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Martínez-García MÁ, Quintero-Tobar A, de Lope Quiñones S, Insenser M, Fernández-Durán E, Escobar-Morreale HF, Luque-Ramírez M. Obesity and polycystic ovary syndrome influence on intestinal permeability at fasting, and modify the effect of diverse macronutrients on the gut barrier. Food Res Int 2024; 186:114338. [PMID: 38729719 DOI: 10.1016/j.foodres.2024.114338] [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: 09/20/2023] [Revised: 04/11/2024] [Accepted: 04/16/2024] [Indexed: 05/12/2024]
Abstract
Women with the extremely prevalent polycystic ovary syndromegather multiple cardiovascular risk factors and chronic subclinical inflammation. Interactions between diet, adiposity, and gut microbiota modulate intestinal permeabilityand bacterial product translocation, and may contribute to the chronic inflammation process associated with the polycystic ovary syndrome. In the present study, we aimed to address the effects of obesity, functional hyperandrogenism, and diverse oral macronutrients on intestinal permeabilityby measuring circulating markers of gut barrier dysfunction and endotoxemia. Participants included 17 non-hyperandrogenic control women, 17 women with polycystic ovary syndrome, and 19 men that were submitted to glucose, lipid, and protein oral loads. Lipopolysaccharide-binding protein, plasma soluble CD14, succinate, zonulin family peptide, and glucagon-like peptide-2 were determined at fasting and after oral challenges. Macronutrient challenges induced diverse changes on circulating intestinal permeabilitybiomarkers in the acute postprancial period, with lipids and proteins showing the most unfavorable and favorable effects, respectively. Particularly, lipopolysaccharide-binding protein, zonulin family peptide, and glucagon-like peptide-2 responses were deregulated by the presence of obesity after glucose and lipid challenges. Obese subjects showed higher fasting intestinal permeabilitybiomarkers levels than non-obese individuals, except for plasma soluble CD14. The polycystic ovary syndromeexacerbated the effect of obesity further increasing fasting glucagon-like peptide-2, lipopolysaccharide-binding protein, and succinate concentrations. We observed specific interactions of the polycystic ovary syndromewith obesity in the postprandial response of succinate, zonulin family peptide, and glucagon-like peptide-2. In summary, obesity and polycystic ovary syndromemodify the effect of diverse macronutrients on the gut barrier, and alsoinfluence intestinal permeabilityat fasting,contributing to the morbidity of functional hyperandrogenism by inducing endotoxemia and subclinical chronic inflammation.
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Affiliation(s)
- M Ángeles Martínez-García
- Diabetes, Obesity and Human Reproduction Research Group, Department of Endocrinology & Nutrition, Hospital Universitario Ramón y Cajal & Universidad de Alcalá & Instituto Ramón y Cajal de Investigación Sanitaria IRYCIS & Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas CIBERDEM, Madrid, Spain
| | - Alejandra Quintero-Tobar
- Diabetes, Obesity and Human Reproduction Research Group, Department of Endocrinology & Nutrition, Hospital Universitario Ramón y Cajal & Universidad de Alcalá & Instituto Ramón y Cajal de Investigación Sanitaria IRYCIS & Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas CIBERDEM, Madrid, Spain
| | - Sara de Lope Quiñones
- Diabetes, Obesity and Human Reproduction Research Group, Department of Endocrinology & Nutrition, Hospital Universitario Ramón y Cajal & Universidad de Alcalá & Instituto Ramón y Cajal de Investigación Sanitaria IRYCIS & Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas CIBERDEM, Madrid, Spain
| | - María Insenser
- Diabetes, Obesity and Human Reproduction Research Group, Department of Endocrinology & Nutrition, Hospital Universitario Ramón y Cajal & Universidad de Alcalá & Instituto Ramón y Cajal de Investigación Sanitaria IRYCIS & Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas CIBERDEM, Madrid, Spain
| | - Elena Fernández-Durán
- Diabetes, Obesity and Human Reproduction Research Group, Department of Endocrinology & Nutrition, Hospital Universitario Ramón y Cajal & Universidad de Alcalá & Instituto Ramón y Cajal de Investigación Sanitaria IRYCIS & Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas CIBERDEM, Madrid, Spain
| | - Héctor Francisco Escobar-Morreale
- Diabetes, Obesity and Human Reproduction Research Group, Department of Endocrinology & Nutrition, Hospital Universitario Ramón y Cajal & Universidad de Alcalá & Instituto Ramón y Cajal de Investigación Sanitaria IRYCIS & Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas CIBERDEM, Madrid, Spain
| | - Manuel Luque-Ramírez
- Diabetes, Obesity and Human Reproduction Research Group, Department of Endocrinology & Nutrition, Hospital Universitario Ramón y Cajal & Universidad de Alcalá & Instituto Ramón y Cajal de Investigación Sanitaria IRYCIS & Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas CIBERDEM, Madrid, Spain.
