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A clinical trial about effects of prebiotic and probiotic supplementation on weight loss, psychological profile and metabolic parameters in obese subjects.
Ben Othman, R, Ben Amor, N, Mahjoub, F, Berriche, O, El Ghali, C, Gamoudi, A, Jamoussi, H
Endocrinology, diabetes & metabolism. 2023;6(2):e402
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Gut microbiota is defined by all the beneficial microorganisms that live and grow in the intestine. It is set up from birth and evolves according to different factors. Today, the microbiota is considered a therapeutic revolution, where researchers use its enrichment to prevent or treat certain diseases including obesity. The aim of this study was to evaluate the effects of a probiotic supplement containing Bifidobacteruim, Lactobacillus strains and a prebiotic supplement by carob on the changes in body composition and metabolic biomarkers in subjects with obesity. This study was a prospective interventional study. Forty-five patients were recruited on their first visit to the obesity unit and were randomly assigned to three groups. All participants were enrolled in the weight loss program at the beginning of the study and followed a low-carbohydrate, reduced-energy intake eating plan. Results showed that a low-carbohydrate, restricted-energy diet effectively showed positive results in terms of weight loss, metabolic parameters and obesity-related psychiatric disorders in obese individuals. Authors concluded that prebiotics and probiotics supplementation with lifestyle measures can be taken into consideration for the management of obesity.
Abstract
INTRODUCTION The management of obesity is difficult with many failures of lifestyle measures, hence the need to broaden the range of treatments prescribed. The aim of our work was to study the influence of pre and probiotics on weight loss psychological profile and metabolic parameters in obese patients. METHODS It is a clinical trial involving 45 obese patients, recruited from the Obesity Unit of the National Institute of Nutrition between March and August 2022 divided into three groups: diet only (low-carbohydrate and reduced energy diet), prebiotics (30 g of carob/day) and probiotics (one tablet containing Bifidobacterium longum, Lactobacillus helveticus, Lactococcus lactis, Streptococcus thermophilus/day). The three groups were matched for age, sex and BMI. Patients were seen after 1 month from the intervention. Anthropometric measures, biological parameters, dietary survey and psychological scores were performed. RESULTS The average age of our population was 48.73 ± 7.7 years, with a female predominance. All three groups showed a significant decrease in weight, BMI and waist circumference with p < .05. Only the prebiotic and probiotic group showed a significant decrease in fat mass (p = .001) and a significant increase in muscle strength with p = .008 and .004, but the differences were not significant between the three groups. Our results showed also a significant decrease in insulinemia and HOMA-IR in the prebiotic group compared to the diet-alone group (p = .03; p = .012) and the probiotic group showed a significant decrease in fasting blood glucose compared to the diet alone group (p = .02). A significant improvement in sleep quality was noted in the prebiotic group (p = .02), with a significant decrease in depression, anxiety and stress in all three groups. CONCLUSIONS The prescription of prebiotics and probiotics with the lifestyle measures seems interesting for the management of obesity especially if it is sarcopenic, in addition to the improvement of metabolic parameters and obesity-related psychiatric disorders.
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Eight-hour time-restricted feeding improves endocrine and metabolic profiles in women with anovulatory polycystic ovary syndrome.
Li, C, Xing, C, Zhang, J, Zhao, H, Shi, W, He, B
Journal of translational medicine. 2021;19(1):148
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Polycystic ovary syndrome (PCOS) is one of the most common reproductive endocrine and metabolic disorders that affects up to 10% women of childbearing age. The aim of this study was to explore the effects of time-restricted feeding (TRF) on menstruation, gonadal and metabolic parameters in women with anovulatory PCOS and propose a basis for its inclusion in the treatment of PCOS. This study is a 6-week trial with 2 consecutive periods: (1) 1-week baseline weight stabilization period; and (2) 5-week TRF period. Fifteen subjects were included in the study whose age varied between 18 and 31 years. Results show that five weeks of TRF improved menstruation, gonadal profiles, body weight, body mass index, body composition profiles, hyperinsulinemia and insulin resistance profiles, decreasing chronic inflammation markers and increasing insulin growth factor –1 [hormone]. Authors conclude that TRF may be suitable for PCOS women with appropriate counselling and patient management.
