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Hjorth MF, Helbo AS, Astrup A. Prevention and management of obesity in a lifetime perspective. Dan Med J 2023; 70:A03230164. [PMID: 37381866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
The prevalence of obesity is increasing across all geographies. Obesity develops due to a disruption of the energy balance regulation. However, the cause is not well understood. Identification of causal factors that may be modified is crucial to reduce the prevalence of obesity. However, the interventions needed will likely differ between life stages. Hence, obesity research should span from pre-conception to adulthood. In this review, we point to gaps and limitations in existing research, highlight recently initiated studies from which we are awaiting results and point to future directions.
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Affiliation(s)
- Mads F Hjorth
- Obesity and Nutritional Sciences, Novo Nordisk Foundation, Denmark
| | | | - Arne Astrup
- Obesity and Nutritional Sciences, Novo Nordisk Foundation, Denmark
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2
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Grandjean P, Meddis A, Nielsen F, Sjödin A, Hjorth MF, Astrup A, Budtz-Jørgensen E. Weight loss relapse associated with exposure to perfluoroalkylate substances. Obesity (Silver Spring) 2023; 31:1686-1696. [PMID: 37069729 DOI: 10.1002/oby.23755] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 02/03/2023] [Accepted: 02/05/2023] [Indexed: 04/19/2023]
Abstract
OBJECTIVE The purpose of this study was to test the hypothesis that perfluorinated alkylate substance (PFAS) exposures are associated with body weight increases in a dietary intervention study. METHODS In the DioGenes trial, adults with obesity first lost at least 8% of their body weight and then completed at least 26 weeks on a specific diet. Concentrations of five major PFASs were assessed in plasma samples from study baseline. RESULTS In 381 participants with complete data, plasma concentrations averaged 2.9 ng/mL and 1.0 ng/mL for perfluorooctanoic acid (PFOA) and perfluorohexanesulfonic acid (PFHxS), respectively. A doubling in plasma PFOA was associated with an increase in weight at 26 weeks by 1.50 kg (95% CI: 0.88-2.11), with an increase of 0.91 kg (95% CI: 0.54-1.27) for PFHxS, independent of diet groups and sex. Associations for other PFASs were in the same direction and significant, although not after adjustment for PFOA and PFHxS. Weight changes associated with elevated PFAS exposures were similar to or larger than average changes ascribed to the different diet groups. CONCLUSIONS Elevated plasma concentrations of PFOA and PFHxS were associated with increased weight gain that exceeded those related to the diets. Obesogenic PFASs may cause weight gain and thus contribute to the obesity pandemic.
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Affiliation(s)
- Philippe Grandjean
- Department of Environmental Medicine, University of Southern Denmark, Odense, Denmark
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Biomedical and Pharmaceutical Sciences, University of Rhode Island, Kingston, Rhode Island, USA
| | - Alessandra Meddis
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Flemming Nielsen
- Department of Environmental Medicine, University of Southern Denmark, Odense, Denmark
| | - Anders Sjödin
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Mads F Hjorth
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
- Department of Obesity and Nutritional Sciences, Novo Nordisk Foundation, Hellerup, Denmark
| | - Arne Astrup
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
- Department of Obesity and Nutritional Sciences, Novo Nordisk Foundation, Hellerup, Denmark
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Magkos F, Rasmussen SI, Hjorth MF, Asping S, Rosenkrans MI, Sjödin AM, Astrup AV, Geiker NRW. Unprocessed red meat in the dietary treatment of obesity: a randomized controlled trial of beef supplementation during weight maintenance after successful weight loss. Am J Clin Nutr 2022; 116:1820-1830. [PMID: 36307956 PMCID: PMC9761757 DOI: 10.1093/ajcn/nqac152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 05/24/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Consumption of unprocessed red meat in randomized trials has no adverse effects on cardiovascular risk factors and body weight, but its physiological effects during weight loss maintenance are not known. OBJECTIVES We sought to investigate the effects of healthy diets that include small or large amounts of red meat on the maintenance of lost weight after successful weight loss, and secondarily on body composition (DXA), resting energy expenditure (REE; indirect calorimetry), and cardiometabolic risk factors. METHODS In this 5-mo parallel randomized intervention trial, 108 adults with BMI 28-40 kg/m2 (45 males/63 females) underwent an 8-wk rapid weight loss period, and those who lost ≥8% body weight (n = 80) continued to ad libitum weight maintenance diets for 12 wk: a moderate-protein diet with 25 g beef/d (B25, n = 45) or a high-protein diet with 150 g beef/d (B150, n = 35). RESULTS In per protocol analysis (n = 69), mean body weight (-1.2 kg; 95% CI: -2.1, -0.3 kg), mean fat mass (-2.7 kg; 95% CI: -3.4, -2.0 kg), and mean body fat content (-2.6%; 95% CI: -3.1, -2.1%) decreased during the maintenance phase, whereas mean lean mass (1.5 kg; 95% CI: 1.0, 2.0 kg) and mean REE (51 kcal/d; 95% CI: 15, 86 kcal/d) increased, with no differences between groups (all P > 0.05). Results were similar in intention-to-treat analysis with multiple imputation for dropouts (20 from B150 compared with 19 from B25, P = 0.929). Changes in cardiometabolic risk factors were not different between groups, the general pattern being a decrease during weight loss and a return to baseline during weight maintenance (and despite the additional mild reduction in weight and fat mass). CONCLUSIONS Healthy diets consumed ad libitum that contain a little or a lot of unprocessed beef have similar effects on body weight, energy metabolism, and cardiovascular risk factors during the first 3 mo after clinically significant rapid weight loss.
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Affiliation(s)
| | - Sidse I Rasmussen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | | | - Sarah Asping
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Maria I Rosenkrans
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Anders M Sjödin
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | | | - Nina R W Geiker
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
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Christensen L, Hjorth MF, Krych L, Licht TR, Lauritzen L, Magkos F, Roager HM. Prevotella abundance and salivary amylase gene copy number predict fat loss in response to wholegrain diets. Front Nutr 2022; 9:947349. [PMID: 36071931 PMCID: PMC9441811 DOI: 10.3389/fnut.2022.947349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 08/02/2022] [Indexed: 11/30/2022] Open
Abstract
Background Salivary amylase (AMY1) gene copy number (CN) and Prevotella abundance in the gut are involved in carbohydrate digestion in the upper and lower gastrointestinal tract, respectively; and have been suggested as prognostic biomarkers for weight loss among overweight individuals consuming diets rich in fiber and wholegrains. Objective We hypothesized that Prevotella abundance would be linked to greater loss of body fat after wholegrain consumption among individuals with low AMY1 CN, but not in those with high AMY1 CN. Methods We reanalyzed data from two independent randomized ad libitum wholegrain interventions (fiber intake ∼33 g/d for 6–8 weeks), to investigate the relationship between baseline Prevotella abundance and body fat loss among healthy, overweight participants stratified into two groups by median AMY1 CN. Individuals with no detected Prevotella spp. were excluded from the main analysis. Results In both studies, individuals with low AMY1 CN exhibited a positive correlation between baseline Prevotella abundance and fat loss after consuming the wholegrain diet (r > 0.5, P < 0.05), but no correlation among participants with high AMY1 CN (P ≥ 0.6). Following consumption of the refined wheat control diets, there were no associations between baseline Prevotella abundance and changes in body fat in any of the AMY1 groups. Conclusion These results suggest that Prevotella abundance together with AMY1 CN can help predict fat loss in response to ad libitum wholegrain diets, highlighting the potential of these biomarkers in personalized obesity management.
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Affiliation(s)
- Lars Christensen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
- *Correspondence: Lars Christensen,
| | | | - Lukasz Krych
- Department of Food Science, University of Copenhagen, Copenhagen, Denmark
| | - Tine Rask Licht
- National Food Institute, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Lotte Lauritzen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Faidon Magkos
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Henrik M. Roager
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
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Aldubayan MA, Pigsborg K, Gormsen SMO, Serra F, Palou M, Galmés S, Palou-March A, Favari C, Wetzels M, Calleja A, Rodríguez Gómez MA, Castellnou MG, Caimari A, Galofré M, Suñol D, Escoté X, Alcaide-Hidalgo JM, M Del Bas J, Gutierrez B, Krarup T, Hjorth MF, Magkos F. A double-blinded, randomized, parallel intervention to evaluate biomarker-based nutrition plans for weight loss: The PREVENTOMICS study. Clin Nutr 2022; 41:1834-1844. [PMID: 35839545 DOI: 10.1016/j.clnu.2022.06.032] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 06/14/2022] [Accepted: 06/20/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND & AIMS Growing evidence suggests that biomarker-guided dietary interventions can optimize response to treatment. In this study, we evaluated the efficacy of the PREVENTOMCIS platform-which uses metabolomic and genetic information to classify individuals into different 'metabolic clusters' and create personalized dietary plans-for improving health outcomes in subjects with overweight or obesity. METHODS A 10-week parallel, double-blinded, randomized intervention was conducted in 100 adults (82 completers) aged 18-65 years, with body mass index ≥27 but <40 kg/m2, who were allocated into either a personalized diet group (n = 49) or a control diet group (n = 51). About 60% of all food was provided free-of-charge. No specific instruction to restrict energy intake was given. The primary outcome was change in fat mass from baseline, evaluated by dual energy X-ray absorptiometry. Other endpoints included body weight, waist circumference, lipid profile, glucose homeostasis markers, inflammatory markers, blood pressure, physical activity, stress and eating behavior. RESULTS There were significant main effects of time (P < 0.01), but no group main effects, or time-by-group interactions, for the change in fat mass (personalized: -2.1 [95% CI -2.9, -1.4] kg; control: -2.0 [95% CI -2.7, -1.3] kg) and body weight (personalized: -3.1 [95% CI -4.1, -2.1] kg; control: -3.3 [95% CI -4.2, -2.4] kg). The difference between groups in fat mass change was -0.1 kg (95% CI -1.2, 0.9 kg, P = 0.77). Both diets resulted in significant improvements in insulin resistance and lipid profile, but there were no significant differences between groups. CONCLUSION Personalized dietary plans did not result in greater benefits over a generic, but generally healthy diet, in this 10-week clinical trial. Further studies are required to establish the soundness of different precision nutrition approaches, and translate this science into clinically relevant dietary advice to reduce the burden of obesity and its comorbidities. CLINICAL TRIAL REGISTRY ClinicalTrials.gov registry (NCT04590989).
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Affiliation(s)
- Mona A Aldubayan
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Denmark; King Saud bin Abdulaziz University for Health Sciences, College of Applied Medical Sciences, Riyadh, Saudi Arabia
| | - Kristina Pigsborg
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Denmark
| | | | - Francisca Serra
- Laboratory of Molecular Biology, Nutrition and Biotechnology (Nutrigenomics, Biomarkers and Risk Evaluation-NuBE), University of the Balearic Islands (UIB), Health Research Institute of the Balearic Islands (IdISBa), CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Alimentómica S.L., Spin-off n.1 of the UIB Islands, Spain
| | - Mariona Palou
- Laboratory of Molecular Biology, Nutrition and Biotechnology (Nutrigenomics, Biomarkers and Risk Evaluation-NuBE), University of the Balearic Islands (UIB), Health Research Institute of the Balearic Islands (IdISBa), CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Alimentómica S.L., Spin-off n.1 of the UIB Islands, Spain
| | - Sebastià Galmés
- Laboratory of Molecular Biology, Nutrition and Biotechnology (Nutrigenomics, Biomarkers and Risk Evaluation-NuBE), University of the Balearic Islands (UIB), Health Research Institute of the Balearic Islands (IdISBa), CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Alimentómica S.L., Spin-off n.1 of the UIB Islands, Spain
| | - Andreu Palou-March
- Laboratory of Molecular Biology, Nutrition and Biotechnology (Nutrigenomics, Biomarkers and Risk Evaluation-NuBE), University of the Balearic Islands (UIB), Health Research Institute of the Balearic Islands (IdISBa), CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Alimentómica S.L., Spin-off n.1 of the UIB Islands, Spain
| | - Claudia Favari
- Human Nutrition Unit, Department of Food and Drug, University of Parma, Parma, Italy
| | - Mart Wetzels
- ONMI: Behaviour Change Technology, Eindhoven, the Netherlands
| | - Alberto Calleja
- R&D Department, Food Division, Grupo Carinsa, Sant Quirze del Valles, Barcelona, Spain
| | - Miguel Angel Rodríguez Gómez
- Eurecat, Centre Tecnològic de Catalunya, Centre for Omic Sciences (COS), Joint Unit Universitat Rovira I Virgili-EURECAT, 43204 Reus, Spain
| | - María Guirro Castellnou
- Eurecat, Centre Tecnològic de Catalunya, Centre for Omic Sciences (COS), Joint Unit Universitat Rovira I Virgili-EURECAT, 43204 Reus, Spain
| | - Antoni Caimari
- Eurecat, Centre Tecnològic de Catalunya, Biotechnology Area, Nutrition and Health Unit, Reus, Spain
| | - Mar Galofré
- Eurecat, Centre tecnològic de Catalunya, Digital Health Unit, Carrer de Bilbao, 72, 08005 Barcelona, Spain
| | - David Suñol
- Eurecat, Centre tecnològic de Catalunya, Digital Health Unit, Carrer de Bilbao, 72, 08005 Barcelona, Spain
| | - Xavier Escoté
- Eurecat, Centre Tecnològic de Catalunya, Biotechnology Area, Nutrition and Health Unit, Reus, Spain
| | | | - Josep M Del Bas
- Eurecat, Centre Tecnològic de Catalunya, Biotechnology Area, Nutrition and Health Unit, Reus, Spain
| | - Biotza Gutierrez
- Eurecat, Centre Tecnològic de Catalunya, Biotechnology Area, Nutrition and Health Unit, Reus, Spain
| | - Thure Krarup
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Denmark; Department of Endocrinology, Bispebjerg and Frederiksberg Hospital, Tuborgvej, Hellerup, Denmark
| | - Mads F Hjorth
- Healthy Weight Centre, Novo Nordisk Foundation, Tuborg Havnevej 19, 2900, Hellerup, Denmark
| | - Faidon Magkos
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Denmark.
