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The ketogenic diet (KD) has gained popularity due to its ability to improve type 2 diabetes, weight loss, antioxidant and anti-inflammatory activity. However, long-term use of the KD might not be safe due to its adverse effects. This study examined the effects of the KD alone or in combination with Zamzam water (holy water for Muslims) on glucose homeostasis, lipid parameters and oxidant-antioxidant variables in rats.

Based on the diet given for ten weeks, three groups of adult male Wistar rats were made (12 rats/group): (1) rats which fed on a chow diet and ordinary water, (2) rats which fed on KD and ordinary water and (3) rats which were given KD along with Zamzam. Fasting blood glucose (FBG), serum insulin, insulin resistance (HOMA-IR), LDL cholesterol, HDL cholesterol, superoxide dismutase and malondialdehyde were compared by one-way ANOVA followed by post-hoc Tukey’s HSD test among groups.

Rats which fed on KD and Zamzam water had significantly reduced FBG and LDL cholesterol compared to the rats which fed on a chow diet and ordinary water (p-values 0.001), and KD and ordinary water (p-value 0.004 and 0.006, respectively). Serum insulin, insulin resistance, HDL cholesterol, superoxide dismutase and malondialdehyde did not differ significantly.

Consumption of KD along with Zamzam for ten weeks significantly reduces FBG and LDL cholesterol. KD alone does not decrease these parameters in ten weeks duration.

Renal failure is an end-stage consequence after persistent hyperglycemia during diabetic nephropathy (DN), and the etiology of DN has been linked to oxidative stress. The purpose of this research was to determine the beneficial synergistic effects of S-Allyl Cysteine (SAC) and Taurine (TAU) on oxidative damage in the kidneys of type 2 diabetic rats induced by hyperglycemia.

Experimental diabetes was developed by administering intraperitoneal single dose of streptozotocin (STZ; 65 mg/kg) with nicotinamide (NA; 230 mg/kg) in adult rats. Diabetic and control rats were treated with SAC (150 mg/kg), TAU (200 mg/kg) or SAC and TAU combination (75 + 100 mg/kg) for four weeks. The estimation of body weight, fasting blood glucose (FBG), oral glucose tolerance test (OGTT), oxidative stress markers along with kidney histopathology was done to investigate the antidiabetic potential of SAC/TAU in the NA/STZ diabetic group.

The following results were obtained for the therapeutic efficacy of SAC/TAU: decrease in blood glucose level, decreased level of thiobarbituric acid reactive substances (TBARS) and increased levels of GSH, glutathione-s-transferase (GST) and catalase (CAT). SAC/TAU significantly modulated diabetes-induced histological changes in the kidney of rats.

SAC/TAU combination therapy modulated the oxidative stress markers in the kidney in diabetic rat model and also prevented oxidative damage as observed through histopathological findings.

This study aims to establish a Japanese-style healthcare program customized for Japan and Asia under ISO 9001: 2008 (ISO: International Organization for Standardization) to improve problem areas and to inspect the effectiveness of the program. Furthermore, the authors wanted to create this health program using the ISO widely available in Asian countries and make an international contribution.

The authors implemented a 6- to 10-month health program in Minowa Town, Matsumoto City and Nagano City in Japan. This study assessed findings from pedometric, anthropometric and blood pressure measurements and physical fitness, blood chemistry and brain function tests.

The comparisons were made by examining the interaction effects between groups of participants. Groups from three regions in Japan showed significant differences on the physical fitness tests; regarding the 10-meter obstacle walk, the results of the Minowa participants showed the greatest improvement and the Matsumoto participants showed the second greatest improvement. In the six-min walk, the time of the Minowa participants significantly improved.

This health education program, which has been conducted by the Japanese authors since 1998, measures anthropometry, brain function and physical fitness and performs blood tests before and after the program and it measures energy consumption with a pedometer during the program. With the aim of improving exercise via encouragement from friends and a sense of community with fellow participants, participants learn together with hands-on training in tai chi and aerobics about the importance of ongoing exercise and proper nutrition. This health education met the Health Education ISO in 2014.

Since 2010, Nagano Prefecture, including Minowa Town, Matsumoto City and Nagano City, where our study was carried out, has been the area with the highest life expectancy rates in Japan.

The authors want to make this health promotion through ISO widely available in Asian countries and an international contribution.

This study aimed to appropriately establish a Japanese-style healthcare program under the ISO 9001:2008 to improve problem areas and inspect its effectiveness.

The purpose of this paper is to examine the effect of the intensive lifestyle modification program on weight and metabolic syndrome risk reduction in rural obese women who have no underlying non-communicable diseases in Thailand.

