Effect of Dietary Counseling on Patients with Asymptomatic Hyperuricemia.

In Japan, hyperuricemia is on the rise. The guideline for the management of hyperuricemia and gout recommends lifestyle changes before beginning drug therapy. This study aimed to evaluate the effectiveness of dietary counseling following the guideline. Thirty-three subjects (24 men and 9 women) with asymptomatic hyperuricemia underwent dietary counseling for 6 months based on the following recommendations : (1) prevent excessive purine intake, (2) prevent excessive fructose intake, (3) limit alcohol drinking, and (4) drink sufficient water. Obese subjects were counseled on adequate energy intake. Blood sampling, anthropometric measurements, dietary surveys, and 24-h urine collection were performed at baseline and at 6 months. Serum uric acid (S-UA) levels were significantly lower at 6 months compared to baseline. Water intake and urine volume were considerably higher at 6 months than at baseline. When compared to baseline, urine UA (U-UA) levels were significantly lower, and renal fractional excretion of UA (FEUA) was significantly higher at 6 months. Changes in renal function (serum creatinine, estimated glomerular filtration rate, and FEUA) were significantly associated with ?S-UA level. In this study, S-UA level was significantly decreased by dietary counseling in line with the guideline. This study illustrates the effectiveness of dietary counseling for asymptomatic hyperuricemia. J. Med. Invest. 70 : 34-40, February, 2023.

Effect of cacao polyphenol-rich chocolate on postprandial glycemia, insulin, and incretin secretion in healthy participants.

OBJECTIVES: There is substantial interest in using dark chocolate to prevent postprandial hyperglycemia. We investigated the effects of cacao polyphenol-rich chocolate on postprandial glycemic and insulinemic responses and whether cacao polyphenol-rich chocolate increases glucagon-like peptide-1 (GLP-1) secretion. METHODS: In a stratified, randomized, crossover study, 48 healthy participants ingested either water (W) or cacao polyphenol-rich chocolate plus water (C) 15 min before a 50 g oral glucose tolerance test (OGTT). Pre- and postprandial concentrations of blood glucose, insulin, free fatty acid, glucagon, and GLP-1 were evaluated. RESULTS: Peak plasma glucose concentrations did not differ significantly between groups W and C; however, plasma glucose concentrations at 120 min in group C were significantly lower than those in group W (P < .01). Postprandial serum insulin and plasma GLP-1 concentrations and incremental serum insulin and plasma GLP-1 area under the curve (AUC)-15-180 min for group C were significantly higher than those for group W (P < .05). When comparing the changes after the OGTT, the incremental plasma glucose AUC0-180 min for group C was significantly lower than that for group W (P < .05), but the incremental serum insulin and plasma GLP-1 AUC0-180 min did not differ significantly between groups W and C. CONCLUSIONS: This study indicated that the intake of cacao polyphenol-rich chocolate before a 50 g OGTT could enhance early insulin and GLP-1 secretion in healthy participants, and illustrates the potential of cacao polyphenol-rich chocolate in managing postprandial glucose excursions.

Acute effect of green tea catechins on uric acid metabolism after alcohol ingestion in Japanese men.

