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Tian W, Zheng Y, Wang W, Wang D, Tilley M, Zhang G, He Z, Li Y. A comprehensive review of wheat phytochemicals: From farm to fork and beyond. Compr Rev Food Sci Food Saf 2022; 21:2274-2308. [PMID: 35438252 DOI: 10.1111/1541-4337.12960] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 02/08/2022] [Accepted: 03/16/2022] [Indexed: 11/28/2022]
Abstract
The health benefits of whole wheat consumption can be partially attributed to wheat's phytochemicals, including phenolic acids, flavonoids, alkylresorcinols, carotenoids, phytosterols, tocopherols, and tocotrienols. It is of increasing interest to produce whole wheat products that are rich in bioactive phytochemicals. This review provides the fundamentals of the chemistry, extraction, and occurrence of wheat phytochemicals and includes critical discussion of several long-lasting issues: (1) the commonly used nomenclature on distribution of wheat phenolic acids, namely, soluble-free, soluble-conjugated, and insoluble-bound phenolic acids; (2) different extraction protocols for wheat phytochemicals; and (3) the chemistry and application of in vitro antioxidant assays. This review further discusses recent advances on the effects of genotypes, environments, field management, and processing techniques including ultrafine grinding, germination, fermentation, enzymatic treatments, thermal treatments, and food processing. These results need to be interpreted with care due to varied sample preparation protocols and limitations of in vitro assays. The bioaccessibility, bioavailability, metabolism, and potential health benefits of wheat phytochemicals are also reviewed. This comprehensive and critical review will benefit scientific researchers in the field of bioactive compounds of cereal grains and also those in the cereal food industry to produce high-quality functional foods.
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Affiliation(s)
- Wenfei Tian
- National Wheat Improvement Centre, Institute of Crop Sciences, Chinese Academy of Agricultural Sciences, Beijing, China.,Department of Grain Science and Industry, Kansas State University, Manhattan, Kansas, USA.,International Maize and Wheat Improvement Centre (CIMMYT) China Office, Chinese Academy of Agricultural Sciences, Beijing, China
| | - Yi Zheng
- Department of Grain Science and Industry, Kansas State University, Manhattan, Kansas, USA
| | - Weiqun Wang
- Department of Food, Nutrition, Dietetics and Health, Kansas State University, Manhattan, Kansas, USA
| | - Donghai Wang
- Department of Biological and Agricultural Engineering, Kansas State University, Manhattan, Kansas, USA
| | - Michael Tilley
- USDA, Agricultural Research Service, Center for Grain and Animal Health Research, Manhattan, Kansas, USA
| | - Guorong Zhang
- Agricultural Research Center-Hays, Kansas State University, Hays, Kansas, USA
| | - Zhonghu He
- National Wheat Improvement Centre, Institute of Crop Sciences, Chinese Academy of Agricultural Sciences, Beijing, China.,International Maize and Wheat Improvement Centre (CIMMYT) China Office, Chinese Academy of Agricultural Sciences, Beijing, China
| | - Yonghui Li
- Department of Grain Science and Industry, Kansas State University, Manhattan, Kansas, USA
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2
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Effects of substitution dietary guidelines targeted at prevention of IHD on dietary intake and risk factors in middle-aged Danish adults: the Diet and Prevention of Ischemic Heart Disease: a Translational Approach (DIPI) randomised controlled trial. Br J Nutr 2021; 126:1179-1193. [PMID: 33357247 DOI: 10.1017/s0007114520005164] [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] [Indexed: 02/01/2023]
Abstract
The objective was to investigate the effects of substitution (SUB) dietary guidelines (DG) targeted at the prevention of IHD on dietary intake and IHD risk factors in Danish adults with minimum one self-assessed IHD risk factor. A 6-month single-blinded parallel randomised controlled trial with a follow-up at month 12 included 219 subjects (median age 51 years, 59 % female, 73 % overweight or obese) randomised into an SUB DG, an official (OFF) DG or a control group following their habitual diet (HAB). Participants in the DG intervention groups received bi-weekly reminders of their DG and recipes for dishes and the HAB group received a greeting. Dietary intake and fasting blood, anthropometric and blood pressure measurements were obtained at baseline, month 6 and month 12. Linear regression analyses were applied. At month 6, when compared with the HAB, the SUB had a greater impact on the extent of dietary changes with increased intake of whole grains, dietary fibre and low fibre vegetables compared with the OFF DG, and both DG groups had similar decreased percentage of energy (E%) intake from SFA. The extent of dietary changes was similar at month 12. No overall significant changes from baseline were found in blood pressure, anthropometrics and IHD risk markers. In conclusion, both SUB and OFF DG resulted in cardioprotective dietary changes. However, neither the SUB nor the OFF DG resulted in any overall effects on the selected intermediate risk factors for IHD.
