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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition and Public Health".

Deadline for manuscript submissions: closed (31 December 2022) | Viewed by 53224

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Dr. Sousana Papadopoulou

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Department of Nutritional Sciences and Dietetics, Faculty of Health Sciences, International Hellenic University, 57001 Thessaloniki, Greece
Interests: nutrition; anthropometry; physical activity; diet
Special Issues, Collections and Topics in MDPI journals

Dr. Pantelis T. Nikolaidis

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School of Health and Caring Sciences, University of West Attica, Athens, Greece

Special Issue Information

Dear Colleagues,

Recently, it has been observed that diets low in carbohydrates (CHO) are more effective in optimizing blood pressure than those high in CHO. In addition, the beneficial role of diets high in protein (PRO) in metabolic disease has also been highlighted. In parallel, it has been shown that diets high in fiber (FIB) have the ability to aid against westernized diseases (e.g., cancers, cardiovascular disease, diabetes, and obesity). Currently, there is limited evidence on the combined effects of a high FIB/high PRO/low CHO diet on human performance and disease.

The aim of this Special Issue is to provide up-to-date knowledge on the impact of a high FIB/high PRO/low CHO diet on human performance and disease prevention and treatment in order to provide practical applications for a wide range of health professionals (exercise physiologists, nutritionists, physicians, and psychologists). We welcome different types of manuscript submissions, including original research articles and up-to-date reviews (systematic reviews and meta-analyses).

Dr. Sousana Papadopoulou
Dr. Pantelis T. Nikolaidis
Guest Editors

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Keywords

Cardiovascular disease
Dietary strategy
Exercise
Glycemic control
Macronutrient
Metabolic syndrome
Obesity
Physical activity
Physical fitness
Protein-to-carbohydrate dietary ratio
Sarcopenia
Alzheimer
Diabetes mellitus
Cancer
Cystic fibrosis
Multiple sclerosis
Anxiety disorders
Epilepsy
Non-alcoholic fatty liver
Intestinal diseases

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Published Papers (10 papers)

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Editorial

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4 pages, 226 KiB

Open AccessEditorial

Low-Carbohydrate Diet and Human Health

by Sousana K. Papadopoulou and Pantelis T. Nikolaidis

Nutrients 2023, 15(8), 2004; https://doi.org/10.3390/nu15082004 - 21 Apr 2023

Cited by 3 | Viewed by 3673

Abstract

Low-carbohydrate diets were initially recommended as a therapeutic dietary scheme for epilepsy, while increasing evidence suggests their potential application in the management of several other pathologies, such as diabetes, neoplasms, gastrointestinal and lung diseases, diseases of the cardiovascular system, as well as obesity [...] Read more.

(This article belongs to the Special Issue Low Carbohydrate Diet and Human Health)

Research

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14 pages, 1171 KiB

Open AccessArticle

The Effect of a Low-Carbohydrate High-Fat Diet on Laboratory Parameters in Women with Lipedema in Comparison to Overweight/Obese Women

by Małgorzata Jeziorek, Andrzej Szuba, Monika Sowicz, Agnieszka Adaszyńska, Krzysztof Kujawa and Angelika Chachaj

Nutrients 2023, 15(11), 2619; https://doi.org/10.3390/nu15112619 - 2 Jun 2023

Cited by 8 | Viewed by 4518

Abstract

The aim of this study was to evaluate alterations in blood parameters after a low-carbohydrate high-fat (LCHF) diet in women with lipedema in comparison to overweight or obese women. A total of 115 women were classified into two groups: the lipedema group and the overweight/obesity group. Both study groups followed the caloric-restricted LCHF diet for 7 months. A total of 48 women completed the study. A reduction in body weight was observed in both study groups. A significant decrease in triglycerides and an increase in HDL-C concentrations were observed in both study groups. Despite the increase in the concentration of LDL-C observed in the lipedema group, changes in LDL-C differed between individual patients. Improvements in liver parameters, glucose tolerance, and a decrease in fasting insulin levels were observed, although they were less pronounced in the lipedema group than in the overweight/obesity group. Kidney and thyroid functions were similar before and after the LCHF diet in both groups. The LCHF diet may be a valuable nutritional strategy for lipedema and overweight/obese women, with a beneficial effect on weight, glucose profile, liver function, the concentration of triglycerides, and HDL-C and with no effect on kidney and thyroid function. Full article