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Hjorth MF, Astrup A. Can Insulin and Glucose Dynamics Bring Us Closer to Precision Dietary Management of Obesity? J Nutr 2022; 152:649-650. [PMID: 35134962 DOI: 10.1093/jn/nxac001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Mads F Hjorth
- Healthy Weight Center, Novo Nordisk Foundation, Hellerup, Denmark
| | - Arne Astrup
- Healthy Weight Center, Novo Nordisk Foundation, Hellerup, Denmark
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Matusheski NV, Caffrey A, Christensen L, Mezgec S, Surendran S, Hjorth MF, McNulty H, Pentieva K, Roager HM, Seljak BK, Vimaleswaran KS, Remmers M, Péter S. Diets, nutrients, genes and the microbiome: recent advances in personalised nutrition. Br J Nutr 2021; 126:1489-1497. [PMID: 33509307 PMCID: PMC8524424 DOI: 10.1017/s0007114521000374] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 01/13/2021] [Accepted: 01/23/2021] [Indexed: 12/28/2022]
Abstract
As individuals seek increasingly individualised nutrition and lifestyle guidance, numerous apps and nutrition programmes have emerged. However, complex individual variations in dietary behaviours, genotypes, gene expression and composition of the microbiome are increasingly recognised. Advances in digital tools and artificial intelligence can help individuals more easily track nutrient intakes and identify nutritional gaps. However, the influence of these nutrients on health outcomes can vary widely among individuals depending upon life stage, genetics and microbial composition. For example, folate may elicit favourable epigenetic effects on brain development during a critical developmental time window of pregnancy. Genes affecting vitamin B12 metabolism may lead to cardiometabolic traits that play an essential role in the context of obesity. Finally, an individual's gut microbial composition can determine their response to dietary fibre interventions during weight loss. These recent advances in understanding can lead to a more complete and integrated approach to promoting optimal health through personalised nutrition, in clinical practice settings and for individuals in their daily lives. The purpose of this review is to summarise presentations made during the DSM Science and Technology Award Symposium at the 13th European Nutrition Conference, which focused on personalised nutrition and novel technologies for health in the modern world.
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Affiliation(s)
- Nathan V. Matusheski
- Nutrition Science and Advocacy, DSM Nutritional Products LLC, Parsippany, NJ, USA
| | - Aoife Caffrey
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, ColeraineBT52 1SA, Northern Republic of Ireland
| | - Lars Christensen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 26, 1958 Frederiksberg, Frederiksberg, Denmark
| | - Simon Mezgec
- Jožef Stefan International Postgraduate School, Jamova cesta 39, 1000Ljubljana, Slovenia
| | - Shelini Surendran
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Whiteknights, ReadingRG6 6DZ, UK
| | - Mads F. Hjorth
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 26, 1958 Frederiksberg, Frederiksberg, Denmark
| | - Helene McNulty
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, ColeraineBT52 1SA, Northern Republic of Ireland
| | - Kristina Pentieva
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, ColeraineBT52 1SA, Northern Republic of Ireland
| | - Henrik M. Roager
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 26, 1958 Frederiksberg, Frederiksberg, Denmark
| | - Barbara Koroušić Seljak
- Computer Systems Department, Jožef Stefan Institute, Jamova cesta 39, 1000 Ljubljana, Ljubljana, Slovenia
| | | | | | - Szabolcs Péter
- Nutrition Innovation Center, DSM Nutritional Products Ltd, Kaiseraugst, Switzerland
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Benítez-Páez A, Hess AL, Krautbauer S, Liebisch G, Christensen L, Hjorth MF, Larsen TM, Sanz Y. Sex, Food, and the Gut Microbiota: Disparate Response to Caloric Restriction Diet with Fiber Supplementation in Women and Men. Mol Nutr Food Res 2021; 65:e2000996. [PMID: 33629506 DOI: 10.1002/mnfr.202000996] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 02/12/2021] [Indexed: 12/30/2022]
Abstract
SCOPE Dietary-based strategies are regularly explored in controlled clinical trials to provide cost-effective therapies to tackle obesity and its comorbidities. The article presents a complementary analysis based on a multivariate multi-omics approach of a caloric restriction intervention (CRD) with fiber supplementation to unveil synergic effects on body weight control, lipid metabolism, and gut microbiota. METHODS AND RESULTS The study explores fecal bile acids (BAs) and short-chain fatty acids (SCFAs), plasma BAs, and fecal shotgun metagenomics on 80 overweight participants of a 12-week caloric restriction clinical trial (-500 kcal day-1 ) randomly allocated into fiber (10 g day-1 inulin + 10 g day-1 resistant maltodextrin) or placebo (maltodextrin) supplementation groups. The multi-omic data integration analysis uncovered the benefits of the fiber supplementation and/or the CRD (e.g., increase of Parabacteroides distasonis and fecal propionate), showing sex-specific effects on either adiposity and fasting insulin; effects thought to be linked to changes of specific gut microbiota species, functional genes, and bacterially produced metabolites like SCFAs and secondary BAs. CONCLUSIONS This study identifies diet-microbe-host interactions helping to design personalised interventions. It also suggests that sex perspective should be considered routinely in future studies on dietary interventions efficacy. All in all, the study uncovers that the dietary intervention is more beneficial for women than men.
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Affiliation(s)
- Alfonso Benítez-Páez
- Microbial Ecology, Nutrition & Health Research Unit, Institute of Agrochemistry and Food Technology, Spanish National Research Council (IATA-CSIC), Valencia, 46980, Spain
| | - Anne Lundby Hess
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg C, 1958, Denmark
| | - Sabrina Krautbauer
- Institute of Clinical Chemistry and Laboratory Medicine, University of Regensburg, Regensburg, 93053, Germany
| | - Gerhard Liebisch
- Institute of Clinical Chemistry and Laboratory Medicine, University of Regensburg, Regensburg, 93053, Germany
| | - Lars Christensen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg C, 1958, Denmark
| | - Mads F Hjorth
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg C, 1958, Denmark
| | - Thomas Meinert Larsen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg C, 1958, Denmark
| | - Yolanda Sanz
- Microbial Ecology, Nutrition & Health Research Unit, Institute of Agrochemistry and Food Technology, Spanish National Research Council (IATA-CSIC), Valencia, 46980, Spain
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9
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Nielsen MS, Alsaoodi H, Hjorth MF, Sjödin A. Correction to: Physical Activity, Sedentary Behavior, and Sleep before and after Bariatric Surgery and Associations with Weight Loss Outcome. Obes Surg 2020; 31:909. [PMID: 33263859 DOI: 10.1007/s11695-020-05137-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Mette S Nielsen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 26, 1958, Frederiksberg C, Denmark. .,The Danish Diabetes Academy, Søndre Blvd. 29, 5000, Odense, Denmark.
| | - Hagir Alsaoodi
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 26, 1958, Frederiksberg C, Denmark
| | - Mads F Hjorth
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 26, 1958, Frederiksberg C, Denmark
| | - Anders Sjödin
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 26, 1958, Frederiksberg C, Denmark
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10
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Christensen L, Sørensen CV, Wøhlk FU, Kjølbæk L, Astrup A, Sanz Y, Hjorth MF, Benítez-Páez A. Microbial enterotypes beyond genus level: Bacteroides species as a predictive biomarker for weight change upon controlled intervention with arabinoxylan oligosaccharides in overweight subjects. Gut Microbes 2020; 12:1847627. [PMID: 33319645 PMCID: PMC7781564 DOI: 10.1080/19490976.2020.1847627] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Recent studies indicate that microbial enterotypes may influence the beneficial effects of wholegrain enriched diets including bodyweight regulation. In a 4-week intervention trial, overweight subjects were randomized to consume either arabinoxylan-oligosaccharides (AXOS) (10.4 g/d) from wheat bran or polyunsaturated fatty acids (PUFA) (3.6 g/d). In the present study, we have stratified the subjects participating in the intervention (n = 29) according to the baseline Prevotella-to-Bacteroides (P/B) ratios through a post-hoc analysis and applied a linear mixed model analysis to identify the influence of this P/B ratio on the differences in weight changes in the intervention arms. Following AXOS consumption (n = 15), the high P/B group showed no bodyweight changes [-0.14 kg (95% CI: -0.67; 0.38, p = .59)], while the low P/B group gained 0.65 kg (95% CI: 0.16; 1.14, p = .009). Consequently, a difference of -0.79 kg was found between P/B groups (95% CI: -1.51; -0.08, p = .030). No differences were found between P/B groups following PUFA consumption (0.61 kg, 95% CI: -0.13; 1.35, p = .10). Among the Bacteroides species, B. cellulosilyticus relative abundance exhibited the highest positive rank correlation (Kendall's tau = 0.51, FDR p = .070) with 4-week weight change on AXOS, and such association was further supported by using supervised classification methods (Random Forest). We outlined several carbohydrate-active enzyme (CAZy) genes involved in xylan-binding and degradation to be enriched in B. cellulosilyticus genomes, as well as multiple accessory genes, suggesting a supreme AXOS-derived glycan scavenging role of such species. This post-hoc analysis, ensuring species and strain demarcation at the human gut microbiota, permitted to uncover the predictive role of Bacteroides species over P/B enterotype in weight gain during a fiber-based intervention. The results of this pilot trial pave the way for future assessments on fiber fermentation outputs from Bacteroides species affecting lipid metabolism in the host and with direct impact on adiposity, thus helping to design personalized interventions.
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Affiliation(s)
- Lars Christensen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark,CONTACT Lars Christensen Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Claudia V. Sørensen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Frederikke U. Wøhlk
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Louise Kjølbæk
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Arne Astrup
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Yolanda Sanz
- Microbial Ecology, Nutrition & Health Research Unit, Institute of Agrochemistry and Food Technology, Spanish National Research Council (IATA-CSIC), Valencia, Spain
| | - Mads F. Hjorth
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Alfonso Benítez-Páez
- Microbial Ecology, Nutrition & Health Research Unit, Institute of Agrochemistry and Food Technology, Spanish National Research Council (IATA-CSIC), Valencia, Spain,Host-Microbe Interactions in Metabolic Health Laboratory, Príncipe Felipe Research Centre (CIPF), Valencia, Spain,Alfonso Benítez-Páez Host-Microbe Interactions in Metabolic Health Laboratory, Príncipe Felipe Research Center (CIPF). Valencia, Spain
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11
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Abstract
Evidence from observational studies and randomized trials suggests that prediabetes and type 2 diabetes mellitus (T2DM) can develop in genetically susceptible individuals in parallel with weight (that is, fat) gain. Accordingly, studies show that weight loss can produce remission of T2DM in a dose-dependent manner. A weight loss of ~15 kg, achieved by calorie restriction as part of an intensive management programme, can lead to remission of T2DM in ~80% of patients with obesity and T2DM. However, long-term weight loss maintenance is challenging. Obesity and T2DM are associated with diminished glucose uptake in the brain that impairs the satiating effect of dietary carbohydrate; therefore, carbohydrate restriction might help maintain weight loss and maximize metabolic benefits. Likewise, increases in physical activity and fitness are an important contributor to T2DM remission when combined with calorie restriction and weight loss. Preliminary studies suggest that a precision dietary management approach that uses pretreatment glycaemic status to stratify patients can help optimize dietary recommendations with respect to carbohydrate, fat and dietary fibre. This approach might lead to improved weight loss maintenance and glycaemic control. Future research should focus on better understanding the individual response to dietary treatment and translating these findings into clinical practice.
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Affiliation(s)
- Faidon Magkos
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg Campus, Copenhagen, Denmark
| | - Mads F Hjorth
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg Campus, Copenhagen, Denmark
| | - Arne Astrup
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg Campus, Copenhagen, Denmark.
