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Yurkovich JT, Evans SJ, Rappaport N, Boore JL, Lovejoy JC, Price ND, Hood LE. The transition from genomics to phenomics in personalized population health. Nat Rev Genet 2024; 25:286-302. [PMID: 38093095 DOI: 10.1038/s41576-023-00674-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2023] [Indexed: 03/21/2024]
Abstract
Modern health care faces several serious challenges, including an ageing population and its inherent burden of chronic diseases, rising costs and marginal quality metrics. By assessing and optimizing the health trajectory of each individual using a data-driven personalized approach that reflects their genetics, behaviour and environment, we can start to address these challenges. This assessment includes longitudinal phenome measures, such as the blood proteome and metabolome, gut microbiome composition and function, and lifestyle and behaviour through wearables and questionnaires. Here, we review ongoing large-scale genomics and longitudinal phenomics efforts and the powerful insights they provide into wellness. We describe our vision for the transformation of the current health care from disease-oriented to data-driven, wellness-oriented and personalized population health.
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Affiliation(s)
- James T Yurkovich
- Phenome Health, Seattle, WA, USA
- Center for Phenomic Health, The Buck Institute for Research on Aging, Novato, CA, USA
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX, USA
| | - Simon J Evans
- Phenome Health, Seattle, WA, USA
- Center for Phenomic Health, The Buck Institute for Research on Aging, Novato, CA, USA
| | - Noa Rappaport
- Center for Phenomic Health, The Buck Institute for Research on Aging, Novato, CA, USA
- Institute for Systems Biology, Seattle, WA, USA
| | - Jeffrey L Boore
- Phenome Health, Seattle, WA, USA
- Center for Phenomic Health, The Buck Institute for Research on Aging, Novato, CA, USA
| | - Jennifer C Lovejoy
- Phenome Health, Seattle, WA, USA
- Center for Phenomic Health, The Buck Institute for Research on Aging, Novato, CA, USA
- Institute for Systems Biology, Seattle, WA, USA
| | - Nathan D Price
- Institute for Systems Biology, Seattle, WA, USA
- Thorne HealthTech, New York, NY, USA
- Department of Bioengineering, University of Washington, Seattle, WA, USA
- Paul G. Allen School of Computer Science & Engineering, University of Washington, Seattle, WA, USA
| | - Leroy E Hood
- Phenome Health, Seattle, WA, USA.
- Center for Phenomic Health, The Buck Institute for Research on Aging, Novato, CA, USA.
- Institute for Systems Biology, Seattle, WA, USA.
- Department of Bioengineering, University of Washington, Seattle, WA, USA.
- Paul G. Allen School of Computer Science & Engineering, University of Washington, Seattle, WA, USA.
- Department of Immunology, University of Washington, Seattle, WA, USA.
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Watanabe K, Wilmanski T, Diener C, Earls JC, Zimmer A, Lincoln B, Hadlock JJ, Lovejoy JC, Gibbons SM, Magis AT, Hood L, Price ND, Rappaport N. Multiomic signatures of body mass index identify heterogeneous health phenotypes and responses to a lifestyle intervention. Nat Med 2023; 29:996-1008. [PMID: 36941332 PMCID: PMC10115644 DOI: 10.1038/s41591-023-02248-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 02/02/2023] [Indexed: 03/23/2023]
Abstract
Multiomic profiling can reveal population heterogeneity for both health and disease states. Obesity drives a myriad of metabolic perturbations and is a risk factor for multiple chronic diseases. Here we report an atlas of cross-sectional and longitudinal changes in 1,111 blood analytes associated with variation in body mass index (BMI), as well as multiomic associations with host polygenic risk scores and gut microbiome composition, from a cohort of 1,277 individuals enrolled in a wellness program (Arivale). Machine learning model predictions of BMI from blood multiomics captured heterogeneous phenotypic states of host metabolism and gut microbiome composition better than BMI, which was also validated in an external cohort (TwinsUK). Moreover, longitudinal analyses identified variable BMI trajectories for different omics measures in response to a healthy lifestyle intervention; metabolomics-inferred BMI decreased to a greater extent than actual BMI, whereas proteomics-inferred BMI exhibited greater resistance to change. Our analyses further identified blood analyte-analyte associations that were modified by metabolomics-inferred BMI and partially reversed in individuals with metabolic obesity during the intervention. Taken together, our findings provide a blood atlas of the molecular perturbations associated with changes in obesity status, serving as a resource to quantify metabolic health for predictive and preventive medicine.
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Affiliation(s)
| | | | | | - John C Earls
- Institute for Systems Biology, Seattle, WA, USA
- Thorne HealthTech, New York, NY, USA
| | - Anat Zimmer
- Institute for Systems Biology, Seattle, WA, USA
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | | | | | | | - Sean M Gibbons
- Institute for Systems Biology, Seattle, WA, USA
- Department of Bioengineering, University of Washington, Seattle, WA, USA
- eScience Institute, University of Washington, Seattle, WA, USA
| | | | - Leroy Hood
- Institute for Systems Biology, Seattle, WA, USA
- Department of Bioengineering, University of Washington, Seattle, WA, USA
- Phenome Health, Seattle, WA, USA
- Department of Immunology, University of Washington, Seattle, WA, USA
- Paul G. Allen School of Computer Science and Engineering, University of Washington, Seattle, WA, USA
| | - Nathan D Price
- Institute for Systems Biology, Seattle, WA, USA
- Thorne HealthTech, New York, NY, USA
- Department of Bioengineering, University of Washington, Seattle, WA, USA
- Paul G. Allen School of Computer Science and Engineering, University of Washington, Seattle, WA, USA
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Domalpally A, Whittier SA, Pan Q, Dabelea DM, Darwin CH, Knowler WC, Lee CG, Luchsinger JA, White NH, Chew EY, Gadde KM, Culbert IW, Arceneaux J, Chatellier A, Dragg A, Champagne CM, Duncan C, Eberhardt B, Greenway F, Guillory FG, Herbert AA, Jeffirs ML, Kennedy BM, Levy E, Lockett M, Lovejoy JC, Morris LH, Melancon LE, Ryan DH, Sanford DA, Smith KG, Smith LL, St.Amant JA, Tulley RT, Vicknair PC, Williamson D, Zachwieja JJ, Polonsky KS, Tobian J, Ehrmann DA, Matulik MJ, Temple KA, Clark B, Czech K, DeSandre C, Dotson B, Hilbrich R, McNabb W, Semenske AR, Caro JF, Furlong K, Goldstein BJ, Watson PG, Smith KA, Mendoza J, Simmons M, Wildman W, Liberoni R, Spandorfer J, Pepe C, Donahue RP, Goldberg RB, Prineas R, Calles J, Giannella A, Rowe P, Sanguily J, Cassanova-Romero P, Castillo-Florez S, Florez HJ, Garg R, Kirby L, Lara O, Larreal C, McLymont V, Mendez J, Perry A, Saab P, Veciana B, Haffner SM, Hazuda HP, Montez MG, Hattaway K, Isaac J, Lorenzo C, Martinez A, Salazar M, Walker T, Hamman RF, Nash PV, Steinke SC, Testaverde L, Truong J, Anderson DR, Ballonoff LB, Bouffard A, Bucca B, Calonge BN, Delve L, Farago M, Hill JO, Hoyer SR, Jenkins T, Jortberg BT, Lenz D, Miller M, Nilan T, Perreault L, Price DW, Regensteiner JG, Schroeder EB, Seagle H, Smith CM, VanDorsten B, Horton ES, Munshi M, Lawton KE, Jackson SD, Poirier CS, Swift K, Arky RA, Bryant M, Burke JP, Caballero E, Callaphan KM, Fargnoli B, Franklin T, Ganda OP, Guidi A, Guido M, Jacobsen AM, Kula LM, Kocal M, Lambert L, Ledbury S, Malloy MA, Middelbeek RJ, Nicosia M, Oldmixon CF, Pan J, Quitingon M, Rainville R, Rubtchinsky S, Seely EW, Sansoucy J, Schweizer D, Simonson D, Smith F, Solomon CG, Spellman J, Warram J, Kahn SE, Fattaleh B, Montgomery BK, Colegrove C, Fujimoto W, Knopp RH, Lipkin EW, Marr M, Morgan-Taggart I, Murillo A, O’Neal K, Trence D, Taylor L, Thomas A, Tsai EC, Dagogo-Jack S, Kitabchi AE, Murphy ME, Taylor L, Dolgoff J, Applegate WB, Bryer-Ash M, Clark D, Frieson SL, Ibebuogu U, Imseis R, Lambeth H, Lichtermann LC, Oktaei H, Ricks H, Rutledge LM, Sherman AR, Smith CM, Soberman JE, Williams-Cleaves B, Patel A, Nyenwe EA, Hampton EF, Metzger BE, Molitch ME, Johnson MK, Adelman DT, Behrends C, Cook M, Fitzgibbon M, Giles MM, Heard D, Johnson CK, Larsen D, Lowe A, Lyman M, McPherson D, Penn SC, Pitts T, Reinhart R, Roston S, Schinleber PA, Wallia A, Nathan DM, McKitrick C, Turgeon H, Larkin M, Mugford M, Abbott K, Anderson E, Bissett L, Bondi K, Cagliero E, Florez JC, Delahanty L, Goldman V, Grassa E, Gurry L, D’Anna K, Leandre F, Lou P, Poulos A, Raymond E, Ripley V, Stevens C, Tseng B, Olefsky JM, Barrett-Connor E, Mudaliar S, Araneta MR, Carrion-Petersen ML, Vejvoda K, Bassiouni S, Beltran M, Claravall LN, Dowden JM, Edelman SV, Garimella P, Henry RR, Horne J, Lamkin M, Janesch SS, Leos D, Polonsky W, Ruiz R, Smith J, Torio-Hurley J, Pi-Sunyer FX, Lee JE, Hagamen S, Allison DB, Agharanya N, Aronoff NJ, Baldo M, Crandall JP, Foo ST, Luchsinger JA, Pal C, Parkes K, Pena MB, Rooney ES, Van Wye GE, Viscovich KA, de Groot M, Marrero DG, Mather KJ, Prince MJ, Kelly SM, Jackson MA, McAtee G, Putenney P, Ackermann RT, Cantrell CM, Dotson YF, Fineberg ES, Fultz M, Guare JC, Hadden A, Ignaut JM, Kirkman MS, Phillips EO, Pinner KL, Porter BD, Roach PJ, Rowland ND, Wheeler ML, Aroda V, Magee M, Ratner RE, Youssef G, Shapiro S, Andon N, Bavido-Arrage C, Boggs G, Bronsord M, Brown E, Love Burkott H, Cheatham WW, Cola S, Evans C, Gibbs P, Kellum T, Leon L, Lagarda M, Levatan C, Lindsay M, Nair AK, Park J, Passaro M, Silverman A, Uwaifo G, Wells-Thayer D, Wiggins R, Saad MF, Watson K, Budget M, Jinagouda S, Botrous M, Sosa A, Tadros S, Akbar K, Conzues C, Magpuri P, Ngo K, Rassam A, Waters D, Xapthalamous K, Santiago JV, Brown AL, Das S, Khare-Ranade P, Stich T, Santiago A, Fisher E, Hurt E, Jones T, Kerr M, Ryder L, Wernimont C, Golden SH, Saudek CD, Bradley V, Sullivan E, Whittington T, Abbas C, Allen A, Brancati FL, Cappelli S, Clark JM, Charleston JB, Freel J, Horak K, Greene A, Jiggetts D, Johnson D, Joseph H, Loman K, Mathioudakis N, Mosley H, Reusing J, Rubin RR, Samuels A, Shields T, Stephens S, Stewart KJ, Thomas L, Utsey E, Williamson P, Schade DS, Adams KS, Canady JL, Johannes C, Hemphill C, Hyde P, Atler LF, Boyle PJ, Burge MR, Chai L, Colleran K, Fondino A, Gonzales Y, Hernandez-McGinnis DA, Katz P, King C, Middendorf J, Rubinchik S, Senter W, Crandall J, Shamoon H, Brown JO, Trandafirescu G, Powell D, Adorno E, Cox L, Duffy H, Engel S, Friedler A, Goldstein A, Howard-Century CJ, Lukin J, Kloiber S, Longchamp N, Martinez H, Pompi D, Scheindlin J, Violino E, Walker EA, Wylie-Rosett J, Zimmerman E, Zonszein J, Orchard T, Venditti E, Wing RR, Jeffries S, Koenning G, Kramer MK, Smith M, Barr S, Benchoff C, Boraz M, Clifford L, Culyba R, Frazier M, Gilligan R, Guimond S, Harrier S, Harris L, Kriska A, Manjoo Q, Mullen M, Noel A, Otto A, Pettigrew J, Rockette-Wagner B, Rubinstein D, Semler L, Smith CF, Weinzierl V, Williams KV, Wilson T, Mau MK, Baker-Ladao NK, Melish JS, Arakaki RF, Latimer RW, Isonaga MK, Beddow R, Bermudez NE, Dias L, Inouye J, Mikami K, Mohideen P, Odom SK, Perry RU, Yamamoto RE, Anderson H, Cooeyate N, Dodge C, Hoskin MA, Percy CA, Enote A, Natewa C, Acton KJ, Andre VL, Barber R, Begay S, Bennett PH, Benson MB, Bird EC, Broussard BA, Bucca BC, Chavez M, Cook S, Curtis J, Dacawyma T, Doughty MS, Duncan R, Edgerton C, Ghahate JM, Glass J, Glass M, Gohdes D, Grant W, Hanson RL, Horse E, Ingraham LE, Jackson M, Jay P, Kaskalla RS, Kavena K, Kessler D, Kobus KM, Krakoff J, Kurland J, Manus C, McCabe C, Michaels S, Morgan T, Nashboo Y, Nelson JA, Poirier S, Polczynski E, Piromalli C, Reidy M, Roumain J, Rowse D, Roy RJ, Sangster S, Sewenemewa J, Smart M, Spencer C, Tonemah D, Williams R, Wilson C, Yazzie M, Bain R, Fowler S, Temprosa M, Larsen MD, Brenneman T, Edelstein SL, Abebe S, Bamdad J, Barkalow M, Bethepu J, Bezabeh T, Bowers A, Butler N, Callaghan J, Carter CE, Christophi C, Dwyer GM, Foulkes M, Gao Y, Gooding R, Gottlieb A, Grimes KL, Grover-Fairchild N, Haffner L, Hoffman H, Jablonski K, Jones S, Jones TL, Katz R, Kolinjivadi P, Lachin JM, Ma Y, Mucik P, Orlosky R, Reamer S, Rochon J, Sapozhnikova A, Sherif H, Stimpson C, Hogan Tjaden A, Walker-Murray F, Venditti EM, Kriska AM, Weinzierl V, Marcovina S, Aldrich FA, Harting J, Albers J, Strylewicz G, Eastman R, Fradkin J, Garfield S, Lee C, Gregg E, Zhang P, O’Leary D, Evans G, Budoff M, Dailing C, Stamm E, Schwartz A, Navy C, Palermo L, Rautaharju P, Prineas RJ, Alexander T, Campbell C, Hall S, Li Y, Mills M, Pemberton N, Rautaharju F, Zhang Z, Soliman EZ, Hu J, Hensley S, Keasler L, Taylor T, Blodi B, Danis R, Davis M, Hubbard* L, Endres** R, Elsas** D, Johnson** S, Myers** D, Barrett N, Baumhauer H, Benz W, Cohn H, Corkery E, Dohm K, Gama V, Goulding A, Ewen A, Hurtenbach C, Lawrence D, McDaniel K, Pak J, Reimers J, Shaw R, Swift M, Vargo P, Watson S, Manly J, Mayer-Davis E, Moran RR, Ganiats T, David K, Sarkin AJ, Groessl E, Katzir N, Chong H, Herman WH, Brändle M, Brown MB, Altshuler D, Billings LK, Chen L, Harden M, Knowler WC, Pollin TI, Shuldiner AR, Franks PW, Hivert MF. Association of Metformin With the Development of Age-Related Macular Degeneration. JAMA Ophthalmol 2023; 141:140-147. [PMID: 36547967 PMCID: PMC9936345 DOI: 10.1001/jamaophthalmol.2022.5567] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 10/29/2022] [Indexed: 12/24/2022]
Abstract
Importance Age-related macular degeneration (AMD) is a leading cause of blindness with no treatment available for early stages. Retrospective studies have shown an association between metformin and reduced risk of AMD. Objective To investigate the association between metformin use and age-related macular degeneration (AMD). Design, Setting, and Participants The Diabetes Prevention Program Outcomes Study is a cross-sectional follow-up phase of a large multicenter randomized clinical trial, Diabetes Prevention Program (1996-2001), to investigate the association of treatment with metformin or an intensive lifestyle modification vs placebo with preventing the onset of type 2 diabetes in a population at high risk for developing diabetes. Participants with retinal imaging at a follow-up visit 16 years posttrial (2017-2019) were included. Analysis took place between October 2019 and May 2022. Interventions Participants were randomly distributed between 3 interventional arms: lifestyle, metformin, and placebo. Main Outcomes and Measures Prevalence of AMD in the treatment arms. Results Of 1592 participants, 514 (32.3%) were in the lifestyle arm, 549 (34.5%) were in the metformin arm, and 529 (33.2%) were in the placebo arm. All 3 arms were balanced for baseline characteristics including age (mean [SD] age at randomization, 49 [9] years), sex (1128 [71%] male), race and ethnicity (784 [49%] White), smoking habits, body mass index, and education level. AMD was identified in 479 participants (30.1%); 229 (14.4%) had early AMD, 218 (13.7%) had intermediate AMD, and 32 (2.0%) had advanced AMD. There was no significant difference in the presence of AMD between the 3 groups: 152 (29.6%) in the lifestyle arm, 165 (30.2%) in the metformin arm, and 162 (30.7%) in the placebo arm. There was also no difference in the distribution of early, intermediate, and advanced AMD between the intervention groups. Mean duration of metformin use was similar for those with and without AMD (mean [SD], 8.0 [9.3] vs 8.5 [9.3] years; P = .69). In the multivariate models, history of smoking was associated with increased risks of AMD (odds ratio, 1.30; 95% CI, 1.05-1.61; P = .02). Conclusions and Relevance These data suggest neither metformin nor lifestyle changes initiated for diabetes prevention were associated with the risk of any AMD, with similar results for AMD severity. Duration of metformin use was also not associated with AMD. This analysis does not address the association of metformin with incidence or progression of AMD.
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Affiliation(s)
- Amitha Domalpally
- Wisconsin Reading Center, Department of Ophthalmology, University of Wisconsin School of Medicine and Public and Health, Madison
| | - Samuel A. Whittier
- Wisconsin Reading Center, Department of Ophthalmology, University of Wisconsin School of Medicine and Public and Health, Madison
| | - Qing Pan
- Department of Statistics, George Washington University, Washington, DC
| | - Dana M. Dabelea
- Department of Epidemiology, University of Colorado School of Public Health, Denver
| | - Christine H. Darwin
- Department of Medicine, Ronald Reagan UCLA Medical Center, Los Angeles, California
| | - William C. Knowler
- Diabetes Epidemiology and Clinical Research Section, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, Arizona
| | - Christine G. Lee
- Division of Diabetes, Endocrinology, and Metabolic Diseases, National Institutes of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland
| | - Jose A. Luchsinger
- Department of Medicine, Columbia University Medical Center, New York, New York
| | - Neil H. White
- Division of Endocrinology & Diabetes, Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, Missouri
| | - Emily Y. Chew
- Division of Epidemiology and Clinical Applications–Clinical Trials Branch, National Eye Institute - National Institutes of Health, Bethesda, Maryland
| | | | | | | | | | | | - Amber Dragg
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Crystal Duncan
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Frank Greenway
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | | | | | - Erma Levy
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Monica Lockett
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | | | - Donna H. Ryan
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | - Lisa L. Smith
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | | | | | | | | | - Janet Tobian
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | | | - Bart Clark
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Kirsten Czech
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | | | - Wylie McNabb
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Jose F. Caro
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Kevin Furlong
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | | | - Jewel Mendoza
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Marsha Simmons
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Wendi Wildman
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Renee Liberoni
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Constance Pepe
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | - Ronald Prineas
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Anna Giannella
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Patricia Rowe
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | | | | | - Rajesh Garg
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Olga Lara
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Carmen Larreal
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Jadell Mendez
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Arlette Perry
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Patrice Saab
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Bertha Veciana
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | | | - Kathy Hattaway
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Juan Isaac
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Carlos Lorenzo
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Monica Salazar
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Tatiana Walker
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | | | | | | | | | | | | | - Brian Bucca
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - B. Ned Calonge
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Lynne Delve
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Martha Farago
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - James O. Hill
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Tonya Jenkins
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Dione Lenz
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Marsha Miller
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Thomas Nilan
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - David W. Price
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | - Helen Seagle
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | | | - Medha Munshi
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | | | - Kati Swift
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Ronald A. Arky
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | | | | | | | | | - Om P. Ganda
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Ashley Guidi
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Mathew Guido
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Lyn M. Kula
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Margaret Kocal
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Lori Lambert
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Sarah Ledbury
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | | | | | - Jocelyn Pan
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | | | - Ellen W. Seely
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Dana Schweizer
