There is limited research regarding insulin dosing changes following adoption of plant-based diets. We conducted a nonrandomized crossover trial utilizing two plant-based diets (Dietary Approaches to ...Stop Hypertension, or DASH, and Whole Food, Plant-Based, or WFPB) to assess acute changes in insulin requirements and associated markers among individuals with insulin-treated type 2 diabetes.
Participants (n = 15) enrolled in a 4-week trial with sequential, one-week phases: Baseline, DASH 1, WFPB, and DASH 2. Each diet was ad libitum and meals were provided.
Compared to baseline, daily insulin usage was 24%, 39%, and 30% lower after DASH 1, WFPB, and DASH 2 weeks respectively (all p < 0.01). Insulin resistance (HOMA-IR) was 49% lower (p < 0.01) and the insulin sensitivity index was 38% higher (p < 0.01) at the end of the WFPB week before regressing toward baseline during DASH 2. Total, LDL, and HDL cholesterol, leptin, urinary glucose, and hsCRP decreased to a nadir at the end of the WFPB week before increasing during DASH 2.
Adopting a DASH or WFPB diet can result in significant, rapid changes in insulin requirements, insulin sensitivity, and related markers among individuals with insulin-treated type 2 diabetes, with larger dietary changes producing larger benefits.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Purpose
Breast cancer treatment is associated with weight gain, and obesity and its related cardiometabolic and hormonal risk factors have been associated with poorer outcomes. Dietary intervention ...may address these risk factors, but limited research has been done in the setting of metastatic breast cancer requiring systemic therapy.
Methods
Women with metastatic breast cancer on stable treatment were randomized 2:1 to an 8-week intervention (
n
= 21) or control (
n
= 11). The intervention included weekly assessment visits and an ad libitum whole-food, plant-based (WFPB) diet with provided meals. Cardiometabolic, hormonal, and cancer markers were assessed at baseline, 4 weeks, and 8 weeks.
Results
Within the intervention group, mean weight decreased by 6.6% (
p
< 0.01) after 8 weeks. Fasting insulin decreased from 16.8 uIU/L to 11.2 uIU/L (
p
< 0.01), concurrent with significantly reduced insulin resistance. Total cholesterol decreased from 193.6 mg/dL to 159 mg/dL (
p
< 0.01), and low-density lipoprotein (LDL) cholesterol decreased from 104.6 mg/dL to 82.2 mg/dL (
p
< 0.01). Total testosterone was unchanged, but free testosterone trended lower within the intervention group (
p
= 0.08) as sex hormone binding globulin increased from 74.3 nmol/L to 98.2 nmol/L (
p
< 0.01). There were no significant differences in cancer progression markers at week 8, although mean CA 15-3, CA 27.29, and CEA were lower in the intervention group (
p
= 0.53,
p
= 0.23, and
p
= 0.54, respectively) compared to control, when adjusted for baseline.
Conclusion
WFPB dietary changes during treatment for metastatic breast cancer are well tolerated and significantly improve weight, cardiometabolic and hormonal parameters. Longer studies are warranted to assess the durability of changes.
Trial registration
First registered at Clinicaltrials.gov (NCT03045289) on February 7, 2017.
Full text
Available for:
EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Americans consume diets that fall short of dietary recommendations, and the cost of healthier diets is often cited as a barrier to dietary change. We conducted a nonrandomized crossover trial with ...meals provided utilizing 2 diets: Dietary Approaches to Stop Hypertension (DASH) and whole food, plant-based (WFPB), and thus had intake data from baseline and both intervention diets.
Using actual diet records, describe food costs of baseline diets of individuals with type 2 diabetes (T2DM) as well as therapeutic DASH and WFPB diets.
Three-day food records were collected and analyzed for each 7-d diet phase: baseline, DASH, and WFPB. Nutrient content was analyzed using the Nutrient Data System for Research and cost was determined using Fillet, an application to manage menu pricing. Food costs were calculated for each diet as consumed and adjusted to a standardized 1800 kcal/d. Ingredient-only costs of food away from home (FAFH) were approximated and analyzed. Costs were analyzed using linear mixed-effect models as a function of diet.
