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Navas-Carretero S, San-Cristobal R, Siig Vestentoft P, Brand-Miller JC, Jalo E, Westerterp-Plantenga M, Simpson EJ, Handjieva-Darlenska T, Stratton G, Huttunen-Lenz M, Lam T, Muirhead R, Poppitt S, Pietiläinen KH, Adam T, Taylor MA, Handjiev S, McNarry MA, Hansen S, Brodie S, Silvestre MP, Macdonald IA, Boyadjieva N, Mackintosh KA, Schlicht W, Liu A, Larsen TM, Fogelholm M, Raben A, Martinez JA. Appraisal of Triglyceride-Related Markers as Early Predictors of Metabolic Outcomes in the PREVIEW Lifestyle Intervention: A Controlled Post-hoc Trial. Front Nutr 2021; 8:733697. [PMID: 34790686 PMCID: PMC8592084 DOI: 10.3389/fnut.2021.733697] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 09/24/2021] [Indexed: 12/19/2022] Open
Abstract
Background: Individuals with pre-diabetes are commonly overweight and benefit from dietary and physical activity strategies aimed at decreasing body weight and hyperglycemia. Early insulin resistance can be estimated via the triglyceride glucose index {TyG = Ln [TG (mg/dl) × fasting plasma glucose (FPG) (mg/dl)/2]} and the hypertriglyceridemic-high waist phenotype (TyG-waist), based on TyG x waist circumference (WC) measurements. Both indices may be useful for implementing personalized metabolic management. In this secondary analysis of a randomized controlled trial (RCT), we aimed to determine whether the differences in baseline TyG values and TyG-waist phenotype predicted individual responses to type-2 diabetes (T2D) prevention programs. Methods: The present post-hoc analyses were conducted within the Prevention of Diabetes through Lifestyle intervention and population studies in Europe and around the world (PREVIEW) study completers (n = 899), a multi-center RCT conducted in eight countries (NCT01777893). The study aimed to reduce the incidence of T2D in a population with pre-diabetes during a 3-year randomized intervention with two sequential phases. The first phase was a 2-month weight loss intervention to achieve ≥8% weight loss. The second phase was a 34-month weight loss maintenance intervention with two diets providing different amounts of protein and different glycemic indices, and two physical activity programs with different exercise intensities in a 2 x 2 factorial design. On investigation days, we assessed anthropometrics, glucose/lipid metabolism markers, and diet and exercise questionnaires under standardized procedures. Results: Diabetes-related markers improved during all four lifestyle interventions. Higher baseline TyG index (p < 0.001) was associated with greater reductions in body weight, fasting glucose, and triglyceride (TG), while a high TyG-waist phenotype predicted better TG responses, particularly in those randomized to physical activity (PA) of moderate intensity. Conclusions: Two novel indices of insulin resistance (TyG and TyG-waist) may allow for a more personalized approach to avoiding progression to T2D. Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT01777893 reference, identifier: NCT01777893.
