Fructose consumption: potential mechanisms for its effects to increase visceral adiposity and induce dyslipidemia and insulin resistance

Are Nutrition Literacy and Sustainable Dietary Habits Associated with Cardiovascular Disease and Diabetes Developmental Risks?

OBJECTIVE

This study aimed to examine the association of nutritional literacy levels and sustainable nutritional behaviors with the risk of developing cardiovascular diseases and diabetes in the Turkish adult population.

METHODS

Sociodemographic information, disease history, nutritional habits, and physical activity levels of 3146 volunteer individuals (male = 1590, female = 1556) between the ages of 40-75 were collected using a questionnaire form and face-to-face interviews. The sustainable nutritional behaviors of the participants were evaluated using Turkish validated scales for Sustainable and Healthy Eating Behavior (SHE) and nutritional literacy levels with the Evaluation Instrument of Nutrition Literacy on Adults (EINLA). Cardiovascular disease risks of the participants were assessed with the Atherosclerotic Cardiovascular Disease (ASCVD) Risk Estimator program and the Heart Score (SCORE) scale and type-2 diabetes risk with the Finnish Diabetes Risk Score (FINDRISC). Each participant's 24-h food consumption record was obtained using the retrospective recall method.

RESULTS

It was determined that ASCVD and SCORE levels were significantly higher in males compared to females. It was observed that individuals with lower cardiovascular and diabetes risk scores had higher educational levels, and the risks increased significantly with age (p < 0.05). Anthropometric measurements such as body mass index, and waist hip circumference were significantly higher in those with higher cardiovascular and diabetes risk scores. Furthermore, in individuals with higher SCORE and FINDRISC levels, SHE and EINLA scores were significantly lower (p < 0.05). It was also observed that SCORE and diabetes risk scores increased with higher energy and macronutrient intakes.

CONCLUSION

The risk of developing cardiovascular disease and diabetes was associated with sustainable nutritional behaviors and nutritional literacy. It may be suggested that increasing nutritional literacy and encouraging sustainable nutritional behaviors may be effective strategies in the management and reduction of the prevalence of certain chronic diseases. KEY TEACHING POINTSCardiovascular diseases and diabetes are two major chronic conditions that can be managed and treated through proper nutrition.Increased nutritional literacy levels and sustainable dietary habits may result in reduced risk of cardiovascular diseases and diabetes.Nutritionists should assess the patients' nutrition literacy levels and implement sustainable, health-focused nutrition education programs to enhance their understanding of nutrition.

Dietary Fructose: A Literature Review of Current Evidence and Implications on Metabolic Health

With the increasing intake of dietary fructose, primarily from sucrose and sweetened beverages, metabolic illnesses such as type 2 diabetes mellitus, hypertension, fatty liver disease, dyslipidemia, and hyperuricemia have become more prevalent worldwide, and there is also growing concern about the development of malignancies. These negative health impacts have been validated in various meta-analyses and randomized controlled trials. In contrast, the naturally occurring fructose found in fruits and vegetables contains only a minimal amount of fructose and, when consumed in moderation, may be a healthier choice. This review focuses on the biology of fructose, including its dietary sources, the physiology of its metabolism, and the pathological basis of various disorders related to high dietary fructose intake.

Deciphering the complex interplay of obesity, epithelial barrier dysfunction, and tight junction remodeling: Unraveling potential therapeutic avenues

Obesity stands as a formidable global health challenge, predisposing individuals to a plethora of chronic illnesses such as cardiovascular disease, diabetes, and cancer. A confluence of genetic polymorphisms, suboptimal dietary choices, and sedentary lifestyles significantly contribute to the elevated incidence of obesity. This multifaceted health issue profoundly disrupts homeostatic equilibrium at both organismal and cellular levels, with marked alterations in gut permeability as a salient consequence. The intricate mechanisms underlying these alterations have yet to be fully elucidated. Still, evidence suggests that heightened inflammatory cytokine levels and the remodeling of tight junction (TJ) proteins, particularly claudins, play a pivotal role in the manifestation of epithelial barrier dysfunction in obesity. Strategic targeting of proteins implicated in these pathways and metabolites such as short-chain fatty acids presents a promising intervention for restoring barrier functionality among individuals with obesity. Nonetheless, recognizing the heterogeneity among affected individuals is paramount; personalized medical interventions or dietary regimens tailored to specific genetic backgrounds and allergy profiles may prove indispensable. This comprehensive review delves into the nexus of obesity, tight junction remodeling, and barrier dysfunction, offering a critical appraisal of potential therapeutic interventions.

Fructose corn syrup induces inflammatory injury and obesity by altering gut microbiota and gut microbiota-related arachidonic acid metabolism

Excessive fructose corn syrup (FCS) intake brings a series of health problems. The aim of the present study was to explore the mechanism of FCS-induced metabolic disorders from the perspective of gut microbiota. Mice were fed for 16 weeks with normal or 30% FCS drinking water. Compared to the control group, FCS caused significantly higher fat deposition, hepatic steatosis, liver and intestinal inflammatory damages (P<.05). FCS increased the abundance of Muribaculaceae in vivo and in vitro, which was positively correlated with the indices of metabolic disorders (P<.05). In vivo and in vitro data indicated that FCS enhanced the microbial function involved in pentose phosphate pathway and arachidonic acid metabolism, metabolomics further demonstrated that FCS led to an increase in prostaglandins (the catabolites of arachidonic acid) (P<.05). Our study confirmed that FCS can directly promote gut microbiota to synthesize inflammatory factor prostaglandins, which provides new insights and directions for the treatment of FCS-induced metabolic disorders and inflammation.

The effect of low-fructose diet on anthropometric and metabolic factors: A systematic review and meta-analysis

AIMS

In recent decades, there has been a rise in the consumption of sugars containing fructose, raising concerns about their association with metabolic disorders and obesity. We conducted a systematic review and meta-analysis of randomized controlled trials to assess the effects of a low-fructose diet on anthropometric and metabolic variables.

DATA SYNTHESIS

We conducted a systematic review and meta-analysis of randomized controlled trials to assess the effects of low-fructose diets on anthropometric and metabolic factors. Relevant studies were identified by searching electronic databases such as PubMed, Scopus, and Web of Science up to January 2023. The quality of the included studies was assessed using the Cochrane risk-of-bias tool. Ten trials with varying intervention durations (ranging from 4 to 24 weeks) and a total of 750 participants were included. The analysis revealed that a low-fructose diet had no significant effect on weight but did have a significant impact on body mass index (SMD = -0.2; 95 % CI: -0.37, -0.04, P = 0.017) and waist circumference (SMD = -0.48; 95 % CI: -0.67, -0.29, P < 0.0001). Furthermore, a low-fructose diet significantly affected systolic blood pressure (SMD = -0.24; 95 % CI: -0.39, -0.09, P = 0.002), fasting blood glucose (SMD = -0.23; 95 % CI: -0.40, -0.07, P = 0.005), hemoglobin A1c (SMD = -0.62; 95 % CI: -0.93, -0.31, P < 0.0001), and triglyceride levels (SMD = -0.17; 95 % CI: -0.33, -0.02, P = 0.028). However, it had no significant effect on diastolic blood pressure, insulin levels, or homeostatic model assessment of insulin resistance. Subgroup analysis indicated that a low-fructose diet had a greater effect on healthy participants aged over 50 years.

CONCLUSIONS

Meta-analysis results suggest that low-fructose diets significantly reduce body mass index, waist circumference, systolic blood pressure, fasting blood glucose, hemoglobin A1c, and triglyceride levels. Additionally, the results of the current study suggest that a low-fructose diet may be more effective in healthy individuals who are older than 50 years old compared to those younger than 50 years old.

Associations between food consumption/dietary habits and the risks of obesity, type 2 diabetes, and hypertension: a cross-sectional study in Jakarta, Indonesia

BACKGROUND/OBJECTIVES

This study aimed to assess the current mean daily intake of 10 food groups, analyze the sociodemographic factors associated with food consumption, and determine the associations between food consumption/dietary intake and the prevalence rates of obesity, type 2 diabetes (T2D), and hypertension (HTN) in Jakarta, Indonesia.

SUBJECTS/METHODS

A total of 600 participants aged 20-85 yrs were included in this cross-sectional study. Food consumption and dietary habits were assessed using a food frequency questionnaire. To determine the association between food consumption/dietary habits and the abovementioned diseases, logistic regression analysis was performed.

RESULTS

The average vegetable and fruit intake was lower, while sugar and salt consumption were higher than that recommended by Indonesia's national dietary guidelines. A high intake of ultra-processed foods (UPFs) was associated with young age, men, "single" status, a high education level, and employment with a high monthly income. Obesity and T2D were positively correlated with high intakes of cereals and tubers, UPFs, sugars, fats, and oils. Conversely, an inverse association was found between legume, vegetable, and fruit consumption and obesity risk. An inverse correlation was also observed between vegetable consumption and T2D risk. Moreover, a high salt intake was inversely correlated with fruit consumption in terms of HTN risk. Non-indulgence in habitual late-night snacking and refrainment from consuming more than one dish at each meal were also negatively related to the prevalence of obesity, T2D, and HTN. Inverse correlations were also observed between the prevalence rates of T2D and HTN and abstaining from adding sugar to beverages.

CONCLUSION

Foods high in fat, sugar, and sodium were strongly associated with the risks of obesity, T2D, and HTN. Additionally, poor eating habits were also associated with disease development.

