Mediterranean Diet and Genetic Determinants of Obesity and Metabolic Syndrome in European Children and Adolescents

Higher risk of metabolic syndrome in children and adolescents and polymorphisms in the fat mass and obesity-associated gene: a systematic review and meta-analysis

BACKGROUND

The relationship between polymorphisms in fat mass and obesity-associated gene (FTO) and the components of metabolic syndrome (MetS) has been explored among children and adolescents, but the results are inconsistent and inconclusive.

METHODS

Electronic databases including Medline, Scopus, Embase, Web of Science, CNKI, and Google Scholar were searched for eligible studies, and data were extracted from each study. Standardized mean differences were calculated to examine the differences in the components of MetS between FTO genotypes.

RESULTS

Forty-six studies (45,100 subjects), seven studies (4216 subjects), and six studies (2699 subjects) were included in the meta-analyses for FTOrs9939609, FTOrs1421085, and FTOrs17817449 polymorphisms, respectively. A-allele carriers of FTOrs9939609 polymorphism had higher levels of waist circumference (WC), systolic blood pressure, and fasting blood glucose, but lower levels of high-density lipoprotein cholesterol (HDL-C) than TT homozygotes (p < 0.05 for all). C-allele carriers of FTOrs1421085 polymorphism had higher levels of WC and lower levels of HDL-C than TT homozygotes (p < 0.05 for both). No significant associations between FTOrs17817449 polymorphism and the components of MetS were detected.

CONCLUSION

The meta-analysis demonstrates that A allele of FTOrs9939609 and C allele of FTOrs1421085 polymorphisms confer a higher risk of MetS among children and adolescents.

IMPACT STATEMENT

Genetic polymorphisms are closely related to metabolic syndrome in children and adolescents. The rs9939609 polymorphism in fat mass and obesity-associated gene is apparently associated with a higher risk of metabolic syndrome among children and adolescents. The findings of this study can provide reference for gene diagnosis and gene therapy of metabolic syndrome in children and adolescents.

Association between Mediterranean diet and metabolic health status among adults was not mediated through serum adropin levels

BACKGROUND

Prevalence of metabolic disorders has been increased in recent years around the world. The relationship between Mediterranean diet (MD) with metabolic health status and serum adropin levels has been less examined in Iranian adults. We investigated the association between MD compliance with metabolic health status and adropin hormone in Iranian adults.

METHODS

This observational study was conducted on 527 men and women. Food intakes were evaluated by a validated food frequency questionnaire. Blood pressure and anthropometric parameters were measured. Fasting blood samples were drawn to measure serum adropin concentrations, blood glucose, triglycerides, high-density lipoprotein cholesterol, high sensitive C-reactive protein and insulin. Metabolic unhealthy (MU) status was defined as having ≥ 2 cardio-metabolic risk factors.

RESULTS

After adjustments for potential confounders, subjects in highest versus lowest tertile of MD had 52% lower odds of MU status (OR = 0.48, 95%CI: 0.23-0.97). Stratified analysis revealed a significant association in normal-weight participants (OR = 0.12; 95%CI: 0.02-0.64), but not in those with overweight/obesity (OR = 0.66, 95%CI: 0.27-1.57). By excluding each component of MD, the association disappeared, except for three components (vegetables, nuts and grains). MD adherence was not significantly related to serum adropin levels in multivariable-adjusted model (unstandardized B= -0.19, 95%CI: -4.97, 4.59; P = 0.94). Serum adropin hormone levels were also not substantially different among metabolic healthy versus unhealthy subjects (P = 0.66).

CONCLUSIONS

This cross-sectional study showed an inverse association between adherence to MD and odds of MU status, especially in subjects with normal-weight. Serum adropin concentrations were not associated with MD adherence or metabolic health status.

Metabolic syndrome therapy in pediatric age - between classic and modern. From diets to pipeline drugs

The metabolic syndrome, made up of the sum of the entities that define it (obesity, hypertension, dyslipidemias and non-alcoholic hepatic steatosis) has gained an important place in the research of the last decades. This aspect is mainly due to the complexity of management in pediatric practice. The main directions in his approach therefore bring together the concern of counteracting the noise or systemic, of the multiple intercurrents at the physiopathological level, as well as the negative imprint exerted on the quality of life. Its appearance and evolution are currently controversial topics, but the influence of genetic predisposition and lifestyle (diet, physical activity, psychological balance) are certainties. Considering the escalation of the incident at the global level, it is self-evident that it is necessary to know the pathogenesis and practice countermeasures for prophylactic or therapeutic purposes. The present work aims to summarize general aspects related to the metabolic syndrome encountered in pediatric age, with an emphasis on complementary therapeutic perspectives and their effectiveness, by analyzing the latest data from the specialized literature, accessed with the help of international databases (e.g., PubMed, Web of Science, Scopus, Embase, Google Scholar).

