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Okekunle AP, Youn J, Song S, Chung GE, Yang SY, Kim YS, Lee JE. Predicted pro-inflammatory hs-CRP score and non-alcoholic fatty liver disease. Gastroenterol Rep (Oxf) 2023; 11:goad059. [PMID: 37842198 PMCID: PMC10568523 DOI: 10.1093/gastro/goad059] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 08/07/2023] [Accepted: 08/23/2023] [Indexed: 10/17/2023] Open
Abstract
Background Non-alcoholic fatty liver disease (NAFLD) is a major contributor to liver diseases globally, yet there are limited studies investigating the impact of diet and lifestyle factors on its development. This study aimed to examine the association between the prevalence of NAFLD and predicted pro-inflammatory high-sensitivity C-reactive protein (hs-CRP) score. Methods We included 1,076 Korean adults who underwent a medical examination at the Seoul National University Hospital Gangnam Healthcare Center in Korea between May and December 2011 and updated in 2021. The predicted pro-inflammatory hs-CRP score was derived from pro-inflammatory demographic, lifestyle, dietary, and anthropometric factors, and NAFLD was diagnosed using liver ultrasound. Multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of NAFLD odds according to predicted pro-inflammatory hs-CRP score were estimated using logistic regression at a two-sided P < 0.05. Results Among the 1,076 participants, 320 had NAFLD. The multivariable-adjusted ORs and 95% CIs for NAFLD by tertiles of predicted pro-inflammatory hs-CRP score were 1.00, 3.30 (2.06, 5.30), 18.25 (10.47, 31.81; P < 0.0001) in men and women combined, 1.00, 1.77 (1.10, 2.84), and 3.26 (2.02, 5.28; P < 0.0001) among men only, and 1.00, 3.03 (1.39, 6.62), and 16.71 (7.05, 39.63; P < 0.0001) among women only. Conclusions Predicted pro-inflammatory hs-CRP score was associated with higher odds of NAFLD. Adopting dietary and lifestyle changes related to lower inflammation might be a valuable strategy for preventing NAFLD.
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Affiliation(s)
- Akinkunmi Paul Okekunle
- Department of Food and Nutrition, College of Human Ecology, Seoul National University, Seoul, Korea
- Research Institute of Human Ecology, Seoul National University, Seoul, Korea
| | - Jiyoung Youn
- Department of Food and Nutrition, College of Human Ecology, Seoul National University, Seoul, Korea
| | - Sihan Song
- Department of Food and Nutrition, College of Human Ecology, Seoul National University, Seoul, Korea
| | - Goh Eun Chung
- Healthcare System Gangnam Center, Healthcare Research Institute, Seoul National University Hospital, Seoul, Korea
| | - Sun Young Yang
- Healthcare System Gangnam Center, Healthcare Research Institute, Seoul National University Hospital, Seoul, Korea
| | - Young Sun Kim
- Healthcare System Gangnam Center, Healthcare Research Institute, Seoul National University Hospital, Seoul, Korea
| | - Jung Eun Lee
- Department of Food and Nutrition, College of Human Ecology, Seoul National University, Seoul, Korea
- Healthcare System Gangnam Center, Healthcare Research Institute, Seoul National University Hospital, Seoul, Korea
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2
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Seva DC, Mônico-Neto M, Antunes HKM, Pino JMV, Bittencourt LRA, Galvão TD, Dâmaso AR, Oyama LM, Shivappa N, Hébert JR, Tufik S, da Silveira Campos RM. Beneficial Short-Term Effects of Bariatric Surgery on Nutritional Inflammatory Profile and Metabolic Biomarkers. Obes Surg 2023; 33:2789-2798. [PMID: 37540480 DOI: 10.1007/s11695-023-06743-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 07/08/2023] [Accepted: 07/14/2023] [Indexed: 08/05/2023]
Abstract
PURPOSE Bariatric surgery (BS) has several potential metabolic benefits. However, little is known about its impact on changes in the inflammatory potential of diet and its effect on inflammatory and metabolic markers. This study aimed to assess the short-term beneficial effects of BS on dietary inflammatory potential and inflammatory and metabolic markers. MATERIALS AND METHODS Participants (n = 20) were evaluated 3 months before and after BS. Body mass, body mass index, anthropometric measurements, fat mass, fat-free mass, visceral fat, skeletal muscle mass, basal metabolic rate, serum lipids, HOMA-IR, QUICKI and inflammatory markers, including leptin, adiponectin, adiponectin/leptin ratio and plasminogen activator inhibitor-1 (PAI-1), were evaluated. Diet data were collected using a 3-day diet record and the dietary inflammatory index (DII®) and energy-adjusted dietary inflammatory index (E-DIITM) scores were computed. RESULTS There was a reduction in DII® (2.56 vs 2.13) and E-DIITM (2.18 vs 0.45) indicating an improvement in inflammatory nutritional profile. Moreover, there were increases in the adiponectin/leptin ratio (0.08 vs 0.21) and QUICKI scores (0.31 vs 0.37), and reductions in leptin (36.66 vs 11.41 ng/ml) and HOMA-IR scores (3.93 vs 1.50). There were also improvements in body composition and anthropometric parameters. CONCLUSIONS BS promotes changes in metabolic profile, inflammatory state and food intake and these modifications appeared to be associated with improvements in diet-related inflammation, an increase in the adiponectin/leptin ratio and a reduction in leptin. These results contribute to knowledge on the contribution bariatric surgery can make to the treatment of obesity and the reduction of related comorbidities.
