Carbohydrate intake and obesity. Eur J Clin Nutr. 2007;61 Suppl 1:S75-S99. [PMID: 17992188 DOI: 10.1038/sj.ejcn.1602939]

Maternal protein intake during pregnancy and obesity risk in mothers and offspring: a prospective cohort study

BACKGROUND

The optimal dietary macronutrient composition during pregnancy to mitigate obesity risk in mothers and offspring remains unclear.

OBJECTIVES

This study aims to assess associations between maternal dietary macronutrient composition and obesity outcomes in mothers and offspring.

METHODS

We analyzed 66,360 singleton pregnancies from the Danish National Birth Cohort, with dietary intake assessed at gestational week 25. Outcomes included maternal postpartum weight retention (PPWR) at 6 and 18 mo and offspring's birth weight, risks of small for gestational age (SGA) and large for gestational age (LGA), body mass index (BMI) z-scores, and overweight/obesity (OWOB) risk at ages 7, 11, and 14 y. Mixture models with response surface visualization examined interactive macronutrient associations, and mixed restricted cubic splines assessed potential nonlinear relationships between maternal protein intake and obesity outcomes.

RESULTS

Mean maternal macronutrient compositions were 15.2% protein, 30.2% fat, and 54.1% carbohydrate. Response surfaces revealed that maternal lower protein intake (%), diluted by higher fat and/or carbohydrate, was associated with higher maternal PPWR at 6 and 18 mo but lower birth weight and BMI z-scores in offspring at ages 7, 11, and 14 y. Mixed restricted cubic splines indicated nonlinear associations between maternal protein intake (%) and SGA risk (nonlinear P = 0.003) and LGA (nonlinear P = 0.04), with a threshold around 15% protein; below this, SGA risk increased whereas LGA risk decreased. Linear associations were observed for risks of substantial PPWR (PPWR >5 kg) and childhood OWOB risk (nonlinear P > 0.05). Each 5% higher protein intake during pregnancy was related to a lower risk of substantial PPWR at 6 mo (odds ratio: 0.90; 95% confidence interval: 0.85, 0.95) and 18 mo (0.88; 0.82, 0.94) but higher risks of OWOB at ages 7 y (1.07; 1.01, 1.15) and 11 y (1.11; 1.03, 1.18), with no association at 14 y (1.02; 0.95, 1.10).

CONCLUSIONS

Higher maternal protein intake during pregnancy was associated with lower PPWR and SGA risk but higher LGA and childhood OWOB risks, highlighting potential trade-offs in maternal and offspring obesity outcomes.

The associations between evening eating and quality of energy and macronutrients and obesity: the National Health and Nutrition Examination Survey (NHANES), 2003-2016

BACKGROUND

This study aimed to investigate the associations between evening eating and quality of energy and macronutrients and obesity among U.S. adults.

SUBJECTS/METHODS

This study adopted the data from the National Health and Nutrition Examination Survey (2003-2016), which involved a total of 27,911 participants. The differences in the ratios of energy and macronutrients with it is subgroups at dinner versus breakfast (ΔRatio) were categorized into quartiles. The differences in the consumption of 17 types of food at dinner versus breakfast (ΔFoods) were considered as continuous variables. Body mass index (BMI) and waist circumference (WC) were used to define general obesity (30.0 ≤ BMI < 40.0), morbid obesity (BMI ≥ 40.0), and abdominal obesity (WC > 102 cm for men or WC > 88 cm for women). Multiple logistic and linear regression models were developed.

RESULTS

After a variety of covariates were adjusted, participants in the highest quartile (higher energy/macronutrient intake at dinner than breakfast) of the ΔRatio in terms of energy were positively associated with morbid obesity compared with those in the lowest quartile (ORΔRatio of energy 1.27; 95% CI 1.01;1.61) from fat (ORΔRatio of fat 1.27, 95% CI 1.01;1.60); saturated fatty acids(ORΔRatio of SFA 1.27, 95% CI 1.01;1.59) and unsaturated fatty acids (ORΔRatio of USFA 1.28, 95% CI 1.02;1.5). The highest quartile of the ΔRatio of low-quality carbohydrates was associated with increased odds of abdominal obesity (ORΔRatio of low-quality carbohydrates 1.16; 95%CI 1.03-1.31). Moreover, the ΔRatio of low-quality carbohydrates was significantly positively associated with BMI (coefficient: 0.562, 95% CI: 0.217-0.907). ΔFoods, including whole fruits, other starchy vegetables, added sugars, poultry, dairy, and nuts, were positively associated with obesity.

CONCLUSIONS

In conclusion, with this nationally representative sample of U.S adults, this study demonstrated that excessive intake of energy at dinner than breakfast during a day was associated with a greater risk of obesity, mainly from low-quality carbohydrates, fat, SFAs, and USFA. This study emphasized the importance of diet quality and evening eating in the prevention of obesity.

Exploring the Association Between Dietary Fruit Intake and Endometriosis: A Systematic Review and Meta-Analysis

Background/Objectives: Endometriosis is a chronic gynecological disorder affecting up to 10% of women of reproductive age. The etiology of endometriosis remains unclear; however, there is growing interest in identifying modifiable risk factors, particularly dietary influences. The present study aims to systematically evaluate the association between fruit consumption and the incidence of endometriosis. Methods: A comprehensive systematic search was conducted across PubMed, Embase, Web of Science, and Google Scholar for studies published from 1 January 1990 to 30 September 2024. Relevant data were extracted and categorized, and the methodological quality of the included studies was assessed using the Joanna Briggs Institute (JBI) checklists. Additionally, meta-analyses were performed using STATA 18.0 to compare daily and weekly fruit consumption among women with and without endometriosis. Results: The analysis included six studies comprising 3689 women with endometriosis and 1463 controls. The meta-analysis revealed no significant association between daily fruit consumption and the risk of endometriosis (odds ratio (OR): 0.95; 95% confidence interval (CI): 0.90-1.01). Similarly, weekly fruit consumption did not demonstrate a significant link to endometriosis risk (OR 1.03, 95% CI: 0.78-1.35). The assessment of publication bias using Begg's and Egger's tests, along with contour-enhanced funnel plots, indicated the absence of publication bias in the data across both analysis groups. Conclusions: This study indicates that fruit consumption does not significantly influence the risk of developing endometriosis. Additional research is necessary to examine preferred dietary interventions for populations affected by this condition.

Association of daily carbohydrate intake with intermuscular adipose tissue in Korean individuals with obesity: a cross-sectional study

BACKGROUND/OBJECTIVES

The prevalence of obesity, a worldwide pandemic, has been increasing steadily in Korea. Reports have shown that increased intermuscular adipose tissue (IMAT) is associated with an increased risk of cardiovascular disease, independent of body mass index. However, the relationship between dietary intake and IMAT accumulation in the Korean population remains undetermined. The objective of this study was to evaluate regional fat compartments using advanced magnetic resonance imaging (MRI) techniques. We also aimed to investigate the association between IMAT amounts and dietary intake, including carbohydrate intake, among Korean individuals with obesity.

SUBJECTS/METHODS

This cross-sectional study, performed at a medical center in South Korea, recruited 35 individuals with obesity (15 men and 20 women) and classified them into 2 groups according to sex. Anthropometry was performed, and body fat distribution was measured using MRI. Blood parameters, including glucose and lipid profiles, were analyzed using commercial kits. Linear regression analysis was used to test whether the IMAT was associated with daily carbohydrate intake.

RESULTS

Carbohydrate intake was positively associated with IMAT in all individuals, with adjustments for age, sex, height, and weight. No significant differences in blood indicators were found between the sexes.

CONCLUSIONS

Regardless of sex and age, higher carbohydrate intake was strongly correlated with greater IMAT accumulation. This suggests the need to better understand sex differences and high carbohydrate diet patterns in relation to the association between obesity and metabolic risk, which may help reduce obesity prevalence.

Do macronutrient intakes affect obesity indices in Jordanian adults?

OBJECTIVE

To determine whether macronutrient intake is associated with novel obesity indices, including the conicity index (CI), body adiposity index (BAI), abdominal volume index (AVI), body roundness index (BRI), and weight-adjusted-waist index (WWI).

METHODOLOGY

A cross-sectional survey was conducted with 491 adults (344 males and 147 females) working at different universities in Jordan (July-December 2019). Daily intake of energy (kcal), carbohydrates (g), protein (g), and fat (g) was obtained using 24-h recalls collected over 2 days. Additionally, obesity indices were calculated.