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Fannie Smith
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | - James Warram
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Steven E. Kahn
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Basma Fattaleh
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | | | | | | | - Michelle Marr
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Anne Murillo
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Kayla O’Neal
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Dace Trence
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Lonnese Taylor
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - April Thomas
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Elaine C. Tsai
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | - Mary E. Murphy
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Laura Taylor
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | | | - Debra Clark
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Uzoma Ibebuogu
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Raed Imseis
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Helen Lambeth
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Hooman Oktaei
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Harriet Ricks
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Amy R. Sherman
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Clara M. Smith
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | - Avnisha Patel
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | | | | | | | | | | | - Michelle Cook
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Mimi M. Giles
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Deloris Heard
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Diane Larsen
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Anne Lowe
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Megan Lyman
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Samsam C. Penn
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Thomas Pitts
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Renee Reinhart
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Susan Roston
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Amisha Wallia
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | | | - Mary Larkin
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Kathy Abbott
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Ellen Anderson
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Laurie Bissett
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Kristy Bondi
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Jose C. Florez
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | - Elaine Grassa
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Lindsery Gurry
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Kali D’Anna
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Peter Lou
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Elyse Raymond
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Valerie Ripley
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Beverly Tseng
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | | | | | | | - Karen Vejvoda
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | | | | | | | | | | | - Javiva Horne
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Marycie Lamkin
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Diana Leos
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Rosa Ruiz
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Jean Smith
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | - Jane E. Lee
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Susan Hagamen
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | | | - Maria Baldo
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Sandra T. Foo
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Carmen Pal
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Kathy Parkes
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Mary Beth Pena
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | | | - Mary de Groot
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | | | - Susie M. Kelly
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Gina McAtee
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Paula Putenney
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | | | | | - Megan Fultz
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - John C. Guare
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Angela Hadden
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | | | - Kisha L Pinner
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Paris J. Roach
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | - Vanita Aroda
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Michelle Magee
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | - Sue Shapiro
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Natalie Andon
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | | | | | | | | | - Susan Cola
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Cindy Evans
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Peggy Gibbs
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Tracy Kellum
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Lilia Leon
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Milvia Lagarda
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | - Asha K. Nair
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Jean Park
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | - Gabriel Uwaifo
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Renee Wiggins
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Karol Watson
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Maria Budget
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Medhat Botrous
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Anthony Sosa
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Sameh Tadros
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Khan Akbar
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | - Kathy Ngo
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Amer Rassam
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Debra Waters
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | | | - Samia Das
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Tamara Stich
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Ana Santiago
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Edwin Fisher
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Emma Hurt
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Tracy Jones
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Michelle Kerr
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Lucy Ryder
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | | | | | - Emily Sullivan
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Caroline Abbas
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Adrienne Allen
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | | | | | - Janice Freel
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Alicia Greene
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Dawn Jiggetts
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Hope Joseph
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Kimberly Loman
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Henry Mosley
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - John Reusing
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Alafia Samuels
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Thomas Shields
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | - LeeLana Thomas
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Evonne Utsey
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | | | | | | | | | - Penny Hyde
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | - Mark R. Burge
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Lisa Chai
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Ateka Fondino
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Ysela Gonzales
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Patricia Katz
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Carolyn King
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | | | - Jill Crandall
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Harry Shamoon
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Janet O. Brown
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | - Elsie Adorno
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Liane Cox
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Helena Duffy
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Samuel Engel
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | | | - Jennifer Lukin
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Stacey Kloiber
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Helen Martinez
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Dorothy Pompi
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Elissa Violino
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | | | - Joel Zonszein
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Trevor Orchard
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Rena R. Wing
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Susan Jeffries
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Gaye Koenning
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - M. Kaye Kramer
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Marie Smith
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Susan Barr
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Miriam Boraz
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Lisa Clifford
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Rebecca Culyba
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Ryan Gilligan
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Susan Harrier
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Louann Harris
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Andrea Kriska
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Monica Mullen
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Alicia Noel
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Amy Otto
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | | | - Linda Semler
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | | | - Tara Wilson
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | - John S. Melish
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | - Mae K. Isonaga
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Ralph Beddow
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Lorna Dias
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Jillian Inouye
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Kathy Mikami
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Sharon K. Odom
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | | | | | | | - Mary A. Hoskin
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Carol A. Percy
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Alvera Enote
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Camille Natewa
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Kelly J. Acton
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Rosalyn Barber
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Shandiin Begay
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | - Evelyn C. Bird
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Brian C. Bucca
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Sherron Cook
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Jeff Curtis
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Tara Dacawyma
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Roberta Duncan
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Cyndy Edgerton
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Justin Glass
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Martia Glass
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Dorothy Gohdes
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Wendy Grant
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Ellie Horse
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Merry Jackson
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Priscilla Jay
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Karen Kavena
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - David Kessler
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | - Jason Kurland
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Cherie McCabe
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Sara Michaels
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Tina Morgan
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | - Steven Poirier
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | - Mike Reidy
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Debra Rowse
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Robert J. Roy
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | - Miranda Smart
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Darryl Tonemah
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | | | - Raymond Bain
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Sarah Fowler
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | - Tina Brenneman
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Solome Abebe
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Julie Bamdad
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Joel Bethepu
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Anna Bowers
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Nicole Butler
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | | | | | - Mary Foulkes
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Yuping Gao
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Robert Gooding
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | | | - Lori Haffner
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | - Steve Jones
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Tara L. Jones
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Richard Katz
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - John M. Lachin
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Yong Ma
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Pamela Mucik
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Robert Orlosky
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Susan Reamer
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - James Rochon
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Hanna Sherif
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | | | | | | | | | | | | | | | - John Albers
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - R. Eastman
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Judith Fradkin
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Christine Lee
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Edward Gregg
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Ping Zhang
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Dan O’Leary
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Gregory Evans
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Matthew Budoff
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Chris Dailing
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Ann Schwartz
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Caroline Navy
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Lisa Palermo
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | | | | | - Sharon Hall
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Yabing Li
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Margaret Mills
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | - Zhuming Zhang
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Julie Hu
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Susan Hensley
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Lisa Keasler
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Tonya Taylor
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Barbara Blodi
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Ronald Danis
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Matthew Davis
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Larry Hubbard*
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Ryan Endres**
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | - Dawn Myers**
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Nancy Barrett
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Wendy Benz
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Holly Cohn
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Ellie Corkery
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Kristi Dohm
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Vonnie Gama
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Anne Goulding
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Andy Ewen
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | - Kyle McDaniel
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Jeong Pak
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - James Reimers
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Ruth Shaw
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Maria Swift
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Pamela Vargo
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Sheila Watson
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Jennifer Manly
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | - Ted Ganiats
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Kristin David
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Erik Groessl
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Naomi Katzir
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Helen Chong
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | | | | | | | | | - Ling Chen
- for the Diabetes Prevention Program Research (DPPOS) Group
| | - Maegan Harden
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Toni I. Pollin
- for the Diabetes Prevention Program Research (DPPOS) Group
| | | | - Paul W. Franks
- for the Diabetes Prevention Program Research (DPPOS) Group
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4
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Heath L, Earls JC, Magis AT, Kornilov SA, Lovejoy JC, Funk CC, Rappaport N, Logsdon BA, Mangravite LM, Kunkle BW, Martin ER, Naj AC, Ertekin-Taner N, Golde TE, Hood L, Price ND. Manifestations of Alzheimer's disease genetic risk in the blood are evident in a multiomic analysis in healthy adults aged 18 to 90. Sci Rep 2022; 12:6117. [PMID: 35413975 PMCID: PMC9005657 DOI: 10.1038/s41598-022-09825-2] [Citation(s) in RCA: 10] [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: 01/03/2022] [Accepted: 03/23/2022] [Indexed: 01/18/2023] Open
Abstract
Genetics play an important role in late-onset Alzheimer's Disease (AD) etiology and dozens of genetic variants have been implicated in AD risk through large-scale GWAS meta-analyses. However, the precise mechanistic effects of most of these variants have yet to be determined. Deeply phenotyped cohort data can reveal physiological changes associated with genetic risk for AD across an age spectrum that may provide clues to the biology of the disease. We utilized over 2000 high-quality quantitative measurements obtained from blood of 2831 cognitively normal adult clients of a consumer-based scientific wellness company, each with CLIA-certified whole-genome sequencing data. Measurements included: clinical laboratory blood tests, targeted chip-based proteomics, and metabolomics. We performed a phenome-wide association study utilizing this diverse blood marker data and 25 known AD genetic variants and an AD-specific polygenic risk score (PGRS), adjusting for sex, age, vendor (for clinical labs), and the first four genetic principal components; sex-SNP interactions were also assessed. We observed statistically significant SNP-analyte associations for five genetic variants after correction for multiple testing (for SNPs in or near NYAP1, ABCA7, INPP5D, and APOE), with effects detectable from early adulthood. The ABCA7 SNP and the APOE2 and APOE4 encoding alleles were associated with lipid variability, as seen in previous studies; in addition, six novel proteins were associated with the e2 allele. The most statistically significant finding was between the NYAP1 variant and PILRA and PILRB protein levels, supporting previous functional genomic studies in the identification of a putative causal variant within the PILRA gene. We did not observe associations between the PGRS and any analyte. Sex modified the effects of four genetic variants, with multiple interrelated immune-modulating effects associated with the PICALM variant. In post-hoc analysis, sex-stratified GWAS results from an independent AD case-control meta-analysis supported sex-specific disease effects of the PICALM variant, highlighting the importance of sex as a biological variable. Known AD genetic variation influenced lipid metabolism and immune response systems in a population of non-AD individuals, with associations observed from early adulthood onward. Further research is needed to determine whether and how these effects are implicated in early-stage biological pathways to AD. These analyses aim to complement ongoing work on the functional interpretation of AD-associated genetic variants.
