Calorie Restriction and Weight Loss

Weight loss of 5% to 10% or more, particularly when accompanied by decreased abdominal adiposity, lowers post-prandial glucose and reduces the risk of new diabetes (25). Although weight loss can be achieved by any dietary modification that reduces calorie intake, strategies that restrict both processed carbohydrates and unhealthy fats (saturated and trans fats) improve post-prandial dysmetabolism, oxidative stress, and inflammation more effectively than other approaches ([1], [2] and [25]).
The degree of post-prandial dysmetabolism is closely related to calorie intake. On the extreme end of the spectrum, fasting completely eliminates post-prandial increases in glucose and triglycerides and the ensuing oxidant stress and inflammation. A reduction in calories by approximately 30% below the intake on an ad libitum diet has been shown to improve health and longevity in animal models (34). A similar degree of calorie restriction in humans has been achieved by diets low in processed foods and high in vegetables, fruits, nuts, low-fat dairy, egg whites, soy protein, whole wheat, and lean meat that provides >100% of the daily value for all of the essential nutrients ([34] and [35]). This diet was associated with improvements in oxidative stress, inflammation, glucose, insulin sensitivity, blood pressure, lipids, and cardiac function ([34] and [35]). Although the ideal caloric intake for optimal health and longevity is yet to be determined in humans, the avoidance of energy-dense processed foods is a logical first step toward the reduction of excess calories.
Light to Moderate Alcohol Consumption

An extensive body of data shows concordant J-shaped associations between alcohol intake and a variety of adverse health outcomes including CAD, diabetes, stroke, dementia, and all-cause mortality (36). Light to moderate alcohol consumption (0.5 to 1 drink daily for women, and 1 to 2 drinks daily for men) is associated with cardioprotective benefits, whereas increasingly excessive consumption results in proportional worsening of outcomes. Although alcohol increases high-density lipoprotein in a dose-dependent fashion, the effects on glucose homeostasis are nonlinear, conferring benefits at lower doses and harm at higher doses (36). Randomized placebo-controlled trials in healthy nondiabetic individuals showed that 1 to 2 drinks immediately before a meal will significantly lower post-prandial glucose and insulin levels (37) (Fig. 7). Tellingly, the interaction between alcohol intake and post-prandial glucose follows the same J-shaped relationship that is seen between alcohol and systemic inflammation, as well as alcohol and adverse CV events (36 J. O’Keefe, K. Bybee and C. Lavie, Alcohol: the razor-sharp double-edged sword, J Am Coll Cardiol 50 (2007), pp. 1009–1014. Article | PDF (457 K) 36).


http://www.sciencedirect.com/science...58cde1885fa238

Figure 7. Alcohol Reduces Post-Prandial Glucose
In this group of healthy individuals, 20 g alcohol (approximately 1.5 drinks) in various beverages reduced postmeal glucose by up to 38%. Data from Brand-Miller et al. (37).

View Within Article



Consuming a light to moderate amount of alcohol, like exercise, will increase insulin sensitivity and glucose metabolism for the ensuing 12 to 24 h (36). Indeed, daily low-dose alcohol is associated with better health than less frequent consumption (36). Regular light to moderate alcohol intake with the evening meal is traditional in many of the cultures with exceptional health and longevity.