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Diekmann C, Wagner M, Huber H, Preuß M, Preuß P, Predel HG, Stoffel-Wagner B, Fimmers R, Stehle P, Egert S. Acute Impact of Dietary Pattern and Walking on Postprandial Attention, Mood, and Satiety in Older Adults: A Randomized Crossover Trial. Nutrients 2019; 11:nu11102294. [PMID: 31561490 PMCID: PMC6835356 DOI: 10.3390/nu11102294] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 09/24/2019] [Accepted: 09/24/2019] [Indexed: 01/27/2023] Open
Abstract
Research suggests that attention, mood, and satiety can be influenced by meal composition and postprandial activity. The present study examined whether this hypothesis applies to persons with a risk phenotype for the development of cardiovascular/neurodegenerative diseases. A randomized crossover trial was conducted in subjects with metabolic syndrome traits (n = 26, 8 female, age 70 ± 5, BMI 30.3 ± 2.3 kg/m2). Each subject participated in four interventions: iso-energetic (4300 kJ) meals (Western diet high-fat, WD, and Mediterranean-type diet, MD) followed by either 30 min of moderate walking (4.6 ± 0.1 km/h) or rest. Attention, mood, satiety and plasma cortisol concentrations were measured at fasting and 1.5, 3.0, 4.5 h postprandially. Data were analyzed by linear mixed models. In all interventions, attention increased continuously in the postprandial period (time effect, P < 0.001). After WD, attention was lower after walking compared to resting (meal × activity effect, P < 0.05). Postprandial mood was generally "good" with no intervention effects. Postprandial satiety increased reaching maximum at 1.5 h after meal (time effect, P < 0.001) and was higher after MD compared to WD (meal effect, P < 0.001). In all interventions, plasma cortisol decreased similar to its diurnal variation (time effect, P < 0.001). In our subjects, meal composition had no relevant impact on attention and mood. After typical WD, resting instead of walking seems to have a more beneficial effect on postprandial attention. MD leads to a strong and long-lasting feeling of satiety, possibly resulting in reduced energy intake in the further course of the day and, thus, long-term effect on weight control.
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Affiliation(s)
- Christina Diekmann
- Department of Nutrition and Food Sciences, Nutritional Physiology, University of Bonn, 53115 Bonn, Germany.
| | - Michael Wagner
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, 53127 Bonn, Germany.
- DZNE, German Center for Neurodegenerative Diseases, 53127 Bonn, Germany.
| | - Hanna Huber
- Department of Nutrition and Food Sciences, Nutritional Physiology, University of Bonn, 53115 Bonn, Germany.
| | - Manuela Preuß
- Human Resource Development, Healthy Campus Bonn, University of Bonn, 53115 Bonn, Germany.
| | - Peter Preuß
- University Sports, University of Bonn, 53117 Bonn, Germany.
| | - Hans-Georg Predel
- Department of Circulation Research and Sports Medicine, Preventive and Rehabilitative Sports and Performance Medicine, German Sport University Cologne, 50933 Cologne, Germany.
| | - Birgit Stoffel-Wagner
- Central Laboratory, Institute of Clinical Chemistry and Clinical Pharmacology, University Hospital Bonn, 53127 Bonn, Germany.
| | - Rolf Fimmers
- Institute of Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, 53127 Bonn, Germany.
| | - Peter Stehle
- Department of Nutrition and Food Sciences, Nutritional Physiology, University of Bonn, 53115 Bonn, Germany.
| | - Sarah Egert
- Department of Nutrition and Food Sciences, Nutritional Physiology, University of Bonn, 53115 Bonn, Germany.
- Institute of Nutritional Medicine, University of Hohenheim, 70599 Stuttgart, Germany.
