Association of dietary factors with abdominal subcutaneous and visceral adiposity in Japanese men

Association Between Alcohol Consumption and Ectopic Fat in the Multi-Ethnic Study of Atherosclerosis

Background The relationship between alcohol consumption and ectopic fat distribution, both known factors for cardiovascular disease, remains understudied. Therefore, we aimed to examine the association between alcohol consumption and ectopic adiposity in adults at risk for cardiovascular disease. Methods and Results In this cross-sectional analysis, we categorized alcohol intake among participants in MESA (Multi-Ethnic Study of Atherosclerosis) as follows (drinks/day): <1 (light drinking), 1 to 2 (moderate drinking), >2 (heavy drinking), former drinking, and lifetime abstention. Binge drinking was defined as consuming ≥5 drinks on 1 occasion in the past month. Visceral, subcutaneous, and intermuscular fat area, pericardial fat volume, and hepatic fat attenuation were measured using noncontrast computed tomography. Using multivariable linear regression, we examined the associations between categories of alcohol consumption and natural log-transformed fat in ectopic depots. We included 6756 MESA participants (62.1±10.2 years; 47.2% women), of whom 6734 and 1934 had chest computed tomography (pericardial and hepatic fat) and abdominal computed tomography (subcutaneous, intermuscular, and visceral fat), respectively. In adjusted analysis, heavy drinking, relative to lifetime abstention, was associated with a higher (relative percent difference) pericardial 15.1 [95% CI, 7.1-27.7], hepatic 3.4 [95% CI, 0.1-6.8], visceral 2.5 [95% CI, -10.4 to 17.2], and intermuscular 5.2 [95% CI, -6.6 to 18.4] fat but lower subcutaneous fat -3.5 [95% CI, -15.5 to 10.2]). The associations between alcohol consumption and ectopic adiposity exhibited a J-shaped pattern. Binge drinking, relative to light-to-moderate drinking, was also associated with higher ectopic fat. Conclusions Alcohol consumption had a J-shaped association with ectopic adiposity. Both heavy alcohol intake and binge alcohol drinking were associated with higher ectopic fat.

Disentangling the impact of alcohol use and hepatitis C on insulin action in Latino individuals

BACKGROUND

Alcohol, insulin resistance (IR), and hepatitis C (HCV) are all significant contributors to adverse outcomes of chronic liver disease. Latinos are disproportionately affected by these risk factors. We investigated the relationship between alcohol use and insulin action in a prospective cohort of Latino individuals with and without HCV.

METHODS

One hundred fifty-three nondiabetic Latino individuals (60 HCV+, 93 HCV-) underwent clinical evaluation and metabolic testing; 56 had repeat testing over a median follow-up of 1.5 years. Peripheral IR and hepatic IR were measured via steady-state plasma glucose (SSPG) and endogenous glucose production during a two-step, 240-min insulin suppression test. Insulin secretion (IS) was measured using the graded glucose infusion test. Alcohol use was categorized as none, moderate (≤1 drink/day for women and ≤2 drinks/day for men), and heavy (>moderate). Multivariable models including HCV status assessed associations of alcohol use with baseline SSPG, hepatic IR and IS, and changes in these parameters over time.

RESULTS

Overall, the median age was 44 years, 63.4% were male, 66.7% overweight/ obese, and 31.9% had heavy lifetime alcohol use while 60.4% had moderate lifetime alcohol use. SSPG and IS were similar by levels of alcohol use at baseline and alcohol use was not statistically significantly associated with change in these measures over time. However, lifetime daily heavy alcohol use (vs. not heavy, coef 2.4 μU-mg/kg-min-ml, p = 0.04) and HCV status (coef 4.4 μU-mg/kg-min-ml, p = 0.0003) were independently associated with higher baseline hepatic IR, and current heavy alcohol use was associated with greater change in hepatic IR in follow-up (coef 5.8 μU-mg/kg-min-ml, p = 0.03).

