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Dietary Choices and the Control of Obesity
Published in Roy J. Shephard, Obesity: A Kinesiologist’s Perspective, 2018
A randomized controlled trial compared the Atkins diet with three other weight-loss systems (the Zone, Weight-Watchers, and Ornish diets). The Zone diet recommends five meals per day, all with a low intake of carbohydrate and a protein intake proportional to the amount of carbohydrate ingested. Weight-Watchers encourage an increase of exercise and eating “more healthily”, usually through group meetings, with the creation of a negative energy balance. No food is off limits to Weight-Watchers, but the total intake is monitored by a points scheme, with high point values assigned for items rich in either sugar or fat, and lower point values for lean meat. The Ornish diet favours a combination of moderate exercise with a plant-based regimen, supplemented occasionally by fish oil and animal products. In the controlled comparison, the four approaches yielded relatively small and similar decreases of body mass, along with small reductions in cardiac risk factors [32]. After a year, respective decreases of body mass and adherence rates were 2.1 kg (53 per cent), 3.2 kg (65 per cent), 3.0 kg (65 per cent), and 3.3 kg (50 per cent).
Therapeutic Nutrition
Published in W. John Diamond, The Clinical Practice of Complementary, Alternative, and Western Medicine, 2017
The Zone Diet — Developed by Barry Sears, Ph.D., this diet emphasizes a high-protein, moderate-fat, and low-carbohydrate intake, a mixture that keeps you in the metabolic “Zone.” Only high-fiber fruits and vegetables are allowed.
Medical Nutrition Therapy for Patients with Type-2 Diabetes
Published in Jeffrey I. Mechanick, Elise M. Brett, Nutritional Strategies for the Diabetic & Prediabetic Patient, 2006
Bantwal Suresh Baliga, Zachary Bloomgarden, Cathy Nonas
Barry Sears, Ph.D., created the Zone Diet [134] and claims it is safe for patients with type-1 diabetes mellitus (T1DM) or T2DM. The rationale behind this diet is that by eating the proper ratio of low-density carbohydrates, dietary fat, and protein, the dieter can keep the body’s insulin production within a therapeutic zone, making it possible to burn excess body fat (and keep the fat off permanently). He describes the “Zone” as a state of homeostasis that allows a person’s body and mind to work together at their ultimate best. In order to get to the “Zone,” the diet has to consist of a ratio of macronutrients made up of less total carbohydrates and more protein (40% carbohydrate:30% protein:30% fat) than is usually prescribed by conventional dietary guidelines (55% carbohydrates:15% protein:30% fat). The 0.75 protein:carbohydrate ratio (three times the ratio found in conventional diets) is thought to reduce the insulin:glucagon ratio and eicosanoid metabolism. There are no level 1–3 clinical scientific data to support these claims. It turns out that this ratio may actually increase the area under the insulin curve and, in general, much of the scientific literature at hand contradicts many of the claims advanced by Zone Diet enthusiasts [135]. Furthermore, claims that a Zone composition of sports drinks (i.e., not having the traditionally high-carbohydrate load) is beneficial on performance have not been scientifically substantiated and may even be detrimental [136,137] A similar ratio of protein:carbo-hydrate is used in the Sugar Busters!™ diet.
Severe anion gap metabolic acidosis associated with initiation of a very low-carbohydrate diet
Published in Journal of Community Hospital Internal Medicine Perspectives, 2019
Sijan Basnet, Niranjan Tachamo, Salik Nazir, Rashmi Dhital, Asad Jehangir, Anthony Donato
Different low carbohydrate diets such as Atkins Diet, the South Beach Diet, and the Zone Diet have been tried effectively for weight loss [3]. The carbohydrate content in these diets is less than 200 grams per day. In very low carbohydrate diet, carbohydrates are greatly reduced to ≤ 20–50 grams per day with an increase in dietary fats and proteins. These diets are believed to promote weight loss through various mechanisms. High-fat content promotes early satiety [1]. Limitation of choices with low carbohydrate diet decreases appetite [4]. Low carbohydrate diet increases glucagon levels and decreases insulin levels which, in turn, activates phosphoenolpyruvate carboxykinase, fructose 1,6-biphosphatase, and glucose 6-phosphatase that favor gluconeogenesis and inhibits pyruvate kinase, 6-phosphofructo-1-kinase, and glucokinase that slow down the glycolytic pathway [5]. This maintains a steady glucose supply to tissues with an obligatory glucose requirement such as red blood cells and brain [1,3]. There is increased protein turnover to provide amino acids as substrates for glucose production. This requires increased energy expenditure contributing to weight loss [3].
Associations of low-carbohydrate with mortality in chronic kidney disease
Published in Renal Failure, 2023
Qidong Ren, Yangzhong Zhou, Huiting Luo, Gang Chen, Yan Han, Ke Zheng, Yan Qin, Xuemei Li
Most previous diet studies in CKD patients focused on protein, and a low-protein diet was generally recommended for CKD patients in clinical practice [31]. Several RCTs and meta-analyses in populations with preexisting kidney disorders supported that a low protein diet played an important role in retarding the progression of CKD and effectively delaying the initiation of dialysis therapy [32–37]. In contrast, the concern of malnutrition, protein-energy waste, and conflict findings on the effectiveness of a low-protein diet leads to debates on the necessity and strategy of adherence to a low-protein diet [38–40]. The effect of a low-protein diet was also influenced by complications such as diabetes [35] and by the source of protein [41]. To meet the daily total energy demand, a low carbohydrate diet, in some aspects, is a high protein or high-fat diet, for example, Atkins and Zone diet [42]. An RCT in 24 pre-diabetes patients showed a high protein diet’s protective effect compared with the high carbohydrate diet [43]. In this study, the amount of protein intake in participants with CKD (0.9 g/kg) was not in the normal low protein diet range (0.6–0.8 g/kg), and replacing carbohydrates with protein up to 30% led to a high protein diet (1.7 g/kg). We observed lower mortality risk with lower carbohydrate intake and reduction in mortality risk when replacing the carbohydrate with protein (including plant and animal protein). Meanwhile, we also found that higher protein intake was associated with lower mortality risk in CKD patients. Several studies also showed that a high-protein diet might be beneficial [44,45]. One possible explanation is that sufficient nutrition is provided with high protein intake which helps to maintain muscle mass. Patients are capable of more physical activity and less likely to be involved in falls and bone fractures with enough muscle strength, which might reduce the mortality risk. Another possible explanation is that high protein intake provides more bioactive peptides. These bioactive peptides were reported to have anti-inflammatory, anti-hypertensive, anti-oxidative, and anti-microbial activities [46–48]. These protective activities might lead to a lower mortality risk. However, the effect of a high protein diet in CKD patients remained controversial, and more long-term and extensive sample-size studies are required [49,50].