A randomized controlled trial was conducted. In total, 60 healthy obese women aged 30-50 years were recruited and randomly assigned to either the intervention (n=30) or control (n=30) group after health screening. Tailored nutritional counseling, health education and exercise training were included in the lifestyle modification program. Behavioral modification techniques were also incorporated. The intervention was conducted weekly for the first eight weeks, then biweekly until week 16.

The student’s t-test was used to compare mean difference between groups. The total weight loss in the intervention group (n=29) was significantly higher, 7.6±2.9 kg, compared with the control group (n=30) who lost 0.7±1.4 kg (p<0.001). The intervention group lost weight 10.2 percent from baseline which was significantly higher than that in the control group (p<0.001). Systolic and diastolic blood pressures, fasting blood sugar, and waist circumference were significantly improved. Triglyceride levels slightly improved while high density lipoprotein cholesterol was slightly lowered. The intervention group showed a statistical reduction in abnormal components of metabolic syndrome compared with the control group, with the relative risk=0.24, 95% confidence interval=0.072-0.791, and p=0.018.

Compatibility of the program activities conducted by a health professional who had achieved healthy weight loss and accepted as a role model was a key to achieving effective weight loss and metabolic syndrome risk reduction in obese women in rural areas. The program should be integrated into the conventional practice of health care centers.

Blood lipid and lipoprotein abnormalities are common among patients with diabetes. The study aimed to assess dietary fat intake and its association with blood lipids among patients with Type 2 diabetes mellitus (T2DM) considering sex differences.

A cross-sectional observational study was conducted with patients (207 males and 197 females) with T2DM. The daily food intake and its contents of fat and fat types were assessed through face-to-face interview. Anthropometric measurements, glycated hemoglobin (HbA1c), triglyceride, total cholesterol (TC), high-density lipoprotein (HDL) cholesterol and low-density lipoprotein (LDL) cholesterol were initially recorded.

The results revealed that TC, LDL and HDL cholesterol levels were significantly higher in females than in males. However, the TC: HDL ratio was significantly higher in males than in females. The results also showed that the daily intake of saturated fatty acid (SFA) slightly exceeded the daily recommended allowance. However, the monounsaturated fatty acid + polyunsaturated fatty acid/SFA (MUFA + PUFA/SFA) ratio was within the recommended ratio. In addition, this study found that the main sources of SFA and cholesterol intake were milk and milk products. A significant association between high fat intake and HbA1c levels was observed (r = 0.234, p < 0.001).

As it is a cross-sectional observational study, this study has the natural limitation where it can only demonstrate an association.

The types of dietary fat intake may contribute to blood lipid abnormalities and differences effects may exist among male and female. Studies on the effect of daily fat intake and its types on blood lipids in patients with diabetes, in particular Saudi patients with diabetes are limited. This study focused on the amount and type of the consumed fat among male and female Saudi patients with T2DM and studied the relationship between the type of consumed fat and blood lipid profiles.

Lactose intolerance is lactose digestive disorder due to lactase enzyme deficiency. This can affect the quality of life by restricting the intake of certain foods. The aim of this study is to show the lactose intolerance to the restriction in food intake and quality of life.

This study was conducted with adults aged 18–60 years. A survey was used to gather information on the demographic characteristics of the patients and their symptoms related to lactose intolerance. In addition, the Visual Analog Scale was administered to identify common symptoms and the World Health Organization Quality of Life (WHOQOL)-Bref Quality of Life Scale to determine their quality of life.

The average quality of life subscale scores was 56.25 ± 14.06 for physical, 58.29 ± 11.72 for mental, 63.28 ± 21.35 for social and 62.36 ± 16.37 for environmental. When VAS scores obtained for the common digestive system symptoms in lactose intolerance were compared with Quality of Life scores; it was found that physical life quality scores decreased (r = −0.239, p = 0.030) as the complaints of diarrhea increased and physical and environmental life quality decreased (r = −0.316, p = 0.004/r = −0.277, p = 0.012, respectively) as abdominal pain increased.

People reduce dairy consumption due to digestive system complaints. Therefore, it is important to inform the people about the effects of lactose intolerance because discomfort caused by intolerance can affect nutrient intake and lower the quality of life.

The study aimed to evaluate the effectiveness of using large data sets for new diabetes patient prescriptions.

This study consisted of 101,766 individuals, who had applied to the hospital with a diabetes diagnosis and were hospitalized for 1–14 days and subjected to laboratory tests and medication.

With the help of Mahout and Scala, data mining methods of random forest and multilayer perceptron were used. Accuracy rates of these methods were found to be 0.879 and 0.849 for Mahout and 0.849 and 0.870 for Scala.

The mahout random forest method provided a better prediction of new prescription requirements than the other methods according to accuracy criteria.

