Inflammation-sensitive plasma proteins are associated with future weight gain

Body mass index mediates the association between four dietary indices and phenotypic age acceleration in adults: a cross-sectional study

Background: Diet and body mass index (BMI) are widely recognized as being closely associated with aging. However, it remains unclear which dietary indices are associated with aging, and the extent to which BMI mediates the relationship between diet and aging. Therefore, this study investigates the mediating role of BMI in the association between various dietary indices and phenotypic age acceleration (PhenoAgeAccel). Methods: Data were sourced from the National Health and Nutrition Examination Survey (NHANES), using two 24 hour recall interviews to compute four dietary indices: the Dietary Inflammatory Index (DII), Healthy Eating Index-2020 (HEI-2020), Alternative Healthy Eating Index-2010 (AHEI-2010), and Composite Dietary Antioxidant Index (CDAI). Linear regression analyses and mediation analyses assessed the associations between dietary indices and PhenoAgeAccel and the mediating effects of BMI. Z-score transformations (zDII, zHEI-2020, zAHEI-2010, and zCDAI) were used to ensure comparability between different dietary indices. Results: After adjusting for covariates, the zHEI-2020, zAHEI-2010, and zCDAI were negatively associated with PhenoAgeAccel (P < 0.05), with β values being -0.36, -0.40, and -0.41, respectively. The zDII was positively associated with PhenoAgeAccel (P < 0.001) with a β value of 0.70. Mediation analyses suggested that BMI significantly mediated the relationships between these dietary indices and PhenoAgeAccel. The mediation proportions were 23.7% for zDII, 43.3% for zHEI-2020, 24.5% for zAHEI-2010, and 23.6% for zCDAI. Conclusions: This study indicates that all dietary indices and BMI were significantly associated with PhenoAgeAccel. In addition, BMI exhibited the highest mediation proportion in the relationship between HEI-2020 and PhenoAgeAccel.

Next Generation, Modifiable Cardiometabolic Biomarkers: Mitochondrial Adaptation and Metabolic Resilience: A Scientific Statement From the American Heart Association

Cardiometabolic risk is increasing in prevalence across the life span with disproportionate ramifications for youth at socioeconomic disadvantage. Established risk factors and associated disease progression are harder to reverse as they become entrenched over time; if current trends are unchecked, the consequences for individual and societal wellness will become untenable. Interrelated root causes of ectopic adiposity and insulin resistance are understood but identified late in the trajectory of systemic metabolic dysregulation when traditional cardiometabolic risk factors cross current diagnostic thresholds of disease. Thus, children at cardiometabolic risk are often exposed to suboptimal metabolism over years before they present with clinical symptoms, at which point life-long reliance on pharmacotherapy may only mitigate but not reverse the risk. Leading-edge indicators are needed to detect the earliest departure from healthy metabolism, so that targeted, primordial, and primary prevention of cardiometabolic risk is possible. Better understanding of biomarkers that reflect the earliest transitions to dysmetabolism, beginning in utero, ideally biomarkers that are also mechanistic/causal and modifiable, is critically needed. This scientific statement explores emerging biomarkers of cardiometabolic risk across rapidly evolving and interrelated "omic" fields of research (the epigenome, microbiome, metabolome, lipidome, and inflammasome). Connections in each domain to mitochondrial function are identified that may mediate the favorable responses of each of the omic biomarkers featured to a heart-healthy lifestyle, notably to nutritional interventions. Fuller implementation of evidence-based nutrition must address environmental and socioeconomic disparities that can either facilitate or impede response to therapy.

Intrauterine food restriction impairs the lipogenesis process in the mesenteric adipocytes from low-birth-weight rats into adulthood

Background

Intrauterine food restriction (IFR) during pregnancy is associated with low birth weight (LBW) and obesity in adulthood. It is known that white adipose tissue (WAT) plays critical metabolic and endocrine functions; however, this tissue's behavior before weight gain and obesity into adulthood is poorly studied. Thus, we evaluated the repercussions of IFR on the lipogenesis and lipolysis processes in the offspring and described the effects on WAT inflammatory cytokine production and secretion.

Methods

We induced IFR by providing gestating rats with 50% of the necessary chow daily amount during all gestational periods. After birth, we monitored the offspring for 12 weeks. The capacity of isolated fat cells from mesenteric white adipose tissue (meWAT) to perform lipogenesis (14C-labeled glucose incorporation into lipids) and lipolysis (with or without isoproterenol) was assessed. The expression levels of genes linked to these processes were measured by real-time PCR. In parallel, Multiplex assays were conducted to analyze pro-inflammatory markers, such as IL-1, IL-6, and TNF-α, in the meWAT.

Results

Twelve-week-old LBW rats presented elevated serum triacylglycerol (TAG) content and attenuated lipogenesis and lipolysis compared to control animals. Inflammatory cytokine levels were increased in the meWAT of LBW rats, evidenced by augmented secretion by adipocytes and upregulated gene and protein expression by the tissue. However, there were no significant alterations in the serum cytokines content from the LBW group. Additionally, liver weight, TAG content in the hepatocytes and serum glucocorticoid levels were increased in the LBW group.

Conclusion

The results demonstrate that IFR throughout pregnancy yields LBW offspring characterized by inhibited lipogenesis and lipolysis and reduced meWAT lipid storage at 12 weeks. The increased serum TAG content may contribute to the augmented synthesis and secretion of pro-inflammatory markers detected in the LBW group.

Endotoxin of Porphyromonas gingivalis amplifies the inflammatory response in hyperglycemia-induced zebrafish through a mechanism involving chitinase-like protein YKL-40 analogs

Porphyromonas gingivalis (P. gingivalis), a key pathogen in periodontal diseases, is also associated with hyperglycemia-associated systemic diseases, including diabetes mellitus (DM). Gingipains are the most important endotoxins of P. gingivalis, and in vivo studies using gingipains are scarce. Zebrafish (Danio rerio) is a vertebrate with high physiological and genetic homology with humans that has multiple co-orthologs for human genes, including inflammation-related proteins. The aim of our study was to determine the effects of gingipain in a hyperglycemia-induced zebrafish model by evaluating inflammation, oxidant-antioxidant status, and the cholinergic system. Adult zebrafish were grouped into the control group (C), hyperglycemia-induced group subjected to 15 days of overfeeding (OF), gingipain-injected group (GP), and gingipain-injected hyperglycemic group (OF + GP). At the end of 15 days, an oral glucose tolerance test (OGTT) was performed, and fasting blood glucose (FBG) levels were measured. Lipid peroxidation (LPO), nitric oxide (NO), glutathione (GSH), glutathione S-transferase, catalase, acetylcholinesterase (AChE), alkaline phosphatase (ALP), and sialic acid (SA) levels were determined spectrophotometrically in the hepatopancreas. The expression levels of tnf-⍺, il-1β, ins, crp, and the acute phase protein YKL-40 analogs chia.5 and chia.6 were evaluated by RT‒PCR. After two weeks of overfeeding, significantly increased weight gain, FBG, and OGTT confirmed that the zebrafish were hyperglycemic. Increased oxidative stress, inflammation, and AChE and ALP activities were observed in both the overfeeding and GP groups. Amplification of inflammation and oxidative stress was evident in the OF + GP group through increased expression of crp, il-1β, chia.5, and chia.6 and increased LPO and NO levels. Our results support the role of gingipains in the increased inflammatory response in hyperglycemia-associated diseases.

Body weight, weight change and the risk of cardiovascular disease in patients with hypertension: a primary-care cohort study

BACKGROUND/OBJECTIVES

Obesity and cardiovascular disease (CVD) often co-occur. However, the effects of excessive body weight and weight change on CVD in patients with hypertension are not clearly established. We examined the associations of BMI, weight change and the risk of CVD in patients with hypertension.

SUBJECTS/METHODS

Our Data were drawn from the medical records of primary-care institutions in China. A total of 24,750 patients with valid weight measurements attending primary healthcare centers were included. Body weight were grouped in BMI categories of underweight ( < 18.5 kg/m2), healthy weight (18.5-22.9 kg/m2), overweight (23.0-24.9 kg/m2) and obesity ( ≥ 25.0 kg/m2). Weight change over 12 months was divided into: gain >4%, gain 1-4%, stable (-1 to 1%), loss 1-4%, and loss ≥4%. Cox regression analyses were used to estimate hazard ratio (HR) and 95% confidence interval (95% CI) between BMI, weight change and the risk of CVD.