CONCLUSIONS

In this cohort of Latino individuals, lifetime and current heavy alcohol use influenced hepatic IR and its change over time. Strategies to decrease rates of heavy alcohol use or increase abstinence along with lifestyle modification and anti-HCV therapy to reduce metabolic risk are critical to prevent adverse liver and metabolic outcomes in Latino individuals.

The Potential Benefit of Monitoring Oxidative Stress and Inflammation in the Prevention of Non-Communicable Diseases (NCDs)

The significant increase in worldwide morbidity and mortality from non-communicable diseases (NCDs) indicates that the efficacy of existing strategies addressing this crisis may need improvement. Early identification of the metabolic irregularities associated with the disease process may be a key to developing early intervention strategies. Unhealthy lifestyle behaviours are well established drivers of the development of several NCDs, but the impact of such behaviours on health can vary considerably between individuals. How can it be determined if an individual's unique set of lifestyle behaviours is producing disease? Accumulating evidence suggests that lifestyle-associated activation of oxidative and inflammatory processes is primary driver of the cell and tissue damage which underpins the development of NCDs. However, the benefit of monitoring subclinical inflammation and oxidative activity has not yet been established. After reviewing relevant studies in this context, we suggest that quantification of oxidative stress and inflammatory biomarkers during the disease-free prodromal stage of NCD development may have clinical relevance as a timely indicator of the presence of subclinical metabolic changes, in the individual, portending the development of disease. Monitoring markers of oxidative and inflammatory activity may therefore enable earlier and more efficient strategies to both prevent NCD development and/or monitor the effectiveness of treatment.

Association of Dietary Patterns with Visceral Adiposity, Lipid Accumulation Product, and Triglyceride-Glucose Index in Iranian Adults

In the present study, we sought to examine the association between dietary patterns (DPs) and visceral adiposity, lipid accumulation product (LAP), and triglyceride-glucose index. This cross-sectional study was conducted on adults aged between 18–45 years old who lived in Tehran, Iran, between February 2017 and December 2018 (n = 270). DPs were derived using principal component analysis. We used analysis of variance to examine differences in continues variables across tertiles of major DPs. Subsequently, for the modeling of these relationships, and also considering the possible effect of the confounding factors, multivariate regression was used. Three DPs were identified: healthy pattern, mixed pattern, and western pattern, respectively. Compared with individuals in the lowest category of mixed pattern, those in the highest category had lower fasting blood sugar (96.26 ± 11.57 vs. 101 ± 28.66, p = 0.01). A significant association was found between healthy pattern, after adjustment for potential confounders, and odds of LAP; such that individuals in the top category of healthy pattern score were 71% less likely to have a high LAP compared with those in the lowest category (odds ratio, 0.29; 95% confidence interval, 0.10–0.81). We found that adherence to a healthy DP was associated with decreased LAP. To confirm the veracity of these findings, more studies should be conducted.

Association between Nutrients and Visceral Fat in Healthy Japanese Adults: A 2-Year Longitudinal Study Brief Title: Micronutrients Associated with Visceral Fat Accumulation

High visceral fat area (VFA) is a stronger predictor of cardiovascular disease and overall mortality than body mass index or waist circumference. VFA may be decreased by proper dietary habits. Although previous epidemiologic studies demonstrated an association between nutritional components or foodstuffs and VFA, only the associations of a few nutrients, such as dietary fiber and calcium, are reported. We performed a comprehensive 2-year longitudinal study in more than 624 healthy people and analyzed 33 micronutrients to investigate nutrients that contribute to changes in visceral fat. Our analyses revealed that “macronutrients” and “micronutrients” were “mutual confounders”. Therefore, when evaluating the association between VFA and micronutrients, associations were adjusted by macronutrients. The ingestion of 7 nutrients: soluble dietary fiber, manganese, potassium, magnesium, vitamin K, folic acid, and pantothenic acid, which are abundant components in vegetable diets, was significantly inversely correlated with a change in VFA. Additionally, a change in the ingestion of one nutrient, monounsaturated fat, was significantly positively correlated with a change in VFA. These associations were independent of body mass index and waist circumference. Thus, a predominantly vegetable diet may decrease VFA. In addition, adjusting the intake of macronutrients might help to clarify the association of micronutrients with VFA.