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Affiliation(s)
- Danielle Cristina Seva
- Post Graduate Program of Interdisciplinary Health Sciences, Universidade Federal de São Paulo, Campus Baixada Santista, Rua Silva Jardim, 136 - Térreo, Vila Matias, Santos, 11015020, Brazil
| | - Marcos Mônico-Neto
- Post Graduate Program of Interdisciplinary Health Sciences, Universidade Federal de São Paulo, Campus Baixada Santista, Rua Silva Jardim, 136 - Térreo, Vila Matias, Santos, 11015020, Brazil.
- Post Graduate Program in Psychobiology, Universidade Federal de São Paulo, São Paulo, Brazil.
- BariMais - Medicina Integrada, São Paulo, Brazil.
| | - Hanna Karen Moreira Antunes
- Post Graduate Program of Interdisciplinary Health Sciences, Universidade Federal de São Paulo, Campus Baixada Santista, Rua Silva Jardim, 136 - Térreo, Vila Matias, Santos, 11015020, Brazil
- Post Graduate Program in Psychobiology, Universidade Federal de São Paulo, São Paulo, Brazil
- Department of Biosciences, Universidade Federal de São Paulo, Santos, Brazil
| | | | - Lia Rita Azeredo Bittencourt
- Post Graduate Program in Psychobiology, Universidade Federal de São Paulo, São Paulo, Brazil
- Department of Psychobiology, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - Ana R Dâmaso
- Post Graduate Program of Nutrition, Paulista Medicine School, Universidade Federal de São Paulo (UNIFESP-EPMP), São Paulo, Brazil
| | - Lila Missae Oyama
- Post Graduate Program of Nutrition, Paulista Medicine School, Universidade Federal de São Paulo (UNIFESP-EPMP), São Paulo, Brazil
- Department of Physiology Paulista Medicine School, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Department of Nutrition, Connecting Health Innovations LLC (CHI), Columbia, SC, USA
| | - James R Hébert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Department of Nutrition, Connecting Health Innovations LLC (CHI), Columbia, SC, USA
| | - Sergio Tufik
- Post Graduate Program in Psychobiology, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Raquel Munhoz da Silveira Campos
- Post Graduate Program of Interdisciplinary Health Sciences, Universidade Federal de São Paulo, Campus Baixada Santista, Rua Silva Jardim, 136 - Térreo, Vila Matias, Santos, 11015020, Brazil
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3
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The association of dietary inflammatory index (DII) and central obesity with non-alcoholic fatty liver disease (NAFLD) in people with diabetes (T2DM). Heliyon 2023; 9:e13983. [PMID: 36915483 PMCID: PMC10006473 DOI: 10.1016/j.heliyon.2023.e13983] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/16/2023] [Accepted: 02/17/2023] [Indexed: 02/25/2023] Open
Abstract
Background & Objective High prevalence of non-alcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes mellitus results in deleterious complications and morbidities related to both diseases. Thus, we aimed to investigate dietary and anthropometric risk factors for progression of Non-alcoholic Fatty Liver Disease (NAFLD) in diabetic people. Methods Anthropometric, and dietary intakes, and hepatic steatosis and fibrosis were assessed in two hundred participants with type two diabetes (T2DM). Subjects with CAP score of more than 270 dB/m were considered to have NAFLD. Multivariable-adjusted ORs and 95% CIs were used to investigate the association between NAFLD and dietary inflammatory index (DII) score and anthropometric indices. Results Participants in the highest tertile of DII had 2.41 (95% CI:1.16-4.97), 2,53 (95% CI: 1.04-6.16), 2.78 (95% CI: 1.09-7.13) times higher odds of developing NAFLD in comparison to the lowest tertile in crude, adjusted model 1 and 2, respectively. Among those with the highest relative to the lowest tertile of trunk-to-leg fat ratio (TLR), ORs and 95% CI were OR = 1.88, 95% CI = 0.9-3.91, and OR = 7.99, 95% CI = 2.43-26.26 in crude and full-adjusted models. Odds of NAFLD in the third tertile of metabolic score for visceral fat (METS-VF) was higher than the first tertile in crude (OR = 9.5, 95% CI = 4.01-22.46) and full-adjusted models (OR = 4.55, 95% CI = 1.46-14.2). Conclusions In conclusion, this study highlighted an association between greater DII (pro-inflammatory diet) and higher NAFLD risk. Moreover, TLR and METS-VF are known as novel estimators of central obesity as a risk factor for NAFLD in diabetes.