RESULTS

After multivariable adjustment, patients with obesity were related to higher risks of CVD (HR = 1.48, 95% CI: 1.19-1.85). Higher risks were seen in participants with loss ≥4% and gain >4% of body weight compared to stable weight (loss ≥4%: HR = 1.33, 95% CI: 1.04-1.70; gain >4%: HR = 1.36, 95% CI: 1.04-1.77).

CONCLUSION

Obesity and weight change of loss ≥4% and gain >4% were related to higher risks of CVD. Close monitoring and appropriate interventions aimed at achieving an optimal weight are needed to prevent adverse cardiovascular outcomes for patients with hypertension.

Dietary inflammatory index and its relation to the pathophysiological aspects of obesity: a narrative review

Obesity, a complex disease that involves energy imbalance and chronic low-grade inflammation, is implicated in the pathogenesis of several chronic non-communicable diseases. As dietary components modulate the human body's inflammatory status, the Dietary Inflammatory Index (DII®), a literature-derived dietary index, was developed in 2009 to characterize the inflammatory potential of a habitual diet. Abundant research has been conducted to investigate the associations between DII and obesity. In this narrative review, we examined the current state of the science regarding the relationships between DII and the inflammatory pathophysiological aspects related to obesity. DII is associated with inflammation in obesity. The most pro-inflammatory diet was directly related to higher levels of pro-inflammatory markers, which included C-reactive protein (CRP), interleukin-6 (IL-6), IL-1β, and tumor necrosis factor-α (TNF-α). Therefore, evidence suggests that the use of the DII may be useful for understanding the relationship between diet and the inflammatory process related to obesity.

The interaction between rs 3,807,992 genotypes with the dietary inflammatory index on Leptin, Leptin resistance, and Galectin 3 in obese and overweight women

OBJECTIVE

Obesity is related to increasing leptin and some inflammatory factors that are associated with low-grade inflammation. Moreover, several studies have shown Caveolin-1 (CAV1) genetic variations may be associated with dietary intake. The current study aimed to evaluate the interaction of CAV1 rs3807992 with types of the energy-adjusted dietary inflammatory index (EDII) in leptin, leptin resistance, and Galectin 3, as inflammatory factors.

METHODS

This cross-sectional study was carried out on 363 overweight and obese females. Dietary intake and DII were obtained from a 147-item food frequency questionnaire (FFQ). The CAV-1 genotype was measured using the PCR-RFLP method. Anthropometric values and serum levels of leptin and Galectin 3 were measured by standard methods.

RESULTS

Increased adherence to EDII in the interaction with CAV1 genotypes led to an increase in leptin level 79.15 (mg/l) (β = 79.15, CI = - 1.23,163.94, P = 0.04) in model 3, after controlling for further potential confounders. By contrast, adherence to EDII in the interaction with the genotype including risk alleles showed no significant interaction, even after adjustment in model 3 (β = 0.55, CI = - 0.99, 2.09, P = 0.48). Although, a marginal positive significant interaction was found between EDII and CAV1 genotypes on Galectin 3, after adjustment in model 3 (β = 31.35, CI = 0.13, 77.13, P = 0.05).

CONCLUSIONS

The present study indicates that a high adherence of EDII and CAV1 genotypes containing risk alleles may be a prognostic factor and increase both leptin and Galectin3. However, it seems that the presence of interaction was not on leptin resistance. Further functional studies are necessary to elucidate the exact mechanism.

Effects of weight loss on bone turnover, inflammatory cytokines, and adipokines in Chinese overweight and obese adults

PURPOSE

Plenty of studies have examined the long term effect of weight loss on bone mineral density. This study aimed to explore the effects of 10% weight loss on early changes in bone metabolism as well as the possible influencing factors.

METHODS

Overweight and obese outpatients (BMI > 24.0 kg/m²) were recruited from the nutrition clinic and followed a calorie-restricted, high-protein, low-carbohydrate diet program. Dietary intake, body composition, serum procollagen type I N-propeptide (PINP), β-Crosslaps, PTH, 25(OH) VitD, a series of inflammatory cytokines and adipokines were measured for the participants before starting to lose weight and after 10% weight loss (NCT04207879).

RESULTS

A total of 75 participants were enrolled and 37 participants achieved a weight loss of at least 10%. It was found that PINP decreased (p = 0.000) and the β-Crosslaps increased (p = 0.035) in female participants. Decreases in PTH (p = 0.001), serum IL-2 (p = 0.013), leptin (p = 0.001) and increases in 25(OH) VitD (p = 0.001), serum ghrelin (p = 0.033) were found in 37 participants after 10% of their weight had been lost. Change in PINP was detected to be significantly associated with change in lean body mass (r = 0.418, p = 0.012) and change in serum ghrelin(r = - 0.374, p = 0.023).

CONCLUSIONS

Bone formation was suppressed and bone absorption was increased in female subjects after a 10% weight loss. Bone turnover was found to be associated with lean body mass and affected by the circulating ghrelin level.

Cohort Study and Bias Analysis of the Obesity Paradox Across Stages of Chronic Kidney Disease

OBJECTIVE

In advanced chronic kidney disease (CKD), patients with obesity often have better outcomes than patients without obesity, often called the 'obesity paradox'. Yet, in CKD, the prevalence of inflammation increases as CKD progresses. Although a potential confounder, inflammation may be left unaccounted in obesity-mortality studies. We examined the associations of body mass index (BMI) with all-cause and cause-specific mortality across CKD stages, with consideration for uncontrolled confounding due to unmeasured inflammation.

METHODS

We investigated 2,703,512 patients with BMI data between 2004 and 2006. We used Cox models to examine the associations of BMI with all-cause, cardiovascular, and cancer mortality, (ref: BMI 25-<30 kg/m2), adjusted for clinical characteristics and stratified by CKD stages. To address uncontrolled confounding, we performed bias analysis using a weighted probabilistic model of inflammation given the observed data applied to weighted Cox models.

RESULTS

The cohort included 5% females and 14% African Americans. In adjusted analyses, the associations of the BMI with all-cause and cardiovascular mortality showed a reverse J-shape, where a higher BMI (>40 kg/m2) was associated with a higher risk. Conversely, a lower mortality risk was observed with a BMI 30-<35 kg/m2 across all CKD stages and for BMI >40 kg/m2 in CKD stage 4/5. Cancer mortality analyses showed an inverse relationship. Bias analysis for uncontrolled confounding suggested that independent of inflammation, the obesity paradox was present.

CONCLUSION

We observed the presence of the obesity paradox in this study. This association was consistent in advanced CKD and in our bias analysis, suggesting that inflammation may not fully explain the observed BMI-mortality associations including in patients with CKD.

The Risks of Cardiovascular Disease Following Weight Change in Adults with Diabetes: A Cohort Study and Meta-analysis (jc.2022-01089)

CONTEXT

Weight management is recognized as critical in reducing cardio-metabolic risk factors for adults with diabetes, but the effects of weight change on cardiovascular disease in patients with diabetes are unknown.

OBJECTIVE

To evaluate 18-month weight change and subsequent risk of macrovascular and microvascular complications in established individuals with type 2 diabetes.

DESIGN AND SETTING

This study consisted of a cohort study and a meta-analysis. In the cohort study, weight change over 18 months was divided into: gain ≥5%, gain 1%-5%, stable (-1%-1%), loss 1%-5%, and loss ≥5%. Cox regression analyses were used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI). We then used random-effect models to pool the results combing our study with other relevant studies.

RESULTS

In the cohort study, 8920 participants with valid weight measurements were included. Compared with patients with stable weight, higher risks were seen in those with weight change for total vascular complications (gain ≥5%: HR=1.43, 95% CI: 1.10-1.85; gain 1-5%: HR=1.44, 95% CI: 1.02-2.03; loss ≥5%: HR=1.58, 95% CI: 1.20-2.08), macrovascular complications (gain ≥5%: HR=1.84, 95% CI: 1.16-2.91; loss 1-5%: HR=1.91, 95% CI: 1.06-3.43; loss ≥5%: HR=2.18, 95% CI: 1.36-3.49) and microvascular complications (loss ≥5%: HR=1.48, 95% CI: 1.06-2.06). Meta-analysis also showed similar results.