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Affiliation(s)
- Santiago Navas-Carretero
- Center for Nutrition Research, University of Navarra, Pamplona, Spain.,Centro de Investigación Biomédica en Red (CIBER) obn, Instituto de Salud Carlos III, Madrid, Spain.,IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | | | - Pia Siig Vestentoft
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Jennie C Brand-Miller
- School of Life and Environmental Sciences and Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Elli Jalo
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Margriet Westerterp-Plantenga
- Department of Nutrition and Movement Sciences, NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands
| | - Elizabeth J Simpson
- Division of Physiology, Pharmacology and Neuroscience, MRC/ARUK Centre for Musculoskeletal Ageing Research, ARUK Centre for Sport, Exercise and Osteoarthritis, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, School of Life Sciences, Queen's Medical Centre, Nottingham, United Kingdom
| | | | - Gareth Stratton
- Applied Sports Technology, Exercise and Medicine (A-STEM) Research Centre, College of Engineering, Swansea, United Kingdom
| | - Maija Huttunen-Lenz
- Institute of Nursing Science, University of Education, Schwäbisch Gmünd, Germany
| | - Tony Lam
- NetUnion Sarl, Lausanne, Switzerland
| | - Roslyn Muirhead
- School of Life and Environmental Sciences and Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Sally Poppitt
- Human Nutrition Unit, Department of Medicine, School of Biological Sciences, University of Auckland, Auckland, New Zealand
| | - Kirsi H Pietiläinen
- Obesity Research Unit, Diabetes and Obesity Research Program, University of Helsinki and Endocrinology, Helsinki, Finland.,Abdominal Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Tanja Adam
- Department of Nutrition and Movement Sciences, NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands
| | - Moira A Taylor
- Division of Physiology, Pharmacology and Neuroscience, MRC/ARUK Centre for Musculoskeletal Ageing Research, ARUK Centre for Sport, Exercise and Osteoarthritis, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, School of Life Sciences, Queen's Medical Centre, Nottingham, United Kingdom
| | - Svetoslav Handjiev
- Department of Pharmacology and Toxicology, Medical University of Sofia, Sofia, Bulgaria
| | - Melitta A McNarry
- Applied Sports Technology, Exercise and Medicine (A-STEM) Research Centre, College of Engineering, Swansea, United Kingdom
| | - Sylvia Hansen
- Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health, University of Cologne, Cologne, Germany
| | - Shannon Brodie
- School of Life and Environmental Sciences and Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Marta P Silvestre
- Human Nutrition Unit, Department of Medicine, School of Biological Sciences, University of Auckland, Auckland, New Zealand.,Center for Health Technology Services Research (CINTESIS), NOVA Medical School, NMS, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Ian A Macdonald
- Division of Physiology, Pharmacology and Neuroscience, MRC/ARUK Centre for Musculoskeletal Ageing Research, ARUK Centre for Sport, Exercise and Osteoarthritis, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, School of Life Sciences, Queen's Medical Centre, Nottingham, United Kingdom
| | - Nadka Boyadjieva
- Department of Pharmacology and Toxicology, Medical University of Sofia, Sofia, Bulgaria
| | - Kelly A Mackintosh
- Applied Sports Technology, Exercise and Medicine (A-STEM) Research Centre, College of Engineering, Swansea, United Kingdom
| | - Wolfgang Schlicht
- Exercise and Health Sciences, University of Stuttgart, Nobelstraße, Germany
| | - Amy Liu
- Human Nutrition Unit, Department of Medicine, School of Biological Sciences, University of Auckland, Auckland, New Zealand
| | - Thomas M Larsen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Mikael Fogelholm
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Anne Raben
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.,Steno Diabetes Centre Copenhagen, Gentofte, Denmark
| | - J Alfredo Martinez
- Center for Nutrition Research, University of Navarra, Pamplona, Spain.,Centro de Investigación Biomédica en Red (CIBER) obn, Instituto de Salud Carlos III, Madrid, Spain.,IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
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Trouwborst I, Goossens GH, Astrup A, Saris WHM, Blaak EE. Sexual Dimorphism in Body Weight Loss, Improvements in Cardiometabolic Risk Factors and Maintenance of Beneficial Effects 6 Months after a Low-Calorie Diet: Results from the Randomized Controlled DiOGenes Trial. Nutrients 2021; 13:nu13051588. [PMID: 34068687 PMCID: PMC8151806 DOI: 10.3390/nu13051588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/03/2021] [Accepted: 05/05/2021] [Indexed: 02/08/2023] Open
Abstract
A low-calorie diet (LCD) is an effective strategy to lose weight and improve cardiometabolic risk factors, however, sexual dimorphism may be present. This study aims to investigate sexual dimorphism in cardiometabolic risk factors following weight loss and after weight maintenance. 782 overweight/obese participants (65% women) of the DiOGenes trial followed an 8-week LCD (~800 kcal/day), with a 6-months follow-up weight maintenance period on ad libitum diets varying in protein content and glycemic index. Men lost more body weight during the LCD period (−12.8 ± 3.9 vs. −10.1 ± 2.8 kg, respectively, p < 0.001), but regained more weight during the follow-up period than women (1.5 ± 5.4 vs. −0.5 ± 5.5 kg, respectively, p < 0.001). Even though beneficial LCD-induced changes in cardiometabolic risk factors were found for both sexes, improvements in HOMA-IR, muscle and hepatic insulin sensitivity, triacylglycerol, HDL−, LDL− and total cholesterol, diastolic blood pressure, cholesterol esters, sphingomyelins and adiponectin were more pronounced in men than women (std. ß range: 0.073–0.144, all q < 0.05), after adjustment for weight change. During follow-up, women demonstrated a lower rebound in HDL-cholesterol, triacylglycerol and diacylglycerol (std. ß range: 0.114–0.164, all q < 0.05), independent of changes in body weight. Overall, we demonstrated sexual dimorphism in LCD-induced changes in body weight and cardiometabolic risk profile, which may be attributed to differences in body fat distribution and metabolic status.
