1
|
Mateu-Fabregat J, Papandreou C, Gutierrez-Tordera L, Rojas M, Novau-Ferré N, Mostafa H, Bulló M. Dietary Glycemic Index and Load and Semen Quality: A Cross-Sectional and Prospective Analysis within the FERTINUTS Trial. World J Mens Health 2024; 42:42.e53. [PMID: 38772538 DOI: 10.5534/wjmh.230328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/22/2023] [Accepted: 01/15/2024] [Indexed: 05/23/2024] Open
Abstract
PURPOSE Infertility is a global health issue and nutrition plays a significant role in fertility outcomes. We aimed to investigate the cross-sectional and prospective associations of glycemic index (GI) and glycemic load (GL) with semen quality parameters in a cohort of healthy young men. MATERIALS AND METHODS The study included 106 men aged 18-35 years from the FERTINUTS trial. Dietary intake was estimated through 3-day dietary records and several semen parameters were assessed. Multivariable linear regression analysis with the Least Absolute Shrinkage and Selection Operator (LASSO) approach was employed. RESULTS The cross-sectional analysis revealed positive associations between GI and GL and total sperm count, sperm concentration, and total motility. In the prospective analysis, baseline GI was associated with increases in pH, vitality, immotile sperm or abnormal midpiece and decreases in total sperm count and motility. Conversely, GL was positively associated with changes in vitality and total sperm count. CONCLUSIONS While these findings suggest that GI may have adverse effects on several sperm quality parameters, the results were not consistently observed in the cross-sectional analysis. However, GL was consistently associated with better sperm quality in both analyses. The impact of carbohydrate quality and quantity on fertility remains uncertain and larger prospective studies are needed.
Collapse
Affiliation(s)
- Javier Mateu-Fabregat
- Nutrition and Metabolic Health Research Group, Department of Biochemistry and Biotechnology, Rovira i Virgili University (URV), Reus, Spain
- Institute of Health Pere Virgili (IISPV), Reus, Spain
- Center of Environmental, Food and Toxicological Technology (TecnATox), Rovira i Virgili University, Reus, Spain
| | - Christopher Papandreou
- Nutrition and Metabolic Health Research Group, Department of Biochemistry and Biotechnology, Rovira i Virgili University (URV), Reus, Spain
- Institute of Health Pere Virgili (IISPV), Reus, Spain
- Center of Environmental, Food and Toxicological Technology (TecnATox), Rovira i Virgili University, Reus, Spain
- Department of Nutrition and Dietetics Sciences, School of Health Sciences, Hellenic Mediterranean University, Siteia, Greece.
| | - Laia Gutierrez-Tordera
- Nutrition and Metabolic Health Research Group, Department of Biochemistry and Biotechnology, Rovira i Virgili University (URV), Reus, Spain
- Institute of Health Pere Virgili (IISPV), Reus, Spain
- Center of Environmental, Food and Toxicological Technology (TecnATox), Rovira i Virgili University, Reus, Spain
| | - Melina Rojas
- Nutrition and Metabolic Health Research Group, Department of Biochemistry and Biotechnology, Rovira i Virgili University (URV), Reus, Spain
- Institute of Health Pere Virgili (IISPV), Reus, Spain
- Center of Environmental, Food and Toxicological Technology (TecnATox), Rovira i Virgili University, Reus, Spain
| | - Nil Novau-Ferré
- Nutrition and Metabolic Health Research Group, Department of Biochemistry and Biotechnology, Rovira i Virgili University (URV), Reus, Spain
- Institute of Health Pere Virgili (IISPV), Reus, Spain
- Center of Environmental, Food and Toxicological Technology (TecnATox), Rovira i Virgili University, Reus, Spain
| | - Hamza Mostafa
- Nutrition and Metabolic Health Research Group, Department of Biochemistry and Biotechnology, Rovira i Virgili University (URV), Reus, Spain
- Institute of Health Pere Virgili (IISPV), Reus, Spain
- Center of Environmental, Food and Toxicological Technology (TecnATox), Rovira i Virgili University, Reus, Spain
| | - Mònica Bulló
- Nutrition and Metabolic Health Research Group, Department of Biochemistry and Biotechnology, Rovira i Virgili University (URV), Reus, Spain
- Institute of Health Pere Virgili (IISPV), Reus, Spain
- Center of Environmental, Food and Toxicological Technology (TecnATox), Rovira i Virgili University, Reus, Spain
- CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, Madrid, Spain.
| |
Collapse
|
2
|
Barragán R, Zuraikat FM, Tam V, RoyChoudhury A, St-Onge MP. Changes in eating patterns in response to chronic insufficient sleep and their associations with diet quality: a randomized trial. J Clin Sleep Med 2023; 19:1867-1875. [PMID: 37409467 PMCID: PMC10620656 DOI: 10.5664/jcsm.10696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 06/20/2023] [Accepted: 06/22/2023] [Indexed: 07/07/2023]
Abstract
STUDY OBJECTIVES Insufficient sleep leads to overconsumption, but the factors contributing to this effect are poorly understood. Therefore, we assessed the influence of prolonged curtailment of sleep on free-living eating patterns linked with overconsumption and explored associations of these eating patterns with diet quality under different sleep conditions. METHODS Sixty-five adults (47 females) participated in outpatient randomized crossover studies with two 6-week conditions: adequate sleep (7-9 h/night) and sleep restriction (-1.5 h/night relative to screening). Food records were collected over 3 nonconsecutive days, from which we ascertained data on eating frequency, midpoint, and window and intakes of energy and nutrients. Linear mixed models were used to assess the impact of sleep condition on change in eating pattern (sleep × week interaction) and the relation between eating patterns and dietary intakes (sleep × eating pattern interaction). RESULTS Sleep condition impacted the change in eating frequency across weeks, with eating frequency increasing in sleep restriction relative to adequate sleep (β = 0.3 ± 0.1; P = .046). Across conditions, eating more frequently tended to relate to higher energy intakes (β = 60.5 ± 34.6; P = .082). Sleep also influenced the relation of variability in eating midpoint with intakes of saturated fat (β = 6.0 ± 2.1; P = .005), polyunsaturated fat (β = -3.9 ± 2.0; P = .051), and added sugar (β = 17.3 ± 6.2; P = .006), with greater midpoint variability associated with more adverse changes in these diet quality components in sleep restriction vs adequate sleep. CONCLUSIONS Chronic short sleep increases eating frequency and adversely influences associations of variability in meal timing with components of diet quality. These findings help to explain how short sleep leads to overconsumption and obesity. CLINICAL TRIAL REGISTRATION Registry: ClinicalTrials.gov; Name: Impact of Sleep Restriction in Women; URL: https://clinicaltrials.gov/ct2/show/NCT02835261; Identifier: NCT02835261 and Name: Impact of Sleep Restriction on Performance in Adults; URL: https://clinicaltrials.gov/ct2/show/NCT02960776; Identifier: NCT02960776. CITATION Barragán R, Zuraikat FM, Tam V, RoyChoudhury A, St-Onge M-P. Changes in eating patterns in response to chronic insufficient sleep and their associations with diet quality: a randomized trial. J Clin Sleep Med. 2023;19(11):1867-1875.