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Ohlsson B. An Okinawan-based Nordic diet improves glucose and lipid metabolism in health and type 2 diabetes, in alignment with changes in the endocrine profile, whereas zonulin levels are elevated. Exp Ther Med 2019; 17:2883-2893. [PMID: 30936958 DOI: 10.3892/etm.2019.7303] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Accepted: 01/28/2019] [Indexed: 12/13/2022] Open
Abstract
The Okinawan-based Nordic diet has been developed to improve glucose metabolism. The aim of the present study was to summarize all anthropometric, subjective, and biochemical findings obtained following two different studies investigating this diet. The diet was administered i) as a single breakfast to healthy volunteers and ii) as a 12-week dietary intervention to patients with type 2 diabetes. The degree of satiety, sweet cravings, gastrointestinal symptoms, and health-related quality of life were estimated. Weight and blood pressures of participants were measured, and analyses including circulating levels of inflammatory and metabolic biomarkers, hormones, and short-chain fatty acids (SCFA), and microbial diversity and amount of Enterobacteriaceae in feces, were performed. A single breakfast of the diet increased satiety (P<0.001), improved glucose homeostasis (P<0.001), and lowered levels of glucose-dependent insulinotropic polypeptide (GIP) (P=0.002), compared with a standard breakfast. A 12-week intervention in type 2 diabetes increased satiety and decreased sweet cravings, at the same time as health-related quality of life and gastrointestinal symptoms were improved. There were reductions in body mass index (P<0.001), waist circumference (P<0.001), and levels of glucose (P<0.001), cholesterol (P<0.001), and triglycerides (P=0.009), in alignment with the endocrine profile. These improvements were maintained at follow-up 16 weeks later, along with lower levels of ghrelin (P=0.012), polypeptide YY (P=0.002), and visfatin (P=0.021), compared with the parameters recorded at the study start. Levels of haptoglobin, interleukin-18 and thrombocytes were lowered, whereas some other inflammatory biomarkers were unaffected and zonulin levels elevated. Gut microbiota and SCFAs levels were mainly unaffected. The mechanisms governing the anthropometric and metabolic improvements appear to be mediated through alterations in the endocrine profile, yet not in the gut microbiota.
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Affiliation(s)
- Bodil Ohlsson
- Department of Clinical Sciences, Lund University, Lund S-221 00, Sweden.,Department of Internal Medicine, Skåne University Hospital, Malmö S-205 02, Sweden
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Nilholm C, Roth B, Höglund P, Blennow K, Englund E, Hansson O, Zetterberg H, Ohlsson B. Dietary intervention with an Okinawan-based Nordic diet in type 2 diabetes renders decreased interleukin-18 concentrations and increased neurofilament light concentrations in plasma. Nutr Res 2018; 60:13-25. [PMID: 30527256 DOI: 10.1016/j.nutres.2018.08.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 07/22/2018] [Accepted: 08/17/2018] [Indexed: 12/20/2022]
Abstract
Food may induce inflammation and favor development of metabolic diseases, which have been associated with increased inflammation and potential risk of cognitive impairment. It is customary to know whether food or disease promote inflammation. Our hypothesis was that Okinawan-based Nordic (O-BN) diet leads to decreased circulating concentrations of inflammatory and neural biomarkers. The objectives of this study were to examine the effects of the O-BN diet on inflammatory and neural responses. First, 2 different breakfasts; one standard and another O-BN-based, were given in random order to 19 healthy volunteers. Second, a 12-week O-BN-dietary intervention was performed in type 2 diabetes mellitus (T2DM), where the participants were followed for another 16-weeks, with registration of anthropometry and metabolic parameters. Non-diabetic subjects served as controls at baseline. Plasma was analyzed for cytokines by a 10-plex Luminex assay and neurofilament light (NfL) by an ultrasensitive Single molecule assay. Cytokine levels decreased after a single breakfast intake, independent of diet composition. Cytokine levels were higher in T2DM than in controls. Anthropometric and metabolic parameters were improved by the dietary intervention. In parallel, cytokine levels were lowered, although only significantly for IL-18 (P = .001), with a tendency of significance for IL-12p70 (P = .07). Levels of IL-18 correlated with glucose, HbA1c and lipids, but not with body mass index, insulin or blood pressure. NfL levels increased during the intervention (P = .049). O-BN-based diet does not affect postprandial cytokine levels in health, whereas it renders decreased circulating IL-18 levels along with metabolic biomarkers in T2DM, with no beneficial effect on NfL.