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4
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Araújo SP, da Silva A, Bressan J, Juvanhol LL, Castro LCV, Hermsdorff HHM. Fat Intake and High Triglyceride-Glucose Index in Individuals at Cardiometabolic Risk: An Isocaloric Substitution Analyses. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2022; 42:452-458. [PMID: 35939090 DOI: 10.1080/07315724.2022.2064001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Insulin resistance (IR) is an important risk factor for cardiovascular diseases, and the triglyceride-glucose index (TyG index) is a potential IR biomarker. Evidence also suggests that fat intake may modulate IR status, but this relationship remains unclear. Thus, the present study aimed to analyze the relationship between the TyG index and isocaloric replacement of macronutrients, including the profile of dietary fatty acids in individuals at cardiometabolic risk. This cross-sectional study enrolled 264 individuals at cardiometabolic risk (age 43.1 ± 16.3 years) who participated in a nutritional intervention study (ReBEC, id: RBR-5n4y2g). The baseline demographic, anthropometric, clinical, dietary, and lifestyle data were used. The TyG index was calculated using the formula ln [fasting triglycerides (mg/dL) × fasting plasma glucose (mg/dL)/2]. Multivariate nutrient density models were used to analyze isocaloric replacement of fatty acids (as 5% of energy). The chance of having a high TyG index (TyG index >8.83, median value) was decreased by 60% after replacing 5% of the energy intake of polyunsaturated fatty acid (PUFA), saturated fatty acid (SFA), and trans fatty acid (TFA) with monounsaturated fatty acid (MUFA) or PUFA and SFA with protein. Isocaloric replacement of PUFA, SFA, and TFA with MUFA and protein was associated with lower chances of having a high TyG index. These results indicate the importance of macronutrient and dietary fat profiles in the dietary planning of individuals at cardiometabolic risk.
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Affiliation(s)
- Susilane Pereira Araújo
- Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
| | - Alessandra da Silva
- Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
| | - Josefina Bressan
- Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
| | - Leidjaira Lopes Juvanhol
- Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
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5
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Batar N, Öztürk ES, Sevdin S, Yıldız N. Relationship Between Weight Loss and Dietary Inflammatory Index and Serum C-Reactive Protein Level Before and After Bariatric Surgery. Bariatr Surg Pract Patient Care 2022. [DOI: 10.1089/bari.2021.0071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Nazlı Batar
- Department of Nutrition and Dietetics, Health Sciences Faculty, Istanbul Kültür University, Istanbul, Turkey
| | - Elif Sıla Öztürk
- Department of Nutrition and Dietetics, Health Sciences Faculty, Istanbul Kültür University, Istanbul, Turkey
| | - Sezen Sevdin
- Department of Nutrition and Dietetics, Health Sciences Faculty, Fenerbahçe University, Istanbul, Turkey
| | - Nida Yıldız
- Department of Nutrition and Dietetics, Institute of Health Sciences, Acıbadem University, Istanbul, Turkey
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6
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Hariharan R, Odjidja EN, Scott D, Shivappa N, Hébert JR, Hodge A, de Courten B. The dietary inflammatory index, obesity, type 2 diabetes, and cardiovascular risk factors and diseases. Obes Rev 2022; 23:e13349. [PMID: 34708499 DOI: 10.1111/obr.13349] [Citation(s) in RCA: 82] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/15/2021] [Accepted: 08/15/2021] [Indexed: 12/19/2022]
Abstract
An unhealthy diet is a recognized risk factor in the pathophysiology of numerous chronic noncommunicable diseases (NCD), including obesity, type 2 diabetes (T2DM), and cardiovascular diseases (CVD). This is, at least in part, due to unhealthy diets causing chronic low-grade inflammation in the gut and systemically. To characterize the inflammatory potential of diet, we developed the Dietary Inflammatory Index (DII®). Following this development, around 500 papers have been published, which examined the association between the DII, energy-adjusted DII (E-DII™), and the children's DII (C-DII™) and many chronic NCDs including obesity and cardiometabolic diseases. Although a previous narrative review published in 2019 briefly summarized the evidence in this area, there was a significant increase in papers on this topic since 2020. Therefore, the purpose of this narrative review is to provide an in-depth updated review by including all papers until July 2021 on DII and its relationship with obesity, T2DM, and CVD. Furthermore, we aim to identify potential gaps in the literature and provide future directions for research. Most studies found that DII was associated with an increased risk of obesity, T2DM, and CVD with some relationships being sex-specific. However, we identified the paucity of papers describing associations between dietary inflammation and T2DM and its risk factors. Few studies used gold-standard measures of cardiometabolic risk factors. We also identified the lack of interventional studies designed to change the inflammatory potential of diets and study its effect on cardiometabolic risk factors and diseases. We recommend that such interventional studies are needed to assess if changes in DII, representing the inflammatory potential of diet, independently of changes in body composition can modulate cardiometabolic risk factors and diseases.