Collapse
Affiliation(s)
- Rocío Barragán
- Department of Preventive Medicine and Public Health, School of Medicine, University of Valencia, Valencia, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Center of Excellence for Sleep & Circadian Research, Department of Medicine, Columbia University Irving Medical Center, New York, New York
| | - Faris M. Zuraikat
- Center of Excellence for Sleep & Circadian Research, Department of Medicine, Columbia University Irving Medical Center, New York, New York
- Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, New York
- Institute of Human Nutrition, College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York
| | - Victoria Tam
- Institute of Human Nutrition, College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York
| | - Arindam RoyChoudhury
- Division of Biostatistics, Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, New York
| | - Marie-Pierre St-Onge
- Center of Excellence for Sleep & Circadian Research, Department of Medicine, Columbia University Irving Medical Center, New York, New York
- Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, New York
- Institute of Human Nutrition, College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York
| |
Collapse
|
3
|
Assi MJ, Poursalehi D, Tirani SA, Shahdadian F, Hajhashemy Z, Mokhtari E, Mohammadi S, Saneei P. Legumes and nuts intake in relation to metabolic health status, serum brain derived neurotrophic factor and adropin levels in adults. Sci Rep 2023; 13:16455. [PMID: 37777675 PMCID: PMC10542386 DOI: 10.1038/s41598-023-43855-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 09/29/2023] [Indexed: 10/02/2023] Open
Abstract
There is controversial evidence about the relationship between consumption of legumes and nuts with metabolic disturbances. The present study was undertaken to explore the association of legumes and nuts intake with metabolic health status among Iranian adults. This cross-sectional study was conducted on 527 adults (45.7% female, aged 20-65 years) chosen through a multistage cluster random-sampling approach. Dietary intakes of individuals were assessed using a validated food frequency questionnaire. Fasting blood samples were gathered to evaluate biochemical parameters. Metabolic health status of subjects was determined according to the criteria defined by Wildman. Data of covariates were collected using pre-tested procedures. The overall prevalence of metabolic unhealthy (MU) phenotype was 42.5%. After controlling all confounders, participants with highest intake of legumes and nuts had lower odds of MU status, compared with the lowest intake (OR 0.35; 95% CI 0.18-0.71). This association was stronger in normal-weight rather than overweight/obese adults and also in women rather than men. Higher consumption of legumes and nuts was additionally related to decreased odds of hyperglycemia, hypertriglyceridemia, and hypertension. A marginally inverse association was observed between legumes and nuts intake with low brain-derived neurotrophic factor (BDNF) levels, in fully-adjusted model (ORT3 vs. T1 0.50; 95% CI 0.25-1.01). Each tertile increase in legumes and nuts intake was marginally related to higher adropin levels ([Formula: see text] = 4.06; P = 0.07). In conclusion, this study demonstrated that higher intake of legumes and nuts is associated with lower chance of MU both in normal weight and overweight/obese adults. The association may be facilitated through serum BDNF and adropin.
Collapse
Affiliation(s)
- Mohammad Javad Assi
- Students' Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, PO Box 81745-151, Isfahan, Iran
| | - Donya Poursalehi
- Students' Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, PO Box 81745-151, Isfahan, Iran
| | - Shahnaz Amani Tirani
- Students' Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, PO Box 81745-151, Isfahan, Iran
| | - Farnaz Shahdadian
- Students' Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Clinical Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Hajhashemy
- Students' Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, PO Box 81745-151, Isfahan, Iran
| | - Elahe Mokhtari
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, PO Box 81745-151, Isfahan, Iran
| | - Sobhan Mohammadi
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, PO Box 81745-151, Isfahan, Iran
| | - Parvane Saneei
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, PO Box 81745-151, Isfahan, Iran.
| |
Collapse
|
4
|
Moslehi N, Golzarand M, Mirmiran P, Hosseinpanah F, Azizi F. Macronutrient quality and the incidence of metabolically unhealthy phenotypes in adults with normal weight and overweight/obesity. Obes Res Clin Pract 2023; 17:369-377. [PMID: 37696712 DOI: 10.1016/j.orcp.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 08/15/2023] [Accepted: 09/04/2023] [Indexed: 09/13/2023]
Abstract
OBJECTIVE We aimed to investigate the associations of macronutrient quality indices with the incident metabolically unhealthy normal weight (MUNW) and metabolically unhealthy overweight/obesity (MUO) phenotypes. METHODS This prospective study included 512 metabolically healthy normal weight and 787 metabolically healthy overweight/obese adults from the third study examination of the Tehran Lipid and Glucose Study. The participants were followed through the sixth study examination. Diet was measured with a food frequency questionnaire. The macronutrient quality index (MQI), carbohydrate quality index (CQI), fat quality index (FQI), and healthy plate quality index (HPPQI) were calculated. Hazard ratio (HR) and 95 % confidence interval (95 % CI) were estimated for incident unhealthy phenotypes using Cox regression. RESULTS After controlling all possible confounding factors, a one-point higher HPPQI was linked to a 28 % lower risk of MUNW (HR = 0.72; 95 % CI = 0.59, 0.87). Compared to the lowest quartile, the incident MUNW was also lower in the two last quartiles of the HPPQI. A one-unit increase in MQI was associated with a 5 % lower incident MUO (HR = 0.95; 95 % CI = 0.92, 0.99). The incident MUO was also higher for the highest compared to the lowest MQI quartile. In quartiles 2-4 of the HPPQI, incident MUO was lower with respective HRs (95 % CI) of 0.71 (0.54, 0.93), 0.60 (0.45, 0.80), and 0.66 (0.50, 0.86) in the fully-adjusted model. CONCLUSIONS A higher overall macronutrient quality was independently associated with a lower incident MUO. A higher dietary protein quality was related to a lower risk for MUNW and MUO.
Collapse
Affiliation(s)
- Nazanin Moslehi
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Mahdieh Golzarand
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parvin Mirmiran
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Farhad Hosseinpanah
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
5
|
Nikrad N, Hosseini B, Pakmehr A, Tousi AZ, Ardekani AM, Farhangi MA, Akhavan-Sigari R. Dietary carbohydrate quality index (CQI), cardio-metabolic risk factors and insulin resistance among adults with obesity. BMC Endocr Disord 2023; 23:171. [PMID: 37568117 PMCID: PMC10416415 DOI: 10.1186/s12902-023-01420-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 07/21/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Metabolic syndrome (MetS), as a cluster of cardiometabolic risk factors, is a global public health concern due to its increasing prevalence. Considering the previous evidence of the association between carbohydrate quality and cardiometabolic risk factors, our study was aimed to evaluate any possible association between carbohydrate quality index (CQI) and cardiometabolic risk factors among obese adults. METHODS In this cross-sectional study, 336 apparently healthy individuals with obesity were participated. Dietary intake was assessed by a semi-quantitative Food Frequency Questionnaire (FFQ), including 168 food items validated for the Iranian population. CQI was calculated with three components of solid carbohydrates to total carbohydrates ratio, dietary fiber intake, and dietary glycemic index (GI). Body composition was determined by bioelectrical impedance analysis (BIA). Blood pressure was measured by sphygmomanometer and enzymatic methods were used to evaluate serum lipid, glucose, and insulin concentrations. RESULTS Subjects in the third quartile of CQI had significantly lower systolic blood pressure (SBP) (P = 0.03) and diastolic blood pressure (DBP) (P = 0.01). Participants in the higher quartiles of CQI had more intake of energy, carbohydrates, fat, saturated fatty acid (SFA), and mono-saturated fatty acid (MUFA) (P < 0.05). Moreover, the homeostasis model assessment of insulin resistance (HOMA-IR) was decreased in the second quartile of CQI [odds ratio (OR) = 0.146, P = 0.01) after adjustment for age, body mass index (BMI), sex, physical activity, socioeconomic status (SES) and energy intake. CONCLUSION According to our findings, a higher quality of dietary carbohydrates, determined by CQI, could be associated with a lower risk of hypertension.
Collapse
Affiliation(s)
- Negin Nikrad
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Babak Hosseini
- Department of Surgery, School of Medicine, Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Azin Pakmehr
- Tehran University of Medical Sciences, Tehran, Iran
| | - Ayda Zahiri Tousi
- Razavi Cancer Research Center, Razavi Hospital, Imam Reza International University, Mashhad, Iran
| | - Abnoos Mokhtari Ardekani
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Science, & Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran.
| | | | - Reza Akhavan-Sigari
- Department of Neurosurgery, University Medical Center Tuebingen, Tuebingen, Germany
- Department of Health Care Management and Clinical Research, Collegium Humanum Warsaw Management University, Warsaw, Poland
| |
Collapse
|
6
|
Jarvis PRE, Cardin JL, Nisevich-Bede PM, McCarter JP. Continuous glucose monitoring in a healthy population: understanding the post-prandial glycemic response in individuals without diabetes mellitus. Metabolism 2023:155640. [PMID: 37356796 DOI: 10.1016/j.metabol.2023.155640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 06/17/2023] [Accepted: 06/19/2023] [Indexed: 06/27/2023]
Abstract
Continuous glucose monitoring has become a common adjunct in the management of Diabetes Mellitus. However, there has been a recent trend among individuals without diabetes using these devices as a means of monitoring their health. The increased visibility of glucose data has allowed users to study the effect lifestyle has upon post-prandial glucose levels. Although post-prandial hyperglycemia is well understood in the setting of diabetes, its impact in individuals without diabetes is less well defined. This article reviews the factors which contribute to post-prandial hyperglycemia in individuals without diabetes and how the data obtained from continuous glucose monitoring can be used to improve an individual's metabolic health.
