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Eveleens Maarse BC, Eggink HM, Warnke I, Bijlsma S, van den Broek TJ, Oosterman JE, Caspers MPM, Sybesma W, Gal P, van Kraaij SJW, Schuren FHJ, Moerland M, Hoevenaars FPM. Impact of fibre supplementation on microbiome and resilience in healthy participants: A randomized, placebo-controlled clinical trial. Nutr Metab Cardiovasc Dis 2024; 34:1416-1426. [PMID: 38499450 DOI: 10.1016/j.numecd.2024.01.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 01/24/2024] [Accepted: 01/25/2024] [Indexed: 03/20/2024]
Abstract
BACKGROUND AND AIMS The gut microbiome exerts important roles in health, e.g., functions in metabolism and immunology. These functions are often exerted via short-chain fatty acid (SCFA) production by gut bacteria. Studies demonstrating causal relationships between interventions targeting the microbiome and clinical outcomes are limited. This study aimed to show a causal relationship between microbiome modulation through fibre intervention and health. METHODS AND RESULTS This randomized, double-blind, cross-over study included 65 healthy subjects, aged 45-70 years, with increased metabolic risk (i.e., body mass index [BMI] 25-30 kg/m2, low to moderate daily dietary fibre intake, <30g/day). Subjects took daily a fibre mixture of Acacia gum and carrot powder or placebo for 12 weeks, with an 8-week wash-out period. Faecal samples for measurement of SCFAs and microbiome analysis were collected every 4 weeks. Before and after each intervention period subjects underwent the mixed-meal PhenFlex challenge Test (PFT). Health effects were expressed as resilience to the stressors of the PFT and as fasting metabolic and inflammatory state. The fibre mixture exerted microbiome modulation, with an increase in β-diversity (p < 0.001). α-diversity was lower during fibre mixture intake compared to placebo after 4, 8 and 12 weeks (p = 0.002; p = 0.012; p = 0.031). There was no effect observed on faecal SCFA concentrations, nor on any of the primary clinical outcomes (Inflammatory resilience: p = 0.605, Metabolic resilience: p = 0.485). CONCLUSION Although the intervention exerted effects on gut microbiome composition, no effects on SCFA production, on resilience or fasting metabolic and inflammatory state were observed in this cohort. REGISTRATION NUMBER CLINICALTRIALS.GOV: NCT04829396.
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Affiliation(s)
- Boukje C Eveleens Maarse
- Centre for Human Drug Research, Leiden, the Netherlands; Leiden University Medical Center, Leiden, the Netherlands
| | - Hannah M Eggink
- TNO, Netherlands Organisation for Applied Scientific Research, Leiden, the Netherlands
| | - Ines Warnke
- dsm-firmenich, CH-4303, Kaiseraugst, Switzerland
| | - Sabina Bijlsma
- TNO, Netherlands Organisation for Applied Scientific Research, Leiden, the Netherlands
| | - Tim J van den Broek
- TNO, Netherlands Organisation for Applied Scientific Research, Leiden, the Netherlands
| | - Johanneke E Oosterman
- TNO, Netherlands Organisation for Applied Scientific Research, Leiden, the Netherlands
| | - Martien P M Caspers
- TNO, Netherlands Organisation for Applied Scientific Research, Leiden, the Netherlands
| | | | - Pim Gal
- Centre for Human Drug Research, Leiden, the Netherlands; Leiden University Medical Center, Leiden, the Netherlands
| | - Sebastiaan J W van Kraaij
- Centre for Human Drug Research, Leiden, the Netherlands; Leiden University Medical Center, Leiden, the Netherlands
| | - Frank H J Schuren
- TNO, Netherlands Organisation for Applied Scientific Research, Leiden, the Netherlands
| | - Matthijs Moerland
- Centre for Human Drug Research, Leiden, the Netherlands; Leiden University Medical Center, Leiden, the Netherlands
| | - Femke P M Hoevenaars
- TNO, Netherlands Organisation for Applied Scientific Research, Leiden, the Netherlands.
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2
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Wopereis S. Phenotypic flexibility in nutrition research to quantify human variability: building the bridge to personalised nutrition. Proc Nutr Soc 2023; 82:346-358. [PMID: 36503652 DOI: 10.1017/s0029665122002853] [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] [Indexed: 12/14/2022]
Abstract
Phenotypic flexibility is a methodology that accurately assesses health in terms of mechanistic understanding of the interrelationship of multiple metabolic and physiological processes. This starts from the perspective that a healthy person is better able to cope with changes in environmental stressors that affect homeostasis compared to people with a compromised health state. The term 'phenotypic flexibility' expresses the cumulative ability of overarching physiological processes to return to homeostatic levels after short-term perturbations. The concept of phenotypic flexibility to define biomarkers for nutrition-related health was introduced in 2009 in the area of health optimisation and prevention and delay of non-communicable disease. The core approach consists of the combination of imposing a challenge test to the body followed by time-resolved analysis of multiple biomarkers. This new approach may better facilitate nutritional health research in intervention studies since it may show effects on early derailed physiological markers and the biomarker response can be extended by perturbing the system, thereby making them more sensitive in detecting health effects from food and nutrition. At the same time, interindividual variation can also be extended and compressed by challenge tests, facilitating the bridge to personalised nutrition. This review will overview where the science is in this research arena and what the phenotypic flexibility potential is for the nutrition field.
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Affiliation(s)
- Suzan Wopereis
- Research Group Microbiology & Systems Biology, TNO, Netherlands Organisation for Applied Scientific Research, 2333 BE Leiden, the Netherlands
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3
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Rundle M, Fiamoncini J, Thomas EL, Wopereis S, Afman LA, Brennan L, Drevon CA, Gundersen TE, Daniel H, Perez IG, Posma JM, Ivanova DG, Bell JD, van Ommen B, Frost G. Diet-induced Weight Loss and Phenotypic Flexibility Among Healthy Overweight Adults: A Randomized Trial. Am J Clin Nutr 2023; 118:591-604. [PMID: 37661105 PMCID: PMC10517213 DOI: 10.1016/j.ajcnut.2023.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 06/28/2023] [Accepted: 07/03/2023] [Indexed: 09/05/2023] Open
Abstract
BACKGROUND The capacity of an individual to respond to changes in food intake so that postprandial metabolic perturbations are resolved, and metabolism returns to its pre-prandial state, is called phenotypic flexibility. This ability may be a more important indicator of current health status than metabolic markers in a fasting state. AIM In this parallel randomized controlled trial study, an energy-restricted healthy diet and 2 dietary challenges were used to assess the effect of weight loss on phenotypic flexibility. METHODS Seventy-two volunteers with overweight and obesity underwent a 12-wk dietary intervention. The participants were randomized to a weight loss group (WLG) with 20% less energy intake or a weight-maintenance group (WMG). At weeks 1 and 12, participants were assessed for body composition by MRI. Concurrently, markers of metabolism and insulin sensitivity were obtained from the analysis of plasma metabolome during 2 different dietary challenges-an oral glucose tolerance test (OGTT) and a mixed-meal tolerance test. RESULTS Intended weight loss was achieved in the WLG (-5.6 kg, P < 0.0001) and induced a significant reduction in total and regional adipose tissue as well as ectopic fat in the liver. Amino acid-based markers of insulin action and resistance such as leucine and glutamate were reduced in the postprandial phase of the OGTT in the WLG by 11.5% and 28%, respectively, after body weight reduction. Weight loss correlated with the magnitude of changes in metabolic responses to dietary challenges. Large interindividual variation in metabolic responses to weight loss was observed. CONCLUSION Application of dietary challenges increased sensitivity to detect metabolic response to weight loss intervention. Large interindividual variation was observed across a wide range of measurements allowing the identification of distinct responses to the weight loss intervention and mechanistic insight into the metabolic response to weight loss.
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Affiliation(s)
- Milena Rundle
- Section of Nutrition, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Jarlei Fiamoncini
- Food Research Center, Department of Food Science and Experimental Nutrition, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - E Louise Thomas
- Research Centre for Optimal Health, School of Life Sciences, University of Westminster, London, United Kingdom
| | - Suzan Wopereis
- Department of Microbiology and Systems Biology, Netherlands Organization for Applied Scientific Research, Hague, The Netherlands
| | - Lydia A Afman
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Lorraine Brennan
- UCD School of Agriculture and Food Science, Institute of Food and Health, University College Dublin, Belfield, Dublin, Ireland
| | - Christian A Drevon
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway; Vitas Ltd, Oslo Science Park, Oslo, Norway
| | | | - Hannelore Daniel
- Hannelore Daniel, Molecular Nutrition Unit, Technische Universität München, München, Germany
| | - Isabel Garcia Perez
- Section of Nutrition, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Joram M Posma
- Section of Bioinformatics, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Diana G Ivanova
- Department of Biochemistry, Molecular Medicine and Nutrigenomics, Faculty of Pharmacy, Medical University, Varna, Bulgaria
| | - Jimmy D Bell
- Research Centre for Optimal Health, School of Life Sciences, University of Westminster, London, United Kingdom
| | - Ben van Ommen
- Department of Microbiology and Systems Biology, Netherlands Organization for Applied Scientific Research, Hague, The Netherlands
| | - Gary Frost
- Section of Nutrition, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, United Kingdom.
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Weinisch P, Raffler J, Römisch-Margl W, Arnold M, Mohney RP, Rist MJ, Prehn C, Skurk T, Hauner H, Daniel H, Suhre K, Kastenmüller G. The HuMet Repository: Watching human metabolism at work. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.08.08.550079. [PMID: 37609175 PMCID: PMC10441358 DOI: 10.1101/2023.08.08.550079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
The human metabolism constantly responds to stimuli such as food intake, fasting, exercise, and stress, triggering adaptive biochemical processes across multiple metabolic pathways. To understand the role of these processes and disruptions thereof in health and disease, detailed documentation of healthy metabolic responses is needed but still scarce on a time-resolved metabolome-wide level. Here, we present the HuMet Repository, a web-based resource for exploring dynamic metabolic responses to six physiological challenges (exercise, 36 h fasting, oral glucose and lipid loads, mixed meal, cold stress) in healthy subjects. For building this resource, we integrated existing and newly derived metabolomics data measured in blood, urine, and breath samples of 15 young healthy men at up to 56 time points during the six highly standardized challenge tests conducted over four days. The data comprise 1.1 million data points acquired on multiple platforms with temporal profiles of 2,656 metabolites from a broad range of biochemical pathways. By embedding the dataset into an interactive web application, we enable users to easily access, search, filter, analyze, and visualize the time-resolved metabolomic readouts and derived results. Users can put metabolites into their larger context by identifying metabolites with similar trajectories or by visualizing metabolites within holistic metabolic networks to pinpoint pathways of interest. In three showcases, we outline the value of the repository for gaining biological insights and generating hypotheses by analyzing the wash-out of dietary markers, the complementarity of metabolomics platforms in dynamic versus cross-sectional data, and similarities and differences in systemic metabolic responses across challenges. With its comprehensive collection of time-resolved metabolomics data, the HuMet Repository, freely accessible at https://humet.org/, is a reference for normal, healthy responses to metabolic challenges in young males. It will enable researchers with and without computational expertise, to flexibly query the data for their own research into the dynamics of human metabolism.
