three months whilst up to 85% of children achieved seizure reduction (very low-certainty evidence). One trial reported a greater incidence of seizure reduction with gradual-onset KD, as opposed to fasting-onset KD. Up to 25% of children were seizure free with MAD and up to 60% achieved seizure reduction. Up to 25% of children became seizure free with MAD and up to 60% experienced seizure reduction. One study used a simplified MAD (sMAD) and reported that 15% of children gained seizure freedom rates and 56% achieved seizure reduction. We judged all the evidence described as very low certainty, thus we are very unsure whether the results are accurate. The most commonly reported adverse effects were vomiting, constipation and diarrhoea (5 studies, very low-certainty evidence). Two studies reported weight loss. One stated that weight loss and gastrointestinal disturbances were more frequent, with 4:1 versus 3:1 KD, whilst one reported no difference in weight loss with 20 mg/d versus 10 mg/d carbohydrates. In one study, there was a higher incidence of hypercalcuria amongst children receiving classic KD compared to MAD. All effects described are unlikely to be accurate. Ketogenic diet versus ketogenic diet for adults One study randomised 80 adults (aged 18 years and over) to either MAD plus KetoCal during the first month with MAD alone for the second month, or MAD alone for the first month followed by MAD plus KetoCal for the second month. No adults achieved seizure freedom. More adults achieved seizure reduction at one month with MAD alone (42.5%) compared to MAD plus KetoCal (32.5%), however, by three months only 10% of adults in both groups maintained seizure reduction. The evidence for both outcomes was of very low certainty; we are very uncertain whether the effects are accurate. Constipation was more frequently reported in the MAD plus KetoCal group (17.5%) compared to the MAD only group (5%) (1 study, very low-certainty evidence). Diarrhoea and increase/change in seizure pattern/semiology were also commonly reported (17.5% to 20% of participants). The true effects of the diets could be substantially different to that reported. AUTHORS' CONCLUSIONS: The evidence suggests that KDs could demonstrate effectiveness in children with drug-resistant epilepsy, however, the evidence for the use of KDs in adults remains uncertain. We identified a limited number of studies which all had small sample sizes. Due to the associated risk of bias and imprecision caused by small study populations, the evidence for the use of KDs was of low to very low certainty. More palatable but related diets, such as the MAD, may have a similar effect on seizure control as the classical KD, but could be associated with fewer adverse effects. This assumption requires more investigation. For people who have drug-resistant epilepsy or who are unsuitable for surgical intervention, KDs remain a valid option. Further research is required, particularly for adults with drug-resistant epilepsy.


Assuntos
Dieta Cetogênica/métodos , Carboidratos da Dieta/administração & dosagem , Gorduras na Dieta/administração & dosagem , Epilepsia Resistente a Medicamentos/dietoterapia , Adolescente , Adulto , Fatores Etários , Idoso , Criança , Pré-Escolar , Dieta com Restrição de Carboidratos/métodos , Dieta Rica em Proteínas e Pobre em Carboidratos/métodos , Dieta Cetogênica/efeitos adversos , Humanos , Lactente , Análise de Intenção de Tratamento , Pessoa de Meia-Idade , Estudos Prospectivos , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Estudos Retrospectivos , Tamanho da Amostra , Adulto Jovem
4.
Arq. bras. med. vet. zootec. (Online) ; 72(3): 936-946, May-June, 2020. tab
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-1129643

RESUMO

The objective for this study was to evaluate the supplementation with different non-fibrous carbohydrate (NFC) sources for grazing dairy cows in diets with high or low concentrations of rumen undegradable protein (RUP). Twelve multiparous cows averaging 30kg/d of milk production and 45±23 days in milk in a 4x4 Latin square design with 2 × 2 factorial arrangement were used. The difference in NFC content of the diets was achieved using ground corn (GC) or dried citrus pulp (DCP). Dietary RUP was altered by the partial replacement of soybean meal (LRUP) by roasted whole soybean and corn gluten meal (HRUP). Greater dry matter intake (DMI) was observed in DCP treatments compared to GC treatments (19.2 and 17.7kg/day of DM, respectively). Milk fat concentration was lower for LRUP treatments (3.4%) when compared to HRUP (3.6%). The milk protein concentration was greater for GC treatments (2.9%) in relation to DCP treatments (2.8%). Lower milk ureic nitrogen was observed when DCP diets were fed compared to those with GC (17.8 and 21.2mg/dL, respectively). The use of DCP as CNF source increased dry matter intake as well as milk fat concentration, although no differences in milk production were observed for RUP level.(AU)


