Lifestyle intervention strategies for diabetes management

The inexorable rise of type 2 diabetes (T2D) worldwide is a serious public health problem with significant health and socioeconomic costs. Diabetes- related complications are underpinned by poor glycaemic control that is greatly influenced by diet composition. Sustainable lifestyle modifications in diet and physical activity form the cornerstone of T2D prevention and management. Energy- restricted, high unrefined carbohydrate, low fat (HC) diets have traditionally been recommended for the dietary management of T2D. However, accumulating nutrition research indicate that carbohydrate restriction and higher intakes of protein and unsaturated fats, improve glycaemic control and reduce cardiovascular disease (CVD) risk markers. Based on this evidence, a novel dietary approach incorporating a very low carbohydrate, high unsaturated fat/ low saturated fat (LC) diet was designed. This LC diet was nutritionally adequate, with the potential to improve glycaemic control and mitigate CVD risk to a greater extent than the traditional HC diet. This thesis discusses the findings of a large, well- controlled, randomised, clinical trial that compared the long- term effects of consuming a traditional HC diet with an energy- matched LC diet, on a range of health outcomes including glycaemic control and CVD risk markers. Both diets were delivered as part of a holistic lifestyle intervention that included a structured exercise program. After one year, both diets achieved substantial weight loss, and reduced blood pressure, HbA1c, fasting glucose and LDL-C. However, the LC diet sustained greater reductions in diabetes medication and glycaemic variability, as well as triglycerides (TAG), and greater increases in HDL-C. Both diets had similar changes in renal and cognitive outcomes, suggesting that the LC diet did not adversely affect renal or cognitive function. These results have important implications for the lifestyle management of T2D with direct relevance to achieving better health outcomes and reducing healthcare costs.Thesis (Ph.D.) (Research by Publication) -- University of Adelaide, School of Medicine, 2016

Child adoption in Singapore.

The issue of adoption has been covered in the local media before. Women lifestyle magazines like Her World, and even the national paper, The Straits Times, have covered only certain aspects of adoption. Authors hoped to give readers a more in-depth and alternative coverage than what has been done before in the local media.Bachelor of Communication Studie

Metabolic effects of weight loss on a very-low-carbohydrate diet compared with an isocaloric high-carbohydrate diet in abdominally obese subjects

Copyright © 2008 by the American College of Cardiology FoundationObjectivesThis study was designed to compare the effects of an energy-reduced, isocaloric very-low-carbohydrate, high-fat (VLCHF) diet and a high-carbohydrate, low-fat (HCLF) diet on weight loss and cardiovascular disease (CVD) risk outcomes.BackgroundDespite the popularity of the VLCHF diet, no studies have compared the chronic effects of weight loss and metabolic change to a conventional HCLF diet under isocaloric conditions.MethodsA total of 88 abdominally obese adults were randomly assigned to either an energy-restricted (approximately 6 to 7 MJ, 30% deficit), planned isocaloric VLCHF or HCLF diet for 24 weeks in an outpatient clinical trial. Body weight, blood pressure, fasting glucose, lipids, insulin, apolipoprotein B (apoB), and C-reactive protein (CRP) were measured at weeks 0 and 24.ResultsWeight loss was similar in both groups (VLCHF -11.9 +/- 6.3 kg, HCLF -10.1 +/- 5.7 kg; p = 0.17). Blood pressure, CRP, fasting glucose, and insulin reduced similarly with weight loss in both diets. The VLCHF diet produced greater decreases in triacylglycerols (VLCHF -0.64 +/- 0.62 mmol/l, HCLF -0.35 +/- 0.49 mmol/l; p = 0.01) and increases in high-density lipoprotein cholesterol (HDL-C) (VLCHF 0.25 +/- 0.28 mmol/l, HCLF 0.08 +/- 0.17 mmol/l; p = 0.002). Low-density lipoprotein cholesterol (LDL-C) decreased in the HCLF diet but remained unchanged in the VLCHF diet (VLCHF 0.06 +/- 0.58 mmol/l, HCLF -0.46 +/- 0.71 mmol/l; p ConclusionsUnder isocaloric conditions, VLCHF and HCLF diets result in similar weight loss. Overall, although both diets had similar improvements for a number of metabolic risk markers, an HCLF diet had more favorable effects on the blood lipid profile. This suggests that the potential long-term effects of the VLCHF diet for CVD risk remain a concern and that blood lipid levels should be monitored. (Long-term health effects of high and low carbohydrate, weight loss diets in obese subjects with the metabolic syndrome; http://www.anzctr.org.au; ACTR No. 12606000203550).Jeannie Tay, Grant D. Brinkworth, Manny Noakes, Jennifer Keogh and Peter M. Cliftonhttp://www.elsevier.com/wps/find/journaldescription.cws_home/505766/description#descriptio