Abstract
BACKGROUND Time-restricted feeding (TRF) is a form of intermittent fasting, which is beneficial for weight loss and cardiometabolic health. Polycystic ovary syndrome (PCOS) is one of the most common reproductive endocrine and metabolic diseases affecting women of childbearing age. It is associated with an increased prevalence of metabolic syndrome, cardiovascular diseases and type 2 diabetes. The effects of TRF on PCOS patients remains undefined, here we investigated the impact of TRF on women with anovulatory PCOS. METHODS Eighteen PCOS women aged between 18 and 31 with anovulation participated in a 6-week trial which were divided into two consecutive periods: (1) 1-week baseline weight stabilization period and (2) 5-week TRF period. Fifteen participants completed the study. Changes in body weight, body mass index (BMI), Waist-to-Hip Ratio, skeletal muscle mass, body fat mass (BFM), body fat percentage (BF%), visceral fat area (VFA), luteinizing hormone (LH), follicle-stimulating hormone (FSH), LH/FSH, total testosterone (TT), sex hormone-binding globulin (SHBG), free androgen index (FAI), fasting glucose, fasting insulin (FINS), homeostasis model assessment-insulin resistance (HOMA-IR), area under the curve (AUC) for insulin (AUCIns), area under the curve (AUC) for glucose (AUCGlu), AUCIns/AUCGlu Ratio, lipids, uric acid, alanine aminotransferase (ALT), aspartate aminotransferase, high-sensitivity C-reactive protein (hsCRP), insulin-like growth factor (IGF-1), menstrual cycle and eating behaviors were evaluated. RESULTS Significant changes in body weight, BMI, BFM, BF%, VFA, TT, SHBG, FAI, FINS, HOMA-IR, AUCIns, AUCIns/AUCGlu Ratio, ALT, hsCRP and IGF-1 were found after the TRF period. An improvement in menstrual cycle irregularity was detected in 73.3% (11/15) patients. CONCLUSION The diet of TRF may be beneficial to anovulatory PCOS on weight loss especially reducing body fat, improving menstruation, hyperandrogenemia, insulin resistance and chronic inflammation. Trial registration Clinicaltrial.gov, NCT04580433, registered October 8, 2020, https://clinicaltrials.gov/ct2/show/NCT04580433.
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Calorie restriction regime enhances physical performance of trained athletes.
Pons, V, Riera, J, Capó, X, Martorell, M, Sureda, A, Tur, JA, Drobnic, F, Pons, A
Journal of the International Society of Sports Nutrition. 2018;15:12
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Athletes commonly aim to reduce body weight to improve their strength-to-mass ratio. In this study caloric restriction (CR) of 33% was achieved through alternate day fasting in trained athletes, which the authors hypothesised to be more easy to adhere to than daily reduced energy intake. The macronutrient composition remained the same as prior to calorie reduction. Study participants lost an average of 4.4% in body weight over 6 weeks, most of which came from fat, 15.1%. Despite also losing some lean mass (2.9%), exercise performance of the athletes improved, as did energy efficiency, possibly due to increased mitochondrial efficiency. Nutritional record analysis revealed that athletes ingested less than the RDA for several nutrients prior to the CR intervention, and intake was even lower with CR. The authors conclude that CR may be a good way for athletes to achieve weight loss as, unlike other body weight reduction techniques, the alternate day fasting CR improved physical performance. They suggest though that to ensure adequate micronutrient intake, supplementation may be required.