Objetivou-se avaliar a suplementação com diferentes fontes de carboidratos não fibrosos (CNF) em vacas manejadas a pasto em dietas com alta ou baixa concentração de proteína não degradável no rúmen (PNDR). Doze vacas multíparas com média de 30kg leite/ dia e 45±23 dias em lactação foram utilizadas em delineamento quadrado latino 4x4 com arranjo fatorial 2 × 2. As fontes de CNF foram milho moído (MM) e polpa cítrica seca (PC). A PNDR da dieta foi alterada pela substituição parcial do farelo de soja da dieta de baixa PNDR (BPNDR) por grão de soja tostado e farelo de glúten de milho dieta de alta PNDR (APNDR). Foi observado maior consumo de matéria seca (CMS) nos tratamentos com PC quando comparado aos tratamentos com MM (19,2 e 17,7kg / dia de MS, respectivamente). O teor de gordura do leite foi menor para os tratamentos com BPNDR (3,4%) em comparação aos tratamentos com APNDR (3,6%). O teor de proteína do leite foi maior nos tratamentos com MM (2,9%) em relação aos tratamentos com PC (2,8%). Foram observados menores teores de nitrogênio ureico no leite dos animais alimentados com PC em relação aos com MM (17,8 e 21,2mg / dL, respectivamente). O uso de PC como fonte de CNF aumentou o consumo de matéria seca, bem como o teor de gordura do leite, embora não tenham sido observadas diferenças na produção de leite relacionada a alteração nos teores de PNDR.(AU)


Assuntos
Animais , Feminino , Bovinos , Carboidratos da Dieta/administração & dosagem , Pectinas , Panicum , Rúmen
5.
J Nutr ; 150(7): 1824-1833, 2020 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-32359153

RESUMO

BACKGROUND: Observational evidence suggests that red meat intake is associated with type 2 diabetes (T2D) and cardiovascular disease incidence, but few randomized controlled trials have assessed effects of lean, unprocessed red meat intake on insulin sensitivity and other cardiometabolic risk factors. OBJECTIVE: This study compared the USDA Healthy US-Style Eating Pattern, low in saturated fat and red meat (<40 g/d red meat; USDA-CON), with a modified version with an additional 150 g/d lean beef as an isocaloric replacement for carbohydrate (USDA-LB) on insulin sensitivity and cardiometabolic risk markers. METHODS: Participants (7 men, 26 women; 44.4 y old) with overweight/obesity [BMI (kg/m2) = 31.3] and prediabetes and/or metabolic syndrome completed this randomized, crossover, controlled-feeding trial consisting of two 28-d treatments (USDA-CON and USDA-LB) separated by a ≥14-day washout. Insulin sensitivity (primary outcome variable), lipoprotein lipids, apolipoproteins (apoA-I and apoB), and high-sensitivity C-reactive protein (hs-CRP) (secondary outcome variables), in plasma or serum, and blood pressures were assessed at baseline and the end of each diet period. RESULTS: USDA-LB and USDA-CON did not differ significantly in effects on whole-body insulin sensitivity and other indicators of carbohydrate metabolism, lipoprotein lipids, apoA-I and apoB, hs-CRP, and blood pressures. USDA-LB produced a shift toward less cholesterol carried by smaller LDL subfractions compared with USDA-CON [least-squares geometric mean ratios for LDL1+2 cholesterol of 1.20 (P = 0.016) and LDL3+4 cholesterol of 0.89 (P = 0.044)] and increased peak LDL time versus USDA-CON (1.01; P = 0.008). CONCLUSIONS: Substituting lean, unprocessed beef for carbohydrate in a Healthy US-Style Eating Pattern resulted in a shift toward larger, more buoyant LDL subfractions, but otherwise had no significant effects on the cardiometabolic risk factor profile in men and women with prediabetes and/or metabolic syndrome.This trial was registered at clinicaltrials.gov as NCT03202680.


Assuntos
Diabetes Mellitus Tipo 2/etiologia , Dieta Saudável , Carboidratos da Dieta/administração & dosagem , Carne Vermelha , Adulto , Animais , Bovinos , Carboidratos da Dieta/efeitos adversos , Gorduras na Dieta , Proteínas na Dieta , Comportamento Alimentar , Feminino , Humanos , Masculino , Sobrepeso , Fatores de Risco
6.
J Nutr ; 150(8): 2009-2015, 2020 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-32470981

RESUMO

BACKGROUND: Longer-term feeding studies suggest that a low-carbohydrate diet increases energy expenditure, consistent with the carbohydrate-insulin model of obesity. However, the validity of methodology utilized in these studies, involving doubly labeled water (DLW), has been questioned. OBJECTIVE: The aim of this study was to determine whether dietary energy requirement for weight-loss maintenance is higher on a low- compared with high-carbohydrate diet. METHODS: The study reports secondary outcomes from a feeding study in which the primary outcome was total energy expenditure (TEE). After attaining a mean Run-in weight loss of 10.5%, 164 adults (BMI ≥25 kg/m2; 70.1% women) were randomly assigned to Low-Carbohydrate (percentage of total energy from carbohydrate, fat, protein: 20/60/20), Moderate-Carbohydrate (40/40/20), or High-Carbohydrate (60/20/20) Test diets for 20 wk. Calorie content was adjusted to maintain individual body weight within ± 2 kg of the postweight-loss value. In analyses by intention-to-treat (ITT, completers, n = 148) and per protocol (PP, completers also achieving weight-loss maintenance, n = 110), we compared the estimated energy requirement (EER) from 10 to 20 wk of the Test diets using ANCOVA. RESULTS: Mean EER was higher in the Low- versus High-Carbohydrate group in models of varying covariate structure involving ITT [ranging from 181 (95% CI: 8-353) to 246 (64-427) kcal/d; P ≤0.04] and PP [ranging from 245 (43-446) to 323 (122-525) kcal/d; P ≤0.02]. This difference remained significant in sensitivity analyses accounting for change in adiposity and possible nonadherence. CONCLUSIONS: Energy requirement was higher on a low- versus high-carbohydrate diet during weight-loss maintenance in adults, commensurate with TEE. These data are consistent with the carbohydrate-insulin model and lend qualified support for the validity of the DLW method with diets varying in macronutrient composition. This trial was registered at clinicaltrials.gov as NCT02068885.