CONCLUSIONS

Weight gain and loss over 18 months among patients with type 2 diabetes, especially weight change ≥5%, may be a warning sign of adverse cardiovascular outcomes.

Prepregnancy body mass index, gestational weight gain, and maternal prepartum inflammation in normal pregnancies: findings from a Chinese cohort

BACKGROUND

Obesity has been linked to systemic inflammation in population studies.

OBJECTIVE

To examine the associations of prepregnancy body mass index (pBMI) and total gestational weight gain (tGWG) with maternal prepartum low-grade inflammation (LGI) and clinically significant inflammation (CSI) defined by serum C-reactive protein (CRP) concentration.

METHODS

Five thousand four hundred seventy-six Chinese women with uncomplicated pregnancies and recorded data on pBMI and prepartum body weight were included in this study. Blood samples were drawn before delivery for high-sensitivity CRP assay. Inadequate, optimal, and excessive tGWG were defined using the Institute of Medicine's recommendation. Multivariable Poisson regressions were used to estimate relative risks (RRs) for having prepartum LGI and CSI (defined as CRP concentration 3-10 and > 10 mg/L, respectively) across pBMI and tGWG categories.

RESULTS

The mean pBMI, mean tGWG, and median maternal prepartum CRP concentration were 20.4 kg/m², 13.9 kg, and 3.3 mg/L, respectively. The prevalence of prepartum CSI and LGI was 7.2% and 47.8%. The adjusted RRs (95% confidence interval) of CSI for normal (18.5-24.9 kg/m²) and high (≥ 25 kg/m²) vs. low pBMI (< 18.5 kg/m²) were 1.35 (1.05-1.74) and 2.28 (1.53-3.39), respectively. The respective adjusted RRs of LGI were 1.19 (1.11-1.28) and 1.59 (1.42-1.77). The adjusted RRs for excessive vs. optimal tGWG was 1.18 (0.94-1.48) for CSI and 1.14 (1.07-1.21) for LGI.

CONCLUSIONS

Prepregnancy overweight/obesity and excessive tGWG increase the risk of maternal prepartum systemic inflammation, which further highlights the importance of weight management before and during pregnancy.

NUCB2/Nesfatin-1 Reduces Obesogenic Diet Induced Inflammation in Mice Subcutaneous White Adipose Tissue

Background: Excess adipose tissue accumulation and obesity are characterised by chronic, low-grade, systemic inflammation. Nestfatin-1 is a neuropeptide derived from the precursor protein nucleobindin-2 (NUCB2), which was initially reported to exert anorexigenic effects. The present study aimed to investigate the effects of an obesogenic diet (OD; high-fat, high-sugar) in NUCB2 knockout (KO) mice and of nesfatin-1 treatment in LPS-stimulated 3T3-L1 preadipocytes. Methods: Subcutaneous white adipose tissue (Sc-WAT) samples from wild type (WT) and NUCB2 KO mice that were fed a normal diet (ND), or the OD for 12 weeks were used for RNA and protein extraction, as well as immunohistochemistry. 3T3-L1 cells were treated with 100 nM nesfatin-1 during differentiation and stimulated with 1 µg/mL LPS for measuring the expression and secretion of pro-inflammatory mediators by qPCR, western blotting, immunofluorescence, Bioplex, and ELISA. Results: Following the OD, the mRNA, protein and cellular expression of pro-inflammatory mediators (Tnfα, Il-6, Il-1β, Adgre1, Mcp1, TLR4, Hmbgb1 and NF-kB) significantly increased in the ScWAT of NUCB2 KO mice compared to ND controls. Adiponectin and Nrf2 expression significantly decreased in the ScWAT of OD-fed NUCB2 KO, without changes in the OD-fed WT mice. Furthermore, nesfatin-1 treatment in LPS-stimulated 3T3-L1 cells significantly reduced the expression and secretion of pro-inflammatory cytokines (Tnfα, Il-6, Il-1β, Mcp1) and hmgb1. Conclusion: An obesogenic diet can induce significant inflammation in the ScWAT of NUCB2 KO mice, involving the HMGB1, NRF2 and NF-kB pathways, while nesfatin-1 reduces the pro-inflammatory response in LPS-stimulated 3T3-L1 cells. These findings provide a novel insight into the metabolic regulation of inflammation in WAT.

The association of high-sensitivity C-reactive protein with future weight gain in adults

Background

Obesity is associated with low-grade systemic inflammation, and it has been suggested that increased inflammation markers could predict future weight gain. Our aim was to investigate the associations of high-sensitivity C-reactive protein (hs-CRP) concentration with changes in weight and waist circumference in adults during 11 years of follow-up.

Methods

We used data from the Health 2000 and Health 2011 surveys consisting of a population-based sample of Finnish adults. We included those 3143 participants, aged 30–75 years at baseline, whose baseline hs-CRP was measured, and who had information on measured weight and height at both time points. Associations between baseline hs-CRP and changes in weight and waist circumference were analyzed using multinomial logistic regression, adjusted for sociodemographic factors (age, sex, marital status, and educational status), lifestyle factors (smoking, alcohol consumption, leisure-time physical activity, sitting time, sleeping time, and psychological distress), and baseline values of BMI and waist circumference.

Results

Hs-CRP was not associated with weight gain (≥5%) when adjusted for potential confounders (OR 0.99, 95% CI 0.96–1.01), compared to stable weight (change <±5%). Higher baseline hs-CRP was associated with decrease in weight (≤−5%) in the unadjusted (OR 1.03, 1.01–1.05), but not in the adjusted (OR 1.01, 0.99–1.03) model. No association was observed between hs-CRP and waist circumference.

Conclusions

Hs-CRP was not associated with future changes in weight or waist circumference in adults. These findings suggest that hs-CRP concentration does not predict future weight gain.

Obesity and risk of female reproductive conditions: A Mendelian randomisation study

BACKGROUND

Obesity is observationally associated with altered risk of many female reproductive conditions. These include polycystic ovary syndrome (PCOS), abnormal uterine bleeding, endometriosis, infertility, and pregnancy-related disorders. However, the roles and mechanisms of obesity in the aetiology of reproductive disorders remain unclear. Thus, we aimed to estimate observational and genetically predicted causal associations between obesity, metabolic hormones, and female reproductive disorders.

METHODS AND FINDINGS

Logistic regression, generalised additive models, and Mendelian randomisation (MR) (2-sample, non-linear, and multivariable) were applied to obesity and reproductive disease data on up to 257,193 women of European ancestry in UK Biobank and publicly available genome-wide association studies (GWASs). Body mass index (BMI), waist-to-hip ratio (WHR), and WHR adjusted for BMI were observationally (odds ratios [ORs] = 1.02-1.87 per 1-SD increase in obesity trait) and genetically (ORs = 1.06-2.09) associated with uterine fibroids (UF), PCOS, heavy menstrual bleeding (HMB), and pre-eclampsia. Genetically predicted visceral adipose tissue (VAT) mass was associated with the development of HMB (OR [95% CI] per 1-kg increase in predicted VAT mass = 1.32 [1.06-1.64], P = 0.0130), PCOS (OR [95% CI] = 1.15 [1.08-1.23], P = 3.24 × 10-05), and pre-eclampsia (OR [95% CI] = 3.08 [1.98-4.79], P = 6.65 × 10-07). Increased waist circumference posed a higher genetic risk (ORs = 1.16-1.93) for the development of these disorders and UF than did increased hip circumference (ORs = 1.06-1.10). Leptin, fasting insulin, and insulin resistance each mediated between 20% and 50% of the total genetically predicted association of obesity with pre-eclampsia. Reproductive conditions clustered based on shared genetic components of their aetiological relationships with obesity. This study was limited in power by the low prevalence of female reproductive conditions among women in the UK Biobank, with little information on pre-diagnostic anthropometric traits, and by the susceptibility of MR estimates to genetic pleiotropy.

CONCLUSIONS

We found that common indices of overall and central obesity were associated with increased risks of reproductive disorders to heterogenous extents in a systematic, large-scale genetics-based analysis of the aetiological relationships between obesity and female reproductive conditions. Our results suggest the utility of exploring the mechanisms mediating the causal associations of overweight and obesity with gynaecological health to identify targets for disease prevention and treatment.