Major dietary patterns and dietary inflammatory index in relation to dyslipidemia using cross-sectional results from the RaNCD cohort study

Dyslipidemia can increase the risk of heart attack and stroke due to the restriction of blood flow through the blood vessels. Dietary modification is an appropriate approach to reducing this phenomenon. This cross-sectional study aimed to evaluate major dietary patterns and the dietary inflammatory index (DII) in relation to dyslipidemia. 5954 participants in the Ravansar non-communicable diseases (RaNCD) cohort study were eligible for this study. Dyslipidemia was diagnosed based on the lipid profile under consideration of the RaNCD physician. Dietary patterns were assessed by principal component analysis. The three identified dietary patterns included (1) plant-based pattern; (2) high protein and sugar pattern; and (3) energy-dense dense pattern. DII was also calculated based on the dietary information from a validated semi-quantitative food frequency questionnaire (FFQ). We found that higher adherence to DII was significantly associated with increased odds of dyslipidemia after adjusting for age, sex, and physical activity (OR: 1.24; CI 95% 1.09-1.42). Additionally, higher adherence to the high protein and sugar diet and an energy-dense diet was significantly associated with higher odds for dyslipidemia (OR: 1.31; CI 95% 1.16-1.49) and (OR: 1.28; CI 95% 1.12-1.46). Nevertheless, according to our results, following plant-based diet had no association with dyslipidemia in both crude and adjusted models. Our findings revealed that greater adherence to DII, a high-protein, high-sugar diet, and an energy-dense diet can have undesirable effects on dyslipidemia.

Single-Nucleotide Polymorphisms in Base-Excision Repair-Related Genes Involved in the Risk of an Occurrence of Non-Alcoholic Fatty Liver Disease

Oxidative stress is one of the pillars crucial in the development of a non-alcoholic fatty liver disease (NAFLD) and may cause DNA damage. Since the main pathway responsible for the repair of oxidative DNA damage is the base-excision repair (BER) pathway, we examined the relationship between the presence of different genetic variants of BER-associated genes and the risk of NAFLD. The study evaluates seven single nucleotide polymorphisms (SNPs) within five genes, hOGG1, APEX1, NEIL1, LIG3, LIG1, in 150 NAFLD patients and 340 healthy controls. The genotyping was performed using TaqMan probes and the results were presented as odds ratio with its corresponding 95% confidence interval. The following SNPs were assessed in the study: hOGG1 (rs1052133), APEX1 (rs176094 and rs1130409), NEIL1 (rs4462560), LIG3 (rs1052536), LIG3 (rs4796030), and LIG1 (rs20579). Four of the investigated SNPs, i.e., rs176094, rs1130409, rs4462560 and rs4796030, were found to be associated with NAFLD risk. Furthermore, the occurrence of insulin resistance in patients with steatosis depended on various LIG3 genetic variants. The findings imply the impact of genes involved in BER on NAFLD and fatty liver-related insulin sensitivity.

Feronia elephantum reverses insulin resistance in fructose-induced hyper-insulinemic rats; an in-silico, in-vitro, and in-vivo approach

ETHNOPHARMACOLOGICAL RELEVANCE

Feronia elephantum corr. (synonym: Feronia limonia, Murraya odorata, Schinus Limonia, or Limonia acidissima; common names: Bela, Kath, Billin, and Kavitha), belonging to the family Rutaceae has been known for clinical conditions such as pruritus, diarrhea, impotence, dysentery, heart diseases, and is also used as a liver tonic. However, the effect of the fruit pulp of F. elephantum on insulin resistance has yet not been reported.

AIM OF THE STUDY

The present study aimed to assess the effect of hydroalcoholic extract/fraction of F. elephantum fruit pulp on fasting blood glucose, oral glucose tolerance test, and glucose uptake in fructose-induced insulin-resistant rats and predict the gene-set enrichment of lead hits of F. elephantum with targets related to insulin resistance.

MATERIAL AND METHODS

System biology tools were used to predict the best category of fraction and propose a possible mechanism. Docking was carried out with adiponectin and its receptor (hub gene). Further, fructose supplementation was used for the induction of insulin resistance. Later, three doses of extract (400, 200, and 100 mg/kg) and a flavonoid-rich fraction (63 mg/kg) were used for treatment along with metformin as standard. The physical parameters like body weight, food intake, and water intake were measured along with oral glucose tolerance test, insulin tolerance test, glycogen content in skeletal muscles and liver, glucose uptake by rat hemidiaphragm, lipid profiles, anti-oxidant biomarkers, and histology of the liver and adipose tissue.

RESULTS

Network pharmacology reflected the potency of F. elephantum to regulate adiponectin (ADIPOQ) which may promote the reversal of insulin resistance and inhibit α-amylase and α-glucosidase. Vitexin was predicted to modulate the most genes associated with diabetes mellitus. Further, F. elephantum ameliorated the exogenous glucose clearance, promoted insulin sensitivity, reduced oxidative stress, and improved glucose and lipid metabolism. HPLC profiling revealed the presence of apigenin and quercetin in the extract for the first time.

CONCLUSION

The fruit pulp of F. elephantum reverses insulin resistance by an increase in glucose uptake and a decrease in gluconeogenesis which may be due to the regulation of multiple proteins via multiple bio-actives.

Effects of a School-Based Nutrition, Gardening, and Cooking Intervention on Metabolic Parameters in High-risk Youth: A Secondary Analysis of a Cluster Randomized Clinical Trial

IMPORTANCE

Although school-based gardening programs for children have consistently been shown to improve dietary behaviors, no cluster randomized clinical trial (RCT) has evaluated the effects of a school-based gardening intervention on metabolic outcomes.

OBJECTIVE

To evaluate the effects of a school-based gardening, nutrition, and cooking intervention (Texas Sprouts) on changes in metabolic outcomes in elementary schoolchildren.

DESIGN, SETTING, AND PARTICIPANTS

This study was a secondary analysis of a cluster RCT, conducted over 3 years from 2016 to 2019, at low-income elementary schools with majority Hispanic students in the greater Austin, Texas, area. Data were analyzed from January to August 2022.

INTERVENTIONS

Texas Sprouts was 1 school year long (9 months) and consisted of (1) Garden Leadership Committee formation; (2) a 0.25-acre outdoor teaching garden; (3) 18 student gardening, nutrition, and cooking lessons taught by trained educators throughout the school year; and (4) 9 monthly parent lessons. The delayed intervention was implemented the following academic year and received an identical intervention.

MAIN OUTCOMES AND MEASURES

The following measures were obtained at baseline and postintervention (9 months): demographics via survey; measured height, weight, and body mass index parameters; and glucose, insulin, homeostatic model assessment of insulin resistance, and a lipid panel via an optional fasting blood draw.

RESULTS

Sixteen elementary schools were randomly assigned to either Texas Sprouts intervention (8 schools) or to delayed intervention (control, 8 schools). A total of 3302 children (aged 7-12 years) were enrolled in Texas Sprouts, and fasting blood samples were obtained from 1104 children (or 33% of those enrolled) at baseline. The final analytic sample included 695 children (307 boys [44.17%]; mean [SE] age, 9.28 [0.04] years; 480 Hispanic children [69.02%]; 452 [65.03%] eligible for free or reduced lunch) with complete demographic data and baseline and postintervention (9-month) fasting blood draws. Compared with control schools, children from Texas Sprouts schools had a 0.02% reduction in mean hemoglobin A1c (95% CI, 0.03%-0.14%; P = .005) and a 6.40 mg/dL reduction in mean low-density lipoprotein cholesterol (95% CI, 3.82-8.97 mg/dL; P = .048). There were no intervention effects on glucose, insulin, homeostatic model assessment of insulin resistance, or other lipid parameters.

CONCLUSIONS AND RELEVANCE

In this cluster RCT, Texas Sprouts improved glucose control and reduced low-density lipoprotein cholesterol in high-risk youth. These findings suggest that elementary schools should incorporate garden-based interventions as a way to improve metabolic parameters in children.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT02668744.

Association of plant-based diets with adropin, atherogenic index of plasma, and metabolic syndrome and its components: A cross-sectional study on adults

Background

Little is known about the association of plant-based diet indices with metabolic syndrome (MetS) and its novel predictive biomarkers, including the atherogenic index of plasma (AIP) and adropin. We aimed to investigate the association of plant-based diets with adropin, atherogenic index of plasma, and MetS and its components in adults.

Methods

The present population-based cross-sectional study was conducted on a representative sample of adults aged 20-60 years in Isfahan, Iran. Dietary intake was obtained through a validated 168-item semi-quantitative food frequency questionnaire (FFQ). Peripheral blood was obtained after an overnight fast of at least 12 h from each participant. MetS was identified based on the Joint Interim Statement (JIS). AIP was calculated as a logarithmically transformed ratio of triglyceride (TG)/high-density lipoprotein cholesterol (HDL-c), and serum levels of adropin were measured by an ELISA kit.

Results

A total of 28.7% of subjects had MetS. No significant association was found between the overall plant-based diet index (PDI) and the healthful plant-based diet index (hPDI) with MetS. However, a non-linear association was observed between hPDI and MetS. Subjects in the third quartile of the unhealthful plant-based diet index (uPDI) had higher odds of MetS compared to the first quartile (OR: 2.39; 95% CI: 1.01, 5.66). The highest quartile of PDI (OR: 0.46; 95% CI: 0.21, 0.97) and the third quartile of hPDI (OR: 0.40; 95% CI: 0.18, 0.89) were associated with decreased odds of having high-risk AIP compared to the first quartile, after adjusting for potential confounders. No linear association was found between quartiles of plant-based diet indices and serum levels of adropin.

Conclusion

Plant-based diet index (PDI) and hPDI were not associated with the prevalence of MetS in adults, while moderate adherence to uPDI increased the prevalence of MetS. In addition, high adherence to PDI and moderate adherence to hPDI were associated with decreased odds of high-risk AIP. No significant association was found between plant-based diet indices and serum adropin levels. To confirm these findings, further studies with prospective designs are warranted.