Collapse
Affiliation(s)
| | | | | | - James P McCarter
- Medical and Clinical Affairs, Abbott Laboratories, Alameda, CA, USA; Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA.
| |
Collapse
|
7
|
Taren D, Alaofè H, Yamanaka AB, Coleman P, Fleming T, Aflague T, Shallcross L, Wilkens L, Novotny R. Diet and Acanthosis Nigricans over a Two-Year Period in Children of the Pacific Region. Nutrients 2023; 15:2718. [PMID: 37375623 DOI: 10.3390/nu15122718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 05/31/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND The impact that dietary carbohydrates have on children developing type 2 diabetes remains controversial. Furthermore, there are limited pediatric longitudinal studies on changes in body mass index (BMI) and diet related to the development of acanthosis nigricans (AN), a risk factor associated with type 2 diabetes. METHODS Two 24 h dietary records were collected for 558 children, 2-8 years of age, at baseline and at a 2-year follow-up. Data on age, sex, BMI, and the presence of AN were also collected at each time point from the Children's Healthy Living Program. Logistic regression was used to determine factors associated with the presence of AN at follow-up. Multinominal regression was used to determine factors associated with changes in AN status. Linear regression was used to measure the associations between changes in dietary intake and in the Burke Score for AN. RESULTS AN was present in 28 children at baseline and 34 children at follow-up. Adjusting for the presence of AN at baseline, age, sex, study group, baseline BMI, change in BMI z-score, time between assessments, and baseline intake, an increase from baseline for each teaspoon of sugar and serving of carbohydrate-rich food increased the risk for having AN at follow-up by 9% and 8%, respectively (p ≤ 0.05). An increased intake of added sugar (teaspoons) increased the risk of developing AN by 13% (p ≤ 0.01) and an increase in servings of foods rich in starch increased the risk of developing AN by 12% (p ≤ 0.01) compared to children who never had AN. Increasing the intake of fruit was also associated with decreased Burke Scores using multiple regression. However, the intake of energy and macronutrients were not associated with AN. CONCLUSIONS Added sugar and foods rich in starch were independently associated with the occurrence of AN, suggesting the type of carbohydrates consumed is a factor in AN occurrence.
Collapse
Affiliation(s)
- Douglas Taren
- Section of Nutrition, Department of Pediatrics, School of Medicine, University of Colorado, Aurora, CO 80045, USA
| | - Halimatou Alaofè
- Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA
| | - Ashley B Yamanaka
- Human Nutrition, Food and Animal Sciences Department, College of Tropical Agriculture and Human Resources, University of Hawai'i at Mānoa, Honolulu, HI 96822, USA
| | - Patricia Coleman
- Cooperative Research, Extension, and Education Service, Northern Marianas College, Saipan, MP 96950, USA
| | - Travis Fleming
- Agriculture, Community and Natural Resources Division, Samoa Community College, Pago Pago, AS 96799, USA
| | - Tanisha Aflague
- Cooperative Extension and Outreach, College of Natural and Applied Sciences, University of Guam, Mangilao, GU 96913, USA
| | - Leslie Shallcross
- Health, Home and Family Development, UAF Institute of Agriculture, Natural Resources and Extension, University of Alaska Fairbanks, Fairbanks, AK 99775, USA
| | - Lynne Wilkens
- Biostatistics Shared Resource, University of Hawai'i Cancer Center, University of Hawai'i at Mānoa, Honolulu, HI 96813, USA
| | - Rachel Novotny
- Human Nutrition, Food and Animal Sciences Department, College of Tropical Agriculture and Human Resources, University of Hawai'i at Mānoa, Honolulu, HI 96822, USA
| |
Collapse
|
8
|
Kordowski A, Tetzlaff-Lelleck VV, Speckmann B, Loh G, Künstner A, Schulz F, Schröder T, Smollich M, Sina C, tom Dieck H. A nutritional supplement based on a synbiotic combination of Bacillus subtilis DSM 32315 and L-alanyl-L-glutamine improves glucose metabolism in healthy prediabetic subjects - A real-life post-marketing study. Front Nutr 2022; 9:1001419. [PMID: 36570155 PMCID: PMC9773202 DOI: 10.3389/fnut.2022.1001419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 11/15/2022] [Indexed: 12/13/2022] Open
Abstract
Introduction Impaired glucose homeostasis is a significant risk factor for cardiometabolic diseases, whereas the efficacy of available standard therapies is limited, mainly because of poor adherence. This post-marketing study assessed the glucose-lowering potential of a synbiotic-based formulation. Methods One hundred ninety-two participants were enrolled in a digital nutrition program with continuous glucose monitoring (CGM) and received a study product comprising Bacillus subtilis DSM 32315 and L-alanyl-L-glutamine. Participants underwent a first sensor phase without supplementation, followed by a 14-day supplementation phase without sensor, and completed by a second sensor phase while continuing supplementation. Fasting glucose levels were determined before and after supplementation by CGM. In addition, the postprandial glycemic response to an oral glucose challenge, body weight, HbA1c concentrations, and BMI was analyzed. Subgroup analyses of subjects with elevated glucose and HbA1c levels vs. normoglycemic subjects were performed. Results Supplementation with the study product resulted in significant improvements in glucose parameters (delta values: fasting glucose -2,13% ± 8.86; iAUC0-120 -4.91% ± 78.87; HbA1c: -1.20% ± 4.72) accompanied by a significant weight reduction (-1.07 kg ± 2.30) in the study population. Subgroup analyses revealed that the improvements were mainly attributed to a prediabetic subgroup with elevated fasting glucose and HbA1c values before supplementation (delta values: fasting glucose -6.10% 4± 7.89; iAUC0-120 -6.28% ± 115.85; HbA1c -3.31% ± 4.36; weight: -1.47 kg ± 2.82). Conclusion This study indicates that the synbiotic composition is an effective and convenient approach to counteract hyperglycemia. Further placebo-controlled studies are warranted to test its efficacy in the treatment of cardiometabolic diseases.