Assuntos
Peso Corporal/fisiologia , Dieta com Restrição de Carboidratos , Dieta Redutora , Carboidratos da Dieta/administração & dosagem , Metabolismo Energético/fisiologia , Adulto , Composição Corporal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
7.
Cochrane Database Syst Rev ; 5: CD011737, 2020 05 19.
Artigo em Inglês | MEDLINE | ID: mdl-32428300

RESUMO

BACKGROUND: Reducing saturated fat reduces serum cholesterol, but effects on other intermediate outcomes may be less clear. Additionally, it is unclear whether the energy from saturated fats eliminated from the diet are more helpfully replaced by polyunsaturated fats, monounsaturated fats, carbohydrate or protein. OBJECTIVES: To assess the effect of reducing saturated fat intake and replacing it with carbohydrate (CHO), polyunsaturated (PUFA), monounsaturated fat (MUFA) and/or protein on mortality and cardiovascular morbidity, using all available randomised clinical trials. SEARCH METHODS: We updated our searches of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (Ovid) and Embase (Ovid) on 15 October 2019, and searched Clinicaltrials.gov and WHO International Clinical Trials Registry Platform (ICTRP) on 17 October 2019. SELECTION CRITERIA: Included trials fulfilled the following criteria: 1) randomised; 2) intention to reduce saturated fat intake OR intention to alter dietary fats and achieving a reduction in saturated fat; 3) compared with higher saturated fat intake or usual diet; 4) not multifactorial; 5) in adult humans with or without cardiovascular disease (but not acutely ill, pregnant or breastfeeding); 6) intervention duration at least 24 months; 7) mortality or cardiovascular morbidity data available. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed inclusion, extracted study data and assessed risk of bias. We performed random-effects meta-analyses, meta-regression, subgrouping, sensitivity analyses, funnel plots and GRADE assessment. MAIN RESULTS: We included 15 randomised controlled trials (RCTs) (16 comparisons, ~59,000 participants), that used a variety of interventions from providing all food to advice on reducing saturated fat. The included long-term trials suggested that reducing dietary saturated fat reduced the risk of combined cardiovascular events by 21% (risk ratio (RR) 0.79; 95% confidence interval (CI) 0.66 to 0.93, 11 trials, 53,300 participants of whom 8% had a cardiovascular event, I² = 65%, GRADE moderate-quality evidence). Meta-regression suggested that greater reductions in saturated fat (reflected in greater reductions in serum cholesterol) resulted in greater reductions in risk of CVD events, explaining most heterogeneity between trials. The number needed to treat for an additional beneficial outcome (NNTB) was 56 in primary prevention trials, so 56 people need to reduce their saturated fat intake for ~four years for one person to avoid experiencing a CVD event. In secondary prevention trials, the NNTB was 32. Subgrouping did not suggest significant differences between replacement of saturated fat calories with polyunsaturated fat or carbohydrate, and data on replacement with monounsaturated fat and protein was very limited. We found little or no effect of reducing saturated fat on all-cause mortality (RR 0.96; 95% CI 0.90 to 1.03; 11 trials, 55,858 participants) or cardiovascular mortality (RR 0.95; 95% CI 0.80 to 1.12, 10 trials, 53,421 participants), both with GRADE moderate-quality evidence. There was little or no effect of reducing saturated fats on non-fatal myocardial infarction (RR 0.97, 95% CI 0.87 to 1.07) or CHD mortality (RR 0.97, 95% CI 0.82 to 1.16, both low-quality evidence), but effects on total (fatal or non-fatal) myocardial infarction, stroke and CHD events (fatal or non-fatal) were all unclear as the evidence was of very low quality. There was little or no effect on cancer mortality, cancer diagnoses, diabetes diagnosis, HDL cholesterol, serum triglycerides or blood pressure, and small reductions in weight, serum total cholesterol, LDL cholesterol and BMI. There was no evidence of harmful effects of reducing saturated fat intakes. AUTHORS' CONCLUSIONS: The findings of this updated review suggest that reducing saturated fat intake for at least two years causes a potentially important reduction in combined cardiovascular events. Replacing the energy from saturated fat with polyunsaturated fat or carbohydrate appear to be useful strategies, while effects of replacement with monounsaturated fat are unclear. The reduction in combined cardiovascular events resulting from reducing saturated fat did not alter by study duration, sex or baseline level of cardiovascular risk, but greater reduction in saturated fat caused greater reductions in cardiovascular events.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Gorduras na Dieta/administração & dosagem , Ácidos Graxos/administração & dosagem , Adulto , Doenças Cardiovasculares/mortalidade , Causas de Morte , Colesterol/sangue , Carboidratos da Dieta/administração & dosagem , Gorduras Insaturadas na Dieta/administração & dosagem , Proteínas na Dieta/administração & dosagem , Ingestão de Energia , Feminino , Humanos , Masculino , Infarto do Miocárdio/mortalidade , Infarto do Miocárdio/prevenção & controle , Ensaios Clínicos Controlados Aleatórios como Assunto , Acidente Vascular Cerebral/prevenção & controle
8.
Nutr Metab Cardiovasc Dis ; 30(6): 984-995, 2020 06 09.
Artigo em Inglês | MEDLINE | ID: mdl-32402585

