Plan de alimentación para hipertensos / Eating plan for hypertensives

La presente publicación describe un enfoque dietético para mantener la presión arterial normal, realizado por el profesional nutricionista basado en el aumento de frutas, verduras y lácteos bajos en grasa e incluye cereales integrales,pescado, aves. menestras y frutas secas. El material ayuda al profesional nutricionista a desarrollar actividades educativas para enseñar al paciente con hipertensión arterial o a personas diagnosticadas con hipertensión arterial a comer más sano, lo que permitirá que disminuya la presión y el colesterol malo elevado, por tratarse de una dieta baja en grasas saturadas, total, colesterol y sodio a la misma vez que es alta en minerales como potasio, magnesio y calcio

Linfangiectasia intestinal en un paciente afectado de síndrome de Sanfilippo B / Intestinal lymphangiectasia in a patient with Sanfilippo B syndrome

La mucopolisacaridosis tipo III B es una enfermedad de depósito lisosomal causada por la deficiencia de la enzima N-acetil-alfa-d-glucosaminidasa, implicada en el catabolismo del heparán sulfato, que produce su acúmulo en diversos tejidos. Se presenta a un paciente de 8 años, afectado de mucopolisacaridosis tipo III B, con historia de diarrea crónica y hallazgos endoscópicos e histológicos compatibles con linfangiectasia intestinal. Tras tratamiento dietético con restricción de ácidos grasos de cadena larga y rica en triglicéridos de cadena media, presentó mejoría clínica, mantenida hasta la actualidad.La patogenia de la diarrea crónica en pacientes con mucopolisacaridosis tipo III B es aún desconocida. Debe investigarse la presencia de linfangiectasia intestinal en estos pacientes e iniciar, en caso de confirmarse, un tratamiento dietético adecuado para mejorar así su calidad de vida.

Mucopolysaccharidosis type IIIB is a lysosomal storage disease caused by a deficiency of the N-acetyl-alpha-d-glucosaminidase enzyme involved in the catabolism of heparan sulfate, causing its accumulation in various tissues. We present an 8-year-old patient with mucopolysaccharidosis type IIIB, with a history of chronic diarrhea and endoscopic and histological findings compatible with intestinal lymphangiectasia. After a dietary treatment with a low-fat diet supplemented with medium-chain triglyceride, our patient presents clinical improvement until today. The pathogenesis of chronic diarrhea in patients with mucopolysaccharidosis type IIIB is still unknown. The presence of intestinal lymphangiectasia in these patients should be investigated, and appropriate dietary treatment should be initiated, if confirmed, to improve their quality of life.

Efeitos da restrição de carboidratos no manejo do diabetes mellitus: revisão de literatura científica / Effects of carbohydrate-restricted diets in the management of diabetes mellitus: review of scientific literature

O objetivo do presente estudo foi avaliar, por meio de uma revisão da literatura, evidências da utilização de dietas com restrição de carboidratos no manejo do diabetes mellitus (DM). As buscas eletrônicas e manuais foram até abril de 2019, e incluíram trabalhos publicados a partir de 2008. Foram excluídos estudos de pesquisas in vitro e em animais, revisões de literatura, livros, monografias, dissertações, teses, estudos de caso e relatos de caso. Os artigos remanescentes foram submetidos à análise de sua qualidade metodológica pela Escala JADAD cinco pontos. Um total de 19 estudos randomizados e com qualidade média de três pontos foram selecionados e analisados quanto aos tipos de dieta utilizadas, adesão, tipo de DM, tempo de intervenção, consumo reportado de carboidratos e resultados observados para os grupos controle e intervenção. Dentre os parâmetros escolhidos para mensurar os possíveis efeitos das dietas, destacaram-se alteração de peso e IMC, Hb1Ac, variabilidade ou controle glicêmico, perfil lipídico e alteração nas doses de insulina ou medicação utilizadas. Em quatro estudos não foram observadas vantagens significativas de uma dieta restrita em carboidratos, e 15 trabalhos relataram melhoras em um ou mais parâmetros. Tais resultados podem representar uma grande vantagem na adoção desta estratégia alimentar no manejo do DM e na prevenção de complicações da doença. Contudo, existem limitações nos estudos, que precisam ter suas hipóteses verificadas no longo prazo, e pesquisas adicionais devem ser realizadas para configurar uma estratégia oficial no controle do DM. (AU)