RESULTS

Regardless of sex, energy, and carbohydrate intakes had a moderately significant positive association, whereas protein and fat intakes had a weakly significant association with BAI, AVI, and BRI. CI and WWI showed a weakly significant association with all macronutrients in males, a moderate correlation with energy and carbohydrate intake, and a weak association with fat and protein intake in females. Male participants had significant increases in the CI (T1 = 1.29 ± 0.01 vs. T3 = 1.36 ± 0.01, p = .018), AVI (T1 = 17.96 ± 0.52 vs. T3 = 22.81 ± 0.57, p = .011), and WWI (T1 = 10.72 ± 0.11 vs. T3 = 11.29 ± 0.09, p = .047) indices scores through the carbohydrate intake tertiles. Additionally, there was a significant increase in scores of AVI (T1 = 18.60 ± 0.56 vs. T3 = 21.42 ± 0.46, p = .048) and an almost significant increase in CI (T1 = 1.30 ± 0.01vs. T3 = 1.33 ± 0.01, p = .056) through the tertiles of protein intake.

CONCLUSION

Macronutrients were significantly associated with all indices. The effect of macronutrients on obesity indices is sex-based. Among men, CI, AVI, and WWI were the indices most affected by carbohydrate and protein intakes. Future studies should further investigate food sources and macronutrient quality.

Association between soft drink consumption and carotid atherosclerosis in a large-scale adult population: The TCLSIH cohort study

BACKGROUND AND AIMS

Carotid atherosclerosis indicates an increased risk for cardiac-cerebral vascular disease. Given the pattern of consumption in China, sugar-sweetened beverage is the main type of soft drink consumed. As soft drinks contain a high amount of fructose, they may be a risk factor of carotid atherosclerosis. A prospective cohort study was conducted to investigate the association between soft drink consumption and the incidence of carotid atherosclerosis in a Chinese adult population.

METHODS AND RESULTS

A total of 3828 participants (men: 2007 and women: 1821) were included. Carotid atherosclerosis was measured by using ultrasonography and was defined by increased carotid intima-media thickness and/or carotid plaques. Soft drink consumption was assessed using a validated food frequency questionnaire. Cox proportional hazards regression analysis was used to assess the association of soft drink consumption categories with the incidence of carotid atherosclerosis. During a mean follow-up of 3.20 years, 1009 individuals of the 3828 eligible participants developed carotid atherosclerosis. After adjusting for potential confounding factors, we compared the higher levels to the lowest level of soft drink consumption in women, and we estimated the multivariable hazard ratios and 95% confidence intervals of incident carotid atherosclerosis to be 1.09 (0.80, 1.50), and 1.56 (1.14, 2.13) (P for trend <0.05). However, there was no significant association between soft drink consumption and the incidence of carotid atherosclerosis in men or total population.

CONCLUSION

The result indicated that soft drink consumption was associated with a higher incidence of carotid atherosclerosis in women.

TRIAL REGISTERED

UMIN Clinical Trials Registry.

TRIAL REGISTRATION NUMBER

UMIN000027174. TRIAL REGISTRATION WEBSITE: https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000031137.

A phenotypic approach to obesity treatment

Obesity is a chronic disease that increases morbidity and mortality and adversely affects quality of life. The rapid rise of obesity has outpaced the development and deployment of effective therapeutic interventions, thereby creating a global health crisis. The presentation, complications, and response to obesity treatments vary, yet lifestyle modification, which is the foundational therapeutic intervention for obesity, is often "one size fits all." The concept of personalized medicine uses genetic and phenotypic information as a guide for disease prevention, diagnosis, and treatment and has been successfully applied in diseases such as cancer, but not in obesity. As we gain insight into the pathophysiologic mechanisms of obesity and its phenotypic expression, specific pathways can be targeted to yield a greater, more sustained therapeutic impact in an individual patient with obesity. A phenotype-based pharmacologic treatment approach utilizing objective measures to classify patients into predominant obesity mechanism groups resulted in greater weight loss (compared with a non-phenotype-based approach) in a recent study by Acosta and colleagues. In this review, we discuss the application of lifestyle modifications, behavior therapy and pharmacotherapy using the obesity phenotype-based approach as a framework.

Taste but not smell sensitivities are linked to dietary macronutrient composition

Macronutrient intake and composition of diets (i.e., carbohydrate, protein, and fat) can vary substantially across individuals. Chemosensory functions are hypothesised to play a key role in modulating nutrient choices and intake. The present study tests links between individual gustatory or olfactory supra-threshold sensitivities and dietary macronutrient intake. A total of 98 European males (N = 81 for final analyses; age: 20-40 yo; BMI: 18.9-48.1 kg∙m^-2) were tested for supra-threshold sensitivities (d') to 3-gustatory (i.e., Sucrose, MSG, Dairy fat) and 3-olfactory stimuli (i.e., Vanillin, Methional, Maltol/Furaneol), followed by a 4-day weighed Food Record to give measures of macronutrient intake (kJ) and composition (%). With multivariate analyses (i.e., K-mean clustering, PCA, and Hierarchical Regression), gustatory and olfactory d' were compared across groups of individuals with distinct macronutrient composition or intake. Significant differences in gustatory d' were found across the clusters based on macronutrient composition (p < 0.05), but not for clusters based on intake. Hierarchical regressions suggested that gustatory d' played a significant role in predicting dietary carbohydrate composition and intake, with one-unit d' increase predicting reduction of 3%-4.66% (R² = 0.21, F_(5,75) = 5.38, p = 0.001). Moreover, every one-unit increase in d' to MSG increased protein composition by 3.45% (R² = 0.10, F_(5,75) = 2.83, p = 0.022) and intake by 392 kJ (R² = 0.08, F_(5,75) = 2.41, p = 0.044). By contrast, olfactory d' showed little association to macronutrient composition or intake (p > 0.05). Overall, we present intriguing new evidence that gustatory, but not olfactory, sensitivities are linked to dietary macronutrient composition, with relatively little effect on actual intake. These findings highlight possible action of a sensory-mediated mechanism guiding food choices.

Body Composition of Young Women and The Consumption of Selected Nutrients

The choices of food products and their nutritional value have a significant impact on nutritional status and body composition parameters. Popular and low-cost indicators of nutritional status, such as BMI, may not reflect the actual condition of the body. The aim of the study was to assess the consumption of energy as well as selected nutrients, such as protein, fats, carbohydrates, unsaturated fatty acids, lactose, starch, and dietary fiber, and to evaluate body mass index (BMI) and the parameters of the body composition among young women. Next, correlations were made between these nutrients and the parameters, such as percent body fat (PBF), visceral fat area (VFA), and fitness score (FS). The study group included 478 young women. To assess their consumption, the participants completed 72 h dietary interviews. In addition, the participants had a body composition analysis performed by bioelectric impedance technology by the InBody 720 Body Composition Analyzer (InBody, South Korea). The average energy value of the diets was about 1480 kcal. Most diets contained adequate portions of protein, fat, and carbohydrates. The diets were deficient in terms of unsaturated fatty acids and fiber. We showed that up to 37% of women with normal BMI had excess body fat. Moreover, the % energy from plant protein consumption negatively correlated with PBF and BMI (r = -0.10, p = 0.029, r = -0.10, p = 0.037, respectively) and dietary fiber with PBF, BMI, VFA, and FS (r = -0.17, p = 0.0003, r = -0.12, p = 0.01, r = -0.18, p = 0.0001, r = 0.09, p = 0.041, respectively). Education on the proper consumption of basic nutrients, including plant-based protein and dietary fiber, seems to be essential in preventing overweight and obesity.

Meeting 24-Hour Movement and Dietary Guidelines: Prevalence, Correlates and Association with Weight Status among Children and Adolescents: A National Cross-Sectional Study in China

China is confronted with a “double burden” of underweight and overweight/obesity in children and adolescents. This study aimed to investigate the prevalence and correlates of meeting 24 h movement and dietary guidelines among Chinese children and adolescents. Further, the study aimed to examine the association of meeting 24 h movement and dietary guidelines with weight status in Chinese children and adolescents. A total of 34,887 Chinese children and adolescents were involved. Only 2.1% of participants met the 24 h movement guidelines. Compared to those who met all three 24 h movement guidelines, those who only met the sleep duration guideline was significantly associated with a higher risk of underweight (p < 0.05), and those who only met the moderate-to-vigorous physical activity, or screen time guidelines were significantly associated with a higher risk of overweight/obesity (p < 0.05). Compared with those meeting the dietary guidelines, those who did not meet the soft drink intake guideline had a significantly lower risk of underweight (p < 0.05), those who did not meet the fruit intake guideline had a significantly lower risk of overweight/obesity (p < 0.05), and those who did not meet the milk intake guideline showed a significantly higher risk of overweight/obesity (p < 0.001). These findings indicate a significant association between meeting the 24 h movement and dietary guidelines and weight status among Chinese children and adolescents.