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Affiliation(s)
- Inez Trouwborst
- Top Institute Food and Nutrition (TIFN), 6708 PW Wageningen, The Netherlands; (G.H.G.); (E.E.B.)
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, 6229 ER Maastricht, The Netherlands;
- Correspondence:
| | - Gijs H. Goossens
- Top Institute Food and Nutrition (TIFN), 6708 PW Wageningen, The Netherlands; (G.H.G.); (E.E.B.)
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, 6229 ER Maastricht, The Netherlands;
| | - Arne Astrup
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, 1165 Copenhagen, Denmark;
| | - Wim H. M. Saris
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, 6229 ER Maastricht, The Netherlands;
| | - Ellen E. Blaak
- Top Institute Food and Nutrition (TIFN), 6708 PW Wageningen, The Netherlands; (G.H.G.); (E.E.B.)
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, 6229 ER Maastricht, The Netherlands;
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Goossens GH, Jocken JWE, Blaak EE. Sexual dimorphism in cardiometabolic health: the role of adipose tissue, muscle and liver. Nat Rev Endocrinol 2021; 17:47-66. [PMID: 33173188 DOI: 10.1038/s41574-020-00431-8] [Citation(s) in RCA: 151] [Impact Index Per Article: 50.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/02/2020] [Indexed: 12/11/2022]
Abstract
Obesity is associated with many adverse health effects, such as an increased cardiometabolic risk. Despite higher adiposity for a given BMI, premenopausal women are at lower risk of cardiometabolic disease than men of the same age. This cardiometabolic advantage in women seems to disappear after the menopause or when type 2 diabetes mellitus develops. Sexual dimorphism in substrate supply and utilization, deposition of excess lipids and mobilization of stored lipids in various key metabolic organs (such as adipose tissue, skeletal muscle and the liver) are associated with differences in tissue-specific insulin sensitivity and cardiometabolic risk profiles between men and women. Moreover, lifestyle-related factors and epigenetic and genetic mechanisms seem to affect metabolic complications and disease risk in a sex-specific manner. This Review provides insight into sexual dimorphism in adipose tissue distribution, adipose tissue, skeletal muscle and liver substrate metabolism and tissue-specific insulin sensitivity in humans, as well as the underlying mechanisms, and addresses the effect of these sex differences on cardiometabolic health. Additionally, this Review highlights the implications of sexual dimorphism in the pathophysiology of obesity-related cardiometabolic risk for the development of sex-specific prevention and treatment strategies.
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Affiliation(s)
- Gijs H Goossens
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, Netherlands.
| | - Johan W E Jocken
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, Netherlands
| | - Ellen E Blaak
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, Netherlands.