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Affiliation(s)
- Patrick Weinisch
- Institute of Computational Biology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Johannes Raffler
- Institute of Computational Biology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
- Digital Medicine, University Hospital of Augsburg, Augsburg, Germany
| | - Werner Römisch-Margl
- Institute of Computational Biology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Matthias Arnold
- Institute of Computational Biology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | | | - Manuela J. Rist
- Department of Physiology and Biochemistry of Nutrition, Max Rubner-Institut, Karlsruhe, Germany
| | - Cornelia Prehn
- Metabolomics and Proteomics Core, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Thomas Skurk
- ZIEL Institute for Food and Health, Core Facility Human Studies, Technical University of Munich, Freising, Germany
- Else Kröner Fresenius Center of Nutritional Medicine, Department of Food and Nutrition, Technical University of Munich, Freising, Germany
| | - Hans Hauner
- Else Kröner Fresenius Center of Nutritional Medicine, Department of Food and Nutrition, Technical University of Munich, Freising, Germany
- Institute for Nutritional Medicine, School of Medicine, Technical University of Munich, Munich, Germany
| | - Hannelore Daniel
- Department of Food and Nutrition, Technical University of Munich, Freising, Germany
| | - Karsten Suhre
- Department of Biophysics and Physiology, Weill Cornell Medicine - Qatar, Doha, Qatar
| | - Gabi Kastenmüller
- Institute of Computational Biology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
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5
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van Steenwijk HP, Winter E, Knaven E, Brouwers JF, van Baardwijk M, van Dalum JB, Luijendijk TJC, van Osch FHM, Troost FJ, Bast A, Semen KO, de Boer A. The beneficial effect of sulforaphane on platelet responsiveness during caloric load: a single-intake, double-blind, placebo-controlled, crossover trial in healthy participants. Front Nutr 2023; 10:1204561. [PMID: 37485383 PMCID: PMC10359317 DOI: 10.3389/fnut.2023.1204561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 06/15/2023] [Indexed: 07/25/2023] Open
Abstract
Background and aims As our understanding of platelet activation in response to infections and/or inflammatory conditions is growing, it is becoming clearer that safe, yet efficacious, platelet-targeted phytochemicals could improve public health beyond the field of cardiovascular diseases. The phytonutrient sulforaphane shows promise for clinical use due to its effect on inflammatory pathways, favorable pharmacokinetic profile, and high bioavailability. The potential of sulforaphane to improve platelet functionality in impaired metabolic processes has however hardly been studied in humans. This study investigated the effects of broccoli sprout consumption, as a source of sulforaphane, on urinary 11-dehydro-thromboxane B2 (TXB2), a stable thromboxane metabolite used to monitor eicosanoid biosynthesis and response to antithrombotic therapy, in healthy participants exposed to caloric overload. Methods In this double-blind, placebo-controlled, crossover trial 12 healthy participants were administered 16g of broccoli sprouts, or pea sprouts (placebo) followed by the standardized high-caloric drink PhenFlex given to challenge healthy homeostasis. Urine samples were collected during the study visits and analyzed for 11-dehydro-TXB2, sulforaphane and its metabolites. Genotyping was performed using Illumina GSA v3.0 DTCBooster. Results Administration of broccoli sprouts before the caloric load reduced urinary 11-dehydro-TXB2 levels by 50% (p = 0.018). The amount of sulforaphane excreted in the urine during the study visits correlated negatively with 11-dehydro-TXB2 (rs = -0.377, p = 0.025). Participants carrying the polymorphic variant NAD(P)H dehydrogenase quinone 1 (NQO1*2) showed decreased excretion of sulforaphane (p = 0.035). Conclusion Sulforaphane was shown to be effective in targeting platelet responsiveness after a single intake. Our results indicate an inverse causal relationship between sulforaphane and 11-dehydro-TXB2, which is unaffected by the concomitant intake of the metabolic challenge. 11-Dehydro-TXB2 shows promise as a non-invasive, sensitive, and suitable biomarker to investigate the effects of phytonutrients on platelet aggregation within hours. Clinical trial registration [https://clinicaltrials.gov/], identifier [NCT05146804].
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Affiliation(s)
- Hidde P. van Steenwijk
- Food Claims Centre Venlo, Faculty of Science and Engineering, Maastricht University, Maastricht, Netherlands
| | - Evi Winter
- Food Claims Centre Venlo, Faculty of Science and Engineering, Maastricht University, Maastricht, Netherlands
| | - Edward Knaven
- Research Group Analysis Techniques in the Life Sciences, Avans University of Applied Sciences, Breda, Netherlands
| | - Jos F. Brouwers
- Research Group Analysis Techniques in the Life Sciences, Avans University of Applied Sciences, Breda, Netherlands
| | - Myrthe van Baardwijk
- Omnigen B.V., Delft, Netherlands
- Department of Pathology and Clinical Bioinformatics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | | | | | - Frits H. M. van Osch
- Department of Clinical Epidemiology, VieCuri Medical Center, Venlo, Netherlands
- Department of Epidemiology, NUTRIM, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Freddy J. Troost
- Division of Gastroenterology-Hepatology, Department of Internal Medicine, School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, Netherlands
- Food Innovation and Health, Centre for Healthy Eating and Food Innovation, Maastricht University, Maastricht, Netherlands
| | - Aalt Bast
- University College Venlo, Faculty of Science and Engineering, Maastricht University, Maastricht, Netherlands
- Department of Pharmacology and Toxicology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Khrystyna O. Semen
- University College Venlo, Faculty of Science and Engineering, Maastricht University, Maastricht, Netherlands
| | - Alie de Boer
- Food Claims Centre Venlo, Faculty of Science and Engineering, Maastricht University, Maastricht, Netherlands
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Short Chain Fatty Acid Metabolism in Relation to Gut Microbiota and Genetic Variability. Nutrients 2022; 14:nu14245361. [PMID: 36558520 PMCID: PMC9788597 DOI: 10.3390/nu14245361] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 12/12/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
It is widely accepted that the gut microbiota plays a significant role in modulating inflammatory and immune responses of their host. In recent years, the host-microbiota interface has gained relevance in understanding the development of many non-communicable chronic conditions, including cardiovascular disease, cancer, autoimmunity and neurodegeneration. Importantly, dietary fibre (DF) and associated compounds digested by the microbiota and their resulting metabolites, especially short-chain fatty acids (SCFA), were significantly associated with health beneficial effects, such as via proposed anti-inflammatory mechanisms. However, SCFA metabolic pathways are not fully understood. Major steps include production of SCFA by microbiota, uptake in the colonic epithelium, first-pass effects at the liver, followed by biodistribution and metabolism at the host's cellular level. As dietary patterns do not affect all individuals equally, the host genetic makeup may play a role in the metabolic fate of these metabolites, in addition to other factors that might influence the microbiota, such as age, birth through caesarean, medication intake, alcohol and tobacco consumption, pathogen exposure and physical activity. In this article, we review the metabolic pathways of DF, from intake to the intracellular metabolism of fibre-derived products, and identify possible sources of inter-individual variability related to genetic variation. Such variability may be indicative of the phenotypic flexibility in response to diet, and may be predictive of long-term adaptations to dietary factors, including maladaptation and tissue damage, which may develop into disease in individuals with specific predispositions, thus allowing for a better prediction of potential health effects following personalized intervention with DF.
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7
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Weinisch P, Fiamoncini J, Schranner D, Raffler J, Skurk T, Rist MJ, Römisch-Margl W, Prehn C, Adamski J, Hauner H, Daniel H, Suhre K, Kastenmüller G. Dynamic patterns of postprandial metabolic responses to three dietary challenges. Front Nutr 2022; 9:933526. [PMID: 36211489 PMCID: PMC9540193 DOI: 10.3389/fnut.2022.933526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 08/01/2022] [Indexed: 11/13/2022] Open
Abstract
Food intake triggers extensive changes in the blood metabolome. The kinetics of these changes depend on meal composition and on intrinsic, health-related characteristics of each individual, making the assessment of changes in the postprandial metabolome an opportunity to assess someone's metabolic status. To enable the usage of dietary challenges as diagnostic tools, profound knowledge about changes that occur in the postprandial period in healthy individuals is needed. In this study, we characterize the time-resolved changes in plasma levels of 634 metabolites in response to an oral glucose tolerance test (OGTT), an oral lipid tolerance test (OLTT), and a mixed meal (SLD) in healthy young males (n = 15). Metabolite levels for samples taken at different time points (20 per individual) during the challenges were available from targeted (132 metabolites) and non-targeted (502 metabolites) metabolomics. Almost half of the profiled metabolites (n = 308) showed a significant change in at least one challenge, thereof 111 metabolites responded exclusively to one particular challenge. Examples include azelate, which is linked to ω-oxidation and increased only in OLTT, and a fibrinogen cleavage peptide that has been linked to a higher risk of cardiovascular events in diabetes patients and increased only in OGTT, making its postprandial dynamics a potential target for risk management. A pool of 89 metabolites changed their plasma levels during all three challenges and represents the core postprandial response to food intake regardless of macronutrient composition. We used fuzzy c-means clustering to group these metabolites into eight clusters based on commonalities of their dynamic response patterns, with each cluster following one of four primary response patterns: (i) “decrease-increase” (valley-like) with fatty acids and acylcarnitines indicating the suppression of lipolysis, (ii) “increase-decrease” (mountain-like) including a cluster of conjugated bile acids and the glucose/insulin cluster, (iii) “steady decrease” with metabolites reflecting a carryover from meals prior to the study, and (iv) “mixed” decreasing after the glucose challenge and increasing otherwise. Despite the small number of subjects, the diversity of the challenges and the wealth of metabolomic data make this study an important step toward the characterization of postprandial responses and the identification of markers of metabolic processes regulated by food intake.