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12
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Hjorth MF, Christensen L, Larsen TM, Roager HM, Krych L, Kot W, Nielsen DS, Ritz C, Astrup A. Pretreatment Prevotella-to-Bacteroides ratio and salivary amylase gene copy number as prognostic markers for dietary weight loss. Am J Clin Nutr 2020; 111:1079-1086. [PMID: 32034403 DOI: 10.1093/ajcn/nqaa007] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 01/16/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The inconsistent link observed between salivary amylase gene copy number (AMY1 CN) and weight management is likely modified by diet and microbiome. OBJECTIVE Based on analysis of a previously published study, we investigated the hypothesis that interaction between diet, Prevotella-to-Bacteriodes ratio (P/B ratio), and AMY1 CN influence weight change. METHODS Sixty-two people with increased waist circumference were randomly assigned to receive an ad libitum New Nordic Diet (NND) high in dietary fiber, whole grain, intrinsic sugars, and starch or an Average Danish (Western) Diet (ADD) for 26 weeks. All foods were provided free of charge. Before subjects were randomly assigned to receive the NND or ADD diet, blood and fecal samples were collected, from which AMY1 CN and P/B ratio, respectively, were determined. Body weight change was described by using linear mixed models, including biomarker [log10(P/B ratio) and/or AMY1 CN] diet-group interactions. RESULTS Baseline means ± SDs of log10(P/B ratio) and AMY1 CN were -2.1 ± 1.8 and 6.6 ± 2.4, respectively. Baseline P/B ratio predicted a 0.99-kg/unit (95% CI: 0.40, 1.57; n = 54; P < 0.001) higher weight loss for those subjects on the NND compared with those on the ADD diet, whereas AMY1 CN was not found to predict weight loss differences between the NND and ADD groups [0.05 kg/CN (95% CI: -0.40, 0.51; n = 54; P = 0.83)]. However, among subjects with low AMY1 CN (<6.5 copies), baseline P/B ratio predicted a 2.12-kg/unit (95% CI: 1.37, 2.88; n = 30; P < 0.001) higher weight loss for the NND group than the ADD group. No such differences in weight loss were found among subjects in both groups with high AMY1 CN [-0.17 kg/unit (95% CI: -1.01, 0.66; n = 24; P = 0.68)]. CONCLUSIONS The combined use of low AMY1 CN and pretreatment P/B ratio for weight loss prediction led to highly individualized weight loss results with the introduction of more fiber, whole grain, intrinsic sugars, and starch in the diet. These preliminary observations suggest that more undigested starch reaches the colon in individuals with low AMY1 CN, and that the fate of this starch depends on the gut microbiota composition. This trial was registered at clinicaltrials.gov as NCT01195610.
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Affiliation(s)
- Mads F Hjorth
- Department of Nutrition, Exercise, and Sports, Faculty of Sciences, University of Copenhagen, Denmark
| | - Lars Christensen
- Department of Nutrition, Exercise, and Sports, Faculty of Sciences, University of Copenhagen, Denmark
| | - Thomas M Larsen
- Department of Nutrition, Exercise, and Sports, Faculty of Sciences, University of Copenhagen, Denmark
| | - Henrik M Roager
- Department of Nutrition, Exercise, and Sports, Faculty of Sciences, University of Copenhagen, Denmark
| | - Lukasz Krych
- Food Science, Faculty of Science, University of Copenhagen, Denmark
| | - Witold Kot
- Department of Plant and Environmental Sciences, Faculty of Science, University of Copenhagen, Denmark
| | - Dennis S Nielsen
- Food Science, Faculty of Science, University of Copenhagen, Denmark
| | - Christian Ritz
- Department of Nutrition, Exercise, and Sports, Faculty of Sciences, University of Copenhagen, Denmark
| | - Arne Astrup
- Department of Nutrition, Exercise, and Sports, Faculty of Sciences, University of Copenhagen, Denmark
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13
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Affiliation(s)
- Mads F Hjorth
- Department of Nutrition, Exercise, and Sports, Faculty of Science, University of Copenhagen, Denmark
| | - Arne Astrup
- Department of Nutrition, Exercise, and Sports, Faculty of Science, University of Copenhagen, Denmark
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14
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Christensen L, Vuholm S, Roager HM, Nielsen DS, Krych L, Kristensen M, Astrup A, Hjorth MF. Prevotella Abundance Predicts Weight Loss Success in Healthy, Overweight Adults Consuming a Whole-Grain Diet Ad Libitum: A Post Hoc Analysis of a 6-Wk Randomized Controlled Trial. J Nutr 2019; 149:2174-2181. [PMID: 31504699 DOI: 10.1093/jn/nxz198] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 05/29/2019] [Accepted: 07/25/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The key to effective weight loss may be to match diet and gut microbes, since recent studies have found that subjects with high Prevotella abundances in their gut microbiota lose more weight on diets rich in fiber than subjects with low Prevotella abundances. OBJECTIVES We reanalyzed a 6-wk, parallel, randomized trial to investigate difference in body weight changes when participants, stratified by fecal microbiota composition, consumed ad libitum a whole-grain (WG) or a refined-wheat (RW) diet. METHODS We stratified 46 (19 men, 27 women; ages 30-65 y) healthy, overweight adults by baseline Prevotella-to-Bacteroides ratios and Prevotella abundances. Subjects with no Prevotella were analyzed separately (n = 24). Compared with the RW diet (mean = 221 g/d), the WG diet (mean = 228 g/d) had a higher fiber content (33 g/d compared with 23 g/d). Linear mixed models and correlations were applied to link 6-wk changes in body weights and metabolic and microbiota markers, according to Prevotella groups and diets. RESULTS The Prevotella abundances correlated inversely with weight changes (r = -0.34; P = 0.043). Consequently, subjects with high Prevotella abundances (n = 15) spontaneously lost 1.80 kg (95% CI: -3.23, -0.37 kg; P = 0.013) more on the WG diet than on the RW diet, whereas those with low Prevotella abundances (n = 31) were weight stable (-0.22 kg; 95% CI: -1.40, 0.96 kg; P = 0.72). Thus, the mean difference between the Prevotella groups was 2.02 kg (95% CI: -3.87, -0.17 kg; P = 0.032). Subjects with no Prevotella lost 1.59 kg (95% CI: -2.65, -0.52 kg; P = 0.004) more on the WG diet than on the RW diet. No 6-wk changes in appetite sensations, glucose metabolisms, or fecal SCFAs were associated with the Prevotella groups. CONCLUSIONS Healthy, overweight adults with high Prevotella abundances lost more weight than subjects with low Prevotella abundances when consuming a diet rich in WG and fiber ad libitum for 6 wk. This further supports enterotypes as a potential biomarker in personalized nutrition for obesity management. This t rial was registered at clinicaltrials.gov as NCT02358122.
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Affiliation(s)
- Lars Christensen
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Denmark
| | - Stine Vuholm
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Denmark
| | - Henrik M Roager
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Denmark
| | - Dennis S Nielsen
- Food Science, Faculty of Science, University of Copenhagen, Denmark
| | - Lukasz Krych
- Food Science, Faculty of Science, University of Copenhagen, Denmark
| | - Mette Kristensen
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Denmark
| | - Arne Astrup
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Denmark
| | - Mads F Hjorth
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Denmark
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15
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Kabisch S, Meyer NMT, Honsek C, Gerbracht C, Dambeck U, Kemper M, Osterhoff MA, Birkenfeld AL, Arafat AM, Hjorth MF, Weickert MO, Pfeiffer AFH. Fasting Glucose State Determines Metabolic Response to Supplementation with Insoluble Cereal Fibre: A Secondary Analysis of the Optimal Fibre Trial (OptiFiT). Nutrients 2019; 11:nu11102385. [PMID: 31590438 PMCID: PMC6835423 DOI: 10.3390/nu11102385] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 09/28/2019] [Accepted: 10/01/2019] [Indexed: 02/07/2023] Open
Abstract
Background: High intake of cereal fibre is associated with reduced risk for type 2 diabetes and long-term complications. Within the first long-term randomized controlled trial specifically targeting cereal fibre, the Optimal Fibre Trial (OptiFiT), intake of insoluble oat fibre was shown to significantly reduce glycaemia. Previous studies suggested that this effect might be limited to subjects with impaired fasting glucose (IFG). Aim: We stratified the OptiFiT cohort for normal and impaired fasting glucose (NFG, IFG) and conducted a secondary analysis comparing the effects of fibre supplementation between these subgroups. Methods: 180 Caucasian participants with impaired glucose tolerance (IGT) were randomized to twice-a-day fibre or placebo supplementation for 2 years (n = 89 and 91, respectively), while assuring double-blinded intervention. Fasting blood sampling, oral glucose tolerance test and full anthropometry were assessed annually. At baseline, out of 136 subjects completing the first year of intervention, 72 (54%) showed IFG and IGT, while 64 subjects had IGT only (labelled “NFG”). Based on these two groups, we performed a stratified per-protocol analysis of glycometabolic and secondary effects during the first year of intervention. Results: The NFG group did not show significant differences between fibre and placebo group concerning anthropometric, glycometabolic, or other biochemical parameters. Within the IFG stratum, 2-h glucose, HbA1c, and gamma-glutamyl transferase levels decreased more in the fibre group, with a significant supplement x IFG interaction effect for HbA1c. Compared to NFG subjects, IFG subjects had larger benefits from fibre supplementation with respect to fasting glucose levels. Results were robust against adjustment for weight change and sex. An ITT analysis did not reveal any differences from the per-protocol analysis. Conclusions: Although stratification resulted in relatively small subgroups, we were able to pinpoint our previous findings from the entire cohort to the IFG subgroup. Cereal fibre can beneficially affect glycemic metabolism, with most pronounced or even isolated effectiveness in subjects with impaired fasting glucose.
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Affiliation(s)
- Stefan Kabisch
- Department of Clinical Nutrition, German Institute of Human Nutrition Potsdam-Rehbrücke, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany.
- Deutsches Zentrum für Diabetesforschung e.V., Geschäftsstelle am Helmholtz-Zentrum München, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany.
| | - Nina M T Meyer
- Department of Clinical Nutrition, German Institute of Human Nutrition Potsdam-Rehbrücke, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany.
- Deutsches Zentrum für Diabetesforschung e.V., Geschäftsstelle am Helmholtz-Zentrum München, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany.
| | - Caroline Honsek
- Department of Clinical Nutrition, German Institute of Human Nutrition Potsdam-Rehbrücke, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany.
| | - Christiana Gerbracht
- Department of Clinical Nutrition, German Institute of Human Nutrition Potsdam-Rehbrücke, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany.
| | - Ulrike Dambeck
- Department of Clinical Nutrition, German Institute of Human Nutrition Potsdam-Rehbrücke, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany.
| | - Margrit Kemper
- Department of Clinical Nutrition, German Institute of Human Nutrition Potsdam-Rehbrücke, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany.
- Deutsches Zentrum für Diabetesforschung e.V., Geschäftsstelle am Helmholtz-Zentrum München, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany.
| | - Martin A Osterhoff
- Department of Clinical Nutrition, German Institute of Human Nutrition Potsdam-Rehbrücke, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany.
- Department of Endocrinology, Diabetes and Nutrition, Campus Benjamin Franklin, Charité University Medicine, Hindenburgdamm 30, 12203 Berlin, Germany.
| | - Andreas L Birkenfeld
- Deutsches Zentrum für Diabetesforschung e.V., Geschäftsstelle am Helmholtz-Zentrum München, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany.
- Section of Metabolic Vascular Medicine, Medical Clinic III and Paul Langerhans Institute Dresden of the Helmholtz Center Munich at University Hospital and Faculty of Medicine, TU Dresden, Fetscherstraße 74, 01307 Dresden, Germany.
- Section of Diabetes and Nutritional Sciences, Rayne Institute, Denmark Hill Campus, King's College London, SE5 9NT London, UK.
| | - Ayman M Arafat
- Department of Clinical Nutrition, German Institute of Human Nutrition Potsdam-Rehbrücke, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany.
- Department of Endocrinology, Diabetes and Nutrition, Campus Benjamin Franklin, Charité University Medicine, Hindenburgdamm 30, 12203 Berlin, Germany.
| | - Mads F Hjorth
- University of Copenhagen, Faculty of Science, Department of Nutrition, Exercise, and Sports, 2200 Copenhagen, Denmark.
| | - Martin O Weickert
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism; The ARDEN NET Centre, ENETS CoE; University Hospitals Coventry and Warwickshire NHS Trust, CV2 2DX Coventry, UK.
- Centre of Applied Biological & Exercise Sciences (ABES), Faculty of Health & Life Sciences, Coventry University, CV1 5FB Coventry, UK.
- Translational & Experimental Medicine, Division of Biomedical Sciences, Warwick Medical School, University of Warwick, CV4 7AL Coventry, UK.
| | - Andreas F H Pfeiffer
- Department of Clinical Nutrition, German Institute of Human Nutrition Potsdam-Rehbrücke, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany.
- Deutsches Zentrum für Diabetesforschung e.V., Geschäftsstelle am Helmholtz-Zentrum München, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany.
- Department of Endocrinology, Diabetes and Nutrition, Campus Benjamin Franklin, Charité University Medicine, Hindenburgdamm 30, 12203 Berlin, Germany.
