OBJECTIVES Reduced glucose utilization in the main parts of the brain involved in memory is a major cause of Alzheimer's disease, in which ketone bodies are used as the only and effective alternative energy source of glucose. This study examined the effects of a low-carbohydrate and high-fat (LCHF) diet supplemented with a ketogenic nutrition drink on cognitive function and physical activity in the elderly at high risk for dementia. METHODS The participants of this study were 28 healthy elderly aged 60-91 years showing a high risk factor of dementia or whose Korean Mini-Mental State Examination (K-MMSE) score was less than 24 points. Over 3 weeks, the case group was given an LCHF diet with nutrition drinks consisting of a ketone/non-ketone ratio of 1.73:1, whereas the control group consumed well-balanced nutrition drinks while maintaining a normal diet. After 3 weeks, K-MMSE, body composition, urine ketone bodies, and physical ability were all evaluated. RESULTS Urine ketone bodies of all case group subjects were positive, and K-MMSE score was significantly elevated in the case group only (p=0.021). Weight and BMI were elevated in the control group only (p<0.05). Grip strength was elevated in all subjects (p<0.01), and measurements of gait speed and one leg balance were improved only in the case group (p<0.05). CONCLUSIONS We suggest that adherence to the LCHF diet supplemented with a ketogenic drink could possibly influence cognitive and physical function in the elderly with a high risk factor for dementia. Further, we confirmed the applicability of this dietary intervention in the elderly based on its lack of any side effects or changes in nutritional status.
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To Keto or Not to Keto? A Systematic Review of Randomized Controlled Trials Assessing the Effects of Ketogenic Therapy on Alzheimer Disease Maria G Grammatikopoulou, Dimitrios G Goulis, Konstantinos Gkiouras, Xenophon Theodoridis, Kalliopi K Gkouskou, Athanasios Evangeliou, Efthimis Dardiotis, Dimitrios P Bogdanos Advances in Nutrition.2020; 11(6): 1583. CrossRef
OBJECTIVES This study was conducted to investigate the effect of a 6-week low-calorie diet (LCD) program including high protein-low carbohydrate protein bar on weight loss, blood pressure, and blood lipid profile in 40 overweight women according to dietary compliance. METHODS Subjects were 62 healthy overweight women (BMI ≥ 23.0 or body fat percentage ≥ 28%), aged 20~59 yrs who were provided a high protein-low carbohydrate protein bar (each 35 g, 154 kcal, protein energy %: 28.6%, carbohydrate energy %: 38.7%) as part of dinner for 6 weeks. Forty subjects who completed the whole diet program were categorized into high compliance (HC) group (days of eating protein bar ≥ 5 weeks) or low compliance (LC) group (days < 5 weeks). RESULTS Energy intake significantly decreased from 1,867.5 kcal at baseline to 1,137.4 kcal at 6 weeks for the HC group and from 1,971.7 kcal to 1,362.2 kcal for the LC group, respectively. On the other hand, a significant increase in protein energy percentage was observed in each group (HC group: 3.5%, LC group: 2.2%). Both groups showed significant decreases in weight (HC group: 1.8 kg, LC group: 1.1 kg), BMI, fat mass, systolic blood pressure, total cholesterol, and LDL-cholesterol. Reduction of body fat percentage and diastolic blood pressure were only observed in the HC group. CONCLUSIONS The inclusion of a high protein-low carbohydrate protein bar as part of a low-calorie diet for a short period can be effective to achieve weight loss and concomitantly improve blood cholesterol level without serious physiological side effects. More evident results can be achieved by eating a diet with low calorie diet including high protein-low carbohydrate protein bar for more than 5 weeks.