Application of accelerated heteronuclear single quantum coherence experiments to the rapid quantification of monosaccharides and disaccharides in dairy products

Monosaccharides and disaccharides are important dietary components, but if insufficiently metabolized by some population subgroups, they are also linked to disease patterns. Thus, the correct analytical identification, quantification, and labeling of these food components are crucial to inform and potentially protect consumers. Enzymatic assays and high-performance anion-exchange chromatography with pulsed amperometric detection are established methods for the quantification of monosaccharides and disaccharides that, however, require long measuring times (60-180 min). Accelerated methods for the identification and quantification of the nutritionally relevant monosaccharides and disaccharides d-glucose, d-galactose, d-fructose, sucrose, lactose, and maltose were therefore developed. To realize this goal, the NMR experiments HSQC (heteronuclear single quantum coherence) and acceleration by sharing adjacent polarization (ASAP)-HSQC were applied. Measurement times were reduced to 27 and 6 min, respectively, by optimizing the interscan delay and applying non-uniform sampling. The optimized methods were used to quantify d-glucose, d-galactose, d-fructose, sucrose, and lactose in various dairy products. Results of the HSQC and ASAP-HSQC methods are equivalent to the results of the reference methods in terms of both precision and accuracy, demonstrating that these methods can be used to correctly analyze nutritionally relevant monosaccharides and disaccharides in short times.

Food as Medicine for Obesity Treatment and Management

PURPOSE

Nutrition is an important lifestyle modification used in the treatment of obesity. The purpose of this review is to highlight different dietary interventions used to promote weight loss in both adults and children.

METHODS

A search using PubMed was performed for articles on topics related to nutrition and management and/or treatment of obesity in adults adolescents and children. The literature was reviewed and pertinent sources were used for this narrative review.

DISCUSSION

There are many effective nutrition interventions used to treat obesity, including altering macronutrient composition, implementing different dietary patterns, and changing meal timing. Although these interventions can induce weight loss in adults, management of obesity in children is more difficult given their varied nutrition needs in growth and development. The use of food as medicine in obesity treatment is individualized based on patient's age, food preference, and concurrent medical conditions.

IMPLICATIONS

Given the multifactorial etiology of obesity, treatment requires multidisciplinary care beyond nutrition intervention.

Increased Variation in Body Weight and Food Intake Is Related to Increased Dietary Fat but Not Increased Carbohydrate or Protein in Mice

A variety of inbred mouse strains have been used for research in metabolic disorders. Despite being inbred, they display large inter-individual variability for many traits like food intake and body weight. However, the relationship between dietary macronutrients and inter-individual variation in body weight and food intake of different mouse strains is still unclear. We investigated the association between macronutrient content of the diet and variations in food intake, body composition, and glucose tolerance by exposing five different mouse strains (C57BL/6, BALB/c, C3H, DBA/2, and FVB) to 24 different diets with variable protein, fat, and carbohydrate contents. We found only increasing dietary fat, but not protein or carbohydrate had a significant association (positive) with variation in both food intake and body weight. The highest variation in both body weight and food intake occurred with 50% dietary fat. However, there were no significant relationships between the variation in fat and lean mass with dietary protein, fat, or carbohydrate levels. In addition, none of the dietary macronutrients had significant impacts on the variation in glucose tolerance ability in C57BL/6 mice. In conclusion, the variations in food intake and body weight changes increased with the elevation of dietary fat levels.

Gut microbiota and BMI throughout childhood: the role of firmicutes, bacteroidetes, and short-chain fatty acid producers

Childhood obesity is a risk factor for numerous health conditions. A critical factor in the etiology of obesity appears to be the gut microbiota, which is the microbial community that resides in the human gut. The ratio of the phyla Firmicutes and Bacteroidetes (F/B) and gut bacterial genera that produce short-chain fatty acids (SCFA) have been suggested to contribute to obesity. The current study investigated (1) whether differences in F/B ratio can be observed in infancy and childhood in relation to zBMI in healthy children, and (2) whether an innovative proxy measure adds evidence to a relationship between SCFA producers and the etiology of obesity. Stool samples were collected at five time points, and zBMI was assessed at eight time points throughout the first 12 years of life. Our confirmatory analyses with Bayesian multilevel models showed no relationship between the F/B ratio and zBMI. Also, a proxy measure constructed from known SCFA producers was unrelated to zBMI throughout the first 12 years of life. Exploratory analyses using multilevel and random forest models suggest that the relative abundances of Firmicutes and Bacteroidetes were independently negatively associated with zBMI from infancy through childhood, and the SCFA producing genera Subdoligranulum and Alistipes were negatively related to future BMI in childhood.

A systematic review and meta-analysis of dietary fat effects on reproductive performance of sows and growth performance of piglets

Effects of added fat in sow diets on the sows’ reproductive performance and offspring growth performance are influenced by multiple factors such as genetics, nutrition, parity, ambient temperatures, and farm management. Individual studies cannot cover all these factors. With the view to address this challenge, we searched all studies that were published from 1986 to 2020, and performed a systematic review and meta-analysis on the fat effect. In total, 19 papers were collected and analyzed. Fat supplementation in sow diets during late gestation and lactation decreased average daily feed intake (ADFI, P < 0.05) and tended to increase average daily energy intake (ADEI, P = 0.11). It had no impact on litter weights at birth (P = 0.40) or weaning (P = 0.46). It increased total numbers of piglets at birth (P = 0.07), but had no effect on liveborn per litter (P = 0.90) or survival rate (P = 0.48) of piglets to weaning. Fat supplementation had no significant effect on sow body weight loss (P = 0.67) or backfat thickness changes (P = 0.66), but sows fed diets with added fat had increased milk fat concentration (P = 0.03) and shorter wean to estrus intervals (WEI, P = 0.01). In specific circumstances, fat supplementation tended to improve growth performance of piglets with low litter weights at birth (P = 0.14), or when the sows lost large amounts of body weight during lactation (P = 0.11). The level of supplemented fat was 10% and higher would decrease liveborn per litter at neutral temperature (P = 0.10). The meta-analysis revealed that fat supplementation to sows diet during late gestation and lactation can be beneficial for sow reproductive performance and litter growth performance.

An Overview of Epigenetics in Obesity: The Role of Lifestyle and Therapeutic Interventions

Obesity has become a global epidemic that has a negative impact on population health and the economy of nations. Genetic predispositions have been demonstrated to have a substantial role in the unbalanced energy metabolism seen in obesity. However, these genetic variations cannot entirely explain the massive growth in obesity over the last few decades. Accumulating evidence suggests that modern lifestyle characteristics such as the intake of energy-dense foods, adopting sedentary behavior, or exposure to environmental factors such as industrial endocrine disruptors all contribute to the rising obesity epidemic. Recent advances in the study of DNA and its alterations have considerably increased our understanding of the function of epigenetics in regulating energy metabolism and expenditure in obesity and metabolic diseases. These epigenetic modifications influence how DNA is transcribed without altering its sequence. They are dynamic, reflecting the interplay between the body and its surroundings. Notably, these epigenetic changes are reversible, making them appealing targets for therapeutic and corrective interventions. In this review, I discuss how these epigenetic modifications contribute to the disordered energy metabolism in obesity and to what degree lifestyle and weight reduction strategies and pharmacological drugs can restore energy balance by restoring normal epigenetic profiles.

Role of macronutrient intake in the epigenetics of obesity

Obesity is caused by a combination of hereditary and environmental factors. Despite extensive study, contemporary through diet, exercise, education, surgery, and pharmacological treatments, no effective long-term solution has been found to this epidemic. Over the last decade, there has been a tremendous advancement in understanding the science of epigenetics, as well as a rise in public interest in learning more about the influence of diet and lifestyle choices on the health of an individual. Without affecting the underlying DNA sequence, epigenetic alterations impact gene expression. Previous animal studies have shown a link between the type of diet and expression or suppression of obesity genes, but there are very few human studies that demonstrate the relationship between dietary intake and obesity gene expression. This review highlights the effects of carbohydrates, lipids, and protein intake from the diet on obesity-related genes.

