Lifestyle Changes which will Reduce Gout and Hyperuricemia

Choi, HK. A Prescription for Lifestyle Change in Patients with Hyperuricemia and Gout. Curr Opin Rheumatol 22(2)165-72.

This study pointed out lifestyle and dietary recommendations for gout patients since gout is often associated with the metabolic syndrome and an increased future risk of cardiovascular disease (CVD) and mortality.  It concluded that weight reduction with daily exercise and limiting intake of red meat and sugary beverages would help reduce uric acid levels and consequently the risk of gout, insulin resistance, and comorbidities. Heavy alcohol consumption should be avoided, whereas moderate consumption, sweet fruits, and seafood intake, particularly oily fish, should be tailored to the individual, considering their anticipated health benefits against CVD. The researchers also found that dairy products, vegetables, nuts, legumes, fruits (less sugary ones), and whole grains are healthy choices for the comorbidities of gout and may also help prevent gout by reducing insulin resistance. Coffee and vitamin C supplementation could be considered as preventive measures as these can lower urate levels, as well as the risk of gout and some of its comorbidities.

 

 

 

Fasting and Mood

Michalsen, A. Prolonged Fasting as a Method of Mood Enhancement in Chronic Pain Syndromes: A Review of Clinical Evidence and Mechanisms. Curr Pain Headache Rep 14(2)80-7. PMID: 20425196

Fasting is part of many religions, cultures, and traditions.  However, it has lost its popularity in the modern world.  In this review, researchers show on a cellular level how fasting could promote health and combat modern diseases.  These claims are supported by experimental research and range from rheumatic diseases and pain management to mood disorders.

Fasting and it's Effect on Cancer

Brandhorst, S and Longo, VD. Fasting and Caloric Restriction in Cancer Prevention and Treatment. Recent Results Cancer Res 207(241-66.

Because of the radical side effects of current cancer treatments, it is common for oncologists to encourage their patients to eat fattening food during therapy to compensate for wasting of the body tissues. These recommendations come with little or no encouragement to consume nutrient-dense food.  This review article looks at preclinical and preliminary clinical studies on dietary restriction and fasting and their role in inducing cellular protection and chemotherapy resistance.  The authors found that various forms of reduced caloric intake such as calorie restriction or fasting demonstrate a wide range of beneficial effects able to help prevent malignancies and increase the efficacy of cancer therapies. Whereas chronic limitation of calories provides both beneficial and detrimental results, as well as significant compliance challenges, periodic fasting, fasting-mimicking diets, and dietary restriction without a reduction in calories, are emerging as interventions with the potential to be widely used to prevent and treat cancer.

 

 

Fasting and Woman's Health

Nair, PM, and Khawale, PG. Role of Therapeutic Fasting in Women's Health: An Overview. J Midlife Health 7(2)61-4. PMC4960941

This is an overview of how fasting in some shape or form could benefit women's health.   Fasting has shown to improve the reproductive and mental health.  The researchers also found that fasting could prevent as well as ameliorate cancers and musculoskeletal disorders which are common in middle-aged and elderly women.

 

Chiofalo, B, Laganà, A, et al. Fasting as Possible Complementary Approach for Polycystic Ovary Syndrome: Hope or Hype? Med Hypotheses 105(1-3. PMID: 28735644

Polycystic ovary syndrome disorder among women of reproductive age. These women show infertility as well as metabolic disorders such as hyperinsulinemia, insulin resistance, dyslipidemia, and obesity.  The cause of this illness is a result of concurrent endocrine modifications, lifestyle factors, and genetic background.  There is no remedy for this condition as yet.  This article shows how fasting could play a role in metabolic homeostasis and help regulate this disease. 

Fasting and the effect on Metabolic Syndrome

Type II diabetes

Arnason, T, Bowen, M, et al. Effects of Intermittent Fasting on Health Markers in Those with Type 2 Diabetes: A Pilot Study. World J Diabetes. 2017 Apr 15; 8(4):154-164. 8(4)154-64. PMID: 28465792

This pilot study tested the safety, and efficacy of daily intermittent fasting on diagnosed type II diabetics. The results indicated that it might be a safe, tolerable, dietary intervention which might improve critical outcomes such as body weight, fasting glucose and variability in blood glucose response to meals. These findings look promising.  However, the authors believe it should be viewed as exploratory, and a larger, longer study is necessary to corroborate these findings.

 

Li, C, Sadraie, B, et al. Effects of a One-Week Fasting Therapy in Patients with Type-2 Diabetes Mellitus and Metabolic Syndrome - a Randomized Controlled Explorative Study. Exp Clin Endocrinol Diabetes 125(9)618-24.