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16
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Ritz C, Astrup A, Larsen TM, Hjorth MF. Weight loss at your fingertips: personalized nutrition with fasting glucose and insulin using a novel statistical approach. Eur J Clin Nutr 2019; 73:1529-1535. [DOI: 10.1038/s41430-019-0423-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 03/26/2019] [Accepted: 03/26/2019] [Indexed: 01/09/2023]
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17
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Hjorth MF, Bray GA, Zohar Y, Urban L, Miketinas DC, Williamson DA, Ryan DH, Rood J, Champagne CM, Sacks FM, Astrup A. Pretreatment Fasting Glucose and Insulin as Determinants of Weight Loss on Diets Varying in Macronutrients and Dietary Fibers-The POUNDS LOST Study. Nutrients 2019; 11:nu11030586. [PMID: 30861997 PMCID: PMC6470525 DOI: 10.3390/nu11030586] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 03/04/2019] [Accepted: 03/06/2019] [Indexed: 12/20/2022] Open
Abstract
Efforts to identify a preferable diet for weight management based on macronutrient composition have largely failed, but recent evidence suggests that satiety effects of carbohydrates may depend on the individual's insulin-mediated cellular glucose uptake. Therefore, using data from the POUNDS LOST trial, pre-treatment fasting plasma glucose (FPG), fasting insulin (FI), and homeostatic model assessment of insulin resistance (HOMA-IR) were studied as prognostic markers of long-term weight loss in four diets differing in carbohydrate, fat, and protein content, while assessing the role of dietary fiber intake. Subjects with FPG <100 mg/dL lost 2.6 (95% CI 0.9;4.4, p = 0.003) kg more on the low-fat/high-protein (n = 132) compared to the low-fat/average-protein diet (n = 136). Subjects with HOMA-IR ≥4 lost 3.6 (95% CI 0.2;7.1, p = 0.038) kg more body weight on the high-fat/high-protein (n = 35) compared to high-fat/average-protein diet (n = 33). Regardless of the randomized diet, subjects with prediabetes and FI below the median lost 5.6 kg (95% CI 0.6;10.6, p = 0.030) more when consuming ≥35 g (n = 15) compared to <35 g dietary fiber/10 MJ (n = 16). Overall, subjects with normal glycemia lost most on the low-fat/high-protein diet, subjects with high HOMA-IR lost most on the high-fat/high protein diet, and subjects with prediabetes and low FI had particular benefit from dietary fiber in the diet.
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Affiliation(s)
- Mads F Hjorth
- Department of Nutrition, Exercise and Sports, Faculty of Sciences, University of Copenhagen, Rolighedsvej 26, 1958 Frederiksberg, Denmark.
| | - George A Bray
- Pennington Biomedical Research Center of the Louisiana State University System, Baton Rouge, LA 70803, USA.
| | | | | | - Derek C Miketinas
- Pennington Biomedical Research Center of the Louisiana State University System, Baton Rouge, LA 70803, USA.
- School of Nutrition and Food Sciences, Texas Woman's University, Denton, TX 76204, USA.
| | - Donald A Williamson
- Pennington Biomedical Research Center of the Louisiana State University System, Baton Rouge, LA 70803, USA.
| | - Donna H Ryan
- Pennington Biomedical Research Center of the Louisiana State University System, Baton Rouge, LA 70803, USA.
| | - Jennifer Rood
- Pennington Biomedical Research Center of the Louisiana State University System, Baton Rouge, LA 70803, USA.
| | - Catherine M Champagne
- Pennington Biomedical Research Center of the Louisiana State University System, Baton Rouge, LA 70803, USA.
| | - Frank M Sacks
- Nutrition Department, Harvard T.H Chan School of Public Health and Department of Medicine, Harvard Medical School, Boston, MA 02115, USA.
| | - Arne Astrup
- Department of Nutrition, Exercise and Sports, Faculty of Sciences, University of Copenhagen, Rolighedsvej 26, 1958 Frederiksberg, Denmark.
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18
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Papandreou C, Camacho-Barcia L, García-Gavilán J, Hansen TT, Hjorth MF, Halford JCG, Salas-Salvadó J, Sjödin A, Bulló M. Circulating metabolites associated with objectively measured sleep duration and sleep variability in overweight/obese participants: a metabolomics approach within the SATIN study. Sleep 2019; 42:5307010. [PMID: 30722060 DOI: 10.1093/sleep/zsz030] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 11/02/2018] [Indexed: 12/19/2022] Open
Affiliation(s)
- Christopher Papandreou
- Human Nutrition Unit, Faculty of Medicine and Health Sciences, Institut d’Investigació Sanitària Pere Virgili, Rovira i Virgili University, Reus, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Lucia Camacho-Barcia
- Human Nutrition Unit, Faculty of Medicine and Health Sciences, Institut d’Investigació Sanitària Pere Virgili, Rovira i Virgili University, Reus, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Jesús García-Gavilán
- Human Nutrition Unit, Faculty of Medicine and Health Sciences, Institut d’Investigació Sanitària Pere Virgili, Rovira i Virgili University, Reus, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Thea Toft Hansen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 26, 1958 Frederiksberg C, Denmark
| | - Mads F Hjorth
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 26, 1958 Frederiksberg C, Denmark
| | - Jason C G Halford
- Department of Psychological Sciences, Institute of Psychology Health and Society, University of Liverpool, Liverpool, UK
| | - Jordi Salas-Salvadó
- Human Nutrition Unit, Faculty of Medicine and Health Sciences, Institut d’Investigació Sanitària Pere Virgili, Rovira i Virgili University, Reus, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Anders Sjödin
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 26, 1958 Frederiksberg C, Denmark
| | - Mónica Bulló
- Human Nutrition Unit, Faculty of Medicine and Health Sciences, Institut d’Investigació Sanitària Pere Virgili, Rovira i Virgili University, Reus, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
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19
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Hjorth MF, Astrup A, Zohar Y, Urban LE, Sayer RD, Patterson BW, Herring SJ, Klein S, Zemel BS, Foster GD, Wyatt HR, Hill JO. Personalized nutrition: pretreatment glucose metabolism determines individual long-term weight loss responsiveness in individuals with obesity on low-carbohydrate versus low-fat diet. Int J Obes (Lond) 2018; 43:2037-2044. [PMID: 30568260 DOI: 10.1038/s41366-018-0298-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 11/22/2018] [Accepted: 11/30/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND/OBJECTIVES The interaction between fasting plasma glucose (FPG) and fasting insulin (FI) concentrations and diets with different carbohydrate content were studied as prognostic markers of weight loss as recent studies up to 6 months of duration have suggested the importance of these biomarkers. SUBJECTS/METHODS This was a retrospective analysis of a clinical trial where participants with obesity were randomized to an ad libitum low-carbohydrate diet or a low-fat diet with low energy content (1200-1800 kcal/day [≈ 5.0-7.5 MJ/d]; ≤ 30% calories from fat) for 24 months. Participants were categorized (pretreatment) as normoglycemic (FPG < 5.6 mmol/L) or prediabetic (FPG ≥ 5.6-6.9 mmol/L) and further stratified by median FI. Linear mixed models were used to examine outcomes by FPG and FI values. RESULTS After 2 years, participants with prediabetes and high FI lost 7.2 kg (95% CI 2.1;12.2, P = 0.005) more with the low-fat than low-carbohydrate diet, whereas those with prediabetes and low FI tended to lose 6.2 kg (95% CI -0.9;13.3, P = 0.088) more on the low-carbohydrate diet than low-fat diet [mean difference: 13.3 kg (95% CI 4.6;22.0, P = 0.003)]. No differences between diets were found among participants with normoglycemia and either high or low FI (both P ≥ 0.16). CONCLUSIONS Fasting plasma glucose and insulin are strong predictors of the weight loss response to diets with different macronutrient composition and might be a useful approach for personalized weight management.
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Affiliation(s)
- Mads F Hjorth
- Department of Nutrition, Exercise and Sports, Faculty of Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Arne Astrup
- Department of Nutrition, Exercise and Sports, Faculty of Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | | | - R Drew Sayer
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | | | | | - Samuel Klein
- Washington University School of Medicine, St. Louis, MO, USA
| | | | | | - Holly R Wyatt
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - James O Hill
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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20
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Berg Schmidt J, Johanneson Bertolt C, Sjödin A, Ackermann F, Vibeke Schmedes A, Lynge Thomsen H, Marie Juncher A, Hjorth MF. Does stress affect food preferences? - a randomized controlled trial investigating the effect of examination stress on measures of food preferences and obesogenic behavior. Stress 2018; 21:556-563. [PMID: 30388041 DOI: 10.1080/10253890.2018.1494149] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Lay summary: Human and animal studies have shown that chronic stress interfers with both homeostatic and hedonic appetite control. Here, we investigated the effect of chronic stress on food preferences and eating behavior in real life settings. In random order, fifty healthy students participated in two test periods of 4-5 days; a stressful period (one week prior to an examination) and a nonstressful period (four weeks after an examination). Food preferences were assessed by counting money spent on highly rewarding foods bought with gift certificates, and changes in eating behavior was further assessed by the Three Factor Eating Questionnaire. Cohen's Perceived Stress Scale, the Recovery-Stress Questionnaire, heart rate variability and Cortisol awakening response were used to evaluate the level of stress. Data on glycemic control, blood pressure, physical activity and sleep were also collected. Forty-four subjects had complete data on the primary outcome. Self-perceived stress was higher and recovery lower in the exam period (p ≤ .001). Subjects were less cognitively restrained (p = .037), less moderately-to-vigorously and lightly physically active (p ≤ .037) and were more sedentary (p = .009) in the examination period. However, no difference was found in money spent on high reward foods, disinhibition or hunger between the examination and control condition. Furthermore, no differences in the physiological markers of stress, glycemic measures and sleep were found. Data does not convincingly support the hypothesis that perceived stress increases the preference for highly palatable foods or leads to adverse effects on different markers of health. However, the stressor might have been to mild to induce obesogenic behaviors.
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Affiliation(s)
- Julie Berg Schmidt
- a Department of Nutrition, Exercise and Sports, faculty of Science , University of Copenhagen , Denmark
| | | | - Anders Sjödin
- a Department of Nutrition, Exercise and Sports, faculty of Science , University of Copenhagen , Denmark
| | - Frederik Ackermann
- a Department of Nutrition, Exercise and Sports, faculty of Science , University of Copenhagen , Denmark
| | - Anne Vibeke Schmedes
- b Department of Clinical Immunology and Biochemistry , Lillebaelt Hospital , Vejle , Denmark
| | - Henriette Lynge Thomsen
- a Department of Nutrition, Exercise and Sports, faculty of Science , University of Copenhagen , Denmark
| | - Anne Marie Juncher
- a Department of Nutrition, Exercise and Sports, faculty of Science , University of Copenhagen , Denmark
| | - Mads F Hjorth
- a Department of Nutrition, Exercise and Sports, faculty of Science , University of Copenhagen , Denmark
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Christensen L, Roager HM, Astrup A, Hjorth MF. Microbial enterotypes in personalized nutrition and obesity management. Am J Clin Nutr 2018; 108:645-651. [PMID: 30239555 DOI: 10.1093/ajcn/nqy175] [Citation(s) in RCA: 112] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 07/06/2018] [Indexed: 12/13/2022] Open
Abstract
Human gut microbiota has been suggested to play an important role in nutrition and obesity. However, formulating meaningful and clinically relevant dietary advice based on knowledge about gut microbiota remains a key challenge. A number of recent studies have found evidence that stratification of individuals according to 2 microbial enterotypes (dominance of either Prevotella or Bacteroides) may be useful in predicting responses to diets and drugs. Here, we review enterotypes in a nutritional context and discuss how enterotype stratification may be used in personalized nutrition in obesity management. Enterotypes are characterized by distinct digestive functions with preference for specific dietary substrate, resulting in short-chain fatty acids that may influence energy balance in the host. Consequently, the enterotype potentially affects the individual's ability to lose weight when following a specific diet. In short, a high-fiber diet seems to optimize weight loss among Prevotella-enterotype subjects but not among Bacteroides-enterotype subjects. In contrast, increasing bifidobacteria in the gut among Bacteroides-enterotype subjects improves metabolic parameters, suggesting that this approach can be used as an alternative weight loss strategy. Thus, enterotypes, as a pretreatment gut microbiota biomarker, have the potential to become an important tool in personalized nutrition and obesity management, although further interventions assessing their applicability are warranted.
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Affiliation(s)
- Lars Christensen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Henrik M Roager
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Arne Astrup
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Mads F Hjorth
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
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22
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Astrup A, Hjorth MF. Classification of obesity targeted personalized dietary weight loss management based on carbohydrate tolerance. Eur J Clin Nutr 2018; 72:1300-1304. [PMID: 30185850 DOI: 10.1038/s41430-018-0227-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 05/22/2018] [Indexed: 11/09/2022]
Affiliation(s)
- Arne Astrup
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark.
| | - Mads F Hjorth
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
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23
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Thorning TK, Fabre O, Legrand R, Astrup A, Hjorth MF. Weight loss and weight loss maintenance efficacy of a novel weight loss program: The retrospective RNPC ® cohort. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.obmed.2018.05.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Abstract
During the past several decades, numerous trials have compared various diets for the management of overweight and obesity, assuming that a single dietary strategy would be appropriate for all individuals. These studies have failed to provide strong evidence for the efficacy of any particular diet, and it is likely that different people will have different levels of success on different diets. We identified studies investigating pretreatment glycemia or insulinemia status, or both, of the individual as prognostic markers of weight loss during periods in which the composition of a participant's diet was known. Overall, research suggests that providing specific diets for weight management based on pretreatment glycemia and insulinemia statuses holds great promise for advancing personalized nutrition.
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Affiliation(s)
- Mads F Hjorth
- Department of Nutrition, Exercise, and Sports, Faculty of Sciences, University of Copenhagen, 1958 Frederiksberg C, Denmark; ,
| | | | - James O Hill
- Colorado Nutrition Obesity Research Center, University of Colorado Denver, Aurora, Colorado 80045, USA;
| | - Arne Astrup
- Department of Nutrition, Exercise, and Sports, Faculty of Sciences, University of Copenhagen, 1958 Frederiksberg C, Denmark; ,
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25
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Geiker NRW, Astrup A, Hjorth MF, Sjödin A, Pijls L, Markus CR. Does stress influence sleep patterns, food intake, weight gain, abdominal obesity and weight loss interventions and vice versa? Obes Rev 2018; 19:81-97. [PMID: 28849612 DOI: 10.1111/obr.12603] [Citation(s) in RCA: 127] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 07/06/2017] [Accepted: 07/22/2017] [Indexed: 12/29/2022]
Abstract
Decades of research have reported only weak associations between the intakes of specific foods or drinks and weight gain and obesity. Randomized controlled dietary intervention trials have only shown very modest effects of changes in nutrient intake and diet composition on body weight in obese subjects. This review summarizes the scientific evidence on the role mental stress (either in or not in association with impaired sleep) may play in poor sleep, enhanced appetite, cravings and decreased motivation for physical activity. All these factors contribute to weight gain and obesity, possibly via decreasing the efficacy of weight loss interventions. We also review evidence for the role that lifestyle and stress management may play in achieving weight loss in stress-vulnerable individuals with overweight.