This study aimed to evaluate, through a literature review, evidence of the use of diets with carbohydrate restriction in the management of diabetes mellitus (DM). Electronic and manual searches were conducted until April 2019, including works published from 2008 onwards. Studies on in vitro and animal research, literature reviews, books, monographs, dissertations, theses, case studies and case reports were excluded. The remaining articles were submitted to analysis of their methodological quality by the five-point JADAD Scale. Nineteen randomized studies with an average quality of three points were selected and analyzed regarding the types of diet used, adherence, type of DM, time of intervention, reported consumption of carbohydrates and results observed for the control and intervention group. Among the parameters chosen to measure the possible effects of diets, weight and BMI changes, Hb1Ac, variability or glycemic control, lipid profile and changes in insulin doses or medication used stood out. In four studies, no significant advantages were observed from a carbohydraterestricted diet, and 15 studies reported improvements in one or more parameters. Such results can represent a great advantage in adopting this dietary strategy in the management of DM and in preventing complications of the disease. However, there are limitations in the studies, which need to have their hypotheses verified in the long term, and additional research must be carried out to configure an official strategy in the control of DM. (AU)

Effect of low-fat diets enriched with fruit purees on the biochemical markers of metabolic syndrome analogy induced-rats / Efecto de dietas bajas en grasa enriquecida con purés de frutas sobre marcadores bioquímicos en ratas inducidas con analogia a sindrome metabólico

Fruit purees can be added to diet as alternative sources of bioactive compounds for the prevention and/or improvement of the complications of metabolic syndrome. In this work we evaluated the effect of the intake of low-fat diets enriched with fruit purees (guava-strawberry, guava-blackberry, guava-soursop, guava-passion fruit) on the body weight and biochemical markers in metabolic syndrome analogy (MSA)-induced rats. The rats (n=6 for each treatment) were induced with a high fat diet and were injected with streptozotocin, one dose every week for 4 consecutive weeks after fasting overnight, then healthy rats were fed with standard diet and MS rats were fed with standard diet plus each of the fruit puree, for 4 weeks. As novel findings, the diet enriched with fruit purees was associated with a reduction in body weight (~13-21 %) and a control in the metabolism of glucose by decreasing plasma glucose (~5963 %). Also, there was a reduction in the total cholesterol, triacylglycerols, low-density lipoproteins, and low enzymatic activities of alanine aminotransferase, alkaline phosphatase and γ-glutamyl transferase, useful metabolites in the control of inflammatory processes in the liver. A notable improvement in the liver morphology was observed indicating that the treatments had a hepatoprotective effect. The diet enriched with guava-blackberry puree caused the best results on most biochemical markers of MS rats. Therefore, diets enriched with fruit purees can be an alternative for MS individuals for the control and improvement of the complications caused by this syndrome.

Los purés de frutas se pueden agregar a la dieta como fuentes alternativas de compuestos bioactivos para la prevención y / o mejora de las complicaciones del síndrome metabólico. En este trabajo evaluamos el efecto de la ingesta de dietas bajas en grasas, enriquecidas con purés de frutas (guayaba-fresa, guayaba-mora, guayaba-guanábana, guayaba-maracuyá) sobre el peso corporal y los marcadores bioquímicos en el síndrome metabólico (SM) inducido en ratas. Las ratas (n = 6 para cada tratamiento) fueron inducidas con una dieta alta en grasas y se les inyectó estreptozotocina, una dosis cada semana durante 4 semanas consecutivas después de ayunar durante la noche. Luego, las ratas sanas fueron alimentadas con una dieta estándar; y las ratas con SM fueron alimentadas con dieta estándar más cada uno de los purés de frutas, durante 4 semanas. Como hallazgos novedosos, la dieta enriquecida con purés de frutas se asoció con una reducción en el peso corporal (~ 13-21 %) y un control en el metabolismo de la glucosa al disminuir la glucosa en plasma (~ 59-63 %). Además, hubo una reducción en el colesterol total, triacilgliceroles, lipoproteínas de baja densidad, y bajas actividades enzimáticas de alanina aminotransferasa, fosfatasa alcalina y gama-glutamil transferasa, metabolitos útiles en el control de los procesos inflamatorios en el hígado. Se observó una mejora notable en la morfología del hígado, lo que indica que los tratamientos tuvieron un efecto hepatoprotector. La dieta enriquecida con puré de guayaba y mora causó los mejores resultados en la mayoría de los marcadores bioquímicos de las ratas con SM. Por lo tanto, las dietas enriquecidas con purés de frutas pueden ser una alternativa para las personas con SM, para el control y la mejora de las complicaciones causadas por este síndrome.