RESUMO

BACKGROUND & AIMS: The effect of pasta consumption within a low-energy Mediterranean diet on body weight regulation has been scarcely explored. This paper investigates the effect of two Mediterranean diets, which differed for lower or higher pasta intake, on body weight change in individuals with obesity. METHODS & RESULTS: Forty-nine volunteers finished a quasi-experimental 6-month two-parallel group dietary intervention. Participants were assigned to a low-energy high pasta (HP) or to a low-energy low Pasta (LP) group on the basis of their pasta intake (HP ≥ 5 or LP ≤ 3 times/week). Anthropometrics, blood pressure and heart rate were measured every month. Weight maintenance was checked at month 12. Body composition (bioelectrical impedance analysis, BIA), food intake (24-h recall plus a 7-day carbohydrate record) and the perceived quality of life (36-item short-form health survey, SF-36) were assessed at baseline, 3 and 6 months. Blood samples were collected at baseline and month 6 to assess glucose and lipid metabolism. After 6-month intervention, body weight reduction was -10 ± 8% and -7 ± 4% in HP and LP diet, respectively, and it remained similar at month 12. Both dietary interventions improved anthropometric parameters, body composition, glucose and lipid metabolism, but no significant differences were observed between treatment groups. No differences were observed for blood pressure and heart rate between treatments and among times. HP diet significantly improved perception of quality of life for the physical component. CONCLUSIONS: Independent of pasta consumption frequency, low-energy Mediterranean diets were successful in improving anthropometrics, physiological parameters and dietary habits after a 6-month weight-loss intervention. This trial was registered at clinicaltrials.gov as NCT03341650.


Assuntos
Dieta com Restrição de Carboidratos , Dieta Mediterrânea , Carboidratos da Dieta/administração & dosagem , Obesidade/dietoterapia , Perda de Peso , Adulto , Composição Corporal , Dieta com Restrição de Carboidratos/efeitos adversos , Carboidratos da Dieta/efeitos adversos , Feminino , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Ensaios Clínicos Controlados não Aleatórios como Assunto , Obesidade/diagnóstico , Obesidade/fisiopatologia , Fatores de Tempo , Resultado do Tratamento
10.
Poult Sci ; 99(4): 2100-2107, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32241495

RESUMO

The present study was conducted to evaluate the effects of dietary marine-derived polysaccharides (MDP) from seaweed Enteromorpha on productive performance, egg quality, antioxidant capacity, and jejunal morphology in late-phase laying hens. A total of 240 Lohmann white laying hens (62 wk of age) were assigned to 4 dietary treatments that included MDP at concentrations of 0, 1,000, 2,500, and 5,000 mg/kg for 6 wk. Each treatment had 6 replicates with 5 cages (2 birds/cage). The results showed that dietary MDP quadratically improved egg production (P < 0.05) during 5 to 6 wk and 1 to 6 wk. There was a linear reduction in cracked egg rate (P < 0.05) with dietary MDP levels increased during 3 to 4 wk and 1 to 6 wk. After 4 wk of feeding trial, the egg shell thickness, yolk color, and Haugh unit showed a linear increase (P < 0.05) in response to increasing dietary MDP levels. Besides, the egg shell breaking strength, egg shell thickness, yolk color, and Haugh unit were improved linearly (P < 0.05) by dietary MDP at the end of the experiment. Moreover, dietary MDP showed a linear and quadratic reduction in serum malondialdehyde (MDA) content (P < 0.05) at the end of third week. At the end of experiment, the activity of total superoxide dismutase in serum was increased quadratically (P < 0.05) by dietary MDP, and dietary MDP quadratically improved the liver catalase (CAT) activity (P < 0.05) and linearly enhanced jejunal CAT activity (P < 0.05), whereas linearly decreased jejunal MDA concentration (P < 0.05). Furthermore, supplemental MDP linearly improved the villus height (P < 0.05) and quadratically increased villus height/crypt depth ratio (P < 0.05) of jejunum. However, dietary MDP had no effect on jejunal trypsin, amylase, and protease activity (P > 0.10). Taken together, these findings provided new insights into the role of MDP in improving the productive performance, egg quality, antioxidant capacity, and jejunal morphology of late-phase laying hens.