Protective Effect of Hydroalcoholic Extract of Punica granatum Leaves on High Fructose Induced Insulin Resistance in Experimental Animals

BACKGROUND

Insulin resistance (IR) is a condition characterized by reduced sensitivity of body tissues to insulin, leading to impaired regulation of downstream metabolic pathways and elevated blood glucose levels. Diets rich in fructose have been proven to cause insulin resistance in test rats, resulting in decreased insulin sensitivity, particularly in the liver, and compromised disposal of glucose from the body. In the search for effective treatments, Plant-derived formulations have gained popularity because to their ability for treating a variety of ailments. One such plant is Punica granatum Linn. from the Punicaceae family, which has long been used in the treatment of diabetes and its consequences. This study investigates the insulin-resistant activity of an extract from Punica granatum leaves. The study goal is to assess the possible protective role of Punica granatum against insulin resistance through various analyses, including serum glucose and insulin levels, lipid profile assessment, measurement of liver enzymes (ALP, SGOT, SGPT), and histopathological examination of liver sections.

METHODS

The study involves several key methods to evaluate the insulin-resistant activity of Punica granatum extract in high fructose diet induced insulin resistance animal model. The extract was administered orally to the experimental animals. These methods include the measurement of serum glucose and serum insulin levels, analysis of the lipid profile, quantification of liver enzymes such as ALP, SGOT, and SGPT, and a detailed histopathological examination of liver tissue sections. These analyses collectively provide insights into the impact of Punica granatum extract on insulin resistance and related metabolic parameters.

RESULTS

Findings of this study provide insight on the possible benefits of Punica granatum extract on insulin resistance. Through the assessment of serum glucose and insulin levels, lipid profile analysis, and measurement of liver enzymes, the study elucidates the impact of the extract on key metabolic indicators. Additionally, the histopathological examination of liver sections provides visual insights into the structural changes that may occur as a result of the treatment.

CONCLUSION

In conclusion, this study highlights the ability of Punica granatum extract as a candidate for addressing insulin resistance. The findings suggest that the extract may have a protective role against insulin resistance, as evidenced by improvements in serum glucose and insulin levels, lipid profile, liver enzyme levels, and histopathological characteristics. Further research and investigations are warranted to fully understand the mechanisms underlying these observed effects and to validate the potential of Punica granatum extract as a therapeutic option for managing insulin resistance and its associated complications.

Benefits of Valsartan and Amlodipine in Lipolysis through PU.1 Inhibition in Fructose-Induced Adiposity

High fructose intake has been implicated in obesity and metabolic syndrome, which are related to increased cardiovascular mortality. However, few studies have experimentally examined the role of renin–angiotensin system blockers and calcium channel blockers (CCB) in obesity. We investigated the effects of valsartan (an angiotensin II receptor blocker) and amlodipine (a CCB) on lipolysis through the potential mechanism of PU.1 inhibition. We observed that high fructose concentrations significantly increased adipose size and triglyceride, monoacylglycerol lipase, adipose triglyceride lipase, and stearoyl-CoA desaturase-1 (SCD1), activating transcription factor 3 and PU.1 levels in adipocytes in vitro. Subsequently, PU.1 inhibitor treatment was able to reduce triglyceride, SCD1, and PU.1 levels. In addition, elevated levels of triglyceride and PU.1, stimulated by a high fructose concentration, decreased with valsartan and amlodipine treatment. Overall, these findings suggest that high fructose concentrations cause triacylglycerol storage in adipocytes through PU.1-mediated activation. Furthermore, valsartan and amlodipine treatment reduced triacylglycerol storage in adipocytes by inhibiting PU.1 activation in high fructose concentrations in vitro. Thus, the benefits of valsartan and amlodipine in lipolysis may be through PU.1 inhibition in fructose-induced adiposity, and PU.1 inhibition might have a potential therapeutic role in lipolysis in fructose-induced obesity.

Long-term high-fructose high-fat diet feeding elicits insulin resistance, exacerbates dyslipidemia and induces gut microbiota dysbiosis in WHHL rabbits

The metabolic syndrome (MetS) has become a global public health burden due to its link to cardiovascular disease and diabetes mellitus. The present study was designed to characterize the metabolic and cardiovascular disturbances, as well as changes in gut microbiota associated with high-fructose high-fat diet (HFFD)-induced MetS in Watanabe heritable hyperlipidemic (WHHL) rabbits. Twenty-one Watanabe rabbits were assigned to a control (n = 9) and HFFD (n = 12) groups, receiving a chow diet and a HFFD, respectively. During a 12-weeks protocol, morphological parameters were monitored; plasma fasting levels of lipids, glucose and insulin were measured and a glucose tolerance test (GTT) was performed. HOMA-IR was calculated. Cardiac function and vascular reactivity were evaluated using the Langendorff isolated heart and isolated carotid arteries methods, respectively. 16S rRNA sequencing of stool samples was used to determine gut microbial composition and abundance. HFFD-fed Watanabe rabbits exhibited increased fasting insulin (p < 0.03, 12^th week vs. Baseline), HOMA-IR (p < 0.03 vs. Control), area under the curve of the GTT (p < 0.02 vs. Control), triglycerides (p < 0.05, 12^th week vs. Baseline), TC (p < 0.01 vs. Control), LDL-C (p < 0.001 vs. Control). The HFFD group also displayed a significant decrease in intestinal microbial richness, evenness and diversity (FDR < 0.001, FDR < 0.0001, FDR < 0.01, respectively vs. Control group) and an increase in its Firmicutes/Bacteroidetes ratio (R = 3.39 in control vs. R = 28.24 in the HFFD group) indicating a shift in intestinal microbial composition and diversity. Our results suggest that HFFD induces insulin resistance and gut microbiota dysbiosis and accentuates dyslipidemia; and that, when subjected to HFFD, Watanabe rabbits might become a potential diet-induced MetS animal models with two main features, dyslipidemia and insulin resistance.

Reversal of insulin resistance by Ficus benghalensis bark in fructose-induced insulin-resistant rats

ETHNOPHARMACOLOGICAL RELEVANCE

Bark of Ficus benghalensis L. (family: Moraceae), commonly known as Banyan is recorded as Nyagrodha in Ayurvedic Pharmacopeia of India to manage burning sensation, obesity, diabetes, bleeding disorders, thirst, skin diseases, wounds, and dysmenorrhoea. However, the effect of F. benghalensis bark over glycolysis, gluconeogenesis, and appetite regulation in insulin-resistant pathogenesis has not been reported yet.

AIM OF THE STUDY

The present study aimed to investigate the effect of hydroalcoholic extract of F. benghalensis bark in gluconeogenesis, glycolysis, and appetite regulation in fructose-induced insulin resistance in experimental rats.

MATERIALS AND METHODS

Male Wister rats were supplemented with fructose in drinking water (10% w/v for 42 days and 20% w/v for next 12 days; a total of 54 days); insulin resistance was confirmed via the elevated area under the curve of the glucose during oral glucose tolerance test after 54 days and was subjected with extract treatment for next 30 days. After 30 days of treatment, animals were fasted to perform oral glucose and insulin tolerance test to estimate glucose and insulin levels. The blood sample was collected for biochemical estimation and the liver homogenate was prepared to estimate hepatic enzymes and enzymatic and non-enzymatic anti-oxidant biomarkers followed by histopathological evaluation. Also, glycogen content was quantified in gastrocnemius muscle and liver homogenates. Further, reported bioactives from the F. benghalensis were retrieved from the ChEBI database and docked against hexokinase, phosphofructokinase, glucose-6-phosphatase, lactate dehydrogenase, and fructose-1,6-biphosphatase to identify the probable lead hits against the enzymes involved in gluconeogenesis.

RESULTS

Treatment with the F. benghalensis bark extract significantly increased the body weight and food intake and significantly decreased fructose supplemented water intake. Further, treatment with extract significantly increased the exogenous glucose clearance and well responded to the exogenous insulin. Further, extract treatment improved lipid metabolism, ameliorated plasma leptin, and multiple enzymatic and non-enzymatic antioxidant biomarkers. Likewise, it also improved gluconeogenesis mediated pathogenesis of non-alcoholic fatty liver injury. Additionally, molecular docking also identified mucusisoflavone A and B as lead hits in downregulating gluconeogenesis.

CONCLUSION

Hydroalcoholic extract of F. benghalensis bark may prevent insulin resistance by downregulating gluconeogenesis and improving the appetite in fructose-induced insulin-resistant rats.

Dietary fructose and its association with the metabolic syndrome in Lebanese healthy adults: a cross-sectional study

BACKGROUND

Epidemiological studies investigating the association between dietary fructose intake and the metabolic syndrome (MetS) are scarce and have produced controversial findings. This study aimed at (1) assessing total dietary fructose intake in a sample of Lebanese healthy adults, and determining the intake levels of natural vs. added fructose; (2) investigating the association of dietary fructose with MetS; and (3) identifying the socioeconomic and lifestyle factors associated with high fructose intake.

METHODS

A cross-sectional survey was conducted on a representative sample of adults living in Beirut, Lebanon (n = 283). Anthropometric and biochemical data were collected, and dietary intake was assessed using a food frequency questionnaire. Intakes of naturally-occurring fructose from fructose-containing food sources, such as fruits, vegetables, honey, were considered as "natural fructose". Acknowledging that the most common form of added sugar in commodities is sucrose or High Fructose Corn Syrup (HFCS), 50% of added sugar in food products was considered as added fructose. Total dietary fructose intake was calculated by summing up natural and added fructose intakes. Logistic regression analyses were conducted to investigate the association of total, added and natural fructose intakes with the MetS and to identify the socioeconomic predictors of high fructose intake.

RESULTS

Mean intake of total fructose was estimated at 51.42 ± 35.54 g/day, representing 6.58 ± 3.71% of energy intakes (EI). Natural and added fructose intakes were estimated at 12.29 ± 8.57 and 39.12 ± 34.10 g/day (1.78 ± 1.41% EI and 4.80 ± 3.56% EI), respectively. Participants in the highest quartile of total and added fructose intakes had higher odds of MetS (OR = 2.84, 95%CI: 1.01, 7.94 and OR = 3.18, 95%CI: 1.06, 9.49, respectively). In contrast, natural fructose intake was not associated with MetS. Age, gender and crowding index were identified as factors that may modulate dietary fructose intakes.