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Affiliation(s)
- N R W Geiker
- Clinical Nutrition Research Unit, Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark
| | - A Astrup
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - M F Hjorth
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - A Sjödin
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - L Pijls
- Loekintofood-gcv/scs, Brussels, Belgium
| | - C Rob Markus
- Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
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26
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Schnurr TM, Viitasalo A, Eloranta AM, Damsgaard CT, Mahendran Y, Have CT, Väistö J, Hjorth MF, Christensen LB, Brage S, Atalay M, Lyytikäinen LP, Lindi V, Lakka T, Michaelsen KF, Kilpeläinen TO, Hansen T. Genetic predisposition to adiposity is associated with increased objectively assessed sedentary time in young children. Int J Obes (Lond) 2018; 42:111-114. [PMID: 28947836 PMCID: PMC5765967 DOI: 10.1038/ijo.2017.235] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 07/28/2017] [Accepted: 09/15/2017] [Indexed: 11/25/2022]
Abstract
Increased sedentariness has been linked to the growing prevalence of obesity in children, but some longitudinal studies suggest that sedentariness may be a consequence rather than a cause of increased adiposity. We used Mendelian randomization to examine the causal relations between body mass index (BMI) and objectively assessed sedentary time and physical activity in 3-8 year-old children from one Finnish and two Danish cohorts [NTOTAL=679]. A genetic risk score (GRS) comprised of 15 independent genetic variants associated with childhood BMI was used as the instrumental variable to test causal effects of BMI on sedentary time, total physical activity, and moderate-to-vigorous physical activity (MVPA). In fixed effects meta-analyses, the GRS was associated with 0.05 SD/allele increase in sedentary time (P=0.019), but there was no significant association with total physical activity (beta=0.011 SD/allele, P=0.58) or MVPA (beta=0.001 SD/allele, P=0.96), adjusting for age, sex, monitor wear-time and first three genome-wide principal components. In two-stage least squares regression analyses, each genetically instrumented one unit increase in BMI z-score increased sedentary time by 0.47 SD (P=0.072). Childhood BMI may have a causal influence on sedentary time but not on total physical activity or MVPA in young children. Our results provide important insights into the regulation of movement behaviour in childhood.
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Affiliation(s)
- Theresia M. Schnurr
- Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anna Viitasalo
- Institute of Biomedicine Physiology, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Aino-Maija Eloranta
- Institute of Biomedicine Physiology, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Camilla T. Damsgaard
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Yuvaraj Mahendran
- Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Christian T. Have
- Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Juuso Väistö
- Institute of Biomedicine Physiology, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Mads F. Hjorth
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Line B. Christensen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Soren Brage
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Mustafa Atalay
- Institute of Biomedicine Physiology, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Leo-Pekka Lyytikäinen
- Institute of Biomedicine Physiology, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Clinical Chemistry, Fimlab Laboratories and Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Virpi Lindi
- Institute of Biomedicine Physiology, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Timo Lakka
- Institute of Biomedicine Physiology, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Clinical Physiology and Nuclear Medicine, School of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
- Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
| | - Kim F. Michaelsen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Tuomas O. Kilpeläinen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Torben Hansen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Hjorth MF, Due A, Larsen TM, Astrup A. Pretreatment Fasting Plasma Glucose Modifies Dietary Weight Loss Maintenance Success: Results from a Stratified RCT. Obesity (Silver Spring) 2017; 25:2045-2048. [PMID: 28985039 DOI: 10.1002/oby.22004] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 08/01/2017] [Accepted: 08/18/2017] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Levels of fasting plasma glucose (FPG) and fasting insulin (FI) were studied as diet-specific prognostic markers for successful weight loss maintenance in participants with overweight. METHODS After losing ≥ 8% of body weight, participants received one of three ad libitum diets for 6 months: (1) a moderate-fat diet high in monounsaturated fatty acids (MUFA); a low-fat, high-fiber diet (Nordic Nutrition Recommendations [NNR]); and the Average Danish Diet (ADD). Participants were categorized as having low (< 90 mg/dL) or high (90-105 mg/dL) FPG based on preintervention values. Median FI among those having high FPG was used as a cutoff for FI (FI ≤ 50 pmol/L; FI > 50 pmol/L). RESULTS Participants with low FPG and randomized to MUFA, NNR, and ADD regained similarly 2.1 to 2.5 kg after 6 months. By contrast, participants with high FPG and randomized to MUFA, NNR, and ADD regained 2.73 kg (95% CI 1.33 to 4.13; P < 0.001), -0.05 kg (95% CI -1.95 to 1.86; P = 0.96), and 4.16 kg (95% CI 2.27 to 6.06; P < 0.001) after 6 months, respectively, resulting in lower weight regain on NNR compared to ADD (-4.21 kg [95% CI -6.83 to -1.59]; P = 0.002) and MUFA (95% CI -2.77 kg [-5.12 to -0.43]; P = 0.020). The addition of FI strengthened these associations. CONCLUSIONS Slightly elevated pretreatment FPG determined success in dietary weight loss maintenance among overweight patients on ad libitum diets differing in macronutrient and fiber content.
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Affiliation(s)
- Mads F Hjorth
- Department of Nutrition, Exercise, and Sports, Faculty of Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anette Due
- Department of Nutrition and Midwifery, Faculty of Health and Technology, Metropolitan University College, Copenhagen, Denmark
| | - Thomas M Larsen
- Department of Nutrition, Exercise, and Sports, Faculty of Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Arne Astrup
- Department of Nutrition, Exercise, and Sports, Faculty of Sciences, University of Copenhagen, Copenhagen, Denmark
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Hjorth MF, Roager HM, Larsen TM, Poulsen SK, Licht TR, Bahl MI, Zohar Y, Astrup A. Pre-treatment microbial Prevotella-to-Bacteroides ratio, determines body fat loss success during a 6-month randomized controlled diet intervention. Int J Obes (Lond) 2017; 42:580-583. [PMID: 28883543 PMCID: PMC5880576 DOI: 10.1038/ijo.2017.220] [Citation(s) in RCA: 110] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 08/04/2017] [Accepted: 08/22/2017] [Indexed: 12/25/2022]
Abstract
On the basis of the abundance of specific bacterial genera, the human gut microbiota can be divided into two relatively stable groups that might have a role in personalized nutrition. We studied these simplified enterotypes as prognostic markers for successful body fat loss on two different diets. A total of 62 participants with increased waist circumference were randomly assigned to receive an ad libitum New Nordic Diet (NND) high in fiber/whole grain or an Average Danish Diet for 26 weeks. Participants were grouped into two discrete enterotypes by their relative abundance of Prevotella spp. divided by Bacteroides spp. (P/B ratio) obtained by quantitative PCR analysis. Modifications of dietary effects of pre-treatment P/B group were examined by linear mixed models. Among individuals with high P/B the NND resulted in a 3.15 kg (95% confidence interval (CI): 1.55; 4.76, P<0.001) larger body fat loss compared with ADD, whereas no differences was observed among individuals with low P/B (0.88 kg (95% CI: −0.61; 2.37, P=0.25)). Consequently, a 2.27 kg (95% CI: 0.09; 4.45, P=0.041) difference in responsiveness to the diets were found between the two groups. In summary, subjects with high P/B ratio appeared more susceptible to lose body fat on diets high in fiber and whole grain than subjects with a low P/B ratio.
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Affiliation(s)
- M F Hjorth
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark
| | - H M Roager
- National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - T M Larsen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark
| | - S K Poulsen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark.,Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - T R Licht
- National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - M I Bahl
- National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Y Zohar
- Gelesis Inc., Boston, MA, USA
| | - A Astrup
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark
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29
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Hjorth MF, Ritz C, Blaak EE, Saris WH, Langin D, Poulsen SK, Larsen TM, Sørensen TI, Zohar Y, Astrup A. Pretreatment fasting plasma glucose and insulin modify dietary weight loss success: results from 3 randomized clinical trials. Am J Clin Nutr 2017; 106:499-505. [PMID: 28679551 DOI: 10.3945/ajcn.117.155200] [Citation(s) in RCA: 126] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 06/09/2017] [Indexed: 11/14/2022] Open
Abstract
Background: Which diet is optimal for weight loss and maintenance remains controversial and implies that no diet fits all patients.Objective: We studied concentrations of fasting plasma glucose (FPG) and fasting insulin (FI) as prognostic markers for successful weight loss and maintenance through diets with different glycemic loads or different fiber and whole-grain content, assessed in 3 randomized trials of overweight participants.Design: After an 8-wk weight loss, participants in the DiOGenes (Diet, Obesity, and Genes) trial consumed ad libitum for 26 wk a diet with either a high or a low glycemic load. Participants in the Optimal well-being, development and health for Danish children through a healthy New Nordic Diet (OPUS) Supermarket intervention (SHOPUS) trial consumed ad libitum for 26 wk the New Nordic Diet, which is high in fiber and whole grains, or a control diet. Participants in the NUGENOB (Nutrient-Gene Interactions in Human Obesity) trial consumed a hypocaloric low-fat and high-carbohydrate or a high-fat and low-carbohydrate diet for 10 wk. On the basis of FPG before treatment, participants were categorized as normoglycemic (FPG <5.6 mmol/L), prediabetic (FPG 5.6-6.9 mmol/L), or diabetic (FPG ≥7.0 mmol/L). Modifications of the dietary effects of FPG and FI before treatment were examined with linear mixed models.Results: In the DiOGenes trial, prediabetic individuals regained a mean of 5.83 kg (95% CI: 3.34, 8.32 kg; P < 0.001) more on the high- than on the low-glycemic load diet, whereas normoglycemic individuals regained a mean of 1.44 kg (95% CI: 0.48, 2.41 kg; P = 0.003) more [mean group difference: 4.39 kg (95% CI: 1.76, 7.02 kg); P = 0.001]. In SHOPUS, prediabetic individuals lost a mean of 6.04 kg (95% CI: 4.05, 8.02 kg; P < 0.001) more on the New Nordic Diet than on the control diet, whereas normoglycemic individuals lost a mean of 2.20 kg (95% CI: 1.21, 3.18 kg; P < 0.001) more [mean group difference: 3.84 kg (95% CI: 1.62, 6.06 kg); P = 0.001]. In NUGENOB, diabetic individuals lost a mean of 2.04 kg (95% CI: -0.20, 4.28 kg; P = 0.07) more on the high-fat and low-carbohydrate diet than on the low-fat and high-carbohydrate diet, whereas normoglycemic individuals lost a mean of 0.43 kg (95% CI: 0.03, 0.83 kg; P = 0.03) more on the low-fat and high-carbohydrate diet [mean group difference: 2.47 kg (95% CI: 0.20, 4.75 kg); P = 0.03]. The addition of FI strengthened these associations.Conclusion: Elevated FPG before treatment indicates success with dietary weight loss and maintenance among overweight patients consuming diets with a low glycemic load or with large amounts of fiber and whole grains. These trials were registered at clinicaltrials.gov as NCT00390637 (DiOGenes) and NCT01195610 (SHOPUS), and at ISRNCT.com as ISRCTN25867281 (NUGENOB).
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Affiliation(s)
- Mads F Hjorth
- Department of Nutrition, Exercise and Sports, Faculty of Sciences,
| | - Christian Ritz
- Department of Nutrition, Exercise and Sports, Faculty of Sciences
| | - Ellen E Blaak
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, Netherlands
| | - Wim Hm Saris
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, Netherlands
| | - Dominique Langin
- INSERM, UMR1048, Obesity Research Laboratory, Institute of Metabolic and Cardiovascular Diseases, Toulouse, France.,University of Toulouse, UMR1048, Paul Sabatier University, Toulouse, France.,Toulouse University Hospitals, Laboratory of Clinical Biochemistry, Toulouse, France.,Institut Universitaire de France, Paris, France
| | - Sanne Kellebjerg Poulsen
- Department of Nutrition, Exercise and Sports, Faculty of Sciences.,Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | | | - Thorkild Ia Sørensen
- Novo Nordisk Foundation Center for Basic Metabolic Research (Section on Metabolic Genetics).,Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Epidemiology (formerly Institute of Preventive Medicine), Bispebjerg and Frederiksberg Hospitals, the Capital Region, Copenhagen, Denmark; and
| | | | - Arne Astrup
- Department of Nutrition, Exercise and Sports, Faculty of Sciences
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30
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Affiliation(s)
- Arne Astrup
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 30, 1958 Frederiksberg C, Denmark.
| | - Mads F Hjorth
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 30, 1958 Frederiksberg C, Denmark
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31
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Schnurr TM, Bech B, Nielsen TRH, Andersen IG, Hjorth MF, Aadahl M, Fonvig CE, Hansen T, Holm JC. Self-Reported Versus Accelerometer-Assessed Daily Physical Activity in Childhood Obesity Treatment. Percept Mot Skills 2017; 124:795-811. [PMID: 28560892 DOI: 10.1177/0031512517710880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We investigated the relationship between interview-based subjective ratings of physical activity (PA) engagement and accelerometer-assessed objectively measured PA in children and adolescents with overweight or obesity. A total of 92 children and adolescents (40 males, 52 females) with BMI ≥ 90th percentile for sex and age, aged 5-17 years had valid GT3X + accelerometer-assessed PA and interview-assessed self-reported information on PA engagement at the time of enrollment in a multidisciplinary outpatient tertiary treatment for childhood obesity. Accelerometer-derived mean overall PA and time spent in moderate to vigorous physical intensity were generated, applying cut-offs based on Vector Magnitude settings as defined by Romanzini et al. (2014), and a physical activity score (PAS) based on self-reported data. Overall, a higher self-reported PAS was correlated with higher accelerometer-assessed daily total PA levels ( r = 0.34, p < .01) and children who reported a high PAS were more physically active compared with children who reported a low PAS. There was a fair level of agreement between self-reported PAS and accelerometer-assessed PA (Kappa agreement = 0.23; 95% CI = [0.03, 0.43]; p = .01). PAS, derived from self-report, may be a useful instrument for evaluating PA at a group level among children and adolescents enrolled in multidisciplinary obesity treatment.