Abstract
BACKGROUND Caloric restriction induces mitochondrial biogenesis and improves physical fitness in rodents. We aimed to provide evidence of how caloric restriction affects the body composition and physical performance of trained athletes and to evaluate the possible impact of an every-other-day feeding diet on nutritional deficiencies of micronutrients and essential fatty acids. METHODS The study was performed with 12 healthy male athletes by carrying out a 33% caloric restriction with respect to their usual diet. Athletes performed a maximal exercise stress test both before and after the caloric restriction period. Blood samples were taken before and after the caloric restriction at basal conditions and 30 min post-exercise. Although energy intake was reduced by about 33%, the contribution of carbohydrates, proteins, and lipids to total energy intake during the caloric restriction was similar to the original diet. RESULTS The caloric restriction reduced the daily specific micronutrient intake to values lower than 90% of recommended dietary allowances. No effects were observed in blood parameters related to iron metabolism and tissue damage, glucose levels, lipid profiles, or erythrocyte fatty acid composition. In addition, oxidative damage markers decreased after the nutritional intervention. The caloric restriction intervention significantly reduced body weight and trunk, arm, and leg weights; it also caused a decrease in fat and lean body mass, the energy expenditure rate when performing a maximal exercise stress test, and the energy cost to run one meter at various exercise intensities. Furthermore, the intervention ameliorated the onset of the anaerobic phase of exercise. CONCLUSION A caloric restriction improves athletes' performance and energy efficiency, but reduces the daily intake of micronutrients; so, when caloric restriction programs are implemented micronutrient supplementation should be considered. TRIAL REGISTRATION The project was registered at ClinicalTrials.gov (NCT02533479).
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Exercise before breakfast increases 24-h fat oxidation in female subjects.
Iwayama, K, Kawabuchi, R, Nabekura, Y, Kurihara, R, Park, I, Kobayashi, M, Ogata, H, Kayaba, M, Omi, N, Satoh, M, et al
PloS one. 2017;12(7):e0180472
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The timing of exercise in relation to food intake can affect the impact on fat reduction. The aim of this small randomised trial of 9 female subjects was to study the effect of exercise done following food intake compared to a fasting state on 24 hour fat breakdown. Measurements were taken over 24 hours using a metabolic chamber. The results showed that exercise performed in a fasted state increased 24 hour fat release in female subjects. Whilst this is a very small study, Nutrition Practitioners may want to discuss exercise timing with their clients who are engaging in a weight loss programme.
Abstract
BACKGROUND Exercise performed in a postprandial state does not increase 24-h fat oxidation of male and female subjects. Conversely, it has been shown in male subjects that exercise performed in a postabsorptive state increases 24-h fat oxidation compared with that in sedentary control and that with exercise trials performed after breakfast, lunch, or dinner. There is a paucity of study evaluating the effect of exercise performed in a postabsorptive state in female subjects. METHOD Nine young female subjects participated in indirect calorimetry measurement over 24-h using a room-size metabolic chamber in which subjects remained sedentary or performed 60 min exercise before breakfast at 50% of [Formula: see text]. Exercise was accompanied by an increase in energy intake to ensure that subjects were in a similar state of energy balance over 24 h for the two trials. FINDINGS Compared with the sedentary condition, exercise performed before breakfast increased 24-h fat oxidation (519 ± 37 vs. 400 ± 41 kcal/day). Time courses of relative energy balance differed between trials with transient negative energy balance observed before breakfast. The lowest values of relative energy balance observed during the 24-h calorimetry, i.e., transient energy deficit, were greater in exercise trials than in sedentary trials. The transient deficit in carbohydrate balance was also observed before breakfast, and magnitude of the deficit was greater in exercise trial compared to that of sedentary trial. INTERPRETATION Under energy-balanced conditions, exercise performed in a post-absorptive state increases 24-h fat oxidation in female subjects. The effect of exercise performed before breakfast can be attributed to nutritional state: a transient deficit in energy and carbohydrate at the end of exercise.
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Effects of eight weeks of time-restricted feeding (16/8) on basal metabolism, maximal strength, body composition, inflammation, and cardiovascular risk factors in resistance-trained males.