Collapse
Affiliation(s)
- Anna Kordowski
- Institute of Nutritional Medicine, University Hospital Schleswig-Holstein, University of Lübeck, Lübeck, Germany,*Correspondence: Anna Kordowski,
| | | | | | - Gunnar Loh
- Evonik Operations GmbH, Hanau-Wolfgang, Germany
| | - Axel Künstner
- Perfood GmbH, Research and Development, Lübeck, Germany
| | | | - Torsten Schröder
- Institute of Nutritional Medicine, University Hospital Schleswig-Holstein, University of Lübeck, Lübeck, Germany,Perfood GmbH, Research and Development, Lübeck, Germany
| | - Martin Smollich
- Institute of Nutritional Medicine, University Hospital Schleswig-Holstein, University of Lübeck, Lübeck, Germany
| | - Christian Sina
- Institute of Nutritional Medicine, University Hospital Schleswig-Holstein, University of Lübeck, Lübeck, Germany
| | | |
Collapse
|
9
|
Khodarahmi M, Siri G, Erahimzadeh F, Farhangi MA, Shanehbandi D. Dietary glycemic index and glycemic load mediate the effect of CARTPT rs2239670 gene polymorphism on metabolic syndrome and metabolic risk factors among adults with obesity. BMC Endocr Disord 2022; 22:288. [PMID: 36404325 PMCID: PMC9677654 DOI: 10.1186/s12902-022-01188-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 10/25/2022] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The importance of genetic and dietary factors in occurrence and progression of chronic diseases such as metabolic syndrome (MetS) has been established. However, complex interrelationships, including direct and indirect effects of these variables are yet to be clarified. So, our aim was to investigate the mediating role of glycemic indices in the relationship between CARTPT rs2239670 polymorphism, socio-demographic and psychological factors and metabolic risk factors and the presence of MetS in adults with obesity. METHODS In a cross-sectional study of 288 apparently healthy adults with obesity aged 20-50 years, dietary glycemic index (GI) and glycemic load (GL) were measured using a validated semi-quantitative food frequency questionnaire (FFQ). Biochemical parameters, blood pressure and anthropometric indicators were assayed by standard methods. Genotyping was carried out by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. Structural equation modeling (SEM) was used in the statistical analysis. RESULTS CARTPT rs2239670 had a positive direct effect on MetS (B = 0.037 ± 0.022; P = 0.043) and, on the other hand, this variant was found to be indirectly associated with MetS presence through mediation of GI (B = 0.039 ± 0.017; P = 0.009). CARTPT was a significant predictor of both dietary GI and GL (B = 1.647 ± 0.080 and B = 3.339 ± 0.242, respectively). Additionally, glycemic indicators appeared to mediate the association of age and gender with LDL-C (B = 0.917 ± 0.332; P = 0.006) and HDL (B = 1.047 ± 0.484; P = 0.031), respectively. GI showed a positive relationship with LDL-C (P = 0.024) in men and similar relationships were found between GL and LDL-C (P = 0.050) and cholesterol (P = 0.022) levels in women. CONCLUSION The SEM findings suggest a hypothesis of the mediating effect of glycemic indices in the relationship between genetic susceptibility to obesity and MetS presence. Our findings need to be confirmed with large prospective studies.
Collapse
Affiliation(s)
- Mahdieh Khodarahmi
- Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Goli Siri
- Department of Internal Medicine, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnoosh Erahimzadeh
- Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Dariush Shanehbandi
- Molecular Medicine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
10
|
Jun S, Lee S, Lee J, Kim J. Diets high in glycemic index and glycemic load are associated with an increased risk of metabolic syndrome among Korean women. Nutr Metab Cardiovasc Dis 2022; 32:1154-1164. [PMID: 35256231 DOI: 10.1016/j.numecd.2022.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 01/10/2022] [Accepted: 01/11/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND AIMS Accurate estimation of the glycemic index (GI) and glycemic load (GL) of diets is essential when assessing health implications of dietary GI and GL. The present study aimed to estimate dietary GI and GL utilizing the updated GI tables with a large number of new, reliable GI values and assess their associations with metabolic syndrome among Korean adults. METHODS AND RESULTS We analyzed data from 3317 men and 6191 women for this cross-sectional study. Dietary intake was assessed with a validated food frequency questionnaire. Metabolic syndrome and its components were defined based on the harmonized criteria with Korean-specific cutoffs for waist circumference. Multivariate logistic regression was used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Compared with women in the lowest quintiles of energy-adjusted dietary GI and GL, women in the highest quintiles had significantly greater risks of metabolic syndrome (GI, OR = 1.56, 95% CI = 1.18-2.06; GL, OR = 1.80, 95% CI = 1.27-2.57), elevated blood pressure, reduced high-density lipoprotein cholesterol (HDL-C, both GI and GL), elevated triglycerides (GI only), elevated waist circumference, and elevated fasting glucose (GL only). Among men, no significant association was noted except for a higher risk of reduced HDL-C (OR = 1.59, 95% CI = 1.01-2.29) in the highest quintile of energy-adjusted dietary GI than in the lowest quintile. CONCLUSION Our findings suggest that dietary GI and GL are positively associated with metabolic syndrome risk among women, but not men, in Korea.
Collapse
Affiliation(s)
- Shinyoung Jun
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang-si, Republic of Korea
| | - Seohyun Lee
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang-si, Republic of Korea
| | - Jeonghee Lee
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang-si, Republic of Korea
| | - Jeongseon Kim
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang-si, Republic of Korea.
| |
Collapse
|
11
|
Majdi M, Imani H, Bazshahi E, Hosseini F, Djafarian K, Lesani A, Akbarzade Z, Shab-Bidar S. Habitual- and Meal-Specific Carbohydrate Quality Index and Their Relation to Metabolic Syndrome in a Sample of Iranian Adults. Front Nutr 2022; 9:763345. [PMID: 35433797 PMCID: PMC9011184 DOI: 10.3389/fnut.2022.763345] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 02/07/2022] [Indexed: 12/16/2022] Open
Abstract
Aim Most studies on diet quality have focused on the habitual and overall intake of foods without considering intakes at specific eating occasions. This study aimed to assess the association between habitual- and meal-specific carbohydrate quality index (CQI) and metabolic syndrome (MetS) in Iranian adults. Methods In this cross-sectional study, data from 850 participants were analyzed. Dietary information was obtained from a 3-day nonconsecutive 24 h recall. CQI was calculated from three criteria: dietary fiber, glycemic index, and solid carbohydrate/total carbohydrate ratio. The association between CQI and MetS was assessed by logistic regression. Results The prevalences of MetS in the lowest and highest tertile of CQI were 30.1 and 33.7, respectively (P = 0.6). In habitual diet and all the three meals, we failed to find any significant association between tertiles of CQI and MetS either before or after adjustment for covariates. However, in the habitual meals [odds ratio (OR): 0.69, 95% CI: 0.47–0.96] and lunch meals (OR: 0.66; 95% CI: 0.47–0.94), the highest CQI in comparison to the lowest one, significantly decreased the low high-density lipoprotein (HDL). In addition, the trend of low-HDL with CQI in habitual meal and lunch meal was statistically significant. Conclusion The results of this study showed that CQI was not associated with MetS and its components. Further investigations into the mechanisms underlying the role of carbohydrate quality in developing metabolic disorders are warranted.
Collapse
Affiliation(s)
- Maryam Majdi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Imani
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Bazshahi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Hosseini
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Kurosh Djafarian
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Azadeh Lesani
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Akbarzade
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- *Correspondence: Sakineh Shab-Bidar
| |
Collapse
|
12
|
Kordowski A, Künstner A, Schweitzer L, Theis S, Schröder T, Busch H, Sina C, Smollich M. PalatinoseTM (Isomaltulose) and Prebiotic Inulin-Type Fructans Have Beneficial Effects on Glycemic Response and Gut Microbiota Composition in Healthy Volunteers—A Real-Life, Retrospective Study of a Cohort That Participated in a Digital Nutrition Program. Front Nutr 2022; 9:829933. [PMID: 35340549 PMCID: PMC8948463 DOI: 10.3389/fnut.2022.829933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 01/27/2022] [Indexed: 11/16/2022] Open
Abstract
It is well-appreciated that the diet is a crucial tool to counteract cardiometabolic disturbances due to its impact on blood glucose concentration and gut microbiome. This retrospective analysis aimed to examine whether the inclusion of isomaltulose and prebiotic inulin-type fructans (ITF) into the habitual diet has an impact on glycemic control and gut microbiota. Furthermore, we examined interindividual differences in glycemic response to sugar replacement with isomaltulose. We retrospectively analyzed data of 117 individuals who participated in a digital nutrition program including a 14-day continuous glucose measurement. Participants underwent six test days with sweetened drinks (isomaltulose vs. sucrose) consumed with their usual breakfasts and lunches. Dinner was supplemented with ITF for 11 days. Postprandial glycemia and 24 h-glycemic variability were determined following test meals and days, respectively. Fecal microbiota was analyzed by 16S rRNA sequencing before and after test phase. Meals with isomaltulose-sweetened drinks compared to meals with sucrose-sweetened drinks induced lower postprandial glycemia. Moreover, glucose oscillations over 24 h were lower on isomaltulose when compared to sucrose test days and improved further during ITF supplementation. Furthermore, ITF modulated gut microbiota composition beneficially. Responder analysis revealed that 72% of participants benefited from the sugar replacement with isomaltulose and that their gut microbiota differed from the low responders. Taken together, the incorporation of isomaltulose and ITF into the habitual diet was shown to be an effective strategy to improve glucose control and beneficially modulate gut microbiota, and thereby aid to maintain metabolic health. Data indicate interindividual differences in glycemic response to ingredients and suggest that gut microbiota might be somehow related to it.