Comparação entre dietas com restrição de carboidratos e de gorduras no combate à obesidade: uma revisão sistemática / Comparison of diets with carbohydrate and fat restriction to fight obesity: a systematic review

OBJETIVO: Comparar dietas com restrição de carboidratos e com restrição de gorduras, para analisar a eficácia de ambas em relação a perda de peso, LDL-c, HDL-c, triglicerídeos, glicemia em jejum e pressão arterial. MÉTODOS: Foram analisados, em três diferentes bancos de dados, estudos de intervenção randomizados publicados entre 2002 e 2016. Após avaliação de qualidade, oito artigos foram selecionados para o presente estudo. RESULTADOS: Dietas com restrição de carboidratos demonstraram maior eficácia em relação à perda ponderal, à elevação dos níveis de HDL-c e à diminuição dos níveis de triglicerídeos, glicemia de jejum e pressóricos. A única variável em que houve maior benefício aparente com a restrição de gorduras foi a diminuição dos níveis de LDL-c. CONCLUSÃO: Uma dieta com restrição de carboidratos pode ser uma alternativa mais eficaz do que com restrição de gorduras no combate à obesidade e à síndrome metabólica. No entanto, a realização de estudos mais aprofundados é essencial para avaliar alterações em outros marcadores metabólicos importantes. (AU)

OBJECTIVES: To compare low-carbohydrate and low-fat diets to analyze their efficacy in relation to weight loss, LDL-cholesterol, HDL-cholesterol, triglycerides, fasting glycaemia and blood pressure. METHODS: For this, three randomized intervention studies published between 2002 and 2016 were analyzed in three different databases. After being evaluated for quality, eight articles were selected for the present study. RESULTS: Low-carbohydrate diets demonstrated greater efficacy concerning weight loss, elevated HDL-C levels and a decrease in triglyceride levels, fasting glycaemia and blood pressure levels. The only variable in which there was a greater apparent benefit with low-fat diet was the decrease in LDL-C levels. CONCLUSION: A low-carbohydrate diet may be a more effective alternative than a low-fat diet in the fight against obesity and metabolic syndrome. However, more in-depth studies are essential to evaluate changes in other important metabolic markers. (AU)

Blood Sugar Control and Low-Carbohydrate High-Fat Diet / 임상당뇨병

Diabetes patients and pre-diabetic patients are increasing worldwide. Type 2 diabetes starts with insulin resistance, and the long-term habit of stimulating insulin secretions causes insulin resistance and accumulates body fat to develop obesity and non-alcoholic fatty liver into diabetes. It also causes a variety of chronic diseases such as high blood pressure, polycystic ovary diseases, cancer and dementia. Insulin resistance is caused by an unbalanced lifestyle, and among other factors, the balance of the macronutrient is a very important factor. Koreans are characterized by high carbohydrate intake. Given the increasing prevalence of diabetes and the characteristics of Korean physical and eating habits, a more effective balance of diet education is needed. Therefore, it is very important for clinical dietitian to understand the carbohydrate and fat metabolism caused by insulin, and the concept of balanced diet for blood sugar control needs to be shifted from low-fat high-carbohydrate diet to low-carbohydrate high-fat diet.