Diet scores and prediction of general and abdominal obesity in the Melbourne collaborative cohort study

OBJECTIVE

To ascertain which of the Alternative Healthy Eating Index (AHEI) 2010, Dietary Inflammatory Index (DII®) and Mediterranean Diet Score (MDS) best predicted BMI and waist-to-hip circumference ratio (WHR).

DESIGN

Body size was measured at baseline (1990-1994) and in 2003-2007. Diet was assessed at baseline using a FFQ, along with age, sex, socio-economic status, smoking, alcohol drinking, physical activity and country of birth. Regression coefficients and 95 % CI for the association of baseline dietary scores with follow-up BMI and WHR were generated using multivariable linear regression, adjusting for baseline body size, confounders and energy intake.

SETTING

Population-based cohort in Melbourne, Australia.

PARTICIPANTS

Included were data from 11 030 men and 16 774 women aged 40-69 years at baseline.

RESULTS

Median (IQR) follow-up was 11·6 (10·7-12·8) years. BMI and WHR at follow-up were associated with baseline DII® (Q5 v. Q1 (BMI 0·41, 95 % CI 0·21, 0·61) and WHR 0·009, 95 % CI 0·006, 0·013)) and AHEI (Q5 v. Q1 (BMI -0·51, 95 % CI -0·68, -0·35) and WHR -0·011, 95 % CI -0·013, -0·008)). WHR, but not BMI, at follow-up was associated with baseline MDS (Group 3 most Mediterranean v. G1 (BMI -0·05, 95 % CI -0·23, 0·13) and WHR -0·004, 95 % CI -0·007, -0·001)). Based on Akaike's Information Criterion and Bayesian Information Criterion statistics, AHEI was a stronger predictor of body size than the other diet scores.

CONCLUSIONS

Poor quality or pro-inflammatory diets predicted overall and central obesity. The AHEI may provide the best way to assess the obesogenic potential of diet.

MALDI-TOF MS Characterisation of the Serum Proteomic Profile in Insulin-Resistant Normal-Weight Individuals

Insulin resistance (IR) is one of the most common metabolic disorders worldwide and is involved in the development of diseases, such as diabetes and cardiovascular diseases, affecting civilisations. The possibility of understanding the molecular mechanism and searching for new biomarkers useful in assessing IR can be achieved through modern research techniques such as proteomics. This study assessed the protein–peptide profile among normal-weight patients with IR to understand the mechanisms and to define new risk biomarkers. The research involved 21 IR and 43 healthy, normal-weight individuals, aged 19–65. Serum proteomic patterns were obtained using matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry. The proposed methodology identified six proteins differentiating normal weight IR and insulin sensitive individuals. They were fibrinogen alpha chain, serum albumin, kininogen-1, complement C3, serotransferrin, and Ig gamma-1 chain, which could potentially be related to inflammation. However, further investigation is required to confirm their correlation with IR.

Baseline Gut Metagenomic Functional Gene Signature Associated with Variable Weight Loss Responses following a Healthy Lifestyle Intervention in Humans

Recent human feeding studies have shown how the baseline taxonomic composition of the gut microbiome can determine responses to weight loss interventions. However, the functional determinants underlying this phenomenon remain unclear. We report a weight loss response analysis on a cohort of 105 individuals selected from a larger population enrolled in a commercial wellness program, which included healthy lifestyle coaching. Each individual in the cohort had baseline blood metabolomics, blood proteomics, clinical labs, dietary questionnaires, stool 16S rRNA gene sequencing data, and follow-up data on weight change. We generated additional targeted proteomics data on obesity-associated proteins in blood before and after intervention, along with baseline stool metagenomic data, for a subset of 25 individuals who showed the most extreme weight change phenotypes. We built regression models to identify baseline blood, stool, and dietary features associated with weight loss, independent of age, sex, and baseline body mass index (BMI). Many features were independently associated with baseline BMI, but few were independently associated with weight loss. Baseline diet was not associated with weight loss, and only one blood analyte was associated with changes in weight. However, 31 baseline stool metagenomic functional features, including complex polysaccharide and protein degradation genes, stress-response genes, respiration-related genes, and cell wall synthesis genes, along with gut bacterial replication rates, were associated with weight loss responses after controlling for age, sex, and baseline BMI. Together, these results provide a set of compelling hypotheses for how commensal gut microbiota influence weight loss outcomes in humans.

IMPORTANCE Recent human feeding studies have shown how the baseline taxonomic composition of the gut microbiome can determine responses to dietary interventions, but the exact functional determinants underlying this phenomenon remain unclear. In this study, we set out to better understand interactions between baseline BMI, metabolic health, diet, gut microbiome functional profiles, and subsequent weight changes in a human cohort that underwent a healthy lifestyle intervention. Overall, our results suggest that the microbiota may influence host weight loss responses through variable bacterial growth rates, dietary energy harvest efficiency, and immunomodulation.

Association between the dietary inflammatory index and obesity in otherwise healthy adults: Role of age and sex

AIM

The dietary inflammatory index (DII^® ) can estimate the overall inflammatory potential of diet. This study aimed to assess the association between DII score and other diet quality parameters with weight status among normal weight, overweight and obese otherwise healthy adults.

METHODS

This retrospective observational study investigated DII, energy-adjusted DII (E-DII^TM ), dietary energy density (DED) and mean adequacy ratio (MAR) scores, based on a valid 168-item food frequency questionnaire, in 100 normal weight, 100 overweight and 100 obese healthy adults (age > 18yr).

RESULTS

Normal-weight participants had higher DII scores than obese participants (mean difference (MD): 0.67, 95% confidence interval (CI): 0.004 - 1.33, P = .048). Body mass index (BMI) had an effect on DII score after adjusting for age (P = .03). A statistically significant interaction was observed between BMI and age on E-DII (P = .03) and MAR (P = .004). E-DII scores were lower (more anti-inflammatory) and MAR was higher with increasing age in the obese compared with normal-weight participants. Additionally, male participants had higher DII (MD: -0.53, 95% CI: -0.97 - -0.09, P = .02), E-DII (MD: -0.76, 95% CI: -1.12 - -0.35, P < .001), DED (MD: -0.09, 95% CI: -0.15 - -0.03, P = .004) and lower MAR (MD: 0.04, 95% CI: 0.02 - 0.06, P = .001), after adjusting for BMI. Obesity (Adjusted odds ratio (AOR) = 0.48, 95% CI: 0.26 - 0.91, P = .02) and DED (AOR =5.81, 95% CI: 2.28 - 14.81, P < .001) were the most important factors associated with high DII.

CONCLUSIONS

This study showed that having a normal body weight is not necessarily indicative of less inflammatory potential of diet and better diet quality. Male sex and increasing age were important determinants of diet quality across BMI subgroups.

Association between Dietary Inflammatory Index, Dietary Patterns, Plant-Based Dietary Index and the Risk of Obesity

Evidence on the association between various dietary constructs and obesity risk is limited. This study aims to investigate the longitudinal relationship between different diet indices and dietary patterns with the risk of obesity. Non-obese participants (n = 787) in the North West Adelaide Health Study were followed from 2010 to 2015. The dietary inflammatory index (DII^®), plant-based dietary index (PDI) and factor-derived dietary pattern scores were computed based on food frequency questionnaire data. We found the incidence of obesity was 7.62% at the 5-year follow up. In the adjusted model, results from multivariable log-binomial logistic regression showed that a prudent dietary pattern (RR_Q5 vs. _Q1 = 0.38; 95% CI: 0.15–0.96), healthy PDI (RR = 0.31; 95% CI: 0.12–0.77) and overall PDI (RR = 0.56; 95% CI: 0.23–1.33) were inversely associated with obesity risk. Conversely, the DII (RR = 1.59; 95% CI: 0.72–3.50), a Western dietary pattern (RR = 2.16; 95% CI: 0.76–6.08) and unhealthy PDI (RR = 1.94; 95% CI: 0.81–4.66) were associated with increased risk of obesity. Based on the cubic spline analysis, the association between an unhealthy PDI or diet quality with the risk of obesity was non-linear. In conclusion, an anti-inflammatory diet, healthy diet or consumption of healthy plant-based foods were all associated with a lower risk of developing obesity.