CONCLUSIONS

The observed association between high added fructose intake and the MetS highlights the need for public health strategies aimed at limiting sugar intake from industrialized foods and promoting healthier dietary patterns in Lebanon.

Interaction of dietary carbohydrate and fat on glucose metabolism in growing pigs

Increased consumption of fructose has been suggested to be a contributing cause of the increased rates of obesity in humans. Rodent studies have shown an increase in de novo lipogenesis and decreased insulin sensitivity in response to feeding high levels of fructose, but it is unclear if these effects occur in the same progression in humans. We aimed to develop a swine model for studying changes in glucose metabolism and insulin resistance resulting from dietary carbohydrate alone or in combination with high dietary fat. Two experiments were conducted to determine if the source of dietary carbohydrate, with or without added fat, had an effect on body weight gain, glucose metabolism, or insulin response in growing pigs. In the first experiment, pigs (24 barrows, initial body weight 28 kg) were fed one of 4 diets in which the source of carbohydrate was varied: 1) 20% starch; 2) 10% glucose + 10% starch; 3) 10% fructose + 10% starch; and 4) 20% fructose for 9 weeks. There were no differences in growth rate or glucose clearance observed. Experiment 2 was conducted as a 3 × 2 factorial with the main effects of carbohydrate source (20% starch, glucose, or fructose) and added fat level (0 vs 10%). Pigs (24 barrows, initial body weight 71 kg) were fed one of 6 experimental diets for 9 weeks. Compared to the other dietary treatments, pigs fed fructose with high fat had an elevated glucose area under the curve during the GTT (Carbohydrate x Fat interaction, P < 0.01). This same group had a lower insulin response (Carbohydrate x Fat, P < 0.05). This work demonstrates that pigs can be a viable model to assess the long-term effects of dietary carbohydrates on metabolism and body composition. Studies of longer duration are needed to determine if these changes are indicative of insulin resistance.

The association between meal specific low carbohydrate diet score and cardiometabolic risk factors: A cross-sectional study of Iranian adults

BACKGROUND AND AIM

Since evidence regarding low-CHO diet and cardiometabolic risk factors is controversial, this study aimed to assess the relation between low-CHO diet score and metabolic syndrome (MetS) and cardiometabolic risk factors among a group of Iranian adults.

METHODS

This cross-sectional study was conducted with 840 subjects with the age range of 20-65 years. Dietary intakes were assessed by completing three 24-hour recalls. Total, animal- and vegetable-based low-CHO diet score were calculated. We used logistic regression with different models to determine whether there were relationships between low-CHO diet score and MetS and MetS components.

RESULTS

We found that there was no significant association between low-CHO diet, animal-based and vegetable-based low-CHO diet scores and risk of MetS in three meals. Except for the animal-based low-CHO diet score, which was significantly associated with general obesity at lunch meal (OR: 1.17, 95% CI: 0.76-1.82, P = .03). There were a significant association between low-CHO diet and high-density lipoprotein cholesterol (HDL-C) levels in lunch meal (OR: 1.50, 95% CI: 1.06-2.14, P = .03). Vegetable-based low-CHO diet score was associated with a lower risk of elevated TG in lunch meal in the fully adjusted model (OR: 0.59, 95% CI: 0.39-0.90, P = .04).

CONCLUSION

Diets with lower amounts of carbohydrate and higher contents of fat and protein were not significantly associated with the risk for MetS in Iranian adults. Only animal-based low-CHO diet score was significantly associated with general obesity at lunch meal.

Total and Free Sugar Levels and Main Types of Sugars Used in 18,784 Local and Imported Pre-Packaged Foods and Beverages Sold in Hong Kong

There is limited information regarding the free sugar content of pre-packaged foods in Hong Kong. This study aims to assess the free sugar content and identify the most frequently used free sugar ingredients (FSI) in pre-packaged foods in Hong Kong. Data from 18,784 products from the 2019 FoodSwitch Hong Kong database were used in this analysis. Ingredient lists were screened to identify FSI. Total sugar content was derived from nutrition labels on packaging. Free sugar content was estimated based on adaptation of a previously established systematic methodology. Descriptive statistics of the total sugar and free sugar content, as well as the mean ± SD contribution of free sugar to total sugar of the audited products were calculated, stratified by food groups. Almost two-thirds (64.5%) of the pre-packaged foods contained at least one FSI. 'Sugar (sucrose)' was the most popular FSI that was found in more than half (54.7%) of the products. 'Fruit and vegetable juices' (median 10.0; IQR 8.3-11.5 g/100 mL) were found to have a higher median free sugar content than 'Soft drinks' (8.0; 6.0-10.6 g/100 mL). Mean ± SD contribution of free sugar to the total sugar content was 65.8 ± 43.4%, with 8 out of 14 food groups having >70% total sugar as free sugar. To conclude, free sugar, especially sucrose, was extensively used in a wide variety of pre-packaged products sold in Hong Kong. Further studies are needed to assess the population intake of free sugar in Hong Kong to inform public health policy on free sugar reduction.

Fasting, non-fasting and postprandial triglycerides for screening cardiometabolic risk

Fasting triacylglycerols have long been associated with cardiovascular disease (CVD) and other cardiometabolic conditions. Evidence suggests that non-fasting triglycerides (i.e. measured within 8 h of eating) better predict CVD than fasting triglycerides, which has led several organisations to recommend non-fasting lipid panels as the new clinical standard. However, unstandardised assessment protocols associated with non-fasting triglyceride measurement may lead to misclassification, with at-risk individuals being overlooked. A third type of triglyceride assessment, postprandial testing, is more controlled, yet historically has been difficult to implement due to the time and effort required to execute it. Here, we review differences in assessment, the underlying physiology and the pathophysiological relevance of elevated fasting, non-fasting and postprandial triglycerides. We also present data suggesting that there may be a distinct advantage of postprandial triglycerides, even over non-fasting triglycerides, for early detection of CVD risk and offer suggestions to make postprandial protocols more clinically feasible.

The Relationship between Daily Fructose Consumption and Oxidized Low-Density Lipoprotein and Low-Density Lipoprotein Particle Size in Children with Obesity

PURPOSE

Obesity has become a very significant health problem in childhood. Fructose taken in an uncontrolled manner and consumed in excessive amounts is rapidly metabolized in the body and gets converted into fatty acids. This single center prospective case-control study aims to investigate the relationship between fructose consumption and obesity and the role of fructose consumption in development of atherosclerotic diseases.

METHODS

A total of 40 obese and 40 healthy children who were of similar ages (between 8 and 18 years) and sexes were included in the study. In the patient and control groups, the urine fructose levels, as well as the levels of oxidized low-density lipoprotein (LDL), small dense LDL, Apolipoprotein A and Apolipoprotein B values, which have been shown to play a role in development of atherosclerotic diseases, were measured.

RESULTS

The levels of oxidized LDL and small dense LDL and the ratio of Apolipoprotein A/Apolipoprotein B were found to be significantly higher in the patient group.

CONCLUSION

We found that urinary fructose levels were higher in the obese children than the healthy children. Our results suggest that overconsumption of fructose in children triggers atherogenic diseases by increasing the levels of small dense LDL and oxidized LDL and the ratio of Apolipoprotein B/Apolipoprotein A.

The potential protective effect of the Polygonum hydropiper L against the development of fructose-induced oxidative stress and metabolic disorders in male Sprague-Dawely rats

OBJECTIVES

Polygnum hydropiper L (Polygonaceae) is commonly known as smart weed. This study was designed to assess the effect of aqueous methanolic extract of P. hydropiper on oxidative stress and metabolic changes in fructose-induced hypertensive rats.

METHODS

Male Sprague-Dawely rats were divided into six groups of five animals each (n = 5) and designated as normotensive group with distilled water, fructose-fed group with 10% fructose, standard control group with 10% fructose plus amlodipine (10 mg/kg) and treated groups with different doses of the aqueous methanolic extract of P. hydropiper (100, 200 and 400 mg/kg) plus 10% fructose daily for 6 weeks. Body weight gain was checked every week. Blood pressure parameters [systolic (SBP), diastolic (DBP), mean arterial pressure (MAP) and heart rate (HR)] and reactivity of extract with phenylephrine and adrenaline were measured by invasive method. Metabolic changes and oxidative stress parameters were measured from blood samples. Phytochemical analysis was also performed.

KEY FINDINGS

Aqueous methanolic extract of P. hydropiper at 400 mg/kg decreased the blood pressure, heart rate, body weight and produced significant effect on metabolic and oxidative stress changes as compared to fructose-fed group. Phytochemical analysis revealed the presence of polyphenols and flavonoids in it.

CONCLUSION

The present results showed that aqueous methanolic extract of P. hydropiper possesses effect on oxidative stress and metabolic changes due to polyphenols and flavonoids.

Effects of High and Low Sugar Diets on Cardiovascular Disease Risk Factors

It has been proposed that a high sugar intake was associated with cardiovascular disease (CVD) risk and metabolic syndrome depending on the amount of carbohydrate (CHO), other nutrients in foods, and underlying metabolic disturbances. This study aimed to investigate the effects of high (HS) and low sugar (LS) diets on metabolic profiles in 25 middle-aged men at increased CVD risk in a 12-week randomised cross-over intervention study. An isocaloric dietary exchanged model consisted of HS (24% energy from sugar) and LS (6% energy from sugar) with comparable total CHO, fat and fibre composition in normal foods was used. Anthropometric, blood pressure and plasma lipid profile were measured pre- and post-intervention. Body weight, waist circumference and fat mass increased and decreased significantly after HS (by 0.7±0.3 kg, 1.4±1.0 cm and 0.5±0.3 kg) and LS (by 2.1±0.5 kg, 2.0±0.8 cm and 1.4±0.3 kg) (p<0.05), respectively. Plasma TG increased significantly after HS by 0.26±0.07 mmol/L and decreased after LS by 0.35±0.16 mmol/L. Plasma HDL decreased by 0.11±0.03 mmol/L (p<0.05) after HS, whilst, plasma TC and LDL decreased significantly by 10% after LS. There was no significant change in other parameters after either diet. This study confirmed that a diet with a greater proportion of sugar increased CVD risk via negative changes in metabolic profiles including body weight, waist circumference and lipid parameters, whereas LS produced the positive effects. A restriction of sugar intake to lower than 10% energy intake is vital to reduce CVD risk.