Association between a High-fat Low-carbohydrate Diet and Non-alcoholic Fatty Liver Disease: Truth or Myth? / 대한내과학회지

Reducing caloric intake is important for weight loss and obesity; a reduction of ~500-700 kcal/day has been recommended previously. However, only a minority of individuals can successfully sustain such a reduced caloric intake. Therefore, many specialized diet programs have been proposed. Until now, many experts have recommended low-fat diets in various countries, but very-low-carbohydrate diets have recently garnered attention in Korea. The various effects of changing the dietary compositions of macro- and micronutrients have been debated. The majority of large-scale studies have demonstrated that total caloric intake, rather than the composition of macronutrients or the consumption of a specialized diet, is important for successful weight loss. While many cross-sectional studies have investigated specialized diet programs for patients with non-alcoholic liver disease, no randomized controlled studies have been performed, except for some that investigated the effect of high consumption of unsaturated fatty acids as part of the Mediterranean diet.

Stages of change and factors associated with misperceived eating behavior in obese individuals / Estágios de mudança e fatores associados à percepção equivocada do comportamento alimentar em obesos

ABSTRACT Objective: To evaluate the stages of behavior change related to fat and fruit/vegetable intakes and the factors associated with misperceived eating behavior (pseudo-maintenance). Methods: This cross-sectional study collected sociodemographic, socioeconomic, health, and food intake data from obese individuals (n=103) aged ≥20 years. Stages of behavior change according to the Transtheoretical Model were measured for fat and fruit/vegetable intakes. The pseudo-maintenance stage was reclassified in subjects in the action/maintenance stage who had inappropriate food habits. Multiple logistic regression models were proposed to assess the factors associated with misperceptions. Results: The prevalences of pseudo-maintenance for fat and fruit/vegetable intakes were 23.3 and 19.4%, respectively. The factors associated with misperceived fat intake were overconsumption of saturated fatty acids (OR=3.84; 1.18-12.56) and age (OR=1.06; 1.02-1.11), and with fruit and vegetable intake, income (OR=0.99; 0.98-0.99). Conclusion: The results reveal that perceived eating behavior and actual food intake diverge from anthropometric and health data, signaling the need of different intervention strategies to raise awareness in this group for the need of modifications.

RESUMO Objetivo: Avaliar os estágios de mudanças de comportamento relacionadas ao consumo de gordura e frutas/hortaliças e os fatores associados à percepção equivocada do comportamento alimentar (pseudomanutenção). Métodos: Estudo transversal com indivíduos obesos (n=103) com idade ≥20 anos. Dados sociodemográficos, econômicos, de saúde e de ingestão de alimentos foram obtidos. Os estágios de mudanças de comportamento foram aferidos segundo o Modelo Transteórico para o consumo de gordura e frutas/hortaliças. A reclassificação no estágio de pseudomanutenção foi realizada nos indivíduos em fase de ação/manutenção que apresentaram inadequações no consumo alimentar. Modelos de regressão logística foram propostos para avaliar os fatores associados às percepções equivocadas. Resultados: As prevalências de pseudomanutenção para o consumo de gordura e frutas/hortaliças foram de 23,3 e 19,4%, respectivamente, e os fatores associados à percepção equivocada do teor de gordura na dieta foram o consumo excessivo de ácidos graxos saturados (OR=3,84; 1,18-12,56) e idade (OR=1,06; 1,02-1,11), enquanto para o consumo de frutas/hortaliças o fator foi a renda (OR=0,99; 0,98-0,99). Conclusão: Os resultados revelam uma discordância entre a percepção do comportamento alimentar e os hábitos reais de consumo alimentar, perfil antropométrico e de saúde, sinalizando a necessidade de estratégias diferenciadas de intervenção a fim de despertar a consciência desses obesos para a necessidade de modificações.

Effects of a Low-carbohydrate, High-fat Diet

It appears that a low-carbohydrate high-fat diet is more effective in weight loss than conventional low-fat diets for short-term periods of approximately 6 months. However, for long-term periods of about 1 year or more, the effects of a low-carbohydrate diet are reduced and the difference in weight loss between low-carbohydrate and low-fat diets disappears. A low-carbohydrate diet can lead to low triglycerides and high HDL cholesterol, and may even lead to an increase in LDL cholesterol. The effects of a low-carbohydrate diet on glycemic control are not clear, and there is no effect on blood pressure. A low-carbohydrate diet may lead to cardiovascular disease, and can increase cardiovascular and all-cause mortality.