 Results of this study suggest that prolonged fasting is feasible and might have beneficial clinical effects with people suffering from Type II diabetes. The effectiveness of fasting should be proved in larger confirmatory trials that include intermittent fasting in follow-ups to enable more pronounced and long-term effects.

The effect of fasting on Inflammation

Traba, J, Kwarteng-Siaw, M, et al. Fasting and Refeeding Differentially Regulate Nlrp3 Inflammasome Activation in Human Subjects. J Clin Invest 125(12)4592-600. PMC4665779

 

This study showed that on the cellular level, fasting has an anti-inflammatory effect with a positive impact on health outcomes.  The researchers concluded that their data indicate that nutrient levels regulate the NLRP3 inflammasome, in part through SIRT3-mediated mitochondrial homeostatic control.  These results suggest that deacetylase-dependent inflammasome attenuation may be amenable to targeting in human disease.

 

Rheumathoid arthritis

Kjeldsen-Kragh, J, Mellbye, OJ, et al. Changes in Laboratory Variables in Rheumatoid Arthritis Patients During a Trial of Fasting and One-Year Vegetarian Diet. Scand J Rheumatol 24(2)85-93.

It was previously reported that significant improvement might be obtained in rheumatoid arthritis patients by fasting followed by a vegetarian diet for one year.  The present study examined the changes in biochemical and immunological variables brought about by fasting and a vegetarian diet compared to a control group of omnivores.  It supported previous findings that diet could be useful in the treatment of rheumatoid arthritis.

Age Related Diseases and Fasting

 

Mattson, MP, Longo, VD, et al. Impact of Intermittent Fasting on Health and Disease Processes. Ageing Res Rev 39(46-58. PMC5411330

 The problem in the modern world is over-eating, consequent caloric overload and gained body weight.  This has a domino effect which negatively affects our health in various ways.  This study showed that in healthy and overweight human subjects, fasting could have a positive impact on weight loss and improvements in multiple health indicators including insulin resistance and reductions in risk factors for cardiovascular disease. The cellular and molecular mechanisms by which fasting improves health and counteracts disease processes involve activation of adaptive cellular stress response signaling pathways that enhance mitochondrial health, DNA repair, and autophagy. Fasting also promotes stem cell-based regeneration as well as long-lasting positive metabolic effects.

 

Fontana, L, Klein, S, et al. Effect of Long-Term Calorie Restriction with Adequate Protein and Micronutrients on Thyroid Hormones. J Clin Endocrinol Metab 91(8)3232-5.

This article shows a reduction in thyroid hormone (T3) in people following intermittent fasting.  This reduction is known to slow aging, making fasting an anti-aging factor.

Vegan Diets and Vitamin B12 deficiency

Roed, C, Skovby, F, et al. [Severe Vitamin B12 Deficiency in Infants Breastfed by Vegans]. Ugeskr Laeger 171(43)3099-101.

Weight loss and reduction of motor skills were documented in pediatric evaluation of a 10-month-old girl and a 12-month-old boy. Both children suffered form anemia and delayed development due to vitamin B12 deficiency.  The latter was presumably caused by strict maternal vegan diet during pregnancy and nursing. Therapy with supplemental vitamin B12 relieved the symptoms. Since infants risk irreversible neurological damage following severe vitamin B12 deficiency, early diagnosis and treatment are mandatory. Vegan and vegetarian women should take vitamin B12 supplementation during the pregnancy and nursing period.

Plant-based Diets, Cancer and Autoimmune Diseases

Dinu, M, Abbate, R, et al. Vegetarian, Vegan Diets and Multiple Health Outcomes: A Systematic Review with Meta-Analysis of Observational Studies. Crit Rev Food Sci Nutr 57(17)3640-9.

This comprehensive meta-analysis showed a significant reduced risk for the development and mortality of ischemic heart disease and cancer amongs people following a vegetarian diet.

 

Tantamango-Bartley, Y, Knutsen, SF, et al. Are Strict Vegetarians Protected against Prostate Cancer? Am J Clin Nutr 103(1)153-60. PMC4691666

Vegan diets showed a statistically significant protective association with prostate cancer risk.  This protection is even better in black males compared to white males.

 

McCarty, M. Vegan Proteins May Reduce Risk of Cancer, Obesity, and Cardiovascular Disease by Promoting Increased Glucagon Activity. Med Hypotheses.  Aug;. 53(6)459-85.

This is a speculation that a higher intake of non-essential amino acids without an unnecessarily high intake of essential amino acids protect against modern western diseases.  Vegans tend to have low blood lipids, less body fat, shorter stature, later puberty, and decreased risk for certain prominent 'Western' cancers; a vegan diet has documented clinical efficacy in rheumatoid arthritis. Low-fat vegan diets may be especially protective in regard to cancers linked to insulin resistance such as breast and colon cancer.