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Affiliation(s)
- Patrick Weinisch
- Institute of Computational Biology, Helmholtz Zentrum München, Neuherberg, Germany
| | - Jarlei Fiamoncini
- Food Research Center – FoRC, Department of Food Science and Experimental Nutrition, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Daniela Schranner
- Institute of Computational Biology, Helmholtz Zentrum München, Neuherberg, Germany
| | - Johannes Raffler
- Institute of Computational Biology, Helmholtz Zentrum München, Neuherberg, Germany
- Digital Medicine, University Hospital of Augsburg, Augsburg, Germany
| | - Thomas Skurk
- Core Facility Human Studies, ZIEL Institute for Food and Health, Technical University of Munich, Freising, Germany
- Else Kröner Fresenius Center for Nutritional Medicine, School of Life Sciences, Technical University of Munich, Freising, Germany
| | - Manuela J. Rist
- Department of Physiology and Biochemistry of Nutrition, Max Rubner-Institut, Karlsruhe, Germany
| | - Werner Römisch-Margl
- Institute of Computational Biology, Helmholtz Zentrum München, Neuherberg, Germany
| | - Cornelia Prehn
- Metabolomics and Proteomics Core, Helmholtz Zentrum München, Neuherberg, Germany
| | - Jerzy Adamski
- Institute of Experimental Genetics, Helmholtz Zentrum München, Neuherberg, Germany
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Institute of Biochemistry, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Hans Hauner
- Else Kröner Fresenius Center for Nutritional Medicine, School of Life Sciences, Technical University of Munich, Freising, Germany
- Institute for Nutritional Medicine, School of Medicine, Technical University of Munich, Munich, Germany
| | - Hannelore Daniel
- Department of Food and Nutrition, Technical University of Munich, Freising, Germany
| | - Karsten Suhre
- Department of Biophysics and Physiology, Weill Cornell Medicine—Qatar, Doha, Qatar
| | - Gabi Kastenmüller
- Institute of Computational Biology, Helmholtz Zentrum München, Neuherberg, Germany
- *Correspondence: Gabi Kastenmüller
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8
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Statistical modeling of health space based on metabolic stress and oxidative stress scores. BMC Public Health 2022; 22:1701. [PMID: 36076235 PMCID: PMC9454208 DOI: 10.1186/s12889-022-14081-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 08/23/2022] [Indexed: 11/12/2022] Open
Abstract
Background
Health space (HS) is a statistical way of visualizing individual’s health status in multi-dimensional space. In this study, we propose a novel HS in two-dimensional space based on scores of metabolic stress and of oxidative stress. Methods These scores were derived from three statistical models: logistic regression model, logistic mixed effect model, and proportional odds model. HSs were developed using Korea National Health And Nutrition Examination Survey data with 32,140 samples. To evaluate and compare the performance of the HSs, we also developed the Health Space Index (HSI) which is a quantitative performance measure based on the approximate 95% confidence ellipses of HS. Results Through simulation studies, we confirmed that HS from the proportional odds model showed highest power in discriminating health status of individual (subject). Further validation studies were conducted using two independent cohort datasets: a health examination dataset from Ewha-Boramae cohort with 862 samples and a population-based cohort from the Korea association resource project with 3,199 samples. Conclusions These validation studies using two independent datasets successfully demonstrated the usefulness of the proposed HS. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14081-0.
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de Hoogh IM, Reinders MJ, Doets EL, Hoevenaars FPM, Top JL. Design issues in personalized nutrition advice systems (Preprint). J Med Internet Res 2022; 25:e37667. [PMID: 36989039 PMCID: PMC10131983 DOI: 10.2196/37667] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 12/21/2022] [Accepted: 01/13/2023] [Indexed: 01/15/2023] Open
Abstract
The current health status of the general public can substantially benefit from a healthy diet. Using a personalized approach to initiate healthy dietary behavior seems to be a promising strategy, as individuals differ in terms of health status, subsequent dietary needs, and their desired behavior change support. However, providing personalized advice to a wide audience over a long period is very labor-intensive. This bottleneck can possibly be overcome by digitalizing the process of creating and providing personalized advice. An increasing number of personalized advice systems for different purposes is becoming available in the market, ranging from systems providing advice about just a single parameter to very complex systems that include many variables characterizing each individual situation. Scientific background is often lacking in these systems. In designing a personalized nutrition advice system, many design questions need to be answered, ranging from the required input parameters and accurate measurement methods (sense), type of modeling techniques to be used (reason), and modality in which the personalized advice is provided (act). We have addressed these topics in this viewpoint paper, and we have demonstrated the feasibility of setting up an infrastructure for providing personalized dietary advice based on the experience of 2 practical applications in a real-life setting.
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Affiliation(s)
- Iris M de Hoogh
- Research Group Microbiology & Systems Biology, Netherlands Organization for Applied Scientific Research, Leiden, Netherlands
- Department of Endocrinology, Leiden University Medical Center, Leiden, Netherlands
| | - Machiel J Reinders
- Wageningen Economic Research, Wageningen University & Research, Den Haag, Netherlands
| | - Esmée L Doets
- Wageningen Food & Biobased Research, Wageningen University & Research, Wageningen, Netherlands
| | - Femke P M Hoevenaars
- Research Group Microbiology & Systems Biology, Netherlands Organization for Applied Scientific Research, Leiden, Netherlands
| | - Jan L Top
- Wageningen Food & Biobased Research, Wageningen University & Research, Wageningen, Netherlands
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10
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Lépine G, Tremblay-Franco M, Bouder S, Dimina L, Fouillet H, Mariotti F, Polakof S. Investigating the Postprandial Metabolome after Challenge Tests to Assess Metabolic Flexibility and Dysregulations Associated with Cardiometabolic Diseases. Nutrients 2022; 14:nu14030472. [PMID: 35276829 PMCID: PMC8840206 DOI: 10.3390/nu14030472] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/14/2022] [Accepted: 01/17/2022] [Indexed: 12/16/2022] Open
Abstract
This review focuses on the added value provided by a research strategy applying metabolomics analyses to assess phenotypic flexibility in response to different nutritional challenge tests in the framework of metabolic clinical studies. We discuss findings related to the Oral Glucose Tolerance Test (OGTT) and to mixed meals with varying fat contents and food matrix complexities. Overall, the use of challenge tests combined with metabolomics revealed subtle metabolic dysregulations exacerbated during the postprandial period when comparing healthy and at cardiometabolic risk subjects. In healthy subjects, consistent postprandial metabolic shifts driven by insulin action were reported (e.g., a switch from lipid to glucose oxidation for energy fueling) with similarities between OGTT and mixed meals, especially during the first hours following meal ingestion while differences appeared in a wider timeframe. In populations with expected reduced phenotypic flexibility, often associated with increased cardiometabolic risk, a blunted response on most key postprandial pathways was reported. We also discuss the most suitable statistical tools to analyze the dynamic alterations of the postprandial metabolome while accounting for complexity in study designs and data structure. Overall, the in-depth characterization of the postprandial metabolism and associated phenotypic flexibility appears highly promising for a better understanding of the onset of cardiometabolic diseases.
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Affiliation(s)
- Gaïa Lépine
- Université Clermont Auvergne, INRAE, UMR 1019, Unité Nutrition Humaine, 63000 Clermont-Ferrand, France; (G.L.); (S.B.); (L.D.)
- Université Paris-Saclay, AgroParisTech, INRAE, UMR PNCA, 75005 Paris, France; (H.F.); (F.M.)
| | - Marie Tremblay-Franco
- Toxalim (Research Centre in Food Toxicology), Université de Toulouse, 31300 Toulouse, France;
- Axiom Platform, MetaToul-MetaboHUB, National Infrastructure for Metabolomics and Fluxomics, 31300 Toulouse, France
| | - Sabrine Bouder
- Université Clermont Auvergne, INRAE, UMR 1019, Unité Nutrition Humaine, 63000 Clermont-Ferrand, France; (G.L.); (S.B.); (L.D.)
| | - Laurianne Dimina
- Université Clermont Auvergne, INRAE, UMR 1019, Unité Nutrition Humaine, 63000 Clermont-Ferrand, France; (G.L.); (S.B.); (L.D.)
- Université Paris-Saclay, AgroParisTech, INRAE, UMR PNCA, 75005 Paris, France; (H.F.); (F.M.)
| | - Hélène Fouillet
- Université Paris-Saclay, AgroParisTech, INRAE, UMR PNCA, 75005 Paris, France; (H.F.); (F.M.)
| | - François Mariotti
- Université Paris-Saclay, AgroParisTech, INRAE, UMR PNCA, 75005 Paris, France; (H.F.); (F.M.)
| | - Sergio Polakof
- Université Clermont Auvergne, INRAE, UMR 1019, Unité Nutrition Humaine, 63000 Clermont-Ferrand, France; (G.L.); (S.B.); (L.D.)
- Correspondence:
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11
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Park SY, Kwon O, Kim JY. Effect of Mori ramulus on the postprandial blood glucose levels and inflammatory responses of healthy subjects subjected to an oral high-fat/sucrose challenge: A double-blind, randomized, crossover clinical trial. Biomed Pharmacother 2021; 146:112552. [PMID: 34923339 DOI: 10.1016/j.biopha.2021.112552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 12/09/2021] [Accepted: 12/13/2021] [Indexed: 11/24/2022] Open
Abstract
Blood glucose is inadequately controlled in diabetes mellitus, causing various inflammation-related complications. This study aimed to investigate responses to an oral sucrose/lipid challenge in the context of glucose metabolism after consumption of Mori ramulus (MR) extract. In this study on healthy subjects, the optimal dose and safety of MR were confirmed in a preliminary pilot trial (n = 24), meanwhile, blood glucose, insulin, and inflammatory marker levels were detected via an oral sucrose/lipid tolerance test in the main trial (n = 36). In the main study, the blood glucose response was significantly decreased after 240 min in the MR group. Compared to the placebo group, the treatment group exhibited plasma insulin levels that were significantly increased at 120 min and decreased at 240 min. In conclusion, a single MR extract dose protects against inflammation induced by high-fat/sugar to maintain normal insulin secretion and thus helps to maintain postprandial blood glucose levels via an inflammatory mechanism.
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Affiliation(s)
- Soo-Yeon Park
- Department of Nutritional Science and Food Management, Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul 03760, Republic of Korea
| | - Oran Kwon
- Department of Nutritional Science and Food Management, Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul 03760, Republic of Korea; Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 03760, Republic of Korea
| | - Ji Yeon Kim
- Department of Food Science and Technology, Seoul National University of Science and Technology, Seoul 01811, Republic of Korea.
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12
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van den Brink W, Bloem R, Ananth A, Kanagasabapathi T, Amelink A, Bouwman J, Gelinck G, van Veen S, Boorsma A, Wopereis S. Digital Resilience Biomarkers for Personalized Health Maintenance and Disease Prevention. Front Digit Health 2021; 2:614670. [PMID: 34713076 PMCID: PMC8521930 DOI: 10.3389/fdgth.2020.614670] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 12/09/2020] [Indexed: 12/26/2022] Open
Abstract
Health maintenance and disease prevention strategies become increasingly prioritized with increasing health and economic burden of chronic, lifestyle-related diseases. A key element in these strategies is the empowerment of individuals to control their health. Self-measurement plays an essential role in achieving such empowerment. Digital measurements have the advantage of being measured non-invasively, passively, continuously, and in a real-world context. An important question is whether such measurement can sensitively measure subtle disbalances in the progression toward disease, as well as the subtle effects of, for example, nutritional improvement. The concept of resilience biomarkers, defined as the dynamic evaluation of the biological response to an external challenge, has been identified as a viable strategy to measure these subtle effects. In this review, we explore the potential of integrating this concept with digital physiological measurements to come to digital resilience biomarkers. Additionally, we discuss the potential of wearable, non-invasive, and continuous measurement of molecular biomarkers. These types of innovative measurements may, in the future, also serve as a digital resilience biomarker to provide even more insight into the personal biological dynamics of an individual. Altogether, digital resilience biomarkers are envisioned to allow for the measurement of subtle effects of health maintenance and disease prevention strategies in a real-world context and thereby give personalized feedback to improve health.