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Affiliation(s)
- Laura Heath
- Institute for Systems Biology, Seattle, WA, USA.
- Sage Bionetworks, Seattle, WA, USA.
| | - John C Earls
- Institute for Systems Biology, Seattle, WA, USA
- Thorne HealthTech, New York, NY, USA
| | | | | | | | - Cory C Funk
- Institute for Systems Biology, Seattle, WA, USA
| | | | | | | | - Brian W Kunkle
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
- Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Eden R Martin
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
- Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Adam C Naj
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Nilüfer Ertekin-Taner
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | - Todd E Golde
- Department of Neuroscience, College of Medicine, McKnight Brain Institute, Center for Translational Research in Neurodegenerative Disease University of Florida, Gainesville, FL, USA
| | - Leroy Hood
- Institute for Systems Biology, Seattle, WA, USA
- Providence St. Joseph Health, Renton, WA, USA
| | - Nathan D Price
- Institute for Systems Biology, Seattle, WA, USA.
- Thorne HealthTech, New York, NY, USA.
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5
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Roach JC, Hara J, Fridman D, Lovejoy JC, Jade K, Heim L, Romansik R, Swietlikowski A, Phillips S, Rapozo MK, Shay MA, Fischer D, Funk C, Dill L, Brant‐Zawadzki M, Hood L, Shankle WR. The Coaching for Cognition in Alzheimer's (COCOA) trial: Study design. A&D Transl Res & Clin Interv 2022; 8:e12318. [PMID: 35910672 PMCID: PMC9322829 DOI: 10.1002/trc2.12318] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 05/07/2022] [Accepted: 05/13/2022] [Indexed: 11/15/2022]
Abstract
Comprehensive treatment of Alzheimer's disease (AD) requires not only pharmacologic treatment but also management of existing medical conditions and lifestyle modifications including diet, cognitive training, and exercise. We present the design and methodology for the Coaching for Cognition in Alzheimer's (COCOA) trial. AD and other dementias result from the interplay of multiple interacting dysfunctional biological systems. Monotherapies have had limited success. More interventional studies are needed to test the effectiveness of multimodal multi‐domain therapies for dementia prevention and treatment. Multimodal therapies use multiple interventions to address multiple systemic causes and potentiators of cognitive decline and functional loss; they can be personalized, as different sets of etiologies and systems responsive to therapy may be present in different individuals. COCOA is designed to test the hypothesis that coached multimodal interventions beneficially alter the trajectory of cognitive decline for individuals on the spectrum of AD and related dementias (ADRD). COCOA is a two‐arm prospective randomized controlled trial (RCT). COCOA collects psychometric, clinical, lifestyle, genomic, proteomic, metabolomic, and microbiome data at multiple timepoints across 2 years for each participant. These data enable systems biology analyses. One arm receives standard of care and generic healthy aging recommendations. The other arm receives standard of care and personalized data‐driven remote coaching. The primary outcome measure is the Memory Performance Index (MPI), a measure of cognition. The MPI is a summary statistic of the MCI Screen (MCIS). Secondary outcome measures include the Functional Assessment Staging Test (FAST), a measure of function. COCOA began enrollment in January 2018. We hypothesize that multimodal interventions will ameliorate cognitive decline and that data‐driven health coaching will increase compliance, assist in personalizing multimodal interventions, and improve outcomes for patients, particularly for those in the early stages of the AD spectrum.
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Affiliation(s)
| | - Junko Hara
- Pickup Family Neurosciences Institute Hoag Memorial Hospital Presbyterian Newport Beach California USA
| | - Deborah Fridman
- Hoag Center for Research and Education Hoag Memorial Hospital Presbyterian Newport Beach California USA
| | | | - Kathleen Jade
- Institute for Systems Biology Seattle Washington USA
| | - Laura Heim
- Hoag Center for Research and Education Hoag Memorial Hospital Presbyterian Newport Beach California USA
| | - Rachel Romansik
- Hoag Center for Research and Education Hoag Memorial Hospital Presbyterian Newport Beach California USA
| | - Adrienne Swietlikowski
- Hoag Center for Research and Education Hoag Memorial Hospital Presbyterian Newport Beach California USA
| | - Sheree Phillips
- Hoag Center for Research and Education Hoag Memorial Hospital Presbyterian Newport Beach California USA
| | | | - Maria A. Shay
- Institute for Systems Biology Seattle Washington USA
| | - Dan Fischer
- Institute for Systems Biology Seattle Washington USA
- Oregon Health & Science University Portland Oregon USA
| | - Cory Funk
- Institute for Systems Biology Seattle Washington USA
| | - Lauren Dill
- Pickup Family Neurosciences Institute Hoag Memorial Hospital Presbyterian Newport Beach California USA
- VA Long Beach Healthcare System Long Beach California USA
| | - Michael Brant‐Zawadzki
- Pickup Family Neurosciences Institute Hoag Memorial Hospital Presbyterian Newport Beach California USA
| | - Leroy Hood
- Institute for Systems Biology Seattle Washington USA
- Providence St. Joseph Health Renton Washington USA
| | - William R. Shankle
- Pickup Family Neurosciences Institute Hoag Memorial Hospital Presbyterian Newport Beach California USA
- Department of Cognitive Sciences University of California Irvine California USA
- Shankle Clinic Newport Beach California USA
- EMBIC Corporation Newport Beach California USA
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6
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Wilmanski T, Diener C, Rappaport N, Patwardhan S, Wiedrick J, Lapidus J, Earls JC, Zimmer A, Glusman G, Robinson M, Yurkovich JT, Kado DM, Cauley JA, Zmuda J, Lane NE, Magis AT, Lovejoy JC, Hood L, Gibbons SM, Orwoll ES, Price ND. Author Correction: Gut microbiome pattern reflects healthy ageing and predicts survival in humans. Nat Metab 2021; 3:586. [PMID: 33731896 PMCID: PMC8366577 DOI: 10.1038/s42255-021-00377-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | | | | | | | - Jack Wiedrick
- Oregon Health and Science University, Portland, OR, USA
| | - Jodi Lapidus
- Oregon Health and Science University, Portland, OR, USA
| | - John C Earls
- Institute for Systems Biology, Seattle, WA, USA
- Onegevity Health, New York, NY, USA
| | - Anat Zimmer
- Institute for Systems Biology, Seattle, WA, USA
| | | | | | | | - Deborah M Kado
- Herbert Wertheim School of Public Health and Human Longevity Science at UCSD and Department of Medicine, University of California, San Diego School of Medicine, La Jolla, CA, USA
| | - Jane A Cauley
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Joseph Zmuda
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Nancy E Lane
- Center for Musculoskeletal Health, Department of Internal Medicine, University of California Davis Medical Center, Sacramento, CA, USA
| | | | - Jennifer C Lovejoy
- Institute for Systems Biology, Seattle, WA, USA
- Lifestyle Medicine Institute, Redlands, CA, USA
| | - Leroy Hood
- Institute for Systems Biology, Seattle, WA, USA
| | - Sean M Gibbons
- Institute for Systems Biology, Seattle, WA, USA.
- eScience Institute, University of Washington, Seattle, WA, USA.
- Department of Bioengineering, University of Washington, Seattle, WA, USA.
| | - Eric S Orwoll
- Oregon Health and Science University, Portland, OR, USA.
| | - Nathan D Price
- Institute for Systems Biology, Seattle, WA, USA.
- Onegevity Health, New York, NY, USA.
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7
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Wilmanski T, Diener C, Rappaport N, Patwardhan S, Wiedrick J, Lapidus J, Earls JC, Zimmer A, Glusman G, Robinson M, Yurkovich JT, Kado DM, Cauley JA, Zmuda J, Lane NE, Magis AT, Lovejoy JC, Hood L, Gibbons SM, Orwoll ES, Price ND. Gut microbiome pattern reflects healthy ageing and predicts survival in humans. Nat Metab 2021; 3:274-286. [PMID: 33619379 PMCID: PMC8169080 DOI: 10.1038/s42255-021-00348-0] [Citation(s) in RCA: 225] [Impact Index Per Article: 75.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 01/19/2021] [Indexed: 12/15/2022]
Abstract
The gut microbiome has important effects on human health, yet its importance in human ageing remains unclear. In the present study, we demonstrate that, starting in mid-to-late adulthood, gut microbiomes become increasingly unique to individuals with age. We leverage three independent cohorts comprising over 9,000 individuals and find that compositional uniqueness is strongly associated with microbially produced amino acid derivatives circulating in the bloodstream. In older age (over ~80 years), healthy individuals show continued microbial drift towards a unique compositional state, whereas this drift is absent in less healthy individuals. The identified microbiome pattern of healthy ageing is characterized by a depletion of core genera found across most humans, primarily Bacteroides. Retaining a high Bacteroides dominance into older age, or having a low gut microbiome uniqueness measure, predicts decreased survival in a 4-year follow-up. Our analysis identifies increasing compositional uniqueness of the gut microbiome as a component of healthy ageing, which is characterized by distinct microbial metabolic outputs in the blood.
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Affiliation(s)
| | | | | | | | - Jack Wiedrick
- Oregon Health and Science University, Portland, OR, USA
| | - Jodi Lapidus
- Oregon Health and Science University, Portland, OR, USA
| | - John C Earls
- Institute for Systems Biology, Seattle, WA, USA
- Onegevity Health, New York, NY, USA
| | - Anat Zimmer
- Institute for Systems Biology, Seattle, WA, USA
| | | | | | | | - Deborah M Kado
- Herbert Wertheim School of Public Health and Human Longevity Science at UCSD and Department of Medicine, University of California, San Diego School of Medicine, La Jolla, CA, USA
| | - Jane A Cauley
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Joseph Zmuda
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Nancy E Lane
- Center for Musculoskeletal Health, Department of Internal Medicine, University of California Davis Medical Center, Sacramento, CA, USA
| | | | - Jennifer C Lovejoy
- Institute for Systems Biology, Seattle, WA, USA
- Lifestyle Medicine Institute, Redlands, CA, USA
| | - Leroy Hood
- Institute for Systems Biology, Seattle, WA, USA
| | - Sean M Gibbons
- Institute for Systems Biology, Seattle, WA, USA.
