DCAT Test Papers

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Overweight and diabetes prevention: is a low-carbohydrate-high-fat diet recommendable?
(Springer-Verlag GmbH Germany, 2018-03-14) Brouns, Fred
In the past, different types of diet with a generally low-carbohydrate content (< 50-< 20 g/day) have been promoted, for weight loss and diabetes, and the effectiveness of a very low dietary carbohydrate content has always been a matter of debate. A significant reduction in the amount of carbohydrates in the diet is usually accompanied by an increase in the amount of fat and to a lesser extent, also protein. Accordingly, using the term "low carb-high fat" (LCHF) diet is most appropriate. Low/very low intakes of carbohydrate food sources may impact on overall diet quality and long-term effects of such drastic diet changes remain at present unknown. This narrative review highlights recent metabolic and clinical outcomes of studies as well as practical feasibility of low LCHF diets. A few relevant observations are as follows: (1) any diet type resulting in reduced energy intake will result in weight loss and related favorable metabolic and functional changes; (2) short-term LCHF studies show both favorable and less desirable effects; (3) sustained adherence to a ketogenic LCHF diet appears to be difficult. A non-ketogenic diet supplying 100-150 g carbohydrate/day, under good control, may be more practical. (4) There is lack of data supporting long-term efficacy, safety and health benefits of LCHF diets. Any recommendation should be judged in this light. (5) Lifestyle intervention in people at high risk of developing type 2 diabetes, while maintaining a relative carbohydrate-rich diet, results in long-term prevention of progression to type 2 diabetes and is generally seen as safe.
The Impact of Dietary Fiber on Gut Microbiota in Host Health and Disease
(CellPress, 2018-06-13) Makki, Kassem; Deehan, Edward C.; Walter, Jens; Bäckhed, Fredrik
Food is a primordial need for our survival and well-being. However, diet is not only essential to maintain human growth, reproduction, and health, but it also modulates and supports the symbiotic microbial communities that colonize the digestive tract—the gut microbiota. Type, quality, and origin of our food shape our gut microbes and affect their composition and function, impacting host-microbe interactions. In this review, we will focus on dietary fibers, which interact directly with gut microbes and lead to the production of key metabolites such as short-chain fatty acids, and discuss how dietary fiber impacts gut microbial ecology, host physiology, and health. Hippocrates’ notion ‘‘Let food be thy medicine and medicine be thy food’’ remains highly relevant millennia later, but requires consideration of how diet can be used for modulation of gut microbial ecology to promote health.
Gut microbiota mediates intermittent-fasting alleviation of diabetes-induced cognitive impairment.
(Springer Nature, 2020-02-18) Liu, Zhigang; Dai, Xiaoshuang; Zhang, Hongbo; Shi, Renjie; Hui, Yan; Jin, Xin; Zhang, Wentong; Wang, Luanfeng; Wang, Qianxu; Wang, Danna; Wang, Jia; Tan, Xintong; Ren, Bo; Liu, Xiaoning; Zhao, Tong; Wang, Jiamin; Pan, Junru; Yuan, Tian; Chu, Chuanqi; Lan, Lei; Yin, Fei; Cadenas, Enrique; Shi, Lin; Zhao, Shancen; Liu, Xuebo
Cognitive decline is one of the complications of type 2 diabetes (T2D). Intermittent fasting (IF) is a promising dietary intervention for alleviating T2D symptoms, but its protective effect on diabetes-driven cognitive dysfunction remains elusive. Here, we find that a 28-day IF regimen for diabetic mice improves behavioral impairment via a microbiota-metabolites-brain axis: IF enhances mitochondrial biogenesis and energy metabolism gene expression in hippocampus, re-structures the gut microbiota, and improves microbial metabolites that are related to cognitive function. Moreover, strong connections are observed between IF affected genes, microbiota and metabolites, as assessed by integrative modelling. Removing gut microbiota with antibiotics partly abolishes the neuroprotective effects of IF. Administration of 3-indolepropionic acid, serotonin, short chain fatty acids or tauroursodeoxycholic acid shows a similar effect to IF in terms of improving cognitive function. Together, our study purports the microbiota-metabolites-brain axis as a mechanism that can enable therapeutic strategies against metabolism-implicated cognitive pathophysiologies.
Age and sex as confounding factors in the relationship between cardiac mitochondrial function and type 2 diabetes in the Nile Grass rat.
(PLOS, 2020-02-21) Schneider, Jillian; Han, Woo Hyun; Matthew, Rebecca; Sauvé, Yves; Lemieux, Hélène
Our study revisits the role of cardiac mitochondrial adjustments during the progression of type 2 diabetes mellitus (T2DM), while considering age and sex as potential confounding factors. We used the Nile Grass rats (NRs) as the animal model. After weaning, animals were fed either a Standard Rodent Chow Diet (SRCD group) or a Mazuri Chinchilla Diet (MCD group) consisting of high-fiber and low-fat content. Both males and females in the SRCD group, exhibited increased body mass, body mass index, and plasma insulin compared to the MCD group animals. However, the females were able to preserve their fasting blood glucose throughout the age range on both diets, while the males showed significant hyperglycemia starting at 6 months in the SRCD group. In the males, a higher citrate synthase activity-a marker of mitochondrial content-was measured at 2 months in the SRCD compared to the MCD group, and this was followed by a decline with age in the SRCD group only. In contrast, females preserved their mitochondrial content throughout the age range. In the males exclusively, the complex IV capacity expressed independently of mitochondrial content varied with age in a diet-specific pattern; the capacity was elevated at 2 months in the SRCD group, and at 6 months in the MCD group. In addition, females, but not males, were able to adjust their capacity to oxidize long-chain fatty acid in accordance with the fat content of the diet. Our results show clear sexual dimorphism in the variation of mitochondrial content and oxidative phosphorylation capacity with diet and age. The SRCD not only leads to T2DM but also exacerbates age-related cardiac mitochondrial defects. These observations, specific to male NRs, might reflect deleterious dietary-induced changes on their metabolism making them more prone to the cardiovascular consequences of aging and T2DM.