The Mediterranean Diet Positively Affects Resting Metabolic Rate and Salivary Microbiota in Human Subjects: A Comparison with the Vegan Regimen

Simple Summary

Salivary microbiota has been shown to be individualized and influenced by genetic and environmental factors, including macronutrient intake and lifestyle. Herein, the effect of two long-term dietary patterns, the Mediterranean and the vegan diet, was analyzed on oral microbiota composition and metabolic profile of human subjects. Moreover, we correlated microbial species to metabolic parameters. Subjects following the Mediterranean diet had a wider spectrum of oral bacteria and a better metabolic profile compared to the vegan diet, confirming the positive effects of a Mediterranean diet.

Abstract

Salivary microbiota, comprising bacteria shed from oral surfaces, has been shown to be individualized, temporally stable, and influenced by macronutrient intake and lifestyle. Nevertheless, the effect of long-term dietary patterns on oral microbiota composition and the relationship between oral microbiota composition and metabolic rate remains to be examined. Herein, salivary microbiota composition and metabolic profile were analyzed in human subjects with vegan (VEG) or Mediterranean (MED) long-term dietary patterns. MED subjects presented significantly higher percentages of Subflava and Prevotella species as compared to VEG ones. Moreover, MED subjects showed a lower carbohydrate and a higher lipid consumption than VEG subjects, and, accordingly, a significantly higher basal metabolic rate (BMR) and a lower respiratory quotient (RQ). Prevotella abundance was demonstrated to be inversely related to RQ and carbohydrate consumption, whereas Subflava percentages were demonstrated to be positively correlated to BMR. Lactobacillus abundance, which was inversely related to Subflava presence in MED subjects, was associated with decreased BMR (Harris–Benedict) values. Overall, our data evidence the influence of macronutrient intake on metabolic profile and oral microbiota and confirm the positive effects of the Mediterranean diet on BMR and on the abundance of microbial species associated with a better macronutrient metabolism.

Anti-Obesity Effect of Hot Water Extract of Barley Sprout through the Inhibition of Adipocyte Differentiation and Growth

Barley sprouts are known to have several effective physiological activities. In this study, the anti-obesity effect of a barley sprout hot water extract (BSE) was confirmed. Saponarin was quantitatively analyzed in BSE using HPLC, and the inhibitory effect on 3T3-L1 pre-adipocyte differentiation into adipocytes was confirmed by Oil Red O staining, TG assay, and Western blotting. In addition, the inhibitory effect of BSE on adipocyte growth was confirmed through glucose uptake and lipolysis of adipocytes. C57/BL/6N mice were induced to obesity with a high-fat diet, and BSE was administered to confirm the effect on an animal model. Weight gain, morphological changes in adipose tissue, changes in the food efficiency ratio, and blood biochemical changes were observed, and an improvement effect on fatty liver was confirmed. As a result, the anti-obesity effect of BSE was confirmed in vitro, and it was confirmed that this effect was also effective in vivo and that it could be helpful in the treatment of obesity-related diseases.

Association between Carbohydrate Intake and the Prevalence of Metabolic Syndrome in Korean Women

Carbohydrates consist of a large proportion of calories in the Asian diet. Therefore, we aimed to investigate the association between carbohydrate intake and metabolic syndrome in Korean women. A cross-sectional analysis was conducted with a total of 4294 Korean women aged 40–69 years from the Korean Genomic and Epidemiology Study (KoGES). Carbohydrate intake was calculated based on a validated food frequency questionnaire. Metabolic syndrome was defined by using the National Cholesterol Education Program, Adult Treatment Panel III (NCEPIII). Logistic regression was used to estimate the association of carbohydrate intake with metabolic syndrome and its components. In this study, high carbohydrate intake seemed to be associated with low socioeconomic status and an imbalanced diet. After adjusting for confounding factors, subjects with higher carbohydrate intake showed an increased risk of metabolic syndrome (odds ratio (OR) 1.34, 95% confidence interval (CI) 1.08–1.66, p-trend = 0.004, highest vs. lowest quartile [≥75.2 vs. <67.0% of energy]), particularly elevated waist circumference. This association was stronger among those with low levels of C-reactive protein (CRP) and those with low dairy intake. In conclusion, higher carbohydrate intake is associated with a higher risk of metabolic syndrome, particularly abdominal obesity, in Korean women. This association may differ according to individuals’ CRP level and dairy intake.

Diet Quality and Lower Refined Grain Consumption are Associated With Less Weight Gain in a Multi-Ethnic Asian Adult Population

BACKGROUND

The prevalence of obesity is increasing in many Asian countries. However, longitudinal data on the impacts of dietary factors on weight gain in Asian populations are sparse.

OBJECTIVES

We evaluated the relationship between changes in intakes of nutrients, foods, and beverages and diet quality and long-term changes in body weight.

METHODS

We used data (n = 3064) from the Singapore Multi-Ethnic Cohort, a prospective cohort including Chinese, Indian, and Malay residents aged 21-65 years. Dietary intakes were assessed using an FFQ, and body weight and waist circumference were measured during health examinations. Diet quality was evaluated using the Dietary Approaches to Stop Hypertension (DASH) and Alternative Healthy Eating Index (AHEI-2010) scores. Data were collected at baseline (2004-2010) and follow-up (2011-2016), with a mean follow-up of 6.0 years. Linear regression was used to assess the associations between dietary changes and weight change, adjusted for socio-demographic and lifestyle variables.

RESULTS

Improvements in dietary quality scores (DASH, -0.34 kg per 5 points; AHEI-2010, -0.35 kg per 10 points) and replacement of carbohydrates with protein (-0.44 kg per 5% of energy) were significantly associated with less weight gain. Increased intakes of white rice (+0.25 kg per serving/d), soft drinks (+0.69 kg), red meat (+0.58 kg), and poultry with skin (+0.74 kg) were directly associated with weight gain. The replacement of 1 serving per day of white rice with whole grains (-0.68 kg), vegetables (-0.33 kg), poultry without skin (-0.79 kg), and eggs (-0.87 kg) was associated with less weight gain. Similar associations were observed between changes in dietary factors and changes in waist circumference.

CONCLUSIONS

Among Asian adults, increasing dietary quality, reducing soft drink consumption, and replacing white rice with whole grains, vegetables, and selected high-protein foods was associated with less weight gain.

The Use of Natural Fiber-Rich Food Product Is Safe and Reduces Aberrant Crypt Foci in a Pre-Clinical Model

BACKGROUND

Colorectal cancer is a highly prevalent disease, requiring effective strategies for prevention and treatment. The present research aimed to formulate a natural fiber-rich food product (NFRFP) and to evaluate its safety, toxicogenetics, and effects on aberrant crypt foci induced by 1,2-dimethyl-hydrazine in a preclinical model.

METHODS

A total of 78 male Wistar rats were distributed in six experimental groups: negative control, positive control (1,2-Dimethylhydrazine-40 mg/Kg), and four groups fed with 10% NFRFP: NFRFP, pre-treatment protocol, simultaneous treatment, and post-treatment protocol.

RESULTS

The NFRFP was shown to be a good source of fibers and did not change biometric, biochemical, hematological, and inflammatory parameters, and did not induce signs of toxicity and genotoxicity/carcinogenicity. NFRFP exhibited a chemopreventive effect, in all protocols, with damage reduction (% DR) of 75% in the comet test. NFRFP reduced the incidence of aberrant crypt outbreaks by 49.36% in the post-treatment protocol.

CONCLUSIONS

The results suggest the applicability of NFRFP in the human diet due to potential production at an industrial scale and easy technological application in different products, since it could be incorporated in food without altering or causing small changes in final product sensory characteristics.