Intrapancreatic fat deposition and visceral fat volume are associated with the presence of diabetes after acute pancreatitis

Ectopic fat and abdominal adiposity phenotypes have never been studied holistically in individuals after acute pancreatitis (AP). The aim of the study was to investigate phenotypical differences in ectopic fat and abdominal fat between individuals after AP (with and without diabetes) and to determine the role of pancreatitis-related factors. Eighty-four individuals were studied cross-sectionally after a median of 21.5 mo since last episode of AP and were categorized into "diabetes" and "no diabetes" groups. Twenty-eight healthy volunteers were also recruited. With the use of magnetic resonance imaging, intrapancreatic fat percentage, liver fat percentage, visceral fat volume (VFV), subcutaneous fat volume, and visceral-to-subcutaneous (V/S) fat volume ratio were quantified. Analysis of variance was used to investigate the differences in these phenotypes between the groups. All analyses were adjusted for age and sex. Linear regression analysis was used to investigate the association between pancreatitis-related factors and the studied phenotypes. Intrapancreatic fat percentage was significantly higher in the diabetes group (10.2 ± 1.2%) compared with the no diabetes (9.2 ± 1.7%) and healthy volunteers (7.9 ± 1.9%) groups (P < 0.001). VFV was significantly higher in the diabetes (2,715.3 ±1,077.6 cm³) compared with no diabetes (1,983.2 ± 1,092.4 cm³) and healthy volunteer (1,126.2 ± 740.4 cm³) groups (P < 0.001). V/S fat volume ratio was significantly higher in the diabetes (0.97 ± 0.27) compared with no diabetes (0.68 ± 0.42) and healthy volunteer (0.52 ± 0.34) groups (P = 0.001). Biliary AP was associated with significantly higher intrapancreatic fat percentage (β = 0.67; 95% CI, 0.01, 1.33; P = 0.047). C-reactive protein levels during hospitalization for AP were associated with significantly higher VFV (β = 3.32; 95% CI, 1.68, 4.96; P < 0.001). In conclusion, individuals with diabetes after AP have higher intrapancreatic fat percentage, VFV, and V/S fat volume ratio. Levels of C-reactive protein during AP are significantly associated with VFV, whereas biliary AP is significantly associated with intrapancreatic fat percentage. NEW & NOTEWORTHY Individuals with diabetes after acute pancreatitis have significantly higher intrapancreatic fat percentage and visceral fat volume compared with individuals without diabetes after acute pancreatitis and healthy controls. C-reactive protein levels during hospitalization for acute pancreatitis and biliary etiology of acute pancreatitis are associated with significantly larger visceral fat and pancreatic fat depots, respectively.

Association of Alcohol Consumption With Fat Deposition in a Community-Based Sample of Japanese Men: The Shiga Epidemiological Study of Subclinical Atherosclerosis (SESSA)

Background

Excessive alcohol intake has been shown to be associated with cardiovascular disease via metabolic pathways. However, the relationship between alcohol intake and obesity has not been fully elucidated. We aimed to examine the association of alcohol consumption with fat deposition and anthropometric measures.

Methods

From 2006–2008, we conducted a cross-sectional study in a population-based sample of Japanese men aged 40 through 79 years. Areas of abdominal visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were calculated using computed tomography imaging. Based on a questionnaire, we classified participants into five groups according to weekly alcohol consumption, excluding former drinkers: non-drinkers (0 g/week), 0.1–160.9, 161–321.9, 322–482.9, and ≥483 g/week. Multivariable linear regression was used to estimate adjusted means of obesity indices for each group.