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3
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Tryggvadottir EA, Halldorsson TI, Landberg R, Hrolfsdottir L, Birgisdottir BE, Magnusdottir OK, Hreidarsdottir IT, Hardardottir H, Gunnarsdottir I. Higher Alkylresorcinol Concentrations, a Consequence of Whole-Grain Intake, are Inversely Associated with Gestational Diabetes Mellitus in Iceland. J Nutr 2021; 151:1159-1166. [PMID: 33693761 DOI: 10.1093/jn/nxaa449] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/12/2020] [Accepted: 12/22/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND A diet rich in whole grains may provide benefits for pregnant women due to whole grains' high nutritional value and dietary fiber content. OBJECTIVES To study the associations of whole-grain consumption, as well as the plasma alkylresorcinol concentration, a whole-grain consumption biomarker, in early pregnancy with gestational diabetes mellitus (GDM) diagnoses. METHODS Subjects were women from the prospective study Pregnant Women in Iceland II (PREWICE II; n = 853) who attended their ultrasound appointment in gestational weeks 11-14 during the period from October 2017 to March 2018. During that visit, whole-grain consumption was estimated using a diet screening questionnaire, and blood samples were collected for analysis of plasma alkylresorcinols (ARs). Information on GDM diagnoses was later extracted from medical records. Multivariate log-binomial regression was used to evaluate the association of dietary whole-grain and AR concentrations with GDM. RESULTS In total, 14.9% of the women adhered to the national food-based dietary guidelines (n = 127), which recommend 2 portions of whole grains daily. GDM was diagnosed in 127 women (14.9%). The frequency of whole-grain consumption was lower in women who were later diagnosed with GDM compared to the women without GDM (median, 5 times/week vs. 6 times/week, respectively; P = 0.02). This difference was reflected in the lower median concentration of total AR in women diagnosed with GDM (163 nmol/L vs. 209 nmol/L, respectively; P < 0.01). The quartile with the highest concentrations of AR had a RR of 0.50 (95% CI: 0.27-0.90) of being diagnosed with GDM, in comparison to the lowest quartile. There was a significant dose response in the GDM risk with higher AR levels. CONCLUSIONS We found that a higher consumption of whole grains, reflected both by reported consumption according to the FFQ and AR biomarkers, was associated with a decreased risk of receiving a GDM diagnosis.