The Implementation of Childhood Obesity Related Policy Interventions in Malaysia-A Non Communicable Diseases Scorecard Project

(1) Background: The prevalence of overweight and obesity among children has increased tremendously in the ASEAN region, including Malaysia. In Malaysia, the National Strategic Plan for Non-Communicable Diseases (2015–2025) provides the overall framework for its response to the non-communicable diseases (NCD) epidemic. Preventing childhood obesity is one of the key strategies for early intervention to prevent NCDs. The objective of this research is to examine the current status of policy interventions in addressing childhood obesity in Malaysia. (2) Methods: A panel of 22 stakeholders and experts from Malaysia, representing the government, industry, academia and non-governmental organizations, were sampled using a modified Delphi technique. Data were collected using a modified NCD scorecard under four domains (governance, risk factors, surveillance and research and health systems response). A heat map was used to measure the success of the four realms of the NCD scorecard. For each domain of the NCD scorecard, the final score was grouped in quintiles. (3) Results: A total of 22 participants responded, comprising of eight (36.4%) males and 14 (63.4%) females. All the domains measured in implementing policies related to childhood obesity were of low progress. Nine governance indicators were reported as 22.5% (low progress), four in the risk factors domain, and two in the surveillance. This shows that timely and accurate monitoring, participatory review and evaluation, and effective remedies are necessary for a country’s surveillance system. (4) Conclusion: Although Malaysia has published several key strategic documents relating to childhood obesity and implemented numerous policy interventions, we have identified several gaps that must be addressed to leverage the whole-of-government and whole-of-society approach in addressing childhood obesity in the country.

Elaboration of Gluten-Free Cookies with Defatted Seed Flours: Effects on Technological, Nutritional, and Consumer Aspects

Cookies, which form the largest category of bakery snacks, are considered a good vehicle to introduce nutrients into the diet. In this study, to increase the nutritional value of traditional commercial cookies, wheat flour was substituted with defatted flours made from flax, sesame, chia, and poppy, which are byproducts of the oil extraction industry. The differences in the technological properties, nutritional composition, and consumer acceptance of the reformulated cookies were evaluated. The results show that the wheat cookies used as the control showed a more elastic behavior than the cookies elaborated with defatted seed flours, which showed a greater tendency to crumble. The use of defatted seed flours yielded cookies with a higher content of protein and fiber, and a lower content in carbohydrates than the wheat cookies. Consumer evaluations for the sesame and flax cookies were similar to those for the traditional wheat cookies, with positive assessments on all of the parameters evaluated. On the other hand, the cookies elaborated using chia and poppy flours received the least positive evaluations from consumers. Thus, the use of some defatted seed flours, mainly flax and sesame, is proposed as an interesting alternative to produce health-promoting cookies in order to cover the current demand for gluten-free products.

Protein quality and quantity influence the effect of dietary fat on weight gain and tissue partitioning via host-microbiota changes

We investigated how protein quantity (10%-30%) and quality (casein and whey) interact with dietary fat (20%-55%) to affect metabolic health in adult mice. Although dietary fat was the main driver of body weight gain and individual tissue weight, high (30%) casein intake accentuated and high whey intake reduced the negative metabolic aspects of high fat. Jejunum and liver transcriptomics revealed increased intestinal permeability, low-grade inflammation, altered lipid metabolism, and liver dysfunction in casein-fed but not whey-fed animals. These differential effects were accompanied by altered gut size and microbial functions related to amino acid degradation and lipid metabolism. Fecal microbiota transfer confirmed that the casein microbiota increases and the whey microbiota impedes weight gain. These data show that the effects of dietary fat on weight gain and tissue partitioning are further influenced by the quantity and quality of the associated protein, primarily via effects on the microbiota.

The Promising Ability of Humulus lupulus L. Iso-α-acids vs. Diabetes, Inflammation, and Metabolic Syndrome: A Systematic Review

For centuries, natural medicines have represented the only option for treating human diseases and, nowadays, plant phytochemicals are considered as promising compounds to treat or prevent chronic conditions. Among them, hop flowers (Humulus lupulus L.), typically used in brewing industries to give the typical aroma and flavor to beer, have attracted particular attention for their health promoting properties. Several in vivo/vitro studies and human interventional trials have demonstrated the beneficial effects of these molecules on weight gain, lipid metabolism, glucose homeostasis, insulin sensitivities, and inflammation by acting on different targets. All these activities suggest a possible role of bitter hop acid in preventing metabolic syndrome and its related diseases. A systematic quest on PubMed and Scopus databases was performed to identify pre-clinical and clinical studies focusing on this topic. This systematic review summarizes the results obtained by different cell lines, animal models, and human interventional trials to propose iso-α-acids as medical nutrition therapy to treat or prevent metabolic syndrome and its related disorders as diabetes, dislipidemia inflammation, etc.

Temporal Dietary Patterns Are Associated with Obesity in US Adults

BACKGROUND

The integration of time with dietary patterns throughout a day, or temporal dietary patterns (TDPs), have been linked with dietary quality but relations to health are unknown.

OBJECTIVE

The association between TDPs and selected health status indicators and obesity, type 2 diabetes (T2D), and metabolic syndrome (MetS) was determined.

METHODS

The first-day 24-h dietary recall from 1627 nonpregnant US adult participants aged 20-65 y from the NHANES 2003-2006 was used to determine timing, amount of energy intake, and sequence of eating occasions (EOs). Modified dynamic time warping (MDTW) and kernel k-means algorithm clustered participants into 4 groups representing distinct TDPs. Multivariate regression models determined associations between TDPs and health status, controlling for potential confounders, and adjusting for the survey design and multiple comparisons (P <0.05/6).

RESULTS

A cluster representing a TDP with evenly spaced, energy balanced EOs reaching ≤1200 kcal between 06:00 to 10:00, 12:00 to 15:00, and 18:00 to 22:00, had statistically significant and clinically meaningful lower mean BMI (P <0.0001), waist circumference (WC) (P <0.0001), and 75% lower odds of obesity compared with 3 other clusters representing patterns with much higher peaks of energy: 1000-2400 kcal between 15:00 and 18:00 (OR: 5.3; 95% CI: 2.8, 10.1), 800-2400 kcal between 11:00 and 15:00 (OR: 4.4; 95% CI: 2.5, 7.9), and 1000-2600 kcal between 18:00 and 23:00 (OR: 6.7; 95% CI: 3.9, 11.6).

CONCLUSIONS

Individuals with a TDP characterized by evenly spaced, energy balanced EOs had significantly lower mean BMI, WC, and odds of obesity compared with the other patterns with higher energy intake peaks at different times throughout the day, providing evidence that incorporating time with other aspects of a dietary pattern may be important to health status.

The burden of type 2 diabetes pre-and during the COVID-19 pandemic - a review

Introduction

Diabetes Mellitus is a chronic disease and a global epidemic. It is a known fact that co-morbidities, including Diabetes Mellitus, pose a higher risk of infection by COVID-19. Additionally, the outcomes following infection are far worse than in people without such co-morbities.Factors contributing to the development of type 2 diabetes mellitus (T2DM) have long been established, yet this disease still bestows a substantial global burden. The aim was to provide a comprehensive review of the burden of diabetes pre-COVID-19 and the additional impact sustained by the diabetes population and healthcare systems during the COVID-19 pandemic, while providing recommendations of how this burden can be subsided.

Methodology

Literature searches were carried out on 'Google Scholar' and 'PubMed' to identify relevant articles for the scope of this review. Information was also collected from reliable sources such as the World Health Organisation and the International Diabetes Federation.

Results

T2DM presented with economic, social and health burdens prior to COVID-19 with an significant 'Disability Adjusted Life Years' impact. Whilst people with diabetes are more susceptible to COVID-19, enforcing lockdown regulations set by the Public Health department to reduce risk of infection brought about its own challenges to T2DM management. Through recommendations and adapting to new methods of management such as telehealth, these challenges and potential consequences of mismanagement are kept to a minimum whilst safeguarding the healthcare system.

Conclusion

By understanding the challenges and burdens faced by this population both evident pre-covid and during, targeted healthcare can be provided during the COVID-19 pandemic. Furthermore, implementation of targeted action plans and recommendations ensures the care provided is done in a safe and effective environment.

Hepatic metabolic adaptation and adipose tissue expansion are altered in mice with steatohepatitis induced by high-fat high sucrose diet

BACKGROUND

Obesity is a chronic progressive disease with several metabolic alterations. Nonalcoholic fatty liver disease (NAFLD) is an important comorbidity of obesity that can progress to nonalcoholic steatohepatitis (NASH), cirrhosis or hepatocarcinoma. This study aimed at clarifying the molecular mechanisms underlying the metabolic alterations in hepatic and adipose tissue during high-fat high-sucrose diet-induced NAFLD development in mice.

