161 results on '"John L, Sievenpiper"'
Search Results
2. Almond Bioaccessibility in a Randomized Crossover Trial: Is a Calorie a Calorie?
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Stephanie K. Nishi, John L. Sievenpiper, Anthony J. Hanley, David J.A. Jenkins, Cyril W.C. Kendall, Elena M. Comelli, and Richard P. Bazinet
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Male ,Calorie ,Hyperlipidemias ,Atwater system ,Excretion ,Hyperlipidemia ,medicine ,Humans ,Food science ,National Cholesterol Education Program ,Aged ,Cross-Over Studies ,business.industry ,food and beverages ,Nutrients ,General Medicine ,Middle Aged ,medicine.disease ,Lipids ,Prunus dulcis ,Crossover study ,Postmenopause ,Energy density ,Female ,Energy Intake ,business ,Body mass index - Abstract
To investigate the energy and macronutrient bioaccessibility of almonds in individuals with hyperlipidemia.In a previously reported randomized crossover trial, men and postmenopausal women with hyperlipidemia incorporated 3 isoenergetic supplements into a National Cholesterol Education Program Step 2 diet for 1 month each between September 20, 2000, and June 27, 2001. Supplements provided consisted of full-dose almonds (73±5 g/d), half-dose almonds (38±3 g/d) plus half-dose muffins, and full-dose muffins (control). Energy and macronutrients, including individual fatty acids, were measured in the dietary supplements and fecal samples using gas chromatography and Association of Official Analytical Chemists methods. Serum was measured for lipids and fatty acids. Bioaccessibility of energy and macronutrients from almond consumption was assessed from dietary intake (7-day food records) and fecal output.Almond-related energy bioaccessibility was 78.5%±3.1%, with an average energy loss of 21.2%±3.1% (40.6 kcal/d in the full-dose almond phase). Bioaccessibility of energy and fat from the diet as a whole was significantly less with almond consumption (in both half- and full-dose phases) compared with the control. Bioaccessibility of fat was significantly different between treatment phases (P.001) and on average lower by 5.1% and 6.3% in the half- and full-dose almond phases, respectively, compared with the control phase. Energy bioaccessibility was significantly different between the treatment phases (P=.02), decreasing by approximately 2% with the inclusion of the full dose of almonds compared with the control.Energy content of almonds may not be as bioaccessible in individuals with hyperlipidemia as predicted by Atwater factors, as suggested by the increased fat excretion with almond intake compared with the control.ClinicalTrials.gov identifier: NCT00507520.
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- 2021
3. Different Food Sources of Fructose-Containing Sugars and Fasting Blood Uric Acid Levels: A Systematic Review and Meta-Analysis of Controlled Feeding Trials
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Vivian L Choo, Danielle Lee, Tauseef Khan, Sonia Blanco Mejia, Thomas M.S. Wolever, David J.A. Jenkins, Laura Chiavaroli, Cyril W.C. Kendall, Andreea Zurbau, Russell J. de Souza, Annette Cheung, Lawrence A. Leiter, Amna Ahmed, Fei Au-Yeung, John L. Sievenpiper, Qi Liu, and Sabrina Ayoub-Charette
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Calorie ,Dried fruit ,Medicine (miscellaneous) ,Fructose ,030204 cardiovascular system & hematology ,Cochrane Library ,Beverages ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,medicine ,Nutritional Epidemiology ,030212 general & internal medicine ,Food science ,2. Zero hunger ,Nutrition and Dietetics ,business.industry ,Fasting ,medicine.disease ,Uric Acid ,Gout ,chemistry ,Fruit ,Meta-analysis ,Uric acid ,Fruit juice ,Sugars ,business - Abstract
Background Although fructose as a source of excess calories increases uric acid, the effect of the food matrix is unclear. Objectives To assess the effects of fructose-containing sugars by food source at different levels of energy control on uric acid, we conducted a systematic review and meta-analysis of controlled trials. Methods MEDLINE, Embase, and the Cochrane Library were searched (through 11 January 2021) for trials ≥ 7 days. We prespecified 4 trial designs by energy control: substitution (energy-matched replacement of sugars in diets); addition (excess energy from sugars added to diets); subtraction (energy from sugars subtracted from diets); and ad libitum (energy from sugars freely replaced in diets) designs. Independent reviewers (≥2) extracted data and assessed the risk of bias. Grading of Recommendations, Assessment, Development, and Evaluation was used to assess the certainty of evidence. Results We included 47 trials (85 comparisons; N = 2763) assessing 9 food sources [sugar-sweetened beverages (SSBs), sweetened dairy, fruit drinks, 100% fruit juice, fruit, dried fruit, sweets and desserts, added nutritive sweetener, and mixed sources] across 4 energy control levels in predominantly healthy, mixed-weight adults. Total fructose-containing sugars increased uric acid levels in substitution trials (mean difference, 0.16 mg/dL; 95% CI: 0.06-0.27 mg/dL; P = 0.003), with no effect across the other energy control levels. There was evidence of an interaction by food source: SSBs and sweets and desserts increased uric acid levels in the substitution design, while SSBs increased and 100% fruit juice decreased uric acid levels in addition trials. The certainty of evidence was high for the increasing effect of SSBs in substitution and addition trials and the decreasing effect of 100% fruit juice in addition trials and was moderate to very low for all other comparisons. Conclusions Food source more than energy control appears to mediate the effects of fructose-containing sugars on uric acid. The available evidence provides reliable indications that SSBs increase and 100% fruit juice decreases uric acid levels. More high-quality trials of different food sources are needed. This trial was registered at clinicaltrials.gov as NCT02716870.
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- 2021
4. Longitudinal changes in adherence to the portfolio and DASH dietary patterns and cardiometabolic risk factors in the PREDIMED-Plus study
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José Lapetra, Estefanía Toledo, Jose Lopez-Miranda, Andrea J. Glenn, Antonio Garcia-Rios, Sonia Eguaras, Julia Wärnberg, J. Luís Serra-Majem, Ana María Gómez-Pérez, Pilar Matía-Martín, Helmut Schröder, Jesús Vioque, Josep Vidal, Jadwiga Konieczna, Miguel Delgado-Rodríguez, Maria Angeles Zulet, Anai Moreno Rodríguez, Lidia Daimiel, David J.A. Jenkins, Miguel Ángel Martínez-González, J. Alfredo Martínez, Dolores Corella, Aurora Bueno-Cavanillas, Itziar Abete, Cyril W.C. Kendall, Ramon Estruch, Itziar Salaverria Lete, Zenaida Vázquez-Ruiz, Sofia Reguero Celada, Montserrat Fitó, Sebastian Mas-Fontao, Dora Romaguera, Rosa Casas, Olga Fernández Barceló, Pablo Hernández-Alonso, Alejandro Oncina-Canovas, José V. Sorlí, Olga Castañer, Xavier Pintó, Emilio Ros, John L. Sievenpiper, José Manuel Santos-Lozano, María Dolores Zomeño, Ángel M. Alonso-Gómez, Josep A. Tur, Jordi Salas-Salvadó, Francisco J. Tinahones, Olga Portolés, Instituto de Salud Carlos III, European Commission, European Research Council, Junta de Andalucía, Generalitat Valenciana, Generalitat de Catalunya, Ministerio de Educación, Cultura y Deporte (España), Canada Research Chairs, Govern de les Illes Balears, and Diabetes Canada
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Male ,PORTFOLIO diet ,0301 basic medicine ,medicine.medical_specialty ,DASH diet ,Dietary Approaches To Stop Hypertension ,education ,Population ,030209 endocrinology & metabolism ,Overweight ,Critical Care and Intensive Care Medicine ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,Risk Factors ,law ,Internal medicine ,Dash ,medicine ,Humans ,Longitudinal Studies ,Dietary patterns ,Aged ,education.field_of_study ,030109 nutrition & dietetics ,Nutrition and Dietetics ,business.industry ,Confounding ,PREDIMED-Plus trial ,Cardiometabolic Risk Factors ,Middle Aged ,medicine.disease ,Metabolic syndrome ,Cardiometabolic risk ,Quartile ,Female ,medicine.symptom ,business - Abstract
[Background & aims]: The Portfolio and Dietary Approaches to Stop Hypertension (DASH) diets have been shown to lower cardiometabolic risk factors in randomized controlled trials (RCTs). However, the Portfolio diet has only been assessed in RCTs of hyperlipidemic patients. Therefore, to assess the Portfolio diet in a population with metabolic syndrome (MetS), we conducted a longitudinal analysis of one-year data of changes in the Portfolio and DASH diet scores and their association with cardiometabolic risk factors in Prevención con Dieta Mediterránea (PREDIMED)-Plus trial. [Methods]: PREDIMED-Plus is an ongoing clinical trial (Trial registration: ISRCTN89898) conducted in Spain that includes 6874 older participants (mean age 65 y, 48% women) with overweight/obesity fulfilling at least three criteria for MetS. Data for this analysis were collected at baseline, six months and one year. Adherence to the Portfolio and DASH diet scores were derived from a validated 143-item food frequency questionnaire. We used linear mixed models to examine the associations of 1-SD increase and quartile changes in the diet scores with concomitant changes in cardiometabolic risk factors. [Results]: After adjusting for several potential confounders, a 1-SD increase in the Portfolio diet score was significantly associated with lower HbA1c (β [95% CI]: −0.02% [−0.02, −0.01], P < 0.001), fasting glucose (−0.47 mg/dL [−0.83, −0.11], P = 0.01), triglycerides (−1.29 mg/dL [−2.31, −0.28], P = 0.01), waist circumference (WC) (−0.51 cm [−0.59, −0.43], P < 0.001), and body mass index (BMI) (−0.17 kg/m2 [−0.19, −0.15], P < 0.001). A 1-SD increase in the DASH diet score was significantly associated with lower HbA1c (−0.03% [−0.04, −0.02], P < 0.001), glucose (−0.84 mg/dL [−1.18, −0.51], P < 0.001), triglycerides (−3.38 mg/dL [−4.37, −2.38], P < 0.001), non-HDL-cholesterol (−0.47 mg/dL [−0.91, −0.04], P = 0.03), WC (−0.69 cm [−0.76, −0.60 cm], P < 0.001), BMI (−0.25 kg/m2 [−0.28, −0.26 kg/m2], P < 0.001), systolic blood pressure (−0.57 mmHg [−0.81, −0.32 mmHg], P < 0.001), diastolic blood pressure (−0.15 mmHg [−0.29, −0.01 mmHg], P = 0.03), and with higher HDL-cholesterol (0.21 mg/dL [0.09, 0.34 mg/dL, P = 0.001]). Similar associations were seen when both diet scores were assessed as quartiles, comparing extreme categories of adherence. [Conclusions]: Among older adults at high cardiovascular risk with MetS, greater adherence to the Portfolio and DASH diets showed significant favourable prospective associations with several clinically relevant cardiometabolic risk factors. Both diets are likely beneficial for cardiometabolic risk reduction., The PREDIMED-Plus trial was supported by the Spanish government's official funding agency for biomedical research, ISCIII, through the Fondo de Investigación para la Salud (FIS) and co-funded by European Union ERDF/ESF, “A way to make Europe”/“Investing in your future” (five coordinated FIS projects led by JS-S and JVid, including the following projects: PI13/00673, PI13/00492, PI13/00272, PI13/01123, PI13/00462, PI13/00233, PI13/02184, PI13/00728, PI13/01090, PI13/01056, PI14/01722, PI14/00636, PI14/00618, PI14/00696, PI14/01206, PI14/01919, PI14/00853, PI14/01374, PI14/00972, PI14/00728, PI14/01471, PI16/00473, PI16/00662, PI16/01873, PI16/01094, PI16/00501, PI16/00533, PI16/00381, PI16/00366, PI16/01522, PI16/01120, PI17/00764, PI17/01183,PI17/00855, PI17/01347, PI17/00525, PI17/01827, PI17/00532, PI17/00215, PI17/01441, PI17/00508, PI17/01732, PI17/00926, PI19/00957, PI19/00386, PI19/00309, PI19/01032, PI19/00576, PI19/00017, PI19/01226, PI19/00781, PI19/01560, and PI19/01332), the Special Action Project entitled: Implementación y evaluación de una intervención intensiva sobre la actividad física Cohorte PREDIMED-Plus grant to JS-S, the European Research Council (Advanced Research Grant 2014–2019, 340918) to MÁM-G, the Recercaixa Grant to JS-S (2013ACUP00194), grants from the Consejería de Salud de la Junta de Andalucía (PI0458/2013, PS0358/2016, and PI0137/2018), a grant from the Generalitat Valenciana (PROMETEO/2017/017), a SEMERGEN grant, and funds from the European Regional Development Fund (CB06/03). This research was also partially funded by EU-H2020 Grant (EAT2BENICE/H2020-SFS-2016-2; Ref 728018). Study resulting from the SLT006/17/00246 grant, funded by the Department of Health of the Generalitat de Catalunya by the call “Acció instrumental de programes de recerca orientats en l'àmbit de la recerca i la innovació en salut”. We thank CERCA Programme/Generalitat de Catalunya for institutional support. This work is partially supported by ICREA under the ICREA Academia programme. IP-G receives a grant from the Spanish Ministry of Education, Culture and Sports (FPU 17/01925). MRBL was supported by “Miguel Servet Type I” program (CP15/00028) from the ISCIII-Madrid (Spain), cofinanced by the Fondo Europeo de Desarrollo Regional-FEDER. AJG was supported by the Nora Martin Fellowship in Nutritional Sciences, the Banting & Best Diabetes Centre Tamarack Graduate Award in Diabetes Research, the Peterborough K.M. Hunter Charitable Foundation Graduate Award and an Ontario Graduate Scholarship. PH-A was supported by a postdoctoral fellowship (Juan de la Cierva-Formación), FJCI-2017–32205, funded by the Ministry of Science and Innovation. RE group has been supported by the ‘Ajut 2017-2021 SGR 1717 from the Generalitat de Catalunya. DJAJ was funded by the Government of Canada through the Canada Research Chair Endowment. JK was supported by the ‘FOLIUM’ programme within the FUTURMed project from the Fundación Instituto de Investigación Sanitaria Illes Balears (financed by 2017 annual plan of the sustainable tourism tax and at 50% with charge to the ESF Operational Program 2014–2020 of the Balearic Islands). JLS was funded by a Diabetes Canada Clinician Scientist Award.