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Affiliation(s)
- Willem van den Brink
- Department of Microbiology and Systems Biology, Netherlands Organization for Applied Scientific Research (TNO), Zeist, Netherlands
| | - Robbert Bloem
- Department of Environmental Modeling Sensing and Analysis, Netherlands Organization for Applied Scientific Research (TNO), Utrecht, Netherlands
| | - Adithya Ananth
- Department of Optics, Netherlands Organization for Applied Scientific Research (TNO), Delft, Netherlands
| | - Thiru Kanagasabapathi
- Holst Center, Netherlands Organization for Applied Scientific Research (TNO), Eindhoven, Netherlands
| | - Arjen Amelink
- Department of Optics, Netherlands Organization for Applied Scientific Research (TNO), Delft, Netherlands
| | - Jildau Bouwman
- Department of Microbiology and Systems Biology, Netherlands Organization for Applied Scientific Research (TNO), Zeist, Netherlands
| | - Gerwin Gelinck
- Holst Center, Netherlands Organization for Applied Scientific Research (TNO), Eindhoven, Netherlands
| | - Sjaak van Veen
- Department of Environmental Modeling Sensing and Analysis, Netherlands Organization for Applied Scientific Research (TNO), Utrecht, Netherlands
| | - Andre Boorsma
- Department of Microbiology and Systems Biology, Netherlands Organization for Applied Scientific Research (TNO), Zeist, Netherlands
| | - Suzan Wopereis
- Department of Microbiology and Systems Biology, Netherlands Organization for Applied Scientific Research (TNO), Zeist, Netherlands
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13
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LaBarre JL, Singer K, Burant CF. Advantages of Studying the Metabolome in Response to Mixed-Macronutrient Challenges and Suggestions for Future Research Designs. J Nutr 2021; 151:2868-2881. [PMID: 34255076 PMCID: PMC8681069 DOI: 10.1093/jn/nxab223] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/26/2021] [Accepted: 06/15/2021] [Indexed: 12/22/2022] Open
Abstract
Evaluating the postprandial response to a dietary challenge containing all macronutrients-carbohydrates, lipids, and protein-may provide stronger insights of metabolic health than a fasted measurement. Metabolomic profiling deepens the understanding of the homeostatic and adaptive response to a dietary challenge by classifying multiple metabolic pathways and biomarkers. A total of 26 articles were identified that measure the human blood metabolome or lipidome response to a mixed-macronutrient challenge. Most studies were cross-sectional, exploring the baseline and postprandial response to the dietary challenge. Large variations in study designs were reported, including the macronutrient and caloric composition of the challenge and the delivery of the challenge as a liquid shake or a solid meal. Most studies utilized a targeted metabolomics platform, assessing only a particular metabolic pathway, however, several studies utilized global metabolomics and lipidomics assays demonstrating the expansive postprandial response of the metabolome. The postprandial response of individual amino acids was largely dependent on the amino acid composition of the test meal, with the exception of alanine and proline, 2 nonessential amino acids. Long-chain fatty acids and unsaturated long-chain acylcarnitines rapidly decreased in response to the dietary challenges, representing the switch from fat to carbohydrate oxidation. Studies were reviewed that assessed the metabolome response in the context of obesity and metabolic diseases, providing insight on how weight status and disease influence the ability to cope with a nutrient load and return to homeostasis. Results demonstrate that the flexibility to respond to a substrate load is influenced by obesity and metabolic disease and flexibility alterations will be evident in downstream metabolites of fat, carbohydrate, and protein metabolism. In response, we propose suggestions for standardization between studies with the potential of creating a study exploring the postprandial response to a multitude of challenges with a variety of macronutrients.
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Affiliation(s)
| | - Kanakadurga Singer
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Charles F Burant
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
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14
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van der Haar S, Hoevenaars FPM, van den Brink WJ, van den Broek T, Timmer M, Boorsma A, Doets EL. Exploring the Potential of Personalized Dietary Advice for Health Improvement in Motivated Individuals With Premetabolic Syndrome: Pretest-Posttest Study. JMIR Form Res 2021; 5:e25043. [PMID: 34185002 PMCID: PMC8277310 DOI: 10.2196/25043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 04/11/2021] [Accepted: 05/19/2021] [Indexed: 12/12/2022] Open
Abstract
Background Dietary quality plays an essential role in the prevention and management of metabolic syndrome (MetS). Objective The aim of this pilot study is to organize personalized dietary advice in a real-life setting and to explore the effects on dietary intake, metabolic health, and perceived health. Methods We followed a one-group pretest-posttest design and included 37 individuals at risk of MetS, who indicated motivation to change dietary behavior. For a period of 16 weeks, participants received personalized advice (t=0 and t=8) and feedback (t=0, t=4, t=8, t=12 and t=16) on dietary quality and metabolic health (ie, waist circumference, BMI, blood pressure, lipid profile, fasting glucose levels, and C-peptide). Personalized advice was generated in a two-stage process. In stage 1, an automated algorithm generated advice per food group, integrating data on individual dietary quality (Dutch Healthy Diet Index; total score 8-80) and metabolic health parameters. Stage 2 included a telephone consultation with a trained dietitian to define a personal dietary behavior change strategy and to discuss individual preferences. Dietary quality and metabolic health markers were assessed at t=0, t=8, and t=16. Self-perceived health was evaluated on 7-point Likert scales at t=0 and t=16. Results At the end of the study period, dietary quality was significantly improved compared with the baseline (Dutch Healthy Diet Index +4.3; P<.001). In addition, lipid profile (triglycerides, P=.02; total cholesterol, P=.01; high-density lipoprotein, P<.001; and low-density lipoprotein, P<.001), BMI (P<.001), waist circumference (P=.01), and C-peptide (P=.01) were all significantly improved, whereas plasma glucose increased by 0.23 nmol/L (P=.04). In line with these results, self-perceived health scores were higher at t=16 weeks than at baseline (+0.67; P=.005). Conclusions This exploratory study showed that personalized dietary advice resulted in positive effects on dietary behavior, metabolic health, and self-perceived health in motivated pre-MetS adults. The study was performed in a do-it-yourself setting, highlighting the potential of at-home health improvement through dietary changes. Trial Registration ClinicalTrials.gov NCT04595669; https://clinicaltrials.gov/ct2/show/NCT04595669
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Affiliation(s)
- Sandra van der Haar
- Wageningen Food & Biobased Research, Wageningen University & Research, Wageningen, Netherlands
| | - Femke P M Hoevenaars
- Microbiology & Systems Biology Department, TNO, Netherlands Organization for Applied Scientific Research, Zeist, Netherlands
| | - Willem J van den Brink
- Microbiology & Systems Biology Department, TNO, Netherlands Organization for Applied Scientific Research, Zeist, Netherlands
| | - Tim van den Broek
- Microbiology & Systems Biology Department, TNO, Netherlands Organization for Applied Scientific Research, Zeist, Netherlands
| | - Mariëlle Timmer
- Wageningen Food & Biobased Research, Wageningen University & Research, Wageningen, Netherlands
| | - André Boorsma
- Microbiology & Systems Biology Department, TNO, Netherlands Organization for Applied Scientific Research, Zeist, Netherlands
| | - Esmée L Doets
- Wageningen Food & Biobased Research, Wageningen University & Research, Wageningen, Netherlands
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15
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Witkamp RF. Nutrition to Optimise Human Health-How to Obtain Physiological Substantiation? Nutrients 2021; 13:2155. [PMID: 34201670 PMCID: PMC8308379 DOI: 10.3390/nu13072155] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/19/2021] [Accepted: 06/21/2021] [Indexed: 12/12/2022] Open
Abstract
Demonstrating in an unambiguous manner that a diet, let alone a single product, 'optimizes' health, presents an enormous challenge. The least complicated is when the starting situation is clearly suboptimal, like with nutritional deficiencies, malnutrition, unfavourable lifestyle, or due to disease or ageing. Here, desired improvements and intervention strategies may to some extent be clear. However, even then situations require approaches that take into account interactions between nutrients and other factors, complex dose-effect relationships etc. More challenging is to substantiate that a diet or a specific product optimizes health in the general population, which comes down to achieve perceived, 'non-medical' or future health benefits in predominantly healthy persons. Presumed underlying mechanisms involve effects of non-nutritional components with subtle and slowly occurring physiological effects that may be difficult to translate into measurable outcomes. Most promising strategies combine classical physiological concepts with those of 'multi-omics' and systems biology. Resilience-the ability to maintain or regain homeostasis in response to stressors-is often used as proxy for a particular health domain. Next to this, quantifying health requires personalized strategies, measurements preferably carried out remotely, real-time and in a normal living environment, and experimental designs other than randomized controlled trials (RCTs), for example N-of-1 trials.
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Affiliation(s)
- Renger F Witkamp
- Division of Human Nutrition and Health, Wageningen University & Research (WUR), 6700 AA Wageningen, The Netherlands
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16
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Serum Metabolites Responding in a Dose-Dependent Manner to the Intake of a High-Fat Meal in Normal Weight Healthy Men Are Associated with Obesity. Metabolites 2021; 11:metabo11060392. [PMID: 34208710 PMCID: PMC8233812 DOI: 10.3390/metabo11060392] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/11/2021] [Accepted: 06/15/2021] [Indexed: 12/28/2022] Open
Abstract
Although the composition of the human blood metabolome is influenced both by the health status of the organism and its dietary behavior, the interaction between these two factors has been poorly characterized. This study makes use of a previously published randomized controlled crossover acute intervention to investigate whether the blood metabolome of 15 healthy normal weight (NW) and 17 obese (OB) men having ingested three doses (500, 1000, 1500 kcal) of a high-fat (HF) meal can be used to identify metabolites differentiating these two groups. Among the 1024 features showing a postprandial response, measured between 0 h and 6 h, in the NW group, 135 were dose-dependent. Among these 135 features, 52 had fasting values that were significantly different between NW and OB men, and, strikingly, they were all significantly higher in OB men. A subset of the 52 features was identified as amino acids (e.g., branched-chain amino acids) and amino acid derivatives. As the fasting concentration of most of these metabolites has already been associated with metabolic dysfunction, we propose that challenging normal weight healthy subjects with increasing caloric doses of test meals might allow for the identification of new fasting markers associated with obesity.