Exposure to high fructose corn syrup during adolescence in the mouse alters hepatic metabolism and the microbiome in a sex-specific manner

KEY POINTS

The prevalence of obesity and non-alcoholic fatty liver disease in children is dramatically increasing at the same time as consumption of foods with a high sugar content. Intake of high fructose corn syrup (HFCS) is a possible aetiology as it is thought to be more lipogenic than glucose. In a mouse model, HFCS intake during adolescence increased fat mass and hepatic lipid levels in male and female mice. However, only males showed impaired glucose tolerance. Multiple metabolites including lipids, bile acids, carbohydrates and amino acids were altered in liver in a sex-specific manner at 6 weeks of age. Some of these changes were also present in adulthood even though HFCS exposure ended at 6 weeks. HFCS significantly altered the gut microbiome, which was associated with changes in key microbial metabolites. These results suggest that HFCS intake during adolescence has profound metabolic changes that are linked to changes in the microbiome and these changes are sex-specific.

ABSTRACT

The rapid increase in obesity, diabetes and fatty liver disease in children over the past 20 years has been linked to increased consumption of high fructose corn syrup (HFCS), making it essential to determine the short- and long-term effects of HFCS during this vulnerable developmental window. We hypothesized that HFCS exposure during adolescence significantly impairs hepatic metabolic signalling pathways and alters gut microbial composition, contributing to changes in energy metabolism with sex-specific effects. C57bl/6J mice with free access to HFCS during adolescence (3-6 weeks of age) underwent glucose tolerance and body composition testing and hepatic metabolomics, gene expression and triglyceride content analysis at 6 and 30 weeks of age (n = 6-8 per sex). At 6 weeks HFCS-exposed mice had significant increases in fat mass, glucose intolerance, hepatic triglycerides (females) and de novo lipogenesis gene expression (ACC, DGAT, FAS, ChREBP, SCD, SREBP, CPT and PPARα) with sex-specific effects. At 30 weeks, HFCS-exposed mice also had abnormalities in glucose tolerance (males) and fat mass (females). HFCS exposure enriched carbohydrate, amino acid, long chain fatty acid and secondary bile acid metabolism at 6 weeks with changes in secondary bile metabolism at 6 and 30 weeks. Microbiome studies performed immediately before and after HFCS exposure identified profound shifts of microbial species in male mice only. In summary, short-term HFCS exposure during adolescence induces fatty liver, alters important metabolic pathways, some of which continue to be altered in adulthood, and changes the microbiome in a sex-specific manner.

High fructose corn syrup, excess-free-fructose, and risk of coronary heart disease among African Americans- the Jackson Heart Study

BACKGROUND

Researchers have sought to explain the black-white coronary heart disease (CHD) mortality disparity that increased from near parity to ~ 30% between 1980 and 2010. Contributing factors include cardiovascular disease prevention and treatment disparities attributable to disparities in insurance coverage. Recent research suggests that dietary/environmental factors may be contributors to the disparity. Unabsorbed/luminal fructose alters gut bacterial load, composition and diversity. There is evidence that such microbiome disruptions promote hypertension and atherosclerosis. The heart-gut axis may, in part, explain the black-white CHD disparity, as fructose malabsorption prevalence is higher among African Americans. Between 1980 and 2010, consumption of excess-free-fructose-the fructose type that triggers malabsorption-exceeded dosages associated with fructose malabsorption (~ 5 g-10 g), as extrapolated from food availability data before subjective, retroactively-applied loss adjustments. This occurred due to an industrial preference shift from sucrose to high-fructose-corn-syrup (HFCS) that began ~ 1980. During this period, HFCS became the main sweetener in US soda. Importantly, there has been more fructose in HFCS than thought, as the fructose-to-glucose ratio in popular sodas (1.9-to-1 and 1.5-to-1) has exceeded generally-recognized-as-safe levels (1.2-to-1). Most natural foods contain a ~ 1-to-1 ratio. In one recent study, ≥5 times/wk. consumers of HFCS sweetened soda/fruit drinks/and apple juice-high excess-free-fructose beverages-were more likely to have CHD, than seldom/never consumers.

METHODS

Jackson-Heart-Study data of African Americans was used to test the hypothesis that regular relative to low/infrequent intake of HFCS sweetened soda/fruit drinks increases CHD risk, but not orange juice-a low excess-free-fructose juice. Cox proportional hazards models were used to calculate hazard ratios using prospective data of 3407-3621 participants, aged 21-93 y (mean 55 y).

RESULTS

African Americans who consumed HFCS sweetend soda 5-6x/wk. or any combination of HFCS sweetened soda and/or fruit drinks ≥3 times/day had ~ 2 (HR 2.08, 95% CI 1.03-4.20, P = 0.041) and 2.5-3 times higher CHD risk (HR 2.98, 95% CI 1.15-7.76; P = 0.025), respectively, than never/seldom consumers, independent of confounders. There were no associations with diet-soda or 100% orange-juice, which has a similar glycemic profile as HFCS sweetened soda, but contains a ~ 1:1 fructose-to-glucose ratio.

CONCLUSION

The ubiquitous presence of HFCS in the food supply may pre-dispose African Americans to increased CHD risk.

A high-fructose diet in rats induces systemic iron deficiency and hepatic iron overload by an inflammation mechanism

Nonalcoholic fatty liver disease (NAFLD) correlates with the high intake of fructose-rich soft drinks. Both inflammation and dysregulated iron metabolism are pathogenic factors in the development of NAFLD. The present investigation assessed the effects of a high-fructose diet (HF diet) on inflammation and iron metabolism. In this study, rats were fed a control or HF diet for 4, 8, or 12 weeks, after which insulin resistance, transaminases levels, serum and liver lipid profiles, inflammatory factors, and iron metabolism-related molecules were evaluated. The activities of the hepatic inflammation-associated pathways, IKKβ/NF-κB, and JAK2/STAT3, were detected by western blot. Result showed that the HF diet-fed animals developed a time-dependent serum lipid increase and hepatic lipid accumulation as well as insulin resistance. Serum iron (SI), serum ferritin (SF), and transferrin saturation (TS) decreased while total iron-binding capacity (TIBC) and serum transferrin (s-TF) increased at 8 and 12 weeks in the HF diet group. The HF diet led to increased transaminases levels at 8 and 12 weeks, and iron deposition was observed in the liver, accompanied by an upregulation of ferritin light chain (FTL), hepcidin (HEPC), transferrin (TF), transferrin receptor 1 (TfR1), iron regulatory protein 1 (IRP1), hemojuvelin (HJV), and divalent metal transporter 1 (DMT1). Moreover, ferroportin (FPN1) levels were downregulated, as expected from the increased HEPC. A progressive inflammation phenotype was apparent, with increased inflammatory factors, MDA, IL-1β, IL-6, and TNF-α, in the serum and liver tissue. Concomitantly, the hepatic IKKβ/NF-κB and JAK2/STAT3 pathways were activated. In summary, we verified that HF diet induces systemic iron deficiency and hepatic iron accumulation, likely due to the activation of inflammation via the NF-κB and JAK2/STAT3 pathways. PRACTICAL APPLICATIONS: As increasing numbers of individuals consume HF diets, the health implications of this type of over nutrition become globally relevant. Using a high-fructose diet rat model, our present study reveals inflammation as the link between a HF diet and dysregulated iron metabolism. Importantly, both inflammation and disrupted iron metabolism have been shown to be pathogenic factors in nonalcoholic fatty liver disease (NAFLD). The iron regulatory hormone, HEPC, is a link between the liver, inflammation, and iron metabolism. As fructose-rich foods become increasingly abundant and people's fructose intake increases, the impact of high fructose on health requires increased attention. Little research has been conducted on the effects of fructose on iron metabolism. Our study provides useful insights into the prevention and treatment of iron metabolism disorders arising from metabolic syndrome.

Sugar-containing beverages and their association with risk of breast, endometrial, ovarian and colorectal cancers among Canadian women

BACKGROUND

The association of sugar containing beverages (SCBs) with risk of breast, endometrial, ovarian and colorectal cancers is unclear. Therefore, we investigated these associations in the Canadian Study of Diet, Lifestyle, and Health.

METHODS

The study population comprised an age-stratified subcohort of 3185 women and 848, 161, 91 and 243 breast, endometrial, ovarian and colorectal cancer cases, respectively. We used Cox proportional hazards regression models modified for the case-cohort design to assess the associations of SCBs with risk of the aforementioned cancers.

RESULTS

Compared to SCB intake in the lowest tertile, SCB intake in the highest tertile was positively associated with endometrial cancer risk (HR_{T3 vs T1} = 1.58, 95 % CI = 1.08-2.33 and 1.78, 95 % CI = 1.12-2.81 for overall and Type 1 endometrial cancer, respectively) and ovarian cancer (HR_{T3 vs T1} = 1.76, 95 % CI: 1.09-2.83). Fruit juice intake was also positively associated with risk of Type 1endometrial (HR_{T3 vs T1} = 1.63, 95 % CI = 1.03-2.60). After excluding women with diabetes or cardiovascular diseases, we also observed sugar-sweetened beverages (SSBs) intake in the highest tertile was associated with higher risk of Type 1 endometrial cancer (HR _{T3 vs T1} = 1.65; 95 % CI: 1.03-2.64). None of the beverages was associated with risk of breast or colorectal cancer.