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Affiliation(s)
- Theresia M Schnurr
- 1 Section of Metabolic Genetics, Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Denmark
| | - Bianca Bech
- 1 Section of Metabolic Genetics, Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Denmark
| | - Tenna R H Nielsen
- 1 Section of Metabolic Genetics, Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Denmark.,2 Department of Pediatrics, The Children's Obesity Clinic, Copenhagen University Hospital Holbæk, Denmark
| | - Ida G Andersen
- 2 Department of Pediatrics, The Children's Obesity Clinic, Copenhagen University Hospital Holbæk, Denmark.,3 Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Køge, Denmark
| | - Mads F Hjorth
- 4 Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Denmark
| | - Mette Aadahl
- 5 Research Centre for Prevention and Health, Copenhagen University Hospital Glostrup, Denmark.,6 Faculty of Health and Medical Science, Department of Public Health, University of Copenhagen, Denmark
| | - Cilius E Fonvig
- 1 Section of Metabolic Genetics, Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Denmark.,2 Department of Pediatrics, The Children's Obesity Clinic, Copenhagen University Hospital Holbæk, Denmark
| | - Torben Hansen
- 1 Section of Metabolic Genetics, Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Denmark
| | - Jens-Christian Holm
- 1 Section of Metabolic Genetics, Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Denmark.,2 Department of Pediatrics, The Children's Obesity Clinic, Copenhagen University Hospital Holbæk, Denmark
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32
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Jaskolowski J, Ritz C, Sjödin A, Astrup A, Szecsi PB, Stender S, Hjorth MF. Weekday variation in triglyceride concentrations in 1.8 million blood samples. J Lipid Res 2017; 58:1204-1213. [PMID: 28381440 DOI: 10.1194/jlr.m074062] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 03/02/2017] [Indexed: 11/20/2022] Open
Abstract
Triglyceride (TG) concentration is used as a marker of cardiometabolic risk. However, diurnal and possibly weekday variation exists in TG concentrations. The objective of this work was to investigate weekday variation in TG concentrations among 1.8 million blood samples drawn between 2008 and 2015 from patients in the Capital region of Denmark. Plasma TG was extracted from a central clinical laboratory information system. Weekday variation was investigated by means of linear mixed models. In addition to the profound diurnal variation, the TG concentration was 4.5% lower on Fridays compared with Mondays (P < 0.0001). The variation persisted after multiple adjustments for confounders and was consistent across all sensitivity analyses. Out-patients and in-patients, respectively, had 5.0% and 1.9% lower TG concentrations on Fridays compared with Mondays (both P < 0.0001). The highest weekday variations in TG concentrations were recorded for out-patients between the ages of 9 and 26 years, with up to 20% higher values on Mondays compared with Fridays (all P < 0.05). In conclusion, TG concentrations were highest after the weekend and gradually declined during the week. We suggest that unhealthy food intake and reduced physical activity during the weekend increase TG concentrations which track into the week. This weekday variation may carry implications for public health and future research practice.
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Affiliation(s)
- Jörn Jaskolowski
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Christian Ritz
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Anders Sjödin
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Arne Astrup
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Pal B Szecsi
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Steen Stender
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Mads F Hjorth
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
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Hjorth MF, Sjödin A. Rebuttal - Factors affecting cognitive performance in children with special reference to sleep and sedentary behavior. Physiol Behav 2016; 167:413. [PMID: 27671682 DOI: 10.1016/j.physbeh.2016.09.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Mads F Hjorth
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.
| | - Anders Sjödin
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
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Quist JS, Sjödin A, Chaput JP, Hjorth MF. Sleep and cardiometabolic risk in children and adolescents. Sleep Med Rev 2016; 29:76-100. [DOI: 10.1016/j.smrv.2015.09.001] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 08/31/2015] [Accepted: 09/02/2015] [Indexed: 12/22/2022]
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Hjorth MF, Sørensen LB, Andersen R, Dyssegaard CB, Ritz C, Tetens I, Michaelsen KF, Astrup A, Egelund N, Sjödin A. Normal weight children have higher cognitive performance - Independent of physical activity, sleep, and diet. Physiol Behav 2016; 165:398-404. [PMID: 27570193 DOI: 10.1016/j.physbeh.2016.08.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Revised: 08/19/2016] [Accepted: 08/20/2016] [Indexed: 01/09/2023]
Abstract
BACKGROUND/OBJECTIVES Aside from the health consequences, observational studies indicate that being overweight may also negatively affect cognitive function. However, existing evidence has to a large extent not controlled for the possible confounding effect of having different lifestyles. Therefore, the objective was to examine the independent associations between weight status and lifestyle indicators with cognitive performance in 8-11year old Danish children. SUBJECTS/METHODS The analyses included 828 children (measured in 2011-2012) each having one to three measurement occasions separated by approximately 100days. Dietary intake, physical activity, sedentary time, and sleep duration were measured using dietary records and accelerometers. The Children's Sleep Habits Questionnaire was used to access sleep problems and the Andersen test was carried out to estimate cardio-respiratory fitness (CRF). Weight status (underweight, normal weight, and overweight/obese) was defined according to body mass index and cognitive performance was assessed using the d2-test of attention, a reading test, and a math test. A linear mixed model including a number of fixed and random effects was used to test associations between lifestyle indicators as well as BMI category and cognitive performance. RESULTS After adjustment for demographics, socioeconomics, and multiple lifestyle indicators, normal weight children had higher cognitive test scores than overweight/obese and underweight children of up to 89% and 48% of expected learning within one school year (P<0.05). Daily breakfast consumption, fewer sleep problems, higher CRF, less total physical activity, more sedentary time, and less light physical activity were associated with higher cognitive performance independently of each other in at least one of the three cognitive tests (P<0.05). CONCLUSIONS Normal weight children had higher cognitive performance compared to overweight/obese as well as underweight children, independent of multiple lifestyle indicators.
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Affiliation(s)
- Mads F Hjorth
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.
| | - Louise B Sørensen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Rikke Andersen
- Division of Nutrition, The National Food Institute, Technical University of Denmark, Denmark
| | | | - Christian Ritz
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Inge Tetens
- Division of Nutrition, The National Food Institute, Technical University of Denmark, Denmark
| | - Kim F Michaelsen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Arne Astrup
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Niels Egelund
- Department of Education, Faculty of Arts, Aarhus University, Denmark
| | - Anders Sjödin
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
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Sørensen LB, Damsgaard CT, Petersen RA, Dalskov SM, Hjorth MF, Dyssegaard CB, Egelund N, Tetens I, Astrup A, Lauritzen L, Michaelsen KF. Differences in the effects of school meals on children's cognitive performance according to gender, household education and baseline reading skills. Eur J Clin Nutr 2016; 70:1155-1161. [PMID: 27302673 DOI: 10.1038/ejcn.2016.99] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 04/18/2016] [Accepted: 04/20/2016] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES We previously found that the OPUS School Meal Study improved reading and increased errors related to inattention and impulsivity. This study explored whether the cognitive effects differed according to gender, household education and reading proficiency at baseline. SUBJECTS/METHODS This is a cluster-randomised cross-over trial comparing Nordic school meals with packed lunch from home (control) for 3 months each among 834 children aged 8 to 11 years. At baseline and at the end of each dietary period, we assessed children's performance in reading, mathematics and the d2-test of attention. Interactions were evaluated using mixed models. Analyses included 739 children. RESULTS At baseline, boys and children from households without academic education were poorer readers and had a higher d2-error%. Effects on dietary intake were similar in subgroups. However, the effect of the intervention on test outcomes was stronger in boys, in children from households with academic education and in children with normal/good baseline reading proficiency. Overall, this resulted in increased socioeconomic inequality in reading performance and reduced inequality in impulsivity. Contrary to this, the gender difference decreased in reading and increased in impulsivity. Finally, the gap between poor and normal/good readers was increased in reading and decreased for d2-error%. CONCLUSIONS The effects of healthy school meals on reading, impulsivity and inattention were modified by gender, household education and baseline reading proficiency. The differential effects might be related to environmental aspects of the intervention and deserves to be investigated further in future school meal trials.
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Affiliation(s)
- L B Sørensen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg C, Denmark
| | - C T Damsgaard
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg C, Denmark
| | - R A Petersen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg C, Denmark
| | - S-M Dalskov
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg C, Denmark
| | - M F Hjorth
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg C, Denmark
| | - C B Dyssegaard
- Department of Education, Faculty of Arts, Aarhus University, Copenhagen, Denmark
| | - N Egelund
- Department of Education, Faculty of Arts, Aarhus University, Copenhagen, Denmark
| | - I Tetens
- Division of Nutrition, The National Food Institute, Technical University of Denmark, Søborg, Denmark
| | - A Astrup
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg C, Denmark
| | - L Lauritzen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg C, Denmark
| | - K F Michaelsen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg C, Denmark
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Dalskov SM, Ritz C, Larnkjær A, Damsgaard CT, Petersen RA, Sørensen LB, Hjorth MF, Ong KK, Astrup A, Mølgaard C, Michaelsen KF. Seasonal variations in growth and body composition of 8-11-y-old Danish children. Pediatr Res 2016; 79:358-63. [PMID: 26488554 DOI: 10.1038/pr.2015.206] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 07/02/2015] [Indexed: 11/09/2022]
Abstract
BACKGROUND Earlier studies on seasonality in growth reported the largest height gains during spring and largest body weight gains during autumn. We examined seasonality in height, body weight, BMI, fat mass index (FMI), and fat-free mass index (FFMI) among contemporary Danish 8-11-y olds. METHODS A total of 760 children from the OPUS School Meal Study provided >2,200 measurements on height, body weight, and composition between September and June. Average velocities were calculated using change-score analyses based on 3-mo intervals. As a complementary analysis, point velocities derived from estimated growth curves were fitted using semiparametric regression that included covariate adjustment and allowed flexible modeling of the time trend. RESULTS Average velocities showed the following trends: height was higher than the average (6.10 cm/y) in January-April. Body weight was below the average (4.02 kg/y) in August-January and above in January-May; BMI (average: 0.49 kg/ m(2)/y) and FFMI (average: 0.17 kg/m(2)/y) showed similar trends. In contrast, FMI was above the average (0.38 kg/m(2)/y) in November-March. Similar trends were seen for point velocities. CONCLUSION Our findings suggest seasonality in growth and body composition of Danish children. We recovered the well-known height velocity peak during spring time, but unlike earlier studies, we found coincident peaks in body weight, BMI, and FFMI velocities.
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Affiliation(s)
- Stine-Mathilde Dalskov
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Christian Ritz
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Anni Larnkjær
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Camilla T Damsgaard
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Rikke A Petersen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Louise B Sørensen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Mads F Hjorth
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Ken K Ong
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Arne Astrup
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Christian Mølgaard
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Kim F Michaelsen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
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Chaput JP, Weippert M, LeBlanc AG, Hjorth MF, Michaelsen KF, Katzmarzyk PT, Tremblay MS, Barreira TV, Broyles ST, Fogelholm M, Hu G, Kuriyan R, Kurpad A, Lambert EV, Maher C, Maia J, Matsudo V, Olds T, Onywera V, Sarmiento OL, Standage M, Tudor-Locke C, Zhao P, Sjödin AM. Are Children Like Werewolves? Full Moon and Its Association with Sleep and Activity Behaviors in an International Sample of Children. Front Pediatr 2016; 4:24. [PMID: 27047907 PMCID: PMC4805596 DOI: 10.3389/fped.2016.00024] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 03/08/2016] [Indexed: 12/05/2022] Open
Abstract
In order to verify if the full moon is associated with sleep and activity behaviors, we used a 12-country study providing 33,710 24-h accelerometer recordings of sleep and activity. The present observational, cross-sectional study included 5812 children ages 9-11 years from study sites that represented all inhabited continents and wide ranges of human development (Australia, Brazil, Canada, China, Colombia, Finland, India, Kenya, Portugal, South Africa, United Kingdom, and United States). Three moon phases were used in this analysis: full moon (±4 days; reference), half moon (±5-9 days), and new moon (±10-14 days) from nearest full moon. Nocturnal sleep duration, moderate-to-vigorous physical activity (MVPA), light-intensity physical activity (LPA), and total sedentary time (SED) were monitored over seven consecutive days using a waist-worn accelerometer worn 24 h a day. Only sleep duration was found to significantly differ between moon phases (~5 min/night shorter during full moon compared to new moon). Differences in MVPA, LPA, and SED between moon phases were negligible and non-significant (<2 min/day difference). There was no difference in the associations between study sites. In conclusion, sleep duration was 1% shorter at full moon compared to new moon, while activity behaviors were not significantly associated with the lunar cycle in this global sample of children. Whether this seemingly minimal difference is clinically meaningful is questionable.