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- 2021
5. The effect of oat β-glucan on postprandial blood glucose and insulin responses: a systematic review and meta-analysis
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Tauseef Khan, Andreea Zurbau, John L. Sievenpiper, Jarvis C. Noronha, and Thomas M. S. Wolever
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Blood Glucose ,0301 basic medicine ,medicine.medical_specialty ,beta-Glucans ,medicine.medical_treatment ,Medicine (miscellaneous) ,030209 endocrinology & metabolism ,Review Article ,Nutrition therapy ,03 medical and health sciences ,0302 clinical medicine ,Primary outcome ,Internal medicine ,Diabetes mellitus ,medicine ,Humans ,Insulin ,Glucan ,chemistry.chemical_classification ,Cross-Over Studies ,030109 nutrition & dietetics ,Nutrition and Dietetics ,business.industry ,Diabetes ,Postprandial Period ,medicine.disease ,Postprandial ,Endocrinology ,chemistry ,Meta-analysis ,business - Abstract
To determine the effect of oat β‑glucan (OBG) on acute glucose and insulin responses and identify significant effect modifiers we searched the MEDLINE, EMBASE, and Cochrane databases through October 27, 2020 for acute, crossover, controlled feeding trials investigating the effect of adding OBG (concentrate or oat-bran) to carbohydrate-containing test-meals compared to comparable or different carbohydrate-matched control-meals in humans regardless of health status. The primary outcome was glucose incremental area-under-the-curve (iAUC). Secondary outcomes were insulin iAUC, and glucose and insulin incremental peak-rise (iPeak). Two reviewers extracted the data and assessed risk-of-bias and certainty-of-evidence (GRADE). Data were pooled using generic inverse-variance with random-effects model and expressed as ratio-of-means with [95% CIs]. We included 103 trial comparisons (N = 538). OBG reduced glucose iAUC and iPeak by 23% (0.77 [0.74, 0.81]) and 28% (0.72 [0.64, 0.76]) and insulin by 22% (0.78 [0.72, 0.85]) and 24% (0.76 [0.65, 0.88]), respectively. Dose, molecular-weight, and comparator were significant effect modifiers of glucose iAUC and iPeak. Significant linear dose-response relationships were observed for all outcomes. OBG molecular-weight >300 kg/mol significantly reduced glucose iAUC and iPeak, whereas molecular-weight p = 0.03) and iPeak (39 vs 25%, p
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- 2021
6. Co-administration of viscous fiber, Salba-chia and ginseng on glycemic management in type 2 diabetes: a double-blind randomized controlled trial
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Sasa Magas, Lawrence A. Leiter, David J.A. Jenkins, Elena Jovanovski, Andreea Zurbau, Lea Duvnjak, Jelena Miocic, Alexandra L Jenkins, Robert G. Josse, John L. Sievenpiper, and Vladimir Vuksan
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0301 basic medicine ,medicine.medical_specialty ,030109 nutrition & dietetics ,Nutrition and Dietetics ,Bran ,ginseng ,viscous fiber ,Salba-chia ,glycemic management ,type 2 diabetes ,business.industry ,Medicine (miscellaneous) ,030209 endocrinology & metabolism ,Type 2 diabetes ,medicine.disease ,law.invention ,03 medical and health sciences ,Ginseng ,0302 clinical medicine ,Randomized controlled trial ,law ,Internal medicine ,Diabetes mellitus ,medicine ,Clinical endpoint ,Adverse effect ,business ,Glycemic - Abstract
Viscous dietary fiber, functional seeds and ginseng roots have individually been proposed for the management of diabetes. We explored whether their co-administration would improve glycemic control in type 2 diabetes beyond conventional therapy. In a randomized, double-blind, controlled trial conducted at two academic centers (Toronto, Canada and Zagreb, Croatia), individuals with type 2 diabetes were assigned to either an active intervention (10 g viscous fiber, 60 g white chia seeds, 1.5 g American and 0.75 g Korean red ginseng extracts), or energy and fiber-matched control (53 g oat bran, 25 g inulin, 25 g maltodextrose and 2.25 g wheat bran) intervention for 24 weeks, while on conventional standard of care. The prespecified primary endpoint was end difference at week 24 in HbA1c, following an intent-to-treat analysis adjusted for center and baseline. Between January 2016 and April 2018, 104 participants (60M:44F; mean ± SEM age 59 ± 0.8 years; BMI 29.0 ± 0.4 kg/m2; HbA1c 7.0 ± 0.6%) managed with antihyperglycemic agent(s) (n = 98) or lifestyle (n = 6), were randomized (n = 52 test; n = 52 control). At week 24, HbA1c levels were 0.27 ± 0.1% lower on test compared to control (p = 0.03). There was a tendency towards an interaction by baseline HbA1c (p = 0.07), in which a greater reduction was seen in participants with baseline HbA1c > 7% vs ≤ 7% (− 0.56 ± 0.2% vs 0.03 ± 0.2%). Diet and body weight remained unchanged. The interventions were well tolerated with no related adverse events and with high retention rate of 84%. Co-administration of selected dietary and herbal therapies was well-tolerated and may provide greater glycemic control as add-on therapy in type 2 diabetes. Registration: Clinicaltrials.gov NCT02553382 (registered on September 17, 2015).
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- 2021
7. Obesity in adults: a clinical practice guideline
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Kristen Jacklin, Leah Walker, Michael E. Green, Stephen Glazer, Betty Calam, Kristi B. Adamo, Valerie H. Taylor, Denis Prud'homme, Lindsay Crowshoe, Richard Tytus, Michel Gagner, Paul Poirier, Angela S. Alberga, Jennifer L. Kuk, Elaine Boyling, Dennis Divalentino, Cindy Grand, Scott Lear, Laurie Twells, Raed Hawa, Carol Clarke, Judy Shiau, David Macklin, Yoni Freedhoff, Megha Poddar, Helena Piccinini-Vallis, Normand G. Boulé, Leticia Pereira, Priya Manjoo, Pam Hung, Sara F. L. Kirk, Ian Patton, Shelly Russell-Mayhew, Arya M. Sharma, Rhonda Bell, Diana Sherifali, Shahebina Walji, David C.W. Lau, Mary Forhan, Sonja Wicklum, Sanjeev Sockalingam, Sue Pedersen, Dennis Hong, Laurent Biertho, Marie-France Langlois, Ellen L. Toth, Kara Nerenberg, Michael Vallis, Ian Janssen, Ashley McInnes, Rita Henderson, Amy Kemp, Jennifer Brown, Ximena Ramos Salas, Margaret Hahn, Denise Campbell-Scherer, Leen Naji, Sean Wharton, John L. Sievenpiper, Marie-Philippe Morin, Christian F. Rueda-Clausen, and Carlene Johnson-Stoklossa
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Adult ,Male ,Canada ,Pregnancy ,medicine.medical_specialty ,Primary Health Care ,business.industry ,MEDLINE ,General Medicine ,Guideline ,medicine.disease ,Obesity ,Body Mass Index ,Clinical Practice ,Chronic disease ,Humans ,Medicine ,Female ,Letters ,business ,Intensive care medicine ,Body mass index - Abstract
KEY POINTS Obesity is a complex chronic disease in which abnormal or excess body fat (adiposity) impairs health, increases the risk of long-term medical complications and reduces lifespan.[1][1] Epidemiologic studies define obesity using the body mass index (BMI; weight/height2), which can stratify
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- 2020
8. Effect of soluble-viscous dietary fibre on coronary heart disease risk score across 3 population health categories: data from randomized, double-blind, placebo-controlled trials
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Lea Smircic-Duvnjak, Alexandra L. Jenkins, Fei Au-Yeung, Elena Jovanovski, John L. Sievenpiper, Allison Komishon, Andreea Zurbau, Vladimir Vuksan, Hoang V.T. Ho, and Dandan Li
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Adult ,Dietary Fiber ,Male ,medicine.medical_specialty ,Physiology ,Endocrinology, Diabetes and Metabolism ,Blood Pressure ,Coronary Disease ,030209 endocrinology & metabolism ,Population health ,030204 cardiovascular system & hematology ,Placebo ,Risk Assessment ,Double blind ,03 medical and health sciences ,0302 clinical medicine ,Double-Blind Method ,Physiology (medical) ,Internal medicine ,Diabetes mellitus ,medicine ,Humans ,Metabolic Syndrome ,Nutrition and Dietetics ,Framingham Risk Score ,Population Health ,Plant Extracts ,business.industry ,soluble-viscous dietary fibre, coronary heart disease risk score, 3 population health categories ,Polysaccharides, Bacterial ,Dietary fibre ,General Medicine ,Middle Aged ,medicine.disease ,Coronary heart disease ,Cholesterol ,Diabetes Mellitus, Type 2 ,Female ,Metabolic syndrome ,business ,Amorphophallus - Abstract
We applied the Framingham risk equation in healthy, metabolic syndrome, and diabetes populations, following treatment with viscous fibre from konjac-based blend (KBB). KBB yielded reduction in estimated risk score by 16% (1.04 ± 0.03 vs. 0.87 ± 0.04, p < 0.01) in type 2 diabetes, 24% (1.08 ± 0.01 vs. 0.82 ± 0.02, p < 0.01) in metabolic syndrome, and 25% (1.09 ± 0.05 vs. 0.82 ± 0.06, p < 0.01) in healthy individuals. Drivers for decreased risk were improvements in blood cholesterol and systolic blood pressure. The composite coronary heart disease risk across populations was reduced 22% (p < 0.01). Novelty Viscous fibre from konjac-xanthan reduced 10-year relative coronary heart disease using Framingham Risk Score across the glycemic status spectrum.
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- 2020
9. Effect of viscous fiber supplementation on obesity indicators in individuals consuming calorie-restricted diets: a systematic review and meta-analysis of randomized controlled trials
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Allison Komishon, Lea Smircic-Duvnjak, Tauseef Khan, Dandan Li, Sonia Blanco Mejia, John L. Sievenpiper, Nourah Mazhar, Elena Jovanovski, Alexandra L Jenkins, Rana Khayyat, and Vladimir Vuksan
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0301 basic medicine ,medicine.medical_specialty ,030109 nutrition & dietetics ,Nutrition and Dietetics ,Calorie ,Waist ,business.industry ,Medicine (miscellaneous) ,030209 endocrinology & metabolism ,body weight ,cardiovascular disease ,meta-analysis ,systematic review ,viscous fiber ,Overweight ,Cochrane Library ,medicine.disease ,Obesity ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Internal medicine ,Meta-analysis ,Weight management ,Medicine ,medicine.symptom ,business - Abstract
Dietary fiber has played a consistent role in weight management, with efficacy potentially attributed to increased viscous fiber consumption. To summarize the effects of viscous fiber on body weight and other anthropometric parameters, along with a calorie-deficient diet, through a systematic review and meta-analysis. MEDLINE, EMBASE, and the Cochrane library were searched through July 24, 2019 for randomized controlled trials that assessed the effect of viscous fiber supplementation as part of a restricted calorie diet for ≥ 4 weeks relative to comparator diets. Data were pooled using the generic inverse-variance method with random-effects models and expressed as mean differences with 95% confidence intervals. Inter-study heterogeneity was assessed using Cochran’s Q and quantified with I2. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to evaluate the overall certainty of evidence. Findings from 15 studies (n = 1347) showed viscous fiber supplementation significantly decreased body weight (− 0.81 kg [− 1.20, − 0.41]; p
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- 2020
10. Can dietary viscous fiber affect body weight independently of an energy-restrictive diet? A systematic review and meta-analysis of randomized controlled trials
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Rana Khayyat, Nourah Mazhar, Lea Smircic-Duvnjak, Alexandra L Jenkins, Elena Jovanovski, Allison Komishon, Dandan Li, Tauseef Khan, Sonia Blanco Mejia, John L. Sievenpiper, and Vladimir Vuksan
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Dietary Fiber ,medicine.medical_specialty ,Nutrition and Dietetics ,Waist ,Diet, Reducing ,business.industry ,body weight ,cardiovascular disease risk ,controlled trials ,meta-analysis ,systematic review ,viscous fiber ,Body Weight ,Medicine (miscellaneous) ,Overweight ,Cochrane Library ,medicine.disease ,Obesity ,law.invention ,Randomized controlled trial ,law ,Weight loss ,Internal medicine ,Meta-analysis ,Humans ,Medicine ,medicine.symptom ,Metabolic syndrome ,Energy Intake ,business - Abstract
Background: The role of dietary fiber in obesity management remains debatable. Evidence suggests that intake of viscous fiber may have the potential to facilitate weight loss. Objective: We aimed to summarize and quantify the effects of viscous fiber on body weight, BMI, waist circumference, and body fat, independent of calorie restriction, through a systematic review and meta-analysis of randomized controlled trials. Methods: Trials ≥4 wk in duration that assessed the effect of viscous fiber supplemented to an ad libitum diet along with comparator diets were included. MEDLINE, EMBASE, and the Cochrane library were searched through 24 July, 2019. Two independent reviewers extracted relevant data. Data were pooled using the generic inverse variance method and random-effects models and expressed as mean differences with 95% CIs. Interstudy heterogeneity was assessed (Cochran Q statistic) and quantified (I2 statistic). The overall certainty of evidence was explored using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. Results: Findings from 62 trials (n = 3877) showed that viscous fiber reduced mean body weight (-0.33 kg ; 95% CI: -0.51, -0.14 kg ; P = 0.004), BMI (in kg/m2) (-0.28 ; 95% CI: -0.42, -0.14 ; P = 0.0001), and waist circumference (-0.63 cm ; 95% CI: -1.11, -0.16 cm ; P = 0.008), with no change in body fat (-0.78% ; 95% CI: -1.56%, 0.00% ; P = 0.05) when consumed with an ad libitum diet. Greater reductions in body weight were observed in overweight individuals and those with diabetes and metabolic syndrome. The certainty of evidence was graded moderate for body weight, high for waist circumference and body fat, and low for BMI. Conclusions: Dietary viscous fiber modestly yet significantly improved body weight and other parameters of adiposity independently of calorie restriction. Future trials are warranted to address the inconsistency and imprecision identified through GRADE and to determine long- term weight-loss sustainability.This systematic review and meta-analysis was registered at clinicaltrials.gov as NCT03257449.
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- 2020
11. Commentary: Dietary Glutamic Acid, Obesity, and Depressive Symptoms in Patients With Schizophrenia
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Tauseef A. Khan, John L. Sievenpiper, and John D. Fernstrom
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Psychiatry ,obesity ,medicine.medical_specialty ,business.industry ,RC435-571 ,Glutamic acid ,medicine.disease ,Obesity ,schizophrenia ,Psychiatry and Mental health ,dietary protein ,Dietary protein ,Schizophrenia ,Internal medicine ,medicine ,In patient ,glutamic acid ,diet ,MSG ,business ,Depressive symptoms ,Depression (differential diagnoses) - Published
- 2021
12. Are fatty nuts a weighty concern? A systematic review and meta‐analysis and dose–response meta‐regression of prospective cohorts and randomized controlled trials
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Stephanie K. Nishi, Effie Viguiliouk, Elena M. Comelli, Jordi Salas Salvadó, Anthony J. Hanley, Sonia Blanco Mejia, David J.A. Jenkins, Cyril W.C. Kendall, John L. Sievenpiper, and Richard P. Bazinet
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medicine.medical_specialty ,business.industry ,Endocrinology, Diabetes and Metabolism ,Body Weight ,Public Health, Environmental and Occupational Health ,MEDLINE ,Overweight ,medicine.disease ,Obesity ,law.invention ,Randomized controlled trial ,law ,Internal medicine ,Meta-analysis ,Humans ,Nuts ,Medicine ,Meta-regression ,medicine.symptom ,business ,Prospective cohort study ,Weight gain ,Randomized Controlled Trials as Topic - Abstract
Nuts are recommended for cardiovascular health, yet concerns remain that nuts may contribute to weight gain due to their high energy density. A systematic review and meta-analysis of prospective cohorts and randomized controlled trials (RCTs) was conducted to update the evidence, provide a dose-response analysis, and assess differences in nut type, comparator and more in subgroup analyses. MEDLINE, EMBASE, and Cochrane were searched, along with manual searches. Data from eligible studies were pooled using meta-analysis methods. Interstudy heterogeneity was assessed (Cochran Q statistic) and quantified (I2 statistic). Certainty of the evidence was assessed by Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Six prospective cohort studies (7 unique cohorts, n = 569,910) and 86 RCTs (114 comparisons, n = 5873) met eligibility criteria. Nuts were associated with lower incidence of overweight/obesity (RR 0.93 [95% CI 0.88 to 0.98] P < 0.001, "moderate" certainty of evidence) in prospective cohorts. RCTs presented no adverse effect of nuts on body weight (MD 0.09 kg, [95% CI -0.09 to 0.27 kg] P < 0.001, "high" certainty of evidence). Meta-regression showed that higher nut intake was associated with reductions in body weight and body fat. Current evidence demonstrates the concern that nut consumption contributes to increased adiposity appears unwarranted.