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Affiliation(s)
- Rohit Hariharan
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
| | - Emmanuel Nene Odjidja
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
| | - David Scott
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia.,Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Nitin Shivappa
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.,Department of Nutrition, Connecting Health Innovations LLC, Columbia, South Carolina, USA
| | - James R Hébert
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.,Department of Nutrition, Connecting Health Innovations LLC, Columbia, South Carolina, USA
| | - Allison Hodge
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - Barbora de Courten
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
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7
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Qin Y, Chen Y, Zhang Z, Huang S, Jiao C, Zhang Z, Mao L. Associations of dietary inflammatory potential with postpartum weight change and retention: Results from a cohort study. Obesity (Silver Spring) 2021; 29:1689-1699. [PMID: 34490743 DOI: 10.1002/oby.23238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 05/11/2021] [Accepted: 05/19/2021] [Indexed: 01/26/2023]
Abstract
OBJECTIVE This study examined the associations of Dietary Inflammatory Index (DII) with weight outcomes within 1 year post partum. METHODS This analysis included women who participated in a cohort study in South China (n = 468). The assessments included maternal height, weight, and dietary intake. The latter variable was based on three consecutive 24-hour food records collected at 2 weeks and 1 year after childbirth and was used to calculate the energy-adjusted DII (EDII) scores during and after puerperium, respectively. A general linear regression was performed to examine the relationships between the EDII scores and postpartum weight outcomes after adjusting for confounders. RESULTS In an analysis adjusted for confounders, the EDII during puerperium was positively associated with the weight change from 3 to 42 days (β: 0.42, 95% CI: 0.11-0.70). The EDII after puerperium was positively correlated with the weight changes from 42 days to 1 year (β: 0.52, 95% CI: 0.02-1.02) and from 3 days to 1 year (β: 0.63, 95% CI: 0.13-1.14), as well as with the postpartum weight retention at 1 year after childbirth (β: 0.75, 95% CI: 0.29-1.22). CONCLUSIONS The results indicate that a diet with a high EDII score might minimize postpartum weight loss and promote higher postpartum weight retention.
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Affiliation(s)
- Yuting Qin
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Nutrition and Food Hygiene, School of Public Health, Southern Medical University, Guangzhou, People's Republic of China
| | - Ying Chen
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Nutrition and Food Hygiene, School of Public Health, Southern Medical University, Guangzhou, People's Republic of China
| | - Zhiwei Zhang
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Nutrition and Food Hygiene, School of Public Health, Southern Medical University, Guangzhou, People's Republic of China
| | - Shaoming Huang
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Nutrition and Food Hygiene, School of Public Health, Southern Medical University, Guangzhou, People's Republic of China
| | - Changya Jiao
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Nutrition and Food Hygiene, School of Public Health, Southern Medical University, Guangzhou, People's Republic of China
| | - Zheqing Zhang
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Nutrition and Food Hygiene, School of Public Health, Southern Medical University, Guangzhou, People's Republic of China
| | - Limei Mao
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Nutrition and Food Hygiene, School of Public Health, Southern Medical University, Guangzhou, People's Republic of China
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8
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Wrigley Kelly NE, Murray KE, McCarthy C, O'Shea DB. An objective analysis of quality and readability of online information on COVID-19. HEALTH AND TECHNOLOGY 2021; 11:1093-1099. [PMID: 34189011 PMCID: PMC8222704 DOI: 10.1007/s12553-021-00574-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 06/16/2021] [Indexed: 01/04/2023]
Abstract
High quality, readable health information is vital to mitigate the impact of the COVID-19 pandemic. The aim of this study was to assess the quality and readability of online COVID-19 information using 6 validated tools. This is a cross-sectional study. "COVID-19" was searched across the three most popular English language search engines. Quality was evaluated using the DISCERN score, Journal of the American Medical Association benchmark criteria and Health On the Net Foundation Code of Conduct. Readability was assessed using the Flesch Reading Ease Score, Flesch-Kincaid Grade Level and Gunning-Fog Index. 41 websites were suitable for analysis. 9.8% fulfilled all JAMA criteria. Only one website was HONCode certified. Mean DISCERN score was 47.8/80 ("fair"). This was highest in websites published by a professional society/medical journal/healthcare provider. Readability varied from an 8th to 12th grade level. The overall quality of online COVID-19 information was "fair". Much of this information was above the recommended 5th to 6th grade level, impeding access for many.