Assuntos
Antioxidantes/metabolismo , Galinhas/fisiologia , Clorófitas/química , Carboidratos da Dieta/metabolismo , Jejuno/efeitos dos fármacos , Óvulo/efeitos dos fármacos , Polissacarídeos/metabolismo , Ração Animal/análise , Animais , Galinhas/anatomia & histologia , Dieta/veterinária , Carboidratos da Dieta/administração & dosagem , Suplementos Nutricionais/análise , Relação Dose-Resposta a Droga , Feminino , Jejuno/anatomia & histologia , Óvulo/fisiologia , Polissacarídeos/administração & dosagem , Distribuição Aleatória
11.
J Nutr ; 150(7): 1765-1772, 2020 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-32297937

RESUMO

BACKGROUND: Fructose ingestion with a high-fat beverage increases postprandial lipemia when compared with glucose. It is unknown whether other sugars, such as galactose, also increase postprandial lipemia. OBJECTIVES: The objective was to assess whether galactose ingestion within a high-fat beverage increases postprandial lipemia relative to glucose or fructose. METHODS: Two experiments were conducted, which contrasted different test drinks under otherwise standardized conditions. In Experiment 1, 10 nonobese men (age: 22 ± 1 y; BMI, 23.5 ± 2.2 kg/2) ingested either galactose or glucose (0.75 g supplemented carbohydrate per⋅kilogram body mass) within a high-fat test drink (0.94 g fat per kilogram body mass). In Experiment 2, a separate group of 9 nonobese men (age: 26 ± 6 y; BMI: 23.5 ± 2.6 kg/m2) ingested either galactose or fructose (identical doses as those in Experiment 1) within the same high-fat test drink. Capillary blood was sampled before and at frequent intervals after ingestion of the test drinks for a 300-min period to determine plasma triacylglycerol, glucose, lactate, nonesterified fatty acid, and insulin concentrations. Paired t tests and 2-way, repeated-measures ANOVA were used to compare conditions within each experiment. RESULTS: The incremental AUC for triacylglycerol was greater following galactose ingestion compared with glucose (127 ± 59 compared with 80 ± 48 mmol⋅L-1 × 300 min, respectively; P = 0.04) but not compared with fructose (136 ± 74 compared with 133 ± 63 mmol⋅L-1 ×300 min, respectively; P = 0.91). Plasma lactate concentrations also increased to a greater extent with galactose compared with glucose ingestion (time-condition interaction: P < 0.001) but not fructose ingestion (time-condition interaction: P = 0.17). CONCLUSIONS: Galactose ingestion within a high-fat beverage exacerbates postprandial lipemia and plasma lactate concentrations compared with glucose but not fructose in nonobese men. These data suggest that galactose metabolism may be more similar to fructose than to glucose, providing a rationale to reassess the metabolic fate of galactose ingestion in humans. This trial was registered at clinicaltrials.gov as NCT03439878.


Assuntos
Bebidas/análise , Gorduras na Dieta/administração & dosagem , Frutose/administração & dosagem , Galactose/administração & dosagem , Glucose/administração & dosagem , Lipídeos/sangue , Adulto , Glicemia , Carboidratos da Dieta/administração & dosagem , Humanos , Masculino , Período Pós-Prandial , Adulto Jovem
12.
Nutrients ; 12(4)2020 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-32252374

RESUMO

Low-carbohydrate diets (LCDs) often differ in their diet composition, which may lead to conflicting results between randomized controlled trials. Therefore, we aimed to compare the effects of different degrees of carbohydrate (CHO) restriction on cardiometabolic risk markers in humans. The experimental LCDs of 37 human trials were classified as (1) moderate-low CHO diets (<45-40 E%, n = 13), (2) low CHO diets (<40-30 E%, n = 16), and (3) very-low CHO diets (<30-3 E%; n = 8). Summary estimates of weighted mean differences (WMDs) in selected risk markers were calculated using random-effect meta-analyses. Differences between the LCD groups were assessed with univariate meta-regression analyses. Overall, the LCDs resulted in significant weight loss, reduced diastolic blood pressure BP, and increased total cholesterol and high-density lipoprotein cholesterol (HDL-C), without significant differences between the three LCD groups. Higher low-density lipoprotein cholesterol (LDL-C) concentrations were found with the very-low CHO diets compared to the moderate-low CHO diets. Decreases in triacylglycerol (TAG) concentrations were more pronounced with the low and very-low CHO diets, compared to the moderate-low CHO diets. Substitution of CHO by mainly saturated fatty acids (SFAs) increased total cholesterol, LDL-C, and HDL-C concentrations. Except for LDL-C and TAGs, effects were not related to the degree of CHO restriction. Potential effects of nutrient exchanges should be considered when following LCDs.


Assuntos
Colesterol/metabolismo , Dieta com Restrição de Carboidratos , Carboidratos da Dieta/administração & dosagem , Carboidratos da Dieta/metabolismo , Triglicerídeos/metabolismo , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/prevenção & controle , Humanos
13.
Nutr Metab Cardiovasc Dis ; 30(6): 853-871, 2020 06 09.
Artigo em Inglês | MEDLINE | ID: mdl-32278608