Dysregulation of miR-21-5p in children with obesity and its predictive value for metabolic syndrome

BACKGROUND

microRNAs (miRNAs) could mediate the glucose and lipid metabolism progress in metabolic syndrome (MetS).

OBJECTIVES

To analyze the value of miRNA (miR)-21-5p for MetS diagnosis in children with obesity. Function of miR-21-5p has been explored by the prediction of target genes and functional and pathway enrichment analysis.

METHODS

Relative miR-21-5p level was examined by qRT-PCR. Predictive value of miR-21-5p for MetS was assessed by ROC curve. miRBase, TargetScan, and miRWalk databases were used to screen the target genes of miR-21-5p. GO and KEGG were operated to analyze the function of candidate genes of miR-21-5p.

RESULTS

Overexpressed miR-21-5p was discovered in MetS children (P < 0.001). High miR-21-5p level could predict MetS patients from children with obesity. Serum miR-21-5p level was closely related to BMI (r = 0.631, P < 0.001), FBG (r = 0.341, P < 0.001), Fasting Insulin (r = 0.438, P < 0.001), TG (r = 0.662, P < 0.001), SBP (r = 0.432, P < 0.001), DBP (r = 0.524, P < 0.001), and HDL-C (r = -0.201, P < 0.001). High miR-21-5p level could predict MetS patients from children with obesity (AUC= 0.827, sensitivity= 0.750, specificity=0.806, cutoff value= 1.0293, P < 0.001). Venn diagram found 83 intersection genes among 3 databases. GO and KEGG analyses indicated that candidate genes of miR-21-5p were mainly correlated with Axon guidance, FoxO signaling pathway, cytokine-cytokine receptor interaction, and insulin resistance pathways.

CONCLUSION

Blood miR-21-5p was elevated in MetS children, and could predict MetS subjects from children with obesity. miR-21-5p could regulate the MetS development via FoxO signaling pathway and insulin resistance pathways.

Exploring the role of genetic variability and exposure to bisphenols and parabens on excess body weight in Spanish children

Gene-environment interaction studies are emerging as a promising tool to shed light on the reasons for the rapid increase in excess body weight (overweight and obesity). We aimed to investigate the influence of several polymorphisms on excess weight in Spanish children according to a short- and long-term exposure to bisphenols and parabens, combining individual approach with the joint effect of them. This case-control study included 144 controls and 98 cases children aged 3-12 years. Thirty SNPs in genes involved in obesity-related pathways, xenobiotic metabolism and hormone systems were genotyped using the GSA microchip technology and qPCRs with Taqman® probes. Levels of bisphenols and parabens in urine and hair were used to assess short- and long-term exposure, respectively, via UHPLC-MS/MS system. LEPR rs9436303 was identified as a relevant risk variant for excess weight (ORDom:AAvsAG+GG=2.65, p<0.001), and this effect persisted across exposure-stratified models. For long-term exposure, GPX1 rs1050450 was associated with increased excess weight at low single paraben exposure (ORGvsA=2.00, p=0.028, p-interaction=0.016), whereas LEPR rs1137101 exhibited a protective function at high co-exposure (ORDom:AAvsAG+GG=0.17, p=0.007, p-interaction=0.043). ESR2 rs3020450 (ORDom:GGvsAG+AA=5.17, p=0.020, p-interaction=0.028) and CYP2C19 rs4244285 (ORDom:GGvsAG+AA=3.54, p=0.039, p-interaction=0.285) were identified as predisposing variants at low and high co-exposure, respectively. In short-term exposure, higher odds were observed for INSIG2 rs7566605 at high bisphenol exposure (ORCvsG=2.97, p=0.035, p-interaction=0.017) and for GSTP1 rs1695 at low levels (ORDom:AAvsAG+GG=5.38, p=0.016, p-interaction=0.016). At low and medium co-exposure, SH2B1 rs7498665 (ORAvsG=0.17, p=0.015, p-interaction=0.085) and MC4R rs17782313 (ORAvsG=0.10, p=0.023, p-interaction=0.045) displayed a protective effect, whereas ESR2 rs3020450 maintained its contributing role (ORGvsA=3.12, p=0.030, p-interaction=0.010). Our findings demonstrate for the first time that understanding the genetic variation in excess weight and how the level of exposure to bisphenols and parabens might interact with it, is crucial for a more in-depth comprehension of the complex polygenic and multifactorial aetiology of overweight and obesity.