- eScience Institute, University of Washington, Seattle, WA, USA.
- Department of Bioengineering, University of Washington, Seattle, WA, USA.
| | - Eric S Orwoll
- Oregon Health and Science University, Portland, OR, USA.
| | - Nathan D Price
- Institute for Systems Biology, Seattle, WA, USA.
- Onegevity Health, New York, NY, USA.
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8
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Manor O, Dai CL, Kornilov SA, Smith B, Price ND, Lovejoy JC, Gibbons SM, Magis AT. Health and disease markers correlate with gut microbiome composition across thousands of people. Nat Commun 2020; 11:5206. [PMID: 33060586 PMCID: PMC7562722 DOI: 10.1038/s41467-020-18871-1] [Citation(s) in RCA: 326] [Impact Index Per Article: 81.5] [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: 08/21/2019] [Accepted: 09/16/2020] [Indexed: 12/14/2022] Open
Abstract
Variation in the human gut microbiome can reflect host lifestyle and behaviors and influence disease biomarker levels in the blood. Understanding the relationships between gut microbes and host phenotypes are critical for understanding wellness and disease. Here, we examine associations between the gut microbiota and ~150 host phenotypic features across ~3,400 individuals. We identify major axes of taxonomic variance in the gut and a putative diversity maximum along the Firmicutes-to-Bacteroidetes axis. Our analyses reveal both known and unknown associations between microbiome composition and host clinical markers and lifestyle factors, including host-microbe associations that are composition-specific. These results suggest potential opportunities for targeted interventions that alter the composition of the microbiome to improve host health. By uncovering the interrelationships between host diet and lifestyle factors, clinical blood markers, and the human gut microbiome at the population-scale, our results serve as a roadmap for future studies on host-microbe interactions and interventions.
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Affiliation(s)
- Ohad Manor
- Century Therapeutics, Seattle, WA, 98102, USA.
| | | | | | - Brett Smith
- Institute for Systems Biology, Seattle, WA, 98109, USA
| | - Nathan D Price
- Institute for Systems Biology, Seattle, WA, 98109, USA
- Department of Bioengineering, University of Washington, Seattle, WA, 98105, USA
| | | | - Sean M Gibbons
- Institute for Systems Biology, Seattle, WA, 98109, USA
- Department of Bioengineering, University of Washington, Seattle, WA, 98105, USA
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9
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Magis AT, Rappaport N, Conomos MP, Omenn GS, Lovejoy JC, Hood L, Price ND. Untargeted longitudinal analysis of a wellness cohort identifies markers of metastatic cancer years prior to diagnosis. Sci Rep 2020; 10:16275. [PMID: 33004987 PMCID: PMC7529776 DOI: 10.1038/s41598-020-73451-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 12/12/2019] [Accepted: 09/16/2020] [Indexed: 01/01/2023] Open
Abstract
We analyzed 1196 proteins in longitudinal plasma samples from participants in a commercial wellness program, including samples collected pre-diagnosis from ten cancer patients and 69 controls. For three individuals ultimately diagnosed with metastatic breast, lung, or pancreatic cancer, CEACAM5 was a persistent longitudinal outlier as early as 26.5 months pre-diagnosis. CALCA, a biomarker for medullary thyroid cancer, was hypersecreted in metastatic pancreatic cancer at least 16.5 months pre-diagnosis. ERBB2 levels spiked in metastatic breast cancer between 10.0 and 4.0 months pre-diagnosis. Our results support the value of deep phenotyping seemingly healthy individuals in prospectively inferring disease transitions.
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Affiliation(s)
- Andrew T Magis
- Institute for Systems Biology, 401 Terry Ave N, Seattle, WA, 98109, USA.
| | - Noa Rappaport
- Institute for Systems Biology, 401 Terry Ave N, Seattle, WA, 98109, USA
| | - Matthew P Conomos
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Gilbert S Omenn
- Institute for Systems Biology, 401 Terry Ave N, Seattle, WA, 98109, USA
- Departments of Computational Medicine & Bioinformatics, Internal Medicine, Human Genetics, and School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | | | - Leroy Hood
- Institute for Systems Biology, 401 Terry Ave N, Seattle, WA, 98109, USA
- Providence St. Joseph Health, Seattle, WA, USA
| | - Nathan D Price
- Institute for Systems Biology, 401 Terry Ave N, Seattle, WA, 98109, USA
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10
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Kornilov SA, Lucas I, Jade K, Dai CL, Lovejoy JC, Magis AT. Plasma levels of soluble ACE2are associated with sex, Metabolic Syndrome, and its biomarkers in a large cohort, pointing to a possible mechanism for increased severity in COVID-19. Crit Care 2020; 24:452. [PMID: 32698840 PMCID: PMC7373836 DOI: 10.1186/s13054-020-03141-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 07/01/2020] [Indexed: 05/12/2023]
Affiliation(s)
- Sergey A Kornilov
- Institute for Systems Biology, Seattle, WA 401 Terry Ave N, Seattle, WA, 98109-5263, USA.
| | - Isabelle Lucas
- Institute for Systems Biology, Seattle, WA 401 Terry Ave N, Seattle, WA, 98109-5263, USA
| | - Kathleen Jade
- Institute for Systems Biology, Seattle, WA 401 Terry Ave N, Seattle, WA, 98109-5263, USA
| | - Chengzhen L Dai
- Institute for Systems Biology, Seattle, WA 401 Terry Ave N, Seattle, WA, 98109-5263, USA
| | - Jennifer C Lovejoy
- Institute for Systems Biology, Seattle, WA 401 Terry Ave N, Seattle, WA, 98109-5263, USA
| | - Andrew T Magis
- Institute for Systems Biology, Seattle, WA 401 Terry Ave N, Seattle, WA, 98109-5263, USA
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11
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Marlatt KL, Redman LM, Beyl RA, Smith SR, Champagne CM, Yi F, Lovejoy JC. Racial differences in body composition and cardiometabolic risk during the menopause transition: a prospective, observational cohort study. Am J Obstet Gynecol 2020; 222:365.e1-365.e18. [PMID: 31610152 DOI: 10.1016/j.ajog.2019.09.051] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 08/29/2019] [Accepted: 09/30/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Obesity disproportionately affects more women than men. The loss of ovarian function during the menopause transition coincides with weight gain, increases in abdominal adiposity, and impaired metabolic health. Racial differences in obesity prevalence that results from the menopause transition are not well understood. OBJECTIVE The purpose of the study was to assess longitudinal changes in body composition and cardiometabolic risk among black and white women during the menopausal transition. STUDY DESIGN In a secondary analysis of a prospective, observational cohort study (the Healthy Transitions study), 161 women ≥43 years old with a body mass index of 20-40 kg/m2 and who had not yet transitioned through menopause were enrolled at Pennington Biomedical Research Center. Women were seen annually for body composition by dual-energy X-ray absorptiometry, for abdominal adipose tissue distribution by computed tomography, for sex steroid hormones, and for cardiometabolic risk factors that include fasting glucose, insulin, and lipids. Surrogate measures of insulin sensitivity were also calculated. RESULTS Ninety-four women (25 black, 69 white) transitioned through menopause and were included within the analyses. At menopause onset, black women weighed more (77.8±3.0 vs 70.8±1.8 kg) and had a higher systolic (125±16 vs 118±14 mm Hg) and diastolic (80±8 vs 74±7 mm Hg) blood pressure compared with white women (all P≤.05). No other differences in body composition, sex steroid hormones, or cardiometabolic risk factors were observed at menopause onset. Before menopause, white women gained significant weight (3 kg), total body adiposity (6% percent body fat, 9% fat mass, 12% trunk fat mass) and abdominal adipose tissue (19% subcutaneous fat, 15% visceral fat, 19% total adipose tissue), which coincided with significant decreases in estradiol, sex hormone-binding globulin, and estrone sulfate and increases in follicle-stimulating hormone, total cholesterol, and low-density lipoprotein cholesterol. Conversely, black women had more abdominal adipose tissue before menopause, which was maintained across the menopause transition. Black women also had significant decreases in estrone sulfate and total testosterone and increases in follicle-stimulating hormone before menopause. In the postmenopausal years, abdominal subcutaneous adipose tissue, total adipose tissue, follicle-stimulating hormone, total cholesterol, and low-density and high-density lipoprotein cholesterol increased only in white women. CONCLUSION White women gained more abdominal adiposity during the menopause transition compared with black women, which, in part, may be due to differences in the pattern of sex steroid hormone changes between women of different racial backgrounds. The gains in abdominal adiposity in white women were observed in tandem with increased cardiometabolic risk factors. Future studies should consider comprehensive lifestyle approaches to target these increased gains in abdominal adiposity (ie, nutrition and physical activity coaching), while taking into account the potential interactions of race, body adiposity, sex steroid hormones, and their influence on cardiometabolic risk.
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Affiliation(s)
| | | | - Robbie A Beyl
- Pennington Biomedical Research Center, Baton Rouge, LA
| | - Steve R Smith
- Translational Research Institute for Metabolism and Diabetes, Advent Health, Orlando, FL
| | | | - Fanchao Yi
- Center for Collaborative Research, Advent Health, Orlando, FL
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12
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Manor O, Zubair N, Conomos MP, Xu X, Rohwer JE, Krafft CE, Lovejoy JC, Magis AT. A Multi-omic Association Study of Trimethylamine N-Oxide. Cell Rep 2020; 24:935-946. [PMID: 30044989 DOI: 10.1016/j.celrep.2018.06.096] [Citation(s) in RCA: 97] [Impact Index Per Article: 24.3] [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: 10/11/2017] [Revised: 01/17/2018] [Accepted: 06/22/2018] [Indexed: 01/16/2023] Open
Abstract
Trimethylamine N-oxide (TMAO) is a circulating metabolite that has been implicated in the development of atherosclerosis and cardiovascular disease (CVD). In this paper, we identify blood markers, metabolites, proteins, gut microbiota patterns, and diets that are significantly associated with levels of plasma TMAO. We find that kidney markers are strongly associated with TMAO and identify CVD-related proteins that are positively correlated with TMAO. We show that metabolites derived by the gut microbiota are strongly correlated with TMAO and that the magnitude of this correlation varies with kidney function. Moreover, we identify diet-associated patterns in the microbiome that are correlated with TMAO. These findings suggest that both the process of TMAO accumulation and the mechanism by which TMAO promotes atherosclerosis are a complex interplay between diet and the microbiome on one hand and other system-level factors such as circulating proteins, metabolites, and kidney function.
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Affiliation(s)
| | | | | | | | | | | | - Jennifer C Lovejoy
- Arivale, Inc., Seattle, WA 98104, USA; Institute for Systems Biology, Seattle, WA 98109, USA
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13
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Javitz HS, Bush TM, Lovejoy JC, Torres AJ, Wetzel T, Wassum KP, Tan MM, Alshurafa N, Spring B. Six Month Abstinence Heterogeneity in the Best Quit Study. Ann Behav Med 2019; 53:1032-1044. [PMID: 31009528 DOI: 10.1093/abm/kaz014] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Understanding the characteristics of smokers who are successful in quitting may help to increase smoking cessation rates. PURPOSE To examine heterogeneity in cessation outcome at 6 months following smoking cessation behavioral counseling with or without weight management counseling. METHODS 2,540 smokers were recruited from a large quitline provider and then randomized to receive proactive smoking cessation behavioral counseling without or with two versions of weight management counseling. A Classification and Regression Tree (CART) analysis was conducted to identify the individual pretreatment and treatment characteristics of groups of smokers with different quitting success (as measured by point prevalence of self-reported smoking of any amount at 6 months). RESULTS CART analysis identified 10 subgroups ranging from 25.5% to 70.2% abstinent. The splits in the CART tree involved: the total number of counseling and control calls received, whether a smoking cessation pharmacotherapy was used, and baseline measures of cigarettes per day, confidence in quitting, expectation that the study would help the participant quit smoking, the motivation to quit, exercise minutes per week, anxiety, and lack of interest or pleasure in doing things. Costs per quitter ranged from a low of $US270 to a high of $US630. Specific treatment recommendations are made for each group. CONCLUSIONS These results indicate the presence of a substantial variation in abstinence following treatment, and that the total extent of contact via counseling calls of any type and baseline characteristics, rather than assigned treatment, were most important to subgroup membership and abstinence. Tailored treatments to subgroups who are at high risk for smoking following a quit attempt could increase successful smoking cessation.