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Affiliation(s)
| | - Madyson Weippert
- Children's Hospital of Eastern Ontario Research Institute , Ottawa, ON , Canada
| | | | | | | | | | - Mark S Tremblay
- Children's Hospital of Eastern Ontario Research Institute , Ottawa, ON , Canada
| | - Tiago V Barreira
- Pennington Biomedical Research Center, Baton Rouge, LA, USA; University of Syracuse, Syracuse, NY, USA
| | | | | | - Gang Hu
- Pennington Biomedical Research Center , Baton Rouge, LA , USA
| | | | - Anura Kurpad
- St. Johns Research Institute , Bangalore , India
| | | | - Carol Maher
- University of South Australia , Adelaide, SA , Australia
| | - Jose Maia
- University of Porto , Porto , Portugal
| | - Victor Matsudo
- Centro de Estudos do Laboratório de Aptidão Física de São Caetano do Sul (CELAFISCS) , Sao Paulo , Brazil
| | - Timothy Olds
- University of South Australia , Adelaide, SA , Australia
| | | | | | | | - Catrine Tudor-Locke
- Pennington Biomedical Research Center, Baton Rouge, LA, USA; University of Massachusetts Amherst, Amherst, MA, USA
| | - Pei Zhao
- Tianjin Women's and Children's Health Center , Tianjin , China
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Hjorth MF, Sjödin A, Dalskov SM, Damsgaard CT, Michaelsen KF, Biltoft-Jensen A, Andersen R, Ritz C, Chaput JP, Astrup A. Sleep duration modifies effects of free ad libitum school meals on adiposity and blood pressure. Appl Physiol Nutr Metab 2016; 41:33-40. [PMID: 26647154 DOI: 10.1139/apnm-2015-0319] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2023]
Abstract
Insufficient sleep can potentially affect both energy intake and energy expenditure, resulting in obesity and reduced cardiometabolic health. The objective of the study was to investigate if habitual sleep duration of 8- to 11-year-olds modifies the effect of free ad libitum school meals on cardiometabolic markers, body composition, dietary intake, and physical activity. For 2 consecutive 3-month periods, this cluster-randomized, controlled, cross-over trial provided 530 children with school meals or usual lunch brought from home. Dietary intake, activity, and sleep were measured simultaneously for 7 consecutive days using dietary records and accelerometers. Short- and long-sleeping children were defined as lower and upper tertile of sleep duration. Body composition, blood pressure, blood lipids, and homeostatic model assessment of insulin resistance (HOMAIR) were measured/calculated. Overall, school meals compared with lunch from home had positive effects on physical activity and blood pressure in long-sleeping children and negative effects on body fat in short-sleeping children. Short-sleeping children increased fat mass compared with long-sleeping children by 0.21 (95% confidence interval 0.03-0.38) kg, android fat mass by 0.02 (0.001-0.04) kg, waist circumference by 0.73 (0.23-1.24) cm, blood pressure by 1.5 (0.4-2.6) mm Hg, fat intake by 1.1 (0.2-2.0) percentage of energy, and decreased total physical activity by 7.2 (1.6-12.7) % (all P ≤ 0.04), while HOMAIR and blood lipids were not modified by sleep duration (all P ≥ 0.32). In conclusion, the susceptibility to increase abdominal adiposity and blood pressure when exposed to dietary changes can potentially be explained by too little sleep, which results in increased caloric intake and reduced physical activity.
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Affiliation(s)
- Mads F Hjorth
- a Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Anders Sjödin
- a Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Stine-Mathilde Dalskov
- a Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Camilla Trab Damsgaard
- a Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Kim F Michaelsen
- a Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Anja Biltoft-Jensen
- b Division of Nutrition, National Food Institute, Technical University of Denmark, Søborg, Denmark
| | - Rikke Andersen
- b Division of Nutrition, National Food Institute, Technical University of Denmark, Søborg, Denmark
| | - Christian Ritz
- a Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Jean-Philippe Chaput
- c Healthy Active Living and Obesity (HALO) Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada
| | - Arne Astrup
- a Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
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Sjödin A, Hjorth MF, Damsgaard CT, Ritz C, Astrup A, Michaelsen KF. Physical activity, sleep duration and metabolic health in children fluctuate with the lunar cycle: science behind the myth. Clin Obes 2015; 5:60-6. [PMID: 25808903 PMCID: PMC4672692 DOI: 10.1111/cob.12092] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Revised: 02/19/2015] [Accepted: 02/20/2015] [Indexed: 11/28/2022]
Abstract
Behaviours of several animal species have been linked to lunar periodicity. Evidence for such links in humans is weak; however, recently, shorter sleep duration was reported around full moon in two small samples of adults. As restrictions in sleep duration have been shown to adversely affect glucose regulation and physical activity to improve glucose regulation, one could speculate that cardiometabolic risk factors might also be affected by the lunar phase. We retrospectively examined 795 Danish children, aged 8-11 years, with more than 13,000 24-h accelerometer recordings of activity and sleep as well as 2000 measurements of different cardiometabolic risk factors, including insulin sensitivity, appetite hormones and blood pressure, during nine lunar phases. During the period around full moon, children were 5.0 and 3.2 min per day less active, slept 2.4 and 4.1 min per night longer, had 0.03 and 0.05 higher homeostatic model assessment of insulin resistance and 0.6 and 0.8 mmHg higher mean arterial blood pressure compared with days around half moon and new moon, respectively (all P ≤ 0.02). Furthermore, ghrelin was lower and leptin was higher during the period around full moon compared with days around half moon (both P < 0.001). The results suggest that physical activity rather than sleep is responsible for the metabolic alterations observed around full moon. However, we have no understanding of potential mechanisms that may mediate a potential true link between childhood behaviour and the lunar cycle or confounders that may explain this, apparently leading to fluctuation in a number of cardiometabolic risk markers conjointly with lunar phases.
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Affiliation(s)
- A Sjödin
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
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Hjorth MF, Damsgaard CT, Michaelsen KF, Astrup A, Sjödin A. Markers of metabolic health in children differ between weekdays--the result of unhealthier weekend behavior. Obesity (Silver Spring) 2015; 23:733-6. [PMID: 25755216 DOI: 10.1002/oby.21034] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 12/31/2014] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The aim of this study was to investigate whether indicators of metabolic health fluctuate during the week in a group of children posing unhealthier physical activity, sedentary time, and sleep during weekends compared to weekdays. METHODS A total of 807 eight- to eleven-year-old children had valid metabolic health markers from one, two, or three measurements contributing 2190 to 2240 observations of metabolic health markers. The weekly variation was tested using linear mixed models. RESULTS Homeostatic model assessment of insulin resistance (HOMAIR), triglycerides, leptin (all P < 0.001), and adiponectin (P = 0.03) decreased from Monday to Friday, whereas ghrelin increased (P < 0.001). HOMAIR , triglycerides, and leptin were 35%, 28%, and 33% higher on Mondays compared to Fridays, respectively, and ghrelin was 7% lower on Mondays compared to Fridays (all P < 0.001). CONCLUSIONS The large weekly variation in HOMAIR , triglycerides, and leptin was likely the result of unhealthier behaviors during weekends. These findings have public health relevance and raise methodological issues that should ideally be taken into account in future studies.
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Affiliation(s)
- Mads F Hjorth
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
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Hjorth MF, Quist JS, Andersen R, Michaelsen KF, Tetens I, Astrup A, Chaput JP, Sjödin A. Change in sleep duration and proposed dietary risk factors for obesity in Danish school children. Pediatr Obes 2014; 9:e156-9. [PMID: 25251317 DOI: 10.1111/ijpo.264] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Revised: 07/04/2014] [Accepted: 08/15/2014] [Indexed: 01/11/2023]
Abstract
BACKGROUND Recent cross-sectional studies found higher consumption of energy-dense foods among children with short sleep duration; however, longitudinal studies examining changes in sleep and diet over time are needed. OBJECTIVE This study aimed to investigate prospective associations between changes in objectively measured sleep duration and alterations in proposed dietary risk factors for obesity in 8-11-year-old Danish children. METHODS Four hundred forty-one children recorded dietary intake during seven consecutive days, along with accelerometer measurements estimating sleep duration at baseline and after ∼200 days. RESULTS Baseline sleep duration did not predict changes in dietary intake or vice versa (all P ≥ 0.69). However, 1-h lower sleep duration was associated with higher intake of added sugar (1.59 E%; P = 0.001) and sugar-sweetened beverages (0.90 E%; P = 0.002) after 200 days with no change in energy density of the diet (P = 0.78). CONCLUSION Our results suggest that a negative change in sleep duration is associated with higher intakes of sugar containing foods/beverages.
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Affiliation(s)
- M F Hjorth
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
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Damsgaard CT, Eidner MB, Stark KD, Hjorth MF, Sjödin A, Andersen MR, Andersen R, Tetens I, Astrup A, Michaelsen KF, Lauritzen L. Eicosapentaenoic acid and docosahexaenoic acid in whole blood are differentially and sex-specifically associated with cardiometabolic risk markers in 8-11-year-old danish children. PLoS One 2014; 9:e109368. [PMID: 25330302 PMCID: PMC4198100 DOI: 10.1371/journal.pone.0109368] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Accepted: 09/01/2014] [Indexed: 12/30/2022] Open
Abstract
n-3 long-chain polyunsaturated fatty acids improve cardiovascular risk markers in adults. These effects may differ between eicosapentaenoic acid (EPA, 20∶5n-3) and docosahexaenoic acid (DHA, 22∶6n-3), but we lack evidence in children. Using baseline data from the OPUS School Meal Study we 1) investigated associations between EPA and DHA in whole blood and early cardiometabolic risk markers in 713 children aged 8-11 years and 2) explored potential mediation through waist circumference and physical activity and potential dietary confounding. We collected data on parental education, pubertal stage, 7-day dietary records, physical activity by accelerometry and measured anthropometry, blood pressure, and heart rate. Blood samples were analyzed for whole blood fatty acid composition, cholesterols, triacylglycerol, insulin resistance by the homeostatic model of assessment (HOMA-IR), and inflammatory markers. Whole blood EPA was associated with a 2.7 mmHg (95% CI 0.4; 5.1) higher diastolic blood pressure per weight% EPA, but only in boys. Heart rate was negatively associated with both EPA and DHA status (P = 0.02 and P = 0.002, respectively). Whole blood EPA was negatively associated with triacylglycerol (P = 0.003) and positively with total cholesterol, low density and high density lipoprotein (HDL) cholesterol and HDL:triacylglycerol (all P<0.01) whereas DHA was negatively associated with insulin and HOMA-IR (P = 0.003) and tended to be negatively associated with a metabolic syndrome-score (P = 0.05). Adjustment for waist circumference and physical activity did not change the associations. The association between DHA and HOMA-IR was attenuated but remained after adjustment for fiber intake and none of the other associations were confounded by dietary fat, protein, fiber or energy intake. This study showed that EPA status was negatively associated with triacylglycerol and positively with cholesterols whereas DHA was negatively associated with insulin resistance, and both were inversely associated with heart rate in children. The sex-specific associations with blood pressure confirm our previous findings and warrant further investigation.
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Affiliation(s)
- Camilla T. Damsgaard
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark
- * E-mail:
| | - Maj B. Eidner
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark
| | - Ken D. Stark
- Department of Kinesiology, University of Waterloo, Waterloo, Alberta, Canada
| | - Mads F. Hjorth
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark
| | - Anders Sjödin
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark
| | - Malene R. Andersen
- Department of Clinical Biochemistry, Copenhagen University Hospital, Gentofte, Denmark
| | - Rikke Andersen
- Division of Nutrition, National Food Institute, Technical University of Denmark, Søborg, Denmark
| | - Inge Tetens
- Division of Nutrition, National Food Institute, Technical University of Denmark, Søborg, Denmark
| | - Arne Astrup
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark
| | - Kim F. Michaelsen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark
| | - Lotte Lauritzen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark
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Hjorth MF, Chaput JP, Damsgaard CT, Dalskov SM, Andersen R, Astrup A, Michaelsen KF, Tetens I, Ritz C, Sjödin A. Low physical activity level and short sleep duration are associated with an increased cardio-metabolic risk profile: a longitudinal study in 8-11 year old Danish children. PLoS One 2014; 9:e104677. [PMID: 25102157 PMCID: PMC4125285 DOI: 10.1371/journal.pone.0104677] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Accepted: 07/16/2014] [Indexed: 01/02/2023] Open
Abstract
Background As cardio-metabolic risk tracks from childhood to adulthood, a better understanding of the relationship between movement behaviors (physical activity, sedentary behavior and sleep) and cardio-metabolic risk in childhood may aid in preventing metabolic syndrome (MetS) in adulthood. Objective To examine independent and combined cross-sectional and longitudinal associations between movement behaviors and the MetS score in 8-11 year old Danish children. Design Physical activity, sedentary time and sleep duration (seven days and eight nights) were assessed by accelerometer and fat mass index (fat mass/height2) was assessed using Dual-energy X-ray absorptiometry. The MetS-score was based on z-scores of waist circumference, mean arterial blood pressure, homeostatic model assessment of insulin resistance, triglycerides and high density lipoprotein cholesterol. All measurements were taken at three time points separated by 100 days. Average of the three measurements was used as habitual behavior in the cross-sectional analysis and changes from first to third measurement was used in the longitudinal analysis. Results 723 children were included. In the cross-sectional analysis, physical activity was negatively associated with the MetS-score (P<0.03). In the longitudinal analysis, low physical activity and high sedentary time were associated with an increased MetS-score (all P<0.005); however, after mutual adjustments for movement behaviors, physical activity and sleep duration, but not sedentary time, were associated with the MetS-score (all P<0.03). Further adjusting for fat mass index while removing waist circumference from the MetS-score rendered the associations no longer statistically significant (all P>0.17). Children in the most favorable tertiles of changes in moderate-to-vigorous physical activity, sleep duration and sedentary time during the 200-day follow-up period had an improved MetS-score relative to children in the opposite tertiles (P = 0.005). Conclusion The present findings indicate that physical activity, sedentary time and sleep duration should all be targeted to improve cardio-metabolic risk markers in childhood; this is possibly mediated by adiposity.