(This article belongs to the Special Issue Low Carbohydrate Diet and Human Health)

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12 pages, 299 KiB

Open AccessArticle

Impact of Christian Orthodox Church Fasting on Metabolic Syndrome Components in Adults Aged 18–49 Years

by Anna Kokkinopoulou, Nikolaos E. Rodopaios, Alexandra-Aikaterini Koulouri, Eleni Vasara, Sousana K. Papadopoulou, Petros Skepastianos, Emmanouil Dermitzakis, Maria Hassapidou and Anthony G. Kafatos

Nutrients 2023, 15(7), 1755; https://doi.org/10.3390/nu15071755 - 4 Apr 2023

Cited by 3 | Viewed by 2074

Abstract

Objective: Studies regarding health effects of religious fasting have been increased during the last decade. Our aim was to investigate the effects of Christian Orthodox Church (COC) fasting on metabolic syndrome in young adults. Methods: Participants were 224 men and women, of whom 111 had been following the COC fasting regime and 113 were non-fasters, all aged 18 to 49 years (mean age 29.23 ± 8.78 years). Anthropometric measurements, including the Bioelectrical Impedance Analysis, were performed on individuals, and they also completed food intake questionnaires, and provided blood samples for biochemical analysis. Metabolic syndrome was defined according to criteria of the National Cholesterol Education Program-Adult Treatment Panel III and all variables were checked. Results: Fasters did not statistically differ in anthropometric measurements when comparing to non-fasters. Differences were found in terms of biochemical variables, and more specific in HDL cholesterol, LDL cholesterol and total blood cholesterol, and in systemic and diastolic blood pressure, although non statistically significant. Statistically significant differences were only noticed in heart pulses and insulin levels, with fasters having lower heart pulses (69.44 ± 9.84 versus 72.63 ± 10.74) and greater mean values of insulin levels (4.16 ± 4.66 versus 3.12 ± 2.35). When analysis was carried to identify which variables were met for metabolic syndrome, it was found that fasters had statistically significant lower values of blood pressure when compared to non-fasters. In more details mean systolic blood pressure was 121.67 ± 12.21 versus 123.41 ± 11.73 for fasters and non-fasters respectively, and mean diastolic blood pressure was 75.77 ± 8.82 versus 78.27 ± 10.07 for fasters and non-fasters. Furthermore, the mean energy intake was higher in non-fasters (1698.25 ± 515.99 kcals) when compared to fasters (1590.24 ± 404.19 kcals) but not statistically significant different. Conclusions: Young adults aged 18 to 49 years who fast according to the COC fasting regimes do not have different metabolic syndrome prevalence when comparing to non-fasters, but there was a statistically significant difference in the prevalence of elevated blood pressure with fasters having lower values. Full article

(This article belongs to the Special Issue Low Carbohydrate Diet and Human Health)

14 pages, 323 KiB

Open AccessArticle

Community Assessment for a Low-Carbohydrate Nutrition Education Program in South Africa

by Georgina Pujol-Busquets, James Smith, Sergi Fàbregues, Anna Bach-Faig and Kate Larmuth

Nutrients 2023, 15(1), 67; https://doi.org/10.3390/nu15010067 - 23 Dec 2022

Cited by 2 | Viewed by 3439

Abstract

Eat Better South Africa (EBSA) is an organization that provides low-carbohydrate, high-fat (LCHF) nutrition and health education programs for women from under-resourced South African communities. Community assessments are essential to explore participants’ potential facilitators and challenges of adhering to new dietary behaviours and should be implemented before any dietary interventions. This study is a qualitative community assessment to enable the EBSA program to better meet potential participants’ needs and explore their willingness to enrol in the EBSA program. Sixty women from two communities in the Western Cape were interviewed through six focus group discussions. A thematic analysis was conducted using NVivo 12 software, and four themes were developed around the women’s (1) role within the households; (2) dietary behaviour; (3) health perceptions; and (4) willingness to participate in an LCHF program. Women mentioned that they were responsible for cooking and shopping for their households. They expressed their understanding of healthy and unhealthy behaviours and their dietary patterns. Some women showed concerns about LCHF diets, but others wanted to learn more due to their knowledge of other people’s positive experiences with the diet. There was a general desire to become healthy. However, the women anticipated dietary behaviour change to be challenging. Those challenges mostly revolved around their socioeconomic environments. The findings are intended to inform EBSA (or other nutrition interventions) on what to consider when implementing their interventions in these communities. Full article