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Affiliation(s)
| | - Terry M Bush
- Optum Center for Wellbeing Research, Optum, Seattle, WA USA
| | - Jennifer C Lovejoy
- Optum Center for Wellbeing Research, Arivale, Inc and Institute for Systems Biology, Seattle, WA, USA
| | - Alula J Torres
- Optum Center for Wellbeing Research, Optum, Seattle, WA USA
| | - Tallie Wetzel
- Education Division, SRI International, Menlo Park, CA, USA
| | - Ken P Wassum
- Optum Center for Wellbeing Research, Optum, Seattle, WA USA
| | - Marcia M Tan
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Nabil Alshurafa
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Bonnie Spring
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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14
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Heath LM, Earls JC, Magis AT, Kornilov SA, Hood L, Lovejoy JC, Price ND. P2-141: THE MANIFESTATION OF GENETIC RISK FOR ALZHEIMER'S DISEASE IN BLOOD ACROSS ADULTHOOD: A MULTI-OMIC PHENOME-WIDE ASSOCIATION STUDY (PHEWAS) APPROACH. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.2548] [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: 10/25/2022]
Affiliation(s)
| | - John C. Earls
- Institute for Systems Biology; Seattle WA USA
- University of Washington; Seattle WA USA
| | | | | | - Leroy Hood
- Institute for Systems Biology; Seattle WA USA
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15
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Roach JC, Hara J, Lovejoy JC, Fridman D, Funk C, Heath LM, Price ND, Hood L, Heim L, Brant-Zawadski M, Shankle WR. P4-017: COACHING FOR COGNITION IN ALZHEIMER'S (COCOA) TRIAL. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.3676] [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: 11/26/2022]
Affiliation(s)
| | - Junko Hara
- Medical Care Corporation; Newport Beach CA USA
- Hoag Memorial Hospital Presbyterian; Newport Beach CA USA
| | | | | | - Cory Funk
- Institute for Systems Biology; Seattle WA USA
| | | | | | - Leroy Hood
- Institute for Systems Biology; Seattle WA USA
| | - Laura Heim
- Hoag Memorial Hospital Presbyterian; Newport Beach CA USA
| | | | - William R. Shankle
- Medical Care Corporation; Newport Beach CA USA
- Hoag Memorial Hospital Presbyterian; Newport Beach CA USA
- Shankle Clinic; Newport Beach CA USA
- University of California at Irvine; Irvine CA USA
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16
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Zubair N, Conomos MP, Hood L, Omenn GS, Price ND, Spring BJ, Magis AT, Lovejoy JC. Genetic Predisposition Impacts Clinical Changes in a Lifestyle Coaching Program. Sci Rep 2019; 9:6805. [PMID: 31048771 PMCID: PMC6497671 DOI: 10.1038/s41598-019-43058-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [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: 11/12/2018] [Accepted: 04/12/2019] [Indexed: 12/31/2022] Open
Abstract
Both genetic and lifestyle factors contribute to an individual's disease risk, suggesting a multi-omic approach is essential for personalized prevention. Studies have examined the effectiveness of lifestyle coaching on clinical outcomes, however, little is known about the impact of genetic predisposition on the response to lifestyle coaching. Here we report on the results of a real-world observational study in 2531 participants enrolled in a commercial "Scientific Wellness" program, which combines multi-omic data with personalized, telephonic lifestyle coaching. Specifically, we examined: 1) the impact of this program on 55 clinical markers and 2) the effect of genetic predisposition on these clinical changes. We identified sustained improvements in clinical markers related to cardiometabolic risk, inflammation, nutrition, and anthropometrics. Notably, improvements in HbA1c were akin to those observed in landmark trials. Furthermore, genetic markers were associated with longitudinal changes in clinical markers. For example, individuals with genetic predisposition for higher LDL-C had a lesser decrease in LDL-C on average than those with genetic predisposition for average LDL-C. Overall, these results suggest that a program combining multi-omic data with lifestyle coaching produces clinically meaningful improvements, and that genetic predisposition impacts clinical responses to lifestyle change.
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Affiliation(s)
| | - Matthew P Conomos
- Arivale, Inc, Seattle, WA, 98104, USA.,Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Leroy Hood
- Institute for Systems Biology, 401 Terry Ave N, Seattle, WA, 98109, USA.,Providence St. Joseph Health, Seattle, Washington, USA
| | - Gilbert S Omenn
- Computational Medicine and Bioinformatics, Department of Human Genetics, Molecular Medicine and Genetics, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Nathan D Price
- Institute for Systems Biology, 401 Terry Ave N, Seattle, WA, 98109, USA
| | - Bonnie J Spring
- Center for Behavior and Health, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | | | - Jennifer C Lovejoy
- Arivale, Inc, Seattle, WA, 98104, USA. .,Institute for Systems Biology, 401 Terry Ave N, Seattle, WA, 98109, USA.
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17
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Abstract
This study evaluated the feasibility and efficacy of integrating mindfulness training into a phone-based weight loss program to improve outcomes in those with high levels of emotional eating. Participants were 75 enrollees into an employer-sponsored weight loss program who reported high levels of overeating in response to thoughts and feelings. Seventy-five overweight and obese participants (92% female, 65% Caucasian, aged 26 to 68 years) were randomized to the new mindfulness weight loss program (n = 50) or the standard behavioral weight loss program (n = 25). Both programs consisted of 11 coaching calls with health coaches and registered dietitians with supplemental online materials. Satisfaction, engagement, and percent weight lost did not significantly differ for intervention vs. control at six months. Intervention participants had significantly better scores at six-month follow-up on mindful eating, binge eating, experiential avoidance, and one mindfulness subscale. Exploratory analyses showed that improvements on several measures predicted more weight loss in the intervention group. This pilot study found that integrating mindfulness into a brief phone-based behavioral weight loss program was feasible and acceptable to participants, but did not produce greater weight loss on average, despite hypothesized changes in mindful eating. Only one third of intervention participants reported participating in mindfulness exercises regularly. Mechanisms of change observed within the intervention group suggest that for adults with high levels of emotional eating those who embrace mindful eating and meditation may lose more weight with a mindfulness intervention.
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Affiliation(s)
| | | | - Erica E Salmon
- Center for Wellbeing Research, Alere Wellbeing, Seattle, WA USA
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18
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Xu X, Conomos MP, Manor O, Rohwer JE, Magis AT, Lovejoy JC. Habitual sleep duration and sleep duration variation are independently associated with body mass index. Int J Obes (Lond) 2017; 42:794-800. [PMID: 28895585 DOI: 10.1038/ijo.2017.223] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [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: 02/27/2017] [Revised: 07/31/2017] [Accepted: 09/03/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Sleep plays a vital role in maintaining homeostasis and promoting health. Previous studies show that shorter sleep duration is associated with elevated body mass index (BMI) and other cardiovascular risk factors. The goal of this study was to investigate the effects of habitual sleep duration and nightly sleep duration variation based on daily device-recorded data on BMI and obesity-related biomarkers. METHODS In all, 748 individuals (50.6% females, 85.4% European-Americans, average age: 49.7 years old) participated in a commercial lifestyle coaching program beginning in July 2015. Daily sleep data were recorded by Fitbit Charge HR wristbands. Clinical laboratory blood tests were measured up to three times over a 12-month period. Linear regression models were used for cross-sectional analyses, and generalized estimating equations for longitudinal analyses. All models were adjusted for age, sex, geographic location, season, genetic ancestry inferred from whole genome sequencing data, and BMI (if applicable). Multiple testing issues were corrected by false discovery rate. RESULTS We calculated habitual sleep duration and nightly sleep duration variation. In general, females slept 15-min longer on average than males. A negative correlation was found between habitual sleep duration and BMI (β=-1.12, standard error=0.25, P<0.001). Moreover, we identified a positive correlation between sleep duration variation and BMI (β=2.97, standard error=0.79, P<0.001) while controlling for sleep duration, indicating that larger sleep duration variation is significantly and independently associated with increased BMI. CONCLUSIONS We explored the impact of habitual sleep duration and sleep duration variation, and identified that shorter habitual sleep duration and larger duration variation were independently associated with increased BMI.
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Affiliation(s)
- X Xu
- Research Department, Arivale Inc, Seattle, WA, USA
| | - M P Conomos
- Research Department, Arivale Inc, Seattle, WA, USA
| | - O Manor
- Research Department, Arivale Inc, Seattle, WA, USA
| | - J E Rohwer
- Research Department, Arivale Inc, Seattle, WA, USA
| | - A T Magis
- Research Department, Arivale Inc, Seattle, WA, USA
| | - J C Lovejoy
- Research Department, Arivale Inc, Seattle, WA, USA.,Institute for Systems Biology, Seattle, WA, USA
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19
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Price ND, Magis AT, Earls JC, Glusman G, Levy R, Lausted C, McDonald DT, Kusebauch U, Moss CL, Zhou Y, Qin S, Moritz RL, Brogaard K, Omenn GS, Lovejoy JC, Hood L. A wellness study of 108 individuals using personal, dense, dynamic data clouds. Nat Biotechnol 2017; 35:747-756. [PMID: 28714965 PMCID: PMC5568837 DOI: 10.1038/nbt.3870] [Citation(s) in RCA: 254] [Impact Index Per Article: 36.3] [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: 10/16/2016] [Accepted: 04/11/2017] [Indexed: 01/01/2023]
Abstract
Personal data for 108 individuals were collected during a 9-month period, including whole genome sequences; clinical tests, metabolomes, proteomes, and microbiomes at three time points; and daily activity tracking. Using all of these data, we generated a correlation network that revealed communities of related analytes associated with physiology and disease. Connectivity within analyte communities enabled the identification of known and candidate biomarkers (e.g., gamma-glutamyltyrosine was densely interconnected with clinical analytes for cardiometabolic disease). We calculated polygenic scores from genome-wide association studies (GWAS) for 127 traits and diseases, and used these to discover molecular correlates of polygenic risk (e.g., genetic risk for inflammatory bowel disease was negatively correlated with plasma cystine). Finally, behavioral coaching informed by personal data helped participants to improve clinical biomarkers. Our results show that measurement of personal data clouds over time can improve our understanding of health and disease, including early transitions to disease states.
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Affiliation(s)
- Nathan D Price
- Institute for Systems Biology, Seattle, Washington, USA.,Arivale, Seattle, Washington, USA
| | | | | | | | - Roie Levy
- Institute for Systems Biology, Seattle, Washington, USA
| | | | | | | | | | - Yong Zhou
- Institute for Systems Biology, Seattle, Washington, USA
| | - Shizhen Qin
- Institute for Systems Biology, Seattle, Washington, USA
| | | | | | - Gilbert S Omenn
- Institute for Systems Biology, Seattle, Washington, USA.,Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, Michigan, USA
| | - Jennifer C Lovejoy
- Institute for Systems Biology, Seattle, Washington, USA.,Arivale, Seattle, Washington, USA
| | - Leroy Hood
- Institute for Systems Biology, Seattle, Washington, USA.,Providence St. Joseph Health, Seattle, Washington, USA
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Anguah KOB, Lovejoy JC, Craig BA, Gehrke MM, Palmer PA, Eichelsdoerfer PE, McCrory MA. Can the Palatability of Healthy, Satiety-Promoting Foods Increase with Repeated Exposure during Weight Loss? Foods 2017; 6:E16. [PMID: 28231094 PMCID: PMC5332909 DOI: 10.3390/foods6020016] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 02/12/2017] [Accepted: 02/17/2017] [Indexed: 11/17/2022] Open
Abstract
Repeated exposure to sugary, fatty, and salty foods often enhances their appeal. However, it is unknown if exposure influences learned palatability of foods typically promoted as part of a healthy diet. We tested whether the palatability of pulse containing foods provided during a weight loss intervention which were particularly high in fiber and low in energy density would increase with repeated exposure. At weeks 0, 3, and 6, participants (n = 42; body mass index (BMI) 31.2 ± 4.3 kg/m²) were given a test battery of 28 foods, approximately half which had been provided as part of the intervention, while the remaining half were not foods provided as part of the intervention. In addition, about half of each of the foods (provided as part or not provided as part of the intervention) contained pulses. Participants rated the taste, appearance, odor, and texture pleasantness of each food, and an overall flavor pleasantness score was calculated as the mean of these four scores. Linear mixed model analyses showed an exposure type by week interaction effect for taste, texture and overall flavor pleasantness indicating statistically significant increases in ratings of provided foods in taste and texture from weeks 0 to 3 and 0 to 6, and overall flavor from weeks 0 to 6. Repeated exposure to these foods, whether they contained pulses or not, resulted in a ~4% increase in pleasantness ratings. The long-term clinical relevance of this small increase requires further study.
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Affiliation(s)
- Katherene O-B Anguah
- Department of Human Ecology, Louisiana Tech University, Ruston, LA 71272, USA.
- Department of Nutrition Science and the Ingestive Behavior Research Center, Purdue University, West Lafayette, IN 47907, USA.
| | - Jennifer C Lovejoy
- School of Public Health, The University of Washington, Seattle, WA 98195, USA.
- Institute for Systems Biology, Seattle, WA 98019, USA.
| | - Bruce A Craig
- Department of Statistics, Purdue University, West Lafayette, IN 47907, USA.
| | - Malinda M Gehrke
- The School of Nutrition and Exercise Science, and the Bastyr University Research Institute, Bastyr University, Kenmore, WA 98028, USA.
| | - Philip A Palmer
- The School of Nutrition and Exercise Science, and the Bastyr University Research Institute, Bastyr University, Kenmore, WA 98028, USA.
| | - Petra E Eichelsdoerfer
- The School of Nutrition and Exercise Science, and the Bastyr University Research Institute, Bastyr University, Kenmore, WA 98028, USA.
| | - Megan A McCrory
- Department of Health Sciences, Programs in Nutrition, Boston University/College of Health & Rehabilitation Sciences: Sargent College, Boston, MA 02215, USA.
- Boston Nutrition and Obesity Research Center, Boston, MA 02118, USA.