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Affiliation(s)
- Clara Nilholm
- Lund University, Skane University Hospital, Department of Internal Medicine, Malmö, Sweden
| | - Bodil Roth
- Lund University, Skane University Hospital, Department of Internal Medicine, Malmö, Sweden
| | - Peter Höglund
- Lund University, Skane University Hospital, Department of Clinical Chemistry & Pharmacology, Lund, Sweden
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Elisabet Englund
- Lund University, Department of Oncology and Pathology, Lund, Sweden
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Sweden; Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden; Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London, UK; UK Dementia Research Institute at UCL, London, UK
| | - Bodil Ohlsson
- Lund University, Skane University Hospital, Department of Internal Medicine, Malmö, Sweden.
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Higher Levels of Serum Zonulin May Rather Be Associated with Increased Risk of Obesity and Hyperlipidemia, Than with Gastrointestinal Symptoms or Disease Manifestations. Int J Mol Sci 2017; 18:ijms18030582. [PMID: 28282855 PMCID: PMC5372598 DOI: 10.3390/ijms18030582] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 02/24/2017] [Accepted: 03/02/2017] [Indexed: 12/12/2022] Open
Abstract
Zonulin is considered a biomarker of increased intestinal permeability, and elevated levels have been found in celiac disease. The primary aim of this study was to examine the association between serum zonulin levels and gastrointestinal (GI) symptoms, and secondarily, between zonulin levels and anthropometric and metabolic factors. The offspring (n = 363) of the participants of the Malmö Diet and Cancer cardiovascular cohort (MDC-CV) were invited to an anthropometric and clinical examination, where fasting plasma glucose levels were measured. Questionnaires about lifestyle factors and medical history were completed along with the Visual Analog Scale for Irritable Bowel Syndrome (VAS-IBS). Zonulin levels were measured in serum by ELISA. Neither GI symptoms nor GI diseases had any influence on zonulin levels. Higher zonulin levels were associated with higher waist circumference (p = 0.003), diastolic blood pressure (p = 0.003), and glucose levels (p = 0.036). Higher zonulin levels were associated with increased risk of overweight (p < 0.001), obesity (p = 0.047), and hyperlipidemia (p = 0.048). We cannot detect altered zonulin levels among individuals reporting GI symptoms or GI diseases, but higher zonulin levels are associated with higher waist circumference, diastolic blood pressure, fasting glucose, and increased risk of metabolic diseases.
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Ohlsson B, Roth B, Larsson E, Höglund P. Calprotectin in serum and zonulin in serum and feces are elevated after introduction of a diet with lower carbohydrate content and higher fiber, fat and protein contents. Biomed Rep 2017; 6:411-422. [PMID: 28413639 PMCID: PMC5374938 DOI: 10.3892/br.2017.865] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 02/01/2017] [Indexed: 01/12/2023] Open
Abstract
Calprotectin is a marker of inflammation and zonulin is a marker of intestinal permeability. Diets with lower carbohydrate content and higher contents of fat, fiber and protein, e.g., Okinawan-based diet, are considered to reduce inflammation and intestinal permeability. The aim of the present study was to evaluate calprotectin and zonulin levels in serum and feces after intervention with an Okinawan-based Nordic diet. Thirty patients (17 women) with type 2 diabetes, mean age 57.5±8.2 years, BMI 29.9±4.1 kg/m2, were served the diet during 12 weeks, and were followed for another 16 weeks. Anthropometric and metabolic parameters were registered. Fasting levels of calprotectin and zonulin in serum and feces, and hormones in plasma, were measured by Luminex or ELISA before study start and after 12 and 28 weeks. Calprotectin in serum tended to be increased (P=0.074) after 12 weeks. Zonulin in serum and feces were elevated after 12 weeks (P=0.019 vs. P<0.001), and remained elevated in serum after 28 weeks (P=0.014). In contrast to baseline, there was a correlation between calprotectin and zonulin in serum and feces after dietary intervention (P=0.025 vs. P=0.079). Energy percentage of protein in breakfast correlated with serum calprotectin (P=0.008) and tended to correlate with serum zonulin (P=0.059). Calprotectin in serum tended to be elevated, and zonulin in serum and feces are elevated after introduction of an Okinawan-based Nordic diet. These biomarkers correlate with energy percentage of protein.
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Affiliation(s)
- Bodil Ohlsson
- Department of Internal Medicine, Skane University Hospital, Malmo, Sweden
| | - Bodil Roth
- Department of Internal Medicine, Skane University Hospital, Malmo, Sweden
| | - Ewa Larsson
- Department of Cardiothoracic Surgery, Lund University, Skane University Hospital, Lund, Sweden
| | - Peter Höglund
- Department of Clinical Chemistry and Pharmacology, Lund University, Skane University Hospital, Lund, Sweden
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