More than Just for Diabetes: SGLT2 Inhibitors Benefit Patients with Heart Failure

SGLT2 inhibitors, from being merely an antidiabetic drug, are contributing a lot to the global fight against cardiovascular and renal diseases.

WeightControl.com Interview with:
Bernardo Cortese, MD FESC FSCAI
Interventional Cardiologist
President, Scientific Committee Fondazione Ricerca e Innovazione Cardiovascolare,
CEO, DCB Academy
www.fondazioneric.org
www.bernardocortese.com

WeightControl.com: What is the background for this study? What are the main findings?

Response: Our report seeks to elucidate the current role of SGLT2 inhibitors in the management of cardiovascular disease and the comprehensive spectrum of heart failure, namely when the heart start deteriorating in its functions.

We start focusing on the pharmacological properties of this class of drugs, thereafter we go through a synthesis and analysis of data derived from the main clinical trials which have involved this class when applied to the cardiovascular patient. Specifically, we aim to consolidate findings that substantiate the safety profile of SGLT2 inhibitors concerning cardiac, renal, and metabolic parameters. Furthermore, our study explores the therapeutic impact of these agents in the context of managing and treating type 2 diabetes.

These “glucoscape maestros”, initially prescribed to diabetic patients, showed a great safety and benefit profile in patients with renal impairment and, most importantly, with a failing heart.

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DIETFITS: Identifying Groups with Varying Weight Loss Success

the most successful subgroup (73% met threshold) had high outcome expectations for making health improvements coupled with high levels of family encouragement

WeightControl.com Interview with:
Matthew J. Landry, PhD, RDN, FAND, FAHA (he/him)
Assistant Professor
Department of Population Health & Disease Prevention
University of California, Irvine

WeightControl.com: What is the background for this study?

Response: Lifestyle interventions are the first-line treatment for obesity; however, not all participants achieve clinically significant weight loss.

As researchers and clinicians, we want to minimize patient burden, maximize clinical outcomes, and conserve constraints (budget & personnel).

Using data from a 12-month diet and weight loss intervention (DIETFITS), we examined 52 demographic, clinical, & psychosocial variables among 436 participants (BMI 28-40) to see if there are distinct subgroups of participants who were more or less successful in losing 5% weight by 12 months?

New Weight Loss Model Targets Individual Response to Food Cues

Individuals who are high on food cue responsiveness typically have uncontrolled eating and ruminate (think) about food a lot of the time

WeightControl.com Interview with:

Dr. Kerri N. Boutelle, Ph.D
Department of Pediatrics
Herbert Wertheim School of Public Health and Human Longevity Science,
Department of Psychiatry
University of California, San Diego, La Jolla, California

WeightControl.com: What is the background for this study? What are the main findings?

Response: Behavioral weight loss, which includes nutrition and physical activity education and behavior therapy techniques (also called a lifestyle intervention), is not effective for all adults with overweight and obesity and of those who lose weight, the majority regain the weight back. This suggests that there are unaddressed underlying mechanisms that impact the effectiveness of these interventions.

We developed a novel weight loss model based on appetitive traits, called regulation of cues (roc), that targets improving responsiveness to hunger and satiety cues and decreasing responsiveness to food cues. This is different than behavioral weight loss as it targets these internal control mechanisms while behavioral weight loss targets external control mechanisms.

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Personalized Coupons, Recipes and Education Helped Shoppers Make Healthier Food Purchases

we are interested in scaling this work so it can reach more US adults and help them improve their diet quality and diet-related health.

WeightControl.com Interview with:
Maya Vadiveloo, PhD, RD
Assistant Professor
Nutrition and Food Sciences
University of Rhode Island

WeightControl.com: What is the background for this study? What are the main findings?

Response: We conducted this study with the goal of helping people make healthier dietary choices while at the grocery store. We know that food companies use personalized messages and discounts that prompt people to buy unhealthy foods. We tested whether similar approaches could be used to encourage people to buy healthier foods by sending people 2 personalized, healthy food coupons each week to make these foods more affordable. We also wanted our recommendations to reflect people’s dietary preferences, so we only sent people coupons that aligned with preferences they told us at the beginning of the study .

The coupons were directly linked to people’s loyalty cards and they also received a brief nutrition message and recipe via email every week.

Overall, we found that people liked the personalized healthy food incentives, that it prompted them to purchase more healthy foods, and improved the overall diet quality of their grocery purchases.

Mediterranean Diet Linked to Liver Fat Reduction

WeightControl.com Interview with:
Anat Yaskolka Meir RD Ph.D.
Post-doctoral fellow
Department of Epidemiology
Faculty of Health Sciences
Ben-Gurion University, Beer-Sheva, Israel

WeightControl.com: What is the background for this study? What are the main findings?

