Effects of a very-low-calorie diet on metabolic control and cardiovascular risk factors in the treatment of obese non-insulin-dependent diabetics

Article Abstract:

Individuals with non-insulin-dependent diabetes mellitus (NIDDM) tend to be older, overweight people, and they are usually treated with diet modifications, exercise, and oral antidiabetic drugs. However, in some patients, these drugs fail to work, and the usual treatment is to start insulin therapy. But the obesity of these patients is thought to increase the resistance of body cells to insulin, thereby contributing to the high blood sugar of NIDDM; if patients could lose weight, blood sugar might become normal. The effect of a very-low-calorie diet on weight, energy production, and cardiovascular risk factors in 10 obese patients with NIDDM was studied. After following a weight-maintaining diet for two weeks, patients were placed on a 500-calorie diet for 12 days, followed by 10 to 11 weeks on 800 calories, and then by the weight-maintaining diet. The very-low-calorie diet was composed of a high-quality formula with vitamin, mineral, and trace element supplements, plus vegetables. Fruits, fish, and meat were added to this for the 800-calorie diet. The average patient weight was over 200 pounds, and an average of 30 pounds was lost during the study. Energy production rates dropped by two weeks, and had not declined further at 12 weeks. Systolic and diastolic blood pressure dropped by two weeks, from approximately 152/92 to 130/80, on average, and remained at the lower level at 12 weeks. These results have been observed in previous studies of low-calorie diets. Fasting blood glucose (sugar) dropped moderately throughout the study, while glucose levels during glucose tolerance tests were decreased only at the two-week point. Further decreases may have been limited by the fact that the patients were still overweight. The blood levels of cholesterol dropped at two weeks and then rose, while the proportion of HDL-cholesterol rose and the levels of triglycerides fell; the latter two changes are thought to reduce risk of heart disease. Other data suggested that the very-low-calorie diet was safe in terms of protein content and micronutrients, as nitrogen balance and electrocardiogram readings were within normal limits after two weeks. The results indicate that a very-low-calorie diet is preferred to insulin treatment for obese patients who have become resistant to oral antidiabetic drugs. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Diabetes, Diabetes mellitus, Type 2 diabetes, Diet therapy, Low-calorie diet, Low calorie diet

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Vitamin B-6 nutrition status and cigarette smoking

Article Abstract:

Advanced age and smoking are major risk factors for coronary artery disease. Both smoking and advanced age are also associated with low blood levels of vitamin B-6. Scientists have suggested that both smoking and aging, which seem to be unrelated risk factors for heart disease, may deplete vitamin B-6 in the body by the same mechanism. However, plasma (blood) levels of the vitamin may not always correspond to levels within cells. Therefore, the relationship between plasma and red blood cell levels of the two major forms of vitamin B-6, pyridoxal-5'-phosphate (PLP) and pyridoxal (PL), in 159 smokers, 59 ex-smokers, and 68 nonsmokers (healthy, sedentary men) were studied. The plasma levels of PLP and PL were significantly lower in smokers compared with nonsmokers and ex-smokers. However, the levels of PLP and PL in red blood cells did not differ among groups. Because PLP is used inside cells and not outside, the medical relevance of plasma PLP levels is unclear, and determination of red blood cell levels of PLP and PL may be more appropriate. In this study, the red blood cell levels of vitamin B-6 showed no evidence of an effect caused by smoking. (Consumer Summary produced by Reliance Medical Information, Inc.)

Risk factors, Coronary heart disease, Tobacco

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Plasma pyridoxal 5'-phosphate concentrations in obese and nonobese black women residing near Petersburg, VA

Article Abstract:

Research on vitamins typically investigates how much a person needs (requirement), the amount circulating in the body (status), and the amount usually consumed in the diet (intake). Little research into the requirement, status and intake of vitamin B-6 among blacks has been reported. One previous study found that southern black and white teenage girls have inadequate vitamin B- 6 status and intake. Thirty black women were evaluated for their vitamin B-6 status and dietary intake. Plasma pyridoxal 5-phosphate (PLP) was used as a test of circulating vitamin B-6. All the participants had adequate B-6 status except for one woman whose level was borderline. The values were equivalent to those previously recorded for white obese and non-obese women. The B-6 status of obese black women did not differ from non-obese black women. The study group included 15 obese and 15 non-obese participants because approximately half the black women in the US are obese, and so the study group represented the population for this characteristic. Obesity was defined as at least 20 percent over ideal weight.

Case studies, Virginia, Food and nutrition, African American women, Vitamin B6 deficiency, Pyridoxine deficiency

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