 

McCarty, M. Upregulation of Lymphocyte Apoptosis as a Strategy for Preventing and Treating Autoimmune Disorders: A Role for Whole-Food Vegan Diets, Fish Oil and Dopamine Agonists. Med Hypotheses.  Aug;. 57(2)258-75. PMID: 11461185

Based on theoretical speculation of some of the biochemical pathways and what is evident in some communities  this study concluded that a whole-food vegan diet, coupled with fish oil and vitamin D supplementation will protect against autoimmune diseases.

 

McCarty, M, Barroso-Aranda, J, et al. The Low-Methionine Content of Vegan Diets May Make Methionine Restriction Feasible as a Life Extension Strategy. Med Hypotheses. 72(2)125-8.

This study tweezes out the positive effects which a low-methionine (an amino acid) diet, such as a plant based diet, has on longevity.  It explains the phenomenon as a decrease in Insulin Growth Factor, a known aging factor.  This is amplified by exercise training and the consumption of ample amounts of fruit, wine and beer!  Plant protein sources are lower in methionine compared to animal derived proteins.  The authors assumed a supplementation in vitamin B12 which is not as abundant in plants.

Plant-based Diets and Blood Lipids

Barnard, ND, Cohen, J, et al. A Low-Fat Vegan Diet and a Conventional Diabetes Diet in the Treatment of Type 2 Diabetes: A Randomized, Controlled, 74-Wk Clinical Trial. Am J Clin Nutr 89(5)1588S-96S. PMC2677007

This study compared two groups of people following a pre assigned diet.  Free-living individuals with type 2 diabetes were randomly assigned to a low-fat vegan diet  or a diet following 2003 American Diabetes Association guidelines.  The vegan diet appeared to have a more pronounced effect on blood lipids and blood glucose than the conventional diet.

 

Wang, F, Zheng, J, et al. Effects of Vegetarian Diets on Blood Lipids: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Am Heart Assoc 4(10)e002408. PMC4845138

This was a systematic review and meta-analysis.  It provides evidence that vegetarian diets effectively lower blood concentrations of total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and non-high-density lipoprotein cholesterol.  It indicates that vegetarian diets could be a useful tool in managing vascular disease caused by high blood lipids.

 

Dinu, M, Abbate, R, et al. Vegetarian, Vegan Diets and Multiple Health Outcomes: A Systematic Review with Meta-Analysis of Observational Studies. Crit Rev Food Sci Nutr 57(17)3640-9.

This comprehensive meta-analysis showed a significant reduced risk for the development and mortality of ischemic heart disease and cancer amongst people following a vegetarian diet.

Vegan Diet and Diabetes

Barnard, ND, Cohen, J, et al. A Low-Fat Vegan Diet and a Conventional Diabetes Diet in the Treatment of Type 2 Diabetes: A Randomized, Controlled, 74-Wk Clinical Trial. Am J Clin Nutr 89(5)1588S-96S. PMC2677007

 

This study compared two groups of people following a pre-assigned diet.  Free-living individuals with type 2 diabetes were randomly assigned to a low-fat vegan diet  or a diet following 2003 American Diabetes Association guidelines.  The vegan diet appeared to have a more pronounced effect on blood lipids and blood glucose than the conventional diet.

Why Organic Produce?

Barnard, ND, Cohen, J, et al. A Low-Fat Vegan Diet and a Conventional Diabetes Diet in the Treatment of Type 2 Diabetes: A Randomized, Controlled, 74-Wk Clinical Trial. Am J Clin Nutr 89(5)1588S-96S. PMC2677007

 

This study compared two groups of people following a pre assigned diet.  Free-living individuals with type 2 diabetes were randomly assigned to a low-fat vegan diet  or a diet following 2003 American Diabetes Association guidelines.  The vegan diet appeared to have a more pronounced effect on blood lipids and blood glucose than the conventional diet.

 

Ketogenesis and COPD

Cai, B, Zhu, Y, et al. Effect of Supplementing a High-Fat, Low-Carbohydrate Enteral Formula in COPD Patients. Nutrition 19(3)229-32.

This was a study done on patients suffering from chronic, obstructive pulmonary disease.  their diets were supplemented with a high-fat, low-carbohydrate (CHO) nutritional supplement for three weeks.  The study demonstrated that pulmonary function in COPD patients can be significantly improved with meal replacement supplement as compared with the traditional high-CHO diet.

Ketogenesis and Obesity Related Disease

Tendler, D, Lin, S, et al. The Effect of a Low-Carbohydrate, Ketogenic Diet on Nonalcoholic Fatty Liver Disease: A Pilot Study. Dig Dis Sci 52(2)589-93.

This was a pilot study done on 5 patients suffering from nonalcoholic fatty liver disease, a disease becoming increasing common as obesity rates rise.   It proved that six months of a low-carbohydrate, ketogenic diet led to significant weight loss and histologic improvement of fatty liver disease.