METHODS

Twenty-four male mice (C57BL/6J) were randomly allocated into 3 groups (n = 8 mice per group) to receive a chow diet, a high-fat diet (HFD), or a high-fat high-sucrose diet (HF-HSD) for 20 weeks. At sacrifice, liver and adipose tissue were obtained for histopathological, metabolomic, and protein expression analyses.

RESULTS

HF-HSD (but not HFD) was associated with NASH and increased oxidative stress. These animals presented an inhibition of hepatic autophagy and alterations in AMP-activated protein kinase/mammalian target of rapamycin activity. We also observed that the ability of metabolic adaptation was adversely affected by the increase of damaged mitochondria. NASH development was associated with changes in adipose tissue dynamics and increased amounts of saturated fatty acids, monounsaturated fatty acids and polyunsaturated fatty acids in visceral adipose tissue.

CONCLUSION

HF-HSD led to a metabolic blockage and impaired hepatic mitochondria turnover. In addition, the continuous accumulation of fatty acids produced adipose tissue dysfunction and hepatic fat accumulation that favored the progression to NASH.

Acute postprandial effect of yacon syrup ingestion on appetite: A double blind randomized crossover clinical trial

Yacon syrup is a rich source of fructooligosaccharides (FOS); however, its diet supplementation effect on subjective sensation and appetite biomarkers in human is still unknown. This study aimed to evaluate the acute postprandial effect of yacon syrup ingestion on appetite. The double-blind crossover clinical trial was carried out with 40 adult women: 20 eutrophic and 20 obese grade I. On each day, the first blood collection was performed after a 12-h fast. Then, the volunteers ingested either intervention A (breakfast + 40 g of placebo) or intervention B (breakfast + 40 g of yacon syrup, containing 14 g of FOS). New aliquots of blood were collected at 45, 60, 90, 120, and 180 min. Appetite was assessed by estimating ghrelin and glucagon-like peptide-1 (GLP-1) levels and by assessing subjective appetite sensation. Analysis was performed using two-way ANOVA, followed by Bonferroni's multiple comparison test. No effect of yacon syrup was observed on postprandial ghrelin and GLP-1 levels at all times evaluated. Similar observations were made after stratifying the analysis by BMI (body mass index) (eutrophic and obese). The effect of yacon syrup on postprandial subjective sensations of hunger, satiety, fullness, and desire to eat was not evident in the total group of women evaluated and even after BMI stratification. We concluded that yacon syrup had no effect on postprandial ghrelin and GLP-1 levels and on the subjective appetite sensation in young adult women.

Carbohydrates, Starch, Total Sugar, Fiber Intakes and Food Sources in Spanish Children Aged One to <10 Years-Results from the EsNuPI Study

Diet quality is a modifiable factor that may contribute to the onset of diet-related chronic diseases. Currently, in Spain there are no studies that examine the intakes and sources for total carbohydrates, starch, total sugar, and fiber by both children consuming all kind of milks and children regularly consuming adapted milk formulas. Our goal was to evaluate the contribution of different food groups to total carbohydrates, starch, total sugar, and fiber consumption within the EsNuPI study participants by assessing their usual intakes by applying two 24 h dietary recalls that were completed by 1448 children (1 to <10 years) divided into two cohorts: one Spanish Reference Cohort (SRS) of the general population (n = 707) and another cohort which included children consuming adapted milks including follow-on milk, toddler’s or growing up milk, fortified and enriched milks, here called Adapted Milk Consumers Cohort” (AMS) (n = 741). Estimation of the usual intake showed that nutrient intake increased with age for all nutrients except for fiber. The percentage of children by age and gender who met the reference intake (RI) range for total carbohydrates, was in all groups more than 50% of individuals, except for girls aged 6 to <10 years from the reference cohort in which only 46.9% complied the RI. Median fiber intake, both in the SRS and the AMS, was well below the adequate intake (AI) for children between 3 and 10 years. Main total carbohydrates sources were cereals, followed by milk and dairy products, fruits, bakery and pastry, vegetables and sugars and sweets. The highest contributors to starch intakes were cereals, bakery and pastry, vegetables, and fruits. Major sources of total sugar intakes were milk and dairy products, fruits, bakery and pastry, sugars and sweets, vegetables, and cereals. Nonetheless, milk and dairy products, and fruits, mainly provided lactose and fructose, respectively, which are not considered free sugars. Higher contribution to fiber intakes was provided by fruits, cereals, vegetables and bakery and pastry. There were no significant differences in relation with the total sugar intake according to the body mass index (BMI) between SRS and AMS. The present study suggests a high proportion of children had total carbohydrates intakes in line with recommendations by public health authorities, but still a significant number presented insufficient total carbohydrate and fiber intakes, while total sugar consumption was high, with no major differences between SRS and AMS cohorts.

Associations of fat and carbohydrate intake with becoming overweight and obese: an 11-year longitudinal cohort study

The effects of macronutrient intake on obesity are controversial. This research aims to investigate the associations between macronutrient intake and new-onset overweight/obesity. The relationship between the consumption of carbohydrate and total fat and obesity was assessed by the multivariable Cox model in this 11-year cohort, which included 6612 adults (3291 men and 3321 women) who were free of overweight and obesity at baseline. The dietary intake was recorded using a 24-h recall method for three consecutive days. Moreover, substitution models were developed to distinguish the effects of macronutrient composition alteration from energy intake modification. During 7·5 person years (interquartile range 4·3, 10·8) of follow-up, 1807 participants became overweight or obese. After adjusting for risk factors, the hazard ratio (HR) of overweight/obesity in extreme quintiles of fat was 1·48 (quintile 5 v. quintile 1, 95 % CI 1·16, 1·89; Ptrend = 0·02) in women. Additionally, replacing 5 % of energy from carbohydrate with equivalent energy from fat was associated with an estimated 4·3 % (HR 1·043, 95 % CI 1·007, 1·081) increase in overweight/obesity in women. Moreover, dietary carbohydrate was inversely associated with overweight/obesity (quintile 5 v. quintile 1, HR 0·70, 95 % CI 0·55, 0·89; Ptrend = 0·02) in women. Total fat was related to a higher risk of overweight/obesity, whereas high carbohydrate intake was related to a lower risk of overweight/obesity in women, which was not observed in men.

The Association of Serum Levels of Leptin and Ghrelin with the Dietary Fat Content in Non-Obese Women with Polycystic Ovary Syndrome

Women with polycystic ovary syndrome (PCOS) are at an increased risk of developing insulin resistance and abdominal obesity in the state of an improper diet balance. Leptin is a peptide considered to be a satiety hormone that plays an important role in the long-term energy balance, whereas ghrelin is a hormone that controls short-term appetite regulation and is considered a hunger hormone. The aim of the present study was to assess the relationship between serum leptin and ghrelin concentrations and the dietary macronutrient content in PCOS women. We examined 73 subjects: 39 women diagnosed with PCOS by the Rotterdam criteria and 34 healthy controls, matched by the body mass index. The subjects completed a consecutive three-day dietary diary to identify the macronutrient and micronutrient intake. Serum concentrations of leptin and total ghrelin were measured and homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. The studied groups did not differ significantly in terms of the intake of macronutrients (proteins, fats, and carbohydrates) and serum concentrations of ghrelin and leptin (all p > 0.05). In the PCOS group, the serum leptin concentration positively correlated with the intake of total fat (r = 0.36, p = 0.02), total cholesterol (r = −0.36, p = 0.02), saturated fatty acids (r = 0.43, p < 0.01), and monounsaturated fatty acids (MUFA) (r = 0.37, p = 0.02), whereas the serum ghrelin concentration correlated in an inverse manner with the intake of total fat (r = −0.37, p = 0.02), MUFA (r = −0.37, p = 0.02), polyunsaturated fatty acids (r = −0.34, p = 0.03), and long chain polyunsaturated fatty acids (r = −0.38, p = 0.02). In this group, we also found a negative association of HOMA-IR with serum ghrelin levels (r = −0.4, p = 0.03) and a positive relationship with the serum leptin concentration (r = 0.5, p < 0.01) and relationships between HOMA-IR and total dietary fat (r = 0.38, p = 0.03) and MUFA (r = 0.35, p = 0.04) intake. In PCOS women, dietary components such as the total fat and type of dietary fat and HOMA-IR are positively connected to serum leptin concentrations and negatively connected to serum ghrelin concentrations, which may influence the energy balance.