Association of Polymorphism rs2736990 of the α-Synuclein Gene with Metabolic Syndrome Among the Population of Kazakhstan with Arterial Hypertension

Background: The prevalence of metabolic syndrome (MetS) in Kazakhstan reaches 40%. The presence of an association between certain genetic markers and the development of MetS will allow more accurately determining the cardiovascular risk for patients with hypertension and personalizing preventive recommendations. Methods: The purpose of the study was to investigate the presence of an associative relationship between various polymorphisms of the α-synuclein gene and the development of MetS in Kazakh people with high blood pressure. Four hundred twenty-six patients were examined [age 49.5 (interquartile range 42.5-56), men 209 (49.1%), women 217 (50.9%)]. Standard clinical and laboratory methods were used. AutoMate Express™ and OpenArray technologies were used for DNA extraction and further genotyping. Patients with MetS made up the ms+ group, those without MetS-the ms- group. Results: In the examined patients, four polymorphisms of the α-synuclein gene were identified: rs356219, rs2736990, rs11931074, and rs2737029. According to the results of statistical analysis, the frequency and risk of developing MetS did not depend on different alleles and inheritance types of polymorphisms rs356219 and rs11931074. The minor allele of polymorphism rs2737029 exhibits a higher frequency in patients with arterial hypertension accompanied by MetS, although the specific model of inheritance remains to be conclusively determined. Conclusions: In carriers of the minor allele of polymorphism rs2736990, the risk of MetS increases 1.3 times, regardless of age and gender [odds ratio (95% confidence interval) = 1.36 (1.01-1.82), P < 0.05], the inheritance model is log-additive.

Interplay of the Mediterranean diet and genetic hypertension risk on blood pressure in European adolescents: Findings from the HELENA study

Early-life onset of high blood pressure is associated with the development of cardiovascular diseases in adulthood. In adolescents, limited evidence exists regarding the association between adherence to the Mediterranean Diet (MedDiet) and normal blood pressure (BP) levels, as well as its potential to modulate genetic predisposition to HTN. This study investigated the interaction between a MedDiet score and a recently developed HTN-genetic risk score (HTN-GRS) on blood pressure levels in a European adolescent cohort. The MedDiet score was derived from two non-consecutive 24-h dietary recalls and ranged from 0 (indicating low adherence) to 9 (indicating high adherence). Multiple linear regression models, adjusted for covariates, were employed to examine the relationship between the MedDiet score and BP z-scores and to assess the interaction effects between the MedDiet score and HTN-GRS on BP z-scores. MedDiet score showed a negative association with z-systolic BP (SBP) (ß = -0.40, p < 0.001) and z-diastolic BP (DBP) (ß = -0.29, p = 0.001). Additionally, a significant interaction effect was identified between the MedDiet score and HTN-GRS on z-SBP (ß = 0.02, p < 0.001) and z-DBP (ß = 0.02, p < 0.001). The modulatory effect of the MedDiet was more pronounced in females than in males, and HTN-GRS exhibited a stronger influence on DBP than on SBP.   Conclusion: The study suggests that higher adherence to the MedDiet is associated with reduced BP levels in adolescents and provides evidence of a genetic-diet interaction influencing BP in adolescents. What is Known: • Adherence to the Mediterranean diet may reduce BP levels. What is New: • It is the first study to assess the connection between adherence to a Mediterranean diet, a hypertension genetic risk score, and how they interact in influencing blood pressure. • It is conducted within a multicenter cohort of European adolescents.

The Benefits of the Mediterranean Diet on Inflamm-Aging in Childhood Obesity

(1) Background: Numerous elements of the Mediterranean diet (MD) have antioxidant and anti-inflammatory qualities. (2) Methods: We present a narrative review of the potential benefits of the Mediterranean dietary pattern (MD) in mitigating aging-related inflammation (inflamm-aging) associated with childhood obesity. The mechanisms underlying chronic inflammation in obesity are also discussed. A total of 130 papers were included after screening abstracts and full texts. (3) Results: A complex interplay between obesity, chronic inflammation, and related comorbidities is documented. The MD emerges as a promising dietary pattern for mitigating inflammation. Studies suggest that the MD may contribute to weight control, improved lipid profiles, insulin sensitivity, and endothelial function, thereby reducing the risk of metabolic syndrome in children and adolescents with obesity. (4) Conclusions: While evidence supporting the anti-inflammatory effects of the MD in pediatric obesity is still evolving, the existing literature underscores its potential as a preventive and therapeutic strategy. However, MD adherence remains low among children and adolescents, necessitating targeted interventions to promote healthier dietary habits. Future high-quality intervention studies are necessary to elucidate the specific impact of the MD on inflammation in diverse pediatric populations with obesity and associated comorbidities.