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- 2021
13. Effect of low glycaemic index or load dietary patterns on glycaemic control and cardiometabolic risk factors in diabetes: systematic review and meta-analysis of randomised controlled trials
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Danielle Lee, Annette Cheung, Mejia, Geoffrey Livesey, Jordi Salas-Salvadó, Amna Ahmed, Tauseef Khan, John L. Sievenpiper, Thomas M.S. Wolever, Sonia Blanco, Dario Rahelić, Hana Kahleova, Arash Mirrahimi, David J.A. Jenkins, Laura Chiavaroli, and Cyril W.C. Kendall
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medicine.medical_specialty ,medicine.medical_treatment ,Population ,Blood lipids ,Type 2 diabetes ,Glycemic Control ,Corrections ,Diabetes mellitus ,Internal medicine ,Glycemic load ,Diet, Diabetic ,Medicine ,Humans ,Medical nutrition therapy ,education ,education.field_of_study ,business.industry ,Insulin ,Research ,Glycemic Load ,Cardiometabolic Risk Factors ,General Medicine ,medicine.disease ,Glycemic index ,Diabetes Mellitus, Type 1 ,Diabetes Mellitus, Type 2 ,Glycemic Index ,business - Abstract
Objective To inform the update of the European Association for the Study of Diabetes clinical practice guidelines for nutrition therapy. Design Systematic review and meta-analysis of randomised controlled trials. Data sources Medline, Embase, and the Cochrane Library searched up to 13 May 2021. Eligibility criteria for selecting studies Randomised controlled trials of three or more weeks investigating the effect of diets with low glycaemic index (GI)/glycaemic load (GL) in diabetes. Outcome and measures The primary outcome was glycated haemoglobin (HbA 1c ). Secondary outcomes included other markers of glycaemic control (fasting glucose, fasting insulin); blood lipids (low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), non-HDL-C, apo B, triglycerides); adiposity (body weight, BMI (body mass index), waist circumference), blood pressure (systolic blood pressure (SBP) and diastolic blood pressure (DBP)), and inflammation (C reactive protein (CRP)). Data extraction and synthesis Two independent reviewers extracted data and assessed risk of bias. Data were pooled by random effects models. GRADE (grading of recommendations assessment, development, and evaluation) was used to assess the certainty of evidence. Results 29 trial comparisons were identified in 1617 participants with type 1 and 2 diabetes who were predominantly middle aged, overweight, or obese with moderately controlled type 2 diabetes treated by hyperglycaemia drugs or insulin. Low GI/GL dietary patterns reduced HbA 1c in comparison with higher GI/GL control diets (mean difference −0.31% (95% confidence interval −0.42 to −0.19%), P2 =75%, P1c and for absolute dietary GI and SBP (P1c and moderate for most secondary outcomes, with downgrades due mainly to imprecision. Conclusions This synthesis suggests that low GI/GL dietary patterns result in small important improvements in established targets of glycaemic control, blood lipids, adiposity, blood pressure, and inflammation beyond concurrent treatment with hyperglycaemia drugs or insulin, predominantly in adults with moderately controlled type 1 and type 2 diabetes. The available evidence provides a good indication of the likely benefit in this population. Study registration ClinicalTrials.gov NCT04045938 .
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- 2021
14. Ethnic Differences in the Association Between Body Mass Index and Type 2 Diabetes Risk: A Meta-Analysis of Prospective Cohort Studies
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Maria Tinajero, Jiayue Yu, Sarah Jarvis, John L. Sievenpiper, Tauseef Khan, Anthony J. Hanley, and Vasanti S. Malik
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Nutrition and Dietetics ,business.industry ,Ethnic group ,Medicine (miscellaneous) ,Type 2 diabetes ,medicine.disease ,Obesity ,Lower body ,Meta-analysis ,Medicine ,business ,Prospective cohort study ,Association (psychology) ,Body mass index ,Food Science ,Demography - Abstract
OBJECTIVES: The association between body mass index (BMI) and total body adiposity differs across ethnic groups. For instance, South Asians (SA) and East Asians (EA) have lower body fat for a given BMI level than Europeans, while the opposite is true for African-Caribbeans (AC). This suggests that the relationship between BMI and type 2 diabetes (T2D) risk may also vary depending on ethnicity. We conducted a meta-analysis to investigate whether the association between BMI and the risk of T2D differs across ethnic groups. METHODS: MEDLINE, EMBASE and Web of Science were searched up to July 2020. We included prospective cohort studies of >2 years, which investigated the association between BMI and T2D incidence among adults of a specified ethnicity. Linear and non-linear dose-response meta-analyses were performed using random effects models, with subgroup analyses by ethnicity. The heterogeneity among studies was estimated using the Cochran Q test and I(2) statistic. Study quality was assessed with the Newcastle-Ottawa Scale. RESULTS: 54 studies were included. Cohorts were stratified into the following ethnic subgroups: AC (N = 67,453), EA (N = 1,012,135), European (N = 206,424), Indigenous (N = 10,533), Latin American (LA) (N = 4,669), SA (N = 9,395), and Southeast Asian (SEA) (N = 51,129). Linear dose-response associations between 1 kg/m(2) increase in BMI and T2D were observed for the SEA (RR = 1.26; 95% CI, 1.10, 1.30) and SA (RR = 1.11; 95% CI: 1.04, 1.19) subgroups with no evidence of departure from linearity. Associations departed from linearity for all other subgroups. At a BMI level of 30 kg/m(2), the non-linear dose-response curves for each of the other subgroups displayed the following risk ratios; AC: RR = 3.13 (95% CI, 1.95, 5.02), EA: RR = 2.39 (95% CI, 1.96, 2.92), European: RR = 7.41 (95% CI, 3.88, 14.18), Indigenous: RR = 8.15 (95% CI, 6.07; 10.95), and LA: RR = 12.82 (95% CI, 5.50, 29.92). For all subgroups, there was a high degree of interstudy heterogeneity (I(2 )> 75%). CONCLUSIONS: Our findings indicated that the association between BMI and the risk of T2D differs across ethnic groups, suggesting that ethnic-specific BMI cut-offs could be helpful in identifying cardiometabolic risk profiles across different populations. FUNDING SOURCES: Canadian Institutes for Health Research.
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- 2021
15. Effect of Intermittent Fasting Strategies on Cardiometabolic Risk Factors: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials
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Stefan Kabisch, Dario Rahelić, Leanne Harris, Michael E. J. Lean, Sean Wharton, Arya M. Sharma, Zhila Semnani-Azad, Lawrence A. Leiter, Tauseef Khan, Hana Kahleova, David C.W. Lau, John L. Sievenpiper, Cyril W.C. Kendall, and Jordi Salas-Salvadó
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medicine.medical_specialty ,Nutrition and Dietetics ,Evidence-based practice ,business.industry ,Comparative effectiveness research ,MEDLINE ,Medicine (miscellaneous) ,medicine.disease ,law.invention ,Randomized controlled trial ,law ,Weight loss ,Meta-analysis ,Internal medicine ,Diabetes mellitus ,Intermittent fasting ,medicine ,Nutritional Epidemiology ,medicine.symptom ,business ,Food Science - Abstract
OBJECTIVES: Intermittent fasting (IF) is a popular trending diet, yet there is limited evidence-based support considering its clinical impact on cardiometabolic outcomes. In an effort to inform the European Association for the Study of Diabetes (EASD) clinical practice guidelines for nutrition therapy, we conducted a network meta-analysis of randomized controlled trials (RCTs) comparing IF strategies and continuous energy restriction (CER) on cardiometabolic outcomes using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. METHODS: MEDLINE, EMBASE, and Cochrane databases were searched through Nov 2020. We included RCTs assessing the effect of IF strategies (alternate-day fasting (ADF), whole-day periodic fasting (WDF), time-restricted feeding (TRF)), CER, and ad libitum diet. Outcomes included body weight, fasting glucose and LDL-cholesterol. Two independent researchers extracted data and assessed risk of bias. A network meta-analysis was performed and data were expressed as mean differences (MD) with 95% confidence intervals (CI). The certainty of the evidence was assessed using GRADE. RESULTS: We identified 19 RCTs (n = 590) including adults of varying health backgrounds. ADF and CER both showed a benefit for body weight reduction compared to ad libitum diet (18 trials, n = 520; MD −3.95 kg [95% CI −6.09, −1.81] and MD −2.85 kg [95% CI −4.99, −0.71], respectively). For fasting glucose (17 trials, n = 590), TRF showed a benefit compared to ad libitum diet (MD −0.39 mmol/L [95% CI −0.59, −0.20]), to CER (MD −0.25 mmol/L [95% CI, −0.45 to −0.06]) and to WDF (MD −0.20 mmol/L [95% CI, −0.45, −0.05]). Furthermore, ADF showed a benefit in reducing LDL-cholesterol (17 trials, n = 590) compared to ad libitum diet (MD −0.21 mmol/L [95% CI −0.40, −0.1]), and to CER (MD −0.15 mmol/L [95% CI −0.31, −0.01]). The certainty of the evidence ranged from high to moderate due to variable downgrades for imprecision. CONCLUSIONS: Current evidence provides a good indication that IF strategies have similar benefits to CER for weight loss but may have additional benefits for fasting glucose and LDL-cholesterol. Long-term high quality RCTs are needed to clarify the effect of different IF strategies on cardiometabolic outcomes. FUNDING SOURCES: Diabetes and Nutrition Study Group of the EASD, Canadian Institutes of Health Research (CIHR), Diabetes Canada.
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- 2021
16. The Effect of Oat β-Glucan on Postprandial Blood Glucose and Insulin Responses: A Systematic Review and Meta-Analysis
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Jarvis C. Noronha, Thomas M. S. Wolever, Tauseef Khan, Andreea Zurbau, and John L. Sievenpiper
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chemistry.chemical_classification ,medicine.medical_specialty ,Nutrition and Dietetics ,business.industry ,Insulin ,medicine.medical_treatment ,Medicine (miscellaneous) ,medicine.disease ,Endocrinology ,Primary outcome ,Postprandial ,chemistry ,Internal medicine ,Meta-analysis ,Diabetes mellitus ,Area under curve ,medicine ,Energy and Macronutrient Metabolism ,business ,Food Science ,Glucan - Abstract
OBJECTIVES: The efficacy of oat beta-glucan (OBG), a viscous soluble fibre, on postprandial glycemic outcomes may depend on the nature of the control and the dose and molecular weight (MW) utilized. We undertook a systematic review and meta-analysis of acute clinical trials to determine whether these features mediate the glycemic and insulinaemic responses to OBG. METHODS: MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched through October 27, 2020. We included acute, single-meal feeding, controlled trials investigating the effect of OBG (concentrate or oat bran) added to a carbohydrate-containing meal compared to a comparable meal (matched control) or a different carbohydrate-containing meal (unmatched control). Two reviewers extracted the data and assessed the risk of bias and certainty of evidence (GRADE). The primary outcome was incremental area under the curve (iAUC) for blood glucose. Data were pooled using the generic-inverse variance method with random effects model and expressed as ratio of means with [95% Cis]. RESULTS: One hundred and three trial comparisons (N = 538) were included. OBG reduced glucose iAUC and iPeak by 23% (0.77 [0.74, 0.81]) and 28% (0.72 [0.64, 0.76]) and insulin by 22% (0.78 [0.72, 0.85]) and 24% (0.76 [0.65, 0.88]), respectively. Dose, molecular-weight and comparator were significant effect modifiers of glucose iAUC and iPeak. Significant linear dose-response relationships were observed for all outcomes. OBG molecular-weight > 300 kg/mol significantly reduced glucose iAUC and iPeak, whereas, molecular-weight
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- 2021
17. Relation of Food Sources of Fructose Containing Sugars With Incident Obesity Outcomes: A Systematic Review and Meta-Analysis of Prospective Cohort Studies
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Laura Chiavaroli, Cyril W.C. Kendall, Andreea Zurbau, Tauseef Khan, Sonia Blanco Mejia, Andrea J. Glenn, Fei Au-Yeung, and John L. Sievenpiper
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medicine.medical_specialty ,Nutrition and Dietetics ,business.industry ,MEDLINE ,Medicine (miscellaneous) ,Fructose ,Overweight ,medicine.disease ,Obesity ,Childhood obesity ,chemistry.chemical_compound ,chemistry ,Meta-analysis ,Internal medicine ,Diabetes mellitus ,Medicine ,Nutritional Epidemiology ,medicine.symptom ,Prospective cohort study ,business ,Food Science - Abstract
OBJECTIVES: Sugars have been implicated in the epidemic of obesity. It is unclear whether food sources of fructose-containing sugars other than sugar-sweetened beverages (SSBs) are associated with increased risk of obesity. To assess the evidence of the relation of food sources of fructose-containing sugars with incident overweight or obesity, we undertook a systematic review and meta-analysis of prospective cohort studies. METHODS: We searched MEDLINE, EMBASE and Cochrane Library through Aug 2019. We included prospective cohort studies of ≥1 year. Two reviewers extracted data and assessed the risk of bias. The primary outcome was incident overweight/obesity. Data were pooled using generic-inverse variance method (random effects) and expressed as relative risks (RR) for incident outcomes and ß-coefficients for WC with 95% confidence intervals (CI). GRADE assessed the certainty of evidence RESULTS: We included 12 and 8 prospective cohorts involving 181,295 adults and 31,717 children, respectively. Four food sources of fructose-containing sugars were identified: SSBs, 100% fruit juice, fruit and yogurt. There was no data available in children for yogurt or WC. SSBs were associated with increased incident overweight/obesity in children (RR, 1.22 [95% CI, 1.03 to 1.44] but not in adults and increased incident abdominal obesity in both children (3.78 [1.08 to 13.25]) and adults (1.51 [1.11 to 2.06]), but there was no association with change in WC in adults. Fruit juice was associated with increased incident overweight/obesity in children (1.28 [1.07 to 1.53]) but not in adults, and there was no association with incident abdominal obesity in either children or adults or WC in adults. Fruit was associated with decreased incident overweight/obesity (0.87 [0.82 to 0.92]) and decreased WC (ß, −0.23 cm [−0.33 to −0.13]) in adults. Yogurt was associated with decreased incident abdominal obesity (0.65 [0.47 to 0.90]) in adults with no data available on WC. The certainty of the evidence was graded as “very low” to “moderate”. CONCLUSIONS: Current evidence indicates that the relation between fructose-containing sugars and obesity outcomes differs by food sources. More research of more food sources of sugars is needed to improve our certainty in the evidence. (ClinicalTrials.gov, NCT02558920) FUNDING SOURCES: ASN, Diabetes Canada, Banting and Best Diabetes Centre.
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- 2021
18. Effect of vegetarian dietary patterns on cardiometabolic risk factors in diabetes: A systematic review and meta-analysis of randomized controlled trials
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Lawrence A. Leiter, Vivian L. Choo, Sonia Blanco Mejia, Sarah E. Stewart, Effie Viguiliouk, Dario Rahelić, David J.A. Jenkins, Cyril W.C. Kendall, John L. Sievenpiper, Hana Kahleova, and Jordi Salas-Salvadó
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Adult ,Male ,0301 basic medicine ,medicine.medical_specialty ,Waist ,Adolescent ,Blood lipids ,Blood Pressure ,030209 endocrinology & metabolism ,Critical Care and Intensive Care Medicine ,law.invention ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Diabetes management ,Internal medicine ,Diabetes mellitus ,Diabetes Mellitus ,Humans ,Medicine ,Obesity ,Medical nutrition therapy ,Randomized Controlled Trials as Topic ,Glycemic ,2. Zero hunger ,030109 nutrition & dietetics ,Nutrition and Dietetics ,business.industry ,Diet, Vegetarian ,Body Weight ,Middle Aged ,medicine.disease ,Lipids ,3. Good health ,Meta-analysis ,Female ,business - Abstract
Summary Background & aims To update the European Association for the Study of Diabetes (EASD) clinical practice guidelines for nutrition therapy, we conducted a systematic review and meta-analysis of randomized controlled trials to summarize the evidence for the effect of vegetarian dietary patterns on glycemic control and other established cardiometabolic risk factors in individuals with diabetes. Methods We searched MEDLINE, EMBASE, and Cochrane databases through February 26, 2018 for randomized controlled trials ≥3 weeks assessing the effect of vegetarian dietary patterns in individuals with diabetes. The primary outcome was HbA1c. Secondary outcomes included other markers of glycemic control, blood lipids, body weight/adiposity, and blood pressure. Two independent reviewers extracted data and assessed risk of bias. Data were pooled by the generic inverse variance method and expressed as mean differences (MD) with 95% CIs. Heterogeneity was assessed (Cochran Q statistic) and quantified (I2 statistic). The overall certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Results Nine trials (n = 664 participants) met the eligibility criteria. Vegetarian dietary patterns significantly lowered HbA1c (MD = −0.29% [95% CI: −0.45, −0.12%]), fasting glucose (MD = −0.56 mmol/L [95% CI: −0.99, −0.13 mmol/L]), LDL-C (MD = −0.12 mmol/L [95% CI: −0.20, −0.04 mmol/L]), non-HDL-C (MD = −0.13 mmol/L [95% CI: −0.26, −0.01 mmol/L]), body weight (MD = −2.15 kg [95% CI: −2.95, −1.34 kg]), BMI (MD = −0.74 kg/m2 [95% CI: −1.09, −0.39 kg/m2]) and waist circumference (MD = −2.86 cm [95% CI: −3.76, −1.96 cm]). There was no significant effect on fasting insulin, HDL-C, triglycerides or blood pressure. The overall certainty of evidence was moderate but was low for fasting insulin, triglycerides and waist circumference. Conclusion Vegetarian dietary patterns improve glycemic control, LDL-C, non-HDL-C, and body weight/adiposity in individuals with diabetes, supporting their inclusion for diabetes management. More research is needed to improve our confidence in the estimates. ClinicalTrials.gov identifier NCT02600377 .
