Caloric-restrictive diets

Medical nutrition therapy is recommended for all patients. For individuals with type 1 DM, the focus is on regulating insulin administration with a balanced diet to achieve and maintain a healthy body weight. A meal plan that is moderate in carbohydrates and low in saturated fat, with a focus on balanced meals is recommended. In addition, patients with type 2 DM often require caloric restriction to promote weight loss. Bedtime and between-meal snacks are not usually needed if pharmacologic management is appropriate. 

Diet/Exercise In initiating treatment for type 2 diabetes, emphasize diet as the primary form of treatment. Caloric restriction and weight loss are essential in the obese diabetic patient. Also, stress the importance of regular physical activity and aid the patient in identifying cardiovascular risk factors and taking corrective measures where possible. 

Most patients with elevated LDL can be managed with a diet restricted in cholesterol and saturated fat but with sufficient calories to achieve and maintain ideal body weight. Total fat calories should be 20-25%, with saturated fats less than 8% and cholesterol less than 200 mg/d. Reductions in serum cholesterol range from 10% to 20% on this regimen. Use of complex carbohydrates and fiber is recommended, and monounsaturated fats should predominate within the fat allowance. Weight reduction and caloric restriction are especially important for patients with elevated VLDL and IDL. Those with hypertriglyceridemia should avoid alcohol. 

Walford RL, Harris SB, Gunion MW. The calorically restricted low-fat nutrient-dense diet in Biosphere 2 significantly lowers blood glucose, total leukocyte count, cholesterol, and blood pressure in humans. Proc Natl Acad Sci USA 1992 89 11533-11537. 

TAC of blood plasma in rats fed an ethanol-supplemented diet increases, although ethanol is known to induce oxidative stress. The effect is due to ethanol-induced purine degradation and increase in the level of uric acid (G2). TAC of blood plasma in critically ill patients with renal dysfunction is augmented, again due to increase in uric acid level (Ml). Caloric restriction, a procedure known to improve the redox status and prolong the life span of mammals, decreases TAC of rat serum (C12). 

Lay publications are inundated with fad diets designed to reduce body weight "quickly and easily" using a variety of caloric restrictions (68). Most individuals attempt to produce a negative energy balance and reduce body weight by decreasing food intake. 

Keenan K, Ballam G, Soper K, et al. (1999) Diet, caloric restriction, and the rodent bioassay. Toxicological Sciences 52 24-34. 

Diet and exercise remain the primary considerations of diabetic patient management. Caloric restriction and weight loss are essential in the obese diabetic. These drugs are an adjunct to, not a substitute for, dietary regulation. In patients with Type-II diabetes who have few or no symptoms... 

Diet (i.e., dietary fat levels) can also have an effect on the disposition and toxicity of PAHs. The metabolism of benzo[a]pyrene in hepatocytes in vitro trom rats fed high-fat (as corn oil) diets was decreased (Zaleski et al. 1991). This effect was not due to a decrease in the activity of AHH. The authors postulated that the high-fat diets allowed benzo[a]pyrene, which is highly lipophilic, to become sequestered in lipid droplets and, therefore, become inaccessible to the P-450 enzymes. Another study suggests that caloric restriction, per se. can reduce the metabolic activation capacity of the liver, thereby reducing the production of mutagenic metabolites from PAHs (Xiao et al. 1993). 

Bough KJ, Valiyil R, Han FT, Eagles DA. Seizure resistance is dependent upon age and caloric restriction in rats fed a ketogenic diet. Epilepsy Res 1999b 35 21-28. 

D-Fructose is the sweetest natural sugar. Its use as a natural sweetener is, therefore, increasing rapidly. It is absorbed slowly from the intestine, and thus does not cause abrupt changes in the serum levels of carbohydrates. It has little, if any, effect on insulin secretion. Thus, it exerts beneficial effects as a component of diets for mild and well-balanced diabetes, but should be taken within caloric restriction,445 as obesity impairs D-glucose tolerance and increases the insulin resistance of peripheral tissue.446 Use of D-fructose in the direct treatment of diabetic ketoacidosis does not offer advantages over routine, fluid therapy, and may even be dangerous on the basis that rapid infusion of large amounts of D-fructose may cause lactate acidosis. 

Kaput, J, Klein, KG, Reyes, EJ, Kibbe, WA, Cooney, CA, Jovanovic, B, Visek, WJ, and Wolff, GL, Identification of genes contributing to the obese yellow avy phenotype caloric restriction, genotype, diet x genotype interactions. Physiol Genomics, 2004. 18(3) 316-324. 

Effects of a low dose of dietary resveratrol that partially mimics caloric restriction and retards aging parameters in mice were investigated [82]. Mice from middle age (14-months) to old age (30-months) were fed with control diet (84kcal/mouse/week), diet with low-dose trans-resveratrol (4.9mg/kg feed/day), or energy restricted (CR 63kcal/mouse/week) diet and their genome-vfide transcriptional profiles were evaluated. A transcriptional overlap of CR and resveratrol was found in the heart, skeletal muscle, and brain neocortex. Both dietary interventions inhibited gene expression... 

Keys A, Menotti A, Karvonen MJ, et al. The diet and 15-year death rate in the seven countries study. Am f Epidemiol. 1986 124(6) 903 —915. Willcox BJ, Willcox DC, Todoriki H, et al. Caloric restriction, the traditional Okinawan diet, and healthy aging the diet of the world s longest-lived people and its potential impact on morbidity and life span. Ann N Y Acad Sci. 2007 1114 434-455. 

Many possible mechanisms for the effect of fat on the process of cancer have been suggested, but to date, no clear mechanism is known (Pariza, 1988 Council for Agricultural Science and Technology, 1991). Complicating the fat/cancer connection further is evidence that caloric restriction decreases cancer risk. A review of caloric restriction studies shows a greater incidence of tumor development on high calorie/low fat diets compared to low calorie/high fat diets (Albanes, 1987). The question arises if it is fat per se or calories in the diet, or both, which influence cancer development. 

Wartime rationing causing a considerable caloric restriction resulted in most cases in lower cholesterol levels, while the frequency of both atherosclerosis and toxemia of pregnancy was reduced. Obviously the qualitative changes in the diet cannot be neglected, and the reduced intake of animal... 

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