Collapse
Affiliation(s)
- Anna Kordowski
- Institute of Nutritional Medicine, University Hospital of Schleswig-Holstein, Campus Lübeck and University of Lübeck, Lübeck, Germany
| | - Axel Künstner
- Group of Medical Systems Biology, Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
| | | | | | - Torsten Schröder
- Institute of Nutritional Medicine, University Hospital of Schleswig-Holstein, Campus Lübeck and University of Lübeck, Lübeck, Germany
- Perfood GmbH, Lübeck, Germany
| | - Hauke Busch
- Group of Medical Systems Biology, Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
| | - Christian Sina
- Institute of Nutritional Medicine, University Hospital of Schleswig-Holstein, Campus Lübeck and University of Lübeck, Lübeck, Germany
| | - Martin Smollich
- Institute of Nutritional Medicine, University Hospital of Schleswig-Holstein, Campus Lübeck and University of Lübeck, Lübeck, Germany
- *Correspondence: Martin Smollich
| |
Collapse
|
13
|
Aoun R, Chokor FAZ, Taktouk M, Nasrallah M, Ismaeel H, Tamim H, Nasreddine L. Dietary fructose and its association with the metabolic syndrome in Lebanese healthy adults: a cross-sectional study. Diabetol Metab Syndr 2022; 14:29. [PMID: 35139893 PMCID: PMC8827166 DOI: 10.1186/s13098-022-00800-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 01/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Epidemiological studies investigating the association between dietary fructose intake and the metabolic syndrome (MetS) are scarce and have produced controversial findings. This study aimed at (1) assessing total dietary fructose intake in a sample of Lebanese healthy adults, and determining the intake levels of natural vs. added fructose; (2) investigating the association of dietary fructose with MetS; and (3) identifying the socioeconomic and lifestyle factors associated with high fructose intake. METHODS A cross-sectional survey was conducted on a representative sample of adults living in Beirut, Lebanon (n = 283). Anthropometric and biochemical data were collected, and dietary intake was assessed using a food frequency questionnaire. Intakes of naturally-occurring fructose from fructose-containing food sources, such as fruits, vegetables, honey, were considered as "natural fructose". Acknowledging that the most common form of added sugar in commodities is sucrose or High Fructose Corn Syrup (HFCS), 50% of added sugar in food products was considered as added fructose. Total dietary fructose intake was calculated by summing up natural and added fructose intakes. Logistic regression analyses were conducted to investigate the association of total, added and natural fructose intakes with the MetS and to identify the socioeconomic predictors of high fructose intake. RESULTS Mean intake of total fructose was estimated at 51.42 ± 35.54 g/day, representing 6.58 ± 3.71% of energy intakes (EI). Natural and added fructose intakes were estimated at 12.29 ± 8.57 and 39.12 ± 34.10 g/day (1.78 ± 1.41% EI and 4.80 ± 3.56% EI), respectively. Participants in the highest quartile of total and added fructose intakes had higher odds of MetS (OR = 2.84, 95%CI: 1.01, 7.94 and OR = 3.18, 95%CI: 1.06, 9.49, respectively). In contrast, natural fructose intake was not associated with MetS. Age, gender and crowding index were identified as factors that may modulate dietary fructose intakes. CONCLUSIONS The observed association between high added fructose intake and the MetS highlights the need for public health strategies aimed at limiting sugar intake from industrialized foods and promoting healthier dietary patterns in Lebanon.
Collapse
Affiliation(s)
- Rita Aoun
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Fatima Al Zahraa Chokor
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Mandy Taktouk
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Mona Nasrallah
- Department of Internal Medicine, Division of Endocrinology, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
- Vascular Medicine Program, American University of Beirut Medical Center, Beirut, Lebanon
| | - Hussain Ismaeel
- Vascular Medicine Program, American University of Beirut Medical Center, Beirut, Lebanon
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Hani Tamim
- Department of Internal Medicine, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
- Clinical Research Institute, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
| | - Lara Nasreddine
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon.
| |
Collapse
|
14
|
Dwivedi AK, Dubey P, Reddy SY, Clegg DJ. Associations of Glycemic Index and Glycemic Load with Cardiovascular Disease: Updated Evidence from Meta-analysis and Cohort Studies. Curr Cardiol Rep 2022; 24:141-161. [PMID: 35119682 DOI: 10.1007/s11886-022-01635-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/02/2021] [Indexed: 02/01/2023]
Abstract
PURPOSE OF REVIEW Diet and lifestyle patterns are considered major contributory factors for cardiovascular disease (CVD) and mortality. In particular, consuming a diet higher in carbohydrates (not inclusive of fruits and vegetables, but more processed carbohydrates) has been associated with metabolic abnormalities that subsequently may increase the risk of CVD and related mortality. Glycemic index (GI) and glycemic load (GL) are values given to foods based on how fast the body converts carbohydrates into glucose also referred to as the glycemic burden of carbohydrates from foods. Conflicting associations of how high GI and GL influence CVDs have been observed even in high-quality meta-analysis studies. We synthesize and report the associations of high GI and GL with various CVDs by sex, obesity, and geographical locations using an updated review of meta-analysis and observational studies. RECENT FINDINGS We identified high GI or high GL is associated with an increased risk of CVD events including diabetes (DM), metabolic syndrome (MS), coronary heart disease (CHD), stroke, and stroke mortality in the general population, and the risk of CVD outcomes appears to be stratified by sex, obesity status, and preexisting CVD. Both high GI and GL are associated with DM and CHD in the general population. However, high GI is strongly associated with DM/MS, while high GL is strongly associated with an increased risk of CHD in females. In addition, high GL is also associated with incident stroke, and appears to be associated with CVD mortality in subjects with preexisting CVD or high BMI and all-cause mortality in non-obese DM subjects. However, high GI appears to be associated with CVD or all-cause mortality only in females without CVD. High GI/GL is an important risk factor for CVD outcomes in the general population. High GI seems to be markedly associated with DM/MS, and it may enhance the risk of CVD or all-cause mortality in both sexes and predominately females. Although both high GI and high GL are risk factors for CHD in females, high GL is associated with CVD outcomes in at-risk populations for CVD. These data suggest that while high GI increases the propensity of CVD risk factors and mortality in healthy individuals, high GL contributes to the risk of severe heart diseases including CVD or all-cause mortality, particularly in at-risk populations. These data indicate dietary interventions designed for focusing carbohydrate quality by lowering both GI and GL are recommended for preventing CVD outcomes across all populations.