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- 2019
19. The Effect of Liquid Meal Replacements on Cardiometabolic Risk Factors in Overweight/Obese Individuals With Type 2 Diabetes: A Systematic Review and Meta-analysis of Randomized Controlled Trials
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Stephanie K. Nishi, Tauseef Khan, Sonia Blanco Mejia, Dario Rahelić, Lawrence A. Leiter, Jordi Salas-Salvadó, Jarvis C. Noronha, Hana Kahleova, Catherine R. Braunstein, Cyril W.C. Kendall, and John L. Sievenpiper
- Subjects
Adult ,Male ,medicine.medical_specialty ,Waist ,Diet, Reducing ,Endocrinology, Diabetes and Metabolism ,Blood lipids ,030209 endocrinology & metabolism ,Type 2 diabetes ,Overweight ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,Risk Factors ,law ,Internal medicine ,Diabetes mellitus ,Internal Medicine ,medicine ,Humans ,Insulin ,Obesity ,030212 general & internal medicine ,Meals ,Randomized Controlled Trials as Topic ,Advanced and Specialized Nursing ,business.industry ,Body Weight ,Fasting ,medicine.disease ,3. Good health ,Blood pressure ,Diabetes Mellitus, Type 2 ,Cardiovascular Diseases ,Meta-analysis ,Female ,medicine.symptom ,business ,Diabetic Angiopathies - Abstract
OBJECTIVE The evidence for liquid meal replacements in diabetes has not been summarized. Our objective was to synthesize the evidence of the effect of liquid meal replacements on cardiometabolic risk factors in overweight/obese individuals with type 2 diabetes. RESEARCH DESIGN AND METHODS Data sources included MEDLINE, EMBASE, and the Cochrane Library through 10 December 2018. We included randomized trials of ≥2 weeks assessing the effect of liquid meal replacements in weight loss diets compared with traditional weight loss diets on cardiometabolic risk factors in overweight/obese subjects with type 2 diabetes. Two independent reviewers extracted relevant data and assessed risk of bias. Data were pooled using the inverse variance method. The overall certainty of the evidence was evaluated using GRADE (Grading of Recommendations Assessment, Development and Evaluation). RESULTS Nine trial comparisons (N = 961 [median follow-up 24 weeks]) met eligibility criteria. Mean differences were for body weight −2.37 kg (95% CI −3.30 to −1.44), BMI −0.87 kg/m2 (−1.31 to −0.42), body fat −1.66% (−2.17 to −1.15), waist circumference −2.24 cm (−3.72 to −0.77), HbA1c −0.43% (−0.66 to −0.19) (−4.7 mmol/mol [−7.2 to −2.1]), fasting glucose −0.63 mmol/L (−0.99 to −0.27), fasting insulin −11.83 pmol/L (−23.11 to −0.54), systolic blood pressure −4.97mmHg (−7.32 to −2.62), and diastolic blood pressure −1.98 mmHg (−3.05 to −0.91). There was no effect on blood lipids. The overall certainty of the evidence was low to moderate owing to imprecision and/or inconsistency. CONCLUSIONS Liquid meal replacements in weight loss diets lead to modest reductions in body weight, BMI, and systolic blood pressure, and reductions of marginal clinical significance in body fat, waist circumference, HbA1c, fasting glucose, fasting insulin, and diastolic blood pressure. More high-quality trials are needed to improve the certainty in our estimates.
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- 2019
20. Should Viscous Fiber Supplements Be Considered in Diabetes Control? Results From a Systematic Review and Meta-analysis of Randomized Controlled Trials
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Nourah Mazhar, Elena Jovanovski, Sonia Blanco Mejia, John L. Sievenpiper, Andreea Zurbau, Lea Duvnjak, Alexandra L Jenkins, Allison Komishon, Rana Khayyat, Vladimir Vuksan, Hoang Vi Thanh Ho, and Dandan Li
- Subjects
Blood Glucose ,Dietary Fiber ,Research design ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,030209 endocrinology & metabolism ,Type 2 diabetes ,law.invention ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Randomized controlled trial ,law ,Internal medicine ,Diabetes mellitus ,Internal Medicine ,medicine ,Humans ,Insulin ,030212 general & internal medicine ,Randomized Controlled Trials as Topic ,Glycemic ,Advanced and Specialized Nursing ,Viscosity ,business.industry ,Therapeutic effect ,Fasting ,medicine.disease ,Fructosamine ,Diabetes Mellitus, Type 2 ,chemistry ,Meta-analysis ,Dietary Supplements ,Insulin Resistance ,business - Abstract
OBJECTIVE Evidence from randomized controlled trials (RCTs) suggests that viscous dietary fiber may offer beneficial effects on glycemic control and, thus, an improved cardiovascular disease risk profile. Our purpose was to conduct a systematic review and meta-analysis of RCTs to synthesize the therapeutic effect of viscous fiber supplementation on glycemic control in type 2 diabetes. RESEARCH DESIGN AND METHODS MEDLINE, Embase, and Cochrane Central Register of Controlled Trials were searched through 15 June 2018. We included RCTs ≥3 weeks in duration that assessed the effects of viscous fiber on markers of glycemic control in type 2 diabetes. Two independent reviewers extracted data. Data were pooled using the generic inverse variance method and expressed as mean differences (MD) with 95% CIs. Heterogeneity was assessed (Cochran Q statistic) and quantified (I2 statistic). The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to evaluate the overall certainty of the evidence. RESULTS We identified 28 eligible trial comparisons (n = 1,394). Viscous fiber at a median dose of ∼13.1 g/day significantly reduced HbA1c (MD −0.58% [95% CI −0.88, −0.28]; P = 0.0002), fasting blood glucose (MD −0.82 mmol/L [95% CI −1.32, −0.31]; P = 0.001), and HOMA-insulin resistance (IR) (MD −1.89 [95% CI −3.45, −0.33]; P = 0.02) compared with control and in addition to standard of care. The certainty of evidence was graded moderate for HbA1c, fasting glucose, fasting insulin, and HOMA-IR and low for fructosamine. CONCLUSIONS Viscous fiber supplements improve conventional markers of glycemic control beyond usual care and should be considered in the management of type 2 diabetes.
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- 2019
21. Effect of coadministration of enriched Korean Red Ginseng (Panax ginseng) and American ginseng (Panax quinquefolius L) on cardiometabolic outcomes in type-2 diabetes: A randomized controlled trial
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Elena Jovanovski, Fei Au-Yeung, John L. Sievenpiper, Dandan Li, Lea Smircic-Duvnjak, Robert G. Josse, Vladimir Vuksan, Alexandra L Jenkins, Andreea Zurbau, Allison Komishon, and Mi-Kyung Sung
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Blood lipids ,Type 2 diabetes ,Biochemistry, Genetics and Molecular Biology (miscellaneous) ,Gastroenterology ,03 medical and health sciences ,Ginseng ,0302 clinical medicine ,Diabetes mellitus ,Internal medicine ,Clinical endpoint ,medicine ,American ginseng ,Type-2 diabetes ,Glycemic ,biology ,Korean Red Ginseng (Panax ginseng) ,American ginseng (Panax quinquefolius L) ,cardiometabolic outcomes ,type-2 diabetes ,business.industry ,Botany ,biology.organism_classification ,medicine.disease ,3. Good health ,030104 developmental biology ,Blood pressure ,Complementary and alternative medicine ,Randomized controlled trial ,QK1-989 ,030220 oncology & carcinogenesis ,Hypertension ,business ,Research Article ,Biotechnology - Abstract
Background Diabetes mellitus and hypertension often occur together, amplifying cardiovascular disease (CVD) risk and emphasizing the need for a multitargeted treatment approach. American ginseng (AG) and Korean red ginseng (KRG) species could improve glycemic control via complementary mechanisms. Additionally, a KRG-inherent component, ginsenoside Rg3, may moderate blood pressure (BP). Our objective was to investigate the therapeutic potential of coadministration of Rg3-enriched Korean red Ginseng (Rg3-KRG) and AG, added to standard of care therapy, in the management of hypertension and cardiometabolic risk factors in type-2 diabetes. Methods Within a randomized controlled, parallel design of 80 participants with type-2 diabetes (HbA1c: 6.5–8%) and hypertension (systolic BP: 140–160 mmHg or treated), supplementation with either 2.25 g/day of combined Rg3-KRG + AG or wheat-bran control was assessed over a 12-wk intervention period. The primary endpoint was ambulatory 24-h systolic BP. Additional endpoints included further hemodynamic assessment, glycemic control, plasma lipids and safety monitoring. Results Combined ginseng intervention generated a mean ± SE decrease in primary endpoint of 24-h systolic BP (−3.98 ± 2.0 mmHg, p = 0.04). Additionally, there was a greater reduction in HbA1c (−0.35 ± 0.1% [–3.8 ± 1.1 mmol/mol], p = 0.02), and change in blood lipids: total cholesterol (−0.50 ± 0.2 mmol/l, p = 0.01), non-HDL-C (−0.54 ± 0.2 mmol/l, p = 0.01), triglycerides (−0.40 ± 0.2 mmol/l, p = 0.02) and LDL-C (−0.35 ± 0.2 mmol/l, p = 0.06) at 12 wks, relative to control. No adverse safety outcomes were observed. Conclusion Coadministration of Rg3-KRG + AG is an effective addon for improving BP along with attaining favorable cardiometabolic outcomes in individuals with type 2 diabetes. Ginseng derivatives may offer clinical utility when included in the polypharmacy and lifestyle treatment of diabetes. Clinical trial registration Clinicaltrials.gov identifier, NCT01578837
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- 2021
22. Rare sugars and their health effects in humans: a systematic review and narrative synthesis of the evidence from human trials
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Tauseef Khan, D. Dan Ramdath, John L. Sievenpiper, Amna Ahmed, and Cyril W.C. Kendall
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0301 basic medicine ,rare sugars ,MEDLINE ,review ,Medicine (miscellaneous) ,030209 endocrinology & metabolism ,Context (language use) ,Type 2 diabetes ,Overweight ,Bioinformatics ,law.invention ,03 medical and health sciences ,AcademicSubjects/MED00060 ,0302 clinical medicine ,Randomized controlled trial ,law ,Weight loss ,Weight Loss ,Medicine ,Humans ,Obesity ,Glycemic ,030109 nutrition & dietetics ,Nutrition and Dietetics ,business.industry ,Rare sugar ,medicine.disease ,Diabetes Mellitus, Type 2 ,Sweetening Agents ,Special Articles ,medicine.symptom ,business ,Sugars ,cardiometabolic health - Abstract
ContextRare sugars are monosaccharides and disaccharides (found in small quantities in nature) that have slight differences in their chemical structure compared with traditional sugars. Little is known about their unique physiological and cardiometabolic effects in humans.ObjectiveThe objective of this study was to conduct a systematic review and synthesis of controlled intervention studies of rare sugars in humans, using PRISMA guidelines.Data SourcesMEDLINE and EMBASE were searched through October 1, 2020. Studies included both post-prandial (acute) and longer-term (≥1 week duration) human feeding studies that examined the effect of rare sugars (including allulose, arabinose, tagatose, trehalose, and isomaltulose) on cardiometabolic and physiological risk factors.Data extractionIn all, 50 studies in humans focusing on the 5 selected rare sugars were found. A narrative synthesis of the selected literature was conducted, without formal quality assessment or quantitative synthesis.Data synthesisThe narrative summary included the food source of each rare sugar, its effect in humans, and the possible mechanism of effect. Overall, these rare sugars were found to offer both short- and long-term benefits for glycemic control and weight loss, with effects differing between healthy individuals, overweight/obese individuals, and those with type 2 diabetes. Most studies were of small size and there was a lack of large randomized controlled trials that could confirm the beneficial effects of these rare sugars.ConclusionRare sugars could offer an opportunity for commercialization as an alternative sweetener, especially for those who are at high cardiometabolic risk.Systematic Review RegistrationOSF registration no. 10.17605/OSF.IO/FW43D.
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- 2020
23. Low-carbohydrate diets and cardiometabolic health: the importance of carbohydrate quality over quantity
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John L. Sievenpiper
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Dietary Fiber ,Medicine (miscellaneous) ,030204 cardiovascular system & hematology ,Biology ,03 medical and health sciences ,Diet, Carbohydrate-Restricted ,0302 clinical medicine ,Nutrient ,Weight loss ,Glycemic load ,Hyperinsulinemia ,medicine ,Diabetes Mellitus ,Dietary Carbohydrates ,Humans ,Insulin ,030212 general & internal medicine ,Food science ,Obesity ,2. Zero hunger ,Nutrition and Dietetics ,Articles ,Carbohydrate ,medicine.disease ,3. Good health ,Glycemic index ,Cardiovascular Diseases ,Glycemic Index ,medicine.symptom ,Weight gain - Abstract
Carbohydrates are increasingly being implicated in the epidemics of obesity, diabetes, and their downstream cardiometabolic diseases. The “carbohydrate-insulin model” has been proposed to explain this role of carbohydrates. It posits that a high intake of carbohydrate induces endocrine deregulation marked by hyperinsulinemia, leading to energy partitioning with increased storage of energy in adipose tissue resulting in adaptive increases in food intake and decreases in energy expenditure. Whether all carbohydrate foods under real-world feeding conditions directly contribute to weight gain and its complications or whether this model can explain these clinical phenomena requires close inspection. The aim of this review is to assess the evidence for the role of carbohydrate quantity vs quality in cardiometabolic health. Although the clinical investigations of the “carbohydrate-insulin model” have shown the requisite decreases in insulin secretion and increases in fat oxidation, there has been a failure to achieve the expected fat loss under low-carbohydrate feeding. Systematic reviews with pairwise and network meta-analyses of the best available evidence have failed to show the superiority of low-carbohydrate diets on long-term clinical weight loss outcomes or that all sources of carbohydrate behave equally. High-carbohydrate diets that emphasize foods containing important nutrients and substances, including high-quality carbohydrate such as whole grains (especially oats and barley), pulses, or fruit; low glycemic index and load; or high fiber (especially viscous fiber sources) decrease intermediate cardiometabolic risk factors in randomized trials and are associated with weight loss and decreased incidence of diabetes, cardiovascular disease, and cardiovascular mortality in prospective cohort studies. The evidence for sugars as a marker of carbohydrate quality appears to be highly dependent on energy control (comparator) and food source (matrix), with sugar-sweetened beverages providing excess energy showing evidence of harm, and with high-quality carbohydrate food sources containing sugars such as fruit, 100% fruit juice, yogurt, and breakfast cereals showing evidence of benefit in energy-matched substitutions for refined starches (low-quality carbohydrate food sources). These data reflect the current shift in dietary guidance that allows for flexibility in the proportion of macronutrients (including carbohydrates) in the diet, with a focus on quality over quantity and dietary patterns over single nutrients.