Effects of disturbed liver growth and oxidative stress of high-fat diet-fed dams on cholesterol metabolism in offspring mice

BACKGROUND/OBJECTIVES: Changes in nutritional status during gestation and lactation have detrimental effects on offspring metabolism. Several animal studies have shown that maternal high-fat diet (HFD) can predispose the offspring to development of obesity and metabolic diseases, however the mechanisms underlying these transgenerational effects are poorly understood. Therefore, we examined the effect of maternal HFD consumption on metabolic phenotype and hepatic expression of involved genes in dams to determine whether any of these parameters were associated with the metabolic outcomes in the offspring. MATERIALS/METHODS: Female C57BL/6 mice were fed a low-fat diet (LFD: 10% calories from fat) or a high-fat diet (HFD: 45% calories from fat) for three weeks before mating, and during pregnancy and lactation. Dams and their male offspring were studied at weaning. RESULTS: Dams fed an HFD had significantly higher body and adipose tissue weights and higher serum triglyceride and cholesterol levels than dams fed an LFD. Hepatic lipid levels and mRNA levels of genes involved in lipid metabolism, including LXRα, SREBP-2, FXR, LDLR, and ABCG8 were significantly changed by maternal HFD intake. Significantly lower total liver DNA and protein contents were observed in dams fed an HFD, implicating the disturbed liver adaptation in the pregnancy-related metabolic demand. HFD feeding also induced significant oxidative stress in serum and liver of dams. Offspring of dams fed an HFD had significantly higher serum cholesterol levels, which were negatively correlated with liver weights of dams and positively correlated with hepatic lipid peroxide levels in dams. CONCLUSIONS: Maternal HFD consumption induced metabolic dysfunction, including altered liver growth and oxidative stress in dams, which may contribute to the disturbed cholesterol homeostasis in the early life of male mice offspring.

Anti-inflammatory and anti-diabetic effects of brown seaweeds in high-fat diet-induced obese mice

BACKGROUND/OBJECTIVES: Seaweeds have been reported to have various health beneficial effects. In this study, we investigated the potential anti-obesity and anti-inflammatory effects of four types of domestic brown seaweeds in a high-fat diet-induced obese mouse model and bone marrow-derived macrophages (BMDM). MATERIALS/METHODS: Male C57BL/6N mice were fed low-fat diet (LFD), high-fat diet (HFD) or HFD containing Undaria Pinnatifida, HFD containing Laminaria Japonica (LJ), HFD containing Sargassum Fulvellum, or HFD containing Hizikia Fusiforme (HF) for 16 weeks. RESULTS: Brown seaweed supplementation did not affect long-term HFD-associated changes in body weight or adiposity, although mice fed HFD + LJ or HFD + HF gained slightly less body weight compared with those fed HFD at the beginning of feeding. Despite being obese, mice fed HFD + LJ appeared to show improved insulin sensitivity compared to mice fed HFD. Consistently, we observed significantly reduced blood glucose concentrations in mice fed HFD + LJ compared with those of mice fed HFD. Although no significant differences in adipocyte size were detected among the HFD-fed groups, consumption of seaweeds decreased formation of HFD-induced crown-like structures in gonadal adipose tissue as well as plasma inflammatory cytokines. BMDM from mice fed HFDs with seaweeds showed differential regulation of pro-inflammatory cytokines such as IL-1beta and IL-6 compared with BMDM from mice fed HFD by LPS stimulation. CONCLUSION: Although seaweed consumption did not prevent long-term HFD-induced obesity in C57BL/6N mice, it reduced insulin resistance (IR) and circulation of pro-inflammatory cytokines. Therefore, seaweeds may ameliorate systemic inflammation and IR in obesity partially due to inhibition of inflammatory signaling in adipose tissue cells as well as bone marrow-derived immune cells.

