Asian Low-Carbohydrate Diet with Increased Whole Egg Consumption Improves Metabolic Outcomes in Metabolic Syndrome: A 52-Week Intervention Study.

BACKGROUND: The low-carbohydrate-ketogenic diet, an effective strategy to address metabolic syndrome (MetS) and obesity has raised concerns about high-fat consumption on atherogenic lipoproteins. OBJECTIVE: The aim of this study was to compare the Asian ketogenic diet (AKD), which incorporates balanced protein and fat intake from Asian foods, with a balanced low-caloric diet (BLC) in individuals diagnosed with MetS. METHODS: A 52-wk randomized clinical trial included 3 parallel groups: AKD with increased whole egg intake [egg yolk Asian ketogenic diet (Yolk-AKD, n = 28)], yolk-free ketogenic diet with egg white supplementation [egg white Asian ketogenic diet (White-AKD, n = 26)], and BLC (n = 22). Primary outcomes were anthropometric and metabolic changes. RESULTS: The AKD groups achieved significant reductions in weight and waist circumference (P < 0.05). Compared with the BLC group, the AKD groups demonstrated significant improvements in insulin resistance at week 6 and in triglyceride concentrations at weeks 12 (Yolk-AKD) and 35 (White-AKD) (P < 0.05). The AKD groups experienced improvements in hormones associated with insulin sensitivity and appetite, whereas only the Yolk-AKD group had a significant decrease in inflammation-related hormones (P < 0.05). From weeks 35-52, the AKD maintained reductions in anthropometric measurements, blood pressure, improved glucose tolerance, enhanced lipid profiles, and better liver function compared with the BLC. CONCLUSIONS: The AKD proved safe and effective, yielding various metabolic improvements in individuals with MetS compared with the BLC. Emphasizing a low-saturated fat diet while disregarding dietary cholesterol, this approach holds promise for MetS and obesity management. The inclusion of both White-AKD and Yolk-AKD groups allowed for a comprehensive assessment of the AKD's impact, elucidating the differential effects of whole egg consumption on metabolic outcomes. Further studies are warranted. This trial was registered at clinicaltrials.gov as NCT04608136.

Perspective: Beyond the Mediterranean Diet-Exploring Latin American, Asian, and African Heritage Diets as Cultural Models of Healthy Eating.

The Mediterranean diet is a well-studied cultural model of healthy eating, yet research on healthy models from other cultures and cuisines has been limited. This perspective article summarizes the components of traditional Latin American, Asian, and African heritage diets, their association with diet quality and markers of health, and implications for nutrition programs and policy. Though these diets differ in specific foods and flavors, we present a common thread that emphasizes healthful plant foods and that is consistent with high dietary quality and low rates of major causes of disability and deaths. In this perspective, we propose that nutrition interventions that incorporate these cultural models of healthy eating show promise, though further research is needed to determine health outcomes and best practices for implementation.

Dietary habits and perceptions of psoriatic patients: Mediterranean versus Asian diets.

BACKGROUND: Mediterranean diets have been reported to improve psoriasis. Asian food has a unique character and differs from Mediterranean diets. METHODS: This study compared the dietary intake of psoriatic patients and individuals without psoriasis, and investigated the association between diet and psoriasis severity. Data were collected on the frequency of consumption of Mediterranean and Asian diets. RESULTS: One-hundred psoriatic patients and 100 individuals (age- and sex-matched controls) was conducted. In the case of the anti-inflammatory diets, the psoriatic patients consumed significantly less olive oil, berry fruits, fish, seafood, tree nuts, and eggs than the controls. As to the pro-inflammatory diets, greater quantities of dairy products and soft drinks were consumed by the psoriatic patients than the controls. Regarding Asian food, the patients consumed significantly less pickled foods and brown rice/Riceberry (a rice variety), but more coconut milk, than the controls. In terms of psoriasis severity, the patients with lower severities consumed significantly more vegetables; in contrast, a higher consumption of red meat, belly meat, and instant noodles was associated with greater psoriasis severities. CONCLUSIONS: Our study adds further information on the role of diets-especially Asian diets-and psoriasis. These data should help patients and clinicians to focus more clearly on diet management.

JCL roundtable: South Asian atherosclerotic risk.