Results

We analyzed 998 men (mean age and body mass index [BMI], 63.8 years and 23.6 kg/m², respectively). Higher weekly alcohol consumption was strongly and significantly associated with higher abdominal VAT area, percentage of VAT, and VAT-to-SAT ratio (all P for trend <0.001), and also with waist circumferences and waist-to-hip ratio (P for trend = 0.042 and 0.007, respectively). These associations remained significant after further adjustment for BMI, whereas alcohol consumption had no significant association with abdominal SAT area.

Conclusions

Higher alcohol consumption was associated with higher VAT area, VAT%, and VAT-to-SAT ratio, independent of confounders, including BMI, in general Japanese men. These results suggest that alcohol consumption may have a potential adverse effect on visceral fat deposition.

Epigenome-Wide Association Study of Dietary Fiber Intake in African American Adolescents

SCOPE

Low fiber intake is associated with increased risk for cardiovascular disease (CVD) and cancer. However, the underlying mechanisms are not well understood. Two hypotheses are tested: 1) dietary fiber would be associated with DNA methylation levels; 2) those DNA methylation changes would be associated with visceral adiposity and inflammation. Also the possibility that the associations between fiber and DNA methylation levels might be confounded with folic acid intake as sensitivity analysis are explored.

METHODS AND RESULTS

An epigenome-wide association study is conducted using Illumina 450K Bead-Chip on leukocyte DNA in 284 African American adolescents. Linear regression is performed to identify differentially methylated CpG sites associated with fiber. The methylation levels of 3 CpG sites (cg15200711, cg19462022, and cg07035602) in LPCAT1 and RASA3 genes are associated with fiber (false discovery rate [FDR] < 0.05) after adjustment for covariates including folic acid. The methylation levels of cg07035602 and cg19462022 are also associated with visceral adiposity and inflammation.

CONCLUSIONS

The data show that DNA methylation levels at LPCAT1 and RASA3 genes are associated with dietary fiber intake as well as with adiposity and inflammation. Future studies are warranted to determine whether epigenetic regulation may underlie the beneficial effects of fiber intake on adiposity and inflammation.

Lipid accumulation product and visceral adiposity index are associated with dietary patterns in adult Americans

In the present study, we aimed to examine the association between lipid accumulation product (LAP) and visceral adiposity index (VAI) with dietary pattern (DP) in the US adults. Participants of the National Health and Nutrition Examination Survey (NHANES) with data available on dietary intake from 2005 to 2010 were included. DPs were derived by principal component analysis. We applied analysis of covariance and multivariable-adjusted linear regressions accounting for the masked variance and utilizing the proposed weighting methodology. The analytical sample comprised 18,318 participants (mean age = 45.8 years), of whom 48.3% (n = 8607) were men with no age difference by gender (P = .126). The first DP was representative of a diet rich in carbohydrate and sugar, total fat and saturated fatty acid (SFA), high-caloric dieatry pattern; the second DP was highly loaded with vitamins, minerals and fiber (nutrient-dense dietary patten), and the third DP was mainly representative of high dietary polyunsaturated fatty acids (PUFAs) and monounsaturated fatty acids (MUFAs) (healthy fat DP). The adjusted (age, sex, race, physical activity, smoking, C-reactive protein) mean of LAP, VAI and glucose homeostasis indices increased across increasing quarters of the first DP score (all P < .001), while across increasing score of the second DP, the adjusted mean of LAP, VAI, glucose homeostasis indices decreased (all P < .001). Findings were similar in adjusted linear regressions models. Our findings support that affordable measurements, such as VAI and LAP, could be good alternative surrogate markers of visceral fat. They are also significantly related to DPs in same line as with glucose/insulin homeostasis and anthropometric indices.

Diet Quality in Midadulthood Predicts Visceral Adiposity and Liver Fatness in Older Ages: The Multiethnic Cohort Study

OBJECTIVE

The relationship of diet quality assessed by established indices (HEI-2010, AHEI-2010, aMED, DASH) with adiposity measures was examined, especially visceral adipose tissue (VAT) and nonalcoholic fatty liver (NAFL).