Effects of dietary macronutrients and body composition on glucose homeostasis in mice

As a major health issue, obesity is linked with elevated risk of type 2 diabetes. However, whether disrupted glucose homeostasis is due to altered body composition alone, or whether dietary macronutrients play an additional role, independent of their impact on body composition, remains unclear. We investigated the associations between macronutrients, body composition, blood hormones and glucose homeostasis. We fed C57BL/6N mice 29 different diets with variable macronutrients for 12 weeks. After 10 weeks, intraperitoneal glucose tolerance tests were performed. Generalized linear models were generated to evaluate the impacts of macronutrients, body composition and blood hormones on glucose homeostasis. The area under the glucose curve (AUC) was strongly associated with body fat mass, but not dietary macronutrients. AUC was significantly associated with fasting insulin levels. Six genes from transcriptomic analysis of epididymal white adipose tissue and subcutaneous white adipose tissue were significantly associated with AUC. These genes may encode secreted proteins that play important previously unanticipated roles in glucose homeostasis.

Double Burden of Malnutrition and Nutrition Transition in Asia: A Case Study of 4 Selected Countries with Different Socioeconomic Development

Disease burden and lifestyle patterns have changed rapidly worldwide, especially in some Asian countries over the past 2 decades. However, cross-country comparative research is limited. This study investigated the nutritional status of preschool children and childbearing women in China, India, Nepal, and Pakistan selected based on their socioeconomic status, population size, and urbanization. Nationally representative data were used from the China National Nutrition and Health Surveillance Report, India National Family Health Survey, Nepal Demographic and Health Survey, Pakistan Demographic and Health Survey, the WHO repository, and the World Bank. The prevalence of underweight, overweight, and obesity and some ratios were compared. These rates varied across these 4 countries and were associated with their economic development levels. China's economic status and prevalence of childhood overweight/obesity (11.5%) were highest; India's economic status was higher than that of Nepal and Pakistan, but had higher rates of stunting, wasting, and underweight (38.4%, 21.0%, and 35.7%, respectively) in preschool children. Pakistan had the highest prevalence of overweight/obesity among childbearing women (52.4% in all, 63.0% in urban areas). Nepal had the lowest economic status and overweight/obesity rate in preschool children (1.2%). In general, the prevalence of overweight/obesity was higher in urban than in rural areas, except among childbearing women in China. Nutritional status and health burden are heavily influenced by economic development. The double burden of malnutrition poses prioritization challenges for policymakers and public health efforts. Prevention of obesity is urgently needed, at least in higher-income countries in Asia.

Enzymatically elongated rice starches by amylosucrase from Deinococcus geothermalis lead to slow down the glucose generation rate at the mammalian α-glucosidase level

Amylosucrase (AS) catalyzes the transfer of a glucosyl unit from sucrose onto α-1,4-linked glucan polymers in starch. In this study, AS from Deinococcus geothermalis (DgAS) was applied to produce modified rice starches with slowly digestible properties. DgAS-treated waxy and normal rice starches showed significantly (p < 0.05) elevated degrees of polymerization, suggesting that the external chains were elongated. Additionally, the crystalline structures of starches changed from A- to B-type, and the temperature transition properties of enzymatically modified rice starches increased. The amounts of slowly digestible starch (SDS) increased remarkably (20.1% and 18.8%; waxy and normal rice starches, respectively), and the DgAS-treated rice starches were slowly hydrolyzed to glucose at the mammalian mucosal α-glucosidase level. Thus, DgAS-treated rice starches can be used to produce SDS-based ingredients that attenuate the glucose spike after glycemic food ingestion.

Dietary and Lifestyle Patterns are Associated with Heart Rate Variability

Assessment of heart rate variability (HRV) and cardiac ectopic beats is a clinically relevant topic. The present exploratory observational study aimed to inspect the relationships of lifestyle, dietary patterns, and anthropometrics with HRV, premature ventricular complexes (PVCs), and supraventricular premature complexes (SVPCs). A cross-sectional study enrolling subjects undergoing Holter monitoring was performed. Sociodemographic and clinical characteristics, body composition (full-body bio-impedentiometry), dietary patterns (validated food frequency questionnaire and 24 h dietary recall), and quality of life were assessed. Generalized additive models were estimated to evaluate the relationships between outcomes of interest and variables collected. The study enrolled 121 consecutive patients undergoing 24 h Holter monitoring. Upon univariable analysis, HRV was found to have an inverse association with mass of body fat (MBF) (p-value 0.015), while doing physical activity was associated with a significantly higher HRV (p-value 0.036). Upon multivariable analysis, fruit consumption in the 24 h dietary recall was found to be directly associated with HRV (p-value 0.044). The present findings might be useful for improving the management of patients attending cardiac rhythm labs, and to tailor ad hoc prevention strategies (modification of lifestyle and eating habits) based on Holter parameters.

Exploring the Perceptions of Women from Under-Resourced South African Communities about Participating in a Low-Carbohydrate High-Fat Nutrition and Health Education Program: A Qualitative Focus Group Study

Scientific evidence suggests that low-carbohydrate high-fat (LCHF) diets may be effective for managing non-communicable diseases (NCDs). Eat Better South Africa (EBSA) is an organization that runs LCHF nutrition education programs for women from low-income communities. Three focus group discussions (FGDs) were held with 18 women who had taken part in an EBSA program between 2015 and 2017, to explore their perceptions and to identify the facilitators and barriers they faced in implementing and sustaining dietary changes. Thematic analysis of the focus groups was conducted using NVivo 12 software. Women reported that they decided to enroll in the program because they suffered from NCDs. Most women said that the EBSA diet made them feel less hungry, more energetic and they felt that their health had improved. Most women spoke of socioeconomic challenges which made it difficult for them to follow EBSA’s recommendations, such as employment status, safety issues in the community, and lack of support from relatives and doctors. Hence, women felt they needed more support from EBSA after the program. The social determinants that affected these women’s ability to change their health behavior are also NCD risk factors, and these should be assessed to improve the program for other communities.

The Effect of Isolated and Synthetic Dietary Fibers on Markers of Metabolic Diseases in Human Intervention Studies: A Systematic Review

Observational studies provide strong evidence for the health benefits of dietary fiber (DF) intake; however, human intervention studies that supplement isolated and synthetic DFs have shown inconsistent results. Therefore, we conducted a systematic review to summarize the effects of DF supplementation on immunometabolic disease markers in intervention studies in healthy adults, and considered the role of DF dose, DF physicochemical properties, intervention duration, and the placebo used. Five databases were searched for studies published from 1990 to 2018 that assessed the effect of DF on immunometabolic markers. Eligible studies were those that supplemented isolated or synthetic DFs for ≥2 wk and reported baseline data to assess the effect of the placebo. In total, 77 publications were included. DF supplementation reduced total cholesterol (TC), LDL cholesterol, HOMA-IR, and insulin AUC in 36-49% of interventions. In contrast, <20% of the interventions reduced C-reactive protein (CRP), IL-6, glucose, glucose AUC, insulin, HDL cholesterol, and triglycerides. A higher proportion of interventions showed an effect if they used higher DF doses for CRP, TC, and LDL cholesterol (40-63%), viscous and mixed plant cell wall DFs for TC and LDL cholesterol (>50%), and longer intervention durations for CRP and glucose (50%). Half of the placebo-controlled studies used digestible carbohydrates as the placebo, which confounded findings for IL-6, glucose AUC, and insulin AUC. In conclusion, interventions with isolated and synthetic DFs resulted mainly in improved cholesterol concentrations and an attenuation of insulin resistance, whereas markers of dysglycemia and inflammation were largely unaffected. Although more research is needed to make reliable recommendations, a more targeted supplementation of DF with specific physicochemical properties at higher doses and for longer durations shows promise in enhancing several of its health effects.

Regular intake of white kidney beans extract (Phaseolus vulgaris L.) induces weight loss compared to placebo in obese human subjects

Scope

Phaseolus vulgaris L. is rich in alpha-amylase inhibitor and has been used for reducing glycemia and calories absorption through preventing or delaying the digestion of complex carbohydrate. A randomized, double-blinded, placebo-controlled study was conducted on obese volunteers to evaluate the degree of significate weight loss by regular intake Phaseolus vulgaris cultivated from Southwestern region of China.