Fifteen subjects enrolled; 12 completed all dietary phases. The baseline, DASH, and WFPB diets, as consumed, cost $15.72/d (95% CI; $13.91, $17.53), $12.74/d ($11.23, $14.25), and $9.78/d ($7.97, $11.59), respectively. When adjusted to an 1800 kcal/d intake, the baseline, DASH, and WFPB diets cost $15.69/d ($13.87, $17.52), $14.92/d ($13.59, $16.26), and $11.96/d ($10.14, $13.78), respectively. When approximated ingredient-only costs of FAFH were analyzed, as consumed baseline $11.01 ($9.53, $12.49) and DASH diets $11.81 ($10.44, $13.18) had similar costs; WFPB diet $8.83 ($7.35, $10.31) cost the least.
In this short-term study with meals provided, the food costs of plant-predominant diets offering substantial metabolic health benefits were less than or similar to baseline food costs of adults with insulin-treated T2DM. Longer-term data without meal provision are needed for more generalizable results.
This trial was registered at clinicaltrials.gov as NCT04048642.
To compare measurements of papilledema using fundus photography, optical coherence tomography (OCT), and Frisén score in patients with idiopathic intracranial hypertension (IIH).
Retrospective, ...noncomparative analysis of randomized controlled trial data.
The Idiopathic Intracranial Hypertension Treatment Trial (IIHTT) evaluated weight management and treatment with acetazolamide compared with placebo in patients with IIH and mild visual loss. Among the 126 subjects in the IIHTT OCT substudy, fundus photographs and OCT scans of the optic disc were taken at baseline and at 6 and 12 months after enrollment. Trained readers scored each eye using a modified Frisén scale and measured the area of disc elevation. OCT scans assessed optic nerve head (ONH) volume. Correlations between volume and area were computed for both study and nonstudy eyes.
Disc area and ONH volume were positively correlated at baseline (R2 = 0.77 in study eyes, P < .001). Correlations between area and volume were similar in the treatment groups at baseline, but were weaker in the acetazolamide group compared with the placebo group at 6 months (R2 = 0.25 vs R2 = 0.76 in study eyes) and 12 months (R2 = 0.19 vs R2 = 0.65 in study eyes). At 6 and 12 months after enrollment, there was no consistent relationship between Frisén score, disc area, and ONH volumes in the acetazolamide group.
Frisén score fails to reflect the photographic area and OCT volume of papilledema after treatment with acetazolamide. Clinicians should use caution when using the Frisén scale to monitor the effect of treatment on papilledema over time.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Diets rich in minimally processed plant-based foods are recommended to breast cancer patients, and some may have an interest in whole-food, plant-based (WFPB) diets that avoid animal-based foods, ...added fats, and refined sugars. Within WFPB diets, the intakes of isoflavones, omega-6 polyunsaturated fatty acids (n-6 PUFAs), and omega-3 polyunsaturated FAs (n-3 PUFAs), which have been discussed in reference to breast cancer outcomes, have not been well characterized.
Women with stage IV breast cancer on stable therapy were randomized 2:1 into (1) a WFPB intervention (
= 21) or (2) usual care (
= 11) for 8 weeks. Three meals per day were provided. Outcomes presented here include dietary intake of isoflavones, n-3 and n-6- PUFAs, which were assessed using three-day food records at baseline and 8 weeks. Baseline and 8-week mean intake within groups were compared using the Wilcoxon signed-rank test and between control and intervention groups by a two-sample
-test.
The WFPB intervention participants increased their daily consumption of total isoflavones from a mean of 0.8 mg/day to 14.5 mg/day (
< 0.0001) and decreased the n-6:n-3 ratio of their diet from a mean of 9.3 to 3.7 (
< 0.0001). Within the WFPB group, linoleic acid (n-6 PUFA) consumption decreased by a mean of 3.8 g (
= 0.0095), from 12.8 g/day to 9.0 g/day; total n-3 PUFA consumption increased by a mean of 1.1 g (
= 0.0005), from 1.6 g/day to 2.7 g/day.
Transitioning to a WFPB diet resulted in significantly increased isoflavone intake and decreased n-6:n-3 ratio in women with breast cancer.