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17
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A Novel Personalized Systems Nutrition Program Improves Dietary Patterns, Lifestyle Behaviors and Health-Related Outcomes: Results from the Habit Study. Nutrients 2021; 13:nu13061763. [PMID: 34067248 PMCID: PMC8224682 DOI: 10.3390/nu13061763] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/14/2021] [Accepted: 05/17/2021] [Indexed: 12/21/2022] Open
Abstract
Personalized nutrition may be more effective in changing lifestyle behaviors compared to population-based guidelines. This single-arm exploratory study evaluated the impact of a 10-week personalized systems nutrition (PSN) program on lifestyle behavior and health outcomes. Healthy men and women (n = 82) completed the trial. Individuals were grouped into seven diet types, for which phenotypic, genotypic and behavioral data were used to generate personalized recommendations. Behavior change guidance was also provided. The intervention reduced the intake of calories (−256.2 kcal; p < 0.0001), carbohydrates (−22.1 g; p < 0.0039), sugar (−13.0 g; p < 0.0001), total fat (−17.3 g; p < 0.0001), saturated fat (−5.9 g; p = 0.0003) and PUFA (−2.5 g; p = 0.0065). Additionally, BMI (−0.6 kg/m2; p < 0.0001), body fat (−1.2%; p = 0.0192) and hip circumference (−5.8 cm; p < 0.0001) were decreased after the intervention. In the subgroup with the lowest phenotypic flexibility, a measure of the body’s ability to adapt to environmental stressors, LDL (−0.44 mmol/L; p = 0.002) and total cholesterol (−0.49 mmol/L; p < 0.0001) were reduced after the intervention. This study shows that a PSN program in a workforce improves lifestyle habits and reduces body weight, BMI and other health-related outcomes. Health improvement was most pronounced in the compromised phenotypic flexibility subgroup, which indicates that a PSN program may be effective in targeting behavior change in health-compromised target groups.
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18
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Changes in Plasma Metabolome Profiles Following Oral Glucose Challenge among Adult Chinese. Nutrients 2021; 13:nu13051474. [PMID: 33925473 PMCID: PMC8146292 DOI: 10.3390/nu13051474] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 04/20/2021] [Accepted: 04/23/2021] [Indexed: 01/07/2023] Open
Abstract
Little is known about changes in plasma metabolome profiles during the oral glucose tolerance test (OGTT) in Chinese. We aimed to characterize plasma metabolomic profiles at 0 and 2 h of OGTT and their changes in individuals of different glycemic statuses. A total of 544 metabolites were detected at 0 and 2 h of OGTT by a nontarget strategy in subjects with normal glucose (n = 234), prediabetes (n = 281), and newly diagnosed type 2 diabetes (T2D) (n = 66). Regression model, mixed model, and partial least squares discrimination analysis were applied. Compared with subjects of normal glucose, T2D cases had significantly higher levels of glycerone at 0 h and 22 metabolites at 2 h of OGTT (false discovery rate (FDR) < 0.05, variable importance in projection (VIP) > 1). Seven of the twenty-two metabolites were also significantly higher in T2D than in prediabetes subjects at 2 h of OGTT (FDR < 0.05, VIP > 1). Two hours after glucose challenge, concentrations of 35 metabolites (normal: 18; prediabetes: 23; T2D: 13) significantly increased (FDR < 0.05, VIP > 1, fold change (FC) > 1.2), whereas those of 45 metabolites (normal: 36; prediabetes: 29; T2D: 18) significantly decreased (FDR < 0.05, VIP > 1, FC < 0.8). Distinct responses between cases and noncases were detected in metabolites including 4-imidazolone-5-acetate and 4-methylene-L-glutamine. More varieties of distinct metabolites across glycemic statuses were observed at 2 h of OGTT compared with fasting state. Whether the different patterns and responsiveness of certain metabolites in T2D reflect a poor resilience of specific metabolic pathways in regaining glucose homeostasis merits further study.
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Oosterman JE, Wopereis S, Kalsbeek A. The Circadian Clock, Shift Work, and Tissue-Specific Insulin Resistance. Endocrinology 2020; 161:5916887. [PMID: 33142318 DOI: 10.1210/endocr/bqaa180] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 09/25/2020] [Indexed: 01/02/2023]
Abstract
Obesity and type 2 diabetes (T2D) have become a global health concern. The prevalence of obesity and T2D is significantly higher in shift workers compared to people working regular hours. An accepted hypothesis is that the increased risk for metabolic health problems arises from aberrantly timed eating behavior, that is, eating out of synchrony with the biological clock. The biological clock is part of the internal circadian timing system, which controls not only the sleep/wake and feeding/fasting cycle, but also many metabolic processes in the body, including the timing of our eating behavior, and processes involved in glucose homeostasis. Rodent studies have shown that eating out of phase with the endogenous clock results in desynchronization between rhythms of the central and peripheral clock systems and between rhythms of different tissue clocks (eg, liver and muscle clock). Glucose homeostasis is a complex process that involves multiple organs. In the healthiest situation, functional rhythms of these organs are synchronized. We hypothesize that desynchronization between different metabolically active organs contributes to alterations in glucose homeostasis. Here we summarize the most recent information on desynchronization between organs due to shift work and shifted food intake patterns and introduce the concept of phenotypic flexibility, a validated test to assess the contribution of each organ to insulin resistance (IR) in humans. We propose this test as a way to provide further insight into the possible desynchronization between tissue clocks. Because different types of IR benefit from different therapeutic approaches, we also describe different chronotherapeutic strategies to promote synchrony within and between metabolically active organs.
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Affiliation(s)
- Johanneke E Oosterman
- Department of Microbiology and Systems Biology, Netherlands Organization for Applied Scientific Research (TNO), HE Zeist, the Netherlands
- Department of Endocrinology and Metabolism, Amsterdam UMC, University of Amsterdam, AZ Amsterdam, the Netherlands
| | - Suzan Wopereis
- Department of Microbiology and Systems Biology, Netherlands Organization for Applied Scientific Research (TNO), HE Zeist, the Netherlands
| | - Andries Kalsbeek
- Department of Endocrinology and Metabolism, Amsterdam UMC, University of Amsterdam, AZ Amsterdam, the Netherlands
- Hypothalamic Integration Mechanisms, Netherlands Institute for Neuroscience (NIN), An Institute of the Royal Netherlands Academy of Arts and Sciences (KNAW), BA Amsterdam, the Netherlands
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20
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Pasman WJ, Memelink RG, de Vogel-Van den Bosch J, Begieneman MPV, van den Brink WJ, Weijs PJM, Wopereis S. Obese Older Type 2 Diabetes Mellitus Patients with Muscle Insulin Resistance Benefit from an Enriched Protein Drink during Combined Lifestyle Intervention: The PROBE Study. Nutrients 2020; 12:E2979. [PMID: 33003389 PMCID: PMC7601009 DOI: 10.3390/nu12102979] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/16/2020] [Accepted: 09/24/2020] [Indexed: 12/25/2022] Open
Abstract
(1) Background: Recent research showed that subtypes of patients with type 2 diabetes may differ in response to lifestyle interventions based on their organ-specific insulin resistance (IR). (2) Methods: 123 Subjects with type 2 diabetes were randomized into 13-week lifestyle intervention, receiving either an enriched protein drink (protein+) or an isocaloric control drink (control). Before and after the intervention, anthropometrical and physiological data was collected. An oral glucose tolerance test was used to calculate indices representing organ insulin resistance (muscle, liver, and adipose tissue) and β-cell functioning. In 82 study-compliant subjects (per-protocol), we retrospectively examined the intervention effect in patients with muscle IR (MIR, n = 42) and without MIR (no-MIR, n = 40). (3) Results: Only in patients from the MIR subgroup that received protein+ drink, fasting plasma glucose and insulin, whole body, liver and adipose IR, and appendicular skeletal muscle mass improved versus control. Lifestyle intervention improved body weight and fat mass in both subgroups. Furthermore, for the MIR subgroup decreased systolic blood pressure and increased VO2peak and for the no-MIR subgroup, a decreased 2-h glucose concentration was found. (4) Conclusions: Enriched protein drink during combined lifestyle intervention seems to be especially effective on increasing muscle mass and improving insulin resistance in obese older, type 2 diabetes patients with muscle IR.
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Affiliation(s)
- Wilrike J. Pasman
- Netherlands Organisation for Applied Scientific Research (TNO), 3704 HE Zeist, The Netherlands; (M.P.V.B.); (W.J.v.d.B.); (S.W.)
| | - Robert G. Memelink
- Department of Nutrition and Dietetics, Faculty of Sports and Nutrition, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, 1067 SM Amsterdam, The Netherlands; (R.G.M.); (P.J.M.W.)
| | | | - Mark P. V. Begieneman
- Netherlands Organisation for Applied Scientific Research (TNO), 3704 HE Zeist, The Netherlands; (M.P.V.B.); (W.J.v.d.B.); (S.W.)
| | - Willem J. van den Brink
- Netherlands Organisation for Applied Scientific Research (TNO), 3704 HE Zeist, The Netherlands; (M.P.V.B.); (W.J.v.d.B.); (S.W.)
| | - Peter J. M. Weijs
- Department of Nutrition and Dietetics, Faculty of Sports and Nutrition, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, 1067 SM Amsterdam, The Netherlands; (R.G.M.); (P.J.M.W.)
- Department of Nutrition and Dietetics, Amsterdam University Medical Centres, Vrije Universiteit, 1081 HV Amsterdam, The Netherlands
| | - Suzan Wopereis
- Netherlands Organisation for Applied Scientific Research (TNO), 3704 HE Zeist, The Netherlands; (M.P.V.B.); (W.J.v.d.B.); (S.W.)
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21
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Hoevenaars F, van der Kamp JW, van den Brink W, Wopereis S. Next Generation Health Claims Based on Resilience: The Example of Whole-Grain Wheat. Nutrients 2020; 12:E2945. [PMID: 32992860 PMCID: PMC7599623 DOI: 10.3390/nu12102945] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 09/21/2020] [Accepted: 09/22/2020] [Indexed: 02/08/2023] Open
Abstract
Health claims on foods are a way of informing consumers about the health benefits of a food product. Traditionally, these claims are based on scientific evaluation of markers originating from a pharmacological view on health. About a decade ago, the definition of health has been rephrased to 'the ability to adapt' that opened up the possibility for a next generation of health claims based on a new way of quantifying health by evaluating resilience. Here, we would like to introduce an opportunity for future scientific substantiation of health claims on food products by using whole-grain wheat as an example. Characterization of the individual whole wheat grain food product or whole wheat flour would probably be considered as sufficiently characterized by the European Food Safety Authority, while the food category whole grain is not specific enough. Meta-analysis provides the scientific evidence that long-term whole-grain wheat consumption is beneficial for health, although results from single 'gold standard' efficacy studies are not always straight forward based on classic measurement methods. Future studies may want to underpin the scientific argumentation that long-term whole grain wheat consumption improves resilience, by evaluating the disruption and rate of a selected panel of blood markers in response to a standardized oral protein glucose lipid tolerance test and aggregated into biomarkers with substantiated physiological benefits, to make a next-generation health claim for whole-grain wheat achievable in the near future.
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Affiliation(s)
| | | | | | - Suzan Wopereis
- Research Group Microbiology & Systems Biology, Netherlands Organization for Applied Scientific Research (TNO), 3704HE Zeist, The Netherlands; (F.H.); (J.-W.v.d.K.); (W.v.d.B.)
