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1 Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition David Geffen School of Medicine, UCLA Nutrition and Diabetes 糖糖糖糖糖糖糖糖

Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition

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糖尿病的营养疗法. Nutrition and Diabetes. Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition David Geffen School of Medicine, UCLA. 1. Obesity. Diabetes. Inflammation. Insulin Resistance. Ascorbic Acid. Rich source for vitamins and minerals, low calorie, high fiber. - PowerPoint PPT Presentation

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Page 1: Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition

1

Zhaoping Li, MD, PhDProfessor of Medicine

Center for Human NutritionDavid Geffen School of Medicine, UCLA

Nutrition and Diabetes

糖尿病的营养疗法

Page 2: Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition
Page 3: Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition

Ascorbic Acid

Rich source for vitamins and minerals, low calorie, high fiber

Page 4: Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition

Phytochemicals/Phytonutrients

Non-nutrient plant compounds

Provide health benefits against certain chronic human illnesses such as cancer, heart disease, neurodegenerative diseases, etc.

Page 5: Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition

5Surh, Nature Reviews Cancer 3:768, 2003

Page 6: Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition

Lycopen

Page 7: Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition

• β-carotene, lycopene

• Ability to neutralize harmful byproducts of photooxidation

• Act as powerful antioxidants in humans– quenching singlet oxygen– scavenging free radicals

Bartley, G.E. and P.A. Scolnik. 1995. Plant carotenoids: pigments for photoprotection, visual attraction, and human health. The Plant Cell 7:1027–1038.Clinton, S.K. 1998. Lycopene: chemistry, biology, and implications for human health and disease. Nutrition Reviews 56(2):35–51.

Carotenoids

Page 8: Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition

Pomegranate: Ellagitannin

Henning et al. 2009

OH

O

O

HO

OH

OHHO

HO

OH

OH

OO OO

CH2

O

O

OH

OHOH

OH

HO

O

O

HO

O

OO

MW = 1084

OH

OH

HO

Ellagic acid(MW = 302)

Page 9: Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition

Pomegranate: Ellagitannin

Pentuk et al. 2006

•Antioxidant•Anti inflammation•Inhibit Angiogenesis•Anti-aromatase•Anti-proliferation

•Antioxidant•Anti inflammation•Inhibit Angiogenesis•Anti-aromatase•Anti-proliferation

Page 10: Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition

Cruciferous Vegetables

• Sulforaphane (SFN), a prominent isothiocyanate

Page 11: Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition

Increased nasal cell counts in response to DEP exposure are attenuated with BSE treatment

0.0

100.0

200.0

300.0

400.0

500.0

600.0

700.0

800.0

900.0

1000.0

0 6 24

Time Post-DEP (Hrs)

% o

f B

as

elin

e

Screen

Control

BSE

*

**

Page 12: Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition

Sources of Resveratrol

• Resveratrol is found in– Grapes (only in skin)– Wine– Grape Juice– Peanuts– Blueberries– Bilberries– Cranberries

Page 13: Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition

Benefits of Resveratrol• Induces apoptosis

(programmed cell death) in unhealthy cells

• Promotes normal nuclear factor kappa B and cyclooxygenase-2 activity

• Promotes normal activity of the SIRT-1 gene (involved in calorie restriction, fat mobilization, mitochondrial function, longevity)

• Promotes cardiovascular health – Normal platelet

activity– Normal

vasorelaxation– Antioxidant

protection of LDL particles

• Possibly Neuroprotective

Page 14: Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition

14

Spices on Lipid Oxidation in Meat Patty

Li et al, ACJN April 2010

Page 15: Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition

15

Spices on Lipid Oxidation in Plasma

Li et al, ACJN April 2010

Page 16: Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition

16

Spices on Lipid Oxidation in Urine

Li et al, ACJN April 2010

Page 17: Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition

Graph of normal endothelial function PAT signal tracings. The Endo–PAT2000 provides a very high degree of sensitivity and specificity as compared to the current Gold Standard of coronary artery endothelial function assessment – the coronary blood flow response to intra-coronary acetylcholine-infusion.

Assessing Endothelial Function

Page 18: Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition

PAT

P=0.02

Page 19: Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition

Urine MDA

P<0.001

Page 20: Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition

Urine NOx

P=0.05

Page 21: Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition

21

Dihydrocapsiate on Energy Expenditure

Lee et al, Experimental Biology 2010

Page 22: Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition

Avocado

Page 23: Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition

PAT

A.