Artificial Intelligence and Medical Humanities
The Moment in Rembrandt’s Night Watch
(GISI - UniTO, 2022) Manca, Joseph
Rembrandt van Rijn’s famous Night Watch is a complex painting and operates on many different levels. This article stresses both the narrative and the moral qualities of the painting, and looks at the interplay between art and philosophy, with a focus on the moment represented and how an incident plays out in a broadly ethical sense across the picture. The painting achieves a kind of unity through the representation of the musket blast, which disturbs or affects a good number of the figures in the scene. In addition, the lack of reaction to the shot on the part of the captain and lieutenant offers us a vivid image of military bravery and firm leadership: they remain focused on their duties, and carry out their tasks with stoical calm. The moment of the firing of the gun thus helps to explain both some of the figural action as well as offering an essential moral meaning of Rembrandt’s masterpiece.
Exploring the impact of a low carbohydrate breakfast on ad libitum dietary patterns in adults with type 2 diabetes
(Cambridge University Press, 2023-03-22) Oetsch, Kate; Oliveria, Barbara F.; Chang, Courtney R.; Davis, R.; Crampton, Kara; Rapini, A.; Little, Johnathan P.; Francois, Monique E.
Lower carbohydrate diets are an effective tool for managing hyperglycaemia in type 2 diabetes (T2D); however, strict lower carbohydrate diets can be difficult for some people to maintain long term. Interest in low carbohydrate dietary patterns and their effectiveness among those with T2D(Reference Chang, Francois and Little1) is therefore becoming an increasing area of interest. The aim of this study was to explore the impact of consuming a breakfast low in carbohydrates on ad libitum dietary patterns across the rest of the day during a 12-week intervention in adults with T2D. A two-site randomised controlled trial (RCT) recruited adults with physician diagnosed T2D > 12 months (age 67.5 ± 7.7 years; BMI 30.2 ± 5.9 kg/m2) on < two oral glucose lowering agents across Canada and Australia. Participants were randomised into low carbohydrate (LC) breakfast (< 10% CHO:65–75% FAT:15–30% PRO) or calorie-matched standard care low fat control (CTL) breakfast (45–75% CHO:20–40% FAT:15–25% PRO) for 12 weeks. They were provided with eight to 10 breakfast recipes that were site specific but matched in macronutrient composition. No other dietary advice was given for other daily meals. Food diaries were kept for three days (two weekdays, one weekend) during weeks 1, 6 and 12. Compliance to breakfasts was recorded using daily photos uploaded to RedCap. Secondary data analyses from the RCT were completed from food diaries of 77 participants (n = 31 Australia site (13 LC and 18 CTL) and n = 46 Canada site (22 LC and 24 CTL)). Compliance to prescribed breakfast meals was high (90% CTL; 88% LC), with no significant difference between groups. The LC arm consumed an average of 9 g of carbohydrate at breakfast compared to 53 g control (p < 0.01) with total overall daily carbohydrate intake significantly lower in the LC group 131 ± 52 g v. CTL 198 ± 56.53 g (p < 0.01). Overall, those in the LC arm consumed less energy across the day compared to the CTL (6865 ± 2032 kJ v. 7706 ± 1855 kJ, p < 0.000). Snacks provided more energy from CHO than any other free-living meal (snacks: 53%; lunch: 43%, dinner: 38%), with the LC group consuming less carbohydrates as snacks compared to the control (37 ± 26 g v. 47 ± 35 g). Skipping snacks was more common in Canada (n = 17) compared to Australia (n = 2), evenly distributed between LC and CTL arms. These findings suggest that consuming a breakfast low in carbohydrates does not lead to compensatory overeating of carbohydrates or energy across the rest of the day. A LC breakfast may reduce total energy intake in adults with T2D, however future research is needed to determine whether this corresponds to improved weight management and glycaemic control over the long term.
Mastodon over Mammon: towards publicly owned scholarly knowledge.
(The Royal Society, 2023-07) Brembs, Björn; Lenardic, Adrian; Murray-Rust, Peter; Chan, Leslie; Irawan, Dasapta Erwin
Twitter is in turmoil and the scholarly community on the platform is once again starting to migrate. As with the early internet, scholarly organizations are at the forefront of developing and implementing a decentralized alternative to Twitter, Mastodon. Both historically and conceptually, this is not a new situation for the scholarly community. Historically, scholars were forced to leave social media platform FriendFeed after it was bought by Facebook in 2006. Conceptually, the problems associated with public scholarly discourse subjected to the whims of corporate owners are not unlike those of scholarly journals owned by monopolistic corporations: in both cases the perils associated with a public good in private hands are palpable. For both short form (Twitter/Mastodon) and longer form (journals) scholarly discourse, decentralized solutions exist, some of which are already enjoying some institutional support. Here we argue that scholarly organizations, in particular learned societies, are now facing a golden opportunity to rethink their hesitations towards such alternatives and support the migration of the scholarly community from Twitter to Mastodon by hosting Mastodon instances. Demonstrating that the scholarly community is capable of creating a truly public square for scholarly discourse, impervious to private takeover, might renew confidence and inspire the community to focus on analogous solutions for the remaining scholarly record-encompassing text, data and code-to safeguard all publicly owned scholarly knowledge.

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