CONCLUSION

We conclude that, in this cohort, relatively high SCB intake was associated with higher risk of endometrial and ovarian cancers, but not of breast or colorectal cancers. Our findings also suggest that relatively high SSB and fruit juice intake are associated with higher risk of Type 1 endometrial cancer.

Knowledge attitudes and behaviors of adult individuals about high fructose corn syrup consumption; cross sectional survey study

OBJECTIVES

The purpose of this study is; to examine the knowledge and attitudes of individuals about ready-to food consumption and food products containing high fructose corn syrup (HFCS).

STUDY DESIGN

Research in the city center in the eastern Mediterranean region of Turkey was held with 18 individuals over the age of two shoppers at the supermarket.

METHODS

The study is a descriptive cross-sectional questionnaire-based study. The research was conducted between 15.09.2018 and 30.03.2019. Data were collected from 254 individuals using face-to-face interview technique. The questionnaire form consisted of questions created by the researcher to determine socio-demographic variables as well as information about ready-made food intake and foods containing high fructose corn syrup.

RESULTS

The suitability of the questionnaire for factor analysis was evaluated with the "Kaiser-Meyer-Olkin coefficient" and "Bartlett Sphericity Test". As a result of the exploratory factor analysis, the 21-item survey form explains 52% of the total variance. The questionnaire items consist of four factors. Cronbach's Alpha reliability of the questionnaire is 0.860 on the whole. In the sub-factors; The first factor was 0.859, the second factor was 0.764, the third factor was 0.652, and the fourth factor was 0.616. The findings obtained in the study were analyzed using the Independent Sample t Test, One Way Anova test, Mann Whitney U test and Tukey test. SPSS 21, USA was used to analyze the study. It was determined that the average age of the participants was 31.3 ± 11.7, the rate of paying attention to ingredients and nutritional values while purchasing ready-made foods was low, and 1/4 of them did not pay attention to high fructose corn syrup in their content. There was a significant correlation between the age and employment status of the participants and their knowledge and attitudes about the foods containing corn syrup (p < 0.05).

CONCLUSION

It was concluded that individuals should be educated about health risks while purchasing ready-made food products and should be more informed about foods containing HFCS. It is recommended that the questionnaire used in the study be tested in different sample groups in order to increase its validity and reliability evidence.

Erica multiflora extract rich in quercetin-3-O-glucoside and kaempferol-3-O-glucoside alleviates high fat and fructose diet-induced fatty liver disease by modulating metabolic and inflammatory pathways in Wistar rats

The wide morbidity of obesity has heightened interest in providing natural and safe compounds to maintain optimal health. The present study was designed to determine the chemical constituents and the effects of methanol leaf extract from Erica multiflora (M-EML) on mitigating high-fat and high-fructose diet (HFFD)-induced metabolic syndrome (MS). LC-MS/MS characterization of M-EML allowed the identification of 14 secondary metabolites and showed that quercetin-3-O-glucoside and kaempferol-3-O-glucoside were the main compounds of our extract. In the in vivo study, the oral administration of M-EML (250 mg/kg) during the last 4 weeks of the experimentation alleviated HFFD-induced obesity, insulin resistance (IR) and cardiovascular diseases. Thus, M-EML treatment significantly normalized body and liver weight, allowed to a sharp decline in plasma levels of TC, TG and LDL-c by 32%, 35% and 66%, respectively. Moreover, hepatic enzymes, total and direct bilirubin, lipase and uric acid levels have been diminished in treated group. Histopathology of the liver confirmed the changes induced by HFFD and the hepatoprotective effect of M-EML. The supply of M-EML reduced NO production and cellular lysosomal enzyme activity by 44% and 60%, respectively compared to HFFD. Besides, M-EML showed decreased pro-inflammatory cytokines levels (259.5±47.35 pg/ml and 56.08±1.56 pg/ml) of TNF-α and IL-6, respectively. In addition, M-EML reduced liver malondialdehyde (MDA) content and enhanced superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx) activities. In contrast, these enzymatic activities have been disrupted in HFFD rats. Overall, M-EML prevented obesity through the modulation of metabolic syndrome, reducing inflammation and promoting antioxidant enzymes activities.

Differential Effects of Chronic Ingestion of Refined Sugars versus Natural Sweeteners on Insulin Resistance and Hepatic Steatosis in a Rat Model of Diet-Induced Obesity

While the detrimental effect of refined sugars on health has been the subject of many investigations, little is known about the long-term impact of natural sweeteners on metabolic disorders. In this study we compared the metabolic responses to chronic ingestion of refined sugars compared to various natural sweeteners in diet-induced obese rats. Wistar rats were fed a high-fat high-sucrose diet (HFHS) for 8 weeks and daily gavaged with a solution containing 1 g of total carbohydrates from refined sugar (sucrose or fructose) or six different natural sugar sources, followed by assessment of glucose homeostasis, hepatic lipid accumulation, and inflammation. While glucose tolerance was similar following treatments with refined and natural sugars, lowered glucose-induced hyperinsulinemia was observed with fructose. Consumption of fructose and all-natural sweeteners but not corn syrup were associated with lower insulin resistance as revealed by reduced fasting insulin and homeostatic model assessment of insulin resistance (HOMA-IR) compared to sucrose treatment of HFHS-fed rats. All-natural sweeteners and fructose induced similar liver lipid accumulation as sucrose. Nevertheless, maple syrup, molasses, agave syrup, and corn syrup as well as fructose further reduced hepatic IL-1β levels compared to sucrose treatment. We conclude that natural sweeteners and especially maple syrup, molasses, and agave syrup attenuate the development of insulin resistance and hepatic inflammation compared to sucrose in diet-induced obese rats, suggesting that consumption of those natural sweeteners is a less harmful alternative to sucrose in the context of obesity.

The Impact of Dietary Glycemic Index and Glycemic Load on Postprandial Lipid Kinetics, Dyslipidemia and Cardiovascular Risk

Many recent studies have acknowledged postprandial hypetriglyceridemia as a distinct risk factor for cardiovascular disease. This dysmetabolic state is the result of the hepatic overproduction of very low-density lipoproteins (VLDLs) and intestinal secretion of chylomicrons (CMs), which leads to highly atherogenic particles and endothelial inflammation. Postprandial lipid metabolism does not only depend on consumed fat but also on the other classes of nutrients that a meal contains. Various mechanisms through which carbohydrates exacerbate lipidemia have been identified, especially for fructose, which stimulates de novo lipogenesis. Glycemic index and glycemic load, despite their intrinsic limitations, have been used as markers of the postprandial glucose and insulin response, and their association with metabolic health and cardiovascular events has been extensively studied with contradictory results. This review aims to discuss the importance and pathogenesis of postprandial hypertriglyceridemia and its association with cardiovascular disease. Then, we describe the mechanisms through which carbohydrates influence lipidemia and, through a brief presentation of the available clinical studies on glycemic index/glycemic load, we discuss the association of these indices with atherogenic dyslipidemia and address possible concerns and implications for everyday practice.

Orally administered octacosanol improves some features of high fructose-induced metabolic syndrome in rats

We examined whether orally administered octacosanol, a long-chain aliphatic saturated alcohol, improves the features of high fructose-induced metabolic syndrome in rats. Five-week-old rats were fed a high fructose diet containing 60% fructose for 3 weeks. Then, the high fructose fed rats received a daily single oral administration of octacosanol (10 or 100 mg/kg body weight) with high fructose feeding for one week. Three- or four-week high fructose feeding increased insulin resistance, serum insulin, triglyceride, total cholesterol, free fatty acids, uric acid, and lipid peroxide concentrations, and hepatic triglyceride and cholesterol contents significantly and decreased serum high-density lipoprotein cholesterol and adiponectin concentrations significantly but did not affect blood pressure and hepatic lipid peroxide and reduced glutathione contents. Four-week high fructose feeding decreased hepatic ascorbic acid content significantly. Oral administration of octacosanol (10 or 50 mg/kg body weight) to high fructose-fed rats for the last 1-week fructose diet feeding attenuated these changes except serum insulin level and insulin resistance significantly and increased hepatic reduced glutathione content significantly. The higher dose of Oct decreased hepatic lipid peroxide content significantly. These results indicate that orally administered octacosanol improves dyslipidemia, hyperuricemia, hypoadiponectinemia, and oxidative stress associated with the features of high fructose-induced metabolic syndrome rats.

Adverse effects of honey on low-density lipoprotein cholesterol and adiponectin concentrations in patients with type 2 diabetes: a randomized controlled cross-over trial

Background

Due to phenolic and fructose content, honey may be a suitable sweetener for patients with type 2 diabetes. However, its effect on oxidative and inflammatory status of diabetes patients is not clear. We aimed to investigate the effect of natural honey on some of oxidative, inflammatory, and anti-inflammatory markers of patients with type 2 diabetes.

Methods

In a randomized controlled cross-over trial, 43 patients with type 2 diabetes were allocated to isocaloric conditions with either dietary recommendations (control) or natural honey (50 g/day) plus dietary recommendations (honey) for 8 weeks with one month washout period in between. Serum lipids, malondialdehyde (MDA), total antioxidant capacity (TAC), high-sensitivity C-reactive protein (hs-CRP), and adiponectin levels were measured at baseline and the end of each sequence.

Results

Malondialdehyde (10.9%, P = 0.01), hs-C reactive protein (10.6%, P = 0.003), and adiponectin (7.1%, P < 0.001) concentrations significantly decreased in honey condition. Low-density lipoprotein cholesterol (LDL-C) (16.8%, P < 0.001) significantly decreased in control and high-density lipoprotein cholesterol (HDL-C) significantly increased in both conditions. Between-group differences were only statistically significant for adiponectin (P = 0.005) and LDL-C (P = 0.005).

Conclusions

Consumption of 50 g/day honey had adverse effects on LDL-C and adiponectin levels in patients with type 2 diabetes. Honey may need to be consumed with caution in type 2 diabetes patients.

