Patient freedom to choose a weight loss diet in the treatment of overweight and obesity: a randomized dietary intervention in type 2 diabetes and pre-diabetes

BackgroundOffering the overweight or obese patient the option of choosing from a selection of weight loss diets has not been investigated in type 2 diabetes. The aim of the study was to investigate if the option to choose from, and interchange between a selection of diets (&ldquo;Choice&rdquo;), as opposed to being prescribed one set diet (&ldquo;No Choice&rdquo;), improves drop out rates and leads to improved weight loss and cardio-metabolic outcomes.MethodsThe study was a 12 month, randomized parallel intervention. A total of 144 volunteers with type 2 diabetes or pre-diabetes and a BMI &gt;27 were randomized to &ldquo;No Choice&rdquo; or &ldquo;Choice&rdquo;. Those in the No Choice group were placed on a set weight loss diet (CSIRO) with no change permitted. Those in the Choice group could choose from, and interchange between, the CSIRO, South Beach or Mediterranean diets.ResultsThere were no differences in attrition rates or weight loss between the &ldquo;Choice&rdquo; and &ldquo;No Choice&rdquo;. In a secondary analysis of the intention-to-treat weight loss data with last measured weight carried forward gave a highly significant diet group by time by gender interaction (p&thinsp;=&thinsp;0.002) with men doing better in the No Choice group overall (maximum difference &ldquo;No Choice &ldquo;-2.9&thinsp;&plusmn;&thinsp;4.6 kg vs. &ldquo;Choice&rdquo;-6.2 kg&thinsp;&plusmn;&thinsp;5.3 kg at 6 months) and women doing better in the Choice group overall (maximum difference Choice -3.1&thinsp;&plusmn;&thinsp;3.7 kg vs. &ldquo;No Choice&rdquo; -2.0 kg&thinsp;&plusmn;&thinsp;2.6 kg at 6 months).ConclusionsMen prefer direction in their weight loss advice and do less well with choice. A gender-specific approach is recommended when prescribing weight loss diets.Trial registrationanzctr.org.au ACTRN12612000310864.<br /

Increased susceptibility of airway epithelial cells from ataxia-telangiectasia to S. pneumoniae infection due to oxidative damage and impaired innate immunity

Respiratory disease is a major cause of morbidity and mortality in patients with ataxia-telangiectasia (A-T) who are prone to recurrent sinopulmonary infections, bronchiectasis, pulmonary fibrosis, and pulmonary failure. Upper airway infections are common in patients and S. pneumoniae is associated with these infections. We demonstrate here that the upper airway microbiome in patients with A-T is different from that to healthy controls, with S. pneumoniae detected largely in patients only. Patient-specific airway epithelial cells and differentiated air-liquid interface cultures derived from these were hypersensitive to infection which was at least in part due to oxidative damage since it was partially reversed by catalase. We also observed increased levels of the pro-inflammatory cytokines IL-8 and TNF-α (inflammasome-independent) and a decreased level of the inflammasome-dependent cytokine IL-β in patient cells. Further investigation revealed that the ASC-Caspase 1 signalling pathway was defective in A-T airway epithelial cells. These data suggest that the heightened susceptibility of these cells to S. pneumoniae infection is due to both increased oxidative damage and a defect in inflammasome activation, and has implications for lung disease in these patients

Author Correction: Increased susceptibility of airway epithelial cells from ataxia-telangiectasia to S. pneumoniae infection due to oxidative damage and impaired innate immunity

An amendment to this paper has been published and can be accessed via a link at the top of the paper