Moro, T, Tinsley, G, Bianco, A, Marcolin, G, Pacelli, QF, Battaglia, G, Palma, A, Gentil, P, Neri, M, Paoli, A
Journal of translational medicine. 2016;14(1):290
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Time-restricted feeding (TRF) allows subjects to consume ad libitum energy intake within a defined window of time, which means a fasting window of 12–21 h per day is employed. The aim of the present study was to investigate the effects of an isoenergetic TRF protocol on body composition, athletic performance, and metabolic factors during resistance training in healthy resistance trained males. The study enrolled thirty-four resistance-trained males. The participants were randomly assigned to a TRF group (n = 17) or standard diet group (n = 17). Training was standardized for both groups. Results indicate that after 8 weeks, a significant decrease in fat mass was observed in the TRF group, while fat-free mass was maintained in both groups. The same trend was observed for arm and thigh muscle cross-sectional area. Leg press maximal strength increased significantly, but no difference was present between treatments. Authors conclude that TRF can maintain muscle mass, reducing body fat, and reducing inflammation markers and anabolic hormones. This kind of regimen could be adopted by athletes during maintenance phases of training in which the goal is to maintain muscle mass while reducing fat mass.
Abstract
BACKGROUND Intermittent fasting (IF) is an increasingly popular dietary approach used for weight loss and overall health. While there is an increasing body of evidence demonstrating beneficial effects of IF on blood lipids and other health outcomes in the overweight and obese, limited data are available about the effect of IF in athletes. Thus, the present study sought to investigate the effects of a modified IF protocol (i.e. time-restricted feeding) during resistance training in healthy resistance-trained males. METHODS Thirty-four resistance-trained males were randomly assigned to time-restricted feeding (TRF) or normal diet group (ND). TRF subjects consumed 100 % of their energy needs in an 8-h period of time each day, with their caloric intake divided into three meals consumed at 1 p.m., 4 p.m., and 8 p.m. The remaining 16 h per 24-h period made up the fasting period. Subjects in the ND group consumed 100 % of their energy needs divided into three meals consumed at 8 a.m., 1 p.m., and 8 p.m. Groups were matched for kilocalories consumed and macronutrient distribution (TRF 2826 ± 412.3 kcal/day, carbohydrates 53.2 ± 1.4 %, fat 24.7 ± 3.1 %, protein 22.1 ± 2.6 %, ND 3007 ± 444.7 kcal/day, carbohydrates 54.7 ± 2.2 %, fat 23.9 ± 3.5 %, protein 21.4 ± 1.8). Subjects were tested before and after 8 weeks of the assigned diet and standardized resistance training program. Fat mass and fat-free mass were assessed by dual-energy x-ray absorptiometry and muscle area of the thigh and arm were measured using an anthropometric system. Total and free testosterone, insulin-like growth factor 1, blood glucose, insulin, adiponectin, leptin, triiodothyronine, thyroid stimulating hormone, interleukin-6, interleukin-1β, tumor necrosis factor α, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides were measured. Bench press and leg press maximal strength, resting energy expenditure, and respiratory ratio were also tested. RESULTS After 8 weeks, the 2 Way ANOVA (Time * Diet interaction) showed a decrease in fat mass in TRF compared to ND (p = 0.0448), while fat-free mass, muscle area of the arm and thigh, and maximal strength were maintained in both groups. Testosterone and insulin-like growth factor 1 decreased significantly in TRF, with no changes in ND (p = 0.0476; p = 0.0397). Adiponectin increased (p = 0.0000) in TRF while total leptin decreased (p = 0.0001), although not when adjusted for fat mass. Triiodothyronine decreased in TRF, but no significant changes were detected in thyroid-stimulating hormone, total cholesterol, high-density lipoprotein, low-density lipoprotein, or triglycerides. Resting energy expenditure was unchanged, but a significant decrease in respiratory ratio was observed in the TRF group. CONCLUSIONS Our results suggest that an intermittent fasting program in which all calories are consumed in an 8-h window each day, in conjunction with resistance training, could improve some health-related biomarkers, decrease fat mass, and maintain muscle mass in resistance-trained males.
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Consumption of calcium-fortified cereal bars to improve dietary calcium intake of healthy women: randomized controlled feasibility study.
Lee, JT, Moore, CE, Radcliffe, JD
PloS one. 2015;10(5):e0125207
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Calcium intake is essential to maintain bone heath and reduce the risk of osteoporosis, however most adult women are not meeting the current daily recommendations. The aim of this trial was to examine the benefits of including a non-dairy source of calcium in the diet of women during a 9-week crossover study. 35 women aged 21-58 were assigned to consume two calcium-fortified cereal bars daily for three weeks, after which diets were switched for another three weeks. Diet diaries were used to monitor intake. This study found that dietary calcium was significantly higher during the intervention period when two calcium-fortified cereal bars were consumed than during the baseline period. This addition did not increase total energy intake or result in weight gain. Further research is warranted to determine the whether consumption of calcium-fortified bars improves calcium bioavailability, and should monitor changes of bone health markers and bone density.