Recent advances in the pathogenesis of hereditary fructose intolerance: implications for its treatment and the understanding of fructose-induced non-alcoholic fatty liver disease

Hereditary fructose intolerance (HFI) is a rare inborn disease characterized by a deficiency in aldolase B, which catalyzes the cleavage of fructose 1,6-bisphosphate and fructose 1-phosphate (Fru 1P) to triose molecules. In patients with HFI, ingestion of fructose results in accumulation of Fru 1P and depletion of ATP, which are believed to cause symptoms, such as nausea, vomiting, hypoglycemia, and liver and kidney failure. These sequelae can be prevented by a fructose-restricted diet. Recent studies in aldolase B-deficient mice and HFI patients have provided more insight into the pathogenesis of HFI, in particular the liver phenotype. Both aldolase B-deficient mice (fed a very low fructose diet) and HFI patients (treated with a fructose-restricted diet) displayed greater intrahepatic fat content when compared to controls. The liver phenotype in aldolase B-deficient mice was prevented by reduction in intrahepatic Fru 1P concentrations by crossing these mice with mice deficient for ketohexokinase, the enzyme that catalyzes the synthesis of Fru 1P. These new findings not only provide a potential novel treatment for HFI, but lend insight into the pathogenesis of fructose-induced non-alcoholic fatty liver disease (NAFLD), which has raised to epidemic proportions in Western society. This narrative review summarizes the most recent advances in the pathogenesis of HFI and discusses the implications for the understanding and treatment of fructose-induced NAFLD.

The effects of melatonin on possible damage that will occur on adipocytokines and liver tissue by coadministration of fructose and bisphenol a (BPA)

BPA, one of the environmental endocrine disruptors, and fructose, reason of liver steatosis which is frequently encountered in the daily diet, contribute to the formation of metabolic syndrome (MetS). This study examines the possible effects of concurrent fructose and BPA administration on MetS and determines the effects of melatonin on this process. In the seven identified groups, a total of forty-two adult male Sprague Dawley rats were treated by following fructose, BPA, and melatonin amounts, separately and together: group 1 (control), group 2 (10% aqueous fructose), group 3 (25 mg/kg BPA), group 4 (10% fructose + 25 mg/kg BPA), group 5 (10% fructose + 20 mg/kg melatonin), group 6 (25 mg/kg BPA + 20 mg/kg melatonin), and group 7 (10% fructose + 25 mg/kg BPA + 20 mg/kg melatonin). At the end of 60 days, histochemical, immunohistochemical, and biochemical procedures were performed on liver tissue. As a result, it was seen that BPA and fructose + BPA induced morphological alteration and inflammation and increased intracellular lipid quantity and amount of collagen and reticular fibers. The percentage of apoptotic liver cells stained by annexin V-FITC/PI was lower in group 7 compared to the group 4 (p < 0,001) and also in group 6 compared to the group 3 (p = 0.014). Both BPA and fructose application caused an increase in lipid peroxidation level due to the increase of oxidative stress. Application of melatonin induced antioxidant enzyme activity and reduced lipid peroxidation level. Our results indicate that fructose and BPA administration triggered the formation of MetS, whereas melatonin healed these variations, although not entirely.

The Effect of Packaging Color and Health Claims on Product Attitude and Buying Intention

Packaging design is an important factor when consumers look out for healthy food. The study tested for effects of packaging color and health claims of a fictional fruit yoghurt package on attitude towards the product and subsequently, consumer’s buying intention, using a 2 × 2 between-subjects experimental design. We also tested whether interest in healthy food is a moderating factor. We found no evidence to support that visual cues (color) and textual cues (health-related advertising claims) are effective in influencing consumer attitude towards the product. Consumers did not show a more positive attitude towards products presented in low-arousal packaging colors (green/blue) compared to high arousal packaging colors (red/yellow). Also, the claim “palatability” did not result in a more positive attitude towards the product than the claim “healthy”. A moderating role of interest in healthy food could not be confirmed. The results confirmed, however, a significant relation of attitude towards the product and buying intention. Thus, buying intention could be explained mostly by whether consumers had a positive or negative attitude towards the product, which confirms that people’s attitudes are powerful predictors of buying decisions.

Impaired glucose transport in inguinal adipocytes after short-term high-sucrose feeding in mice

Diets enriched in sucrose severely impair metabolic regulation and are associated with obesity, insulin resistance and glucose intolerance. In the current study, we investigated the effect of 4 weeks high-sucrose diet (HSD) feeding in C57BL6/J mice, with specific focus on adipocyte function. Mice fed HSD had slightly increased adipose tissue mass but displayed similar hepatic triglycerides, glucose and insulin levels, and glucose clearance capacity as chow-fed mice. Interestingly, we found adipose depot-specific differences, where both the non- and insulin-stimulated glucose transports were markedly impaired in primary adipocytes isolated from the inguinal fat depot from HSD-fed mice. This was accompanied by decreased protein levels of both GLUT4 and AS160. A similar but much less pronounced trend was observed in the retroperitoneal depot. In contrast, both GLUT4 expression and insulin-stimulated glucose uptake were preserved in adipocytes isolated from epididymal adipose tissue with HSD. Further, we found a slight shift in cell size distribution towards larger cells with HSD and a significant decrease of ACC and PGC-1α expression in the inguinal adipose tissue depot. Moreover, fructose alone was sufficient to decrease GLUT4 expression in cultured, mature adipocytes. Altogether, we demonstrate that short-term HSD feeding has deleterious impact on insulin response and glucose transport in the inguinal adipose tissue depot, specifically. These changes occur before the onset of systemic glucose dysmetabolism and therefore could provide a mechanistic link to overall impaired energy metabolism reported after prolonged HSD feeding, alone or in combination with HFD.

Fructose Consumption During Pregnancy Influences Milk Lipid Composition and Offspring Lipid Profiles in Guinea Pigs

Excess dietary fructose is a major public health concern (1-4). Evidence shows increased fructose intake can cause insulin resistance, hepatic de novo lipogenesis, hypertriglyceridemia, obesity and non-alcoholic fatty liver disease (NAFLD) (5-9). However, little is known about the effects of fructose during pregnancy and its influence on offspring development and predisposition to later-life disease. To determine whether moderately increased maternal fructose intake could have health consequences on offspring, we have investigated the effects of 10% w/v fructose water intake during preconception and pregnancy. Female Dunkin Hartley guinea pigs were fed a control diet (CD) or fructose diet (FD;10% kcal from fructose) ad-libitum 60 days prior to mating and throughout gestation. Offspring were culled at weaning, day 21 (d21). Compared to CD dams, FD dams had altered glucose metabolism and increased milk free fatty acid content. Matsuda-DeFronzo insulin sensitivity index (M-ISI) from OGTT plasma showed no significant difference in whole-body insulin sensitivity between FD and CD dams 60 days post-dietary intervention and during midgestation. Fetal exposure to increased maternal fructose resulted in offspring with significantly altered serum free fatty acids at days 0, 7, 14, and 21 [including pentadecanoic acid (15:0), dma16:0, margaric acid (17:0) palmitoleic acid, total omega-7 and total saturates], increased levels of uric acid and triglycerides were also observed at d21. We have demonstrated that increased fructose intake during pregnancy can cause significant changes in maternal metabolic function and milk composition, which alters offspring metabolism. Taken together, these changes in pregnancy outcomes and feto-maternal condition may underlie their offspring's predisposition to metabolic dysfunction during later-life.

Vitamin A and its metabolic pathway play a determinant role in high-fructose-induced triglyceride accumulation of the visceral adipose depot of male Wistar rats

Here, we tested a hypothesis that vitamin A and/or its metabolic pathways are involved in the high-fructose-mediated alteration in adipose tissue biology. For this purpose, weanling male Wistar rats were provided with one of the following diets: control (C), control with vitamin A deficiency (C-VAD), high fructose (HFr), and HFr with VAD (HFr-VAD) for 16 weeks, except that half of the C-VAD diet-fed rats were shifted to HFr diet (C-VAD(s)HFr), after 8-week period. Compared with control, feeding of HFr diet significantly increased the triglyceride content (P ≤ .01) and thus adipocyte size (hypertrophy) (P ≤ .001) in visceral adipose depot; retroperitoneal white adipose tissue (RPWAT) and these changes were corroborated with de novo lipogenesis, as evidenced by the increased glycerol-3-phosphate dehydrogenase activity (P ≤ .01) and up-regulation of lipogenic pathway transcripts, fructose transporter, and aldehyde dehydrogenase 1 A1. On the contrary, the absence of vitamin A in the HFr diet (HFr-VAD) failed to exert these changes; however, it induced adipocyte hyperplasia. Further, vitamin A deficiency-mediated changes were reversed by replenishment, as evident from the group that was shifted from C-VAD to HFr diet. In conclusion, vitamin A and its metabolic pathway play a key determinant role in the high-fructose-induced triglyceride accumulation and adipocyte hypertrophy of visceral white adipose depot. SIGNIFICANCE OF THE STUDY: Here, we report the metabolic impact of high-fructose feeding under vitamin A-sufficient and vitamin A-deficient conditions. Feeding of high-fructose diet induced triglyceride accumulation and adipocyte hypertrophy of the visceral white adipose depots. These changes corroborated with augmented expression of vitamin A and lipid metabolic pathway genes. Contrarily, absence of vitamin A in the high-fructose diet did not elicit such responses, while vitamin A replenishment reversed the changes exerted by vitamin A deficiency. To our knowledge, this is the first study to report the role of vitamin A and its metabolic pathway in the high-fructose-induced triglyceride synthesis and its accumulation in visceral adipose depot and thus provide a new insight and scope to understand these nutrients interaction in clinical conditions.