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21
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Bush T, Lovejoy JC, Deprey M, Carpenter KM. The effect of tobacco cessation on weight gain, obesity, and diabetes risk. Obesity (Silver Spring) 2016; 24:1834-41. [PMID: 27569117 PMCID: PMC5004778 DOI: 10.1002/oby.21582] [Citation(s) in RCA: 106] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 04/21/2016] [Accepted: 05/17/2016] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Most smokers gain weight after quitting, and some develop new onset obesity and type 2 diabetes. The purpose of this paper is to synthesize the current science investigating the consequences of tobacco cessation on body weight and diabetes, as well as intervention strategies that minimize or prevent weight gain while still allowing for successful tobacco cessation. METHODS Systematic reviews and relevant studies that were published since prior reviews were selected. RESULTS Smoking cessation can cause excessive weight gain in some individuals and can be associated with clinically significant outcomes such as diabetes or obesity onset. Interventions that combine smoking cessation and weight control can be effective for improving cessation and minimizing weight gain but need to be tested in specific populations. CONCLUSIONS Despite the health benefits of quitting tobacco, post-cessation weight gain and new onset obesity and diabetes are a significant concern. Promising interventions may need to be more widely applied to reduce the consequences of both obesity and tobacco use.
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Abstract
The Hundred Person Wellness Project (HPWP) is a 10-month pilot study of 100 'well' individuals where integrated data from whole-genome sequencing, gut microbiome, clinical laboratory tests and quantified self measures from each individual are used to provide actionable results for health coaching with the goal of optimizing wellness and minimizing disease. In a commentary in BMC Medicine, Diamandis argues that HPWP and similar projects will likely result in 'unnecessary and potential harmful over-testing'. We argue that this new approach will ultimately lead to lower costs, better healthcare, innovation and economic growth. The central points of the HPWP are: 1) it is focused on optimizing wellness through longitudinal data collection, integration and mining of individual data clouds, enabling development of predictive models of wellness and disease that will reveal actionable possibilities; and 2) by extending this study to 100,000 well people, we will establish multiparameter, quantifiable wellness metrics and identify markers for wellness to early disease transitions for most common diseases, which will ultimately allow earlier disease intervention, eventually transitioning the individual early on from a disease back to a wellness trajectory.
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Affiliation(s)
- Leroy Hood
- Institute for Systems Biology, 401 Terry Avenue North, Seattle 98109, WA, USA.
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23
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Carpenter KM, Lovejoy JC, Lange JM, Hapgood JE, Zbikowski SM. Outcomes and utilization of a low intensity workplace weight loss program. J Obes 2014; 2014:414987. [PMID: 24688791 PMCID: PMC3941961 DOI: 10.1155/2014/414987] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Accepted: 12/12/2013] [Indexed: 02/07/2023] Open
Abstract
Obesity is related to high health care costs and lost productivity in the workplace. Employers are increasingly sponsoring weight loss and wellness programs to ameliorate these costs. We evaluated weight loss outcomes, treatment utilization, and health behavior change in a low intensity phone- and web-based, employer-sponsored weight loss program. The intervention included three proactive counseling phone calls with a registered dietician and a behavioral health coach as well as a comprehensive website. At six months, one third of those who responded to the follow-up survey had lost a clinically significant amount of weight (≥5% of body weight). Clinically significant weight loss was predicted by the use of both the counseling calls and the website. When examining specific features of the web site, the weight tracking tool was the most predictive of weight loss. Health behavior changes such as eating more fruits and vegetables, increasing physical activity, and reducing stress were all predictive of clinically significant weight loss. Although limited by the low follow-up rate, this evaluation suggests that even low intensity weight loss programs can lead to clinical weight loss for a significant number of participants.
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Affiliation(s)
- Kelly M. Carpenter
- Alere Wellbeing, 999 Third Avenue, Suite 2100, Seattle, WA 98104, USA
- *Kelly M. Carpenter:
| | - Jennifer C. Lovejoy
- Alere Wellbeing, 999 Third Avenue, Suite 2100, Seattle, WA 98104, USA
- University of Washington, Seattle, WA 98195, USA
| | | | - Jenny E. Hapgood
- Alere Wellbeing, 999 Third Avenue, Suite 2100, Seattle, WA 98104, USA
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Putiri AL, Lovejoy JC, Gillham S, Sasagawa M, Bradley R, Sun GC. Psychological effects of Yi Ren Medical Qigong and progressive resistance training in adults with type 2 diabetes mellitus: a randomized controlled pilot study. Altern Ther Health Med 2012; 18:30-4. [PMID: 22516850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
BACKGROUND Previous studies suggest that qigong therapy has physiological benefits for adults with type 2 diabetes; however, information about the psychological benefits of qigong therapy in this population is limited. OBJECTIVE The objective of this research project was to identify psychological responses to qigong vs control interventions in adults with type 2 diabetes. DESIGN The research team designed a randomized, controlled, three-arm clinical trial comparing 12 weeks of Yi Ren Medical Qigong (YRMQ), progressive resistance training (PRT), and standard care. SETTING The study was performed at Bastyr University Research Institute, Kenmore, Washington. PARTICIPANTS Participants were 13 men and 19 women (N=32) with diagnosed type 2 diabetes, a mean age of 56.3 ± 8.1 (standard deviation) years, glycated hemoglobin > 7.5%, and fasting blood glucose > 7 mmol/dL (126 mg/dL). INTERVENTION For 12 weeks, participants in the YRMQ and PRT group attended a 1-hour weekly group session that a certified instructor led and were instructed to practice at least twice a week for 30 minutes. PRIMARY OUTCOME MEASURES The research team used the Perceived Stress Scale and the Beck Depression Inventory scores to analyze the data. RESULTS YRMQ decreased perceived-stress scores by 29.3% (P < .05) and depression scores by 14.3% (not significant [NS]). The active control group, PRT, also decreased stress scores by 18.6% (NS) and decreased depression scores by 50% (P < .03). Stress and depression measures remained unchanged in the standard care group. CONCLUSION YRMQ and PRT may be beneficial in reducing perceived stress and improving depression in patients with type 2 diabetes, although verification of the clinical significance of these findings requires a longer study with a larger sample size.
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Affiliation(s)
- Amy L Putiri
- Bastyr University Research Institute, Kenmore, Washington, USA
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Abstract
The prevalence of obesity has reached epidemic proportions, making finding effective solutions to reduce obesity a public health priority. One part of the solution could be for individuals to increase consumption of nonoilseed pulses (dry beans, peas, chickpeas, and lentils), because they have nutritional attributes thought to benefit weight control, including slowly digestible carbohydrates, high fiber and protein contents, and moderate energy density. Observational studies consistently show an inverse relationship between pulse consumption and BMI or risk for obesity, but many do not control for potentially confounding dietary and other lifestyle factors. Short-term (≤1 d) experimental studies using meals controlled for energy, but not those controlled for available carbohydrate, show that pulse consumption increases satiety over 2-4 h, suggesting that at least part of the effect of pulses on satiety is mediated by available carbohydrate amount or composition. Randomized controlled trials generally support a beneficial effect of pulses on weight loss when pulse consumption is coupled with energy restriction, but not without energy restriction. However, few randomized trials have been conducted and most were short term (3-8 wk for whole pulses and 4-12 wk for pulse extracts). Overall, there is some indication of a beneficial effect of pulses on short-term satiety and weight loss during intentional energy restriction, but more studies are needed in this area, particularly those that are longer term (≥1 y), investigate the optimal amount of pulses to consume for weight control, and include behavioral elements to help overcome barriers to pulse consumption.
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Affiliation(s)
- Megan A. McCrory
- Department of Foods and Nutrition
- Department of Psychological Sciences
- Ingestive Behavior Research Center
| | - Bruce R. Hamaker
- Ingestive Behavior Research Center
- Whistler Center for Carbohydrate Research, and
- Department of Food Science, Purdue University, West Lafayette, IN 47907-2059
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McCrory MA, Lovejoy JC, Palmer PA, Eichelsdoerfer PE, Gehrke MM, Kavanaugh IT. A randomized study of legume consumption during weight loss: effects on food cravings. FASEB J 2010. [DOI: 10.1096/fasebj.24.1_supplement.95.2] [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: 11/11/2022]
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Murphy EA, Lovejoy JC, Palmer PA, Eichelsdoerfer PE, Gehrke MM, Kavanaugh IT, McCrory MA. Psychological factor (PF) changes during a randomized trial of legume consumption during weight loss. FASEB J 2010. [DOI: 10.1096/fasebj.24.1_supplement.936.16] [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: 11/11/2022]
Affiliation(s)
| | | | | | | | | | | | - Megan A McCrory
- Foods and NutritionPurdue UniversityWest LafayetteIN
- Bastyr UniversityKenmoreWA
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Sun GC, Lovejoy JC, Gillham S, Putiri A, Sasagawa M, Bradley R. Effects of Qigong on glucose control in type 2 diabetes: a randomized controlled pilot study. Diabetes Care 2010; 33:e8. [PMID: 20040671 PMCID: PMC6898913 DOI: 10.2337/dc09-1543] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Guan-Cheng Sun
- From the Bastyr University Research Institute, Kenmore, Washington
| | | | - Sara Gillham
- From the Bastyr University Research Institute, Kenmore, Washington
| | - Amy Putiri
- From the Bastyr University Research Institute, Kenmore, Washington
| | - Masa Sasagawa
- From the Bastyr University Research Institute, Kenmore, Washington
| | - Ryan Bradley
- From the Bastyr University Research Institute, Kenmore, Washington
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Abstract
Obesity prevalence is generally higher in women than in men, and there is also a sex difference in body fat distribution. Sex differences in obesity can be explained in part by the influence of gonadal steroids on body composition and appetite; however, behavioural, socio-cultural and chromosomal factors may also play a role. This review, which evolved from the 2008 Stock Conference on sex differences in obesity, summarizes current research and recommendations related to hormonal and neuroendocrine influences on energy balance and fat distribution. A number of important gaps in the research are identified, including a need for more studies on chromosomal sex effects on energy balance, the role of socio-cultural (i.e. gender) factors in obesity and the potential deleterious effects of high-fat diets during pregnancy on the foetus. Furthermore, there is a paucity of clinical trials examining sex-specific approaches and outcomes of obesity treatment (lifestyle-based or pharmacological), and research is urgently needed to determine whether current weight loss programmes, largely developed and tested on women, are appropriate for men. Last, it is important that both animal and clinical research on obesity be designed and analysed in such a way that data can be separately examined in both men and women.
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Affiliation(s)
- J C Lovejoy
- Free and Clear Inc., 999 Third Avenue, Seattle, WA 98104, USA.
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30
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Affiliation(s)
- Jennifer C. Lovejoy
- Free & Clear, Inc., and University of Washington, School of Public Health, Seattle, WA
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Smith SR, Lovejoy JC, Bray GA, Rood J, Most MM, Ryan DH. Triiodothyronine increases calcium loss in a bed rest antigravity model for space flight. Metabolism 2008; 57:1696-703. [PMID: 19013293 DOI: 10.1016/j.metabol.2008.07.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [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: 09/15/2005] [Accepted: 07/24/2008] [Indexed: 10/21/2022]
Abstract
Bed rest has been used as a model to simulate the effects of space flight on bone metabolism. Thyroid hormones accelerate bone metabolism. Thus, supraphysiologic doses of this hormone might be used as a model to accelerate bone metabolism during bed rest and potentially simulate space flight. The objective of the study was to quantitate the changes in bone turnover after low doses of triiodothyronine (T(3)) added to short-term bed rest. Nine men and 5 women were restricted to bed rest for 28 days with their heads positioned 6 degrees below their feet. Subjects were randomly assigned to receive either placebo or oral T(3) at doses of 50 to 75 microg/d in a single-blind fashion. Calcium balance was measured over 5-day periods; and T(3), thyroxine, thyroid-stimulating hormone, immunoreactive parathyroid hormone, osteocalcin, bone alkaline phosphatase, and urinary deoxypyridinoline were measured weekly. Triiodothyronine increased 2-fold in the men and 5-fold in the women during treatment, suppressing both thyroxine and thyroid-stimulating hormone. Calcium balance was negative by 300 to 400 mg/d in the T(3)-treated volunteers, primarily because of the increased fecal loss that was not present in the placebo group. Urinary deoxypyridinoline to creatinine ratio, a marker of bone resorption, increased 60% in the placebo group during bed rest, but more than doubled in the T(3)-treated subjects (P < .01), suggesting that bone resorption was enhanced by treatment with T(3). Changes in serum osteocalcin and bone-specific alkaline phosphatase, markers of bone formation, were similar in T(3)- and placebo-treated subjects. Triiodothyronine increases bone resorption and fecal calcium loss in subjects at bed rest.
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Affiliation(s)
- Steven R Smith
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA
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Abstract
OBJECTIVE This study assessed longitudinal changes in body composition, fat distribution and energy balance in perimenopausal women. We hypothesized that total fat and abdominal body fat would increase at menopause due to decreased energy expenditure (EE) and declining estrogen, respectively. DESIGN Observational, longitudinal study with annual measurements for 4 years. SUBJECTS Healthy women (103 Caucasian; 53 African-American), initially premenopausal. During follow-up, lack of menstruation for 1 year and follicle-stimulating hormone >30 mIU ml(-1) defined a subject as postmenopausal. MEASUREMENTS Fat and lean mass (dual-energy X-ray absorptiometry), visceral (VAT) and subcutaneous abdominal fat (SAT) (computed tomography), dietary intake (4-day food record), serum sex hormones and physical activity (tri-axial accelerometry). Twenty-four hour EE was measured by whole-room calorimeter in a subset of 34 women at baseline and at year 4. RESULTS Body fat and weight increased significantly over time only in those women who became postmenopausal by year 4 (n=51). All women gained SAT over time; however, only those who became postmenopausal had a significant increase in VAT. The postmenopausal group also exhibited a significant decrease in serum estradiol. Physical activity decreased significantly 2 years before menopause and remained low. Dietary energy, protein, carbohydrate and fiber intake were significantly higher 3-4 years before the onset of menopause compared with menopause onset. Twenty-four hour EE and sleeping EE decreased significantly with age; however, the decrease in sleeping EE was 1.5-fold greater in women who became postmenopausal compared with premenopausal controls (-7.9 vs -5.3%). Fat oxidation decreased by 32% in women who became postmenopausal (P<0.05), but did not change in those who remained premenopausal. CONCLUSION Middle-aged women gained SAT with age, whereas menopause per se was associated with an increase in total body fat and VAT. Menopause onset is associated with decreased EE and fat oxidation that can predispose to obesity if lifestyle changes are not made.