METHODS

Close to 2,000 participants of the Multiethnic Cohort completed validated food frequency questionnaires at cohort entry (1993-1996) and clinic visit (2013-2016) when they underwent whole-body dual-energy x-ray absorptiometry and abdominal magnetic resonance imaging scans. Linear regression was used to estimate mean values of adiposity measures by dietary index tertiles at baseline and standardized regression coefficients (β_s ) after adjusting for total adiposity and other covariates. Logistic regression of VAT and NAFL on dietary indices was also performed.

RESULTS

Higher dietary quality scores at cohort entry were inversely related to all adiposity measures, with the strongest associations for percent liver fat (β_s  = -0.14 to -0.08), followed by VAT (β_s  = -0.11 to -0.05), BMI (β_s  = -0.11 to -0.06), and total body fat (β_s  = -0.09 to -0.05). Odds ratios adjusted for total adiposity ranged between 0.57 and 0.77 for NAFL and between 0.41 and 0.65 for high VAT when comparing the highest versus lowest tertiles of diet quality.

CONCLUSIONS

These longitudinal findings indicate that maintaining a high-quality diet during mid-to-late adulthood may prevent adverse metabolic consequences related to VAT and NAFL.

Chrono-nutrition: a review of current evidence from observational studies on global trends in time-of-day of energy intake and its association with obesity

The importance of the circadian rhythm in regulating human food intake behaviour and metabolism has long been recognised. However, little is known as to how energy intake is distributed over the day in existing populations, and its potential association with obesity. The present review describes global trends in time-of-day of energy intake in the general population based on data from cross-sectional surveys and longitudinal cohorts. Evidence of the association between time-of-day of energy intake and obesity is also summarised. Overall, there were a limited number of cross-sectional surveys and longitudinal cohorts that provided data on time-of-day of energy intake. In the identified studies, a wide variation in time-of-day of energy intake was observed, with patterns of energy distribution varying greatly by country and geographical area. In relation to obesity, eight cross-sectional surveys and two longitudinal cohorts were identified. The association between time-of-day of energy intake and obesity varied widely, with several studies reporting a positive link between evening energy intake and obesity. In conclusion, the current review summarises global trends in time-of-day of energy intake. The large variations across countries and global regions could have important implications to health, emphasising the need to understand the socio-environmental factors guiding such differences in eating patterns. Evidence of the association between time-of-day of energy intake and BMI also varied. Further larger scale collaborations between various countries and regions are needed to sum data from existing surveys and cohorts, and guide our understanding of the role of chrono-nutrition in health.

Investigation of Genetic Variation Underlying Central Obesity amongst South Asians

South Asians are 1/4 of the world's population and have increased susceptibility to central obesity and related cardiometabolic disease. Knowledge of genetic variants affecting risk of central obesity is largely based on genome-wide association studies of common SNPs in Europeans. To evaluate the contribution of DNA sequence variation to the higher levels of central obesity (defined as waist hip ratio adjusted for body mass index, WHR) among South Asians compared to Europeans we carried out: i) a genome-wide association analysis of >6M genetic variants in 10,318 South Asians with focused analysis of population-specific SNPs; ii) an exome-wide association analysis of ~250K SNPs in protein-coding regions in 2,637 South Asians; iii) a comparison of risk allele frequencies and effect sizes of 48 known WHR SNPs in 12,240 South Asians compared to Europeans. In genome-wide analyses, we found no novel associations between common genetic variants and WHR in South Asians at P<5x10-8; variants showing equivocal association with WHR (P<1x10-5) did not replicate at P<0.05 in an independent cohort of South Asians (N = 1,922) or in published, predominantly European meta-analysis data. In the targeted analyses of 122,391 population-specific SNPs we also found no associations with WHR in South Asians at P<0.05 after multiple testing correction. Exome-wide analyses showed no new associations between genetic variants and WHR in South Asians, either individually at P<1.5x10-6 or grouped by gene locus at P<2.5x10-6. At known WHR loci, risk allele frequencies were not higher in South Asians compared to Europeans (P = 0.77), while effect sizes were unexpectedly smaller in South Asians than Europeans (P<5.0x10-8). Our findings argue against an important contribution for population-specific or cosmopolitan genetic variants underlying the increased risk of central obesity in South Asians compared to Europeans.