OBJECTIVES The purpose of this study was to estimate the distribution and exposure prevalence of total carbohydrate intake and the carbohydrate-based foods such as rice, noodles, sweet potatoes, sweet drinks, milk and fruits and to characterize intake patterns among obese Korean adults. METHODS Subjects included 137,363 adults aged 40 years or older who participated in a Health Examinees (HEXA) Study. Multiple regression analysis of data from Semi-Quantitative Food Frequency Questionnaire (SQFFQ) identified food sources of carbohydrates. Weight, height and waist circumstance (WC) were measured, and the body mass index (BMI) was calculated. Obesity was defined as BMI ≥ 25 kg/m2 and abdominal obesity as WC ≥ 90 cm and ≥ 85 cm for males and females, respectively. RESULTS Obese adults appeared to have a higher total carbohydrate intake in the univariate analysis but had eaten less after adjustment for general and lifestyle factors, compared to normal weight adults (OR 0.78, 95% CI 0.73-0.82 for general obesity; OR 0.79, 95% CI 0.74-0.85, for abdominal obesity; P trend < 0.0001, respectively). Based on advance analysis for the food sources of carbohydrates, obese subjects had lower intake of rice (OR 0.86, 95% CI 0.68 -1.09 for general obesity; OR 0.87, 95% CI 0.67-1.13, for abdominal obesity; P trend < 0.0001, respectively) and higher intake of noodles (OR 1.21, 95% CI 1.16-1.27 for general obesity; OR 1.25, 95% CI 1.19-1.32, for abdominal obesity; P trend < 0.0001 respectively). With regard to other food sources of carbohydrates such as milk and fruits, intake was lower among obese compared to normal weight subjects. CONCLUSIONS In the Korean middle-aged and older obesity groups, the intake of carbohydrates and the related foods was lower than in normal weight subjects, except for noodles. We conclude that a higher intake of noodles may enhance weight-gain. Therefore, this study suggested that the guidelines should consider the types of carbohydrate sources and the amount consumed from foods in order to provide proper guidance with regard to control and prevent obesity among Korean adults.
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OBJECTIVES Korean elderly people are known to consume diets high in carbohydrates low in vegetables compared to other age groups. This study evaluated the chronic disease risks and nutritional status in this group based on the percentage of energy from carbohydrates and the frequency of vegetable intake. METHODS Using the 2007~2009 Korean National Health Nutrition Examination Survey data, except those who were undergoing treatment for chronic disease, final 1,487 subjects aged 65 and older were divided into 4 groups: moderate carbohydrate energy ratio of 55~70% and low frequency of vegetable intake defined as less than 5 times per day (MCLV), moderate carbohydrate ratio and high frequency of vegetable intake more than 5 times (MCHV), high carbohydrate energy ratio above 70% and low frequency of vegetable intake less than 5 times (HCLV), and high carbohydrate ratio and high frequency of vegetable intake more than 5 times (HCHV). All data were analyzed after the application of weighted value, using a general linear model or logistic regression. RESULTS More than half of Korean elderly consumed diets with HCLV, and this group showed poor nutritional status and lower frequency of intake of most food items, but with no risk of chronic disease such as diabetes, obesity, hypertension, cardiovascular disease or anemia probably due to low intake of energy. On the contrary, MCHV group with a high percentage of energy from fat and protein showed the highest intake of energy and most nutrients, the highest frequency of intake of most of food items and a tendency of high risk of abdominal obesity, being followed by the MCLV group. Meanwhile, HCHV group showed a tendency of high risk of hypertension, followed by HCLV group with low frequency of intake of vegetables compared with the two moderate carbohydrate groups. CONCLUSIONS The results suggested that the percentage of energy from carbohydrate and the frequency of vegetable intake affected the nutritional status, but not significantly affected the risk of chronic disease in Korean elderly. Further studies using more detailed category of % energy from carbohydrates and of type and amount of vegetables with consideration of individual energy intake level, excessive or deficient, are needed to confirm the results.
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The purpose of this study was to evaluate pancreatic beta-cell function of Korean adult and to examine the associations between beta-cell function and nutrient intakes. Data were analyzed for 1,917 male and 2,885 female subjects older than 30 years using 'The Forth Korean National Health and Nutrition Survey in 2009'. We calculated HOMA beta-cell (The homeostasis model assessment of beta-cell function) using fasting glucose and fasting insulin for assessing beta-cell function. Subjects were divided into HHG (High HOMA beta-cell Group) or LHG (Low HOMA beta-cell Group) according to median of HOMA beta-cell, and then nutrient intakes were compared between two groups. In the entire study population, HHG showed lower percent of carbohydrate intakes (p < 0.05), and higher fat (p < 0.01), percent of fat (p < 0.05), vitamin A (p < 0.05), carotene (p < 0.05) and riboflavin (p < 0.05) intakes than LHG. In addition, levels of HOMA beta-cell were negatively correlated with percent of carbohydrate (beta = -0.040, p < 0.05), and positively correlated with percent of fat (beta = 0.046, p < 0.01). The subjects were then divided into two subgroups according to body mass index values, either < 23 kg/m2 (under- and normal-weight) or > or = 23 kg/m2 (over-weight and obese). Significant differences of some nutrients intakes and correlations with HOMA beta-cell were observed only in under- and normal weight subjects, but not in over-weight and obese subjects. In conclusion, high carbohydrate, lower fat and lower vitamin intakes may be related with pancreatic beta-cell dysfunction in under- and normal-weight Korean.
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