(This article belongs to the Special Issue Low Carbohydrate Diet and Human Health)

11 pages, 264 KiB

Open AccessArticle

Assessing the Nutrient Status of Low Carbohydrate, High-Fat (LCHF) Meal Plans in Children: A Hypothetical Case Study Design

by Caryn Zinn, Kayla-Anne Lenferna De La Motte, Amy Rush and Rebecca Johnson

Nutrients 2022, 14(8), 1598; https://doi.org/10.3390/nu14081598 - 12 Apr 2022

Cited by 4 | Viewed by 7607

Abstract

There is well-established evidence for low-carbohydrate, high-fat (LCHF) diets in the management of chronic health conditions in adults. The natural next step is to understand the potential risks and benefits of LCHF diets for children, where they may have useful applications for general health and a variety of chronic health conditions. It is vital that any diet delivers sufficient micronutrients and energy to ensure health, wellbeing, and growth. This descriptive study assesses the nutrient and energy status of LCHF sample meal plans for children. We designed four meal plans for hypothetical weight-stable male and female children (11 years) and adolescents (16 years). Carbohydrates were limited to ≤80 g, protein was set at 15–25% of the total energy, and fat supplied the remaining calories. Using FoodWorks dietary analysis software, data were assessed against the national Australian/New Zealand nutrient reference value (NRV) thresholds for children and adolescents. All meal plans exceeded the minimum NRV thresholds for all micronutrients; protein slightly exceeded the AMDR recommendations by up to three percentage points. This study demonstrates that LCHF meal plans can be energy-, protein-, and micronutrient-replete for children and adolescents. As with any dietary approach, well-formulated meals and careful planning are key to achieving the optimal nutrient status. Full article

(This article belongs to the Special Issue Low Carbohydrate Diet and Human Health)

Review

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22 pages, 1835 KiB

Open AccessReview

The Relationship of Ketogenic Diet with Neurodegenerative and Psychiatric Diseases: A Scoping Review from Basic Research to Clinical Practice

by Maria Mentzelou, Antonios Dakanalis, Georgios K. Vasios, Maria Gialeli, Sousana K. Papadopoulou and Constantinos Giaginis

Nutrients 2023, 15(10), 2270; https://doi.org/10.3390/nu15102270 - 11 May 2023

Cited by 10 | Viewed by 12263

Abstract

Background: The ketogenic diet (KD) has become widespread for the therapy of epileptic pathology in childhood and adulthood. In the last few decades, the current re-emergence of its popularity has focused on the treatment of obesity and diabetes mellitus. KD also exerts anti-inflammatory and neuroprotective properties, which could be utilized for the therapy of neurodegenerative and psychiatric disorders. Purpose: This is a thorough, scoping review that aims to summarize and scrutinize the currently available basic research performed in in vitro and in vivo settings, as well as the clinical evidence of the potential beneficial effects of KD against neurodegenerative and psychiatric diseases. This review was conducted to systematically map the research performed in this area as well as identify gaps in knowledge. Methods: We thoroughly explored the most accurate scientific web databases, e.g., PubMed, Scopus, Web of Science, and Google Scholar, to obtain the most recent in vitro and in vivo data from animal studies as well as clinical human surveys from the last twenty years, applying effective and characteristic keywords. Results: Basic research has revealed multiple molecular mechanisms through which KD can exert neuroprotective effects, such as neuroinflammation inhibition, decreased reactive oxygen species (ROS) production, decreased amyloid plaque deposition and microglial activation, protection in dopaminergic neurons, tau hyper-phosphorylation suppression, stimulating mitochondrial biogenesis, enhancing gut microbial diversity, restoration of histone acetylation, and neuron repair promotion. On the other hand, clinical evidence remains scarce. Most existing clinical studies are modest, frequently uncontrolled, and merely assess the short-term impacts of KD. Moreover, several clinical studies had large dropout rates and a considerable lack of compliance assessment, as well as an increased level of heterogeneity in the study design and methodology. Conclusions: KD can exert substantial neuroprotective effects via multiple molecular mechanisms in various neurodegenerative and psychiatric pathological states. Large, long-term, randomized, double-blind, controlled clinical trials with a prospective design are strongly recommended to delineate whether KD may attenuate or even treat neurodegenerative and psychiatric disease development, progression, and symptomatology. Full article

