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Biomedical subjects

A R Leeds

Publications and source records attributed to A R Leeds.

At least 19 recordsLinked to original sources
PubMed1979

The dietary management of diabetes in adults.

The ultimate object of all types of dietary management before the introduction of insulin was to prevent emaciation and death: the consequences of metabolic derangements due to lack of insulin. Now, while dietary therapy continues to be important in minimizing the requirement for endogenous insulin or in balancing administered insulin, the major objects are changing to prevention of large vessel and microvascular disease. The next decade will probably see a more widespread introduction of diets containing a lower proportion of energy derived from fat. The increased carbohydrate intake will almost inevitably result in increased dietary fibre intake. Whether David Jenkins' Lente carbohydrate foods (those containing viscous unabsorbable polysaccharides) will prove to be of lasting value is not yet known. Since galactomannans occur in legumes perhaps we should consider the possibility of diets containing large proportions of legumes: a twentieth century 'Legume cure'? If this should prove of value it would not have excited ancient Indian physicians who wrote (in the Caraka-Samita) of their use of legumes in the treatment of glycosuria, at least as early as the first century AD, before Aretaeus had applied the term diabetes.

Adult↗
PubMed1979

Dietary fiber and blood lipids: reduction of serum cholesterol in type II hyperlipidemia by guar gum.

Guar gum, a storage polysaccharide galactomannan and a form of dietary fiber, was administered to 10 patients with type II a or b hyperlipidemia for 2 weeks. Five grams of gum was given before each of three meals daily, either in a specially prepared soup or mixed with fruit juice or milk. No other deliberate change of diet was made. Three patients had been taking 12 to 16 g/day of cholestyramine for more than 2 years and one had been taking 1000 mg of clofibrate daily. These drugs were continued throughout the trial. Serum cholesterol levels of all 10 patients had been stable for 6 to 18 months before the trial at the start of which the mean level was 345 +/- 15 mg/dl. After 2 weeks of guar gum the mean was 308 +/- 16 mg/dl, a fall of 10.6% (P less than 0.01). Serum triglyceride was not changed significantly. Guar gum, which can be incorporated into foods, merits further study as a potential hypocholesterolemic agent.

Anticholesteremic Agents↗
PubMed1979

Hypocholesterolemic action of dietary fiber unrelated to fecal bulking effect.

Twenty-two healthy volunteers took approximately 20 g/day of concentrated dietary fiber from either carrot, cabbage, apple, bran, or guar gum or 31 g from pectin, added for 3-week periods to controlled diets. Total serum cholesterol fell by 13% on both guar and pectin (P less than 0.01) with no significant change in high density lipoprotein cholesterol. Over the 3-week supplementation period, the other fibers were without effect with the exception of carrot, where both control and test high density lipoprotein levels fell (P less than 0.05 and less than 0.01, respectively). If, however, the 3rd week of the control was compared with the 3rd test week, the values for total cholesterol were 7% lower after apple (P less than 0.02) while after carrot the high density lipoprotein cholesterol level was 10% lower than the control (P less than 0.01). No significant change was seen in serum triglyceride or body weight either as judged by differences over the 3-week periods or by comparing test and control values at 3 weeks. Comparison of stool weights obtained in this study indicate that the fecal bulking action of dietary fiber is independent of its hypocholesterolaemic effect.

Adult↗
PubMed1979

High-fibre foods: a feasibility study using guar gum.

Guar gum at different concentrations was incorporated into foods from six groups to establish some principles to aid the production of high-viscosity therapeutic foods. The amounts of gum that could be incorporated into a food, without major loss of acceptability, were higher in products with low final water content than those with high final water content. The domestic preparation of these recipes should be possible provided that recipe modifications are carefully followed.

Cellulose↗
PubMed1978

Dietary fibres, fibre analogues, and glucose tolerance: importance of viscosity.

To define the type of dietary fibre of fibre analogue with the greatest potential use in diabetic treatment, groups of four to six volunteers underwent 50-g glucose tolerance tests (GTT) with and without the addition of either guar, pectin, gum tragacanth, methylcellulose, wheat bran, or cholestyramine equivalent to 12 g fibre. The addition of each substance significantly reduced blood glucose concentration at one or more points during the GTT and generally reduced serum insulin concentrations. The greatest flattening of the glucose response was seen with guar, but this effect was abolished when hydrolysed non-viscous guar was used. The reduction in the mean peak rise in blood glucose concentration for each substance correlated positively with its viscosity (r = 0.926; P less than 0.01), as did delay in mouth-to-caecum transit time (r = 0.885; P less than 0.02). Viscous types of dietary fibre are therefore most likely to be therapeutically useful in modifying postprandial hyperglycaemia.

Adult↗
PubMed1977

Treatment of diabetes with guar gum. Reduction of urinary glucose loss in diabetics.

When nine diabetic patients supplemented either their normal home diets (four patients) or metabolic ward diets (five patients) with 25 g guar gum daily for 5 or 7 days their mean urinary glucose excretion fell by 46% (P less than 0-05) and 54% (P less than 0-01), respectively. Gel-forming,, unabsorbable carbohydrate may therefore be a useful adjunct to anti-diabetic therapy, irrespective of the type of treatment or insulin dosage used.

Adult↗
PubMed1977

Decrease in postprandial insulin and glucose concentrations by guar and pectin.

Postprandila glycaemia and rise in serum insulin after carbohydrate-containing meals were reduced by the addition of guar flour or pectin, or both. After a liquid test meal (four subjects) the 30-min blood glucose was reduced from 6.33 +/- 0.19 mmol/litre (114 +/- mg/dl), mean +/- SEM, in the control subjects of 4.77 +/- 0.17 mmol/litre (86 +/- 3 mg/dl) by addition of guar gum (P less than 0.05). The mean insulin level was also significantly lower at 15 min. A breakfast test meal (bread, butter, marmalade, and tea) resulted in a mean 15-min blood glucose of 6.18 +/- 0.21 mmol/litre (111 +/- 4 mg/dl) in eight subjects; 10 g of pectin added to the marmalade reduced this level to 5.64 +/- 0.17 mmol/litre (102 +/- 3 mg/dl) (P less than 0.01). The insulin levels were significantly lower at 15, 30, and 45 min. A similar meal in which guar was added to the bread and pectin to the marmalade resulted in significant reductions of blood glucose at 15 min (P less than 0.002) and 30 min (P less than 0.01). The insulin values were also significantly lower throughout the first 90 min of the test. This action of unavailable carbohydrate may prove useful in the dietary control of diabetes.

Adult↗
PubMed1977

Effect of dietary fiber on complications of gastric surgery: prevention of postprandial hypoglycemia by pectin.

The dumping syndrome is a very troublesome problem to some patients after gastric surgery. Gel-forming carbohydrates have recently been used to modify glucose absorption. The addition of 14.5 g of pectin to a 50-g oral glucose load prevented the occurrence of hypoglycemic symptoms and maintained the blood glucose levels above control values by 64% at 90 min (P less than 0.002) and 46% at 120 min (P less than 0.01) in postgastric surgery patients whose 120-min values after 50 g of glucose alone had fallen below 50 mg per 100 ml (2.8 mmoles per liter). Breath H2 production, used as an index of bacterial fermentation of glucose, was abolished or reduced by pectin in all 5 cases in which this had previously occurred. A trial of 10 g of pectin per day prevented recurrent postprandial hypoglycemic attacks in the most severely affected individual. Pectin and perhaps other unabsorbable polysaccharides are likely to prove useful in the treatment of abnormal carbohydrate absorption after gastric surgery.

Adult↗