Other Dietary Strategies for Weight Loss & Nutritional Supplements

Question 1

The Mediterranean Diet?

Answer 1

• Epidemiological studies report increased longevity and reduced morbidity in Mediterranean countries versus North America & Northern Europe
– Attributed to dietary pattern
– Adherence to these dietary patterns has started to decline as these nations have westernized (increasing prevalence of obesity)

Question 2

is the ideal protein a ketogenic diet?

Answer 2

no, starvation diet

Question 3

What is the Mediterranean Diet?

Answer 3

The Mediterranean diet is not so much a specific
diet but a dietary pattern
– High consumption of plant-based foods (e.g. fruits,
vegetables, legumes, nuts, etc.)
– Seasonally fresh and locally grown foods
– Extra virgin olive oil as the primary source of dietary lipid
– Moderate intake of wine (red)
– Fresh fish & seafood
– Moderate consumption of dairy products, poultry, &
eggs
– Low consumption of red and processed meat

looks like Canada food guide w/ fish, wine, olive oil

Question 4

Why Might the Mediterranean Diet

be a more Healthful Diet?

Answer 4

• Quality of fat (diet is low in saturated and trans fats,
but high in monounsaturated fats)
• Diet may increase satiety (still debated whether fat is
more satiating than carbs)
• High use of olive oil and legumes enhances palatability
of the diet (increased consumption of foods high in
dietary fibre and low in energy density)
• Diets rich in monounsaturated fat improve glucose
homeostasis (important in obesity/type 2 diabetes)

Question 5

What Does the Epidemiological Data Tell Us?

Answer 5

Prospective Studies of Cardiovascular Disease

a lot of better cardiovascular benefit attributed to those who consume these diets.
does not cause harm

Question 6

Studies of Obesity
• 18 clinical study-based systematic review (Bendall CL
et al. Critical Reviews in Food Science and Nutrition.
2017.)
– 8 incorporated a Mediterranean diet with energy restriction
– High level of heterogeneity between the Mediterranean diet
interventions
• Obesity outcomes measured

Answer 6

– Waist circumference (16 out of 18) – 12 reported reductions in waist circumference
– Waist-hip ratio (5 out of 18) – 1 reported reductions in waisthip ratios
– Visceral fat (2 out of 18) – both reported reductions in visceral fat mass

Question 7

The Gluten-Free Diet (GFD)

Answer 7

• Gluten is a family of proteins found within grains (e.g.
wheat, rye, barley)
– Present in the endosperm (gliadins and glutenins)
– Regular western diet typically involves consumption of 10-20
g/day
• Gluten-free dieting is simply restricting the consumption of food products containing gluten
• Gluten substitutes include the following;
– Quinoa
– Amaranth
– Sorghum
– Flax
– Chickpeas
rice and corn not nutrient dense

athletes believe it is better

Question 8

The GFD is used as a dietary

strategy/intervention for the following;

Answer 8

– Celiac Disease (CD, chronic inflammatory bowel
disease triggered by gluten)
– Non-celiac gluten/wheat sensitivity (NCGS)
– Wheat allergy
• Pancreatic peptidases fail to significantly digest
peptides rich in proline & glutamine
– These peptides may reach subepithelial regions in the
small intestinal mucosa of people with celiac disease
(CD)

Question 9

____ per kg of product is the cutoff in
Canada/USA to describe a product as “glutenfree”
•____ gluten per day = adverse morphological
effects
• >0.015 mg gluten per day = adverse clinical
effects

Answer 9

20mg

>0.4 mg

Question 10

• Pathogenesis of Celiac disease involves the following;

Answer 10

Exposure to immunogenic gliadin peptides leads to a cascade of changes in both the surface epithelium and lamina propria through immune-mediated mechanisms (innate & adaptive)
– Increased IL-15 increases recruitment of cytotoxic intraepithelial lymphocytes
– Gliadin becomes more immunogenic once it reaches the lamina propria and is deaminated by tissue transglutaminase
• Diagnosis of Celiac Disease
– Positive Celiac Disease-specific serology
– Small bowel biopsy specimens with characteristic histological features
– Positive response to a gluten-free diet

Question 11

Some studies suggest that GFD consumption in people
with celiac disease (CD) increases body weight gain
why?

Answer 11

– Improved absorption of nutrients
– Reduced stomach discomfort
eat more food

188 people with CD met the criteria, majority gained
weight regardless of starting BMI when consuming GFD for 2 years
– No retrospective analysis of dietary advice & caloric intake

Question 12

The GFD & Heart Disease

Answer 12

Prospective cohort study of >60,000
women and >40,000 men without CD
studied from 1986-2012 assessing
gluten intake & cardiovascular risk
– Food frequency questionnaires every
4 years
• Estimated gluten consumption was
associated with a lower risk of coronary
heart disease (HR = 0.85)

Question 13

Intermittent Fasting

Answer 13

• Voluntary abstinence from food & drink
• Many different forms
• Striking evidence in preclinical studies suggests that
intermittent fasting has numerous health benefits

Question 14

know types of intermittent fasting (not religious ones)

Answer 14

see slide 23

type it in directly to search

Question 15

Potential Salutary Mechanisms

Associated w/ Intermittent Fasting

Answer 15

So your circadian rhythm is disrupted and how you metabolize your nutrients optimally.
And so stop that intermittent fasting will realign your circadian clock and that is thought to possibly due to alterations in your gut microbiome
So the bacteria in the gut flora that living your GI tract that intermittent fasting may modify the types of bacteria there and that will rely on your circadian rhythm.

Ultimately, leading to improve blood sugar control lower insulin lower blood lipids and anti inflammatory reactions

another mech is browning of adipose tissue
ntermittent fasting may promote weight loss and
improve metabolic health through altering gut microbiota
metabolism and subsequent browning of adipose tissue