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Dordevic AL, Coort SL, Evelo CT, Murgia C, Sinclair AJ, Bonham MP, Larsen AE, Gran P, Cameron-Smith D. Blunted nutrient-response pathways in adipose tissue following high fat meals in men with metabolic syndrome: A randomized postprandial transcriptomic study. Clin Nutr 2020; 40:1355-1366. [PMID: 32928582 DOI: 10.1016/j.clnu.2020.08.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 08/04/2020] [Accepted: 08/18/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Excessive adipose tissue is central to disease burden posed by the Metabolic Syndrome (MetS). Whilst much is known of the altered transcriptomic regulation of adipose tissue under fasting conditions, little is known of the responses to high-fat meals. METHODS Nineteen middle-aged males (mean ± SD 52.0 ± 4.6 years), consumed two isocaloric high-fat, predominately dairy-based or soy-based, breakfast meals. Abdominal subcutaneous adipose biopsies were collected after overnight fast (0 h) and 4 h following each meal. Global gene expression profiling was performed by microarray (Illumina Human WG-6 v3). RESULTS In the fasted state, 13 genes were differently expressed between control and MetS adipose tissue (≥1.2 fold-difference, p < 0.05). In response to the meals, the control participants had widespread increases in genes related to cellular nutrient responses (≥1.2 fold-change, p < 0.05; 2444 & 2367 genes; dairy & soy, respectively). There was blunted response in the MetS group (≥1.2 fold-change, p < 0.05; 332 & 336 genes; dairy & soy, respectively). CONCLUSIONS In middle-aged males with MetS, a widespread suppression of the subcutaneous adipose tissue nutrient responsive gene expression suggests an inflexibility in the transcriptomic responsiveness to both high-fat meals.
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Affiliation(s)
- Aimee L Dordevic
- Department of Nutrition, Dietetics & Food, Monash University, Melbourne, Australia.
| | - Susan L Coort
- Department of Bioinformatics - BiGCaT, NUTRIM School of Nutrition and Metabolism in Translational Research, Maastricht University, Maastricht, the Netherlands
| | - Chris T Evelo
- Department of Bioinformatics - BiGCaT, NUTRIM School of Nutrition and Metabolism in Translational Research, Maastricht University, Maastricht, the Netherlands
| | - Chiara Murgia
- School of Agriculture and Food, University of Melbourne, Melbourne, Australia
| | - Andrew J Sinclair
- Department of Nutrition, Dietetics & Food, Monash University, Melbourne, Australia; Faculty of Health, Deakin University, Melbourne, Australia
| | - Maxine P Bonham
- Department of Nutrition, Dietetics & Food, Monash University, Melbourne, Australia
| | - Amy E Larsen
- Department of Physiology, Anatomy, and Microbiology, La Trobe University, Melbourne, Australia
| | - Petra Gran
- Faculty of Health, Deakin University, Melbourne, Australia
| | - David Cameron-Smith
- Liggins Institute, University of Auckland, Auckland, New Zealand; The Riddet Institute, Massey University, Palmerston North, New Zealand; Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
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Hoevenaars FPM, Berendsen CMM, Pasman WJ, van den Broek TJ, Barrat E, de Hoogh IM, Wopereis S. Evaluation of Food-Intake Behavior in a Healthy Population: Personalized vs. One-Size-Fits-All. Nutrients 2020; 12:nu12092819. [PMID: 32942627 PMCID: PMC7551874 DOI: 10.3390/nu12092819] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 09/08/2020] [Accepted: 09/09/2020] [Indexed: 12/16/2022] Open
Abstract
In public health initiatives, generic nutrition advice (GNA) from national guidelines has a limited effect on food-intake improvement. Personalized nutrition advice (PNA) may enable dietary behavior change. A monocentric, randomized, parallel, controlled clinical trial was performed in males (n = 55) and females (n = 100) aged 25 to 70 years. Participants were allocated to control, GNA or PNA groups. The PNA group consisted of automatically generated dietary advice based on personal metabolic health parameters, dietary intake, anthropometric and hemodynamic measures, gender and age. Participants who received PNA (n = 51) improved their nutritional intake status for fruits P (p < 0.0001), whole grains (p = 0.008), unsalted nuts (p < 0.0001), fish (p = 0.0003), sugar-sweetened beverages (p = 0.005), added salt (p = 0.003) and less unhealthy choices (p = 0.002), whereas no improvements were observed in the control and GNA group. PNA participants were encouraged to set a goal for one or multiple food categories. Goal-setting led to greater improvement of food categories within the PNA group including; unsalted nuts (p < 0.0001), fruits (p = 0.0001), whole grains (p = 0.005), fish (p = 0.0001), dairy (p = 0.007), vegetables (p = 0.01) and unhealthy choices (p = 0.02). In a healthy population, participants receiving PNA changed their food-intake behavior more favorably than participants receiving GNA or no advice. When personal goals were set, nutritional behavior was more prone to change.
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Affiliation(s)
- Femke P. M. Hoevenaars
- TNO, Netherlands Organization for Applied Scientific Research, Research Group Microbiology & Systems Biology, P.O. Box 360, 3700 AJ Zeist, The Netherlands; (F.P.M.H.); (C.M.M.B.); (W.J.P.); (T.J.v.d.B.); (I.M.d.H.)
| | - Charlotte M. M. Berendsen
- TNO, Netherlands Organization for Applied Scientific Research, Research Group Microbiology & Systems Biology, P.O. Box 360, 3700 AJ Zeist, The Netherlands; (F.P.M.H.); (C.M.M.B.); (W.J.P.); (T.J.v.d.B.); (I.M.d.H.)
| | - Wilrike J. Pasman
- TNO, Netherlands Organization for Applied Scientific Research, Research Group Microbiology & Systems Biology, P.O. Box 360, 3700 AJ Zeist, The Netherlands; (F.P.M.H.); (C.M.M.B.); (W.J.P.); (T.J.v.d.B.); (I.M.d.H.)
| | - Tim J. van den Broek
- TNO, Netherlands Organization for Applied Scientific Research, Research Group Microbiology & Systems Biology, P.O. Box 360, 3700 AJ Zeist, The Netherlands; (F.P.M.H.); (C.M.M.B.); (W.J.P.); (T.J.v.d.B.); (I.M.d.H.)
| | - Emmanuel Barrat
- Laboratoire Lescuyer, Department of Research, 15 rue le Corbusier, CEDEX, F-17442 Aytré, France;
| | - Iris M. de Hoogh
- TNO, Netherlands Organization for Applied Scientific Research, Research Group Microbiology & Systems Biology, P.O. Box 360, 3700 AJ Zeist, The Netherlands; (F.P.M.H.); (C.M.M.B.); (W.J.P.); (T.J.v.d.B.); (I.M.d.H.)
| | - Suzan Wopereis
- TNO, Netherlands Organization for Applied Scientific Research, Research Group Microbiology & Systems Biology, P.O. Box 360, 3700 AJ Zeist, The Netherlands; (F.P.M.H.); (C.M.M.B.); (W.J.P.); (T.J.v.d.B.); (I.M.d.H.)
- Correspondence:
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Griffiths JC, De Vries J, McBurney MI, Wopereis S, Serttas S, Marsman DS. Measuring health promotion: translating science into policy. Eur J Nutr 2020; 59:11-23. [PMID: 32852581 PMCID: PMC7497380 DOI: 10.1007/s00394-020-02359-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Commonly, it is the end of life when our health is deteriorating, that many will make drastic lifestyle changes to improve their quality of life. However, it is increasingly recognized that bringing good health-promoting behaviors into practice as early in life as possible has the most significant impact across the maximal healthspan. The WHO has brought clarity to health promotion over the last fifteen years, always centering on language relating to a process of enabling people to increase control over, and to improve, their physical, mental and social health. A good healthspan is not just freedom from morbidity and mortality, it is that joie de vivre ("joy of living") that should accompany every day of our lifespan. Therefore, health promotion includes not only the health sector, but also needs individual commitment to achieve that target of a healthspan aligned with the lifespan. This paper explores health promotion and health literacy, and how to design appropriate nutritional studies to characterize contributors to a positive health outcome, the role the human microbiome plays in promoting health and addressing and alleviating morbidity and diseases, and finally how to characterize phenotypic flexibility and a physiologic resilience that we must maintain as our structural and functional systems are bombarded with the insults and perturbations of life.
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Affiliation(s)
- James C Griffiths
- Council for Responsible Nutrition-International, Washington, DC, USA.
| | - Jan De Vries
- Nutrition in Transition Foundation, Gorssel, The Netherlands
| | - Michael I McBurney
- Department of Human Health & Nutritional Sciences, University of Guelph, Guelph, ON, N1G 2W1, Canada
| | - Suzan Wopereis
- Research Group Microbiology and Systems Biology, Netherlands Organization for Applied Scientific Research (TNO), Utrechtseweg 48, NL-3704 HE, Zeist, The Netherlands
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25
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Wickramasinghe K, Mathers JC, Wopereis S, Marsman DS, Griffiths JC. From lifespan to healthspan: the role of nutrition in healthy ageing. J Nutr Sci 2020; 9:e33. [PMID: 33101660 PMCID: PMC7550962 DOI: 10.1017/jns.2020.26] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 07/13/2020] [Accepted: 07/14/2020] [Indexed: 12/14/2022] Open
Abstract
Across the globe, there has been a marked increase in longevity, but significant inequalities remain. These are exacerbated by inadequate access to proper nutrition and health care services and to reliable information to make the decisions related to nutrition and health care. Many in economically developing as well as developed societies are plagued with the double-burden of energy excess and undernutrition. This has resulted in mental and physical deterioration, increased non-communicable disease rates, lost productivity, increased medical costs and reduced quality of life. While adequate nutrition is fundamental to good health at all stages of the life course, the impact of diet on prolonging good quality of life during ageing remains unclear. For progress to continue, there is need for new and/or innovative approaches to promoting health as individuals age, as well as qualitative and quantitative biomarkers and other accepted tools that can measure improvements in physiological integrity throughout life. A framework for progress has been proposed by the World Health Organization in their Global Strategy and Action Plan on Ageing and Health. Here, we focused on the impact of nutrition within this framework, which takes a broad, person-centred emphasis on healthy ageing, stressing the need to better understand each individual's intrinsic capacity, their functional abilities at various life stages, and the impact of their mental, and physical health, as well as the environments they inhabit.