Chronic intermittent hypoxia increases encoding pigment epithelium-derived factor gene expression, although not that of the protein itself, in the temporal cortex of rats, / Hipóxia intermitente crônica aumenta a expressão gênica, mas não proteica, de pigment epithelium-derived factor no córtex temporal de ratos

Objective: Obstructive sleep apnea syndrome is mainly characterized by intermittent hypoxia (IH) during sleep, being associated with several complications. Exposure to IH is the most widely used animal model of sleep apnea, short-term IH exposure resulting in cognitive and neuronal impairment. Pigment epithelium-derived factor (PEDF) is a hypoxia-sensitive factor acting as a neurotrophic, neuroprotective, and antiangiogenic agent. Our study analyzed performance on learning and cognitive tasks, as well as PEDF gene expression and PEDF protein expression in specific brain structures, in rats exposed to long-term IH. Methods: Male Wistar rats were exposed to IH (oxygen concentrations of 21-5%) for 6 weeks-the chronic IH (CIH) group-or normoxia for 6 weeks-the control group. After CIH exposure, a group of rats were allowed to recover under normoxic conditions for 2 weeks (the CIH+N group). All rats underwent the Morris water maze test for learning and memory, PEDF gene expression and PEDF protein expression in the hippocampus, frontal cortex, and temporal cortex being subsequently assessed. Results: The CIH and CIH+N groups showed increased PEDF gene expression in the temporal cortex, PEDF protein expression remaining unaltered. PEDF gene expression and PEDF protein expression remained unaltered in the frontal cortex and hippocampus. Long-term exposure to IH did not affect cognitive function. Conclusions: Long-term exposure to IH selectively increases PEDF gene expression at the transcriptional level, although only in the temporal cortex. This increase is probably a protective mechanism against IH-induced injury. .

Objetivo: A síndrome da apneia obstrutiva do sono caracteriza-se principalmente por episódios de hipóxia intermitente (HI) durante o sono e associa-se a diversas complicações. A exposição à HI é o mais usado modelo animal de apneia do sono, e protocolos de curta duração causam diversos prejuízos cognitivos e neuronais. Pigment epithelium-derived factor (PEDF, fator derivado do epitélio pigmentado) é um fator neurotrófico, neuroprotetor e antiangiogênico sensível à hipóxia celular. Nosso estudo analisou o desempenho em tarefas cognitivas e de aprendizagem, bem como a expressão do gene PEDF e da proteína PEDF em estruturas cerebrais específicas em ratos expostos a HI de longa duração. Métodos: Ratos Wistar foram expostos a HI (21-5% de oxigênio) durante 6 semanas - o grupo HI crônica (HIC) - ou a normóxia durante 6 semanas - o grupo controle. Após a exposição à HIC, um grupo de ratos foi exposto a normóxia durante 2 semanas (o grupo HIC+N). Todos os animais foram submetidos ao labirinto aquático de Morris para avaliação de memória e aprendizado; avaliou-se também a expressão do gene PEDF e da proteína PEDF no hipocampo e nos córtices frontal e temporal. Resultados: Os grupos HIC e HIC+N apresentaram um aumento de expressão do gene PEDF no córtex temporal, porém sem aumento dos níveis proteicos. A expressão do gene PEDF e da proteína PEDF manteve-se inalterada nas demais estruturas. A exposição de longa duração à HI não afetou a função cognitiva. Conclusões: A exposição de longa duração à HI aumenta seletivamente a expressão do gene PEDF ao nível transcricional, embora apenas no córtex temporal. Esse aumento é provavelmente um mecanismo de proteção contra a HI. .

Protective effects of restricted diet and antioxidants on testis tissue in rats fed with high-fat diet

A high-fat diet [HFD] promotes the oxidative stress formation, which in turn has hazardous effects on reproductive system and fertility. The present study examines the potential positive effects of a restricted high fat diet [RHFD] and antioxidants consumption on sperm parameters and testis tissue in rats. Male rats [n = 48] were divided into four groups [12 in each group]: control group [Cont], HFD group, RHFD, and RHFD with astaxanthin and vitamins E and C group [RHFDA]. After 12 weeks, serum analysis and sperm parameters study were performed. Sections of fixed testes were stained with Hematoxilin and Eosin to study the histological changes. A one-way ANOVA was used to compare the data. HFD fed animals presented significant increase in weight load and serum low density lipoprotein [LDL-C] levels [P < 0.05]. The sperm count in RHFD was lower than three other groups [P < 0.05] and sperm motility of RHFDA group was significantly higher than HFD and RHFD groups [P < 0.05]. The histological study was showed a significant increase in spermatogonium number in RHFDA compared to three other groups [P < 0.05]. The number of spermatocyte I and spermatid in RHFD was significantly [P < 0.05] lower than Cont and HFD groups. HFD and obesity can affect sperm parameters and spermatogenesis and antioxidants consumption may improve their quality. Although the RHFD is a benefit way in weight loss and decrease of LDL-C of serum, but it is suggested that is not effective on sperm quality improvement