Collapse
Affiliation(s)
- Alok Kumar Dwivedi
- Division of Biostatistics & Epidemiology, Department of Molecular and Translational Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, 5001 El Paso Drive, TX, 79905, USA.
| | - Pallavi Dubey
- Department of Obstetrics & Gynecology, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, 4800 Alberta Avenue, El Paso, TX, 79905, USA
| | - Sireesha Y Reddy
- Department of Obstetrics & Gynecology, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, 4800 Alberta Avenue, El Paso, TX, 79905, USA
| | - Deborah J Clegg
- Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, 4800 Alberta Avenue, El Paso, TX, 79905, USA
| |
Collapse
|
15
|
Fernandes AC, Marinho AR, Lopes C, Ramos E. Dietary glycemic load and its association with glucose metabolism and lipid profile in young adults. Nutr Metab Cardiovasc Dis 2022; 32:125-133. [PMID: 34893403 DOI: 10.1016/j.numecd.2021.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 09/08/2021] [Accepted: 10/01/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIM To evaluate the association of Glycemic Load (GL) with glucose metabolism and blood lipids among young adults. METHODS AND RESULTS This study included 1538 participants (51% females), evaluated at 21 years of age as part of the EPITeen cohort. The GL of each individual was obtained from the assessment of their dietary intake by using a 86-item semi-quantitative food frequency questionnaire. The evaluation included anthropometric measurements and a fasting blood sample was used to measure glucose, insulin, triglycerides, total cholesterol, high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C). Insulin resistance was calculated based on the homeostasis model method (HOMA-IR). The association between the GL and the biochemical parameters was evaluated by linear regression models using β and 95% confidence intervals (95% CI), stratified by sex and adjusted for body mass index (BMI), energy and fiber intake, and self-perceived social class. No association was found between GL and the glucose metabolism parameters after adjustment. Regarding blood lipids, a positive association was found with LDL-C (β = 1.507, 95% CI 0.454; 2.561 for females; β = 0.216, 95% CI -0.587; 1.020 for males) and a negative association with HDL-C (β = -0.647, 95% CI -1.112; -0.181 for females; β = -0.131, 95% CI -0.422; 0.160 for males). CONCLUSIONS Our results suggest that, in healthy young subjects, a high GL diet may have a negative impact on lipid profile.
Collapse
Affiliation(s)
| | - Ana Rita Marinho
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Portugal
| | - Carla Lopes
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Portugal
| | - Elisabete Ramos
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Portugal.
| |
Collapse
|
16
|
Janbozorgi N, Djafarian K, Mohammadpour S, Zareie Abyane M, Zameni M, Badeli M, Akbarzade Z, C. T. Clark C, Shab-Bidar S. Association between carbohydrate quality index and general and central obesity in adults: A population-based study in Iran. J Cardiovasc Thorac Res 2021; 13:298-308. [PMID: 35047134 PMCID: PMC8749369 DOI: 10.34172/jcvtr.2021.47] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 09/07/2021] [Accepted: 09/24/2021] [Indexed: 12/18/2022] Open
Abstract
Introduction: To determine whether dietary carbohydrates quality index (CQI), glycemic index, and glycemic load is associated with general and abdominal obesity.
Methods: 850 participants, 20 to 59 years old, were enrolled in a cross-sectional study from five Tehran districts through health houses. The 168 items in the semi--quantitative food frequency questionnaire were used to assess dietary intake. The CQI was calculated by using the following four components: glycemic index, total fiber, solid carbohydrate to total carbohydrate ratio, and whole grains: total grains ratio.
Results: After adjusting for confounding factors, the chance of obesity in men (OR=0.38, 95% CI 0.15to 0.95; P =0.04) measured by waist circumference (WC) was significantly lower in the fourth quintile of CQI in comparison with the first quintile. In addition, OR for obesity in men (OR=2.53, 95% CI0.52 to 1.37; P =0.04) was significantly 2.5 times higher among those in the fourth quintile of glycemic index compared with those in the lowest quintile. There was no significant association between dietary carbohydrates with general obesity in men and women.
Conclusion: In summary, dietary CQI is significantly inversely related to central obesity in men,according to this study. Additionally, adherence to a diet with a higher glycemic index in men is positively associated with central obesity.
Collapse
Affiliation(s)
- Nasim Janbozorgi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Kurosh Djafarian
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Saba Mohammadpour
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Mahtab Zareie Abyane
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Mahdi Zameni
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Mostafa Badeli
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Zahra Akbarzade
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Cain C. T. Clark
- Centre for Intelligent Healthcare, Coventry University, Coventry, CV15FB, U.K
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| |
Collapse
|
17
|
Che X, Chen Z, Liu M, Mo Z. Dietary Interventions: A Promising Treatment for Polycystic Ovary Syndrome. ANNALS OF NUTRITION AND METABOLISM 2021; 77:313-323. [PMID: 34610596 DOI: 10.1159/000519302] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 08/30/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Dietary interventions as a first-line treatment for patients with polycystic ovary syndrome (PCOS) have been evaluated, but the optimal diet has not been determined. Proper diet and the maintenance of adequate nutritional status are of great importance in the prevention of this disorder, and therapeutics and dietary habits play an important role in the recovery of patients with PCOS. SUMMARY A range of dietary patterns have been shown to impact weight loss and insulin resistance (IR) and improve reproductive function, including the Mediterranean diet, the ketogenic diet, Dietary Approaches to Stop Hypertension, and other dietary patterns. Key Messages: Diets that can reduce rates of obesity and IR are beneficial to women with PCOS, the status of obesity and IR should be determined at the early stage of the disease, so as to develop individualized and sustainable dietary intervention. The long-term efficacy, safety, and health benefits of diet management in patients with PCOS need to be tested by further researches.
Collapse
Affiliation(s)
- Xuan Che
- Clinical Anatomy & Reproductive Medicine Application Institute, Hengyang Medical School, University of South China, Hengyang, China, .,Guangxi Key Laboratory of Diabetic Systems Medicine, Guilin Medical University, Guilin, China,
| | - Zhuo Chen
- Guangxi Province Postgraduate Cotraining Base for Cooperative Innovation in Basic Medicine (Guilin Medical University and Yueyang Women & Children's Medical Center), Yueyang, China
| | - Mingqi Liu
- Guangxi Key Laboratory of Diabetic Systems Medicine, Guilin Medical University, Guilin, China
| | - Zhongcheng Mo
- Guangxi Key Laboratory of Diabetic Systems Medicine, Guilin Medical University, Guilin, China.,Guangxi Province Postgraduate Cotraining Base for Cooperative Innovation in Basic Medicine (Guilin Medical University and Yueyang Women & Children's Medical Center), Yueyang, China
| |
Collapse
|
18
|
Askari M, Dehghani A, Abshirini M, Raeisi T, Alizadeh S. Glycemic index, but not glycemic load, is associated with an increased risk of metabolic syndrome: Meta-analysis of observational studies. Int J Clin Pract 2021; 75:e14295. [PMID: 33928722 DOI: 10.1111/ijcp.14295] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 03/02/2021] [Accepted: 04/27/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Diets with high glycemic index (GI) or high glycemic load (GL) have been linked to important risk factors associated with the development of metabolic syndrome (MetS), such as dyslipidemia, higher blood glucose, and insulin concentrations. However, the role of GI and GL in relation to Mets is still understudied and controversial. This review, therefore, assessed whether high GI or GL contribute to development of Mets. METHODS A systematic search of four bibliographic databases was conducted (MEDLINE/PubMed, EMBASE, Web of Sciences, and Scopus) from inception to January 2020 for observational studies assessing GI/GL in relation to MetS. Risk estimates were pooled using random-effect models for the highest versus lowest intake categories, and assessed for heterogeneity using subgroup analysis. The dose-response nature of the relationship was also investigated. Sensitivity analysis and Egger test were used to check the robustness of findings and the possibility of publication bias, respectively. RESULTS Data from 12 publications (one cohort study and eleven cross-sectional studies) with a total sample size of 36,295 subjects are included. The pooled effect sizes from the nine studies indicated high versus low dietary GI was associated with increased risk of MetS (OR = 1.05, 95% CI: 1.01 to 1.09) (I2 = 58.1, P = .004). This finding was supported by all subgroup analyses except where studies used 24-h recalls for dietary assessment. Additionally, a linear dose-response investigation revealed that each 5-point increment in GI was associated with 2% increase in the risk of MetS (OR = 1.02, 95% CI: 1.01 to 1.02); non-linear pattern was insignificant, however (p-nonlinearity = 0.63). Moreover, pooled effect sizes from ten studies suggested that no association was found between the GL and MetS with results remaining consistent in all subgroup analyses. CONCLUSION A diet with lower GI may protect against MetS. Nutrition policy and clinical practices should encourage a diet with low GI. Future studies should include both GI and GL and different criteria of MetS to provide a better comparison.