Obesity and diabetes as high-risk factors for severe coronavirus disease 2019 (Covid-19)

The outbreak of the coronavirus disease 2019 (Covid-19) has become an evolving worldwide health crisis. With the rising prevalence of obesity and diabetes has come an increasing awareness of their impacts on infectious diseases, including increased risk for various infections, post-infection complications and mortality from critical infections. Although epidemiological and clinical characteristics of Covid-19 have been constantly reported, no article has systematically illustrated the role of obesity and diabetes in Covid-19, or how Covid-19 affects obesity and diabetes, or special treatment in these at-risk populations. Here, we present a synthesis of the recent advances in our understanding of the relationships between obesity, diabetes and Covid-19 along with the underlying mechanisms, and provide special treatment guidance for these at-risk populations.

Associations of dietary inflammatory index, serum levels of MCP-1 and body composition in Iranian overweight and obese women: a cross-sectional study

OBJECTIVE

Although, several studies have illustrated that there is a relation between dietary inflammatory index (DII) with obesity-related parameters, and inflammation, their results were controversial. This study aimed to investigate this relationship among Iranian women.

RESULTS

Multivariable linear regression showed that fat mass was 0.14 kg lower in the anti-inflammatory diet group, with respect to the pro-inflammatory group, after adjusting covariates such as age, physical activity, economic and job status (β = - 0.142, 95% CI - 4.44, - 1.71, P = 0.03). Fat-free mass (FFM) was 1.5 kg more in the anti-inflammatory diet group, compared to the pro-inflammatory diet group, after adjusting for potentials cofounders (β = 1.50, 95% CI 0, 3.01, p = 0.05). Furthermore, after adjusting for potentials cofounders, it was revealed that the subjects with lower DII had lower monocyte chemoattractant protein-1 (MCP-1) levels in serum (β = - 18.81, 95% CI - 35.84, - 1.79, p = 0.03). These findings suggest an inverse and significant relationship between DII and FFM and also DII is directly related to Fat mass and the level of MCP-1. This finding can be used for developing interventions that aim to promote healthy eating to prevent inflammation and non-communicable disease development among obese females.

Postpartum Weight Retention and Its Determinants in Lebanon and Qatar: Results of the Mother and Infant Nutrition Assessment (MINA) Cohort

Excessive Postpartum Weight Retention (PWR) is postulated to increase the risk of adverse health outcomes for mothers and offspring. Using data from the Mother and Infant Nutritional Assessment (MINA) cohort in Lebanon and Qatar, this study aimed to examine PWR and its determinants at 6 months after delivery. Pregnant women (n = 183) were recruited during their first trimester and were followed up through pregnancy and after delivery. During this period, face-to-face interviews as well as extraction from medical charts were conducted to collect data regarding the socioeconomic, anthropometric and dietary intake of participants. The mean PWR (kg) among participants was 3.1 ± 5.6 at delivery, and 3.3 ± 5.3 and 2.7 ± 4.7 at 4 and 6 months after delivery, respectively. Results of the multiple logistic regression analyses showed that a Qatari nationality and excessive GWG were associated with higher odds of a high PWR (above median) while an insufficient GWG had lower odds. After adjustment for energy, participants with a high PWR reported a greater intake of proteins, Trans fat, cholesterol, sodium and lower intakes of mono and polyunsaturated fat as compared to those with a low PWR (below median). These findings suggested priority areas for interventions to prevent excessive PWR amongst women of childbearing age in Lebanon and Qatar.

Oxytocin reduces adipose tissue inflammation in obese mice

BACKGROUND

Obesity and adipose tissue expansion is characterized by a chronic state of systemic inflammation that contributes to disease. The neuropeptide, oxytocin, working through its receptor has been shown to attenuate inflammation in sepsis, wound healing, and cardiovascular disease. The current study examined the effects of chronic oxytocin infusions on adipose tissue inflammation in a murine model of obesity, the leptin receptor-deficient (db/db) mouse.

METHODS

The effect of obesity on oxytocin receptor protein and mRNA expression in adipose tissue was evaluated by Western blotting and real-time polymerase chain reaction. Mice were implanted with osmotic minipumps filled with oxytocin or vehicle for 8 weeks. At study endpoint adipose tissue inflammation was assessed by measurement of cytokine and adipokine mRNA tissue levels, adipocyte size and macrophage infiltration via histopathology, and plasma levels of adiponectin and serum amyloid A as markers of systemic inflammation.

RESULTS

The expression of adipose tissue oxytocin receptor was increased in obese db/db mice compared to lean controls. In adipose tissue oxytocin infusion reduced adipocyte size, macrophage infiltration, IL-6 and TNFα mRNA expression, and increased the expression of the anti-inflammatory adipokine, adiponectin. In plasma, oxytocin infusion reduced the level of serum amyloid A, a marker of systemic inflammation, and increased circulating adiponectin.

CONCLUSIONS

In an animal model of obesity and diabetes chronic oxytocin treatment led to a reduction in visceral adipose tissue inflammation and plasma markers of systemic inflammation, which may play a role in disease progression.

The association between dietary inflammatory index and risk of central obesity in adults: An updated systematic review and meta-analysis

Backgrounds: Central obesity, as a pivotal component of metabolic syndrome is associated with numerous co-morbidities. Dietary factors influence central obesity by increased inflammatory status. However, recent studies didn't evaluate the association between central obesity and dietary inflammation index (DII^®) that give score to dietary factors according to their inflammatory potential. In the current systematic review and meta-analysis, we summarized the studies that investigated the association between DII^® with central obesity indices in the general populations. Methods: In a systematic search from PubMed, SCOPUS, Web of Sciences and Cochrane electronic databases, we collected relevant studies written in English and published until 30 October 2019. The population of included studies were apparently healthy subjects or individuals with obesity or obesity-related diseases. Observational studies that evaluated the association between DII^® and indices of central obesity including WC or WHR were included. Results: Totally thirty-two studies were included; thirty studies were cross-sectional and two were cohort studies with 103071 participants. Meta-analysis of observational studies showed that higher DII^® scores were associated with 1.81 cm increase in WC (Pooled weighted mean difference (WMD) = 1.813; CI: 0.785-2.841; p = 0.001). Also, a non-significant increase in the odds of having higher WC (OR = 1.162; CI: 0.95-1.43; p = 0.154) in the highest DII category was also observed. In subgroup analysis, the continent, dietary assessment tool and gender were the heterogeneity sources. Conclusion: The findings proposed that adherence to diets with high DII^® scores was associated with increased WC. Further studies with interventional designs are necessary to elucidate the causality inference between DII^® and central obesity indices.

Intergenerational associations of dietary inflammatory index with birth outcomes and weight status at age 5 and 9: Results from the Lifeways cross-generation cohort study

BACKGROUND

Maternal diet and chronic inflammation may influence early-life offspring health. No comparative data regarding intergenerational associations between dietary inflammation and offspring growth exist.

OBJECTIVE

To investigate potential associations between parental and grandparental dietary inflammatory index (DII®) scores with offspring birth outcomes and childhood adiposity.

METHODS

This analysis of the Lifeways Study includes 1082 mother-child pairs, 333 index-child's fathers and 707 grandparents. Energy-adjusted DII (E-DII) scores were derived from a validated FFQ for all adults. Birth outcomes were abstracted from hospital records. Childhood BMI was determined at age 5 and 9. Logistic regression and mediation analyses using the PROCESS macro for SPSS were performed.

RESULTS

Higher maternal E-DII scores, reflecting a more pro-inflammatory diet, were associated with increased risk of low birthweight (LBW), BW < 2500 g (OR:1.20, 95%CI:1.02-1.47, p = 0.03). Higher maternal grandmothers' (MGM) E-DII scores were associated with increased risk of macrosomia (OR:1.35, 95% CI:1.02-1.79, p = 0.03) and with increased risk of an overweight grandchild at age 9 (OR:1.47, 95% CI:1.26-1.72, p = 0.02). Results from the mediation analyses revealed a significant total effect between MGMs' E-DII scores and grandchild's BW. Higher father's and paternal grandmothers' (PGM) E-DII scores were associated with greater risk of childhood overweight/obesity at 5 years (OR:1.03, 95%CI:1.01-1.19, p = 0.04 and OR:1.07, 95%CI:1.05-1.09, p = 0.01, respectively). The association with the PGMs' E-DII persisted at age 9 (OR:1.13, 95%CI:1.01-1.90, p = 0.04).