Method

The volunteers were divided into two groups, homogeneous for age, gender, and body weight. Phaseolus vulgaris extract or placebo was given 2,400 mg per day before each daily meal for 35 consecutive days. Each subject's body weight, fat mass, body mass index, blood biochemical parameters, skinfold fat thickness, and waist/hip circumferences were monitored and analyzed.

Result and conclusion

As a result, the average amount of weight lost by the Phaseolus vulgaris extract group was 2.24 kg (average of 0.448 kg per week), compared with a 0.29 kg weight loss (average of 0.058 kg per week) in placebo group after 35 days. The differences between groups were significant (p < .01). The body mass index decreased by an average of 0.79, and the body fat decreased by 1.53% on average compared to baseline (p < .05). The thickness of subcutaneous fat was significantly reduced at the four measurement points, and the decrease of waist circumference and hip circumference was significant as well. No adverse or side effects were observed during the trial period. The results indicate that Phaseolus vulgaris extract can significantly induce weight loss in a short time period.

High Intake of Free Sugars, Fructose, and Sucrose Is Associated with Weight Gain in Japanese Men

BACKGROUND

Available evidence for associations between sugar intake and body weight is largely from short-term controlled trials and studies focusing on sugar-sweetened beverages. Studies on long-term weight change related to the intake of types of sugar are thus needed.

OBJECTIVE

We examined the associations between weight change and the intake of various types of carbohydrates, including starch, total sugars, and free or naturally occurring sugars and saccharides (i.e., glucose, fructose, sucrose, and lactose), among Japanese men and women.

METHODS

This prospective cohort study included 14,971 residents of Takayama City in Japan who were aged 35-69 y at the first survey in 1992 and responded to a self-administrated questionnaire at the second survey in 2002. We excluded those with cancer, coronary artery disease, stroke, or diabetes on the first survey and those with missing information about body weight on both surveys, leaving 13,229 participants for analysis (5879 men and 7350 women). Mean (95% CI) values of 10-y weight change according to types of carbohydrates were estimated using linear regression models with adjustment for total energy intake and other dietary and lifestyle factors. Dietary intake was assessed at the first survey using a validated FFQ.

RESULTS

Among men, free sugar intake was associated with weight gain and the estimated means (95% CIs) of weight change were -0.60 (-0.67, -0.54), -0.31 (-0.38, -0.24), -0.12 (-0.19, -0.05), and 0.20 (0.13, 0.27) kg from the first to fourth quartiles (P-trend = 0.002). Moreover, high intakes of sucrose and fructose were associated with weight gain (P-trend: 0.018 for sucrose and 0.001 for fructose). Among women, the intake of any type of carbohydrate was not significantly associated with weight change.

CONCLUSIONS

These results suggested that high intakes of free sugars, sucrose, and fructose were associated with long-term weight gain among Japanese men.

Histone Methylation of H3K4 Involved in the Anorexia of Carnivorous Mandarin Fish (Siniperca chuatsi) After Feeding on a Carbohydrate-Rich Diet

Food intake of carnivorous fish decreases after feeding on a carbohydrate-rich diet. However, the molecular mechanism underlying the anorexia caused by high-carbohydrate diets has remained elusive. We domesticated the mandarin fish to feed on carbohydrate-rich (8%) diets. After 61 days of feeding, several fish (Group A) fed well on artificial diets during the whole feeding period; the other fish (Group B) fed well on artificial diets at the beginning of the feeding period, with their food intake then decreasing to half (anorexia) and then to zero for 5 days; and, finally, a negative control (Group C) fed on live prey fish throughout the experimental process. The plasma glucose was significantly higher in the mandarin fish of Group B than in those of Group A, whereas levels of hepatic glycogen and plasma triglyceride were significantly lower. Using transcriptome sequencing, we investigated the differentially expressed genes between Groups A and B and excluded the genes that were not differentially expressed between Groups A and C. The activation of mTOR and Jak/STAT pathways were found in the mandarin fish with anorexia, which was consistent with the higher expression levels of pepck and pomc genes. We found a higher expression of histone methyltransferase setd1b gene and an increased histone H3 tri-methylated at lysine 4 (H3K4me3) in the fish of Group B. Furthermore, using ChIP assay and inhibitor treatment, we found that the up-regulated H3K4me3 could activate pepck expression, which might have contributed to the hyperglycemia and anorexia in the mandarin fish that fed on carbohydrate-rich diets. Our study initially indicated a link between histone methylation and pepck expression, which might be a novel regulatory mechanism of fish who are fed a carbohydrate-rich diet.

Composition of Sugars in Wild and Cultivated Lingonberries (Vaccinium vitis-idaea L.)

Products of lingonberries are widely used in the human diet; they are also promising beauty and health therapeutic candidates in the cosmetic and pharmaceutical industries. It is important to examine the sugar profile of these berries, due to potential deleterious health effects resulting from high sugar consumption. The aim of this study was to determine the composition of sugars in wild clones and cultivars or lower taxa of lingonberries by HPLC–ELSD method of analysis. Acceptable system suitability, linearity, limits of detection and quantification, precision, and accuracy of this analytical method were achieved. The same sugars with moderate amounts of fructose, glucose, and low amounts of sucrose were found in wild and cultivated lingonberries. Cultivar ‘Erntekrone’ and wild lingonberries collected from full sun, dry pine tree forests with lower altitude and latitude of the location, distinguished themselves with exclusive high contents of sugars. The changes in the sugar levels during the growing season were apparent in lingonberries and the highest amounts accumulated at the end of the vegetation. According to our findings, lingonberries seem to be an appropriate source of dietary sugars.

Effect of Oral Nutritional Supplements with Sucromalt and Isomaltulose versus Standard Formula on Glycaemic Index, Entero-Insular Axis Peptides and Subjective Appetite in Patients with Type 2 Diabetes: A Randomised Cross-Over Study

Oral diabetes-specific nutritional supplements (ONS-D) induce favourable postprandial responses in subjects with type 2 diabetes (DM2), but they have not been correlated yet with incretin release and subjective appetite (SA). This randomised, double-blind, cross-over study compared postprandial effects of ONS-D with isomaltulose and sucromalt versus standard formula (ET) on glycaemic index (GI), insulin, glucose-dependent insulinotropic polypeptide (GIP), glucagon-like peptide 1 (GLP-1) and SA in 16 individuals with DM2. After overnight fasting, subjects consumed a portion of supplements containing 25 g of carbohydrates or reference food. Blood samples were collected at baseline and at 30, 60, 90, 120, 150 and 180 min; and SA sensations were assessed by a visual analogue scale on separate days. Glycaemic index values were low for ONS-D and intermediate for ET (p < 0.001). The insulin area under the curve (AUC0-180 min) (p < 0.02) and GIP AUC (p < 0.02) were lower after ONS-D and higher GLP-1 AUC when compared with ET (p < 0.05). Subjective appetite AUC was greater after ET than ONS-D (p < 0.05). Interactions between hormones, hunger, fullness and GI were found, but not within the ratings of SA; isomaltulose and sucromalt may have influenced these factors.

'The hunger trap hypothesis': New horizons in understanding the control of food intake

The global obesity epidemic continues to present significant challenges to individuals and healthcare providers. Public health initiatives to tackle the rise in overweight and obesity in developed and developing nations have largely failed to tackle the problem and research into the underlying causes is of increasing importance. Central to understanding overconsumption of calories is an appreciation of the mechanisms of hunger and satiety. Research to date has revealed considerable detail regarding meal size, macronutrient composition of the diet and control of energy balance via adipose store derived signalling. It is clear however that such control mechanisms are overwhelmed in a significant proportion of the population. We hypothesize the hitherto under-researched possibility that micronutrient status may have an important role in energy balance. Poor vitamin and mineral profiles in the diets of the obese may potentiate overconsumption of calories due to an insufficiency of micronutrient intake relative to macronutrient consumption, a situation aggravated by increased requirements in the obese state. Amongst the multiplicity of metabolic and biochemical processes dependent upon micronutrients and which are impacted by their relative insufficiency, there may be triggers for increased food consumption in an attempt to bridge the gap between high energy consumption and low co-factor availability. This 'hunger trap' will continue as long as low nutrient density foods represent the mainstay of the diet. The accepted paradigm of variety seeking leading to vitamin and mineral adequacy of diets may not apply in the context of highly processed foods which use technological means to mimic organoleptic properties of nutrient density without delivering the same at the level of metabolism.