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Affiliation(s)
- N E Wrigley Kelly
- St. Vincent's University Hospital, University College Dublin, Dublin, Ireland
| | - K E Murray
- St. Vincent's University Hospital, University College Dublin, Dublin, Ireland
| | - C McCarthy
- St. Vincent's University Hospital, University College Dublin, Dublin, Ireland
| | - D B O'Shea
- St. Vincent's University Hospital, University College Dublin, Dublin, Ireland
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9
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Malcomson FC, Willis ND, McCallum I, Xie L, Shivappa N, Wirth MD, Hébert JR, Kocaadam-Bozkurt B, Özturan-Sirin A, Kelly SB, Bradburn DM, Belshaw NJ, Johnson IT, Mathers JC. Diet-Associated Inflammation Modulates Inflammation and WNT Signaling in the Rectal Mucosa, and the Response to Supplementation with Dietary Fiber. Cancer Prev Res (Phila) 2020; 14:337-346. [PMID: 33115783 DOI: 10.1158/1940-6207.capr-20-0335] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 07/29/2020] [Accepted: 10/22/2020] [Indexed: 01/10/2023]
Abstract
Inflammation drives colorectal cancer development, and colorectal cancer risk is influenced by dietary factors, including dietary fiber. Hyperactive WNT signaling occurs in colorectal cancer and may regulate inflammation. This study investigated (i) relationships between the inflammatory potential of diet, assessed using the Energy-adjusted Dietary Inflammatory Index (E-DII), and markers of WNT signaling, and (ii) whether DII status modulated the response to supplementation with two types of dietary fiber. Seventy-five healthy participants were supplemented with resistant starch and/or polydextrose (PD) or placebo for 50 days. Rectal biopsies were collected before and after intervention and used to assess WNT pathway gene expression and crypt cell proliferation. E-DII scores were calculated from food frequency questionnaire data. High-sensitivity C-reactive protein (hsCRP) and fecal calprotectin concentrations were quantified. hsCRP concentration was significantly greater in participants with higher E-DII scores [least square means (LSM) 4.7 vs. 2.4 mg/L, P = 0.03]. Baseline E-DII score correlated with FOSL1 (β = 0.503, P = 0.003) and WNT11 (β = 0.472, P = 0.006) expression, after adjusting for age, gender, body mass index, endoscopy procedure, and smoking status. WNT11 expression was more than 2-fold greater in individuals with higher E-DII scores (LSM 0.131 vs. 0.059, P = 0.002). Baseline E-DII modulated the effects of PD supplementation on FOSL1 expression (P = 0.04). More proinflammatory diets were associated with altered WNT signaling and appeared to modulate the effects of PD supplementation on expression of FOSL1 This is the first study to investigate relationships between the E-DII and molecular markers of WNT signaling in rectal tissue of healthy individuals.Prevention Relevance: Our finding that more inflammatory dietary components may impact large bowel health through effects on a well-recognized pathway involved in cancer development will strengthen the evidence base for dietary advice to help prevent bowel cancer.
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Affiliation(s)
- Fiona C Malcomson
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Framlington Place, Newcastle upon Tyne, United Kingdom
| | - Naomi D Willis
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Framlington Place, Newcastle upon Tyne, United Kingdom
| | - Iain McCallum
- Northumbria Healthcare NHS Foundation Trust, North Shields, United Kingdom
| | - Long Xie
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Framlington Place, Newcastle upon Tyne, United Kingdom
| | - Nitin Shivappa
- Department of Epidemiology and Biostatistics and Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Michael D Wirth
- Department of Epidemiology and Biostatistics and Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina.,College of Nursing, University of South Carolina, Columbia, South Carolina
| | - James R Hébert
- Department of Epidemiology and Biostatistics and Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Betul Kocaadam-Bozkurt
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Framlington Place, Newcastle upon Tyne, United Kingdom.,Department of Nutrition and Dietetics, Faculty of Health Sciences, Gazi University, Ankara, Turkey.,Department of Nutrition and Dietetics, Faculty of Health Sciences, Trakya University, Edirne, Turkey
| | - Aycil Özturan-Sirin
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Framlington Place, Newcastle upon Tyne, United Kingdom.,Department of Nutrition and Dietetics, Faculty of Health Sciences, Adnan Menderes University, Aydin, Turkey
| | - Seamus B Kelly
- Northumbria Healthcare NHS Foundation Trust, North Shields, United Kingdom
| | | | - Nigel J Belshaw
- University of East Anglia, Norwich Research Park, Norwich, United Kingdom
| | - Ian T Johnson
- Quadram Institute, Norwich Research Park, Norwich, United Kingdom
| | - John C Mathers
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Framlington Place, Newcastle upon Tyne, United Kingdom.
