Article Impact Level: HIGH Data Quality: STRONG Summary of Cell Reports Medicine, 101667. https://doi.org/10.1016/j.xcrm.2024.101667 Dr. Aaron Hengist et al.
Points
- Both low free-sugar and ketogenic diets reduce fat mass without lowering energy expenditure, indicating maintained physical activity levels despite reduced energy intake.
- A low free-sugar diet minimally impacts metabolism and gut microbiome but significantly lowers low-density lipoprotein cholesterol (LDL-C).
- The ketogenic diet initially decreases glucose tolerance and increases skeletal muscle pyruvate dehydrogenase kinase 4 (PDK4), with reductions in AMP-activated protein kinase (AMPK) and glucose transporter type 4 (GLUT4).
- Early in the ketogenic diet intervention, there are increased levels of apolipoprotein B, C-reactive protein, and postprandial glycerol, which diminish by the 12th week.
- The ketogenic diet alters gut microbial beta diversity, suggesting potential long-term adaptations, and may pose initial risks to glucose metabolism and atherogenic lipid profiles.
Summary
In a comprehensive cohort study of 14,399 women, researchers explored the effectiveness of using moderate to vigorous physical activity (MVPA) time and step counts to reduce all-cause mortality and cardiovascular disease (CVD) risks among women aged 62 and older. This analysis utilized data from an ongoing follow-up to the Women’s Health Study, initially a randomized clinical trial evaluating the effects of low-dose aspirin and vitamin E from 1992 to 2004. At the outset, participants, free from CVD and cancer, tracked their physical activity using an accelerometer during a 2011-2015 ancillary study, with follow-ups extending through December 2022.
The study findings revealed that MVPA time and daily step counts were similarly effective in associating with lower risks of all-cause mortality and CVD. Specifically, for each standard deviation increase, the hazard ratios (HR) for all-cause mortality were 0.82 (95% CI, 0.75-0.90) for MVPA time and 0.74 (95% CI, 0.69-0.80) for step counts. Furthermore, participants in the top three quartiles for MVPA time and step counts, compared to those in the lowest quartile, experienced an extended period free from death by 2.22 (95% CI, 1.58-2.85) months and 2.36 (95% CI, 1.73-2.99) months, respectively, over a 9-year follow-up. The area under the curve (AUC) values for predicting all-cause mortality were similarly modest for both measures at 0.55 (95% CI, 0.52-0.57).
These results support including step count-based goals alongside traditional time-based recommendations in future physical activity guidelines for older women. The findings indicate that both metrics are similarly effective in enhancing longevity and reducing CVD risk, allowing for flexibility in how individuals meet their physical activity goals based on personal preference and lifestyle. This could lead to more tailored and, thus, more effective interventions in population health management.
Link to the article: https://www.cell.com/cell-reports-medicine/fulltext/S2666-3791(24)00381-1
References Hengist, A., Davies, R. G., Walhin, J.-P., Buniam, J., Merrell, L. H., Rogers, L., Bradshaw, L., Moreno-Cabañas, A., Rogers, P. J., Brunstrom, J. M., Hodson, L., Van Loon, L. J. C., Barton, W., O’Donovan, C., Crispie, F., O’Sullivan, O., Cotter, P. D., Proctor, K., Betts, J. A., … Gonzalez, J. T. (2024). Ketogenic diet but not free-sugar restriction alters glucose tolerance, lipid metabolism, peripheral tissue phenotype, and gut microbiome: RCT. Cell Reports Medicine, 101667. https://doi.org/10.1016/j.xcrm.2024.101667