INTRODUCTION/OBJECTIVES: Alcohol consumption is associated with hyperuricemia and gout. Previous studies have indicated a role for green tea catechins in uric acid (UA) metabolism. This study aimed to elucidate the acute effect of green tea catechins in terms of enhancing urinary excretion of UA and xanthine/hypoxanthine (Xa/HX; UA precursors) after alcohol ingestion. METHODS: In a randomized crossover study, ten healthy Japanese subjects consumed test meals, including a Japanese distilled spirit (Shochu) with water (SW) or Shochu with catechin-rich green tea (SC), each containing 20 g of alcohol. The SC contained 617 mg of catechin in total. Serum and urine UA and Xa/HX concentrations were measured. Blood samples were collected after 2.5 h, and urine samples were collected between 0 and 5 h after consuming the test meal. RESULTS: Urine UA and Xa/HX excretions were significantly higher in the SC group than in the SW group (UA: SW, 0.45 ± 0.08; SC, 0.52 ± 0.09; Xa/HX: SW, 0.08 ± 0.04; SC, 0.16 ± 0.05 mg/kg/h). UA clearance (CUA) and fractional UA excretion (FEUA) tended to increase more in the SC group than in the SW group (CUA: SW, 7.76 ± 2.14; SC, 8.75 ± 2.23 mL/min/1.73 m2; FEUA: SW, 6.08 ± 1.36; SC, 6.64 ± 1.42%). No significant differences in serum UA and Xa/HX concentrations were observed between two groups. CONCLUSIONS: It was concluded that green tea catechins can enhance the excretion of UA and Xa/HX, even though alcohol is ingested. TRIAL REGISTRATION NUMBER: UMIN000040076. Retrospectively registered 7 April 2020. https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000045687 Key Points • Green tea catechins enhance the excretion of uric acid and xanthine/hypoxanthine, even when alcohol is ingested simultaneously. • In case of non-adherence of limiting alcohol intake, catechin-rich green tea may be an effective dietary component to continue dietary therapy.

The Effects of Long-Term Dietary Therapy on Patients with Hypertriglyceridemia.

AIM: This study aimed to evaluate the effect of diet on serum lipids and to assess the effectiveness of long-term dietary therapy for hypertriglyceridemia. METHODS: Seventy-nine patients (34 males and 45 females) with hypertriglyceridemia were enrolled and underwent dietary counseling for 12 months based on the following three recommendations: (1) reduce carbohydrate intake, (2) increase n-3 polyunsaturated fatty acid (PUFA) intake, and (3) limit alcohol drinking. We examined the effect of dietary therapy for 6 months on serum triglyceride (TG) levels and also compared the effectiveness of dietary and combined drug therapies on preventing arteriosclerotic disease from 7 to 12 months. RESULTS: We observed that serum TG levels of the patients receiving dietary counseling were decreased compared with baseline at 6 months. Body weight and serum TG levels were decreased, and serum high-density lipoprotein levels were increased in the dietary therapy alone group, whereas BW, body mass index, and abdominal circumference were decreased in the combined drug treatment group compared with baselines at 6 and 12 months. Furthermore, the dietary therapy alone group demonstrated reductions in intake of total energy, carbohydrate, and saturated fatty acids, as well as n-6/n-3 PUFA ratio compared with baselines, but only n-6/n-3 PUFA ratio was decreased in the combined drug treatment group. CONCLUSION: This study demonstrated a decrease in serum TG level after 12 months of dietary therapy similar to drug therapy, which suggests that it is an effective treatment for hypertriglyceridemia, and heightened awareness should be made to encourage its use.The clinical trial registration number: UMIN000028860.

UDP-galactose transporter gene hUGT1 expression in tobacco plants leads to hyper-galactosylated cell wall components.

We reported previously that tobacco plants transformed with the human UDP-galactose transporter 1 gene (hUGT1-transgenic plants) displayed morphological, architectural, and physiological alterations, such as enhanced growth, increased accumulation of chlorophyll and lignin, and a gibberellin-responsive phenotype. In the present study, we demonstrated that hUGT1 expression altered the monosaccharide composition of cell wall matrix polysaccharides, such as pectic and hemicellulosic polysaccharides, which are biosynthesized in the Golgi lumen. An analysis of the monosaccharide composition of the cell wall matrix polysaccharides revealed that the ratio of galactose to total monosaccharides was significantly elevated in the hemicellulose II and pectin fractions of hUGT1-transgenic plants compared with that of control plants. A hyper-galactosylated xyloglucan structure was detected in hemicellulose II using oligosaccharide mass profiling. These results indicated that, because of the enhanced UDP-galactose transport from the cytosol to the Golgi apparatus by hUGT1, galactose incorporation in the cell wall matrix polysaccharides increased. This increased galactose incorporation may have contributed to increased galactose tolerance in hUGT1-transgenic plants.