 

Haimoto, H, Iwata, M, et al. Long-Term Effects of a Diet Loosely Restricting Carbohydrates on Hba1c Levels, Bmi and Tapering of Sulfonylureas in Type 2 Diabetes: A 2-Year Follow-up Study. Diabetes Res Clin Pract 79(2)350-6.

In this study two groups of type II diabetic patients were followed for two years.   One of the groups followed a conventional diet while the other group followed a carbohydrate restricted diet.   After the two years, HbA1c, BMI and cholesterol levels were significantly improved in the last group, while less medication was needed.

 

Ketogenesis and Cancer

Schroeder, U, Himpe, B, et al. Decline of Lactate in Tumor Tissue after Ketogenic Diet: In Vivo Microdialysis Study in Patients with Head and Neck Cancer. Nutr Cancer 65(6)843-9.

In tumor cells, pyruvate is converted to lactate at a higher rate compared to normal cells.  This rate of conversion is even higher in metastatic cells.  This study showed that a ketogenic diet lowers the rate of this conversion.  It suggests that a  ketogenic diet suppresses metabolic activity for cancer cells.

 

Klement, RJ and Sweeney, RA. Impact of a Ketogenic Diet Intervention During Radiotherapy on Body Composition: I. Initial Clinical Experience with Six Prospectively Studied Patients. BMC Res Notes 9(143. PMC4779584

This study supports the hypothesis that ketogenic diets administered as supportive measures during standard radio therapy are safe and might be helpful in preservation of muscle mass.

Ketogenesis and Neuro Protection

Arslan, N, Kose, E, et al. The Effect of Ketogenic Diet on Serum Selenium Levels in Patients with Intractable Epilepsy. Biol Trace Elem Res 178(1)1-6.

This study showed that continous following of high fat, low carb diet has a consequent drop in serum selimium levels.  Therefore it is advised that selinium is supplemented in the long term when following the diet.  this study was specifically daone on children suffering from epilepsy.

 

Choragiewicz, T, Zarnowska, I, et al. [Anticonvulsant and Neuroprotective Effects of the Ketogenic Diet]. Przegl Lek 67(3)205-12.

This study  suggest that the ketogenic diet also has neuroprotective properties, which makes it a useful alternative therapeutic method in the modification of the natural history of the diseases related with neurodegeneration processes. 

 

Gumus, H, Bayram, AK, et al. The Effects of Ketogenic Diet on Seizures, Cognitive Functions, and Other Neurological Disorders in Classical Phenotype of Glucose Transporter 1 Deficiency Syndrome. Neuropediatrics 46(5)313-20.

 This study showed that treatment with KD resulted in a marked improvement in seizures and cognitive functions of children suffering from epilepsy as a result of  glucose transporter protein 1 deficiency syndrome.  There were also improvement, although less striking on the other neurological disorders of the patients such as alertness, concentration, motivation and activity .

 

Kim, JA, Yoon, JR, et al. Efficacy of the Classic Ketogenic and the Modified Atkins Diets in Refractory Childhood Epilepsy. Epilepsia 57(1)51-8.

This study showed that a modified high protein diet had advantages with respect to better tolerability and fewer serious side effects.  this diet might be considered as the primary choice for the treatment of intractable epilepsy in children, but the classic ketogenic diet is more suitable as the first line of diet therapy in patients <2 years of age.

 

Sariego-Jamardo, A, Garcia-Cazorla, A, et al. Efficacy of the Ketogenic Diet for the Treatment of Refractory Childhood Epilepsy: Cerebrospinal Fluid Neurotransmitters and Amino Acid Levels. Pediatr Neurol 53(5)422-6.

This study showed a 50% reduction in rate of epileptic seizures in children suffering from it.  Although another goal of the study was to determine the mechanism of protection from the ketogenic diet, it did not succeed in this. 

 

Herbert, MR and Buckley, JA. Autism and Dietary Therapy: Case Report and Review of the Literature. J Child Neurol 28(8)975-82.

This as a case study of a child with autism and epilepsy who, after limited response to other interventions following her regression into autism, was placed on a gluten-free, casein-free diet.  Over the course of several years following her initial diagnosis, the child's Childhood Autism Rating Scale score decreased from 49 to 17, representing a change from severe autism to nonautistic, and her intelligence quotient increased 70 points.  Also, 14 months after the initiation of the diet the child was essentially seizure free.  Secondary benefits included resolution of morbid obesity and improvement of cognitive and behavioral features.

 

Husain, AM, Yancy, WS, Jr., et al. Diet Therapy for Narcolepsy. Neurology 62(12)2300-2.

This study showed that patients with narcolepsy experienced modest improvements in daytime sleepiness on a ketogenic diet.