(This article belongs to the Special Issue Low Carbohydrate Diet and Human Health)

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16 pages, 1313 KiB

Open AccessReview

Christian Orthodox Fasting as a Traditional Diet with Low Content of Refined Carbohydrates That Promotes Human Health: A Review of the Current Clinical Evidence

by Constantinos Giaginis, Maria Mantzorou, Sousana K. Papadopoulou, Maria Gialeli, Andreas Y. Troumbis and Georgios K. Vasios

Nutrients 2023, 15(5), 1225; https://doi.org/10.3390/nu15051225 - 28 Feb 2023

Cited by 5 | Viewed by 3164

Abstract

Introduction: Christian Orthodox fasting is a pattern high in complex carbohydrates and low in refined carbohydrates. It has been explored in association with its potential health benefits. The present review aims to comprehensively explore the existing available clinical data concerning the potential favorable impact of the dietary pattern of Christian Orthodox fasting on human health. Methods: PubMed database, Web of Science and Google Scholar were extensively searched in order to identify the more appropriate clinical studies that explore the effect of Christian Orthodox fasting on health-related outcomes in humans utilizing relative keywords. We initially retrieved 121 records through database searching. After applying several exclusion criteria, 17 clinical studies were finally included in this review study. Discussion: Christian Orthodox fasting showed beneficial effects concerning glucose and lipid control, whereas the data for blood pressure remain inconclusive. Concerning weight control, fasters were characterized by lower body mass and lower caloric intake in the course of the fasting periods. During fasting, this pattern is higher in fruits and vegetables, showing the absence of dietary deficiencies for iron and folate. Nevertheless, dietary deficiencies were recorded for calcium and vitamin B2, and also hypovitaminosis D has been noticed in monks. Interestingly, the vast majority of monks do present with both good quality of life and mental health. Conclusions: Overall, Christian Orthodox fasting is a dietary pattern low in refined carbohydrates and high in complex carbohydrates and fiber that may be beneficial for human health promotion and chronic disease prevention. However, further studies are strongly recommended on the impact of long-term religious fasting on HDL cholesterol levels and blood pressure. Full article

(This article belongs to the Special Issue Low Carbohydrate Diet and Human Health)

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Other

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19 pages, 2203 KiB

Open AccessStudy Protocol

Effectiveness of a Digitally Delivered Continuous Care Intervention (Defeat Diabetes) on Type 2 Diabetes Outcomes: A 12-Month Single-Arm, Pre–Post Intervention Study

by Despina Kolivas, Liz Fraser, Ronald Schweitzer, Peter Brukner and George Moschonis

Nutrients 2023, 15(9), 2153; https://doi.org/10.3390/nu15092153 - 30 Apr 2023

Viewed by 2968

Abstract

Low-carbohydrate dietary approaches can lead to improvements in blood glucose levels and weight loss, as well as a reduction and/or cessation in medication use in people with type 2 diabetes (T2D). Recent technological advances have led to the development of health-related applications (apps), including a high proportion dedicated to the management of diabetes. The Defeat Diabetes Program is a smartphone- and web-based app that provides guidance on a low-carbohydrate dietary approach for T2D and was designed to be used in conjunction with standard care in the medical management of T2D. The primary aim of this protocol is to provide the rationale and design of a single-arm 12-month pre–post intervention clinical trial using the Defeat Diabetes Program in an Australian community-based cohort of people with T2D who were referred by their general practitioner (GP). The study seeks to engage the GP community to help demonstrate whether the results of using a low-carbohydrate dietary approach for T2D can be achieved by the Defeat Diabetes Program in their patients. This protocol describes (1) the rationale for the selection of primary and secondary outcome measures, (2) the sampling procedures and methodological steps used to identify eligible participants and collect data, and (3) the approach followed to involve and educate GPs to support the trial. Full article

(This article belongs to the Special Issue Low Carbohydrate Diet and Human Health)