RESUMO

BACKGROUND AND AIMS: Despite the proven evidence of high glycemic index (GI) and glycemic load (GL) diets to increase cardiometabolic risks, knowledge about the meta-evidence for carbohydrate quality within world geographic regions is limited. We conducted a meta-analysis to synthesize the evidence of GI/GL studies and carbohydrate quality, gathering additional exposures for carbohydrate, high glycemic carbohydrate, total dietary fiber, and cereal fiber and risks for type 2 diabetes (T2DM), coronary heart disease (CHD), stroke, and mortality, grouped into the US, Europe, and Asia. Secondary aims examined cardiometabolic risks in overweight/obese individuals, by sex, and dose-response dietary variable trends. METHODS AND RESULTS: 40-prospective observational studies from 4-Medline bibliographical databases (Ovid, PubMed, EBSCOhost, CINAHL) were search up to November 2019. Random-effects hazard ratios (HR) and 95% confidence intervals (CI) for highest vs. lowest categories and continuous form combined were reported. Heterogeneity (I2>50%) was frequent in US GI/GL studies due to differing study characteristics. Increased risks ((HRGI,T2DM,US=1.14;CI:1.06,1.21), HRGL,T2DM,US=1.02 (1.01, 1.03)), HRGI,T2DM,Asia=1.25;1.02,1.53), and HRGL,T2DM,Asia=1.37 (1.17, 1.60)) were associated with cardiometabolic diseases. GI/GL in overweight/obese females had the strongest magnitude of risks in US-and Asian studies. Total dietary fiber (HRT2DM,US = 0.92;0.88,0.96) and cereal fiber (HRT2DM,US = 0.83;0.77,0.90) decreased risk of developing T2DM. Among females, we found protective dose-response risks for total dietary fiber (HR5g-total-dietary-fiber,T2DM,US = 0.94;0.92,0.97), but cereal fiber showed better ability to lower T2DM risk (HR5g-cereal-fiber,T2DM,US = 0.67;0.60,0.74). Total dietary-and cereal fibers' dose-response effects were nullified by GL, but not so for cereal fiber with GI. CONCLUSIONS: Overweight/obese females could shift their carbohydrate intake for higher cereal fiber to decrease T2DM risk, but higher GL may cancel-out this effect.


Assuntos
Glicemia/metabolismo , Doença das Coronárias/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Carboidratos da Dieta/administração & dosagem , Índice Glicêmico , Carga Glicêmica , Acidente Vascular Cerebral/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Ásia/epidemiologia , Biomarcadores/sangue , Doença das Coronárias/diagnóstico , Doença das Coronárias/mortalidade , Doença das Coronárias/prevenção & controle , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/mortalidade , Diabetes Mellitus Tipo 2/prevenção & controle , Carboidratos da Dieta/efeitos adversos , Carboidratos da Dieta/sangue , Europa (Continente)/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Estudos Observacionais como Assunto , Prognóstico , Medição de Risco , Fatores de Risco , Fatores Sexuais , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/mortalidade , Acidente Vascular Cerebral/prevenção & controle , Estados Unidos/epidemiologia , Adulto Jovem
15.
Am J Surg ; 220(4): 999-1003, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32252984

RESUMO

BACKGROUND: We aimed to determine the effects of preoperative carbohydrate-loading (CHO) as part of an enhanced recovery after surgery (ERAS) pathway on patients with/without type II diabetes (DMII). METHODS: Retrospective review of ERAS patients with CHO, including 80 with DMII, 275 without DMII in addition to 89 patients with DMII from the previous (non-ERAS) year. Outcomes included glucose-levels, insulin requirements, and complications. Logistic regression was used to determine the association of any complication with perioperative glucose control variables. RESULTS: Among ERAS versus non-ERAS patients with DMII, there were significant differences in median preoperative (142 mg/dL versus 129.5 mg/dL, p = 0.017) and postoperative day-1 glucose levels (152 mg/dL, versus 137.5 mg/dL, p = 0.004). There were no differences in insulin requirements, hypoglycemic episodes, or complications. Complications were not associated with Hgb-A1C%, home DMII-medications, or preoperative glucose measurement on logistic regression. CONCLUSIONS: Patients with DMII tolerated CHO without increasing insulin requirements or substantially affecting glucose levels or complications.


Assuntos
Glicemia/metabolismo , Diabetes Mellitus Tipo 2/complicações , Dieta da Carga de Carboidratos/métodos , Carboidratos da Dieta/administração & dosagem , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Recuperação Pós-Cirúrgica Melhorada , Cuidados Pré-Operatórios/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Diabetes Mellitus Tipo 2/sangue , Feminino , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Período Pós-Operatório , Prognóstico , Estudos Retrospectivos , Estados Unidos/epidemiologia , Adulto Jovem
16.
Scand J Med Sci Sports ; 30(6): 998-1007, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32187403