Thoracic Duct Embolization with Lipiodol for Chylothorax due to Thoracic Endovascular Aortic Repair with Debranching Procedure

Chylothorax is a rare postoperative complication of a thoracic surgical procedure. Here, we report a case of chylothorax after thoracic endovascular aortic repair with debranching for the distal arch aneurysm of the aorta. First, the patient was treated by a medical method (nil per os, fat-free diet, and octreotide), but this method failed. The patient strongly refused surgical treatment. Therefore, we tried to occlude the thoracic duct by lymphangiography Lipiodol, and this line of treatment was successful.

Effects of R219K polymorphism of ATP-binding cassette transporter 1 gene on serum lipids ratios induced by a high-carbohydrate and low-fat diet in healthy youth

BACKGROUND: Diets are the important players in regulating plasma lipid profiles. And the R219K polymorphism at the gene of ATP-binding cassette transporter 1(ABCA1) was reported to be associated with the profiles. However, no efforts have been made to investigate the changes of lipid profiles after a high-carbohydrate and low-fat diet in different subjects with different genotypes of this polymorphism. This study was to evaluate the effects of ABCA1 R219K polymorphism on serum lipid and apolipoprotein (apo) ratios induced by a high-carbohydrate/low-fat (high-CHO) diet. After a washout diet of 54.1% carbohydrate for 7 days, 56 healthy young subjects (22.89 ± 1.80 years old) were given a high-CHO diet of 70.1% carbohydrate for 6 days. Height, weight, waist circumference, hip circumference, glucose (Glu), triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), apoA-1 and apoB-100 were measured on the 1st, 8th and 14th days of this study. Body mass index (BMI), waist-to-hip ratios (WHR), log(TG/HDL-C), TC/HDL-C, LDL-C/HDL-C and apoA-1/apoB-100 were calculated. ABCA1 R219K was analyzed by a PCR-RFLP method. RESULTS: The results indicate that the male subjects of all the genotypes had higher WHR than their female counterparts on the 1st, 8th and 14th days of this study. The male K carriers had higher log(TG/HDL-C) and TC/HDL-C than the female carriers on the 1st and 14th days, and higher LDL-C/HDL-C on the 14th day. When compared with that on the 8th day, TC/HDL-C was decreased regardless of the genotypes and genders on the 14th day. Log(TG/HDL-C) was increased in the males with the RR genotype and the female K carriers. Lowered BMI, Glu and LDL-C/HDL-C were found in the male K carriers, but only lowered BMI in the female K carriers and only lowered LDL-C/HDL-C in the females with the RR genotype. CONCLUSIONS: These results suggest that ABCA1 R219K polymorphism is associated differently in males and females with elevated log(TG/HDL-C) and decreased LDL-C/HDL-C induced by the high-CHO diet.

Effects of exercise and low-fat diet on the TNF-alpha expression of insulin resistance in rats / 中国应用生理学杂志