CONCLUSIONS

Dietary inflammation is associated with adverse offspring birth outcomes and childhood adiposity. A more pro-inflammatory maternal line diet appears to influence early-life growth, whereas paternal line dietary inflammation appears to influence childhood obesity.

A Proteomics-Based Approach Reveals Differential Regulation of Urine Proteins between Metabolically Healthy and Unhealthy Obese Patients

Metabolic dysfunction associated with obesity threatens to inundate health care resources by increasing the incidences of obesity-related diseases. The aim of the present study was to investigate the changes in the urinary proteome of 18 individuals classified into metabolically healthy obese (MHO) and metabolically unhealthy obese (MUHO) patients. Proteome analysis was performed using the two-dimensional difference in gel electrophoresis (2D-DIGE) coupled with mass spectrometry (MS). Upon analysis, a total of 54 proteins were found to be affected with ≥1.5-fold change (ANOVA, p ≤ 0.05), of which 44 proteins were upregulated and 10 proteins were downregulated. These differentially abundant proteins were related to nuclear factor κB (NF-κB) and p38 mitogen-activated protein (MAP) kinase pathways and were involved in cellular compromise, inflammatory response, and cancer. Proteins involved in inflammation (fibrinogen alpha (FIBA), serotransferrin (TRFE, and kininogen-1 (KNG1)) and insulin resistance (ADP-ribosylation factor (ARF)-like protein 15 (ARL15) and retinol-binding protein 4 (RET4)) were found to be significantly increased in the urine samples of MUHO compared to MHO patients. Investigating the effects of obesity on urinary proteins can help in developing efficient diagnostic procedures for early detection and prevention of obesity-related complications.

Effects of Telephone Follow-Up Intervention on %Body Fat, Inflammatory Cytokines, and Oxidative Stress in Obese Hispanic Children

This study investigated whether 10 month telephone follow-up intervention effectively stabilizes reductions in %body fat, and markers of inflammation and oxidative stress obtained from summer camp in obese Hispanic children. Fifty-six obese children (19 SUTI: summer camp and 10 months of follow-up telephone intervention, 18 SU: summer camp intervention only, and 19 CON: no intervention) completed this study. Anthropometric data and blood samples were obtained before (PRE), after 8 weeks of summer camp, and a 10month follow-up telephone intervention to measure markers of inflammation and oxidative stress. Eight weeks of summer camp significantly reduced %body fat, and levels of tumor necrosis factor-alpha, C-reactive protein and 8-hydroxydeoxyguanosine. It also elevated levels of adiponectin and total antioxidant status in SUTI and SU (p < 0.05). However, results of the 10month follow-up measurement were reverted back to PRE in SU, whereas the results for SUTI remained different to PRE (p < 0.05). Results confirm that levels of inflammation and oxidative stress are correlated to changes in %body fat, indicating that fat loss is effective in preventing and managing obesity-associated disorders. It is suggested that a telephone intervention is an effective follow-up tool for stabilizing reductions in %body fat as well as levels of inflammation and oxidative stress that were obtained from an intensive summer camp program in obese Hispanic children.

Long Daytime Napping Is Associated with Increased Adiposity and Type 2 Diabetes in an Elderly Population with Metabolic Syndrome

Research examining associations between objectively-measured napping time and type 2 diabetes (T2D) is lacking. This study aimed to evaluate daytime napping in relation to T2D and adiposity measures in elderly individuals from the Mediterranean region. A cross-sectional analysis of baseline data from 2190 elderly participants with overweight/obesity and metabolic syndrome, in the PREDIMED-Plus trial, was carried out. Accelerometer-derived napping was measured. Prevalence ratios (PR) and 95% confidence intervals (CI) for T2D were obtained using multivariable-adjusted Cox regression with constant time. Linear regression models were fitted to examine associations of napping with body mass index (BMI) and waist circumference (WC). Participants napping ≥90 min had a higher prevalence of T2D (PR 1.37 (1.06, 1.78)) compared with those napping 5 to <30 min per day. Significant positive associations with BMI and WC were found in those participants napping ≥30 min as compared to those napping 5 to <30 min per day. The findings of this study suggest that longer daytime napping is associated with higher T2D prevalence and greater adiposity measures in an elderly Spanish population at high cardiovascular risk.

Sex-Dependent Association between Weight Change and Thyroid Dysfunction: Population-Level Analysis Using the Korean National Health and Nutrition Examination Survey

BACKGROUND

Although body weight change (BWC) is a common manifestation of thyroid dysfunction, solid evidence for whether to perform or on whom to perform thyroid function test in subjects complaining of BWC is lacking.

OBJECTIVE

To evaluate the association between thyroid dysfunction and BWC using a nationwide survey.

METHOD

Data was obtained from the Korea National Health and Nutrition Examination Survey VI 2013-2015 and 5,456 subjects without previous thyroid disease were included. Serum thyroid-stimulating hormone (TSH), free T4, and self-reported BWC during the previous year were used for the evaluation. Weight loss or gain was defined as weight change of at least 3 kg.

RESULTS

In total, 1,017 men (37.3%) and 1,175 women (43.0%) reported BWCs during the previous year. The overall weighted prevalence of thyroid dysfunction was not significantly associated with the extent of BWC in men (p = 0.705) or women (p = 0.094). However, when the impact of TSH levels on weight change was separately evaluated for weight gain and loss after adjusting for age and body mass index in each sex, weight loss in women was significantly associated with TSH levels (hazard ratio 0.64, 95% CI 0.47-0.85, p = 0.03). No association of thyroid dysfunction was observed for weight gain in women (p = 0.23) or any changes in men (p = 0.875 in weight gain, p = 0.923 in weight loss).

CONCLUSIONS

This study highlights the necessity of performing thyroid function testing in women who complain of weight loss, but such testing may be less vital in women with weight gain or men with any changes in weight.

The relationship between chronic stress, hair cortisol and hypertension

Inconsistencies in studies of chronic psychosocial stress and hypertension may be explained by the use of stress markers greatly influenced by circadian rhythm and transient stressors. We assessed whether hair cortisol, a marker that captures systemic cortisol over months, was independently associated with hypertension. We measured hair cortisol and blood pressure in 75 consecutive participants in the Survey of the Health of Wisconsin, using an ELISA test. Individuals with values ​≥ ​median (78.1 ​pg/mg) were considered exposed. We used approximate Bayesian logistic regression, with a prior odds ratio of 1.0–4.0, to quantify the multivariate-adjusted hair cortisol-hypertension association. Participants' average age was 46.9 years; 37.3% were male; and 25.3% were hypertensive. Hypertension prevalence was 2.23 times higher in exposed (95% CI: 1.69–3.03). This finding was unlikely explained by differential measurement errors, since we conducted blinded measurements of exposure and outcome. Sensitivity analyses showed the association was unlikely explained by an unmeasured confounder, survival bias, or reverse causality bias. Findings suggest elevated hair cortisol is a risk factor for hypertension. Although feasible, the clinical value of hair cortisol as a tool for hypertension risk stratification or for monitoring the effect of chronic psychosocial stress management interventions is still uncertain.

Maternal Sleep in Pregnancy and Postpartum Part II: Biomechanisms and Intervention Strategies

PURPOSE OF REVIEW

As described in Part I of this two-part review, maternal sleep has wide-ranging implications for maternal health and overall family functioning. In addition, poor sleep quality and insufficient sleep are highly prevalent and characterized by considerable racial disparities.

RECENT FINDINGS

Part II of this review discusses physiological mechanisms, including inflammation and appetite hormones, by which sleep impacts multiple facets of women's health during pregnancy and postpartum. These mechanisms are increasingly being delineated, but require further study and better integration with studies of behavioral and physical health outcomes. Further, there are multiple potential strategies for improving maternal sleep, providing the opportunity to tailor treatment approaches to individual needs. Ultimately, as a critical health behavior that is amenable to intervention, sleep provides a promising future direction for measurably impacting clinically relevant health parameters in women of childbearing age.