Demand for dietary fibre-enriched and low sugar bakery products is increasing rapidly due to current high incidence of type 2 diabetes mellitus. Overripe banana has been discarded due to its low quality and appearance. However, overripe banana exhibits rich sources of natural sweetener and dietary fibre which could potentially be used as a novel food ingredient in bakery product. Thus, the study aims to determine the nutritional properties, sensory acceptability and glycaemic index (GI) value of chocolate cookies formulated with overripe banana sweetener (OBS) as partial replacement (10, 15 and 20%) for table sugar and utilization of overripe banana residue (OBR) as partial replacement (8%) for wheat flour.

Nutritional composition was analysed using AOAC methods and sensory acceptability using 7-point hedonic scaling method. In Vivo GI determination was continued according to FAO/WHO method.

Incorporation of OBR and OBS significantly (p < 0.05) increased nutritional values of chocolate cookies. Chocolate cookies formulated with 8% OBR +20% OBS recorded the highest TDF (7.80%) and ash (1.47%) content. Sucrose content of chocolate cookies was reduced significantly with increasing level of OBS. Sensory scores for control and 8% OBR-incorporated cookie were not significant difference for all the sensory attributes. Moreover, incorporation of OBS up to 15% produced higher scores in term of aroma, flavour and overall acceptance. Three formulations of chocolate cookies (control, 8% OBR and 8% OBR +15% OBS) were selected for GI testing and recorded GI values of 63, 56 and 50, respectively.

Overripe banana can be used as a food ingredient in developing high fibre and low-GI cookie.

One limitation of research that assesses the effectiveness of physical activity interventions for people with dementia is that most do not describe the intervention in sufficient detail to ascertain a theoretical basis or mechanism of action that determines the effective components. This paper aims to identify studies which evaluate the mechanisms of action of physical activity interventions for people with dementia, to further inform effective intervention development.

Papers were screened for evidence of evaluation of specific forms of physical activity, using pre-defined inclusion criteria. Analysis was conducted to ascertain if mechanisms of action were corroborated by data within and between studies.

The authors identified 26 studies with a measured mechanism of action; these related to the effects of physical activity on either neurological structure or endocrinal markers, including hormones. Physical activity had potential to reduce hippocampal atrophy, increase neural recruitment, activate the noradrenergic system and improve anti-inflammatory responses. While individual studies were hampered by small sample sizes, the body of evidence indicated that physical activity may have potential to delay cognitive decline.

Mechanisms of action in relation to dementia and physical activity are likely to be multifaceted, and physical activity may be protective against progression in the early stages of cognitive decline. Physical activity may be of greatest benefit if incorporated into on-going lifestyle, rather than engaged in for short periods, and combined with social interaction.

This paper is unique in its focus on the mechanisms of action of physical activity interventions for people with dementia.

Background: Hyperglycemia in pregnancy (HIP) is a common medical complication during pregnancy and is associated with several short and long-term maternal-fetal consequences. We aimed to determine the prevalence and factors associated with HIP among Ugandan women.

Methods: We consecutively enrolled eligible pregnant women attending antenatal care at Kawempe National Referral Hospital, Kampala, Uganda in September 2020. Mothers known to be living with diabetes mellitus or haemoglobinopathies and those with anemia (hemoglobin <11g/dl) were excluded. Random blood sugar (RBS) and glycated hemoglobin A1c (HbA_1c) were measured on peripheral venous blood samples. HIP was defined as an HbA1c ≥5.7% with its subsets of diabetes in pregnancy (DIP) and prediabetes defined as HbA1c_1c of ≥6.5% and 5.7–6.4% respectively. ROC curve analysis was performed to determine the optimum cutoff of RBS to screen for HIP.

Results: A total of 224 mothers with a mean (±SD) age 26±5 years were enrolled, most of whom were in the 2^nd or 3^rd trimester (94.6%, n=212) with a mean gestation age of 26.6±7.3 weeks. Prevalence of HIP was 11.2% (n=25) (95% CI: 7.7–16.0). Among the mothers with HIP, 2.2% (n=5) had DIP and 8.9% (n=20) prediabetes. Patients with HIP were older (28 years vs. 26 years, p=0.027), had previous tuberculosis (TB) contact (24% vs. 6.5%, p=0.003) and had a bigger hip circumference (107.8 (±10.4) vs. 103.3 (±9.7) cm, p=0.032). However only previous TB contact was predictive of HIP (odds ratio: 4.4, 95% CI: 1.2–14.0; p=0.022). Using HbA_1c as a reference variable, we derived an optimum RBS cutoff of 4.75 mmol/L as predictive of HIP with a sensitivity and specificity of 90.7% and 56.4% (area under the curve=0.75 (95% CI: 0.70–0.80, p<0.001)), respectively.

Conclusions: HIP is common among young Ugandan women, the majority of whom are without identifiable risk factors.