RESUMO

Prolonged low-frequency force depression (PLFFD) induced by fatiguing exercise is characterized by a persistent depression in submaximal contractile force during the recovery period. Muscle glycogen depletion is known to limit physical performance during prolonged low- and moderate-intensity exercise, and accelerating glycogen resynthesis with post-exercise carbohydrate intake can facilitate recovery and improve repeated bout exercise performance. Short-term, high-intensity exercise, however, can cause PLFFD without any marked decrease in glycogen. Here, we studied whether recovery from PLFFD was accelerated by carbohydrate ingestion after 60 minutes of moderate-intensity glycogen-depleting cycling exercise followed by six 30-seconds all-out cycling sprints. We used a randomized crossover study design where nine recreationally active males drank a beverage containing either carbohydrate or placebo after exercise. Blood glucose and muscle glycogen concentrations were determined at baseline, immediately post-exercise, and during the 3-hours recovery period. Transcutaneous electrical stimulation of the quadriceps muscle was performed to determine the extent of PLFFD by eliciting low-frequency (20 Hz) and high-frequency (100 Hz) stimulations. Muscle glycogen was severely depleted after exercise, with a significantly higher rate of muscle glycogen resynthesis during the 3-hours recovery period in the carbohydrate than in the placebo trials (13.7 and 5.4 mmol glucosyl units/kg wet weight/h, respectively). Torque at 20 Hz was significantly more depressed than 100 Hz torque during the recovery period in both conditions, and the extent of PLFFD (20/100 Hz ratio) was not different between the two trials. In conclusion, carbohydrate supplementation enhances glycogen resynthesis after glycogen-depleting exercise but does not improve force recovery when the exercise also involves all-out cycling sprints.


Assuntos
Glicemia/metabolismo , Carboidratos da Dieta/administração & dosagem , Exercício Físico , Glicogênio/metabolismo , Contração Muscular , Músculo Esquelético/metabolismo , Adolescente , Adulto , Bebidas , Estudos Cross-Over , Humanos , Masculino , Músculo Quadríceps , Adulto Jovem
17.
J Nutr ; 150(6): 1600-1609, 2020 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-32211803

RESUMO

BACKGROUND: Postprandial inflammation that occurs concurrently with hyperglycemia and hyperlipidemia after ingestion of a high-saturated-fat, high-carbohydrate meal (HFCM) is a risk factor for cardiovascular disease (CVD). Numerous preclinical and clinical studies demonstrate anti-inflammatory effects of individual spices. However, the effect of consumption of a spice blend on inflammatory mediators has not been examined in a randomized controlled trial. OBJECTIVES: The objective of this study was to investigate the postprandial effect of a blend of spices in a HFCM on inflammatory cytokine responses. METHODS: Nonsmoking men (40-65 y old) with overweight/obesity (25 ≤ BMI ≤ 35 kg/m2), elevated waist circumference (≥ 94 cm), and ≥ 1 CVD risk factor were recruited for a 3-period crossover study ( n = 12). In random order, participants consumed the following: a HFCM (∼1000 kcal, 33% kcal from saturated fat and 36% kcal from carbohydrate), a HFCM containing 2 g spice blend, or an HFCM containing 6 g spice blend. The spice blend consisted of basil, bay leaf, black pepper, cinnamon, coriander, cumin, ginger, oregano, parsley, red pepper, rosemary, thyme, and turmeric. Blood was collected before, and hourly for 4 h after the HFCM. Peripheral blood mononuclear cells (PBMCs) were isolated, and the percentage of CD14 +/Human Leukocyte Antigen-DR isotype + (HLA-DR +) monocytes and proinflammatory cytokine concentrations in plasma and LPS-stimulated PBMCs were quantified as secondary outcomes. RESULTS: There was a significant spice-by-time interaction on IL-1ß (P < 0.001), IL-8 (P = 0.020), and TNF-α (P = 0.009) secretion from LPS-stimulated PBMCs. IL-1ß secretion from LPS-stimulated PBMCs was significantly reduced (1314%) at 240 min after HFCM consumption containing 6 g, but not 2 g, of spice blend compared with 0 g spice blend. CONCLUSIONS: A HFCM containing 6 g spice blend attenuated HFCM-induced postprandial IL-1ß secretion in men with overweight/obesity.This trial was registered at clinicaltrials.gov as NCT03064958.


Assuntos
Carboidratos da Dieta/administração & dosagem , Gorduras na Dieta/administração & dosagem , Período Pós-Prandial , Especiarias , Estudos Cross-Over , Humanos , Masculino , Sobrepeso
18.
J Dairy Sci ; 103(5): 4315-4326, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32113775

RESUMO

Protein is an expensive component of the dairy cow diet, and overfeeding protein can have adverse economic and environmental impacts. Our objective was to maintain milk production and components while decreasing dietary crude protein (CP) through use of a heat-treated, rumen-resistant sugar amino acid complex (SAAC) as the Schiff base, as an addition to low-protein diets. Dietary treatments included a negative control [NC, 146 g of CP/kg of dry matter (DM)], a positive control (PC, 163 g of CP/kg of DM), and the NC supplemented with SAAC in lieu of some barley grain (SAAD, 151 g of CP/kg of DM). Diets were fed to 30 multiparous Holstein-Friesian dairy cows for the first 50 d postpartum. Dry matter intake (DMI) was determined daily. Milk yield and content of fat, protein, lactose, and casein were recorded weekly from wk 2 to 7 of lactation. The fixed effects of treatment, week, treatment × week, month of calving, and BCS at calving, and a random effect of cow, were analyzed using the MIXED procedure of SAS (SAS Institute Inc., Cary, NC). The SAAD treatment had greater energy-corrected milk yield than did NC. The PC treatment had greater DMI than did NC, and SAAD tended to have greater DMI than did NC. We found significant treatment effects for fat percentage and yield. The NC and SAAD treatments had higher fat percentages than did PC, and SAAD had a higher fat yield than did the NC and PC treatments. Treatment effects were found for casein yield and percentage. We discovered a treatment effect for protein percentage and yield. The PC treatment had higher protein percentage than did NC and SAAD. The PC treatment had a higher protein yield than did NC, and analysis revealed no difference in protein yield between PC and SAAD. The SAAD treatment had higher total milk solids than did the NC treatment. Lactose yield tended to be higher in PC than in NC, and no differences were found between PC and NC and SAAD treatments. The PC treatment had a higher casein percentage than did NC and SAAD; however, the SAAD and PC treatments had higher casein yields than did NC. The PC treatment had a higher casein:fat ratio than did the NC and SAAD treatments. The NC and SAAD treatments had higher Cheddar cheese yields than did PC. We found no treatment × week interactions for any parameter. Supplementing low-protein dairy cow diets with a heat-treated, rumen-resistant SAAC caused beneficial effects by improving milk components and increasing cheese yield to levels similar to those found when feeding expensive and environmentally damaging high-protein diets.