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Affiliation(s)
- Kremlin Wickramasinghe
- WHO European Office for Prevention and Control of Noncommunicable Diseases (NCD Office), Moscow, Russian Federation
| | - John C. Mathers
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle upon TyneNE2 4HH, UK
| | - Suzan Wopereis
- Research Group Microbiology and Systems Biology, Netherlands Organization for Applied Scientific Research (TNO), Zeist, NL-3704 HE, The Netherlands
| | | | - James C. Griffiths
- International and Scientific Affairs, Council for Responsible Nutrition-International, Washington, DC20036, USA
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26
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Abstract
Thanks to advances in modern medicine over the past century, the world’s population has experienced a marked increase in longevity. However, disparities exist that lead to groups with both shorter lifespan and significantly diminished health, especially in the aged. Unequal access to proper nutrition, healthcare services, and information to make informed health and nutrition decisions all contribute to these concerns. This in turn has hastened the ageing process in some and adversely affected others’ ability to age healthfully. Many in developing as well as developed societies are plagued with the dichotomy of simultaneous calorie excess and nutrient inadequacy. This has resulted in mental and physical deterioration, increased non-communicable disease rates, lost productivity and quality of life, and increased medical costs. While adequate nutrition is fundamental to good health, it remains unclear what impact various dietary interventions may have on improving healthspan and quality of life with age. With a rapidly ageing global population, there is an urgent need for innovative approaches to health promotion as individual’s age. Successful research, education, and interventions should include the development of both qualitative and quantitative biomarkers and other tools which can measure improvements in physiological integrity throughout life. Data-driven health policy shifts should be aimed at reducing the socio-economic inequalities that lead to premature ageing. A framework for progress has been proposed and published by the World Health Organization in its Global Strategy and Action Plan on Ageing and Health. This symposium focused on the impact of nutrition on this framework, stressing the need to better understand an individual’s balance of intrinsic capacity and functional abilities at various life stages, and the impact this balance has on their mental and physical health in the environments they inhabit.
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27
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Adams SH, Anthony JC, Carvajal R, Chae L, Khoo CSH, Latulippe ME, Matusheski NV, McClung HL, Rozga M, Schmid CH, Wopereis S, Yan W. Perspective: Guiding Principles for the Implementation of Personalized Nutrition Approaches That Benefit Health and Function. Adv Nutr 2020; 11:25-34. [PMID: 31504115 PMCID: PMC7442375 DOI: 10.1093/advances/nmz086] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 07/17/2019] [Accepted: 07/22/2019] [Indexed: 01/05/2023] Open
Abstract
Personalized nutrition (PN) approaches have been shown to help drive behavior change and positively influence health outcomes. This has led to an increase in the development of commercially available PN programs, which utilize various forms of individual-level information to provide services and products for consumers. The lack of a well-accepted definition of PN or an established set of guiding principles for the implementation of PN creates barriers for establishing credibility and efficacy. To address these points, the North American Branch of the International Life Sciences Institute convened a multidisciplinary panel. In this article, a definition for PN is proposed: "Personalized nutrition uses individual-specific information, founded in evidence-based science, to promote dietary behavior change that may result in measurable health benefits." In addition, 10 guiding principles for PN approaches are proposed: 1) define potential users and beneficiaries; 2) use validated diagnostic methods and measures; 3) maintain data quality and relevance; 4) derive data-driven recommendations from validated models and algorithms; 5) design PN studies around validated individual health or function needs and outcomes; 6) provide rigorous scientific evidence for an effect on health or function; 7) deliver user-friendly tools; 8) for healthy individuals, align with population-based recommendations; 9) communicate transparently about potential effects; and 10) protect individual data privacy and act responsibly. These principles are intended to establish a basis for responsible approaches to the evidence-based research and practice of PN and serve as an invitation for further public dialog. Several challenges were identified for PN to continue gaining acceptance, including defining the health-disease continuum, identification of biomarkers, changing regulatory landscapes, accessibility, and measuring success. Although PN approaches hold promise for public health in the future, further research is needed on the accuracy of dietary intake measurement, utilization and standardization of systems approaches, and application and communication of evidence.
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Affiliation(s)
- Sean H Adams
- Arkansas Children's Nutrition Center and Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | | | | | - Lee Chae
- Brightseed, San Francisco, CA, USA
| | - Chor San H Khoo
- International Life Sciences Institute North America, Washington, DC, USA
| | - Marie E Latulippe
- International Life Sciences Institute North America, Washington, DC, USA,Address correspondence to MEL (e-mail: )
| | | | - Holly L McClung
- US Army Research Institute of Environmental Medicine, Natick, MA, USA
| | - Mary Rozga
- Academy of Nutrition and Dietetics, Chicago, IL, USA
| | | | - Suzan Wopereis
- Research Group Microbiology & Systems Biology, TNO, Zeist, Netherlands
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28
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Hoevenaars FPM, Esser D, Schutte S, Priebe MG, Vonk RJ, van den Brink WJ, van der Kamp JW, Stroeve JHM, Afman LA, Wopereis S. Whole Grain Wheat Consumption Affects Postprandial Inflammatory Response in a Randomized Controlled Trial in Overweight and Obese Adults with Mild Hypercholesterolemia in the Graandioos Study. J Nutr 2019; 149:2133-2144. [PMID: 31504709 PMCID: PMC6887734 DOI: 10.1093/jn/nxz177] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 03/27/2019] [Accepted: 07/03/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Whole grain wheat (WGW) consumption is associated with health benefits in observational studies. However, WGW randomized controlled trial (RCT) studies show mixed effects. OBJECTIVES The health impact of WGW consumption was investigated by quantification of the body's resilience, which was defined as the "ability to adapt to a standardized challenge." METHODS A double-blind RCT was performed with overweight and obese (BMI: 25-35 kg/m2) men (n = 19) and postmenopausal women (n = 31) aged 45-70 y, with mildly elevated plasma total cholesterol (>5 mmol/L), who were randomly assigned to either 12-wk WGW (98 g/d) or refined wheat (RW). Before and after the intervention a standardized mixed-meal challenge was performed. Plasma samples were taken after overnight fasting and postprandially (30, 60, 120, and 240 min). Thirty-one biomarkers were quantified focusing on metabolism, liver, cardiovascular health, and inflammation. Linear mixed-models evaluated fasting compared with postprandial intervention effects. Health space models were used to evaluate intervention effects as composite markers representing resilience of inflammation, liver, and metabolism. RESULTS Postprandial biomarker changes related to liver showed decreased alanine aminotransferase by WGW (P = 0.03) and increased β-hydroxybutyrate (P = 0.001) response in RW. Postprandial changes related to inflammation showed increased C-reactive protein (P = 0.001), IL-6 (P = 0.02), IL-8 (P = 0.007), and decreased IL-1B (P = 0.0002) in RW and decreased C-reactive protein (P < 0.0001), serum amyloid A (P < 0.0001), IL-8 (P = 0.02), and IL-10 (P < 0.0001) in WGW. Health space visualization demonstrated diminished inflammatory (P < 0.01) and liver resilience (P < 0.01) by RW, whereas liver resilience was rejuvenated by WGW (P < 0.05). CONCLUSIONS Twelve-week 98 g/d WGW consumption can promote liver and inflammatory resilience in overweight and obese subjects with mildly elevated plasma cholesterol. The health space approach appeared appropriate to evaluate intervention effects as composite markers. This trial was registered at www.clinicaltrials.gov as NCT02385149.
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Affiliation(s)
- Femke P M Hoevenaars
- TNO, Netherlands Organization for Applied Scientific Research, Zeist, Netherlands
| | - Diederik Esser
- Wageningen University, Division of Human Nutrition, Wageningen, Netherlands
| | - Sophie Schutte
- Wageningen University, Division of Human Nutrition, Wageningen, Netherlands
| | - Marion G Priebe
- University Medical Center Groningen, University of Groningen, Center for Medical Biomics, Groningen, Netherlands
| | - Roel J Vonk
- University Medical Center Groningen, University of Groningen, Center for Medical Biomics, Groningen, Netherlands
| | | | | | - Johanna H M Stroeve
- TNO, Netherlands Organization for Applied Scientific Research, Zeist, Netherlands
| | - Lydia A Afman
- Wageningen University, Division of Human Nutrition, Wageningen, Netherlands
| | - Suzan Wopereis
- TNO, Netherlands Organization for Applied Scientific Research, Zeist, Netherlands
- Address correspondence to SW (e-mail: )
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van den Brink W, van Bilsen J, Salic K, Hoevenaars FPM, Verschuren L, Kleemann R, Bouwman J, Ronnett GV, van Ommen B, Wopereis S. Current and Future Nutritional Strategies to Modulate Inflammatory Dynamics in Metabolic Disorders. Front Nutr 2019; 6:129. [PMID: 31508422 PMCID: PMC6718105 DOI: 10.3389/fnut.2019.00129] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 07/30/2019] [Indexed: 12/13/2022] Open
Abstract
Obesity, type 2 diabetes, and other metabolic disorders have a large impact on global health, especially in Western countries. An important hallmark of metabolic disorders is chronic low-grade inflammation. A key player in chronic low-grade inflammation is dysmetabolism, which is defined as the inability to keep homeostasis resulting in loss of lipid control, oxidative stress, inflammation, and insulin resistance. Although often not yet detectable in the circulation, chronic low-grade inflammation can be present in one or multiple organs. The response to a metabolic challenge containing lipids may magnify dysfunctionalities at the tissue level, causing an overflow of inflammatory markers into the circulation and hence allow detection of early low-grade inflammation. Here, we summarize the evidence of successful application of metabolic challenge tests in type 2 diabetes, metabolic syndrome, obesity, and unhealthy aging. We also review how metabolic challenge tests have been successfully applied to evaluate nutritional intervention effects, including an "anti-inflammatory" mixture, dark chocolate, whole grain wheat and overfeeding. Additionally, we elaborate on future strategies to (re)gain inflammatory flexibility. Through epigenetic and metabolic regulation, the inflammatory response may be trained by regular mild and metabolic triggers, which can be understood from the perspective of trained immunity, hormesis and pro-resolution. New strategies to optimize dynamics of inflammation may become available.