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- 2020
24. Important Food Sources of Sugars and Body Weight: A Systematic Review and Meta-Analysis of Controlled Feeding Trials
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Annette Cheung, Tauseef Khan, Sonia Blanco Mejia, Nema McGlynn, Fei Au-Yeung, Danielle Lee, John L. Sievenpiper, Laura Chiavaroli, and Sabrina Ayoub-Charette
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Nutrition and Dietetics ,business.industry ,digestive, oral, and skin physiology ,MEDLINE ,Medicine (miscellaneous) ,Fructose ,Sweetening agents ,Body weight ,medicine.disease ,chemistry.chemical_compound ,chemistry ,Weight loss ,Meta-analysis ,Diabetes mellitus ,Medicine ,Food science ,Obesity ,medicine.symptom ,business ,Weight gain ,Food Science - Abstract
OBJECTIVES: Sugar-sweetened beverages (SSBs) have been linked to weight gain, and it is unclear if other food sources of fructose-containing sugars behave similarily. We conducted a systematic review and meta-analysis of controlled feeding trials to assess the effect of different food sources of fructose-containing sugars on body weight. METHODS: MEDLINE, EMBASE, and The Cochrane library were searched through January 2019. We included controlled feeding trials of ≥2 weeks investigating the effect of different food sources of sugars. Four levels of energy control were prespecified: substitution (energy-matched comparisons); addition (energy from sugars added to diet); subtraction (energy from sugars subtracted from diet); or ad libitum (energy from sugars freely replaced). The primary outcome was body weight. Two independent reviewers extracted data and assessed risk of bias. Data were pooled using random effects models and expressed as mean differences (MDs) with 95% confidence intervals (CIs). GRADE assessed the certainty of evidence. RESULTS: We identified 110 controlled trials (N = 5133) assessing the effect of 7 different food sources of fructose-containing sugars (SSBs, fruit, fruit juice, dried fruit; baked goods, sweets, & desserts; mixed sources; added caloric sweeteners). No effect on body weight was observed in substitution trials, whereas there was an increasing effect in addition trials (MD, 0.23 kg [95% CI, 0.06 to 0.40]) and ad libitum trials (1.43 kg [0.78 to 2.16]), and a decreasing effect in subtraction trials (–0.52 kg [–1.02 to −0.02]). There was evidence of interaction by food source with fruit showing weight loss in substitution trials and SSBs showing weight gain in addition trials. The certainty of evidence was moderate for the effects in the addition and subtraction trials and high for the effects in the substitution and ad libitum trials. CONCLUSIONS: Energy control and food source appear to mediate the effect of fructose-containing sugars on body weight. Food sources of fructose-containing sugars adding excess energy to diets (especially sugars-sweetened beverages) appear to lead to weight gain. There is low to moderate likelihood that more research will substantially alter our estimates (ClinicalTrials.gov Identifier, NCT02558920) FUNDING SOURCES: American Society for Nutrition Foundation (commissioned and funded), Diabetes Canada.
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- 2020
25. Selenium, antioxidants, cardiovascular disease, and all-cause mortality: a systematic review and meta-analysis of randomized controlled trials
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Tom Tsirakis, Darshna Patel, David D. Kitts, Sonia Blanco Mejia, Edward Giovannucci, John L. Sievenpiper, Sathish C. Pichika, David J.A. Jenkins, Sandhya Sahye-Pudaruth, Cyril W.C. Kendall, Melanie Paquette, and Meaghan Kavanagh
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medicine.medical_specialty ,Antioxidant ,medicine.medical_treatment ,Medicine (miscellaneous) ,chemistry.chemical_element ,Disease ,030204 cardiovascular system & hematology ,Cochrane Library ,Antioxidants ,law.invention ,AcademicSubjects/MED00160 ,supplements ,03 medical and health sciences ,Selenium ,AcademicSubjects/MED00060 ,0302 clinical medicine ,Randomized controlled trial ,law ,cardiovascular disease ,Internal medicine ,Medicine ,Humans ,Randomized Controlled Trials as Topic ,Nutrition and Dietetics ,business.industry ,Cancer ,medicine.disease ,meta-analysis ,Original Research Communications ,chemistry ,Cardiovascular Diseases ,030220 oncology & carcinogenesis ,Meta-analysis ,Dietary Supplements ,all-cause mortality ,business ,All cause mortality - Abstract
Background Antioxidants have been promoted for cardiovascular disease (CVD) risk reduction and for the prevention of cancer. Our preliminary analysis suggested that only when selenium was present were antioxidant mixtures associated with reduced all-cause mortality. Objective We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to determine the effect of selenium supplementation alone and of antioxidant mixtures with or without selenium on the risk of CVD, cancer, and mortality. Methods We identified studies using the Cochrane Library, Medline, and Embase for potential CVD outcomes, cancer, and all-cause mortality following selenium supplementation alone or after antioxidant supplement mixtures with and without selenium up to June 5, 2020. RCTs of ≥24 wk were included and data were analyzed using random-effects models and classified by the Grading of Recommendations, Assessment, Development, and Evaluation approach. Results The meta-analysis identified 9423 studies, of which 43 were used in the final analysis. Overall, no association of selenium alone or antioxidants was seen with CVD and all-cause mortality. However, a decreased risk with antioxidant mixtures was seen for CVD mortality when selenium was part of the mix (RR: 0.77; 95% CI: 0.62, 0.97; P = 0.02), with no association when selenium was absent. Similarly, when selenium was part of the antioxidant mixture, a decreased risk was seen for all-cause mortality (RR: 0.90; 95% CI: 0.82, 0.98; P = 0.02) as opposed to an increased risk when selenium was absent (RR: 1.09; 95% CI: 1.04, 1.13; P = 0.0002). Conclusion The addition of selenium should be considered for supplements containing antioxidant mixtures if they are to be associated with CVD and all-cause mortality risk reduction. This trial was registered at https://www.crd.york.ac.uk/PROSPERO/ as CRD42019138268.
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- 2020
26. The association between body mass index trajectories and cardiometabolic risk in young children
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Xuedi Li, Gerald Lebovic, Jonathon L Maguire, Anthony J. Hanley, Muhammad Mamdani, Mark S. Tremblay, Khosrow Adeli, Catherine S Birken, Jill Hamilton, Charles D G Keown-Stoneman, Brian W. McCrindle, John L. Sievenpiper, Patricia C. Parkin, and Jessica A Omand
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Male ,0301 basic medicine ,Waist ,030209 endocrinology & metabolism ,Body Mass Index ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Metabolic Diseases ,Risk Factors ,Linear regression ,Humans ,Medicine ,Longitudinal Studies ,Early childhood ,2. Zero hunger ,030109 nutrition & dietetics ,Nutrition and Dietetics ,business.industry ,Health Policy ,Infant, Newborn ,Public Health, Environmental and Occupational Health ,Infant ,Repeated measures design ,medicine.disease ,Circumference ,Lipids ,Obesity ,Blood pressure ,Cardiovascular Diseases ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Female ,Waist Circumference ,business ,Body mass index ,Demography - Abstract
BACKGROUND Rapid growth is associated with increased cardiometabolic risk (CMR) in adolescence and adulthood. Little is known about whether the association between rapid growth and increased CMR originates in early childhood. OBJECTIVES To identify age and sex standardized body mass index (zBMI) trajectories and to examine the association between zBMI trajectories and CMR outcomes in children 0 to 60 months. STUDY DESIGN A longitudinal cohort study was conducted through The Applied Research Group for Kids (TARGet Kids!) in Toronto, Canada. Participants had repeated measures of weight and length or height performed from birth to 60 months of age. Latent class mixed modelling was used to identify the zBMI trajectories. Linear regressions were performed to determine the association between zBMI trajectories and the primary outcome, a CMR score, quantified as the sum of age- and sex- standardized waist circumference, systolic blood pressure, glucose, log-triglycerides and negative high-density lipoprotein cholesterol (HDL-C), divided by √5. Secondary outcomes were the individual components of the CMR formula as well as diastolic blood pressure and non-HDL-C. RESULTS Four BMI trajectories were identified among the 1166 children. After adjusting for all covariates, children in the rapidly accelerating trajectory had increased total CMR score (β = 1.38, 95% CI 0.77; 1.99, P
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- 2020
27. Nuts in the Prevention and Management of Diabetes
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Stephanie K. Nishi, Cyril W.C. Kendall, David Jenkins, Effie Viguiliouk, Sonia Blanco Mejia, and John L. Sievenpiper
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business.industry ,Diabetes mellitus ,Environmental health ,Medicine ,business ,medicine.disease - Published
- 2020
28. Dried Fruits in the Prevention and Control of Diabetes (Insulin Resistance and Prediabetes)
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Yakup Kohen, John L. Sievenpiper, Melanie Paquette, Cyril W.C. Kendall, Melody Ong, Zoha Prasla, Kristie Srichaikul, Sandhya Sahye-Pudaruth, Iris Mandalozano, David Jenkins, and Darshna Patel
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Diabetes insulin resistance ,medicine.medical_specialty ,Endocrinology ,Dried fruit ,business.industry ,Internal medicine ,Medicine ,Prediabetes ,business ,medicine.disease - Published
- 2020
29. The Effects of Different Quantities and Qualities of Protein Intake in People with Diabetes Mellitus
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Anne-Marie Aas, John L. Sievenpiper, Stephanie Gebauer, Jordi Salas-Salvadó, Dario Rahelić, Eva Pedersen, Anastasia Thanopoulou, Ursula Schwab, Andreas Pfeiffer, Matti Uusitupa, Kjeld Hermansen, Hana Kahleova, Ulf Risérus, Cyril W.C. Kendall, Pfeiffer, Andreas FH, Pedersen, Eva, Schwab, Ursula, Riserus, Ulf, Aas, Anne Marie, Uusitupa, Matti, Thanopoulou, Anastasia, Kendall, Cyril, Sievenpiper, John L, Kahleova, Hana, Rahelic, Dario, Salas-Salvado, Jordi, Gebauer, Stephanie, and Hermansen, Kjeld
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0301 basic medicine ,Male ,Weight loss ,Physiology ,Blood lipids ,Blood Pressure ,Type 2 diabetes ,Animal protein ,0302 clinical medicine ,plant protein ,Hypocaloric diet ,Nutrition and Dietetics ,Communication ,Middle Aged ,Näringslära ,Plant protein ,Endokrinologi och diabetes ,Diet, High-Protein ,Female ,Dietary Proteins ,type 2 diabetes ,medicine.symptom ,hypocaloric diet ,lcsh:Nutrition. Foods and food supply ,Glomerular Filtration Rate ,Adult ,Renal function ,030209 endocrinology & metabolism ,lcsh:TX341-641 ,Endocrinology and Diabetes ,03 medical and health sciences ,Diabetes mellitus ,Weight Loss ,medicine ,Diet, Protein-Restricted ,Humans ,Glycated Hemoglobin ,030109 nutrition & dietetics ,business.industry ,medicine.disease ,protein intake ,Blood pressure ,Diabetes Mellitus, Type 2 ,Protein intake ,Metabolic control analysis ,animal protein ,weight loss ,business ,Energy Intake ,Food Science - Abstract
The recommended amount and quality of protein in diets of diabetic patients are highly controversial. In order to provide evidence-based information, the Diabetes Nutrition Study Group (DNSG) used a grading procedure used for quality of evidence and strength of recommendations (GRADE). A protein intake of 10% to 20% of energy intake (E%) or about 0.8 to 1.3 g/kg body weight in people below 65 years of age, and 15% to 20% of E% in people above 65 years of age appeared safe in weight-stable conditions. There were no intervention studies addressing metabolic effects, mortality, or cardiovascular events over prolonged periods. Body weight is closely linked to metabolic control and high protein diets are often recommended. Weight-loss diets that include 23% to 32% of E% as protein for up to one year reduced blood pressure and body weight slightly but significantly more than lower protein diets, whereas blood lipids, fasting blood glucose, and HbA1c improved similarly with higher or lower protein intakes in participants with a glomerular filtration rate (GFR) >60 mL/min/1.73 m2. Patients with a GFR 2 did not show a faster decline of GFR or kidney function with protein intakes around 0.8 g/kg body weight as compared with lower intakes, thereby arguing against a restriction. The effects of protein intake on diabetic eye or nerve disease have not been reported. There are a number of studies that have compared different types of animal proteins (milk, chicken, beef, pork, and fish) or compared animal with plant protein in diabetic patients and have reported a greater reduction of serum cholesterol with plant protein. In summary, the suggested range of protein intake appears to be safe and can be adapted according to personal dietary preferences.
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- 2020
30. Diet—microbiome interaction in colorectal cancer: a potentially discriminatory role for Fusobacterium nucleatum
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Julia Mw Wong, Cyril W.C. Kendall, Zoe Lofft, David Jenkins, Elena M. Comelli, Amel Taibi, and John L. Sievenpiper
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biology ,Colorectal cancer ,Physiology ,medicine.disease ,biology.organism_classification ,digestive system diseases ,Tumor Subtype ,stomatognathic diseases ,Increased risk ,Intestinal homeostasis ,Western diet ,medicine ,Microbiome ,Fusobacterium nucleatum ,Cohort study - Abstract
Intestinal homeostasis depends on the dynamic interplay among the host, its gut microbiome, and diet. Cohort studies and intervention trials emphasize plant-based diets for chronic disease prevention. Fermentable fiber in these diets is a preferred metabolic fuel for the gut microbiome; prudent diets, encompassing a higher intake of fruits, vegetables, legumes, and rich in fiber, rather than a Western diet, are associated with reduced risk for colorectal cancer (CRC). CRC is characterized by a typical gut microbiome signature, with Fusobacterium nucleatum being an emerging critical species. Remarkably, an inverse association between prudent diets and F. nucleatum–positive CRC risk has been demonstrated, while inflammatory and Western dietary patterns are associated with an increased risk of F. nucleatum–positive CRC tumor subtype. This relationship does not apply to F. nucleatum–negative tumors. The intersection between diet, microbiota composition, and CRC warrants the application of nutritional strategies to prevent the development of CRC.
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- 2020
31. Dietary glycemic index, glycemic load, and chronic disease: an umbrella review of meta-analyses of prospective cohort studies
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John L. Sievenpiper, Sakineh Shab-Bidar, Ahmad Jayedi, David J.A. Jenkins, and Sepideh Soltani
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medicine.medical_specialty ,Type 2 diabetes ,Industrial and Manufacturing Engineering ,Risk Factors ,Internal medicine ,Glycemic load ,Dietary Carbohydrates ,Humans ,Medicine ,Prospective Studies ,Prospective cohort study ,business.industry ,Glycemic Load ,General Medicine ,medicine.disease ,Observational Studies as Topic ,Glycemic index ,Diabetes Mellitus, Type 2 ,Glycemic Index ,Relative risk ,Meta-analysis ,Chronic Disease ,Observational study ,business ,Food Science ,Cohort study - Abstract
We aimed to present a comprehensive review of the association of dietary glycemic index (GI) and load (GL) with the risk of chronic disease. Published meta-analyses of prospective observational studies evaluating the association of dietary GI and GL with risk of chronic disease were identified by a search in PubMed and Scopus to November, 2020. Summary relative risks (SRRs) were recalculated using random-effects models. The certainty of evidence was rated by the GRADE approach. Eighteen meta-analyses of prospective cohort studies, reporting 19 SRRs for dietary GI and 17 SRRs for dietary GL were identified. There was a positive association between dietary GI and the risk of type 2 diabetes, coronary heart disease, and colorectal, breast, and bladder cancers, as well as between dietary GL and the risk of coronary heart disease, type 2 diabetes, and stroke. With regard to cancers at other sites, there was no significant association. The certainty of evidence ranged from very low to low. Although by GRADE classification no associations were rated stronger than low, they were classified as one grade higher when the NutriGrade system was used. Further research is needed to add evidence for the relation of dietary GI and GL with cancer risk.
