Enhanced cardiac rehabilitation with ultra-Processed food reduction and time-restricted eating resolves metabolic syndrome and prediabetes in coronary heart patients: the DIABEPIC-1 study
Bibliographic record
Abstract
Abstract Background Cardiac rehabilitation programs provide a valuable opportunity to promote the adoption of healthy lifestyle behaviors in patients with atherosclerotic cardiovascular diseases (ASCVD) and metabolic comorbidities, including metabolic syndrome (MetS) and prediabetes. However, strategies to reverse these conditions remain to be explored. Objectives The DIABEPIC-1 study aimed to assess the feasibility of an enhanced six-month cardiac rehabilitation program for patients with ASCVD while investigating prediabetes and MetS remission. Methods The study’s program combined exercise training with an intensive nutritional intervention involving counseling on reducing ultra-processed foods (UPFs), adopting a Mediterranean diet, and implementing time-restricted eating (TRE). Segmental body-composition measurements, complete blood analysis, maximal exercise testing, a 3-day nutritional diary recorded with the Keenoa artificial intelligence App, and lifestyle questionnaires were completed at baseline, three months, and six months. Complete remission of prediabetes was defined as a HbA1c level below the diagnostic threshold (<5.7%) for ≥3 months without pharmacological therapy. Partial remission was defined when HbA1c was <5.7% at six months. Complete remission of MetS was reached when <3 NCEP/ATP-III Criteria were met at three months and maintained at six months. Partial remission occurred when <3 NCEP/ATP-III Criteria were met at six months. Results The study enrolled 36 participants with a six-month completion rate of 88.9% and compliance with all protocol interventions of 92.5%. Waist circumference decreased significantly by -9.2 cm (95%CI: -7.4 to -10.9; p <0.001), and participants lost an average of -8.0 kg (95%CI: -6.3 to -9.7; p<0.001), primarily from fat mass and visceral fat. Participants showed improved glycemic and lipid profiles, insulin resistance markers, and liver health (Table 1). They also improved cardiorespiratory fitness, reduced UPF consumption, and increased adherence to the Mediterranean diet and TRE, leading to lower caloric intake and enhanced nutrient profiles. Notably, 50% of participants achieved prediabetes remission, with higher initial HbA1c levels associated with a 100% remission rate. Additionally, 70% of participants with MetS at the study's outset achieved remission (Figure 1). Conclusion Our findings indicate the feasibility of enhancing a cardiac rehabilitation program with a stepwise intensive nutritional intervention, resulting in clinically significant outcomes. This includes the remission of key causal risk factors in a substantial number of ASCVD patients. Baseline Charactersitics and Changes. MetS and Prediabetes Remission.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".