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Affiliation(s)
- Ellen A Tryggvadottir
- Unit for Nutrition Research, Landspitali University Hospital and Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
| | - Thorhallur I Halldorsson
- Unit for Nutrition Research, Landspitali University Hospital and Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland.,Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Rikard Landberg
- Division of Food and Nutrition Science, Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Laufey Hrolfsdottir
- Unit for Nutrition Research, Landspitali University Hospital and Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland.,Institution of Health Science Research, University of Akureyri and Akureyri Hospital, Akureyri, Iceland
| | - Bryndis E Birgisdottir
- Unit for Nutrition Research, Landspitali University Hospital and Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
| | - Ola K Magnusdottir
- Unit for Nutrition Research, Landspitali University Hospital and Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
| | | | - Hildur Hardardottir
- Faculty of Medicine, University of Iceland Reykjavík, Reykjavík, Iceland.,Livio Reykjavík, Reproductive Center in Reykjavík, Reykjavík, Iceland
| | - Ingibjorg Gunnarsdottir
- Unit for Nutrition Research, Landspitali University Hospital and Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
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Zimorovat A, Mohammadi M, Ramezani-Jolfaie N, Salehi-Abargouei A. The healthy Nordic diet for blood glucose control: a systematic review and meta-analysis of randomized controlled clinical trials. Acta Diabetol 2020; 57:1-12. [PMID: 31172295 DOI: 10.1007/s00592-019-01369-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 05/14/2019] [Indexed: 12/14/2022]
Abstract
AIMS Investigations on the possible effect of the Nordic diet (ND) on the glycemic control and the risk of diabetes have led to inconsistent results. The present study tried to determine the effect of the ND on the markers of blood glucose control using a systematic review and meta-analysis of randomized controlled clinical trials (RCTs). METHODS Predefined keywords were used to search PubMed, ISI Web of Science, Scopus and Google Scholar up to April 2019. The random effects model was used to compute the overall estimates. RESULTS In total, six RCTs with 618 participants (6-26 weeks of follow-up period) were included in the present study. The meta-analysis revealed that the ND might not have a considerable effect on fasting blood glucose levels [weighted mean difference (WMD) = -0.05 mmol/l, 95% CI - 0.13, 0.01, P = 0.112]. In contrast, the analyses showed that the ND significantly reduces serum insulin concentrations (WMD = -1.12 mU/l, 95% CI - 1.84, - 0.39, P = 0.002) and the homeostasis model assessment for insulin resistance (HOMA-IR) (WMD = - 0.34, 95% CI - 0.53, - 0.14, P = 0.001) compared to control diets. The effect on serum insulin levels was sensitive to one of the included studies. This dietary pattern did not significantly affect 2-h post-prandial blood glucose and Matsuda index. CONCLUSIONS Adherence to the ND might improve serum insulin and HOMA-IR levels; however, this effect was not confirmed for other markers of blood glucose control. Future well-designed and long-term clinical trials are highly recommended.
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Affiliation(s)
- Alireza Zimorovat
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Mohammadi
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Nahid Ramezani-Jolfaie
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Amin Salehi-Abargouei
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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5
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Biomarkers of Whole-Grain and Cereal-Fiber Intake in Human Studies: A Systematic Review of the Available Evidence and Perspectives. Nutrients 2019; 11:nu11122994. [PMID: 31817759 PMCID: PMC6950731 DOI: 10.3390/nu11122994] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 11/15/2019] [Accepted: 11/29/2019] [Indexed: 12/14/2022] Open
Abstract
High whole-grain consumption is related to better health outcomes. The specific physiological effect of these compounds is still unrevealed, partly because the accurate estimation of the intake of whole grains from dietary assessments is difficult and prone to bias, due to the complexity of the estimation of the intake by the consumer. A biomarker of whole-grain intake and type of whole-grain intake would be useful for quantifying the exposure to whole-grain intake. In this review, we aim to review the evidence on the potential biomarkers for whole-grain intake in the literature. We conducted a systematic search in Medline, Embase, Web of Science, and the Cochrane database. In total, 39 papers met the inclusion criteria following the PRISMA guidelines and were included. The relative validity, responsiveness, and reproducibility of these markers were assessed for short-, medium-, and long-term exposure as important criteria for the potential use of these biomarkers from a clinical and research perspective. We found three major groups of biomarkers: (1) alkylresorcinol, as well as its homologs and metabolites, assessed in plasma, adipose tissue biopsies, erythrocyte membranes, and urine; (2) avenacosides, assessed in urine samples; and (3) benzoxazinoid-derived phenylacetamide sulfates, assessed in blood and urine samples. The reviewed biomarkers may be used for improved assessment of associations between whole-grain intake and health outcomes.