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- 2020
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32. Prevention of Type 2 Diabetes by Lifestyle Changes:A Systematic Review and Meta-Analysis
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Ursula Schwab, John L. Sievenpiper, Angela A. Rivellese, Andreas Pfeiffer, Kjeld Hermansen, Effie Viguiliouk, Hana Kahleova, Anastasia Thanopoulou, Tauseef Khan, Jordi Salas-Salvadó, and Matti Uusitupa
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Male ,medicine.medical_specialty ,complications ,Saturated fat ,Health Behavior ,030209 endocrinology & metabolism ,lcsh:TX341-641 ,lifestyles ,Type 2 diabetes ,Review ,Lower risk ,law.invention ,Impaired glucose tolerance ,Diabetes Complications ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,prevention ,law ,Diabetes mellitus ,medicine ,Humans ,030212 general & internal medicine ,Medical nutrition therapy ,Intensive care medicine ,Exercise ,Life Style ,Nutrition and Dietetics ,business.industry ,Glucose Tolerance Test ,medicine.disease ,3. Good health ,Diet ,Diabetes Mellitus, Type 2 ,Meta-analysis ,Female ,type 2 diabetes ,business ,lcsh:Nutrition. Foods and food supply ,Food Science - Abstract
Prevention of type 2 diabetes (T2D) is a great challenge worldwide. The aim of this evidence synthesis was to summarize the available evidence in order to update the European Association for the Study of Diabetes (EASD) clinical practice guidelines for nutrition therapy. We conducted a systematic review and, where appropriate, meta-analyses of randomized controlled trials (RCTs) carried out in people with impaired glucose tolerance (IGT) (six studies) or dysmetabolism (one study) to answer the following questions: What is the evidence that T2D is preventable by lifestyle changes? What is the optimal diet (with a particular focus on diet quality) for prevention, and does the prevention of T2D result in a lower risk of late complications of T2D? The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was applied to assess the certainty of the trial evidence. Altogether seven RCTs (N = 4090) fulfilled the eligibility criteria and were included in the meta-analysis. The diagnosis of incident diabetes was based on an oral glucose tolerance test (OGTT). The overall risk reduction of T2D by the lifestyle interventions was 0.53 (95% CI 0.41; 0.67). Most of the trials aimed to reduce weight, increase physical activity, and apply a diet relatively low in saturated fat and high in fiber. The PREDIMED trial that did not meet eligibility criteria for inclusion in the meta-analysis was used in the final assessment of diet quality. We conclude that T2D is preventable by changing lifestyle and the risk reduction is sustained for many years after the active intervention (high certainty of evidence). Healthy dietary changes based on the current recommendations and the Mediterranean dietary pattern can be recommended for the long-term prevention of diabetes. There is limited or insufficient data to show that prevention of T2D by lifestyle changes results in a lower risk of cardiovascular and microvascular complications.
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- 2019
33. The effect of small doses of fructose and allulose on postprandial glucose metabolism in type 2 diabetes: A double-blind, randomized, controlled, acute feeding, equivalence trial
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Jarvis C. Noronha, Catherine R. Braunstein, John L. Sievenpiper, Andrea J. Glenn, Rebecca Noseworthy, Lawrence A. Leiter, Effie Viguiliouk, Thomas M.S. Wolever, Tauseef Khan, Sonia Blanco Mejia, and Cyril W.C. Kendall
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Adult ,Blood Glucose ,Male ,0301 basic medicine ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,Cmax ,030209 endocrinology & metabolism ,Fructose ,Type 2 diabetes ,Carbohydrate metabolism ,Drug Administration Schedule ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Endocrinology ,Double-Blind Method ,dietary intervention ,Internal medicine ,randomized trial ,Internal Medicine ,medicine ,Humans ,glucose ,Aged ,030109 nutrition & dietetics ,Dose-Response Relationship, Drug ,business.industry ,Area under the curve ,clinical trial ,Feeding Behavior ,Original Articles ,Middle Aged ,Postprandial Period ,medicine.disease ,3. Good health ,Dose–response relationship ,Postprandial ,Diabetes Mellitus, Type 2 ,chemistry ,dose–response relationship ,Female ,Original Article ,Blood sugar regulation ,type 2 diabetes ,business ,metabolism - Abstract
AIM To assess and compare the effect of small doses of fructose and allulose on postprandial blood glucose regulation in type 2 diabetes. METHODS A double-blind, multiple-crossover, randomized, controlled, acute feeding, equivalence trial in 24 participants with type 2 diabetes was conducted. Each participant was randomly assigned six treatments separated by >1-week washouts. Treatments consisted of fructose or allulose at 0 g (control), 5 g or 10 g added to a 75-g glucose solution. A standard 75-g oral glucose tolerance test protocol was followed with blood samples at -30, 0, 30, 60, 90 and 120 minutes. The primary outcome measure was plasma glucose incremental area under the curve (iAUC). RESULTS Allulose significantly reduced plasma glucose iAUC by 8% at 10 g compared with 0 g (717.4 ± 38.3 vs. 777.5 ± 39.9 mmol × min/L, P = 0.015) with a linear dose response gradient between the reduction in plasma glucose iAUC and dose (P = 0.016). Allulose also significantly reduced several related secondary and exploratory outcome measures at 5 g (plasma glucose absolute mean and total AUC) and 10 g (plasma glucose absolute mean, absolute and incremental maximum concentration [Cmax ], and total AUC) (P < .0125). There was no effect of fructose at any dose. Although allulose showed statistically significant reductions in plasma glucose iAUC compared with fructose at 5 g, 10 g and pooled doses, these reductions were within the pre-specified equivalence margins of ±20%. CONCLUSION Allulose, but not fructose, led to modest reductions in the postprandial blood glucose response to oral glucose in individuals with type 2 diabetes. There is a need for long-term randomized trials to confirm the sustainability of these improvements.
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- 2018
34. Nuts as a replacement for carbohydrates in the diabetic diet: a reanalysis of a randomised controlled trial
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Monica S. Banach, John L. Sievenpiper, Christopher Ireland, Joseph Beyene, Balachandran Bashyam, David J.A. Jenkins, Korbua Srichaikul, Cyril W.C. Kendall, Benoît Lamarche, Edward Vidgen, Stephanie K. Nishi, Tina Parker, Robert G. Josse, Russell J. de Souza, Sathish C. Pichika, and Sandy Mitchell
- Subjects
Nut ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Blood lipids ,030209 endocrinology & metabolism ,Type 2 diabetes ,030204 cardiovascular system & hematology ,Article ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Animal science ,Glycaemic control ,Internal Medicine ,medicine ,Clotting factors ,Nuts ,2. Zero hunger ,Clotting factor ,Cholesterol ,business.industry ,Unsaturated fat ,digestive, oral, and skin physiology ,Repeated measures design ,medicine.disease ,3. Good health ,Diabetic diet ,chemistry ,business - Abstract
Aims/hypothesis In line with current advice, we assessed the effect of replacing carbohydrate consumption with mixed nut consumption, as a source of unsaturated fat, on cardiovascular risk factors and HbA1c in type 2 diabetes. The data presented here are from a paper that was retracted at the authors’ request (10.2337/dc16-rt02) owing to lack of adjustment for repeated measures in the same individual. Our aim, therefore, was to fix the error and add new complementary data of interest, including information on clotting factors and LDL particle size. Methods A total of 117 men and postmenopausal women with type 2 diabetes who were taking oral glucose-lowering agents and with HbA1c between 47.5 and 63.9 mmol/mol (6.5–8.0%) were randomised after stratification by sex and baseline HbA1c in a parallel design to one of three diets for 3 months: (1) ‘full-dose nut diet’ (n = 40): a diet with 2.0 MJ (477 kcal) per 8.4 MJ (2000 kcal) energy provided as mixed nuts (75 g/day); (2) ‘full-dose muffin diet’ (n = 39): a diet with 1.97 MJ (471 kcal) per 8.4 MJ (2000 kcal) energy provided as three whole-wheat muffins (188 g/day), with a similar protein content to the nuts, and the same carbohydrate-derived energy content as the monounsaturated fatty acid-derived energy content in the nuts; or (3) ‘half-dose nut diet’ (n = 38): a diet with 1.98 MJ (474 kcal) per 8.4 MJ (2000 kcal) energy provided as half portions of both the nuts and muffins. The primary outcome was change in HbA1c. The study was carried out in a hospital clinical research centre and concluded in 2008. Only the statistician, study physicians and analytical technicians could be blinded to the group assessment. Results A total of 108 participants had post-intervention data available for analysis (full-dose nut group, n = 40; full-dose muffin group, n = 35; half-dose nut group, n = 33). Compared with the full-dose muffin diet, the full-dose nut diet provided 9.2% (95% CI 7.1, 11.3) greater total energy intake from monounsaturated fat. The full-dose nut diet (median intake, 75 g/day) also reduced HbA1c compared with the full-dose muffin diet by −2.0 mmol/mol (95% CI −3.8, −0.3 mmol/mol) (−0.19% [95% CI −0.35%, −0.02%]), (p = 0.026). Estimated cholesterol levels in LDL particles with a diameter
- Published
- 2018
35. Efficacy and safety of American ginseng (Panax quinquefolius L.) extract on glycemic control and cardiovascular risk factors in individuals with type 2 diabetes: a double-blind, randomized, cross-over clinical trial
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Elena Jovanovski, Vladimir Vuksan, John L. Sievenpiper, Michael Z. C. Li, Lea Duvnjak, Alexandra L Jenkins, P. Mark Stavro, Andreea Zurbau, Uljana Beljan-Zdravkovic, and Zenith Zheng Xu
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Blood Glucose ,Male ,0301 basic medicine ,medicine.medical_specialty ,Panax ,Medicine (miscellaneous) ,030209 endocrinology & metabolism ,Type 2 diabetes ,Placebo ,Gastroenterology ,03 medical and health sciences ,Ginseng ,0302 clinical medicine ,Double-Blind Method ,Risk Factors ,Internal medicine ,Diabetes mellitus ,medicine ,Humans ,Hypoglycemic Agents ,Insulin ,American ginseng ,Aged ,Glycemic ,Cross-Over Studies ,030109 nutrition & dietetics ,Nutrition and Dietetics ,biology ,Plant Extracts ,business.industry ,Middle Aged ,medicine.disease ,biology.organism_classification ,Treatment Outcome ,Blood pressure ,Postprandial ,Diabetes Mellitus, Type 2 ,Cardiovascular Diseases ,Female ,business - Abstract
Despite the lack of evidence, a growing number of people are using herbal medicine to attenuate the burden of diabetes. There is an urgent need to investigate the clinical potential of herbs. Preliminary observations suggest that American ginseng (Panax quinquefolius [AG]) may reduce postprandial glycemia. Thus, we aimed to evaluate the efficacy and safety of AG as an add-on therapy in individuals with type 2 diabetes (T2DM) controlled by conventional treatment. 24 individuals living with T2DM completed the study (F:M = 11:13; age = 64 ± 7 year; BMI = 27.8 ± 4.6 kg/m2; HbA1c = 7.1 ± 1.2%). Utilizing a double-blind, cross-over design, the participants were randomized to receive either 1 g/meal (3 g/day) of AG extract or placebo for 8 weeks while maintaining their original treatment. Following a ≥ 4-week washout period, the participants were crossed over to the opposite 8-week treatment arm. The primary objective was HbA1c, and secondary endpoints included fasting blood glucose and insulin, blood pressure, plasma lipids, serum nitrates/nitrites (NOx), and plasominogen-activating factor-1 (PAI-1). Safety parameters included liver and kidney function. Compared to placebo, AG significantly reduced HbA1c (− 0.29%; p = 0.041) and fasting blood glucose (− 0.71 mmol/L; p = 0.008). Furthermore, AG lowered systolic blood pressure (− 5.6 ± 2.7 mmHg; p
- Published
- 2018
36. Effect of Oats and Oat-Fiber on Glycemic Control in Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
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Fei Au-Yeung, John L. Sievenpiper, Tauseef Khan, Amna Ahmed, Cyril W.C. Kendall, Andreea Zurbau, and Victoria Chen
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medicine.medical_specialty ,business.industry ,Endocrinology, Diabetes and Metabolism ,General Medicine ,medicine.disease ,law.invention ,Endocrinology ,Randomized controlled trial ,law ,Diabetes mellitus ,Meta-analysis ,Internal medicine ,Internal Medicine ,medicine ,Fiber ,business ,Glycemic - Published
- 2021
37. Effect of a low glycemic index diet versus a high-cereal fibre diet on markers of subclinical cardiac injury in healthy individuals with type 2 diabetes mellitus: An exploratory analysis of a randomized dietary trial
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Vanessa Ha, Effie Viguiliouk, John L. Sievenpiper, Peter A. Kavsak, Bashyam Balachandran, David J.A. Jenkins, and Cyril W.C. Kendall
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Blood Glucose ,Dietary Fiber ,Male ,medicine.medical_specialty ,Galectin 3 ,Clinical Biochemistry ,030209 endocrinology & metabolism ,030204 cardiovascular system & hematology ,Low glycemic index ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,Risk Factors ,law ,Fibrosis ,Diabetes mellitus ,Internal medicine ,Humans ,Medicine ,Adverse effect ,Aged ,Subclinical infection ,biology ,business.industry ,Troponin I ,Type 2 Diabetes Mellitus ,Feeding Behavior ,General Medicine ,Middle Aged ,medicine.disease ,Troponin ,Diet ,3. Good health ,Endocrinology ,Diabetes Mellitus, Type 2 ,Cardiovascular Diseases ,Glycemic Index ,biology.protein ,Female ,business ,Biomarkers - Abstract
Background Markers of subclinical cardiac injury are elevated in individuals with type 2 diabetes mellitus (T2DM) compared to healthy individuals. Low glycemic index (LGI) diets may improve both diabetes and cardiovascular risk but their effects on cardiac injury and fibrosis have not been previously studied. To test the effect of a LGI diet on markers of subclinical cardiac injury and fibrosis, we assessed the effect of a LGI compared with a high-cereal fibre diet on high-sensitivity cardiac troponin I (hs-cTnI) and galectin-3 in otherwise healthy individuals with T2DM in an exploratory analysis of a completed randomized trial. Methods A total of 201 participants completed the trial and had measurements of hs-cTnI and galectin-3 at baseline and at trial completion. Participants were randomized to follow a LGI or a high-cereal fibre diet over a 6-month period. Treatment differences were tested using Analysis of Covariance (ANCOVA) with sex, baseline values, and diet x sex interaction included as covariates. Results In a completer's analysis, no significant differences were observed for change in hs-cTnI (− 0.16 ng/L vs. − 0.22 ng/L, p = 0.713) and galectin-3 levels (0.64 μg/L vs. 0.14 μg/L, p = 0.166) when a LGI diet was compared to a high-cereal fibre diet. Conclusions The effect of a LGI diet was similar to a high-cereal fibre diet on hs-cTnI and galectin-3 levels in otherwise healthy individuals with T2DM over a 6-month period. Nevertheless, in the absence of any adverse effects, LGI diets remain an option for diabetes and cardiovascular disease risk management. ClinicalTrials.gov identifier: NCT00438698
- Published
- 2017
38. Effects of Honey on Metabolic Risk Factors in Healthy Adults: A Systematic Review and Meta-Analysis
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Tauseef Khan, Amna Ahmed, Zujajatul Noor, and John L. Sievenpiper
- Subjects
Nutrition and Dietetics ,Calorie ,business.industry ,MEDLINE ,Medicine (miscellaneous) ,Lipid Measurement ,Bioinformatics ,medicine.disease ,Obesity ,chemistry.chemical_compound ,Blood pressure ,chemistry ,Meta-analysis ,Nutritional Epidemiology ,Uric acid ,Medicine ,Hemoglobin ,business ,Food Science - Abstract
OBJECTIVES: Excess calories from free sugars have been implicated in the epidemics of obesity and type 2 diabetes. Honey has been lumped into the category of free sugars according to the World Health Organization but is considered a healthy alternative to sugar by many in the public. The objective of this study was to assess the effect of honey on cardiometabolic risk factors by conducting a systematic review and meta-analysis of controlled trials using GRADE. METHODS: MEDLINE, Embase, and Cochrane Library were searched up to 4 January 2021 for controlled trials of ≥1 weeks’ duration assessing the effect of oral honey intake on adiposity, glycemic control, lipids, blood pressure, uric acid, inflammatory markers, and markers of non-alcoholic fatty liver disease. Trial designs were prespecified based on energy control: substitution (energy matched replacement of honey by other macronutrients); addition (excess energy from honey added to diets); subtraction (energy from honey subtracted from diets); and ad libitum (energy from honey freely replaced by other macronutrients) trials. Independent reviewers extracted data and assessed risk of bias. Data were pooled using the inverse variance method and expressed as mean differences (MDs) with 95% CIs. Certainty of evidence was assessed using the GRADE approach. (PROSPERO identifier, CRD42015023580) RESULTS: We included 17 controlled trials (29 trial comparisons, n = 1073) assessing the effect of honey across two energy levels, substitution and addition. Honey reduced glycated hemoglobin (mean difference (MD), −0.27%, [95% confidence interval (CI), −0.50 to −0.04%], P = 0.019), LDL cholesterol (MD, −0.34 mmol/L, [95% CI, −0.67 to −0.042 mmol/L], P = 0.040), and fasting triglycerides (MD, −0.15 mmol/L, [95% CI, −0.30 to −0.00 mmol/L], P = 0.043) in addition trials. No effects of honey were seen in substitution trials on any of the outcomes assessed. The overall certainty of the evidence was low to very low for most comparisons. CONCLUSIONS: The available evidence provides some indication that honey might have a benefit for glycemic control and lipid levels when consumed in a healthy dietary pattern. More high-quality randomized controlled trials are needed to improve our estimates. FUNDING SOURCES: CIHR, Diabetes Canada, PSI, Banting & Best Diabetes Centre, Toronto 3D foundation.