Response: In the past 15 years, Prof. Shai’s group at the Ben Gurion University of the Negev has conducted several large-scale, long-term clinical trials among over 1000 participants. Results from our previous DIRECT, CASCADE, and CENTRAL trials indicated that the Mediterranean diet is superior to other diets in terms of reducing cardiometabolic risk (e.g., by achieving lower blood lipids levels). Moreover, specific plant components named “polyphenols” (secondary metabolites of plants with antioxidant properties) might associate with this beneficial effect observed. Following the conclusions from these trials, we designed the DIRECT PLUS trial, aimed to examine whether we can enhance the observed and known effect of the Mediterranean diet by adding specific polyphenol-rich food items. Specifically, we enriched the Mediterranean diet, naturally rich in polyphenols, by adding specific components: Mankai aquatic plant (as green shake), walnuts, and green tea, which provided additional 1240 mg polyphenols a day. We also instructed the participants to avoid red and processed meat.

The main finding from this study is that the green Mediterranean diet, the enhanced version of the Mediterranean diet, rich in walnuts, green tea, and Mankai aquatic plant and low in red/processed meat, was the most successful in liver fat reduction. This group showed the greatest reduction of hepatic fat (-39%), as compared to the traditional Mediterranean diet (-20%) and the healthy dietary guidelines (-12%). The results were significant after adjusting for weight loss (currently, the primary treatment for fatty liver). Moreover, the prevalence of non-alcoholic fatty liver diseases was reduced in the green group by 50%.

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How Much Fasting Is Necessary to Lose Weight?

The main findings of this study were a 3% weight loss in 8 weeks in both groups with a 550-calorie restriction (unintentional) and good adherence to both diets.

MedicalResearch.com Interview with:
Sofia Cienfuegos
PhD Candidate, Human Nutrition.
Department of Kinesiology and Nutrition
University of Illinois at Chicago

MedicalResearch.com: What is the background for this study?

Response: Intermittent fasting has been gaining a lot of popularity lately mainly due to a large group of the general population that don’t like to keep tabs on their caloric intake. Intermittent fasting is a safe and effective alternative to weight loss that does not require people consciously restricting calories. Time restricted feeding (TRF) is one specific type of IF that has been gaining a lot of popularity and public interest lately. Previous studies in TRF with the 16/8 method made people want to try and follow this diet strategy achieving promising results. Some people were wondering if shortening the feeding window even further would induce better results in terms of weight loss and cardiometabolic health.

Based on this question, we decided to test two different short time restricted feeding methods (18/6 and 20/4) to see if they could induce even better results in weight and health outcomes. We were also wondering if people were able to stick to these interventions considering the short eating window.

MedicalResearch.com: What are the main findings?

Response: The main findings of this study were a 3% weight loss in 8 weeks in both groups with a 550-calorie restriction (unintentional) and good adherence to both diets. Also, we found significant reductions in insulin resistance and oxidative stress in both intervention groups.

Does Alternate Day Fasting Lead To Better Weight Control?

This JAMA study evaluates alternate day fasting as a means to better weight control and metabolic health. The conclusion:

“Alternate-day fasting did not produce superior adherence, weight loss, weight maintenance, or cardioprotection vs daily calorie restriction.”

Trepanowski JF, Kroeger CM, Barnosky A, Klempel MC, Bhutani S, Hoddy KK, Gabel K, Freels S, Rigdon J, Rood J, Ravussin E, Varady KA. Effect of Alternate-Day Fasting on Weight Loss, Weight Maintenance, and Cardioprotection Among Metabolically Healthy Obese AdultsA Randomized Clinical Trial. JAMA Intern Med. 2017;177(7):930-938. doi:10.1001/jamainternmed.2017.0936

Physical Exercise At Various Tempos Useful For Improving Physical Fitness

Study demonstrates that physical exercise at various tempos is useful for improving physical fitness, developing motor skills, and thus probably preventing obesity complications.

J Endocrinol Invest. 2017 May 20. doi: 10.1007/s40618-017-0689-8. [Epub ahead of print]

Benefits of a regular vs irregular rhythm-based training programme on physical fitness and motor skills in obese girls.

Racil G¹, Elmontassar W^2,³, Rommene I², Tourny C⁴, Chaouachi A², Coquart JB⁴.

DASH Diet Linked To Lower Risk of Gout

A British Medical Journal study concluded “the DASH diet may provide an attractive preventive dietary approach for men at risk of gout”.

Rai Sharan K, Fung Teresa T, Lu Na, Keller Sarah F, Curhan Gary C, Choi Hyon K et al. The Dietary Approaches to Stop Hypertension (DASH) diet, Western diet, and risk of gout in men: prospective cohort study BMJ 2017; 357 :j1794