Abstract
UNLABELLED Calcium is an important structural component of the skeletal system. Although an adequate intake of calcium helps to maintain bone health and reduce the risk of osteoporosis, many women do not meet recommended daily intakes of calcium. Previous interventions studies designed to increase dietary intake of women have utilized primarily dairy sources of calcium or supplements. However, lactose intolerance, milk protein allergies, or food preferences may lead many women to exclude important dairy sources of dietary calcium. Therefore, we undertook a 9 week randomized crossover design trial to examine the potential benefit of including a non-dairy source of calcium in the diet of women. Following a 3 week run-in baseline period, 35 healthy women > 18 years were randomized by crossover design into either Group I or Group II. Group I added 2 calcium-fortified cereal bars daily (total of 400 mg calcium/day) (intervention) to their usual diet and Group II continued their usual diet (control). At the end of 3 weeks, diets were switched for another 3 weeks. Intakes of calcium and energy were estimated from 3-day diet and supplemental diaries. Wilcoxon signed-rank tests were used for within group comparisons and Mann Whitney U tests were used for between group comparisons of calcium and energy intake. Dietary calcium was significantly higher during intervention (1071 mg/d) when participants consumed 2 calcium-fortified cereal bars daily than during the baseline (720 mg/d, P <0.0001) or control diets (775 mg/d, P = 0.0001) periods. Furthermore, the addition of 2 calcium-fortified cereal bars daily for the 3 week intervention did not significantly increase total energy intake or result in weight gain. In conclusion, consumption of calcium-fortified cereal bars significantly increased calcium intake of women. Further research examining the potential ability of fortified cereal bars to help maintain and improve bone health of women is warranted. TRIAL REGISTRATION ClinicalTrials.gov NCT01508689.
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Physiologic and behavioral indicators of energy deficiency in female adolescent runners with elevated bone turnover.
Barrack, MT, Van Loan, MD, Rauh, MJ, Nichols, JF
The American journal of clinical nutrition. 2010;92(3):652-9
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Young female runners are more likely to have a low bone mass for their age. It is thought that this might be partly due to them using more energy (calories) than they consume. This study looked at the relationship between nutrition intake and biomarkers of bone turnover in young female runners. Participants were competitive cross-country runners, aged 14-17. The girls ate their usual diet and kept a food diary for a week, to allow the researchers to analyse their nutritional intakes. Runners that had an elevated bone turnover consumed significantly less calories and calcium than the runners with a normal bone turnover. They were also more likely to have a lower body mass, fewer menstrual cycles, lower oestrogen and vitamin D levels, lower BMI and lower bone mass. The authors concluded that nutritional support to increase energy and calcium intake, and vitamin D levels may improve bone growth in young female runners.
Abstract
BACKGROUND Female adolescent runners have an elevated prevalence of low bone mass for agemdashan outcome that may be partially due to inadequate energy intake. OBJECTIVE The objective was to evaluate diet, menstrual history, serum hormone concentrations, and bone mass in female adolescent runners with normal or abnormal bone turnover. DESIGN Thirty-nine cross-country runners (age: 15.7 plusmn 0.2 y) participated in the study, which included a 7-d dietary assessment with the use of a food record and daily 24-h dietary recalls; serum measures of insulin-like growth factor I, estradiol, leptin, parathyroid hormone, progesterone, triiodothyronine, 25-hydroxycholecalciferol, bone-specific alkaline phosphatase (BAP), and cross-linked C-telopeptides of type I collagen (CTX); an evaluation of height, weight, bone mass, and body composition with the use of dual-energy X-ray absorptiometry; and a questionnaire to assess menses and sports participation. Age- and sex-specific BAP and CTX concentrations of at least the 97th percentile and no greater than the third percentile, respectively, were considered abnormal. RESULTS All abnormal BAP and CTX concentrations fell within the elevated ( ge 97%) range. Runners with an elevated bone turnover (EBT) (n = 13) had a lower body mass, fewer menstrual cycles in the past year, lower estradiol and 25-hydroxycholecalciferol concentrations, and a higher prevalence of body mass index lt 10% for age, vitamin D insufficiency, amenorrhea, and low bone mass. Girls with EBT consumed less than the recommended amounts of energy and had a higher prevalence of consuming lt 1300 mg Ca than did those with normal bone turnover. CONCLUSIONS Runners with EBT had a profile consistent with energy deficiency. Nutritional support to increase energy, calcium intake, and 25-hydroxycholecalciferol concentrations may improve bone mineral accrual in young runners with EBT. This trial was registered at clinicaltrials.gov as NCT01059968.