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Affiliation(s)
- J C Lovejoy
- Department of Molecular Endocrinology, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA 70808, USA
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McCrory MA, Lovejoy JC, Palmer PA, Eichelsdoerfer PE, Gehrke MM, Kavanaugh IT, Buesing SA, Rose TL. Effectiveness of legume consumption for facilitating weight loss: a randomized trial. FASEB J 2008. [DOI: 10.1096/fasebj.22.1_supplement.1084.8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Barak A, McCrory MA, Lovejoy JC, Weber W. Eating patterns and risk for overweight in children with Attention Deficit Hyperactive Disorder (ADHD). FASEB J 2008. [DOI: 10.1096/fasebj.22.1_supplement.316.3] [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: 11/11/2022]
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Krueger AC, Eldridge GD, Gehrke MM, Lovejoy JC, Koutoubi S, Oberg EB, Johnson JM, Schenk KE, McCrory MA. Taste Preferences and Taste Sensitivity: Associations with Food Preferences, Dietary Intake and Body Composition. FASEB J 2006. [DOI: 10.1096/fasebj.20.4.a175] [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: 11/11/2022]
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Lefevre M, Lovejoy JC, Smith SR, Delany JP, Champagne C, Most MM, Denkins Y, de Jonge L, Rood J, Bray GA. Comparison of the acute response to meals enriched with cis- or trans-fatty acids on glucose and lipids in overweight individuals with differing FABP2 genotypes. Metabolism 2005; 54:1652-8. [PMID: 16311100 DOI: 10.1016/j.metabol.2005.06.015] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.7] [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: 03/01/2005] [Accepted: 06/27/2005] [Indexed: 10/25/2022]
Abstract
Trans-fatty acids have been implicated as a risk factor for cardiovascular disease and diabetes. In addition, a polymorphism at codon 54 (Ala54Thr) in the fatty acid-binding protein 2 (FABP2) gene has been suggested to modify an interaction between dietary fat and insulin sensitivity. We examined the postprandial metabolic profiles after meals enriched with C18:1trans- relative to a similar meal with C18:1cis-fatty acid in individuals who were either FABP2 Ala54 homozygotes or Thr54 carriers. Moderately overweight men and women ate 2 breakfast test meals, separated by 1 week, each providing 40% of their daily energy requirement and containing 50% of energy as fat. In one meal, 10% of energy was from C18:1trans, and in the other meal, the C18:1trans was replaced with C18:1cis. Metabolic parameters were assessed during an 8-hour period. Insulin and C-peptide levels increased more after the C18:1trans meal, and this was associated with a greater fall in free fatty acids. Postprandial glucose levels and oxidation of fatty acids and carbohydrate were not different between the 2 test meals. The Thr54 allele for FABP2 increased the rise in postprandial glucose but not triacylglycerols. Fractional triacylglycerol synthetic rates were higher after consumption of the C18:1trans meal relative to the C18:1cis meal only in Thr54 carriers. These data show that a single meal enriched with C18:1trans-fatty acids can significantly increase insulin resistance, and that in the presence of the FABP2 Thr54 allele, may contribute to increased partitioning of glucose to triacylglycerols and insulin resistance.
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Affiliation(s)
- Michael Lefevre
- Pennington Biomedical Research Center, 6400 Perkins Rd, Baton Rouge, LA 70808, USA.
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Abstract
Nuts have many nutritional benefits: they are high in monounsaturated and polyunsaturated fats, fiber, vitamin, minerals, and phytonutrients. Population studies indicate that individuals who regularly consume nuts have reduced risk for cardiovascular disease and diabetes. In clinical trials, nuts appear to have a neutral effect on glucose and insulin, and a beneficial effect on lipid profile. Thus, nuts can be a healthy dietary component for individuals with diabetes or those at risk for diabetes, providing overall caloric intake is regulated to maintain a healthy body weight.
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Affiliation(s)
- Jennifer C Lovejoy
- School of Nutrition and Exercise Science, Bastyr University, 14500 Juanita Drive N.E., Kenmore, WA 98028, USA.
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Lara-Castro C, Hunter GR, Lovejoy JC, Gower BA, Fernández JR. Apolipoprotein A-II polymorphism and visceral adiposity in African-American and white women. ACTA ACUST UNITED AC 2005; 13:507-12. [PMID: 15833935 DOI: 10.1038/oby.2005.53] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
To determine the association between the -265 T to C substitution in the apolipoprotein A-II (APOA-II) gene and levels of visceral adipose tissue (VAT) in a group of premenopausal African-American and white women, we genotyped 237 women (115 African-American and 122 white) for this polymorphism. Body composition was assessed by DXA, and VAT was determined from a single computed tomography scan. In addition to VAT, we examined the association between the polymorphism and other phenotypes (total body fat, total abdominal adipose tissue, and subcutaneous abdominal adipose tissue). The mutant C allele in the APOA-II gene was less frequent in African-American compared with white women, 23% vs. 36%, respectively (p < 0.01). VAT was significantly higher in carriers of the C allele compared with noncarriers after adjustment for total body fat (p < 0.05). When separate analyses by ethnic group were conducted, the association between the polymorphism and VAT was observed in white (p < 0.05) but not African-American (p = 0.57) women. There was no association between the polymorphism and the other phenotypes. These results indicate a significant association between the T265C APOA-II polymorphism and levels of VAT in premenopausal women. This association is present in white but not African-American women.
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Affiliation(s)
- Cristina Lara-Castro
- Division of Physiology and Metabolism, Department of Nutrition Sciences, University of Alabama, Birmingham, AL 35294, USA.
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Tulley RT, Vaidyanathan J, Wilson JB, Rood JC, Lovejoy JC, Most MM, Volaufova J, Peters JC, Bray GA. Daily intake of multivitamins during long-term intake of olestra in men prevents declines in serum vitamins A and E but not carotenoids. J Nutr 2005; 135:1456-61. [PMID: 15930452 DOI: 10.1093/jn/135.6.1456] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The objective of this study was to determine whether vitamin supplementation during long-term (36 wk) ingestion of olestra supplemented with vitamin E could prevent decreases in vitamin E, vitamin A, and carotenoids. This was a 36-wk study of 37 healthy males randomly assigned to consume a control diet composed of 33% energy from fat, a similar diet in which one third of the energy from fat had been replaced with olestra, or a fat-reduced (25% of energy from fat) diet. Subjects also ingested a daily multivitamin (Centrum). Serum concentrations of alpha-tocopherol, retinol, beta-carotene, lycopene, and lutein + zeaxanthin were analyzed by HPLC. Subjects eating the olestra-containing diet had substantial decreases in serum beta-carotene, lycopene, and lutein + zeaxanthin, which occurred by 12 wk; these changes were found despite correcting for serum total cholesterol or BMI. Serum beta-carotene and lycopene concentrations were below the lower limit of the reference range (<0.186 and <0.298 mumol/L, respectively) at one or more time points. The slight decline in serum alpha-tocopherol concentration, significant at 24 wk, was caused by the decline in serum cholesterol. Retinol concentrations decreased with time in all 3 groups, but were not affected by olestra. We conclude that supplementation with a multivitamin containing vitamins A and E was adequate to prevent olestra-induced decrease in serum alpha-tocopherol and retinol. Olestra-induced decreases in serum beta-carotene, lycopene, and lutein + zeaxanthin were not prevented by the vitamin supplement used in this study.
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Affiliation(s)
- Richard T Tulley
- Pennington Biomedical Research Center, Baton Rouge, LA 70112, USA.
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Mayer-Davis EJ, Sparks KC, Hirst K, Costacou T, Lovejoy JC, Regensteiner JG, Hoskin MA, Kriska AM, Bray GA. Dietary intake in the diabetes prevention program cohort: baseline and 1-year post randomization. Ann Epidemiol 2005; 14:763-72. [PMID: 15573453 DOI: 10.1016/j.annepidem.2004.02.004] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE To describe usual dietary intake assessment at baseline and 1-year post-randomization in the ethnically diverse Diabetes Prevention Program cohort. METHODS Participants were randomized to Lifestyle Modification, Metformin, or Placebo. Usual diet was assessed by a modified, previously validated food frequency interview. RESULTS Complete data were available for 2934 subjects (90.7% of those randomized). Baseline median estimated energy intake was 7676 kJ/d (1828 kcal/d) and 8585 kJ/d (2044 kcal/d) for women and men, respectively. The median percent of energy from fat ranged from 30.6% for Asian American men to 37.5% for American Indian men and women. After 1 year among the Lifestyle group, the median change in total energy and percent energy from fat was -1897 kJ/d (-452 kcal/d) and -6.6%, respectively. For the Metformin and Placebo groups, change in median total energy was -1235 kJ/d (-294 kcal/d) and-1051 kJ/d (-250 kcal/d), respectively, and change in median percent energy from fat was -0.8% and-0.8%, respectively (p < 0.001 for differences between groups, adjusted for gender and ethnicity). CONCLUSIONS One-year post-randomization, significant differences in dietary intake were observed in the Lifestyle compared with the Metformin or Placebo group, and these were consistent with the general intent of the DPP lifestyle modification intervention.
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Affiliation(s)
- Elizabeth J Mayer-Davis
- The Diabetes Prevention Program Coordinating Center, George Washington University Biostatistics Center, Rockville, MD 20852, USA.
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Lara-Castro C, Hunter GR, Lovejoy JC, Gower BA, Fernández JR. Association of the intestinal fatty acid-binding protein Ala54Thr polymorphism and abdominal adipose tissue in African-American and Caucasian women. J Clin Endocrinol Metab 2005; 90:1196-201. [PMID: 15572430 DOI: 10.1210/jc.2004-0676] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Genetic variants in the intestinal fatty acid-binding protein-2 (FABP2) gene have been associated with body composition phenotypes. We examined the association between the Ala(54)Thr variant in the FABP2 gene and levels of visceral (VAT) and sc (SAAT) abdominal fat in a group of 223 premenopausal African-American (n = 103) and Caucasian (n = 120) women. Subjects were genotyped for the marker. In addition, body composition was assessed by dual energy x-ray absorptiometry, and VAT was determined from a single computed tomography scan. The frequency of the Thr mutant allele did not differ significantly by ethnic group. After adjusting for total body fat, total abdominal adipose tissue (TAT) and SAAT were significantly lower in carriers of either one or two copies of the mutant Thr allele (P < 0.01). There was no association between total fat mass or VAT and the FABP2 polymorphism. Separate analyses by ethnic group showed that the association between the polymorphism and TAT and SAAT was observed in Caucasian (P < 0.01), but not in African-American (not significant), women. We conclude that women carriers of the FABP2 Thr allele have lower TAT and SAAT than noncarriers of the mutation. This association is present in Caucasian, but not in African-American, women.
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Affiliation(s)
- Cristina Lara-Castro
- Department of Nutrition Sciences, University of Alabama, Birmingham, Alabama 35294, USA.
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Veldhuis JD, Roemmich JN, Richmond EJ, Rogol AD, Lovejoy JC, Sheffield-Moore M, Mauras N, Bowers CY. Endocrine control of body composition in infancy, childhood, and puberty. Endocr Rev 2005; 26:114-46. [PMID: 15689575 DOI: 10.1210/er.2003-0038] [Citation(s) in RCA: 273] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Body composition exhibits marked variations across the early human lifetime. The precise physiological mechanisms that drive such developmental adaptations are difficult to establish. This clinical challenge reflects an array of potentially confounding factors, such as marked intersubject differences in tissue compartments; the incremental nature of longitudinal intrasubject variations in body composition; technical limitations in quantitating the unobserved mass of mineral, fat, water, and muscle ad seriatim; and the multifold contributions of genetic, dietary, environmental, hormonal, nutritional, and behavioral signals to physical and sexual maturation. From an endocrine perspective (reviewed here), gonadal sex steroids and GH/IGF-I constitute prime determinants of evolving body composition. The present critical review examines hormonal regulation of body composition in infancy, childhood, and puberty.
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Affiliation(s)
- Johannes D Veldhuis
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Mayo Medical and Graduate Schools of Medicine, General Clinical Research Center, Mayo Clinic, Rochester, Minnesota 55905, USA.