Adherence to a healthy lifestyle behavior composite score and cardiometabolic risk factors in Spanish children from the CORALS cohort

To assess the associations between the adherence to a composite score comprised of 6 healthy lifestyle behaviors and its individual components with several cardiometabolic risk factors in Spanish preschool children. Cross-sectional analyses were conducted in 938 participants included in the CORALS cohort aged 3-6 years. Six recognized healthy lifestyle behaviors (breastfeeding, sleep duration, physical activity, screentime, adherence to the Mediterranean diet, and eating speed) were assessed in a composite score. Multiple linear and logistic regression models were fitted to assess the associations with cardiometabolic risk factors (weight status, waist circumference, fat mass index, blood pressure, fasting plasma glucose, and lipid profile). In the adjusted multiple linear and logistic regression models, compared with the reference category of adherence to the healthy lifestyle behavior composite score, those participants in the category of the highest adherence showed significant decreased prevalence risk of overweight or obesity [OR (95% CI), 0.4 (0.2, 0.6)] as well as significant lower waist circumference, fat mass index (FMI), systolic blood pressure and fasting plasma glucose concentration [β (95% CI), - 1.4 cm (- 2.5, - 0.4); - 0.3 kg/m2 (- 0.5, - 0.1); and - 3.0 mmHg (- 5.2, - 0.9); - 1.9 mg/dL (- 3.5, - 0.4), respectively]. Slow eating speed was individually associated with most of the cardiometabolic risk factors.   Conclusions: Higher adherence to the healthy lifestyle behavior composite score was associated with lower waist circumference, FMI, other cardiometabolic risk factors, and risk of overweight or obesity in Spanish preschool children. Further studies are required to confirm these associations. What is Known: • Lifestyle is a well-recognized etiologic factor of obesity and its comorbidities. • Certain healthy behaviors such as adhering to a healthy diet, increasing physical activity, and decreasing screentime are strategies for prevention and treatment of childhood obesity. What is New: • Higher adherence to the healthy lifestyle behavior composite score to 6 healthy behaviors (breastfeeding, sleep duration, physical activity, screentime, eating speed, and adherence to the Mediterranean diet) was associated with decreased adiposity, including prevalence risk of overweight or obesity, and cardiometabolic risk in preschool children. • Slow eating and greater adherence to the Mediterranean diet were mainly associated to lower fasting plasma and serum triglycerides concentration, respectively.

Polymorphisms of Fat Mass and Obesity-Associated Gene in the Pathogenesis of Child and Adolescent Metabolic Syndrome

Childhood metabolic syndrome (MetS) is prevalent around the world and is associated with a high likelihood of suffering from severe diseases such as cardiovascular disease later in adulthood. MetS is associated with genetic susceptibility that involves gene polymorphisms. The fat mass and obesity-associated gene (FTO) encodes an RNA N6-methyladenosine demethylase that regulates RNA stability and molecular functions. Human FTO contains genetic variants that significantly contribute to the early onset of MetS in children and adolescents. Emerging evidence has also uncovered that FTO polymorphisms in intron 1, such as rs9939609 and rs9930506 polymorphisms, are significantly associated with the development of MetS in children and adolescents. Mechanistic studies reported that FTO polymorphisms lead to aberrant expressions of FTO and the adjacent genes that promote adipogenesis and appetite and reduce steatolysis, satiety, and energy expenditure in the carriers. The present review highlights the recent observations on the key FTO polymorphisms that are associated with child and adolescent MetS with an exploration of the molecular mechanisms underlying the development of increased waist circumference, hypertension, and hyperlipidemia in child and adolescent MetS.