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Ruuth M, Nguyen SD, Vihervaara T, Hilvo M, Laajala TD, Kondadi PK, Gisterå A, Lähteenmäki H, Kittilä T, Huusko J, Uusitupa M, Schwab U, Savolainen MJ, Sinisalo J, Lokki ML, Nieminen MS, Jula A, Perola M, Ylä-Herttula S, Rudel L, Öörni A, Baumann M, Baruch A, Laaksonen R, Ketelhuth DFJ, Aittokallio T, Jauhiainen M, Käkelä R, Borén J, Williams KJ, Kovanen PT, Öörni K. Susceptibility of low-density lipoprotein particles to aggregate depends on particle lipidome, is modifiable, and associates with future cardiovascular deaths. Eur Heart J 2019; 39:2562-2573. [PMID: 29982602 PMCID: PMC6047440 DOI: 10.1093/eurheartj/ehy319] [Citation(s) in RCA: 111] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 05/21/2018] [Indexed: 12/15/2022] Open
Abstract
Aims Low-density lipoprotein (LDL) particles cause atherosclerotic cardiovascular disease (ASCVD) through their retention, modification, and accumulation within the arterial intima. High plasma concentrations of LDL drive this disease, but LDL quality may also contribute. Here, we focused on the intrinsic propensity of LDL to aggregate upon modification. We examined whether inter-individual differences in this quality are linked with LDL lipid composition and coronary artery disease (CAD) death, and basic mechanisms for plaque growth and destabilization. Methods and results We developed a novel, reproducible method to assess the susceptibility of LDL particles to aggregate during lipolysis induced ex vivo by human recombinant secretory sphingomyelinase. Among patients with an established CAD, we found that the presence of aggregation-prone LDL was predictive of future cardiovascular deaths, independently of conventional risk factors. Aggregation-prone LDL contained more sphingolipids and less phosphatidylcholines than did aggregation-resistant LDL. Three interventions in animal models to rationally alter LDL composition lowered its susceptibility to aggregate and slowed atherosclerosis. Similar compositional changes induced in humans by PCSK9 inhibition or healthy diet also lowered LDL aggregation susceptibility. Aggregated LDL in vitro activated macrophages and T cells, two key cell types involved in plaque progression and rupture. Conclusion Our results identify the susceptibility of LDL to aggregate as a novel measurable and modifiable factor in the progression of human ASCVD.
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Affiliation(s)
- Maija Ruuth
- Atherosclerosis Research Laboratory, Wihuri Research Institute, Haartmaninkatu 8, 00290 Helsinki, Finland.,Research Programs Unit, Faculty of Medicine, University of Helsinki, Haartmaninkatu 8, P.O. Box 63, 00014 University of Helsinki, Finland
| | - Su Duy Nguyen
- Atherosclerosis Research Laboratory, Wihuri Research Institute, Haartmaninkatu 8, 00290 Helsinki, Finland
| | | | - Mika Hilvo
- Zora Biosciences, Biologinkuja 1, 02150 Espoo, Finland
| | - Teemu D Laajala
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Tukholmankatu 8, P.O. Box 20, 00014 University of Helsinki, Finland.,Department of Mathematics and Statistics, University of Turku, Vesilinnantie 5, 20014 University of Turku, Finland
| | - Pradeep Kumar Kondadi
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, SU Sahlgrenska, 41345 Gothenburg, Sweden
| | - Anton Gisterå
- Department of Medicine, Karolinska University Hospital, Karolinska Institute, Solna 171 76 Stockholm, Sweden
| | - Hanna Lähteenmäki
- Atherosclerosis Research Laboratory, Wihuri Research Institute, Haartmaninkatu 8, 00290 Helsinki, Finland
| | - Tiia Kittilä
- Atherosclerosis Research Laboratory, Wihuri Research Institute, Haartmaninkatu 8, 00290 Helsinki, Finland
| | - Jenni Huusko
- Department of Biotechnology and Molecular Medicine, A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Yliopistonranta 1, P.O. Box 1627, 70211 Kuopio, Finland
| | - Matti Uusitupa