B.

*

Page 24: Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition

Inflammatory Markers

A. IL-6

B. TNF-alpha

Page 25: Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition

TURMERIC

Historical Uses:• Used as a condiment, healing remedy, and

textile dye• Used in Indian and Chinese medical systems

as an anti-inflammatory agent

Page 26: Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition
Page 27: Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition

AP-1

-catenin

CREB-BP

EGR-1

Notch-1

ERE

NF-B

HIF-1 WT-1

Nrf-2

PPAR-

STAT-1

STAT-3

STAT-4 STAT-5

Curcumin

Transcriptional factors

IL-1

IL-2

IL-5

IL-6

IL-8

IL-12

MCP

MIP

MaIP

TNF-α

IL-18

AATF-1

ATFase

ATPase

COX-2

5-LOX

Desaturase

DNA pol

FPT

GST

GCL

iNOS

MMP

NQO-1

ODC

PhP D

Src-2

Telomerase

TMMP-3

GlCL

AAPKCa2+PK

EGFR-K

ERK

FAK

IL-1R AK

JAK

JNK

MAPKPhK

PAK PKAPKB

Pp60c-tk

PTK

CTGF

EGF

FGF

HGF

NGFPDGF

TF

TGF-1

VEGF

AR

AHR

CXCR4

EGFR

EPCR

ER-αFas R

H2R

HER-2

IL-8 R

ITR

IR

LDLR

DR-5

ELAM-1

ICAM-1

VCAM-1

Bcl-2

Bcl-xL

IAP-1

Cyclin D1

Hsp-70

MDRP

uPA

DEF-40

p53

Inflammatory cytokines

Kinases

EnzymesGrowthfactors

Receptors

Others

Molecular targets upregulated

Molecular targetsdownregulated

Anand etal, CL, 2008

Page 28: Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition

Piperine Enhance Curcumin Bioavailability

Planta Med. 1998 May;64(4):353-6.

Page 29: Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition

Lipid Peroxide(nmoles/ml)

Total Cholesterol(mg/100ml)

7

6

5

4

3

2Pre Post Pre Post

250

220

190

160

130

100Pre Post

100

90

80

70

60

50

HDL-C(nmoles/ml)

Triglycerides(nmoles/ml)

300

260

220

180

140

100Pre Post

Changes in serum lipid levels in healthy subjects by curcumin

Ser

um

Lip

id l

evel

Sony & Kuttan, 1992

500 mg/day x 7days; N=10

Page 30: Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition
Page 31: Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition

31

Pistachio

•Monounsaturated fatty acids

•Antioxidants

•Plant sterols

•Lutein

•Anthocyanins

•Resveratrol

Page 32: Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition

32

Calories and Fats not Equal

56 grams pistachios

=

53 grams pretzel

Page 33: Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition

33

Pistachios Lower Triglycerides

* *

Base line 6 weeks 12 weeks

Pist

achi

os

Pret

zels

Page 34: Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition

34

BMI

*

Page 35: Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition

35

Tea

•NO Calories

•Tea Catechins

Page 37: Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition

Green Tea Increases Metabolic Rate

•Increase metabolic rate

•Promotes fat oxidation

•Inhibit pancreatic lipase

Page 38: Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition

Weight Loss by Green Tea

•Meta-analysis with 15 studies

•GTCs with caffeine reduce •BMI•Body weight•WC

Page 39: Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition

Green Tea Effects on Diabetes

•1 - 2 cups/day

•Reduced incidence of Diabetes by 70%

•Decreased fasting glucose

Yonsei Med J. 2009 Feb 28;50(1):31-8. Epub 2009 Feb 24.

Page 40: Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition
Page 41: Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition

Cell. 2010 Sep 3;142(5):687-98

Page 42: Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition

Macrophage Infiltration

: Decreased macrophages on HFD+ω3

HFD HFD+ω3

Page 43: Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition

Supplements

Unknown: optimal therapeutic dosage, Unknown: optimal therapeutic dosage, effects of chronic use, potential toxicityeffects of chronic use, potential toxicity

Single compound works differently from Single compound works differently from whole foodwhole food

False sense of healthy life styleFalse sense of healthy life style