The Effect of High Carbohydrate-to-fat Intake Ratios on Hypo-HDL-cholesterolemia Risk and HDL-cholesterol Levels over a 12-year Follow-up

Sweet swell of burning fat: emerging role of high-density lipoprotein in energy homeostasis

PURPOSE OF REVIEW

Metabolism of lipids and lipoproteins, including high-density lipoprotein (HDL), plays a central role in energy homeostasis. Mechanisms underlying the relationship between energy homeostasis and HDL however remain poorly studied.

RECENT FINDINGS

Available evidence reveals that HDL is implicated in energy homeostasis. Circulating high-density lipoprotein-cholesterol (HDL-C) levels are affected by energy production, raising with increasing resting metabolic rate. Lipolysis of triglycerides as a source of energy decreases plasma levels of remnant cholesterol, increases levels of HDL-C, and can be cardioprotective. Switch to preferential energy production from carbohydrates exerts opposite effects.

SUMMARY

Low HDL-C may represent a biomarker of inefficient energy production from fats. HDL-C-raising can be beneficial when it reflects enhanced energy production from burning fat.

An Evaluation of Metabolic, Dietetic, and Nutritional Status Reveals Impaired Nutritional Outcomes in Breast Cancer Patients

Nutritional status can change in breast cancer patients after treatment. However, the metabolic implications of those alterations are poorly understood. We used a cross-sectional study design to compare body composition, lipids, glucose levels, and adiposity indices in breast cancer patients with a matched control and a healthy group. We recruited women who completed their chemotherapy (BC group) and compared them with a group of women without cancer age and body mass index-paired (MC group) and a group of healthy women (HC group). We estimated body composition by bioelectrical impedance analysis, physical function by handgrip strength, and food consumption by 24-hour food record. A blood sample was collected. We calculated visceral obesity indices (VAI and LAP) and insulin resistance-triglyceride glucose (TyG). Eighty-eight women were included (BC = 36, MC = 36, HC = 16). BC patients demonstrated worse phase angle values, nutritional risk index and lower handgrip strength. Additionally, according to the indices, BC had impairments in lipids, worse glucose levels, and elevated visceral fat adiposity and presented important unhealthy dietary patterns characterized by under-recommended protein consumption and higher caloric intake than the other groups. No differences were observed between both control groups. Further investigations are required to examine the underlying mechanisms and the potential longitudinal changes during surveillance.

Interactive effects of the low‐carbohydrate diet score and genetic risk score on Hypo‐HDL‐cholesterolemia among Korean adults: A cross‐sectional analysis from the Ansan and Ansung Study of the Korean Genome and Epidemiology Study

This cross‐sectional study investigated the interaction between the genetic risk score (GRS) and abnormal high‐density lipoprotein (HDL) cholesterol lipid levels, which are modified by low‐carbohydrate diets (LCDs) and their effects on the prevalence of hypo‐HDL‐cholesterolemia (hypo‐HDL‐C) in Korean adults. Baseline data were obtained from the Ansan and Ansung study of the Korean Genome and Epidemiology Study (KoGES), conducted from 2001 to 2002, that targeted 8,314 Korean adults aged 40–69 years, including old men (47.6%) and women (52.4%), and whole genomic single nucleotide polymorphism (SNP) genotyping was performed. We identified 18 SNPs significantly associated with hypo‐HDL‐C in the proximity of several genes, including LPL, APOA5, LIPC, and CETP, and calculated the GRS. The low‐carbohydrate diet score (LCDS) was calculated on the basis of energy intake information from food frequency questionnaires. Furthermore, we performed multivariable‐adjusted logistic modeling to examine the odds ratio (OR) for hypo‐HDL‐C across tertiles of LCDS and GRS, adjusted for several covariates. Among participants in the highest GRS tertile, those in the highest tertile of the LCDS had a significantly lower risk of hypo‐HDL‐C (OR: 0.759, 95% CI (confidence interval): 0.625–0.923) than those in the lowest tertile of the LCDS. In the joint effect model, the group with the lowest GRS and highest LCDS was found to have the lowest risk of hypo‐HDL‐C prevalence. This study suggests that individuals with a high genetic risk for low HDL concentrations may have a beneficial effect on a lower intake of carbohydrates.

Substitution of Carbohydrates for Fats and Risk of Type 2 Diabetes among Korean Middle-Aged Adults: Findings from the Korean Genome and Epidemiology Study

Using data from a 16 year follow-up cohort of the Korean Genome Epidemiology Study, this study assessed the effects of carbohydrate intake on incident diabetes, including replacement of fats or proteins with carbohydrates. In addition, this study evaluated modification effects based on 24 genetic variants associated with type 2 diabetes. For the daily intake of macronutrients, the energy-adjusted intake and percentage of total energy intake were calculated. The effects were assessed using a Cox proportional hazards model; results were presented as hazard ratios with 95% confidence intervals (CIs). Among the 7413 participants considered to be diabetes-free at baseline, 1193 individuals were considered to have incident diabetes. The risk of incident diabetes was found to be high at both extremes of carbohydrate intake, with the lowest risk at 78 E%. The replacement of 5 E% intake from fats with isocaloric carbohydrates showed an 11% increase in the risk of diabetes (95% CI: 1.01−1.21), which was significant in men, participants >50 years of age, and participants with a high educational level. Regarding gene−environment interactions, the relationship between carbohydrate intake and incident diabetes was not dependent on genetic variants. A nonlinear relationship was observed between carbohydrate intake and incident diabetes. The substitution of carbohydrates for fats was also associated with an increased risk of incident diabetes.