Association between asthma, obesity, and health behaviors in African American youth

Background: There is a clear relationship between obesity and asthma, with obesity recognized as a risk factor for asthma. There is mounting evidence, however, that asthma may predict obesity risk via behavioral pathways. Objectives: The purpose of this study was to assess the cross-sectional relationships between asthma, body mass index (BMI) percentile, and behavioral factors including caloric intake, dietary inflammatory index, moderate-vigorous physical activity (MVPA), and sedentary time (SED) among African American adolescents. Methods: A community-based sample of 195 African American youth (ages 11-18 years) were included in this analysis. Asthma status was based on self-report using the International Study of Asthma and Allergies in Children's Phase Three questionnaire. MVPA and SED were measured via accelerometry, and caloric intake and dietary inflammatory index were evaluated with the Food Frequency Questionnaire. Weight status was assessed via BMI percentile using measured weight, height, and CDC growth charts. Results: Adolescents with a history of asthma were significantly more overweight (62% vs. 43%, p = 0.04) and consumed a higher inflammatory diet (1.6 ± 0.3 vs. 1.0 ± 0.2, p = 0.02) than their peers who never had asthma. After adjusting for all covariates, activity and dietary variables, odds ratio analysis revealed adolescents who reported ever having asthma were 3.1 ± 1.5 times as likely to be overweight or obese than adolescents with no asthma history (p = 0.02). Conclusions: Presence of asthma history was associated with increased obesity risk in African American adolescents, independent of behavioral factors. Longitudinal studies are needed to better understand the relationship between asthma and obesity in African American adolescents.

Metabolite and lipoprotein responses and prediction of weight gain during breast cancer treatment

Background

Breast cancer treatment has metabolic side effects, potentially affecting risk of cardiovascular disease (CVD) and recurrence. We aimed to compare alterations in serum metabolites and lipoproteins during treatment between recipients and non-recipients of chemotherapy, and describe metabolite profiles associated with treatment-related weight gain.

Methods

This pilot study includes 60 stage I/II breast cancer patients who underwent surgery and were treated according to national guidelines. Serum sampled pre-surgery and after 6 and 12 months was analysed by MR spectroscopy and mass spectrometry. In all, 170 metabolites and 105 lipoprotein subfractions were quantified.

Results

The metabolite and lipoprotein profiles of chemotherapy recipients and non-recipients changed significantly 6 months after surgery (p < 0.001). Kynurenine, the lipid signal at 1.55–1.60 ppm, ADMA, 2 phosphatidylcholines (PC aa C38:3, PC ae C42:1), alpha-aminoadipic acid, hexoses and sphingolipids were increased in chemotherapy recipients after 6 months. VLDL and small dense LDL increased after 6 months, while HDL decreased, with triglyceride enrichment in HDL and LDL. At baseline, weight gainers had less acylcarnitines, phosphatidylcholines, lyso-phosphatidylcholines and sphingolipids, and showed an inflammatory lipid profile.

Conclusion

Chemotherapy recipients exhibit metabolic changes associated with inflammation, altered immune response and increased risk of CVD. Altered lipid metabolism may predispose for treatment-related weight gain.

Effects of periconceptional maternal alcohol intake and a postnatal high-fat diet on obesity and liver disease in male and female rat offspring

The effects of maternal alcohol consumption around the time of conception on offspring are largely unknown and difficult to determine in a human population. This study utilized a rodent model to examine if periconceptional alcohol (PC:EtOH) consumption, alone or in combination with a postnatal high-fat diet (HFD), resulted in obesity and liver dysfunction. Sprague-Dawley rats were fed a control or an ethanol-containing [12.5% (vol/vol) EtOH] liquid diet from 4 days before mating until 4 days of gestation ( n = 12/group). A subset of offspring was fed a HFD between 3 and 8 mo of age. In males, PC:EtOH and HFD increased total body fat mass ( P_PC:EtOH < 0.05, P_HFD < 0.0001); in females, only HFD increased fat mass ( P_HFD < 0.0001). PC:EtOH increased microvesicular liver steatosis in male, but not female, offspring. Plasma triglycerides, HDL, and cholesterol were increased in PC:EtOH-exposed males ( P_PC:EtOH < 0.05), and LDL, cholesterol, and leptin (Lep) were increased in PC:EtOH-exposed females ( P_PC:EtOH < 0.05). mRNA levels of Tnf-α and Lep in visceral adipose tissue were increased by PC:EtOH in both sexes ( P_PC:EtOH < 0.05), and Il-6 mRNA was increased in males ( P_PC:EtOH < 0.05). These findings were associated with reduced expression of microRNA-26a, a known regulator of IL-6 and TNF-α. Alcohol exposure around conception increases obesity risk, alters plasma lipid and leptin profiles, and induces liver steatosis in a sex-specific manner. These programmed phenotypes were similar to those caused by a postnatal HFD, particularly in male offspring. These results have implications for the health of offspring whose mothers consumed alcohol around the time of conception.

Dietary inflammatory index in relation to obesity and body mass index: a meta-analysis

Purpose

Studies investigating the association between dietary inflammatory index (DII) and body mass index (BMI) have led to inconsistent findings. Therefore, to decisively conclude, this paper aims to clarify the relationship between DII and obesity by performing meta-analysis.

Design/methodology/approach

PubMed, Scopus and Google Scholar were searched up to July 2017 using key words selected from Medical Subject Headings and other related keywords to identify all relevant articles. In total, 22 articles were entered into the meta-analysis; 22 studies compared the mean of BMI among subjects with highest versus the lowest DII and 4 studies had data on the hazard risk (HR) or odds ratio (OR) for obesity.

Findings

A meta-analysis on included studies indicated a significant association on either mean differences (MD) in BMI (MD = 0.811; 95 per cent CI: 0.365-1.256; p: 0.0001) or obesity OR (OR: 1.310; 95 per cent CI: 1.144-1.500; p = 0.000) by comparing the highest and lowest DII categories. Between-study heterogeneity was high (Cochrane Q test, p < 0.001, I2 = 98.1 per cent, df = 21, τ2 = 0.9273), and only dietary assessment methods could explain the source of heterogeneity in which 24-h dietary recalls were homogeny (I2 = 8.4 per cent, df = 2, p = 0.335).

Originality/value

The results of the present meta-analysis suggest that adherence to high DII score increased BMI and obesity. More prospective studies in different populations are needed to better clarify this relation.

IL-1 Family Cytokine Pathways Underlying NAFLD: Towards New Treatment Strategies

Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease worldwide. Pathways responsible for the activation of IL-1 family cytokines are key in the development of NAFLD but underlying mechanisms are not fully understood. Many studies have focused on the inflammasome-caspase-1 pathway and have shown that this pathway is an important inducer of inflammation in NAFLD. However, this pathway is not solely responsible for the activation of proinflammatory cytokines. Also, neutrophil serine proteases (NSPs) are capable of activating cytokines and recent studies reported that these proteases also contribute to NAFLD. These studies provided, for the first time, evidence that this inflammasome-independent pathway is involved in NAFLD. In our opinion, these new insights open up new approaches for therapeutic intervention.

Inflammatory potential of diet, weight gain, and incidence of overweight/obesity: The SUN cohort

OBJECTIVE

This study prospectively assessed the association of the inflammatory potential of a diet using the dietary inflammatory index (DII) with average yearly weight changes and incident overweight/obesity.

METHODS

Seven thousand and twenty-seven university graduates with body mass index <25 from the Seguimiento Universidad de Navarra (SUN) cohort were followed up during a median of 8.1 years. The DII, a validated tool based on scientific evidence to appraise the relationship between dietary parameters and inflammatory biomarkers, was used. A validated food-frequency questionnaire was used to assess intake of total energy, food, and nutrients, from which DII scores were calculated at baseline and after 10 years of follow-up.

RESULTS

After a median follow-up of 8.1 years, 1,433 incident cases of overweight or obesity were observed. Hazard ratios for overweight/obesity were calculated, including multivariable time-dependent Cox regression models with repeated measures of diet. The hazard ratio for subjects in the highest quartile (most pro-inflammatory diet) was 1.32 (95% confidence interval 1.08-1.60) compared with participants in the lowest quartile (most anti-inflammatory diet), with a significant linear dose-response relationship (P = 0.004). Consistently, increases in average yearly weight gains were significantly associated with proinflammatory diets.