A review of the putative causal mechanisms associated with lower macular pigment in diabetes mellitus

Macular pigment (MP) confers potent antioxidant and anti-inflammatory effects at the macula, and may therefore protect retinal tissue from the oxidative stress and inflammation associated with ocular disease and ageing. There is a body of evidence implicating oxidative damage and inflammation as underlying pathological processes in diabetic retinopathy. MP has therefore become a focus of research in diabetes, with recent evidence suggesting that individuals with diabetes, particularly type 2 diabetes, have lower MP relative to healthy controls. The present review explores the currently available evidence to illuminate the metabolic perturbations that may possibly be involved in MP's depletion. Metabolic co-morbidities commonly associated with type 2 diabetes, such as overweight/obesity, dyslipidaemia, hyperglycaemia and insulin resistance, may have related and independent relationships with MP. Increased adiposity and dyslipidaemia may adversely affect MP by compromising the availability, transport and assimilation of these dietary carotenoids in the retina. Furthermore, carotenoid intake may be compromised by the dietary deficiencies characteristic of type 2 diabetes, thereby further compromising redox homeostasis. Candidate causal mechanisms to explain the lower MP levels reported in diabetes include increased oxidative stress, inflammation, hyperglycaemia, insulin resistance, overweight/obesity and dyslipidaemia; factors that may negatively affect redox status, and the availability, transport and stabilisation of carotenoids in the retina. Further study in diabetic populations is warranted to fully elucidate these relationships.

Effects of Fructose or Glucose on Circulating ApoCIII and Triglyceride and Cholesterol Content of Lipoprotein Subfractions in Humans

ApoCIII and triglyceride (TG)-rich lipoproteins (TRL), particularly, large TG-rich lipoproteins particles, have been described as important mediators of cardiovascular disease (CVD) risk. The effects of sustained consumption of dietary fructose compared with those of sustained glucose consumption on circulating apoCIII and large TRL particles have not been reported. We measured apoCIII concentrations and the TG and cholesterol content of lipoprotein subfractions separated by size in fasting and postprandial plasma collected from men and women (age: 54 ± 8 years) before and after they consumed glucose- or fructose-sweetened beverages for 10 weeks. The subjects consuming fructose exhibited higher fasting and postprandial plasma apoCIII concentrations than the subjects consuming glucose (p < 0.05 for both). They also had higher concentrations of postprandial TG in all TRL subfractions (p < 0.05, effect of sugar), with the highest increases occurring in the largest TRL particles (p < 0.0001 for fructose linear trend). Compared to glucose consumption, fructose consumption increased postprandial TG in low-density lipoprotein (LDL) particles (p < 0.05, effect of sugar), especially in the smaller particles (p < 0.0001 for fructose linear trend). The increases of both postprandial apoCIII and TG in large TRL subfractions were associated with fructose-induced increases of fasting cholesterol in the smaller LDL particles. In conclusion, 10 weeks of fructose consumption increased the circulating apoCIII and postprandial concentrations of large TRL particles compared with glucose consumption.

Tissue Changes in the Development of Fatty Liver by Chronic Ingestion of Sucrose Associated with Obesity and Dyslipidemia in Rats

A diet high in sucrose, which is a common food constituent, induces obesity and non- alcoholic fatty liver (NFLD) caused by high caloric intake; however, it is important to investigate those sequential changes in the hepatic parenchyma related to sugar consumption which are associated to obesity and dyslipidemia. We analyzed the effects of long-term sucrose intake on fatty liver development, by the administration of 30% sucrose in drinking water in healthy Wistar rats during 30 weeks. Serum variables, body fat index, caloric intake and microscopic examination of liver tissue were monitored. In the first week, grade 1 steatosis was observed with ballooned hepatocytes, with a caloric intake of 125 ± 1.90 kcal / day / 100 g of body weight; together with a gain of 71% in abdominal fat with respect to the control group and dyslipidemia. During the 10 to 20 weeks period, steatosis grade 2 with noticeable inflammation (steatohepatitis), polymorphic cells and ballooned hepatocytes were evident. After 10 weeks, the caloric intake was 72.9 ± 5.99 kcal / day / 100 g of body weight with 199% of gain in abdominal fat in SUC groups with respect control group (p < 0.01) and moderate dyslipidemia; while after 20 weeks, the caloric intake was 61.6 ± 4.65 kcal / day / 100 g of body weight with 208% of gain in abdominal fat and also moderate dyslipidemia. After 30 weeks steatosis grade 3 with marked inflammation (steatohepatitis), periportal fibrosis, globose and fat-filled hepatocytes were observed, with a caloric intake of 52.3 ± 3.05 kcal / day / 100 g of body weight and 232% of gain in abdominal fat that was related to severe dyslipidemia. In conclusion, the sequential changes in the development of NAFLD were associated with the ingestion of sucrose and obesity since the first week of administration.

Effects of Dietary Protein and Fat Content on Intrahepatocellular and Intramyocellular Lipids during a 6-Day Hypercaloric, High Sucrose Diet: A Randomized Controlled Trial in Normal Weight Healthy Subjects

Sucrose overfeeding increases intrahepatocellular (IHCL) and intramyocellular (IMCL) lipid concentrations in healthy subjects. We hypothesized that these effects would be modulated by diet protein/fat content. Twelve healthy men and women were studied on two occasions in a randomized, cross-over trial. On each occasion, they received a 3-day 12% protein weight maintenance diet (WM) followed by a 6-day hypercaloric high sucrose diet (150% energy requirements). On one occasion the hypercaloric diet contained 5% protein and 25% fat (low protein-high fat, LP-HF), on the other occasion it contained 20% protein and 10% fat (high protein-low fat, HP-LF). IHCL and IMCL concentrations (magnetic resonance spectroscopy) and energy expenditure (indirect calorimetry) were measured after WM, and again after HP-LF/LP-HF. IHCL increased from 25.0 ± 3.6 after WM to 147.1 ± 26.9 mmol/kg wet weight (ww) after LP-HF and from 30.3 ± 7.7 to 57.8 ± 14.8 after HP-LF (two-way ANOVA with interaction: p < 0.001 overfeeding x protein/fat content). IMCL increased from 7.1 ± 0.6 to 8.8 ± 0.7 mmol/kg ww after LP-HF and from 6.2 ± 0.6 to 6.9 ± 0.6 after HP-LF, (p < 0.002). These results indicate that liver and muscle fat deposition is enhanced when sucrose overfeeding is associated with a low protein, high fat diet compared to a high protein, low fat diet.

Association between major dietary patterns and polycystic ovary syndrome: evidence from a case-control study

Polycystic ovary syndrome (PCOS) is a multifactorial endocrine disorder in women. Change in lifestyle, especially dietary pattern, might have a role in the prevalence of PCOS. The limited number of studies has made it difficult to draw any conclusion about the relationship of dietary patterns with PCOS. This study aimed to investigate the association between dietary patterns and PCOS. A case-control study was performed on 225 patients newly diagnosed with PCOS and 345 healthy women in Isfahan, Iran. The presence of PCOS was confirmed by expert gynecologists based on Rotterdam criteria. Usual dietary intake was assessed by a 168-item food frequency questionnaire. Dietary patterns were identified by principal component analysis. Three major dietary patterns including Western, plant-based, and mixed were identified that explained 53.93% of the variance in food intake. The top tertile of the Western dietary pattern significantly increased the odds of PCOS (odds ratio (OR), 2.03; 95% confidence interval (CI), 1.12–3.67), both before and after adjustments for covariates. After adjustments for potential confounders, the highest tertile of the plant-based dietary pattern was related to higher odds of PCOS than the lowest tertile (OR, 2.32; 95% CI, 1.23–4.37). In addition, those in the second tertile of the mixed dietary pattern were 66% less likely to have PCOS compared with those in the lowest tertile (OR, 0.34; 95% CI, 0.18–0.61). In conclusion, we found that Western and plant-based dietary patterns were associated with an increased risk of PCOS. Also, moderate adherence to the mixed dietary pattern was associated with a reduced risk of PCOS. Additional studies with a longitudinal design are required to confirm our findings.

The protective effect of neonatal oral administration of oleanolic acid against the subsequent development of fructose-induced metabolic dysfunction in male and female rats

BACKGROUND

Consumption of fructose-rich diets has been implicated in the increasing global prevalence of metabolic syndrome (MetS). Interventions during periods of early ontogenic developmental plasticity can cause epigenetic changes which program metabolism for positive or negative health benefits later in life. The phytochemical oleanolic acid (OA) possesses anti-diabetic and anti-obesity effects. We investigated the potential protective effects of neonatal administration of OA on the subsequent development of high fructose diet-induced metabolic dysfunction in rats.

METHOD

Male and female (N = 112) suckling rats were randomly assigned to four groups and administered orally: distilled water (DW), oleanolic acid (OA; 60 mg/kg), high-fructose solution (HF; 20% w/v) or OA + HF for 7 days. The rats were weaned onto normal commercial rat chow up to day 55. From day 56, half of the rats in each treatment group were continued on plain water and the rest on a high fructose solution as drinking fluid for 8 weeks. On day 110, the rats were subjected to an oral glucose tolerance test and then euthanased on day 112. Tissue and blood samples were collected to determine the effects of the treatments on visceral fat pad mass, fasting plasma levels of cholesterol, insulin, glucose, triglycerides, insulin resistance (HOMA-IR) and glucose tolerance.

RESULTS

Rats which consumed fructose as neonates and then later as adults (HF + F) and those which consumed fructose only in adulthood (DW + F) had significant increases in terminal body mass (females only), visceral fat mass (males and females), serum triglycerides (females only), epididymal fat (males only), fasting plasma glucose (males and females), impaired glucose metabolism (females only), β-cell dysfunction and insulin resistance (males and females) compared to the other treatment groups (P < 0.05). There were no differences in fasting serum cholesterol levels across all treatment groups in both male and female rats (P > 0.05).

CONCLUSION

We conclude that neonatal oral administration of OA during the critical window of developmental plasticity protected against the development of health outcomes associated with fructose-induced metabolic disorders in the rats.