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Navas-Carretero S, San-Cristobal R, Livingstone KM, Celis-Morales C, Marsaux CF, Macready AL, Fallaize R, O'Donovan CB, Forster H, Woolhead C, Moschonis G, Lambrinou CP, Jarosz M, Manios Y, Daniel H, Gibney ER, Brennan L, Walsh MC, Drevon CA, Gibney M, Saris WHM, Lovegrove JA, Mathers JC, Martinez JA. Higher vegetable protein consumption, assessed by an isoenergetic macronutrient exchange model, is associated with a lower presence of overweight and obesity in the web-based Food4me European study. Int J Food Sci Nutr 2018; 70:240-253. [PMID: 30049236 DOI: 10.1080/09637486.2018.1492524] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The objective was to evaluate differences in macronutrient intake and to investigate the possible association between consumption of vegetable protein and the risk of overweight/obesity, within the Food4Me randomised, online intervention. Differences in macronutrient consumption among the participating countries grouped by EU Regions (Western Europe, British Isles, Eastern Europe and Southern Europe) were assessed. Relation of protein intake, within isoenergetic exchange patterns, from vegetable or animal sources with risk of overweight/obesity was assessed through the multivariate nutrient density model and a multivariate-adjusted logistic regression. A total of 2413 subjects who completed the Food4Me screening were included, with self-reported data on age, weight, height, physical activity and dietary intake. As success rates on reducing overweight/obesity are very low, form a public health perspective, the elaboration of policies for increasing intakes of vegetable protein and reducing animal protein and sugars, may be a method of combating overweight/obesity at a population level.
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Affiliation(s)
- Santiago Navas-Carretero
- a Department of Nutrition Food Science and Physiology , Centre for Nutrition Research, University of Navarra , Pamplona , Spain.,b CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III , Madrid , Spain
| | - Rodrigo San-Cristobal
- a Department of Nutrition Food Science and Physiology , Centre for Nutrition Research, University of Navarra , Pamplona , Spain
| | - Katherine M Livingstone
- c Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University , Newcastle Upon Tyne , UK
| | - Carlos Celis-Morales
- c Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University , Newcastle Upon Tyne , UK
| | - Cyril F Marsaux
- d Department of Human Biology , NUTRIM School for Nutrition and Translational Research in Metabolism. Maastricht University Medical Centre , Maastricht , The Netherlands
| | - Anna L Macready
- e Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading , Reading , UK
| | - Rosalind Fallaize
- e Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading , Reading , UK
| | - Clare B O'Donovan
- f UCD Institute of Food and Health, UCD School of Agriculture and Food Science , University College Dublin , Dublin , Republic of Ireland
| | - Hannah Forster
- f UCD Institute of Food and Health, UCD School of Agriculture and Food Science , University College Dublin , Dublin , Republic of Ireland
| | - Clara Woolhead
- f UCD Institute of Food and Health, UCD School of Agriculture and Food Science , University College Dublin , Dublin , Republic of Ireland
| | - George Moschonis
- g Department of Nutrition and Dietetics , Harokopio University of Athens , Athens , Greece
| | - Christina P Lambrinou
- g Department of Nutrition and Dietetics , Harokopio University of Athens , Athens , Greece
| | | | - Yannis Manios
- g Department of Nutrition and Dietetics , Harokopio University of Athens , Athens , Greece
| | - Hannelore Daniel
- i ZIEL Research Center of Nutrition and Food Sciences , Biochemistry Unit, Technische Universität München , Munich , Germany
| | - Eileen R Gibney
- f UCD Institute of Food and Health, UCD School of Agriculture and Food Science , University College Dublin , Dublin , Republic of Ireland
| | - Lorraine Brennan
- f UCD Institute of Food and Health, UCD School of Agriculture and Food Science , University College Dublin , Dublin , Republic of Ireland
| | - Marianne C Walsh
- f UCD Institute of Food and Health, UCD School of Agriculture and Food Science , University College Dublin , Dublin , Republic of Ireland
| | - Christian A Drevon
- j Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine , University of Oslo , Oslo , Norway
| | - Mike Gibney
- f UCD Institute of Food and Health, UCD School of Agriculture and Food Science , University College Dublin , Dublin , Republic of Ireland
| | - Wim H M Saris
- d Department of Human Biology , NUTRIM School for Nutrition and Translational Research in Metabolism. Maastricht University Medical Centre , Maastricht , The Netherlands
| | - Julie A Lovegrove
- e Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading , Reading , UK
| | - John C Mathers
- c Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University , Newcastle Upon Tyne , UK
| | - J Alfredo Martinez
- a Department of Nutrition Food Science and Physiology , Centre for Nutrition Research, University of Navarra , Pamplona , Spain.,b CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III , Madrid , Spain.,k Instituto de Investigaciones Sanitarias de Navarra (IDisNa) , Pamplona , Spain.,l Institute IMDEA Food , Madrid , Spain
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