CONCLUSIONS

A proinflammatory diet was significantly associated with a higher annual weight gain and higher risk of developing new-onset overweight or obesity.

Personalized protein corona on nanoparticles and its clinical implications

It is now well understood that once in contact with biological fluids, nanoscale objects lose their original identity and acquire a new biological character, referred to as a protein corona. The protein corona changes many of the physicochemical properties of nanoparticles, including size, surface charge, and aggregation state. These changes, in turn, affect the biological fate of nanoparticles, including their pharmacokinetics, biodistribution, and therapeutic efficacy. It is progressively being accepted that even slight variations in the composition of a protein source (e.g., plasma and serum) can substantially change the composition of the corona formed on the surface of the exact same nanoparticles. Recently it has been shown that the protein corona is strongly affected by the patient's specific disease. Therefore, the same nanomaterial incubated with plasma proteins of patients with different pathologies adsorb protein coronas with different compositions, giving rise to the concept of personalized protein corona. Herein, we review this concept along with recent advances on the topic, with a particular focus on clinical relevance.

Acute-phase proteins and incidence of diabetes: a population-based cohort study

AIMS

To examine the relationship between plasma levels of the acute-phase proteins ceruloplasmin, alpha-1-antitrypsin, orosomucoid, haptoglobin and C-reactive protein (CRP), and incidence of diabetes in the population-based Malmö Diet and Cancer Study-Cardiovascular Cohort (MDCS-CC).

METHODS

The study population consists of 4246 participants (aged 46-67 years, 60.8 % women) with no previous history of diabetes. Participants were followed, and incidence of diabetes was assessed by linkage with national registers and a clinical re-examination of the cohort. Cox proportional hazard regression analysis was used to compare incidence of diabetes in relation to sex-specific quartiles of the acute-phase proteins.

RESULTS

During a mean follow-up period of 15.6 ± 3.4 years, a total of 390 participants were diagnosed with diabetes. Orosomucoid, haptoglobin, and CRP showed a significant increased risk of diabetes after adjustment for potential confounders. However, further adjustments for fasting glucose at baseline resulted in significant association only for CRP. The multivariable-adjusted hazard ratios (HR: 4th vs. 1st quartile) were 1.18 (95 % CI: 0.83-1.67; p = 0.51), 1.19 (CI: 0.85-1.62; p = 0.10), and 1.40 (CI: 1.01-1.95; p = 0.046) for orosomucoid, haptoglobin, and CRP respectively.

CONCLUSION

The study demonstrated that there are associations between orosomucoid, haptoglobin and CRP and the risk of incidence of diabetes. However, after additional adjustment for fasting glucose levels at baseline, the association stayed significant only for CRP.

Weight Gain Trajectories Associated With Elevated C-Reactive Protein Levels in Chinese Adults

BACKGROUND

Recent longitudinal work suggests that weight change is an important risk factor for inflammation across the full range of BMI. However, few studies have examined whether the risk of inflammation differs by patterns of weight gain over time. Using latent class trajectory analysis, we test whether patterns of weight gain are associated with elevated high-sensitivity C-reactive protein (hs-CRP 2-10 mg/L).

METHODS AND RESULTS

Data come from China Health and Nutrition Survey (CHNS) participants (n=5536), aged 18 at baseline to 66 years in 2009, with measured weight over 18 years. Latent class trajectory analysis was used to identify weight-change trajectories in 6 age and sex strata. Multivariable general linear mixed-effects models fit with a logit link were used to assess the risk of elevated hs-CRP across weight trajectory classes. Models were fit within age and sex strata, controlling for baseline weight, adult height, and smoking, and included random intercepts to account for community-level correlation. Steeper weight-gain trajectories were associated with greater risk of elevated hs-CRP compared to more moderate weight-gain trajectories in men and women. Initially high weight gain followed by weight loss was associated with lower risk of elevated hs-CRP in women aged 18 to 40.

CONCLUSIONS

Latent class trajectory analysis identified heterogeneity in adult weight change associated with differential risk of inflammation independently of baseline weight and smoking. These results suggest that trajectories of weight gain are an important clinical concern and may identify those at risk for inflammation and the development of cardiometabolic disease.

Incidence of Myocardial Infarction and Death in Relation to Walking-Induced Calf Pain and Plasma Levels of Inflammation-Sensitive Proteins

Walking-induced calf pain as well as levels of different inflammation-sensitive plasma proteins (ISPs) are related to cardiovascular disease (CVD). This prospective cohort study explored the relationship between ISPs and walking-related calf pain and the interrelationships between ISPs and calf pain in the prediction of death and incidence of coronary events (CE). In 5,725 apparently healthy men, 46 ±3.0 years old, plasma concentrations of orosomucoid (a1-acid glycoprotein), a1-antitrypsin, haptoglobin, fibrinogen, and ceruloplasmin were measured. Walking-induced calf pain was assessed by questionnaire. Mortality and incidence of CE were monitored over a mean follow-up of 18 years in subjects defined by the presence of calf pain and ISP level (0 to 1 or 2 to 5 ISP(s) in the top quartile). The prevalence of calf pain (7.3%) was significantly related to age, lifestyle, and traditional risk factors of CVD and ISP levels. The risk factor-adjusted relative risks for CE, CVD- and all-cause mortality were 1.89 (CI: 1.27 to 2.82), 2.90 (CI: 1.82 to 4.62), and 2.67 (CI: 1.97 to 3.57), respectively, for men with calf pain and high ISP levels (reference: no calf pain and low ISP levels). The corresponding risk for those with calf pain and low ISP levels were 1.34 (CI: 0.91 to 1.97), 1.47 (CI: 0.90 to 2.41), and 1.31 (CI: 0.95 to 1.81), respectively. These results indicate, on the one hand, that walking-induced calf pain is associated with high ISP levels and, on the other, that the risk of CVD in men with calf pain is substantially higher in those with high ISP levels than in those with low levels.

Activins and Inhibins: Roles in Development, Physiology, and Disease

Since their original discovery as regulators of follicle-stimulating hormone (FSH) secretion and erythropoiesis, the TGF-β family members activin and inhibin have been shown to participate in a variety of biological processes, from the earliest stages of embryonic development to highly specialized functions in terminally differentiated cells and tissues. Herein, we present the history, structures, signaling mechanisms, regulation, and biological processes in which activins and inhibins participate, including several recently discovered biological activities and functional antagonists. The potential therapeutic relevance of these advances is also discussed.

Associations of Apelin, Visfatin, and Urinary 8-Isoprostane With Severe Hypertension in African Americans: The MH-GRID Study

BACKGROUND

Apelin is an adipokine directly associated with adiposity, insulin resistance, and decreased blood pressure. Urinary 8-isoprostane is a marker of chronic oxidative endothelial stress. Visfatin, an adipokine that acts by binding and activating the insulin receptor, has been associated with hypertension. As severe hypertension (SH) is highly prevalent among African Americans (AA), we aimed to assess the association of these biomarkers with SH status.

METHODS

A sample of 250 AA participants (134 normotensive controls and 116 with SH (including 98 treatment controlled, SCH: severe controlled hypertension, and 18 treatment resistant, SRH: severe resistant hypertension)) from the Minority Health Genomics and Translational Research Bio-Repository Database (MH-GRID) in metro Atlanta had blood analyzed for apelin and visfatin and urine for 8-isoprostane. T-tests, sex-specific age-adjusted correlation coefficients, and multivariable logistic regression models were used to assess the association of biomarkers with hypertensive status.

RESULTS

Levels of apelin and 8-isoprostane were not statistically different between controls and SCH or SRH. Statistically significant differences were present in levels of visfatin between controls (1.03±0.84 pg/ml), SCH (1.34±1.14 pg/ml), and SRH (1.59±0.85 pg/ml). After multivariable adjustment, categorization in the middle 2 quartiles of urinary 8-isoprostane were associated with SH. In similar models, categorization into the highest quartile of visfatin was associated with SH (odds ratio = 2.80; 95% confidence interval: 1.02-7.02). A continuous association of visfatin with SH was present.

CONCLUSION

In our community sample of AA, there were increased odds of SH with increased levels of urinary 8-isoprostane and visfatin, but not with apelin.