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17 pages, 640 KiB

Open AccessEditor’s ChoiceSystematic Review

Mediterranean Diet and Sarcopenia Features in Apparently Healthy Adults over 65 Years: A Systematic Review

by Sousana K. Papadopoulou, Paraskevi Detopoulou, Gavriela Voulgaridou, Despoina Tsoumana, Maria Spanoudaki, Faviola Sadikou, Vasiliki G. Papadopoulou, Christiana Zidrou, Ioanna P. Chatziprodromidou, Constantinos Giaginis and Pantelis Nikolaidis

Nutrients 2023, 15(5), 1104; https://doi.org/10.3390/nu15051104 - 22 Feb 2023

Cited by 29 | Viewed by 3976

Abstract

Low muscle mass combined with changes in physical function and muscle quality is defined as sarcopenia. In people > 60 years, sarcopenia reaches 10% and tends to increase with age. Individual nutrients, such as protein, may have a protective role against sarcopenia, but recent evidence suggests that protein alone has been ineffective in increasing muscle strength. Dietary patterns, instead, with a high “anti-inflammatory” potential, such as the Mediterranean dietary pattern, have been considered as an emerging dietary remedy against sarcopenia. The aim of this systematic review was to summarize the evidence of the role of Mediterranean diet in sarcopenia prevention and/or improvement, including recent data, in healthy elders. We searched published studies about sarcopenia and the Mediterranean diet until December 2022 in Pubmed, Cochrane, Scopus search engine and grey literature. In total, ten articles were identified as relevant: four cross-sectional studies and six prospective. No clinical trial was identified. Only three studies assessed sarcopenia presence and four measured muscle mass, which is an essential criterion in sarcopenia diagnosis. Mediterranean diet adherence had, in general, a positive role in muscle mass and muscle function, while the results were less clear with regard to muscle strength. Additionally, there was no evidence of a positive effect of the Mediterranean diet on sarcopenia. There is a need for conduction of clinical trials in order to reach cause–effects conclusions regarding the importance of the Mediterranean diet in sarcopenia prevention and management in Mediterranean and non-Mediterranean populations. Full article

(This article belongs to the Special Issue Low Carbohydrate Diet and Human Health)

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18 pages, 1055 KiB

Open AccessSystematic Review

Effect of Ketogenic Diet on Quality of Life in Adults with Chronic Disease: A Systematic Review of Randomized Controlled Trials

by Myriam Abboud, Fatme AlAnouti, Evridiki Georgaki and Dimitrios Papandreou

Nutrients 2021, 13(12), 4463; https://doi.org/10.3390/nu13124463 - 14 Dec 2021

Cited by 11 | Viewed by 7604

Abstract

Background: Chronic diseases adversely affect quality of life (QOL). The ketogenic diet (KD) may improve the QOL. Objective: The aim of this systematic review was to summarize the available evidence of randomized controlled trials (RCTs) to establish the effect of KD on the QOL in adults with chronic diseases. Methods: Reporting followed PRISMA guidelines. We included randomized controlled trials (RCTs) conducted on adults with chronic disease including an intervention group that received KD and a control group, and where QOL was reported as outcome. We searched PubMed, APA PsycInfo, EMBASE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Cochrane Library, and Clinicaltrials.gov, and the references of the included articles and previous relevant reviews, without language or time restrictions. We critically appraised included studies and narratively synthesized their findings. Results: Nine RCTs were included. The risk of bias was low, except of allocation concealment and blinding. In patients with cancer: one RCT found an improvement in overall QOL, another reported improved physical component summary, and one found no superiority of KD in all QOL domains. In patients with neurological disorders: improved QOL was reported in Alzheimer’s disease patients, whereas no difference in mental and physical health QOL was noted in patients with multiple sclerosis. In patients with obesity and type II diabetes: one RCT reported superiority of energy-restricted KD in improving role functioning, mental health, health perceptions, and pain compared with guideline-based diet, whereas in another RCT, high and low carbohydrate diets achieved comparable improvements. Among patients with knee osteoarthritis, no differences between KD and low-fat groups were noted. Dietary compliance with the KD, reported in three studies, was shown to be high. Side effects were mostly noted during the first weeks of intervention, and adverse events were not markedly different with KD and the comparison diet. Conclusions: The evidence from RCTs investigating the effect of KD on QOL in adults with chronic disease is inconclusive. The promising effect noted in some included studies and the low rates of adverse events and side effects encourage future investigations in this regard. Full article

(This article belongs to the Special Issue Low Carbohydrate Diet and Human Health)

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