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Affiliation(s)
- Willem van den Brink
- Department of Microbiology and Systems Biology, Netherlands Organisation for Applied Scientific Research (TNO), Zeist, Netherlands
| | - Jolanda van Bilsen
- Department of Risk Analysis for Products in Development, Netherlands Organisation for Applied Scientific Research (TNO), Zeist, Netherlands
| | - Kanita Salic
- Department of Metabolic Health Research, Netherlands Organisation for Applied Scientific Research (TNO), Leiden, Netherlands
| | - Femke P. M. Hoevenaars
- Department of Microbiology and Systems Biology, Netherlands Organisation for Applied Scientific Research (TNO), Zeist, Netherlands
| | - Lars Verschuren
- Department of Microbiology and Systems Biology, Netherlands Organisation for Applied Scientific Research (TNO), Zeist, Netherlands
| | - Robert Kleemann
- Department of Metabolic Health Research, Netherlands Organisation for Applied Scientific Research (TNO), Leiden, Netherlands
| | - Jildau Bouwman
- Department of Microbiology and Systems Biology, Netherlands Organisation for Applied Scientific Research (TNO), Zeist, Netherlands
| | | | - Ben van Ommen
- Department of Microbiology and Systems Biology, Netherlands Organisation for Applied Scientific Research (TNO), Zeist, Netherlands
| | - Suzan Wopereis
- Department of Microbiology and Systems Biology, Netherlands Organisation for Applied Scientific Research (TNO), Zeist, Netherlands
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30
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Tans R, Verschuren L, Wessels HJCT, Bakker SJL, Tack CJ, Gloerich J, van Gool AJ. The future of protein biomarker research in type 2 diabetes mellitus. Expert Rev Proteomics 2018; 16:105-115. [DOI: 10.1080/14789450.2018.1551134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- Roel Tans
- Translational Metabolic Laboratory, Department of Laboratory Medicine and Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Lars Verschuren
- Department of Microbiology and Systems Biology, TNO, Zeist, The Netherlands
| | - Hans J. C. T. Wessels
- Translational Metabolic Laboratory, Department of Laboratory Medicine and Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Stephan J. L. Bakker
- Department of Internal Medicine, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Cees J. Tack
- Department of Internal Medicine and Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jolein Gloerich
- Translational Metabolic Laboratory, Department of Laboratory Medicine and Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Alain J. van Gool
- Translational Metabolic Laboratory, Department of Laboratory Medicine and Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
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Kim Y, Kim KJ, Park SY, Lim Y, Kwon O, Lee JH, Kim JY. Differential responses of endothelial integrity upon the intake of microencapsulated garlic, tomato extract or a mixture: a single-intake, randomized, double-blind, placebo-controlled crossover trial. Food Funct 2018; 9:5426-5435. [PMID: 30280751 DOI: 10.1039/c8fo01431k] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
This study investigated the effect of microencapsulated garlic and/or tomato on endothelial dysfunction induced by the PhenFlex test (PFT) in healthy male smokers. In a randomized, double-blind, placebo-controlled crossover trial, 41 healthy male smokers were randomly assigned to one of four groups to receive the test groups (in microencapsulated garlic powder, tomato extract and a mixture thereof) or the placebo group. Proteomic biomarkers related to endothelial integrity were measured in plasma. Microencapsulated garlic, tomato extract and the mixture affected endothelial integrity biomarkers differently. Garlic consumption increased prothrombin time and decreased SAA and IL-12. Tomato extract intake increased activated partial thrombin time and decreased d-dimer, SAA, sVCAM-1, IL-13 and MCP-3 levels. Consumption of the mixture increased sE-selectin and lowered D-dimer, SAA, IL-13 and IL-10 responses after PFT challenge for 6 h. The different responses became clearer under high compliance in the dietary restriction groups. This single-intake clinical trial addressed the different responses of biomarkers related to endothelial integrity.
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Affiliation(s)
- Yunyoung Kim
- Department of Food Science and Technology, Seoul National University of Science and Technology, Seoul 01811, Republic of Korea.
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Fiamoncini J, Rundle M, Gibbons H, Thomas EL, Geillinger-Kästle K, Bunzel D, Trezzi JP, Kiselova-Kaneva Y, Wopereis S, Wahrheit J, Kulling SE, Hiller K, Sonntag D, Ivanova D, van Ommen B, Frost G, Brennan L, Bell J, Daniel H. Plasma metabolome analysis identifies distinct human metabotypes in the postprandial state with different susceptibility to weight loss-mediated metabolic improvements. FASEB J 2018; 32:5447-5458. [PMID: 29718708 DOI: 10.1096/fj.201800330r] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Health has been defined as the capability of the organism to adapt to challenges. In this study, we tested to what extent comprehensively phenotyped individuals reveal differences in metabolic responses to a standardized mixed meal tolerance test (MMTT) and how these responses change when individuals experience moderate weight loss. Metabolome analysis was used in 70 healthy individuals. with profiling of ∼300 plasma metabolites during an MMTT over 8 h. Multivariate analysis of plasma markers of fatty acid catabolism identified 2 distinct metabotype clusters (A and B). Individuals from metabotype B showed slower glucose clearance, had increased intra-abdominal adipose tissue mass and higher hepatic lipid levels when compared with individuals from metabotype A. An NMR-based urine analysis revealed that these individuals also to have a less healthy dietary pattern. After a weight loss of ∼5.6 kg over 12 wk, only the subjects from metabotype B showed positive changes in the glycemic response during the MMTT and in markers of metabolic diseases. Our study in healthy individuals demonstrates that more comprehensive phenotyping can reveal discrete metabotypes with different outcomes in a dietary intervention and that markers of lipid catabolism in plasma could allow early detection of the metabolic syndrome.-Fiamoncini, J., Rundle, M., Gibbons, H., Thomas, E. L., Geillinger-Kästle, K., Bunzel, D., Trezzi, J.-P., Kiselova-Kaneva, Y., Wopereis, S., Wahrheit, J., Kulling, S. E., Hiller, K., Sonntag, D., Ivanova, D., van Ommen, B., Frost, G., Brennan, L., Bell, J. Daniel, H. Plasma metabolome analysis identifies distinct human metabotypes in the postprandial state with different susceptibility to weight loss-mediated metabolic improvements.
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Affiliation(s)
- Jarlei Fiamoncini
- Department of Food and Nutrition, Technische Universität München, Freising-Weihenstephan, Germany
| | - Milena Rundle
- Division of Diabetes, Endocrinology, and Metabolism, Department of Medicine, Imperial College London, London, United Kingdom
| | - Helena Gibbons
- University College Dublin (UCD) School of Agriculture and Food Science, Institute of Food and Health, Dublin, Ireland
| | - E Louise Thomas
- Research Centre for Optimal Health, Department of Life Sciences, University of Westminster, London, United Kingdom
| | | | - Diana Bunzel
- Department of Safety and Quality of Fruit and Vegetables, Max Rubner Institut, Karlsruhe, Germany
| | - Jean-Pierre Trezzi
- Integrated Biobank of Luxembourg, Dudelange, Luxembourg.,Centre for Systems Biomedicine, Esch-sur-Alzette, Luxembourg
| | - Yoana Kiselova-Kaneva
- Department of Biochemistry, Molecular Medicine, and Nutrigenomics, Medical University-Varna, Varna, Bulgaria
| | - Suzan Wopereis
- Department of Microbiology and Systems Biology, Netherlands Organization for Applied Scientific Research (TNO), Zeist, The Netherlands
| | | | - Sabine E Kulling
- Department of Safety and Quality of Fruit and Vegetables, Max Rubner Institut, Karlsruhe, Germany
| | - Karsten Hiller
- Braunschweig Integrated Centre of Systems Biology, University of Braunschweig, Braunschweig, Germany.,Department of Computational Biology of Infection Research, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Denise Sonntag
- Department of Microbiology and Systems Biology, Netherlands Organization for Applied Scientific Research (TNO), Zeist, The Netherlands
| | - Diana Ivanova
- Department of Biochemistry, Molecular Medicine, and Nutrigenomics, Medical University-Varna, Varna, Bulgaria
| | - Ben van Ommen
- Department of Microbiology and Systems Biology, Netherlands Organization for Applied Scientific Research (TNO), Zeist, The Netherlands
| | - Gary Frost
- Division of Diabetes, Endocrinology, and Metabolism, Department of Medicine, Imperial College London, London, United Kingdom
| | - Lorraine Brennan
- University College Dublin (UCD) School of Agriculture and Food Science, Institute of Food and Health, Dublin, Ireland
| | - Jimmy Bell
- Research Centre for Optimal Health, Department of Life Sciences, University of Westminster, London, United Kingdom
| | - Hannelore Daniel
- Department of Food and Nutrition, Technische Universität München, Freising-Weihenstephan, Germany
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Fazelzadeh P, Hangelbroek RWJ, Joris PJ, Schalkwijk CG, Esser D, Afman L, Hankemeier T, Jacobs DM, Mihaleva VV, Kersten S, van Duynhoven J, Boekschoten MV. Weight loss moderately affects the mixed meal challenge response of the plasma metabolome and transcriptome of peripheral blood mononuclear cells in abdominally obese subjects. Metabolomics 2018; 14:46. [PMID: 29527144 PMCID: PMC5838115 DOI: 10.1007/s11306-018-1328-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The response to dietary challenges has been proposed as a more accurate measure of metabolic health than static measurements performed in the fasted state. This has prompted many groups to explore the potential of dietary challenge tests for assessment of diet and lifestyle induced shifts in metabolic phenotype. OBJECTIVES We examined whether the response to a mixed-meal challenge could provide a readout for a weight loss (WL)-induced phenotype shift in abdominally obese male subjects. The underlying assumption of a mixed meal challenge is that it triggers all aspects of phenotypic flexibility and provokes a more prolonged insulin response, possibly allowing for better differentiation between individuals. METHODS Abdominally obese men (n = 29, BMI = 30.3 ± 2.4 kg/m2) received a mixed-meal challenge prior to and after an 8-week WL or no-WL control intervention. Lean subjects (n = 15, BMI = 23.0 ± 2.0 kg/m2) only received the mixed meal challenge at baseline to have a benchmark for WL-induced phenotype shifts. RESULTS Levels of several plasma metabolites were significantly different between lean and abdominally obese at baseline as well as during postprandial metabolic responses. Genes related to oxidative phosphorylation in peripheral blood mononuclear cells (PBMCs) were expressed at higher levels in abdominally obese subjects as compared to lean subjects at fasting, which was partially reverted after WL. The impact of WL on the postprandial response was modest, both at the metabolic and gene expression level in PBMCs. CONCLUSION We conclude that mixed-meal challenges are not necessarily superior to measurements in the fasted state to assess metabolic health. Furthermore, the mechanisms accounting for the observed differences between lean and abdominally obese in the fasted state are different from those underlying the dissimilarity observed during the postprandial response.
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Affiliation(s)
- Parastoo Fazelzadeh
- Nutrition, Metabolism and Genomics Group, Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
- Top Institute Food and Nutrition, Wageningen, The Netherlands
| | - Roland W J Hangelbroek
- Nutrition, Metabolism and Genomics Group, Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
- Top Institute Food and Nutrition, Wageningen, The Netherlands
| | - Peter J Joris
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
- Top Institute Food and Nutrition, Wageningen, The Netherlands
| | - Casper G Schalkwijk
- Department of Internal Medicine, CARIM School for Cardiovascular Diseases, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Diederik Esser
- Nutrition, Metabolism and Genomics Group, Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | - Lydia Afman
- Nutrition, Metabolism and Genomics Group, Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | | | - Doris M Jacobs
- Netherlands Metabolomics Centre, Leiden, The Netherlands
- Unilever R&D, Vlaardingen, The Netherlands
| | - Velitchka V Mihaleva
- Netherlands Metabolomics Centre, Leiden, The Netherlands
- Unilever R&D, Vlaardingen, The Netherlands
| | - Sander Kersten
- Nutrition, Metabolism and Genomics Group, Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | - John van Duynhoven
- Laboratory of Biophysics, Wageningen University, Stippeneng 4, 6708WE, Wageningen, The Netherlands.
- Top Institute Food and Nutrition, Wageningen, The Netherlands.
- Netherlands Metabolomics Centre, Leiden, The Netherlands.
- Unilever R&D, Vlaardingen, The Netherlands.
| | - Mark V Boekschoten
- Nutrition, Metabolism and Genomics Group, Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
- Top Institute Food and Nutrition, Wageningen, The Netherlands
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