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10
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Pinto SL, Juvanhol LL, da Silva A, Shivappa N, Hébert JR, Bressan J. The Preoperative Dietary Inflammatory Index Predicts Changes in Cardiometabolic Risk Factors After 12 Months of Roux-en-Y Gastric Bypass. Obes Surg 2020; 30:3932-3939. [PMID: 32514776 DOI: 10.1007/s11695-020-04756-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND The objective of this study was to evaluate Dietary Inflammatory Index (DII®) in the preoperative period as well as 3 and 12 months post-surgery and its association with cardiometabolic risk factors after RYGB. MATERIALS AND METHODS This is a prospective cohort study of 50 patients (both sexes) who underwent RYGB. All data were collected in 3 phases: before surgery, 3, and 12 months post-surgery. To calculate DII scores, we utilized mean nutrients from three 24-h recalls at each time point. RESULTS The patients had median age of 39.1 ± 7.9 years (70% women). Mean preoperative DII® score of 0.39 ± 1.49 was slightly pro-inflammatory. Mean DII score reduced to - 1.52 ± 1.27 after 3 months post-surgery and was classified anti-inflammatory. This value rebounded to - 0.88 ± 1.49 at 12 months but was still anti-inflammatory. From the adjusted linear regression analysis, we observed that preoperative DII score was statistically associated with variations in neck circumference (β = - 0.50; p = 0.03), waist-hip ratio (β = 0.01; p = 0.02), total cholesterol (β = 6.47; p = 0.002), and LDL cholesterol (β = 6.42; p = 0.001) after 12 months post-surgery. Changes in DII® at 3 and 12 months were not associated with changes in cardiometabolic risk factors. CONCLUSION We observe significant changes in the inflammation potential of diet after 3 and 12 months of RYGB. Patients with higher preoperative E-DII scores have a greater metabolic improvement after 12 months of surgery.
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Affiliation(s)
- Sônia L Pinto
- Nutrition Course of the Federal University of Tocantins/TO, Federal University of Viçosa, Quadra 109 North, NS-15, ALCNO-14, Plano Diretor Norte, Palmas, Tocantins, 77001-090, Brazil. .,Department of Nutrition and Health, Federal University of Viçosa/MG, University Campus, Viçosa, Minas Gerais, 36570-900, Brazil.
| | - Leidjaira L Juvanhol
- Department of Nutrition and Health, Federal University of Viçosa/MG, University Campus, Viçosa, Minas Gerais, 36570-900, Brazil
| | - Alessandra da Silva
- Department of Nutrition and Health, Federal University of Viçosa/MG, University Campus, Viçosa, Minas Gerais, 36570-900, Brazil
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, 29208, USA.,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.,Connecting Health Innovations LLC, Columbia, SC, 29201, USA
| | - James R Hébert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, 29208, USA.,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.,Connecting Health Innovations LLC, Columbia, SC, 29201, USA
| | - Josefina Bressan
- Department of Nutrition and Health, Federal University of Viçosa/MG, University Campus, Viçosa, Minas Gerais, 36570-900, Brazil
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11
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Aslani Z, Sadeghi O, Heidari-Beni M, Zahedi H, Baygi F, Shivappa N, Hébert JR, Moradi S, Sotoudeh G, Asayesh H, Djalalinia S, Qorbani M. Association of dietary inflammatory potential with cardiometabolic risk factors and diseases: a systematic review and dose-response meta-analysis of observational studies. Diabetol Metab Syndr 2020; 12:86. [PMID: 33117453 PMCID: PMC7590706 DOI: 10.1186/s13098-020-00592-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 09/22/2020] [Indexed: 02/07/2023] Open
Abstract
CONTEXT The association of dietary inflammatory index (DII®), as an index of inflammatory quality of diet, with cardiometabolic diseases (CMDs) and risk factors (CMRFs) has been inconsistent in previous studies. OBJECTIVE The current systematic review and dose-response meta-analysis was performed to investigate the association of the DII score with CMDs and CMRFs. DATA SOURCES All published observational studies (cohort, case-control and cross-sectional) using PubMed/Medline, Scopus, ISI Web of Science, and Google Scholar databases were retrieved from inception through November 2019. DATA EXTRACTION Two reviewers independently extracted the data from included studies. DATA ANALYSIS Pooled hazard ratio (HR) or odds ratio (OR) were calculated by using a random-effects model. RESULTS Ten prospective cohort studies (total n = 291,968) with 31,069 CMDs-specific mortality, six prospective cohort studies (total n = 43,340) with 1311 CMDs-specific morbidity, two case-control studies with 2140 cases and 6246 controls and one cross-sectional study (total n = 15,613) with 1734 CMDs-specific morbidity were identified for CMDs. Meta-analyses of published observational studies demonstrated that the highest DII score category versus the lowest DII score category was associated with 29% increased risk of CMDs mortality (HR = 1.29; 95% confidence interval (CI) 1.18, 1.41). Moreover, there was a significant association between the DII score and risk of CMDs in cohort studies (HR = 1.35; 95% CI 1.13, 1.61) and non-cohort study (HR = 1.36; 95% CI 1.18, 1.57). We found a significant association between the DII score and metabolic syndrome (MetS) (OR: 1.13; 95% CI 1.03, 1.25), hyperglycemia and hypertension. None-linear dose response meta-analysis showed that there was a significant association between the DII score and risk of CMDs mortality (Pnonlinearity < 0.001). Moreover, evidence of none-linear association between the DII score and risk of CMDs was not observed (p-value = 0.1). CONCLUSIONS Adherence to pro-inflammatory diet was associated with increased risk of CMDs, mortality and MetS.