- Published
- 2021
39. Greater Adherence to the Portfolio Diet Is Associated with Lower Incidence of Type 2 Diabetes in the Women’s Health Initiative
- Author
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Andrea J. Glenn, Barbara V. Howard, Steven D. Chessler, Beatrice A. Boucher, Aladdin Shadyab, Lesley F. Tinker, Kenneth Lo, Simin Liu, Anthony J. Hanley, David J.A. Jenkins, Cyril W.C. Kendall, and John L. Sievenpiper
- Subjects
Nutrition and Dietetics ,business.industry ,Women's Health Initiative ,education ,Ethnic group ,Medicine (miscellaneous) ,Type 2 diabetes ,medicine.disease ,Drug usage ,Lower incidence ,Diabetes mellitus ,medicine ,Nutritional Epidemiology ,Portfolio ,Medical history ,business ,Food Science ,Demography - Abstract
OBJECTIVES: To assess the association of the plant-based cholesterol-lowering diet, the Portfolio Diet, with incident type 2 diabetes in women. METHODS: We followed 147,732 postmenopausal women initially free of diabetes in the Women's Health Initiative (WHI) Clinical Trials and Observational Study from 1993 through 2017. Adherence to the Portfolio Diet was assessed using an a priori diet index based on six food categories (high in plant protein [soy & pulses], nuts, viscous fiber, plant sterols and monounsaturated fat, and low in saturated fat) that were previously found to lower cardiovascular risk factors in the Portfolio Diet trials. We used Cox proportional-hazard models to estimate hazard ratios (HRs) and 95% confidence intervals (CI) of the association of adherence to a Portfolio Diet score with incident type 2 diabetes, adjusting for potential confounders (demographics, lifestyle behaviors, and medical history). The Portfolio Diet score was cumulatively assessed at baseline and year three using a validated food frequency questionnaire. Type 2 diabetes diagnosis was ascertained by self-reported medication use. RESULTS: There were 14,096 cases of incident type 2 diabetes over a mean follow-up of 14.3 years. In the fully adjusted models, adherence to the Portfolio Diet score was associated with a lower risk of incident type 2 diabetes (HR, 0.88, CIs, 0.83, 0.93; P for trend
- Published
- 2021
40. Effect of Oats and Oat-Fiber on Glycemic Control in Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
- Author
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Tauseef Khan, John L. Sievenpiper, Victoria Chen, Amna Ahmed, Andreea Zurbau, and Cyril W.C. Kendall
- Subjects
medicine.medical_specialty ,Nutrition and Dietetics ,business.industry ,Medicine (miscellaneous) ,medicine.disease ,law.invention ,Randomized controlled trial ,law ,Meta-analysis ,Internal medicine ,Diabetes mellitus ,medicine ,Energy and Macronutrient Metabolism ,Fiber ,business ,Food Science ,Glycemic - Abstract
OBJECTIVES: Current approved health claims in Canada, US and Europe recognize the ability of oat ß-glucan to lower blood cholesterol; however, its ability to improve glycemic control is less certain. We undertook a systematic review and meta-analysis of randomized controlled trials to update the evidence of the effect of oats and oat-fiber on markers of glycemic control in people with and without diabetes. Here we present data for the subgroup with diabetes. METHODS: MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials were searched through September 23(rd), 2020. We included randomized controlled trials of ≥ 2-weeks of sources of oat ß-glucan and measures of glycemic control in diabetes. Two independent reviewers extracted relevant data and assessed the risk of bias (Cochrane Risk of Bias 2.0 Tool). The outcomes were fasting plasma glucose (FPG), 2h-plasma glucose (2h-PG) from a 75 g-oral glucose tolerance test, HbA1c and fasting plasma insulin (FPI). Data were pooled using the generic inverse variance method. Heterogeneity was assessed (Cochran Q statistic) and quantified (I(2) statistic). Pooled estimates were expressed as mean differences with 95% confidence intervals (CI). GRADE assessed the certainty of the evidence. RESULTS: Eligibility criteria were met by 5 trial comparisons (N = 359) in type 2 diabetes. No trials were identified in type 1 diabetes. Consumption of oat ß-glucan sources reduced FPG (MD = −0.37 mmol/L [95% CI: −0.70, −0.05 mmol/L], P = 0.03, I(2) = 0.00%, P(Q) = 0.76) and 2h-PG (MD = −1.24 mmol/L [95% CI: −1.97, −0.51 mmol/L], P = 0.00, I(2) = 0.00%, P(Q )= 0.56). There were non-significant reductions in HbA1c (MD = −0.12%, [95% CI: −0.26, 0.01%], P = 0.07, I(2) = 0.00%, P(Q) = 1.00) and FPI (MD = −4.59 pmol/L, [95% CI: −14.71, 5.52 pmol/L], P = 0.37, I(2) = 40.84%, P(Q) = 0.19). The certainty of evidence was high for 2h-PG and moderate for FPG, HbA1c and FPI (single downgrades for imprecision in each case). CONCLUSIONS: Current evidence provides a good indication that consumption of oat ß-glucan results in small improvements of glycemic control in type 2 diabetes. More high quality randomized trials are required to improve the precision of the pooled estimates. (ClinicalTrials.gov identifier, NCT04631913) FUNDING SOURCES: Quaker Oats Center of Excellence, Diabetes Canada, Banting & Best Diabetes Centre, Toronto 3D foundation
- Published
- 2021
41. Relation of total sugars, fructose and sucrose with incident type 2 diabetes: a systematic review and meta-analysis of prospective cohort studies
- Author
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Viranda H. Jayalath, Marco Di Buono, Joseph Beyene, Arash Mirrahimi, Alexandra L Jenkins, Adrian I. Cozma, Russell J. de Souza, John L. Sievenpiper, Lawrence A. Leiter, Vanessa Ha, Reem Tawfik, Tauseef Khan, Sonia Blanco Mejia, Christine S. Tsilas, David J.A. Jenkins, Cyril W.C. Kendall, and Thomas M.S. Wolever
- Subjects
medicine.medical_specialty ,business.industry ,030209 endocrinology & metabolism ,General Medicine ,Type 2 diabetes ,Cochrane Library ,medicine.disease ,Confidence interval ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Meta-analysis ,Internal medicine ,Relative risk ,Diabetes mellitus ,medicine ,030212 general & internal medicine ,Risk assessment ,Prospective cohort study ,business - Abstract
BACKGROUND: Sugar-sweetened beverages are associated with type 2 diabetes. To assess whether this association holds for the fructose-containing sugars they contain, we conducted a systematic review and meta-analysis of prospective cohort studies. METHODS: We searched MEDLINE, Embase, CINAHL and the Cochrane Library (through June 2016). We included prospective cohort studies that assessed the relation of fructose-containing sugars with incident type 2 diabetes. Two independent reviewers extracted relevant data and assessed risk of bias. We pooled risk ratios (RRs) using random effects meta-analyses. The overall quality of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. RESULTS: Fifteen prospective cohort studies (251 261 unique participants, 16 416 cases) met the eligibility criteria, comparing the highest intake (median 137, 35.2 and 78 g/d) with the lowest intake (median 65, 9.7 and 25.8 g/d) of total sugars, fructose and sucrose, respectively. Although there was no association of total sugars (RR 0.91, 95% confidence interval [CI] 0.76–1.09) or fructose (RR 1.04, 95% CI 0.84–1.29) with type 2 diabetes, sucrose was associated with a decreased risk of type 2 diabetes (RR 0.89, 95% CI 0.80–0.98). Our confidence in the estimates was limited by evidence of serious inconsistency between studies for total sugars and fructose, and serious imprecision in the pooled estimates for all 3 sugar categories. INTERPRETATION: Current evidence does not allow us to conclude that fructose-containing sugars independent of food form are associated with increased risk of type 2 diabetes. Further research is likely to affect our estimates. Trial registration: ClinicalTrials.gov, no. NCT01608620
- Published
- 2017
42. Can pulses play a role in improving cardiometabolic health? Evidence from systematic reviews and meta-analyses
- Author
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Effie Viguiliouk, John L. Sievenpiper, Sonia Blanco Mejia, and Cyril W.C. Kendall
- Subjects
0301 basic medicine ,medicine.medical_specialty ,MEDLINE ,Disease ,Overweight ,General Biochemistry, Genetics and Molecular Biology ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,History and Philosophy of Science ,Randomized controlled trial ,law ,Diabetes mellitus ,medicine ,030212 general & internal medicine ,Intensive care medicine ,Prospective cohort study ,2. Zero hunger ,030109 nutrition & dietetics ,business.industry ,General Neuroscience ,medicine.disease ,Obesity ,3. Good health ,Systematic review ,Physical therapy ,medicine.symptom ,business - Abstract
Obesity, diabetes, and cardiovascular disease (CVD) present important unmet prevention and treatment challenges. Dietary pulses are sustainable, affordable, and nutrient-dense foods that have shown a wide range of health benefits in the prevention and management of these conditions. Despite these findings, recommendations for pulse intake continue to vary across chronic disease guidelines, and intake levels continue to remain low. Here, we summarize findings from recent systematic reviews and meta-analyses assessing the relationship between dietary pulse consumption and cardiometabolic health and assess the overall strength of the evidence using the Grading of Recommendations, Assessment, Development, and Evaluation tool. We conclude that systematic reviews and meta-analyses of prospective cohort studies assessing the relationship between legumes and the risk of coronary heart disease appear to provide moderate-quality evidence of a benefit, and several systematic reviews and meta-analyses of randomized controlled trials assessing the effect of pulses on cardiometabolic risk factors provide low- to moderate-quality evidence of a benefit. There remains an urgent need, however, for more high-quality prospective cohort studies and large, high-quality, randomized trials to clarify the benefits of dietary pulses in the prevention and management of overweight/obesity, diabetes, and CVD.
- Published
- 2017
43. Salba-chia (Salvia hispanica L.) in the treatment of overweight and obese patients with type 2 diabetes: A double-blind randomized controlled trial
- Author
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L. Choleva, Fei Au-Yeung, John L. Sievenpiper, Alison L. Gibbs, Robert G. Josse, C. Brissette, Lea Duvnjak, Alexandra L Jenkins, Hoang Vi Thanh Ho, A. K. Hanna, Richard P. Bazinet, Andreea Zurbau, Elena Jovanovski, and Vladimir Vuksan
- Subjects
Male ,0301 basic medicine ,medicine.medical_specialty ,Time Factors ,Waist ,Diet, Reducing ,Endocrinology, Diabetes and Metabolism ,Medicine (miscellaneous) ,030209 endocrinology & metabolism ,Type 2 diabetes ,Overweight ,Gastroenterology ,Management of obesity ,03 medical and health sciences ,0302 clinical medicine ,Double-Blind Method ,Weight loss ,Diabetes mellitus ,Internal medicine ,Weight Loss ,Humans ,Medicine ,Obesity ,Salvia ,Adiposity ,Caloric Restriction ,Glycemic ,Ontario ,Plants, Medicinal ,030109 nutrition & dietetics ,Nutrition and Dietetics ,business.industry ,Middle Aged ,medicine.disease ,Treatment Outcome ,Endocrinology ,Diabetes Mellitus, Type 2 ,Seeds ,Female ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Phytotherapy - Abstract
Background and Aim Preliminary findings indicate that consumption of Salba-chia ( Salvia hispanica L.), an ancient seed, improves management of type 2 diabetes and suppresses appetite. The aim of this study was to assesse the effect of Salba-chia on body weight, visceral obesity and obesity-related risk factors in overweight and obese adults with type 2 diabetes. Methods A double-blind, randomized, controlled trial with two parallel groups involved 77 overweight or obese patients with type 2 diabetes (HbA 1c : 6.5–8.0%; BMI: 25–40 kg/m 2 ). Both groups followed a 6-month calorie-restricted diet; one group received 30 g/1000 kcal/day of Salba-chia, the other 36 g/1000 kcal/day of an oat bran-based control. Primary endpoint was change in body weight over 6-months. Secondary endpoints included changes in waist circumference, body composition, glycemic control, C-reactive protein, and obesity-related satiety hormones. Results At 6-months, participants on Salba-chia had lost more weight than those on control (1.9 ± 0.5 kg and 0.3 ± 0.4 kg, respectively; P = 0.020), accompanied by a greater reduction in waist circumference (3.5 ± 0.7 cm and 1.1 ± 0.7 cm, respectively; P = 0.027). C-reactive protein was reduced by 1.1 ± 0.5 mg/L (39 ± 17%) on Salba-chia, compared to 0.2 ± 0.4 mg/L (7 ± 20%) on control ( P = 0.045). Plasma adiponectin on the test intervention increased by 6.5 ± 0.7%, with no change observed on control ( P = 0.022). Conclusions The results of this study, support the beneficial role of Salba-chia seeds in promoting weight loss and improvements of obesity related risk factors, while maintaining good glycemic control. Supplementation of Salba-chia may be a useful dietary addition to conventional therapy in the management of obesity in diabetes. Registration clinicaltrials.gov identifier: NCT01403571 .
- Published
- 2017
44. What is the appropriate upper limit for added sugars consumption?
- Author
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John S. White, John L. Sievenpiper, Kim-Anne Lê, Theodore J. Angelopoulos, James M. Rippe, and Roger Clemens
- Subjects
0301 basic medicine ,Heart Diseases ,Heart disease ,Medicine (miscellaneous) ,Nutrition Policy ,Scientific evidence ,03 medical and health sciences ,Meta-Analysis as Topic ,Non-alcoholic Fatty Liver Disease ,Diabetes mellitus ,Environmental health ,Nonalcoholic fatty liver disease ,medicine ,Humans ,Obesity ,Randomized Controlled Trials as Topic ,Metabolic Syndrome ,Consumption (economics) ,030109 nutrition & dietetics ,Nutrition and Dietetics ,High-fructose corn syrup ,business.industry ,medicine.disease ,United States ,Diabetes Mellitus, Type 2 ,Biochemistry ,Special Articles ,Insulin Resistance ,Metabolic syndrome ,business ,Nutritive Sweeteners - Abstract
Dramatic increases in obesity and diabetes have occurred worldwide over the past 30 years. Some investigators have suggested that these increases may be due, in part, to increased added sugars consumption. Several scientific organizations, including the World Health Organization, the Scientific Advisory Council on Nutrition, the Dietary Guidelines Advisory Committee 2015, and the American Heart Association, have recommended significant restrictions on upper limits of sugars consumption. In this review, the scientific evidence related to sugars consumption and its putative link to various chronic conditions such as obesity, diabetes, heart disease, nonalcoholic fatty liver disease, and the metabolic syndrome is examined. While it appears prudent to avoid excessive calories from sugars, the scientific basis for restrictive guidelines is far from settled.