<p><b>OBJECTIVE</b>To investigate the effects of exercise (EX), low-fat diet (LFD) and their combination intervention on the tumor necrosis factor-alpha (TNF-alpha) expression of insulin resistance in rats.</p><p><b>METHODS</b>One hundred and thirty male rats randomly assigned to 2 groups: Control (CON)-10 rats consuming a low-fat diet; HFD-120 rats consuming a high-fat diet (HFD). The dietary regimen was sustained for 8 wk, at which point the 40 HFD group rats gaining the most weight were referred to as the obese rats. Glucose tolerance was assessed by an oral glucose tolerance test (OGTT). During the procedure of OGTT, the blood was drawn for insulin assay (insulin release test). The whole body insulin resistance was assessed by glucose-insulin index. The obese HFD group rats were randomized into one of four intervention groups: HFD-sedentary (HFD-SED), HFD-exercise(HFD-EX), low fat diet-SED (LFD-SED), LFD-EX. Ex rats performed 8-wk exercise training on a motorized treadmill. The CON group had access to low-fat diet for another 8 wk. After 8 wk of exercise and low-fat diet intervention, the OGTT and insulin release test were performed again. To use ELISA technique for detecting TNF-alpha in soleus muscle and adipose tissue.</p><p><b>RESULTS</b>After being fed high-fat diet for 8 wk, glucose-insulin index in the HFD group were significantly greater than that in CON group (P < 0.01). After 8-week exercise and low-fat diet intervention, glucose-insulin index in HFD-SED group was significantly greater than that in CON group (P < 0.01). The index in three intervention groups was significantly less than that in HFD-SED group (P < 0.01) . TNF-alpha content in adipose tissue and the soleus muscle for HFD-SED group was significantly greater than that in CON group (P < 0.01). Three intervention groups were significantly less than HFD-SED group (P < 0.01).</p><p><b>CONCLUSION</b>Exercise and low-fat diet interventions can decrease the TNF-alpha expression in insulin resistance rat.</p>

Isolated Chylopericardium after Mitral Valve Replacement: the First Description of Adult Heart Disease in Korea / 대한구급학회지

Isolated chylopericardium as a complication of cardiac surgery is very rare. Two cases of chylopericardium have been previously reported in Korea; both patients suffered from chylopericardium after a corrective cardiac surgery for a congenital heart disease such as atrial or ventricular septal defect. We report a case of chylopericardium in a 55-year-old mitral valve replacement patient. The reason for chylopericardium was unclear, but it might have been related with the damaged lymph nodes and blunt dissection of the thymus. While most chylopericardium cases require surgical intervention, we managed this chylopericardium case with a low-fat diet for 3 days.

The effect of high-carbohydrate diet and low-fat diet for the risk factors of metabolic syndrome in Korean adolescents: Using the Korean National Health and Nutrition Examination Surveys (KNHANES) 1998-2009 / 한국영양학회지

PURPOSE: The prevalence of metabolic syndrome has increased in both the adult population and in adolescents. How-ever, few studies have been conducted for adolescents. The aim of this study was to examine the association of metabolic syndrome and its risk factors with high carbohydrate diet and high fat diet using data from the Korea National Health and Nutrition Examination Survey (1998-2009). METHODS: Using the Acceptable Macronutrient Distribution Range for Korean Dietary Reference Intakes, subjects whose energy intake from carbohydrate was greater than 70% and from fat was less than 15% were classified as the 'High-carbohydrate & low-fat diet (HCLF)' group and subjects whose energy intake from carbohydrate was less than 60% and from fat was 25% or more were classified as the 'Low-carbohydrate & high-fat Diet (LCHF)' group. Among 5,931 eligible subjects, HCLF included 853 subjects and LCHF included 1,084 subjects. RESULTS: The mean age in both groups was 14 years and significant difference in age, BMI, sex, physical activity, and household income was observed between the HCLF and LCHF groups. Regarding the energy intake compared to Estimated Energy Re-quirement, the HCLF group met 79.0% and the LCHF group met 100.3%. Regarding nutrient intake per 1,000 kcal, carbo-hydrate, iron, potassium, and vitamin C intake in the HCLF group were significantly higher, but protein, fat, calcium, phos-phorus, vitamin A, thiamin, riboflavin, and niacin intakes were significantly lower in the HCLF group compared to the LCHF group. After adjusting for age, sex, BMI, study year, household income, physical activity, and energy intake, the serum tri-glycerides level and systolic blood pressure were slightly higher, while the serum HDL-cholesterol level was significantly lower in HCLF than LCHF. The odds ratio of metabolic syndrome did not differ significantly between HCLF and LCHF. CONCLUSION: Our findings indicate an association of a high carbohydrate diet with increased risks for metabolic syndrome components. Conduct of future studies would be necessary in order to explore the underlying mechanism and to confirm our findings in a prospective study.