Collapse
Affiliation(s)
- Mohammadreza Askari
- Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Azadeh Dehghani
- Nutrition Research Center, Department of Community Nutrition, faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Abshirini
- School of Health Sciences, College of Health, Massey University, Palmerston North, New Zealand
| | - Tahereh Raeisi
- Department of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Shahab Alizadeh
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
19
|
Lennerz BS, Koutnik AP, Azova S, Wolfsdorf JI, Ludwig DS. Carbohydrate restriction for diabetes: rediscovering centuries-old wisdom. J Clin Invest 2021; 131:142246. [PMID: 33393511 DOI: 10.1172/jci142246] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Carbohydrate restriction, used since the 1700s to prolong survival in people with diabetes, fell out of favor after the discovery of insulin. Despite costly pharmacological and technological developments in the last few decades, current therapies do not achieve optimal outcomes, and most people with diabetes remain at high risk for micro- and macrovascular complications. Recently, low-carbohydrate diets have regained popularity, with preliminary evidence of benefit for body weight, postprandial hyperglycemia, hyperinsulinemia, and other cardiometabolic risk factors in type 2 diabetes and, with more limited data, in type 1 diabetes. High-quality, long-term trials are needed to assess safety concerns and determine whether this old dietary approach might help people with diabetes attain clinical targets more effectively, and at a lower cost, than conventional treatment.
Collapse
Affiliation(s)
- Belinda S Lennerz
- New Balance Foundation Obesity Prevention Center, Boston Children's Hospital, and.,Division of Endocrinology, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - Andrew P Koutnik
- Human Health, Resilience & Performance, Institute for Human and Machine Cognition, and.,Department of Molecular Pharmacology and Physiology, University of South Florida, Tampa, Florida, USA
| | - Svetlana Azova
- New Balance Foundation Obesity Prevention Center, Boston Children's Hospital, and.,Division of Endocrinology, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - Joseph I Wolfsdorf
- Division of Endocrinology, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - David S Ludwig
- New Balance Foundation Obesity Prevention Center, Boston Children's Hospital, and.,Division of Endocrinology, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
20
|
Jomaa L, Hamamji S, Kharroubi S, Diab-El-Harakeh M, Al Zahraa Chokor F, Nasreddine L. Dietary intakes, sources, and determinants of free sugars amongst Lebanese children and adolescents: findings from two national surveys. Eur J Nutr 2021; 60:2655-2669. [PMID: 33389083 DOI: 10.1007/s00394-020-02444-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 11/12/2020] [Indexed: 01/28/2023]
Abstract
PURPOSE To determine the intake levels, dietary sources, and determinants of free sugars (FS) consumption amongst Lebanese children and adolescents. METHODS This study is based on data collected by two national cross-sectional surveys conducted on representative samples of Lebanese children: survey 1 (under-five years (U5) children) (n = 899) and survey 2 (5-18 years-old children) (n = 1133). Multi-component questionnaires were used for data collection. Dietary intakes were assessed using one 24 h dietary recall. Median daily intakes of FS, and percent contribution of various food groups to FS intake were compared between sex and age groups. Logistic regressions were conducted to explore the determinants of high FS intake (> 10% energy intake/d), as per the WHO recommendations. RESULTS Median contribution of FS to daily energy intake was 8.5% in U5 children and 11.9% amongst those aged 5-18 years old. The top contributors to FS in both surveys were sugar-sweetened beverages and biscuits and chocolates. The proportion of children and adolescents exceeding WHO upper limits for FS was estimated at 43 and 62% in survey 1 and survey 2, respectively. Regression models showed females, higher household monthly incomes and higher parental educational levels were associated with significantly lower odds of exceeding the WHO upper limit for FS. CONCLUSION The study showed that a high proportion of Lebanese children and adolescents exceeded the WHO upper limit for FS intake, while also documenting a socioeconomic gradient in FS intake. Findings call for devising food system-based interventions to help reduce FS intake in this nutritionally vulnerable age group.
Collapse
Affiliation(s)
- Lamis Jomaa
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Riad El-Solh, PO Box 11-0236, Beirut, 1107-2020, Lebanon
| | - Samer Hamamji
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Riad El-Solh, PO Box 11-0236, Beirut, 1107-2020, Lebanon
| | - Samer Kharroubi
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Riad El-Solh, PO Box 11-0236, Beirut, 1107-2020, Lebanon
| | - Marwa Diab-El-Harakeh
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Riad El-Solh, PO Box 11-0236, Beirut, 1107-2020, Lebanon
| | - Fatima Al Zahraa Chokor
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Riad El-Solh, PO Box 11-0236, Beirut, 1107-2020, Lebanon
| | - Lara Nasreddine
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Riad El-Solh, PO Box 11-0236, Beirut, 1107-2020, Lebanon.
| |
Collapse
|
21
|
Abhilasha A, Kaur L, Monro J, Hardacre A, Singh J. Intact, Kibbled, and Cut Wheat Grains: Physico‐Chemical, Microstructural Characteristics and Gastro‐Small Intestinal Digestion In vitro. STARCH-STARKE 2021. [DOI: 10.1002/star.202000267] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Abhilasha Abhilasha
- Riddet Institute Massey University Palmerston North 4442 New Zealand
- School of Food and Advanced Technology Massey University Palmerston North 4442 New Zealand
| | - Lovedeep Kaur
- Riddet Institute Massey University Palmerston North 4442 New Zealand
- School of Food and Advanced Technology Massey University Palmerston North 4442 New Zealand
| | - John Monro
- Riddet Institute Massey University Palmerston North 4442 New Zealand
- The New Zealand Institute for Plant and Food Research Limited Palmerston North 4442 New Zealand
| | - Allan Hardacre
- School of Food and Advanced Technology Massey University Palmerston North 4442 New Zealand
| | - Jaspreet Singh
- Riddet Institute Massey University Palmerston North 4442 New Zealand
- School of Food and Advanced Technology Massey University Palmerston North 4442 New Zealand
| |
Collapse
|
22
|
González-Castañeda H, Pineda-García G, Serrano-Medina A, Martínez AL, Bonilla J, Ochoa-Ruíz E. Neuropsychology of metabolic syndrome: A systematic review and meta-analysis. COGENT PSYCHOLOGY 2021. [DOI: 10.1080/23311908.2021.1913878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Hévila González-Castañeda
- Facultad De Medicina Y Psicología, Universidad Autónoma De Baja California, Tijuana B.C., Calzada Universidad 14418, Parque Industrial Internacional, Tijuana 22300, Mexico
| | | | | | | | - Julieta Bonilla
- Escuela de psicología, Universidad Xochicalco, Mexicali, 21376, Mexico
| | | |
Collapse
|
23
|
Liu R, Mi B, Zhao Y, Li Q, Dang S, Yan H. Gender-specific association between carbohydrate consumption and blood pressure in Chinese adults. BMJ Nutr Prev Health 2021; 4:80-89. [PMID: 34308115 PMCID: PMC8258083 DOI: 10.1136/bmjnph-2020-000165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 12/19/2020] [Accepted: 12/23/2020] [Indexed: 01/30/2023] Open
Abstract
Background The association between dietary carbohydrate consumption and blood pressure (BP) is controversial. The present study aimed to evaluate the possible gender-specific association of carbohydrate across the whole BP distribution. Method Cross-sectional survey including 2241 rural adults was conducted in northwestern China in 2010. BP was measured by trained medical personnel. Dietary information was collected by semiquantitative Food-Frequency Questionnaire. Multivariate quantile regression model was used to estimate the association between total carbohydrates consumption and systolic BP (SBP) and diastolic BP (DBP) at different quantiles. Gender-specific β coefficient and its 95% CI was calculated. Results The average carbohydrate intake was 267.4 (SD 112.0) g/day in males and 204.9 (SD 90.7) g/day in females, with only 10.6% of males and 6.5% females consumed at least 65% of total energy from carbohydrates. And more than 80% carbohydrates were derived from refined grains. In females, increased total carbohydrates intake was associated with adverse SBP and DBP. An additional 50 g carbohydrates per day was positively associated with SBP at low and high quantiles (10th-20th and 60th-80th) and with DBP almost across whole distribution (30th-90th), after adjusting for age, fortune index, family history of hypertension, body mass index, physical activity level, alcohol intake and smoke, energy, two nutrient principal components, protein and sodium intake. Both relatively low and high carbohydrate intake were associated with increased SBP, with minimum level observed at 130-150 g carbohydrate intake per day from restricted cubic splines. However, no significant associations were observed in males. Conclusions Higher total carbohydrates consumption might have an adverse impact on both SBP and DBP in Chinese females but not males. Additionally, the positive association varies across distribution of BP quantiles. Further research is warranted to validate these findings and clarify the causality.