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The association of calcium and vitamin D with risk of colorectal adenomas.
Hartman, TJ, Albert, PS, Snyder, K, Slattery, ML, Caan, B, Paskett, E, Iber, F, Kikendall, JW, Marshall, J, Shike, M, et al
The Journal of nutrition. 2005;135(2):252-9
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Calcium and vitamin D may play a role in colorectal cancer incidence. One possible explanation is that they may act synergistically on a number of mechanisms to protect against recurrence of colonic adenomas. The aim of the study was to determine the effects of a high-fibre, high-fruit and vegetable, and low-fat diet on the recurrence of adenomatous polyps in the large bowel. For the present study, 1905 participants from the 2079 Polyp Prevention Trial participants who completed the full trial follow-up were evaluated. The participants’ diet was assessed at baseline and annually, and they also received full colonoscopies at baseline, their 1-year visit and at the end of the trial i.e. 4 years after randomization. Results show that there were no significant associations between any of the adenoma recurrence outcome variables and dietary or total calcium intake, consumption of low or high-fat dairy products or dietary vitamin D intake. However, total vitamin D intake was weakly inversely associated with adenoma recurrence. Calcium and vitamin D supplementation were also inversely associated with single and multiple adenoma recurrence. The study shows that calcium and vitamin D intake may provide weakly protective associations with the risk for recurrence of adenoma polyps.
Abstract
The Polyp Prevention Trial (PPT) was a multicenter randomized clinical trial designed to determine the effects of a high-fiber, high-fruit and vegetable, low-fat diet on the recurrence of adenomatous polyps in the large bowel. Detailed dietary intake and supplement use data were collected at baseline and at each of 4 annual study visits. Adenoma recurrence was ascertained by complete colonoscopy at baseline and after 1 and 4 y. Recurrence was found in 754 of the 1905 trial participants. We evaluated the association between calcium and vitamin D intake and adenomatous polyp recurrence after adjusting for intervention group, age, gender, nonsteroidal anti-inflammatory drug use, total energy intake, and the interaction of gender and intervention group. Vitamin D models were also adjusted for the location of the clinic site. Dietary variables were adjusted for total energy intake via the residual method. There were no overall significant associations between adenoma recurrence and dietary calcium intake [odds ratio (OR) for the 5th compared with the lowest quintile = 0.91; 95% CI = 0.67-1.23; P-trend = 0.68], total calcium intake (OR = 0.86; 95% CI = 0.62-1.18; P-trend = 0.20), or dietary vitamin D intake (OR = 0.93; 95% CI = 0.69-1.25; P-trend = 0.43) averaged over follow-up. Total vitamin D intake was weakly inversely associated with adenoma recurrence (OR = 0.84; 95% CI = 0.62-1.13; P-trend = 0.03). Supplemental calcium and vitamin D use during follow-up also were inversely associated with adenoma recurrence (OR for any compared with no use = 0.82; 95% CI = 0.68-0.99; and OR = 0.82; 95% CI = 0.68-0.99; for calcium and vitamin D, respectively). Slightly stronger associations were noted for the prevention of multiple recurrences. Our analyses did not suggest a significant effect modification between total calcium and total vitamin D intake (P = 0.14) on risk for adenoma recurrence. This trial cohort provides some evidence that calcium and vitamin D may be inversely associated with adenoma recurrence.