- Published
- 2016
45. 2016 Canadian Cardiovascular Society Guidelines for the Management of Dyslipidemia for the Prevention of Cardiovascular Disease in the Adult
- Author
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Daniel Ngui, Martin Dawes, G.B. John Mancini, Milan Gupta, Ruth McPherson, Arden R. Barry, David C.W. Lau, Glen J. Pearson, Eva Lonn, Paul Poirier, Lawrence A. Leiter, Robert A. Hegele, James A. Stone, George Thanassoulis, Todd J. Anderson, Richard Ward, Patrick Couture, Gordon A. Francis, John L. Sievenpiper, Jacques Genest, Jean Grégoire, and Steven A. Grover
- Subjects
Adult ,medicine.medical_specialty ,Health Behavior ,Disease ,030204 cardiovascular system & hematology ,Coronary Angiography ,Risk Assessment ,Diabetes Complications ,03 medical and health sciences ,0302 clinical medicine ,Pharmacotherapy ,medicine ,Humans ,Mass Screening ,030212 general & internal medicine ,Renal Insufficiency, Chronic ,Vascular Calcification ,Intensive care medicine ,Exercise ,Life Style ,Mass screening ,Dyslipidemias ,Hypolipidemic Agents ,Framingham Risk Score ,business.industry ,Canadian Cardiovascular Society ,Atherosclerosis ,medicine.disease ,Lipids ,Diet ,Primary Prevention ,Clinical trial ,Cardiovascular Diseases ,Physical therapy ,Smoking Cessation ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,Cardiology and Cardiovascular Medicine ,Risk assessment ,business ,Stress, Psychological ,Dyslipidemia ,Aortic Aneurysm, Abdominal - Abstract
Since the publication of the 2012 guidelines new literature has emerged to inform decision-making. The 2016 guidelines primary panel selected a number of clinically relevant questions and has produced updated recommendations, on the basis of important new findings. In subjects with clinical atherosclerosis, abdominal aortic aneurysm, most subjects with diabetes or chronic kidney disease, and those with low-density lipoprotein cholesterol ≥ 5 mmol/L, statin therapy is recommended. For all others, there is an emphasis on risk assessment linked to lipid determination to optimize decision-making. We have recommended nonfasting lipid determination as a suitable alternative to fasting levels. Risk assessment and lipid determination should be considered in individuals older than 40 years of age or in those at increased risk regardless of age. Pharmacotherapy is generally not indicated for those at low Framingham Risk Score (FRS;10%). A wider range of patients are now eligible for statin therapy in the FRS intermediate risk category (10%-19%) and in those with a high FRS (20%). Despite the controversy, we continue to advocate for low-density lipoprotein cholesterol targets for subjects who start therapy. Detailed recommendations are also presented for health behaviour modification that is indicated in all subjects. Finally, recommendation for the use of nonstatin medications is provided. Shared decision-making is vital because there are many areas in which clinical trials do not fully inform practice. The guidelines are meant to be a platform for meaningful conversation between patient and care provider so that individual decisions can be made for risk screening, assessment, and treatment.
- Published
- 2016
46. Integrating nutrition science and consumer behaviour into future food policy
- Author
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Petra Klassen Wigger, Jayne V. Woodside, Philippe Legrand, John L. Sievenpiper, Ronald P. Mensink, Dariush Mozaffarian, Nutrition and Movement Sciences, RS: NUTRIM - R1 - Obesity, diabetes and cardiovascular health, Queen's University [Belfast] (QUB), Nestlé Research Centre, Laboratoire de Biochimie et Nutrition Humaine, AGROCAMPUS OUEST, Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro), Maastricht University [Maastricht], Tufts University [Medford], Department of Chemistry [University of Toronto], and University of Toronto
- Subjects
Conference Article ,[SDV]Life Sciences [q-bio] ,Advancing Risk Assessment Science ,consumer behaviour ,Plant Science ,010501 environmental sciences ,01 natural sciences ,food policy ,0403 veterinary science ,Multidisciplinary approach ,Food choice ,TX341-641 ,Marketing ,saturated fats ,2. Zero hunger ,digestive, oral, and skin physiology ,04 agricultural and veterinary sciences ,3. Good health ,nutrition ,language ,Risk assessment ,Developed country ,medicine.medical_specialty ,040301 veterinary sciences ,Veterinary (miscellaneous) ,TP1-1185 ,Microbiology ,SDG 3 - Good Health and Well-being ,Political science ,medicine ,[SDV.BBM]Life Sciences [q-bio]/Biochemistry, Molecular Biology ,SDG 2 - Zero Hunger ,Consumer behaviour ,0105 earth and related environmental sciences ,Nutrition ,Nutrition. Foods and food supply ,Public health ,Chemical technology ,controlled trials ,medicine.disease ,language.human_language ,Malnutrition ,veterinary (miscalleneous) ,sugars ,13. Climate action ,Food policy ,Animal Science and Zoology ,Parasitology ,chronic metabolic diseases ,SDG 12 - Responsible Consumption and Production ,[SDV.AEN]Life Sciences [q-bio]/Food and Nutrition ,Food Science - Abstract
The session 'Advancing risk assessment science - Nutrition' at EFSA's third Scientific Conference 'Science, Food and Society' aimed to foster the ongoing debate on the extent to which single nutrients, whole foods and overall diets may impact human health in wealthy populations, and to explore how societal and technological developments could affect food choices and diets in the future. The overarching goal of the session was to discuss how dietary guidelines could evolve to account for the switch from single nutrient deficiencies to diseases of malnutrition in all its forms as the predominant public health concern in developed countries. Speakers addressed the contribution of single nutrients to the prevalence of chronic metabolic diseases, discussed the need to move towards diets focusing on whole foods and overall eating patterns, provided insides on food innovation and consumer behaviour and stressed the need for multidisciplinary approaches to face these challenges. (C) 2019 European Food Safety Authority. EFSA Journal published by John Wiley and Sons Ltd on behalf of European Food Safety Authority.
- Published
- 2019
47. Relation of Vegetarian Dietary Patterns With Major Cardiovascular Outcomes: A Systematic Review and Meta-Analysis of Prospective Cohort Studies
- Author
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Andrea J. Glenn, Effie Viguiliouk, Maxine Seider, Beatrice A. Boucher, Tauseef A. Khan, Sonia Blanco Mejia, David J. A. Jenkins, Hana Kahleová, Dario Rahelić, Jordi Salas-Salvadó, Cyril W. C. Kendall, and John L. Sievenpiper
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,vegetarian dietary patterns ,030209 endocrinology & metabolism ,lcsh:TX341-641 ,prospective cohort studies ,vegetarian diets ,03 medical and health sciences ,0302 clinical medicine ,systematic review ,cardiovascular disease ,Internal medicine ,Diabetes mellitus ,medicine ,Medical nutrition therapy ,Prospective cohort study ,Nutrition ,2. Zero hunger ,030109 nutrition & dietetics ,Nutrition and Dietetics ,business.industry ,Incidence (epidemiology) ,medicine.disease ,Confidence interval ,3. Good health ,Clinical trial ,meta-analysis ,GRADE ,Meta-analysis ,Relative risk ,business ,lcsh:Nutrition. Foods and food supply ,Food Science - Abstract
Background: Vegetarian dietary patterns are recommended for cardiovascular disease (CVD) prevention and management due to their favorable effects on cardiometabolic risk factors, however, the role of vegetarian dietary patterns in CVD incidence and mortality remains unclear. Objective: To update the European Association for the Study of Diabetes (EASD) clinical practice guidelines for nutrition therapy, we undertook a systematic review and meta-analysis of the association of vegetarian dietary patterns with major cardiovascular outcomes in prospective cohort studies that included individuals with and without diabetes using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. Methods: MEDLINE, EMBASE, and Cochrane databases were searched through September 6th, 2018. We included prospective cohort studies ≥1 year of follow-up including individuals with or without diabetes reporting the relation of vegetarian and non-vegetarian dietary patterns with at least one cardiovascular outcome. Two independent reviewers extracted data and assessed study quality (Newcastle-Ottawa Scale). The pre-specified outcomes included CVD incidence and mortality (total CVD, coronary heart disease (CHD) and stroke). Risk ratios for associations were pooled using inverse variance random effects model and expressed as risk ratios (RRs) with 95% confidence intervals (CIs). Heterogeneity was assessed (Cochran Q-statistic) and quantified (I2-statistic). The overall certainty of the evidence was assessed using GRADE. Results: Seven prospective cohort studies (197,737 participants, 8,430 events) were included. A vegetarian dietary pattern was associated with reduced CHD mortality [RR, 0.78 (CI, 0.69, 0.88)] and incidence [0.72 (0.61, 0.85)] but were not associated with CVD mortality [0.92 (0.84, 1.02)] and stroke mortality [0.92 (0.77, 1.10)]. The overall certainty of the evidence was graded as “very low” for all outcomes, owing to downgrades for indirectness and imprecision. Conclusions: Very low-quality evidence indicates that vegetarian dietary patterns are associated with reductions in CHD mortality and incidence but not with CVD and stroke mortality in individuals with and without diabetes. More research, particularly in different populations, is needed to improve the certainty in our estimates. Clinical Trial Registration: Clinicaltrials.gov, identifier: {"type":"clinical-trial","attrs":{"text":"NCT03610828","term_id":"NCT03610828"}}NCT03610828.
- Published
- 2019
48. Dietary Glycemic Index and Load and the Risk of Type 2 Diabetes: A Systematic Review and Updated Meta-Analyses of Prospective Cohort Studies
- Author
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Antonio Ceriello, Anette E. Buyken, David J.A. Jenkins, Cyril W.C. Kendall, Richard J. K. Taylor, Antonia Trichopoulou, Salwa W. Rizkalla, Walter C. Willett, Arne Astrup, Carlo La Vecchia, Sara Baer-Sinnott, Gabriele Riccardi, Geoffrey Livesey, Alan W. Barclay, Jennie Brand-Miller, Livia S. A. Augustin, Inger Björck, Andrea Poli, Furio Brighenti, Simin Liu, Helen F. Livesey, John L. Sievenpiper, Jordi Salas-Salvadó, Thomas M.S. Wolever, and M.-A. Ha
- Subjects
0301 basic medicine ,Blood Glucose ,Male ,Epidemiology ,Type 2 diabetes ,Review ,0302 clinical medicine ,cohort studies ,Risk Factors ,Glycemic load ,Odds Ratio ,Faculty of Science ,Glycemic index ,Medicine ,Prospective Studies ,education.field_of_study ,Nutrition and Dietetics ,alcohol ,Middle Aged ,dietary fiber ,3. Good health ,Cohort studies ,Female ,epidemiology ,type 2 diabetes ,Alcohol ,lcsh:Nutrition. Foods and food supply ,Cohort study ,Adult ,Population ,030209 endocrinology & metabolism ,lcsh:TX341-641 ,03 medical and health sciences ,glycemic load ,Dietary Carbohydrates ,Humans ,Fietary fiber ,education ,030109 nutrition & dietetics ,business.industry ,Protein ,Odds ratio ,medicine.disease ,Confidence interval ,Diet ,meta-analysis ,Meta-analysis ,Diabetes Mellitus, Type 2 ,Relative risk ,glycemic index ,business ,protein ,human activities ,Food Science ,Demography - Abstract
Published meta-analyses indicate significant but inconsistent incident type-2 diabetes (T2D)-dietary glycemic index (GI) and glycemic load (GL) risk ratios or risk relations (RR). It is now over a decade ago that a published meta-analysis used a predefined standard to identify valid studies. Considering valid studies only, and using random effects dose−response meta-analysis (DRM) while withdrawing spurious results (p < 0.05), we ascertained whether these relations would support nutrition guidance, specifically for an RR > 1.20 with a lower 95% confidence limit >1.10 across typical intakes (approximately 10th to 90th percentiles of population intakes). The combined T2D−GI RR was 1.27 (1.15−1.40) (p < 0.001, n = 10 studies) per 10 units GI, while that for the T2D−GL RR was 1.26 (1.15−1.37) (p < 0.001, n = 15) per 80 g/d GL in a 2000 kcal (8400 kJ) diet. The corresponding global DRM using restricted cubic splines were 1.87 (1.56−2.25) (p < 0.001, n = 10) and 1.89 (1.66−2.16) (p < 0.001, n = 15) from 47.6 to 76.1 units GI and 73 to 257 g/d GL in a 2000 kcal diet, respectively. In conclusion, among adults initially in good health, diets higher in GI or GL were robustly associated with incident T2D. Together with mechanistic and other data, this supports that consideration should be given to these dietary risk factors in nutrition advice. Concerning the public health relevance at the global level, our evidence indicates that GI and GL are substantial food markers predicting the development of T2D worldwide, for persons of European ancestry and of East Asian ancestry.
- Published
- 2019
49. Letter by Khan et al Regarding Article, 'Artificially Sweetened Beverages and Stroke, Coronary Heart Disease, and All-Cause Mortality in the Women's Health Initiative'
- Author
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Tauseef Khan, John L. Sievenpiper, and Vasanti S. Malik
- Subjects
Advanced and Specialized Nursing ,medicine.medical_specialty ,business.industry ,Women's Health Initiative ,Coronary Disease ,medicine.disease ,Coronary heart disease ,Article ,Beverages ,Stroke ,Sweetening Agents ,Emergency medicine ,medicine ,Humans ,Women's Health ,Female ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine ,business ,All cause mortality - Published
- 2019
50. Positioning the Value of Dietary Carbohydrate, Carbohydrate Quality, Glycemic Index, and GI Labelling to the Canadian Consumer for Improving Dietary Patterns
- Author
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Carolyn Gall Casey, Joanna Castellano, David J.A. Jenkins, Julianne Curran, Christopher P F Marinangeli, Jackie Tanuta, Scott V Harding, Joanne Lewis, John L. Sievenpiper, and Peg Torrance
- Subjects
Adult ,Male ,Canada ,genetic structures ,labelling ,lcsh:TX341-641 ,030209 endocrinology & metabolism ,Overweight ,Article ,03 medical and health sciences ,0302 clinical medicine ,Diabetes management ,Food Labeling ,Environmental health ,Labelling ,Dietary Carbohydrates ,Medicine ,Humans ,030212 general & internal medicine ,Prediabetes ,carbohydrate quality ,Nutrition and Dietetics ,business.industry ,Feeding Behavior ,Consumer Behavior ,Focus Groups ,Middle Aged ,medicine.disease ,Glycemic index ,Socioeconomic Factors ,Glycemic Index ,Female ,medicine.symptom ,regulatory ,business ,lcsh:Nutrition. Foods and food supply ,Weight gain ,Body mass index ,Food Science - Abstract
The objectives of this qualitative study was to: (1) understand Canadian consumers&rsquo, knowledge and perception of dietary carbohydrates, carbohydrate quality, and the glycemic index (GI), and (2) determine Canadian&rsquo, s receptiveness to GI labelling to assist with identifying and consuming foods of higher carbohydrate quality. Focus groups were recruited in Vancouver, Toronto, and Montreal and grouped according to body mass index (BMI) (NBW, normal body weight, PO, previously obese, and OW/OB, overweight/obese) and diagnosis with prediabetes and diabetes (PO (Vancouver) and OW/OB (Montreal and Toronto). Subjects in all groups linked excess consumption of carbohydrate with weight gain. PO and OW/OB groups were conflicted between perceived negative consequences and feelings of pleasure associated with carbohydrate consumption. Subjects were largely unfamiliar with the term &lsquo, carbohydrate quality&rsquo, but were often associated with classifying carbohydrates as &lsquo, good&rsquo, or &lsquo, bad&rsquo, The concept of the GI resonated well across groups after exposure to corresponding educational materials. However, NBW groups largely felt that the GI was irrelevant to their dietary choices as they did not have a history of diabetes. PO and OW/OB groups associated the GI with diabetes management. The concept of a GI labelling program to help facilitate healthier carbohydrate choices was well received across all groups, especially when the low GI was interpreted as giving permission to consume foods they enjoyed eating. Results suggest that the GI could be used as a consumer-facing labelling program in Canada and assist with de-stigmatizing carbohydrate foods by helping to facilitate the consumption of carbohydrate foods that align with healthy dietary patterns.
- Published
- 2019
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