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Affiliation(s)
- Mads F Hjorth
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Camilla T Damsgaard
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Stine-Mathilde Dalskov
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Rikke Andersen
- National Food Institute, Division of Nutrition, Technical University of Denmark, Søborg, Denmark
| | - Arne Astrup
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Kim F Michaelsen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Inge Tetens
- National Food Institute, Division of Nutrition, Technical University of Denmark, Søborg, Denmark
| | - Christian Ritz
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Anders Sjödin
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
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Biltoft-Jensen A, Hjorth MF, Trolle E, Christensen T, Brockhoff PB, Andersen LF, Tetens I, Matthiessen J. Comparison of estimated energy intake using Web-based Dietary Assessment Software with accelerometer-determined energy expenditure in children. Food Nutr Res 2013; 57:21434. [PMID: 24358037 PMCID: PMC3867750 DOI: 10.3402/fnr.v57i0.21434] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Revised: 11/11/2013] [Accepted: 11/25/2013] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The OPUS (Optimal well-being, development and health for Danish children through a healthy New Nordic Diet) project carried out a school meal study to assess the impact of a New Nordic Diet (NND). The random controlled trial involved 834 children aged 8-11 in nine local authority schools in Denmark. Dietary assessment was carried out using a program known as WebDASC (Web-based Dietary Assessment Software for Children) to collect data from the children. OBJECTIVE To compare the energy intake (EI) of schoolchildren aged 8-11 estimated using the WebDASC system against the total energy expenditure (TEE) as derived from accelerometers worn by the children during the same period. A second objective was to evaluate the WebDASC's usability. DESIGN Eighty-one schoolchildren took part in what was the pilot study for the OPUS project, and they recorded their total diet using WebDASC and wore an accelerometer for two periods of seven consecutive days: at baseline, when they ate their usual packed lunches and at intervention when they were served the NND. EI was estimated using WebDASC, and TEE was calculated from accelerometer-derived activity energy expenditure, basal metabolic rate, and diet-induced thermogenesis. WebDASC's usability was assessed using a questionnaire. Parents could help their children record their diet and answer the questionnaire. RESULTS Evaluated against TEE as derived from the accelerometers worn at the same time, the WebDASC performed just as well as other traditional methods of collecting dietary data and proved both effective and acceptable with children aged 8-11, even with perhaps less familiar foods of the NND. CONCLUSIONS WebDASC is a useful method that provided a reasonably accurate measure of EI at group level when compared to TEE derived from accelerometer-determined physical activity in children. WebDASC will benefit future research in this area.
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Affiliation(s)
- Anja Biltoft-Jensen
- Department of Nutrition, National Food Institute, Technical University of Denmark, Søborg, Denmark
| | - Mads F. Hjorth
- Department of Human Nutrition, Faculty of Life Sciences, University of Copenhagen, Frederiksberg C, Denmark
| | - Ellen Trolle
- Department of Nutrition, National Food Institute, Technical University of Denmark, Søborg, Denmark
| | - Tue Christensen
- Department of Nutrition, National Food Institute, Technical University of Denmark, Søborg, Denmark
| | - Per B. Brockhoff
- Department of Applied Mathematics and Computer Science, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Lene F. Andersen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Inge Tetens
- Department of Nutrition, National Food Institute, Technical University of Denmark, Søborg, Denmark
| | - Jeppe Matthiessen
- Department of Nutrition, National Food Institute, Technical University of Denmark, Søborg, Denmark
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Hjorth MF, Chaput JP, Michaelsen K, Astrup A, Tetens I, Sjödin A. Seasonal variation in objectively measured physical activity, sedentary time, cardio-respiratory fitness and sleep duration among 8-11 year-old Danish children: a repeated-measures study. BMC Public Health 2013; 13:808. [PMID: 24010811 PMCID: PMC3846279 DOI: 10.1186/1471-2458-13-808] [Citation(s) in RCA: 97] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Accepted: 09/03/2013] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Understanding fluctuations in lifestyle indicators is important to identify relevant time periods to intervene in order to promote a healthy lifestyle; however, objective assessment of multiple lifestyle indicators has never been done using a repeated-measures design. The primary aim was, therefore, to examine between-season and within-week variation in physical activity, sedentary behaviour, cardio-respiratory fitness and sleep duration among 8-11 year-old children. METHODS A total of 1021 children from nine Danish schools were invited to participate and 834 accepted. Due to missing data, 730 children were included in the current analytical sample. An accelerometer was worn for 7 days and 8 nights during autumn, winter and spring, from which physical activity, sedentary time and sleep duration were measured. Cardio-respiratory fitness was assessed using a 10-min intermittent running test. RESULTS The children had 5% more sedentary time, 23% less time in moderate-to-vigorous physical activity and 2% longer sleep duration during winter compared to spring and cardio-respiratory fitness was 4% higher during spring compared to autumn (P < 0.001). Sedentary time was higher and total physical activity, moderate-to-vigorous physical activity and sleep duration (boys only) were lower during weekends at all seasons (P ≤ 0.01). Intraclass correlation coefficients between seasons ranged from 0.47-0.74, leaving 45-78% to seasonal variation. CONCLUSIONS Overall, sedentary time was higher and physical activity lower during winter and during weekends. The most accurate and unbiased estimates of physical activity came from autumn; however, the considerable intra-individual variation suggests that a single measurement may not adequately characterise children's habitual sleep and activity.
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Affiliation(s)
- Mads F Hjorth
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 30, DK-1958 Frederiksberg C, Copenhagen, Denmark
| | - Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Kim Michaelsen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 30, DK-1958 Frederiksberg C, Copenhagen, Denmark
| | - Arne Astrup
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 30, DK-1958 Frederiksberg C, Copenhagen, Denmark
| | - Inge Tetens
- Division of Nutrition, DTU Food, National Food Institute, Technical University of Denmark, Copenhagen, Denmark
| | - Anders Sjödin
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 30, DK-1958 Frederiksberg C, Copenhagen, Denmark
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Kjeldsen JS, Hjorth MF, Andersen R, Michaelsen KF, Tetens I, Astrup A, Chaput JP, Sjödin A. Short sleep duration and large variability in sleep duration are independently associated with dietary risk factors for obesity in Danish school children. Int J Obes (Lond) 2013; 38:32-9. [PMID: 23924757 DOI: 10.1038/ijo.2013.147] [Citation(s) in RCA: 138] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Revised: 07/04/2013] [Accepted: 07/21/2013] [Indexed: 02/08/2023]
Abstract
BACKGROUND Lack of sleep and increased consumption of energy-dense foods and sugar-sweetened beverages (SSBs) have all been suggested as factors contributing to the increased prevalence of overweight and obesity. OBJECTIVE To evaluate whether objectively measured sleep duration (average and day-to-day variability) as well as parent-reported sleep problems are independently associated with proposed dietary risk factors for overweight and obesity in 8-11-year-old children. DESIGN In this cross-sectional study, data on sleep duration and day-to-day variability in sleep duration were measured in 676 Danish, apparently healthy children by an objective measure (actigraphy) for 8 nights, and the Children's Sleep Habits Questionnaire (CSHQ) was filled out by the parents. Diet was recorded using a web-based food record for 7 consecutive days. Fasting blood samples were obtained for measurements of plasma leptin and ghrelin levels. RESULTS Sleep duration (h per night) was negatively associated with energy density (ED) of the diet (β = -0.32 kJ g(-1)), added sugar (β = -1.50 E%) and SSBs (β = -1.07 E%) (all P ≤ 0.003). Furthermore, variability in sleep duration (10-min per night) was positively associated with SSBs (β = 0.20 E%, P = 0.03), independent of sleep duration, and CSHQ score was positively associated with ED (β = 0.16 kJ g(-1), P = 0.04). All of these associations were independent of potential confounders (age, sex, pubertal status, height, weight, screen time, moderate-to-vigorous physical activity and parental education and ethnicity). CONCLUSION Our study suggests that short sleep duration, high sleep duration variability and experiencing sleep problems are all associated with a poor, obesity-promoting diet in children.
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Affiliation(s)
- J S Kjeldsen
- 1] Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark [2] Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - M F Hjorth
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - R Andersen
- Division of Nutrition, National Food Institute, Technical University of Denmark, Søborg, Denmark
| | - K F Michaelsen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - I Tetens
- Division of Nutrition, National Food Institute, Technical University of Denmark, Søborg, Denmark
| | - A Astrup
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - J-P Chaput
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada
| | - A Sjödin
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
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Klingenberg L, Christensen LB, Hjorth MF, Zangenberg S, Chaput JP, Sjödin A, Mølgaard C, Michaelsen KF. No relation between sleep duration and adiposity indicators in 9-36 months old children: the SKOT cohort. Pediatr Obes 2013; 8:e14-8. [PMID: 23225774 DOI: 10.1111/j.2047-6310.2012.00109.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2012] [Revised: 06/29/2012] [Accepted: 08/14/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND Epidemiological studies in adults and children have repeatedly reported an association between short sleep duration and the risk of obesity. Studies using both objective measurements of sleep and dual-energy X-ray absorptiometry in children aged three are, however, lacking. OBJECTIVE The study aims to examine both the longitudinal and cross-sectional associations between sleep duration and adiposity indicators in children aged 3 and younger. METHODS On a cohort of 311 infants born at term, we used parent-reported sleep duration at 9 months, 18 months and 3 years of age, and accelerometer estimated nocturnal sleep duration at 3 years of age. Sleep duration at 9 and 18 months were used to predict adiposity at 3 years of age. RESULTS We found no associations between any of the adiposity indicators at 3 years of age and (i) parent-reported total sleep duration at 9 months, 18 months and 3 years, and (2) nocturnal sleep duration measured with accelerometry at 3 years of age. Multivariate adjustments were used in both approaches. CONCLUSION Our results do not support the hypothesis that short sleep duration is associated with increased adiposity in this cohort of young Danish children.
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Affiliation(s)
- L Klingenberg
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.
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Damsgaard CT, Dalskov SM, Petersen RA, Sørensen LB, Mølgaard C, Biltoft-Jensen A, Andersen R, Thorsen AV, Tetens I, Sjödin A, Hjorth MF, Vassard D, Jensen JD, Egelund N, Dyssegaard CB, Skovgaard I, Astrup A, Michaelsen KF. Design of the OPUS School Meal Study: a randomised controlled trial assessing the impact of serving school meals based on the New Nordic Diet. Scand J Public Health 2012; 40:693-703. [PMID: 23108477 DOI: 10.1177/1403494812463173] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Danish children consume too much sugar and not enough whole grain, fish, fruit, and vegetables. The Nordic region is rich in such foods with a strong health-promoting potential. We lack randomised controlled trials that investigate the developmental and health impact of serving school meals based on Nordic foods. AIM This paper describes the rationale, design, study population, and potential implications of the Optimal well-being, development and health for Danish children through a healthy New Nordic Diet (OPUS) School Meal Study. METHODS In a cluster-randomised cross-over design, 1021 children from 3rd and 4th grades (8-11 years old) at nine Danish municipal schools were invited to participate. Classes were assigned to two 3-month periods with free school meals based on the New Nordic Diet (NND) or their usual packed lunch (control). Dietary intake, nutrient status, physical activity, cardiorespiratory fitness, sleep, growth, body composition, early metabolic and cardiovascular risk markers, illness, absence from school, wellbeing, cognitive function, social and cultural features, food acceptance, waste, and cost were assessed. RESULTS In total, 834 children (82% of those invited) participated. Although their parents were slightly better educated than the background population, children from various socioeconomic backgrounds were included. The proportion of overweight and obese children (14%) resembled that of earlier examinations of Danish school children. Drop out was 8.3%. CONCLUSIONS A high inclusion rate and low drop out rate was achieved. This study will be the first to determine whether school meals based on the NND improve children's diet, health, growth, cognitive performance, and early disease risk markers.
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Affiliation(s)
- Camilla T Damsgaard
- Department of Human Nutrition, Faculty of Science, University of Copenhagen, Denmark.
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