Association of Dietary Proportions of Macronutrients with Visceral Adiposity Index: Non-Substitution and Iso-Energetic Substitution Models in a Prospective Study

We aimed to investigate associations between dietary macronutrient proportions and prospective visceral adiposity index changes (ΔVAI). The study included 1254 adults (18–74 years), from the Tehran Lipid and Glucose Study (TLGS), who were followed for three years. Dietary intakes were assessed twice using food frequency questionnaires. Associations of dietary macronutrient with ΔVAI and risk of visceral adiposity dysfunction (VAD) after three years were investigated. The percentage of energy intake from protein in the total population, and from fat in women, were associated with higher increases in VAI. A 5% higher energy intake from protein substituted for carbohydrate, monounsaturated fatty acids (MUFAs), and polyunsaturated fatty acids (PUFAs) was associated with higher ΔVAI. Higher energy intake from animal protein substituted for PUFAs was positively associated with ΔVAI. Substituting protein and PUFAs with MUFAs were related to higher ΔVAI. The associations were similar in men and women, but reached significance mostly among women. Risk of VAD was increased when 1% of energy from protein was replaced with MUFAs. Substituting protein for carbohydrate and fat, and fat for carbohydrate, resulted in increased risk of VAD in women. Higher dietary proportions of protein and animal-derived MUFA may be positively associated with ΔVAI and risk of VAD.

MRI-determined total volumes of visceral and subcutaneous abdominal and trunk adipose tissue are differentially and sex-dependently associated with patterns of estimated usual nutrient intake in a northern German population

BACKGROUND

Visceral (VAT) and subcutaneous abdominal (SAAT) and trunk (STRAT) adipose tissue (AT) have been suggested to be differentially influenced by diet.

OBJECTIVE

We investigated whether and to what extent usual patterns of nutrient intake are associated with VAT, SAAT, and STRAT compared with nondietary predictors in northern German adults (n = 583).

DESIGN

AT volumes were quantified by magnetic resonance imaging. Nutrient intake was estimated by a 112-item food-frequency questionnaire linked to the German Food Code and Nutrient Database. Exploratory nutrient patterns were derived by principal components analysis (PCA) and partial least-squares regression (PLS) of 87 nutrients. Cross-sectional associations between nutrient patterns, single nutrients, or total energy intake and AT compartments were analyzed by multiple linear regression.

RESULTS

Next to sex and age, respectively, which were important nondietary predictors and accounted for more of the variation in VAT (∼13% and ∼4%) than in SAAT or STRAT (both 4-7% and <1%), variation in VAT (16.8% or 17.6%) was explained to a greater extent by 9 or 2 nutrient patterns derived by principal components analysis or partial least-squares regression, respectively, than was variation in SAAT (10.6% or 8.2%) or STRAT (11.5% or 8.6%). Whereas VAT (16.6%) was primarily explained by nutrient quality, SAAT (6.9%) and STRAT (7.4%) were mainly explained by total energy intake. VAT was positively associated with nutrients characteristic of animal (except for dairy) products, including arachidonic acid (standardized β: 0.25; 95% CI: 0.15, 0.34; P < 0.0001), but negatively with dietary fiber, including polypentoses (standardized β: -0.17; 95% CI: -0.24, -0.09; P < 0.0001), and nutrients found in milk. The direction and strength of many associations, however, depended strongly on sex and adjustment for BMI.

CONCLUSION

VAT may be particularly associated with sex-specific interplays of nutrients found in animal products and fiber, whereas SAAT and STRAT are associated with total energy intake.