Assuntos
Bovinos/fisiologia , Queijo/análise , Carboidratos da Dieta/metabolismo , Proteínas na Dieta/metabolismo , Ingestão de Alimentos , Leite/metabolismo , Aminoácidos/administração & dosagem , Aminoácidos/metabolismo , Ração Animal/análise , Animais , Dieta/veterinária , Carboidratos da Dieta/administração & dosagem , Proteínas na Dieta/administração & dosagem , Suplementos Nutricionais/análise , Feminino , Distribuição Aleatória , Sacarose/administração & dosagem , Sacarose/metabolismo
19.
Nutrients ; 12(2)2020 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-32069857

RESUMO

Carbohydrate is the macronutrient that has the greatest impact on blood glucose response. Limited data are available on how carbohydrate distribution throughout the day affects blood glucose in women with gestational diabetes mellitus (GDM). We aimed to assess how a high-carbohydrate morning-intake (HCM) versus a low-carbohydrate-morning-intake (LCM), affect glycemic variability and glucose control. In this randomized crossover study continuous glucose monitoring (CGM) was performed in 12 women with diet treated GDM (75 g, 2-h OGTT ≥ 8.5 mmol/L), who went through 2 × 3 days of HCM and LCM. A within-subject-analysis showed a significantly higher mean amplitude of glucose excursions (MAGE) (0.7 mmol/L, p = 0.004) and coefficient of variation (CV) (5.1%, p = 0.01) when comparing HCM with LCM, whereas a significantly lower mean glucose (MG) (-0.3 mmol/L, p = 0.002) and fasting blood glucose (FBG) were found (-0.4 mmol/L, p = 0.01) on the HCM diet compared to the LCM diet. In addition, insulin resistance, expressed as Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), decreased significantly during HCM. Results indicate that a carbohydrate distribution of 50% in the morning favors lower blood glucose and improvement in insulin sensitivity in women with GDM, but in contrary gives a higher glycemic variability.


Assuntos
Desjejum/fisiologia , Diabetes Gestacional/dietoterapia , Dieta com Restrição de Carboidratos/métodos , Carboidratos da Dieta/administração & dosagem , Índice Glicêmico/fisiologia , Adulto , Glicemia/análise , Automonitorização da Glicemia , Estudos Cross-Over , Diabetes Gestacional/sangue , Ingestão de Alimentos/fisiologia , Feminino , Humanos , Insulina/sangue , Resistência à Insulina , Gravidez , Fatores de Tempo
20.
Int J Sports Physiol Perform ; 15(5): 720-723, 2020 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-32015212

RESUMO

PURPOSE: To examine whether the use of a carbohydrate mouth rinse (CMR) can improve multiple choice reaction time in amateur boxers during sparring. METHODS: A total of 8 male amateur boxers (age 22 [3] y, stature 1.78 [0.07] m, mass 73.6 [14.2] kg) with at least 18 months of experience in the sport volunteered to participate in the study. All participants attended a familiarization session, followed by an experimental (CMR; 6% dextrose) and placebo trials in a randomized order. Participants undertook 3 × 2 minutes of sparring against an ability- and size-matched (stature and mass) opponent. Multiple choice reaction time and perceived exertion were measured before round 1 and then after each round. The respective mouth rinse was administered in a 25-mL solution for 10 seconds before each round. Magnitude-based inferences were used to compare the results of each round (mean difference; ±90% confidence limits). RESULTS: The CMR was unlikely to have a beneficial effect on multiple choice reaction time compared with placebo (mean ± 90% confidence limits: 5 ± 9.5, 4 ± 3.4, -1 ± 8.5 lights for rounds 1 to 3, respectively) and had a possibly harmful effect on perceived exertion in round 1 (10 ± 20). There was an unlikely harmful effect on perceived exertion in rounds 2 (1 ± 12) and 3 (9 ± 23). CONCLUSION: There is no evidence to support the use of CMR during sparring in amateur boxers.


Assuntos
Boxe/fisiologia , Comportamento de Escolha/fisiologia , Carboidratos da Dieta/administração & dosagem , Antissépticos Bucais , Substâncias para Melhoria do Desempenho/administração & dosagem , Tempo de Reação/fisiologia , Humanos , Masculino , Percepção/fisiologia , Esforço Físico/fisiologia , Adulto Jovem
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