Collapse
Affiliation(s)
- Ruru Liu
- Department of Epidemiology and Biostatistics, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China.,Department of Disinfection, Xi'an Center for Disease Control and Prevention, Xi'an, Shaanxi Province, China
| | - Baibing Mi
- Department of Epidemiology and Biostatistics, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Yaling Zhao
- Department of Epidemiology and Biostatistics, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Qiang Li
- Department of Epidemiology and Biostatistics, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Shaonong Dang
- Department of Epidemiology and Biostatistics, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Hong Yan
- Department of Epidemiology and Biostatistics, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| |
Collapse
|
24
|
Kazemi M, Hadi A, Pierson RA, Lujan ME, Zello GA, Chilibeck PD. Effects of Dietary Glycemic Index and Glycemic Load on Cardiometabolic and Reproductive Profiles in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Adv Nutr 2020; 12:161-178. [PMID: 32805007 PMCID: PMC7850057 DOI: 10.1093/advances/nmaa092] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 07/09/2020] [Accepted: 07/13/2020] [Indexed: 02/06/2023] Open
Abstract
Women with polycystic ovary syndrome (PCOS) exhibit cardiometabolic (e.g., insulin resistance) and associated reproductive disruptions. Lifestyle modification (e.g., diet) is recommended as the first-line therapy to manage PCOS; however, a favorable dietary regimen remains unclear beyond energy restriction. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to summarize evidence on impacts of dietary glycemic index (GI) or glycemic load (GL) on cardiometabolic and reproductive profiles to update the International Evidence-based Guideline for the Assessment and Management of PCOS. Databases of MEDLINE, Cochrane, Web of Science, and Scopus were searched through 30 October 2019, and confirmed on 25 March 2020, to identify RCTs (≥8 wk) comparing the effects of diets with lower (LGI/LGL) and higher (HGI/HGL) GI/GL on glucoregulatory outcomes, lipid profile, anthropometrics, and androgen status in PCOS. The primary outcome was HOMA-IR. Data were pooled by random-effects models and expressed as weighted mean differences and 95% CIs. The risk of bias was assessed by the Cochrane tool. Ten RCTs (n = 403) were eligible. Eight evaluated LGI and 2 LGL diets. LGI diets decreased HOMA-IR (-0.78; -1.20, -0.37; I2 = 86.6%), fasting insulin (-2.39; -4.78, 0.00 μIU/mL; I2 = 76.8%), total cholesterol (-11.13; -18.23, -4.04 mg/dL; I2 = 0.0%), LDL cholesterol (-6.27; -12.01, -0.53 mg/dL; I2 = 0.0%), triglycerides (-14.85; -28.75, -0.95 mg/dL; I2 = 31.0%), waist circumference (-2.81; -4.40, -1.23 cm; I2 = 53.9%), and total testosterone (-0.21; -0.32, -0.09 nmol/L; I2 = 8.6%) compared with HGI diets (all: P ≤ 0.05) without affecting fasting glucose, HDL cholesterol, weight, or free androgen index (all: P ≥ 0.07). Some results were contradictory and only described narratively for 2 RCTs that evaluated LGL diets, since inclusion in meta-analyses was not possible. LGI diets improved glucoregulatory outcomes (HOMA-IR, insulin), lipid profiles, abdominal adiposity, and androgen status, conceivably supporting their inclusion for dietary management of PCOS. Further RCTs should confirm these observations and address whether LGI diets improve more patient-pressing complications, including ovulatory cyclicity, infertility, and cardiovascular disease risk in this high-risk population. This review was registered at www.crd.york.ac.uk/PROSPERO as CRD42020175300.
Collapse
Affiliation(s)
| | - Amir Hadi
- Halal Research Center of IRI, FDA, Tehran, Iran
| | - Roger A Pierson
- Obstetrics and Gynecology, College of Medicine, University of Saskatchewan, Saskatchewan, Canada
| | - Marla E Lujan
- Division of Nutritional Sciences, Human Metabolic Research Unit, Cornell University, Ithaca, NY, USA
| | - Gordon A Zello
- Division of Nutrition and Dietetics, College of Pharmacy and Nutrition, University of Saskatchewan, Saskatchewan, Canada
| | | |
Collapse
|
25
|
Association between metabolic syndrome and endometrial cancer risk: a systematic review and meta-analysis of observational studies. Aging (Albany NY) 2020; 12:9825-9839. [PMID: 32439832 PMCID: PMC7288955 DOI: 10.18632/aging.103247] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 04/20/2020] [Indexed: 12/24/2022]
Abstract
Existing evidence has revealed inconsistent results on the association between metabolic syndrome (MetS) and endometrial cancer (EC) risk. Herein, we aim to better understand this association. Systematic searches of PubMed, EMBASE, and Web of Science through 12 December 2019 were conducted. Observational studies that provided risk estimates of MetS and EC risk were eligible. The quality of the included studies was judged based on the Newcastle–Ottawa scale. Summary odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a random-effects model. Six studies, comprising 17,772 EC cases and 150,371 participants were included. MetS, diagnosed according to the criteria of the National Cholesterol Education Program—Third Adult Treatment Panel, was associated with an increased risk of EC (OR: 1.62; 95% CI = 1.26–2.07) with substantial heterogeneity (I2 = 78.3%). Furthermore, we found that women with MetS, diagnosed according to the criteria of the International Diabetes Federation, had a significantly higher risk of EC compared to healthy controls (OR: 1.45; 95% CI = 1.16–1.81; I2 = 64.6%). Our findings were generally consistent with the main results in the majority of prespecified subgroups, as well as in sensitivity analyses. In conclusion, MetS is associated with EC risk.
Collapse
|
26
|
Dietary Glycemic Index and Glycemic Load Are Not Associated with the Metabolic Syndrome in Lebanese Healthy Adults: A Cross-Sectional Study. Nutrients 2020; 12:nu12051394. [PMID: 32414004 PMCID: PMC7284586 DOI: 10.3390/nu12051394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 04/23/2020] [Accepted: 04/26/2020] [Indexed: 11/26/2022] Open
Abstract
High dietary glycemic index (GI) and glycemic load (GL) were suggested to increase the risk of metabolic syndrome (MetS). This study aims to estimate dietary GI and GL in a sample of healthy Lebanese adults and examine their association with MetS and its individual abnormalities. The study uses data from a community-based survey of 501 Lebanese urban adults. Dietary intake was assessed using a food frequency questionnaire. Biochemical, anthropometric, and blood pressure measurements were obtained. Subjects with previous diagnosis of chronic disease, metabolic abnormalities, or with incomplete data or implausible energy intakes were excluded, yielding a sample of 283. Participants were grouped into quartiles of GI and GL. Multivariate logistic regression analyses were performed. Average dietary GI and GL were estimated at 59.9 ± 8 and 209.7 ± 100.3. Participants belonging to the highest GI quartile were at increased risk of having MetS (odds ratio (OR) = 2.251, 95% CI:1.120–4.525) but this association lost significance with further adjustments. Those belonging to the second quartile of GI had significantly lower odds of having hyperglycemia (OR: 0.380, 95% CI:0.174–0.833). No associations were detected between GL and MetS. The study contributes to the body of evidence discussing the relationship between GI, GL, and MetS, in a nutrition transition context.
Collapse
|