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Affiliation(s)
- Zahra Aslani
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Omid Sadeghi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Motahar Heidari-Beni
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hoda Zahedi
- Hematopoietic Stem Cell Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereshteh Baygi
- Center of Maritime Health and Society, Department of Public Health, University of Southern Denmark, Esbjerg, Denmark
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208 USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208 USA
- Connecting Health Innovations LLC, Columbia, SC 29201 USA
| | - James R. Hébert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208 USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208 USA
- Connecting Health Innovations LLC, Columbia, SC 29201 USA
| | - Sajjad Moradi
- Halal Research Center of IRI, FDA, Tehran, Iran
- Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Gity Sotoudeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Asayesh
- Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran
| | - Shirin Djalalinia
- Development of Research & Technology Center, Ministry of Health and Medical Education, Tehran, Iran
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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12
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Oliveira TMS, Bressan J, Pimenta AM, Martínez-González MÁ, Shivappa N, Hébert JR, Hermsdorff HHM. Dietary inflammatory index and prevalence of overweight and obesity in Brazilian graduates from the Cohort of Universities of Minas Gerais (CUME project). Nutrition 2019; 71:110635. [PMID: 31881508 DOI: 10.1016/j.nut.2019.110635] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 10/09/2019] [Accepted: 10/16/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the independent association of the dietary inflammatory index (DII®) score with overweight and obesity in Brazilian participants of the Cohort of Universities of Minas Gerais (CUME project). METHODS This was a cross-sectional study consisting of 3,151 graduates and postgraduates (2197 women) with a mean (SD) age of 36.3 y (±9.4 y). Sociodemographic characteristics, lifestyle, and anthropometric data were assessed via online self-reported questionnaire. Additionally, a validated food frequency questionnaire with 144 food items was used to generate energy-adjusted DII (E-DIITM) scores, which evaluated the inflammatory potential of the diet. RESULTS The prevalence of overweight and obesity were 28.2% and 11%, respectively. Participants in the highest E-DII quartile (most proinflammatory diet) were more likely to be smokers/former smokers; sedentary; and consumers of red and ultra-processed meats, fats and oils (excluding olive oil), bottled fruit juices and soft drinks, sugars, sweets, and higher overall caloric intake, compared with the first quartile of E-DII. Both men and women in the fourth E-DII quartile had the highest prevalence of overweight and obesity (prevalence ratio [PR], 1.35; 95% confidence interval [CI], 1.14-1.59 and PR, 1.97; 95% CI, 1.20-3.22, respectively, in men; PR, 1.38; 95% CI, 1.17 to 1.65 and PR, 1.95; 95% CI, 1.31-2.90, respectively, in women). CONCLUSION The most proinflammatory dietary pattern was associated with a higher prevalence of overweight and obesity and other unhealthy lifestyles including being sedentary, smoking, and consuming a obesogenic diet.
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Affiliation(s)
| | - Josefina Bressan
- Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Brazil
| | - Adriano Marçal Pimenta
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Miguel-Ángel Martínez-González
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA; Connecting Health Innovations LLC, Columbia, SC, USA
| | - James R Hébert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA; Connecting Health Innovations LLC, Columbia, SC, USA
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13
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Phillips CM, Chen LW, Heude B, Bernard JY, Harvey NC, Duijts L, Mensink-Bout SM, Polanska K, Mancano G, Suderman M, Shivappa N, Hébert JR. Dietary Inflammatory Index and Non-Communicable Disease Risk: A Narrative Review. Nutrients 2019; 11:E1873. [PMID: 31408965 PMCID: PMC6722630 DOI: 10.3390/nu11081873] [Citation(s) in RCA: 167] [Impact Index Per Article: 33.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 07/30/2019] [Accepted: 08/05/2019] [Indexed: 12/13/2022] Open
Abstract
There are over 1,000,000 publications on diet and health and over 480,000 references on inflammation in the National Library of Medicine database. In addition, there have now been over 30,000 peer-reviewed articles published on the relationship between diet, inflammation, and health outcomes. Based on this voluminous literature, it is now recognized that low-grade, chronic systemic inflammation is associated with most non-communicable diseases (NCDs), including diabetes, obesity, cardiovascular disease, cancers, respiratory and musculoskeletal disorders, as well as impaired neurodevelopment and adverse mental health outcomes. Dietary components modulate inflammatory status. In recent years, the Dietary Inflammatory Index (DII®), a literature-derived dietary index, was developed to characterize the inflammatory potential of habitual diet. Subsequently, a large and rapidly growing body of research investigating associations between dietary inflammatory potential, determined by the DII, and risk of a wide range of NCDs has emerged. In this narrative review, we examine the current state of the science regarding relationships between the DII and cancer, cardiometabolic, respiratory and musculoskeletal diseases, neurodevelopment, and adverse mental health outcomes. We synthesize the findings from recent studies, discuss potential underlying mechanisms, and look to the future regarding novel applications of the adult and children's DII (C-DII) scores and new avenues of investigation in this field of nutritional research.
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Affiliation(s)
- Catherine M Phillips
- HRB Centre for Diet and Health Research, School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Belfield, Dublin 4, Ireland.