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Gouvier WD, Pinkston JB, Lovejoy JC, Smith SR, Bray GA, Santa Maria MP, Hammer JH, Hilsabeck RC, Smiroldo B, Bentz B, Browndyke J. Neuropsychological and emotional changes during simulated microgravity: effects of triiodothyronine alendronate, and testosterone. Arch Clin Neuropsychol 2004; 19:153-63. [PMID: 15010082 DOI: 10.1016/j.acn.2002.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2002] [Indexed: 10/26/2022] Open
Abstract
INTRODUCTION We present the results of a two-experiment study designed to evaluate the neurocognitive and psychological effects of six-degree head-down bedrest and pharmacologic interventions (3,5,3'-triiodothyronine; T3) implemented to enhance the muscle and bone atrophy associated with simulated microgravity. Subsequently, the effects of countermeasures (alendronate and testosterone) administered to retard or reverse these T3 plus bedrest enhanced atrophic changes, were evaluated. Each participant was tested weekly for 5 weeks during Bedrest or non-bedrest (Up) conditions with the Neurobehavioral Evaluation System 2 (NES2), the Symptom Check List 90 Revised (SCL-90-R), and the Coping Responses Inventory (CRI). Resultant data were subjected to repeated measures, between groups analysis of variance testing for all 82 neurocognitive and psychological test measures. RESULTS In Experiment 1, participants in the Placebo-Bedrest condition performed better on several neurocognitive measures compared to participants in the T3-Up condition. However, participants in the Placebo-Bedrest condition also reported more confusion. In Experiment 2 (countermeasure trials), superior coordination was observed for participants in the Testosterone-T3 condition over those in the Alendronate-T3 condition, but just the opposite for reaction time. Also, testosterone and to a lesser degree, alendronate, were associated with less self-reported emotional distress than T3 plus bedrest alone. CONCLUSION Triiodothyronine, alendronate, and testosterone each influence participant response to simulated microgravity. Between group differences for significant findings were substantial and averaged 1.62 standard deviations. Although the observed neurocognitive effects likely pose no immediate danger for research participants, the significantly greater level of self-reported psychological symptoms by T3-Placebo and Placebo-Bedrest treated participants is of clinical importance.
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Affiliation(s)
- Wm Drew Gouvier
- Department of Psychology, Louisiana State University, Baton Rouge, LA 70803, USA.
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Lovejoy JC, Bray GA, Lefevre M, Smith SR, Most MM, Denkins YM, Volaufova J, Rood JC, Eldridge AL, Peters JC. Consumption of a controlled low-fat diet containing olestra for 9 months improves health risk factors in conjunction with weight loss in obese men: the Ole' Study. Int J Obes (Lond) 2003; 27:1242-9. [PMID: 14513073 DOI: 10.1038/sj.ijo.0802373] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [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] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To compare the effects of a standard American diet, a traditional low-fat diet, and a low-fat diet containing the fat substitute olestra on risk factors for heart disease and diabetes. DESIGN A 9-month, double-blind, randomized, parallel-arm, feeding study comparing three diets: (1). control (33% fat), (2). fat-reduced (FR; 25% fat), and (3). fat-substituted (FS) where olestra replaced 1/3 of dietary fat (33% lipid and 25% digestible fat). Subjects were allowed to adjust their total energy intake as desired, allowing weight to fluctuate. SUBJECTS A total of 37 healthy, obese men (age 36.7+/-1.3 y; body mass index 30.8+/-0.4 kg/m(2)). MEASUREMENTS Body weight and composition by dual-energy X-ray absorptiometry, blood pressure, serum lipids, lipoproteins, hemostatic factors, glucose, insulin, and leptin at baseline and every 3 months. RESULTS The FS group lost 6.27 kg of body weight by 9 months vs 4.0 kg in the control and 1.79 kg in the FR groups. There was a significant diet main effect on cholesterol (P=0.002), low-density lipoprotein cholesterol (P=0.003), and triglycerides (P=0.01), all of which decreased in the FS group but not the other groups by 9 months. Apolipoprotein B (ApoB) increased in the FR and control groups but was unchanged in the FS group (diet main effect P=0.04). High-density lipoprotein (HDL) cholesterol increased in all groups over 9 months (time main effect P=0.0001). Time main effects were also observed for cholesterol, ApoA1, ApoB, Factor VII, diastolic blood pressure, and glucose. After adjustment for % fat loss at 9 months, the effects of diet on change in risk factors remained significant only for triglycerides. DISCUSSION Consumption of a low-fat diet containing olestra for 9 months produced significant improvement in cardiovascular risk factors, an effect largely explained by weight loss. Long-term low-fat diet consumption with or without olestra does not decrease HDL cholesterol.
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Affiliation(s)
- J C Lovejoy
- Pennington Biomedical Research Center, Baton Rouge, LA70808, USA.
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Abstract
In summary, menopause tends to be associated with an increased risk of obesity and a shift to an abdominal fat distribution with associated increase in health risks. Changes in body composition at menopause may be caused by the decrease in circulating estrogen, and, for fat distribution shifts, the relative increase in the androgen-estrogen ratio is likely to be important. Clinicians need to be aware of the likelihood of weight gain during the perimenopausal and postmenopausal years because behavioral strategies for weight loss can be effectively used in this population. Weight loss or prevention of weight gain is likely to have significant health benefits for older women.
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Affiliation(s)
- Jennifer C Lovejoy
- Women's Nutrition Research Program, Pennington Biomedical Research Center, Louisiana State University, 6400 Perkins Road, Baton Rouge, LA 70808, USA.
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Smith SR, Lovejoy JC, Rood J, Most M, Wickersham PJ, Volaufova J, Ryan D, Tulley R, Bray GA. The effects of triiodothyronine on bone metabolism in healthy ambulatory men. Thyroid 2003; 13:357-64. [PMID: 12804104 DOI: 10.1089/105072503321669848] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [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] [Indexed: 11/12/2022]
Abstract
The purpose of the present study was to determine the effects of supraphysiologic doses of triiodothyronine (T(3)) on skeletal metabolism, calcium balance, and the calciotropic hormones. Seven healthy, lean men were studied in an inpatient metabolic unit over a 63-day period. All volunteers received oral T(3) at doses of 50-75 microg/d. There was a prompt and sustained increase in calciuria and an overall net negative calcium balance. The pattern of changes in serum osteocalcin, urinary deoxypyridinoline (DPD)/creatinine ratio, and serum bone-specific alkaline phosphatase indicated an early increase in bone resorption followed by a late, incomplete compensatory increase in bone formation. Cumulative net calcium loss was 18.5 +/- 5.4 g over the 63-day treatment period, averaging 218.5 +/- 41.4 mg/d. This represents 0.22% +/- 0.075% of the total skeletal calcium content. The cumulative net calcium loss over the 63-day treatment period was highly correlated with the change in DPD (r = -0.95, p = 0.001). Prompt increases in corrected serum calcium values resulted in serum intact parathyroid hormone (iPTH) levels decreasing by 30.4% (p = 0.08). Bone mineral density showed no change. We conclude that T(3) accelerates bone turnover and that bone formation does not increase acutely to prevent bone loss.
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Affiliation(s)
- Steven R Smith
- Pennington Biomedical Research Center, Baton Rouge, Louisiana 70808, USA.
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Lovejoy JC, Most MM, Lefevre M, Greenway FL, Rood JC. Effect of diets enriched in almonds on insulin action and serum lipids in adults with normal glucose tolerance or type 2 diabetes. Am J Clin Nutr 2002; 76:1000-6. [PMID: 12399271 DOI: 10.1093/ajcn/76.5.1000] [Citation(s) in RCA: 158] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Nuts appear to have cardiovascular benefits but their effect in diabetic patients is unclear. OBJECTIVE The objective was to assess effects of almond-enriched diets on insulin sensitivity and lipids in patients with normoglycemia or type 2 diabetes. DESIGN Study 1 assessed the effect of almonds on insulin sensitivity in 20 free-living healthy volunteers who received 100 g almonds/d for 4 wk. Study 2 was a randomized crossover study that compared 4 diets in 30 volunteers with type 2 diabetes: 1) high-fat, high-almond (HFA; 37% total fat, 10% from almonds); 2) low-fat, high-almond (LFA; 25% total fat, 10% from almonds); 3) high-fat control (HFC; 37% total fat, 10% from olive or canola oil); and 4) low-fat control (LFC; 25% total fat, 10% from olive or canola oil). After each 4-wk diet, serum lipids and oral glucose tolerance were measured. RESULTS In study 1, almond consumption did not change insulin sensitivity significantly, although body weight increased and total and LDL cholesterol decreased by 21% and 29%, respectively (P < 0.05). In study 2, total cholesterol was lowest with the HFA diet (4.46 +/- 0.14, 4.52 +/- 0.14, 4.63 +/- 0.14, and 4.63 +/- 0.14 mmol/L with the HFA, HFC, LFA, and LFC diets, respectively; P = 0.0004 for fat level). HDL cholesterol was significantly lower with the almond diets (P = 0.002); however, no significant effect of fat source on LDL:HDL was observed. Glycemia was unaffected. CONCLUSIONS Almond-enriched diets do not alter insulin sensitivity in healthy adults or glycemia in patients with diabetes. Almonds had beneficial effects on serum lipids in healthy adults and produced changes similar to high monounsaturated fat oils in diabetic patients.
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Affiliation(s)
- Jennifer C Lovejoy
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge 70808, USA.
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Bray GA, Lovejoy JC, Most-Windhauser M, Smith SR, Volaufova J, Denkins Y, de Jonge L, Rood J, Lefevre M, Eldridge AL, Peters JC. A 9-mo randomized clinical trial comparing fat-substituted and fat-reduced diets in healthy obese men: the Ole Study. Am J Clin Nutr 2002; 76:928-34. [PMID: 12399262 DOI: 10.1093/ajcn/76.5.928] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Dietary fat has been implicated as a risk factor for cardiovascular disease and obesity. OBJECTIVE We evaluated the effect on body weight, body fat, lipids, glucose, and insulin of replacing dietary fat with olestra in moderately obese men. DESIGN Forty-five healthy overweight men were randomly assigned to 1 of 3 diets: control diet (33% fat), fat-reduced diet (25% fat), or fat-substituted diet (one-third of dietary fat replaced by olestra to achieve a diet containing 25% metabolizable fat). Body fat was measured by dual-energy X-ray absorptiometry and visceral and subcutaneous abdominal fat by computed tomography. RESULTS Thirty-six men completed the 9-mo study. Body weight and body fat in the fat-substituted group declined by a mean (+/- SEM) of 6.27 +/- 1.66 and 5.85 +/- 1.34 kg, respectively, over 9 mo compared with 3.8 +/- 1.34 and 3.45 +/- 1.0 kg in the control group and 1.79 +/- 0.81 and 1.68 +/- 0.75 kg in the fat-reduced diet group. At 9 mo, the mean difference in body fat between the fat-reduced and fat-substituted groups was -4.19 +/- 1.19 kg (95% CI: -6.57, -1.81), that between the control and fat-substituted groups was -2.55 +/- 1.21 kg (-0.13, -4.97), and that between the control and fat-reduced groups was 1.63 +/- 1.18 kg (3.96, -0.70). The men eating the fat-reduced diet asked for almost no extra foods, in contrast with the significantly higher requests (P < 0.05) from both of the other 2 groups. CONCLUSION Replacement of dietary fat with olestra reduces body weight and total body fat when compared with a 25%-fat diet or a control diet containing 33% fat.
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Affiliation(s)
- George A Bray
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA.
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Abstract
Dietary fat has been implicated in the development of insulin resistance in both animals and humans. Most, although not all, studies suggest that higher levels of total fat in the diet result in greater whole-body insulin resistance. Although, in practice, obesity may complicate the relationship between fat intake and insulin resistance, clinical trials demonstrate that high levels of dietary fat can impair insulin sensitivity independent of body weight changes. In addition, it appears that different types of fat have different effects on insulin action. Saturated and certain monounsaturated fats have been implicated in causing insulin resistance, whereas polyunsaturated and omega-3 fatty acids largely do not appear to have adverse effects on insulin action. Given the importance of insulin resistance in the development of diabetes and heart disease, establishing appropriate levels of fat in the diet is an important clinical goal.
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Affiliation(s)
- Jennifer C Lovejoy
- Women's Nutrition Research Program, Pennington Biomedical Research Center, Louisiana State University, 6400 Perkins Road, Baton Rouge, LA 70808, USA.
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Paeratakul S, Lovejoy JC, Ryan DH, Bray GA. The relation of gender, race and socioeconomic status to obesity and obesity comorbidities in a sample of US adults. Int J Obes (Lond) 2002; 26:1205-10. [PMID: 12187397 DOI: 10.1038/sj.ijo.0802026] [Citation(s) in RCA: 227] [Impact Index Per Article: 10.3] [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: 08/31/2002] [Revised: 01/31/2002] [Accepted: 02/14/2002] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To examine the obesity-related chronic diseases in the US adult population according to gender, race and socioeconomic status. METHODS Data from the 1994-1996 Continuing Survey of Food Intakes by Individuals (1994-1996 CSFII) conducted by the US Department of Agriculture/Agricultural Research Service (USDA/ARS) were used in the analysis. Relevant data included self-reported weight and height, self-reported physician-diagnosed diabetes mellitus, hypertension, heart disease and high serum cholesterol. Analysis was conducted according to gender, race, income level and education level. RESULTS There was a graded increase in diabetes, hypertension and high serum cholesterol with increasing body weight in nearly all gender, racial and socioeconomic groups. Among the obese individuals, the prevalence of hypertension was higher in black subjects and the prevalence of diabetes, hypertension and heart disease was higher in individuals with lower education compared to their counterparts. The odds of having diabetes, hypertension, heart disease and high serum cholesterol increased with increasing body weight after adjusting for age, gender, race, income, education and smoking. CONCLUSION Although cross-sectional in nature, our results suggest that the disease burden associated with obesity in the population may be substantial. This burden increases with increasing severity of obesity. Our findings support the current opinion that, although the nature of obesity-related health risks is similar in all populations, the specific level of risk associated with a given level of obesity may be different depending on gender, race and socioeconomic condition.
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Affiliation(s)
- S Paeratakul
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge 70808, USA.
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