(1) Background: Mediterranean ketogenic nutrition (MKN) may directly target multiple neurobiological mechanisms associated with dementia risk in older adults. Despite its promise, this type of nutrition can be challenging to learn and adhere to in a healthy manner. Our team used the National Institutes of Health Obesity Related Behavioral Intervention Trials (NIH ORBIT) model to develop and pilot a program to help older adults with memory concerns use MKN. (2) Methods: Using a two-arm, randomized design, we evaluated an MKN Adherence (MKNA) program compared to an MKN education (MKNE) program (N = 58). The primary difference between study arms involved the use of motivational interviewing (MI) strategies and behavior change techniques (BCT) only in the MKNA arm. Participants were included if they evidenced subjective memory concerns or objective memory impairment on the Montreal Cognitive Assessment (Score 19 ≤ 26). Primary outcomes examined included feasibility, acceptability, adherence, and clinical outcomes associated with the program. (3) Results: Overall, there was relatively high program completion in both groups, with 79% of participants completing the 6-week program. The recruitment protocol required adjustment but was successful in reaching the target sample size. Retention (82%) and session attendance (91%) were higher in the MKNA arm compared to the MKNE (retention = 72%; attendance = 77%). Overall, most participants in both groups rated the program as “excellent” using the client satisfaction questionnaire. Participants in the MKNA arm evidenced higher objective and self-reported adherence to MKN during the 6-week program. Further, there was some evidence of clinical benefits of the program, although these effects diminished as adherence decreased in the 3 months follow-up. (4) Discussion: This pilot trial demonstrated that the MKN program incorporating MI and BCT strategies may better engage and retain participants than a nutrition education program alone, although participants in both groups reported high satisfaction.

Type 2 diabetes mellitus is a major contributor to morbidity and mortality worldwide. This disease often leads to poor health outcomes, such as neuropathy and diabetic foot ulcers, and increased risk for comorbidities such as cardiovascular complications and renal disease. Lifestyle modifications including diet and physical activity interventions are often explored as prevention and management strategies for T2DM. It is well established that fruits are a rich source of fiber and a variety of phytochemicals, vitamins, minerals, and bioactive compounds that can help optimize human health. Unfortunately, many experts associate the consumption of fruit with a moderate to high glycemic index (GI), which leads to a spike in blood glucose and eventually elevated hemoglobin A1c (HbA1c). The purpose of this comprehensive review is to outline the current clinical literature on the relationship between fruit consumption and various indices of glucose metabolism. A variety of fruits have been clinically studied to determine this relationship, namely in the fresh form (e.g., berries, apples, watermelon, cherries, mangoes), dried fruits (raisins and dates), and juices (derived from cranberry, orange, grape, cherry, and pomegranate). Overall, intake of fruits and fruit-derived products is beneficial for healthy subjects and subjects with T2DM regarding their impact on glucose metabolism and other cardiometabolic markers (e.g., inflammatory responses, lipid profiles). Nonetheless, it is more advisable for diabetic patients to consume fresh or dried fruits rather than fruit-derived products. A special consideration needs to be attributed to both the amount of fruit intake with regards to their respective GI and glycemic load (GL), and when these fruits are consumed. Trials with more a comprehensive design and specific outcomes are required to reveal the mechanisms underlying the beneficial effects of fruit consumption on the T2DM population particularly.