South Asian risk for atherosclerotic cardiovascular disease (ASCVD) has received special emphasis in the 2018 US AHA/ACC/Multisociety Cholesterol Guidelines. The term "South Asian" refers specifically to the countries of India, Pakistan, Nepal, Bhutan, Bangladesh, Sri Lanka, and Maldives and to the worldwide diaspora of families from these countries. With this definition, approximately 25% of the world's population is South Asian, but about 50% of ASCVD occurs in this group. In this JCL Roundtable, we discuss the roles of visceral adiposity, diabetes, and features of the metabolic syndrome; lipoprotein(a); and diet and lifestyle, including the transition of both diet and lifestyle over the past 40 to 50 years. Genetic and/or hidden risk is an area of ongoing research. Individual patient assessment and intervention should recognize the earlier onset of ASCVD and the value of screening for traditional risk factors as well as waist circumference, coronary artery calcium scoring, and lipoprotein(a) assay. Culturally acceptable dietary strategies are available, although not widely implemented or evaluated as yet. In very-high-risk cases of secondary prevention, one should consider combining medications to drive low-density lipoprotein cholesterol much lower than 70 mg/dL. Our discussion concludes by insisting that the signal of alarm must be accompanied by decisive action.

The Effects of Gelatinized Wheat Starch and High Salt Diet on Gut Microbiota and Metabolic Disorder.

Diets high in gelatinized starch and high in gelatinized starch supplemented with salt-induced metabolic disorders and changes in gut microbiota have scarcely been studied. In this study, mice on wheat starch diets (WD) exhibited significantly higher body weight, white adipose tissue (WAT), and gut permeability compared to those on normal diet (ND). However, gelatinized wheat starch diet (GWD) and NaCl-supplemented gelatinized wheat starch diet (SGW) mice did not increase body and WAT weights or dyslipidemia, and maintained consistent colon pH at ND levels. WD mice showed higher levels of Desulfovibrio, Faecalibaculum, and Lactobacillus and lower levels of Muribaculum compared to ND mice. However, GWD and SGW mice showed a significantly different gut microbial composition, such as a lower proportion of Lactobacillus and Desulfovibrio, and higher proportion of Faecalibaculum and Muribaculum compared to WD mice. High starch diet-induced dysbiosis caused increase of lipid accumulation and inflammation-related proteins' expression, thereby leading to non-alcoholic fatty liver disease. However, GWD and SGW showed lower levels than that, and it might be due to the difference in the gut microbial composition compared to WD. Taken together, diets high in gelatinized starch and high in gelatinized starch supplemented with salt induced mild metabolic disorders compared to native starch.

JCL roundtable: Healthy ethnic diets.

Epidemiology has long suggested that diet plays a major role in determining risk for atherosclerotic cardiovascular disease. A small number of important randomized controlled trials support this contention. We have to recognize that dietary patterns also constitute a large part of ethnic identity. In our increasingly connected world of international mobility and influence, lipidologists face new challenges in counseling patients with diverse nutritional preferences. In this JCL roundtable, we discuss Hispanic, South Asian, and Mediterranean dietary patterns and their association with atherosclerotic risk. Culturally acceptable ways are suggested to mitigate the atherogenic aspects of Hispanic and South Asian diets and to reinforce their heart healthy aspects. The Mediterranean diet provides a model for ameliorating risk, but one should understand how it is practiced in its native countries compared with its adaptations abroad.

The Alternate Consumption of Quercetin and Alliin in the Traditional Asian Diet Reshaped Microbiota and Altered Gene Expression of Colonic Epithelial Cells in Rats.

The diet of traditional Asian is similar to the Mediterranean that was considered as a healthy dietary pattern. The report was scarce on whether different plant-derived components with similar anti-oxidative and anti-inflammatory function such as quercetin and alliin in traditional Asian diet consumed in an alternate style cooperatively affect health including the growth of host and the status of the gut microbiota and colonic epithelial immunity. In the present study, the effects of alternate consumption of quercetin and alliin on host health judging by the profile of gut microbiota and gene expression of colonic epithelial cells were investigated with the Illumina MiSeq sequencing (16S rRNA genes) and Illumina HiSeq (RNA-seq) technique, respectively. The results showed that the alternate consumption significantly increased the rat body weight and reshaped the gut microbiota composition. At the phylum level, it significantly increased the relative abundance of fecal Firmicutes and Cyanobacteria but decreased that of Bacteroidetes (P < 0.05) and increased the relative abundance of Candidatus Arthromitus, Lactococcus, Geobacillus, and Ruminococcus at the genus level that benefits the host's health. The alternate consumption of quercetin and alliin also altered 13 genes expression involved in the KEGG pathways of complement and coagulation cascades and hematopoietic cell lineage to improve the gut immunity. Therefore, the alternate consumption of quercetin and alliin in traditional Asian diet can contribute beneficial metabolic effects by optimizing gut microbiota and altering the immunologic function of colonic epithelial cells, resulting in its potential to improve the sub-health status.