A key point for the development of the hydrogen economy at a large scale is the possibility to use the current natural gas network and storage capacity to transport and store hydrogen. This study is ...dedicated to evaluate the integrity of materials used for underground aquifer storage regarding hydrogen embrittlement. In this environment, the water vapor content in the gas stored may progressively increase. It is known that the presence of impurities in the gas, such as H2O, can promote or inhibit hydrogen embrittlement phenomenon, depending on the nature of the steel. This work investigates mechanical properties of a tempered martensite N80 Q steel, and a ferrite-perlite L360 NB C-Mn steel issued from a completion and a collect tube respectively. The testing environments are NG + 25%H2 and NG saturated in water vapor at 8.5 MPa and room temperature. These environmental conditions aim at replicating the storage service conditions. Fracture toughness and fatigue crack growth properties are assessed. So far, the mechanical behavior of such steels under hydrogen gas pressure saturated with water vapor has poorly been addressed. Regarding toughness properties, the two steels present different behavior: for the L360 NB crack has not propagated for any testing environments, while cracks propagated in all the tests for the N80 Q. Despite this difference, for the two steels, the toughness does not seem to be affected by hydrogen as the results obtained in NG + 25%H2 + H2O and NG + H2O are similar. Based on the literature C-Mn steels toughness is affected by the presence of dry hydrogen. Hence, the results presented here show that H2O inhibits hydrogen embrittlement as far as toughness is concerned. FCG (fatigue crack growth) results, on the opposite, clearly highlight the influence of hydrogen on the mechanical behavior of the two steels. The FCG rates are faster from a factor five (resp. 10) in NG + 25%H2 + H2O compared to NG + H2O for the N80 Q (resp. L360). In this article, toughness and FGC results on the two steels are discussed in terms of microstructure and mechanical loading modes, aiming to quantify and better understand the influence of H2O on the sensitivity of low alloy steels to hydrogen embrittlement.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
A key point for the development of a renewable energy economy at a large scale is the possibility to use the current natural gas network and storage capacity to transport and store hydrogen. This ...study is dedicated to evaluate the integrity of materials used for underground aquifer storage regarding hydrogen embrittlement in a gaseous environment saturated with water vapour and containing few amounts of H2S. In this environment, the water vapour content in the gas stored may reach saturation at bottom well pressure and temperature. It is known that the presence of impurities in the gas, such as H2O, can promote or inhibit hydrogen embrittlement phenomenon, depending on the nature of the steel. This work investigates mechanical properties of a tempered martensite N80-Q steel, and a ferrite-perlite L360-NB C–Mn steel issued from a completion and a collect tube respectively. The testing environments are NG, NG + H2S, NG + 25%H2 and NG + 25%H2 + H2S saturated in water vapour at 8.5 MPa and room temperature. These environmental conditions aim at replicating the storage service conditions.
Fracture toughness and fatigue crack growth properties are assessed. So far, the mechanical behaviour of such steels under hydrogen gas pressure saturated with water vapour and low amount of H2S has poorly been addressed. Regarding toughness properties, the two steels present different behaviour: for the L360 NB crack has not propagated for any testing environments, while cracks propagated in all the tests for the N80 Q. Despite this difference, for the two steels, the toughness does not seem to be affected by hydrogen as the results obtained in NG + 25%H2 + H2O and NG + H2O are similar. Based on the literature C–Mn steels toughness is affected by the presence of dry hydrogen. Hence, the results presented here show that H2O inhibits hydrogen embrittlement as far as toughness is concerned. The L360NB, however, presented a slight decrease in toughness properties with the combination of NG + 25%H2 + H2S + H2O. FCG (fatigue crack growth) results, on the opposite, clearly highlight the influence of hydrogen on the mechanical behaviour of the two steels. The FCG rates are faster from a factor five (resp. 10) in NG + 25%H2 + H2O compared to NG + H2O for the N80 Q (resp. L360). In this article, toughness and FGC results on the two steels are discussed in terms of microstructure and mechanical loading modes, aiming to quantify and better understand the influence of H2O and H2S on the sensitivity of low alloy steels to hydrogen embrittlement.
•The hydrogen embrittlement of metallic components used for underground hydrogen storage is studied.•The fracture toughness and fatigue crack growth properties in 8.5 MPa H2 are discussed.•The effect of a gas saturated with water vapour and/or containing small amount of H2S is studied.•Water vapour mitigates hydrogen deleterious effect on fracture toughness of the two studied steels (ferritic and martensitic).•A synergetic hydrogen embrittlement effect between water vapour and H2S is highlighted.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Vascular and valvular calcifications, commonly seen in renal patients, increase operative mortality and can preclude conventional valvular management. We show a novel approach to treat aortic ...stenosis and degenerative mitral regurgitation under hypothermic circulatory arrest in a hemodialysis patient with aortic, mitral disease and porcelain aorta with surgical and transcatheter contraindications.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
PDF