Genetic risk score for common obesity and anthropometry in Spanish schoolchildren

IntroductionCommon or non-syndromic obesity is a complex polygenic trait conditioned by biallelic or single-base polymorphisms called SNPs (Single-Nucleotide Polymorphisms) that present an additive effect and act synergistically. Most genotype-obese phenotype association studies include body mass index (BMI) or waist-to-height ratio (WtHR), and very few introduce a broad anthropometric profile. ObjectiveTo verify whether a genetic risk score (GRS) developed from 10 SNPs is associated with the obesity phenotype assessed from anthropometric measures indicative of excess weight, adiposity and fat distribution. Material and methodsA series of 438 Spanish schoolchildren (6-16 years old) were evaluated anthropometrically (weight, height, waist circumference, skinfold thickness, BMI, WtHR, body fat percentage [%BF]). Ten SNPs were genotyped from saliva samples, generating a GRS for obesity, establishing genotype-phenotype association. ResultsSchoolchildren categorised as obese by BMI, ICT and %BF had higher GRS than their non-obese peers. The prevalence of overweight and adiposity was higher in subjects with a GRS above the median. Similarly, between 11 and 16 years of age, all anthropometric variables presented higher averages. ConclusionsGRS estimated from the 10 SNPs can be a diagnostic tool for the potential risk of obesity in Spanish schoolchildren and could be useful from the preventive perspective.

Nutrient patterns in relation to metabolic health status in overweight and obese adolescents

The association between dietary nutrient patterns (NPs) and metabolic health status has not been investigated in adolescents. This study aimed to evaluate the relationship between NPs and metabolic health status in Iranian adolescents with overweight and obesity. In this cross-sectional study, 203 obese/overweight adolescents were selected using a multistage mass random sampling method. To assess usual dietary intakes, a validated food frequency questionnaire was applied. Data of anthropometric and blood pressure were collected. Insulin, lipid profile, and glucose levels were determined using fasting blood samples. Two approaches [International Diabetes Federation (IDF) and a combination of IDF with Homeostasis Model Assessment Insulin Resistance (HOMA-IR)] were applied to identify metabolically healthy obese and metabolically unhealthy obese (MUO) adolescents. Participants had a mean age of 13.9 ± 1.61 years and 52.2% of them were girls. Three NPs were identified and labeled as "high minerals and vitamins" (NP1), "high carbohydrate" (NP2) and "high fat and sodium" (NP3). After adjustments for all potential confounders, no significant association was observed between higher adherence to NP1 and NP2 and odds of MUO; however, greater adherence to "high fat and sodium" NP was associated with higher odds of being MUO based on IDF (OR = 3.12; 95% CI 1.19, 8.09) and IDF/HOMA-IR (OR = 2.81; 95% CI 1.02, 7.74) definitions. Stratified analysis revealed that these associations were stronger in boys (versus girls) and obese (versus overweight) adolescents. In conclusion, high adherence to a "high fat and sodium" nutrient pattern was related to elevated chance of being MUO in Iranian adolescents, especially in boys and obese individuals. Therefore, less consumption of trans fatty acids, saturated fatty acids and sodium could be recommended to prevent MUO prevalence especially in boys with obesity.

Genome-Environment Associations, an Innovative Tool for Studying Heritable Evolutionary Adaptation in Orphan Crops and Wild Relatives

Leveraging innovative tools to speed up prebreeding and discovery of genotypic sources of adaptation from landraces, crop wild relatives, and orphan crops is a key prerequisite to accelerate genetic gain of abiotic stress tolerance in annual crops such as legumes and cereals, many of which are still orphan species despite advances in major row crops. Here, we review a novel, interdisciplinary approach to combine ecological climate data with evolutionary genomics under the paradigm of a new field of study: genome-environment associations (GEAs). We first exemplify how GEA utilizes in situ georeferencing from genotypically characterized, gene bank accessions to pinpoint genomic signatures of natural selection. We later discuss the necessity to update the current GEA models to predict both regional- and local- or micro-habitat-based adaptation with mechanistic ecophysiological climate indices and cutting-edge GWAS-type genetic association models. Furthermore, to account for polygenic evolutionary adaptation, we encourage the community to start gathering genomic estimated adaptive values (GEAVs) for genomic prediction (GP) and multi-dimensional machine learning (ML) models. The latter two should ideally be weighted by de novo GWAS-based GEA estimates and optimized for a scalable marker subset. We end the review by envisioning avenues to make adaptation inferences more robust through the merging of high-resolution data sources, such as environmental remote sensing and summary statistics of the genomic site frequency spectrum, with the epigenetic molecular functionality responsible for plastic inheritance in the wild. Ultimately, we believe that coupling evolutionary adaptive predictions with innovations in ecological genomics such as GEA will help capture hidden genetic adaptations to abiotic stresses based on crop germplasm resources to assist responses to climate change. "I shall endeavor to find out how nature's forces act upon one another, and in what manner the geographic environment exerts its influence on animals and plants. In short, I must find out about the harmony in nature" Alexander von Humboldt-Letter to Karl Freiesleben, June 1799.