Urbanized South Asians' susceptibility to coronary heart disease: The high-heat food preparation hypothesis.

OBJECTIVE: Known risk factors do not fully explain the comparatively high susceptibility to coronary heart disease (CHD) in South Asians (Indian, Pakistani, Bangladeshi, and Sri Lankan populations in South Asia and overseas). The search for explanatory hypotheses and cofactors that raise susceptibility of South Asians to CHD continues. The aim of this study was to propose "the high-heat food preparation hypothesis," where neo-formed contaminants (NFCs) such as trans-fatty acids (TFAs) and advanced glycation end-products (AGEs) are the cofactors. METHODS: We reviewed the actions of AGEs and TFAs, the burden of these products in tissues and blood in South Asians, the relationship between these products and CHD, the effects of preparing food and reheating oils at high temperatures on NFCs, and the foods and mode of preparation in South Asian and Chinese cuisines. RESULTS: Animal and human studies show NFCs increase the risk for CHD. Evidence on the consumption and body burden of these products across ethnic groups is not available, and comparable data on the NFC content of the cuisine of South Asians and potential comparison populations (e.g., the Chinese with lower CHD rates) are limited. South Asians' cuisine is dominated by frying and roasting techniques that use high temperatures. South Asian foods have high TFA content primarily through the use of partially hydrogenated fats, reheated oils, and high-heat cooking. Reheating oils greatly increases the TFA content. In comparison, Chinese cuisine involves mostly braising, steaming, and boiling rather than frying. CONCLUSION: We hypothesize that South Asians' susceptibility to CHD is partly attributable to high-heat treated foods producing high NFCs. Research to accrue direct evidence is proposed.

Westernized diets lower arsenic gastrointestinal bioaccessibility but increase microbial arsenic speciation changes in the colon.

Arsenic (As) is an important contaminant present in food and water. Several studies have indicated that the occurrence of As based skin lesions is significantly different when root and gourd rich diets are consumed compared to meat rich diets. Additionally, urinary As speciation from orally exposed individuals appears to depend on the composition of the diet. These observations imply that diet composition can affect both the bioavailable As fraction as the As speciation in the body. In this study, we used the in vitro gastrointestinal method (IVG) to evaluate how an Asian type diet (fiber rich) and a Western type diet (fat and protein rich), differ in their capability to release inorganic As (iAs(V)) and dimethyl arsinate (DMA(V)) from a rice matrix following gastrointestinal digestion. Moreover, we used a validated dynamic gut simulator to investigate whether diet background affects As metabolism by gut microbiota in a colon environment. An Asian diet background resulted in a larger As bioaccessibility (81.2%) than a Western diet background (63.4%). On the other hand, incubation of As contaminated rice with human colon microbiota in the presence of a Western type diet resulted in a larger amount of hazardous As species - monomethyl arsonite and monomethylmonothio arsonate - to be formed after 48 h. The permeability of these As species (60.5% and 50.5% resp.) across a Caco-2 cell line was significantly higher compared to iAs(V) and DMA(V) (46.5% and 28% resp.). We conclude that dietary background is a crucial parameter to incorporate when predicting bioavailability with bioaccessibility measurements and when assessing health risks from As following oral exposure.

Nutraceuticals and amyloid neurodegenerative diseases: a focus on natural phenols.

A common molecular feature of amyloid neurodegenerative diseases is the unfolding/misfolding of specific proteins/peptides which consequently become prone to aggregate into toxic assemblies and deposits that are the key histopathological trait of these pathologies. Apart from the rare early-onset familiar forms, these neurodegenerative diseases are age-associated disorders whose symptoms appear in aged people after long incubation periods. This makes the therapeutic approach particularly compelling and boosts the search for both early diagnostic tools and preventive approaches. In this last respect, natural compounds commonly present in foods and beverages are considered promising molecules, at least on the bench side. The so-called 'nutraceutical approach' suggests life-long healthy diets, particularly focusing on food molecules that are candidates to enter clinical trials as such or following a targeted molecular engineering. Natural phenols abundant in 'healthy' foods such as extra virgin olive oil, red wine, green tea, red berries and spices, appear particularly promising.