- HRB Centre for Diet and Health Research, School of Public Health, University College Cork, Western Gateway Building, Western Rd, Cork, Co. Cork, Ireland.
| | - Ling-Wei Chen
- HRB Centre for Diet and Health Research, School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Belfield, Dublin 4, Ireland
| | - Barbara Heude
- Research Team on the Early Life Origins of Health (EAROH), Centre for Research in Epidemiology and Statistics (CRESS), INSERM, Université de Paris, F-94807 Villejuif, France
| | - Jonathan Y Bernard
- Research Team on the Early Life Origins of Health (EAROH), Centre for Research in Epidemiology and Statistics (CRESS), INSERM, Université de Paris, F-94807 Villejuif, France
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK
| | - Liesbeth Duijts
- The Generation R Study Group, Erasmus MC, University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
- Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center, P.O. Box 2060, 3000 CB Rotterdam, The Netherlands
- Department of Pediatrics, Division of Neonatology, Erasmus MC, University Medical Center, P.O. Box 2060, 3000 CB Rotterdam, The Netherlands
| | - Sara M Mensink-Bout
- The Generation R Study Group, Erasmus MC, University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
- Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center, P.O. Box 2060, 3000 CB Rotterdam, The Netherlands
| | - Kinga Polanska
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, 91-348 Lodz, Poland
| | - Giulia Mancano
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2BN, UK
| | - Matthew Suderman
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2BN, UK
| | - Nitin Shivappa
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - James R Hébert
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
- Connecting Health Innovations LLC, Columbia, SC 29201, USA
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14
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Ferreira YAM, Kravchychyn ACP, Vicente SDCF, Campos RMDS, Tock L, Oyama LM, Boldarine VT, Masquio DCL, Thivel D, Shivappa N, Hébert JR, Dâmaso AR. An Interdisciplinary Weight Loss Program Improves Body Composition and Metabolic Profile in Adolescents With Obesity: Associations With the Dietary Inflammatory Index. Front Nutr 2019; 6:77. [PMID: 31214594 PMCID: PMC6557169 DOI: 10.3389/fnut.2019.00077] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 05/10/2019] [Indexed: 12/23/2022] Open
Abstract
Background and Aims: The prevalence of overweight and obesity consitutes a global epidemic and it is growing around the world. Food and nutrition are essential requirements for promoting health and protecting against non-communicable chronic diseases, such as obesity and cardiovascular disease. Specific dietary components may modulate inflammation and oxidative stress in obese individuals. The Dietary Inflammatory Index (DII®) was developed to characterize the anti- and pro-inflammatory effects of individuals' diet. Few studies have investigated the role of diet-associated inflammation in adolescents with obesity. The present study aims to investigate the effects of an interdisciplinary weight loss therapy on DII scores and cardiometabolic risk in obese adolescents and possibles correlations. Methods: A total of 45 volunteers (14–19 years old) were recruited and enrolled for long-term interdisciplinary therapy including clinical, nutritional, psychological counseling, and exercise training. Adolescents had access to videos about health education weekly. Body composition and inflammatory and serum profiles were evaluated at baseline and after intervention. The food intake was obtained by 24-h food recall. Data was used to calculate energy-adjusted DII (E-DII) scores. Negative scores indicate an anti-inflammatory diet and positive scores indicates a pro-inflammatory diet. The sample was divided according to whether individuals increased or decreased E-DII scores after therapy. Results: After therapy the body mass index (BMI), body weight, body fat, abdominal, waist, neck, and hip circumferences decreased significantly. The mean of high-density lipoprotein cholesterol (HDL-c) increased after the therapy. There was found an improvement of inflammatory and cardiometabolic parameters. In exploratory analyses, this occurred mainly when the EDII improved. Conclusion: Long-term interdisciplinary therapy combined with a health education website improved inflammatory serum markers in obese adolescents. Reduction in DII scores was associated with reduction of cardiometabolic parameters, suggesting that an anti-inflammatory diet may be an effective strategy to prevent and treat obesity and related comorbidities. Trial:http://www.ensaiosclinicos.gov.br/rg/RBR-6txv3v/, Register Number: RBR-6txv3v
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Affiliation(s)
- Yasmin Alaby Martins Ferreira
- Post Graduate Program of Nutrition, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | | | | | - Lian Tock
- Post Graduate Program of Nutrition, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Lila Missae Oyama
- Post Graduate Program of Nutrition, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.,Department of Physiology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Valter Tadeu Boldarine
- Department of Physiology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - David Thivel
- Clermont Auvergne University, EA 3533, Laboratory of the Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), Clermont-Ferrand, France.,CRNH-Auvergne, Clermont-Ferrand, France
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, United States.,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States.,Connecting Health Innovations LLC (CHI), Columbia, SC, United States
| | - James R Hébert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, United States.,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States.,Connecting Health Innovations LLC (CHI), Columbia, SC, United States
| | - Ana R Dâmaso
- Post Graduate Program of Nutrition, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
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