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Yliopistonranta 1, P.O. Box 1627, 70211 Kuopio, Finland
| | - Ursula Schwab
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Yliopistonranta 1, P.O. Box 1627, 70211 Kuopio, Finland.,Institute of Clinical Medicine, Internal Medicine, Kuopio University Hospital, Puijonlaaksontie 2, P.O. Box 100, 70029 Kuopio, Finland
| | - Markku J Savolainen
- Research Unit of Internal Medicine, University of Oulu, Pentti Kaiteran katu 1, P.O. Box 8000, 90014, Oulu, Finland.,Medical Research Center, Oulu University Hospital, Pentti Kaiteran katu 1, P.O. Box 8000, 90014 Oulu, Finland
| | - Juha Sinisalo
- Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Haartmaninkatu 4, P.O. Box 340, 00029 Helsinki, Finland
| | - Marja-Liisa Lokki
- Transplantation Laboratory, Medicum, University of Helsinki, Haartmaninkatu 3, P.O. Box 21, 00014 Helsinki, Finland
| | - Markku S Nieminen
- Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Haartmaninkatu 4, P.O. Box 340, 00029 Helsinki, Finland
| | - Antti Jula
- Genomics and Biomarkers Unit, Department of Health, National Institute for Health and Welfare, Genomics and Biomarkers Unit, Mannerheimintie 166, P.O. Box 30, 00271 Helsinki, Finland
| | - Markus Perola
- Genomics and Biomarkers Unit, Department of Health, National Institute for Health and Welfare, Genomics and Biomarkers Unit, Mannerheimintie 166, P.O. Box 30, 00271 Helsinki, Finland.,Institute for Molecular Medicine Finland and Diabetes and Obesity Research Program, University of Helsinki, Haartmaninkatu 8, P.O. Box 63, 00014 University of Helsinki, Finland
| | - Seppo Ylä-Herttula
- Department of Biotechnology and Molecular Medicine, A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Yliopistonranta 1, P.O. Box 1627, 70211 Kuopio, Finland.,Heart Center and Gene Therapy Unit, Kuopio University Hospital, Puijonlaaksontie 2, P.O. Box 100, 70029 Kuopio, Finland
| | - Lawrence Rudel
- Department of Biochemistry Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
| | - Anssi Öörni
- Information Systems, Åbo Akademi University, Fänriksgatan 3A, 20500 Turku, Finland
| | - Marc Baumann
- Meilahti Clinical Proteomics Core Facility, Faculty of Medicine, University of Helsinki, Haartmaninkatu 8, P.O. Box 63, 00014 University of Helsinki, Finland
| | - Amos Baruch
- Genentech Research and Early Development, 1 DNA Way Mailstop 258A, South San Francisco, CA 94080, USA
| | - Reijo Laaksonen
- Zora Biosciences, Biologinkuja 1, 02150 Espoo, Finland.,Finnish Cardiovascular Research Center, University of Tampere, Kalevantie 4, 33100 Tampere, Finland.,Finnish Clinical Biobank Tampere, University Hospital of Tampere, Arvo Ylpön katu 6, 33520 Tampere, Finland
| | - Daniel F J Ketelhuth
- Department of Medicine, Karolinska University Hospital, Karolinska Institute, Solna 171 76 Stockholm, Sweden
| | - Tero Aittokallio
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Tukholmankatu 8, P.O. Box 20, 00014 University of Helsinki, Finland.,Department of Mathematics and Statistics, University of Turku, Vesilinnantie 5, 20014 University of Turku, Finland
| | - Matti Jauhiainen
- Genomics and Biomarkers Unit, Department of Health, National Institute for Health and Welfare, Genomics and Biomarkers Unit, Mannerheimintie 166, P.O. Box 30, 00271 Helsinki, Finland.,Minerva Foundation Institute for Medical Research, Tukholmankatu 8, 00290 Helsinki, Finland
| | - Reijo Käkelä
- Molecular and Integrative Biosciences Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Viikinkaari 1, P.O. Box 65, 00014 University of Helsinki, Finland.,Helsinki University Lipidomics Unit, Helsinki Institute for Life Science (HiLIFE), Viikinkaari 1, P.O. Box 65, 00014 University of Helsinki, Finland
| | - Jan Borén
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, SU Sahlgrenska, 41345 Gothenburg, Sweden
| | - Kevin Jon Williams
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, SU Sahlgrenska, 41345 Gothenburg, Sweden
| | - Petri T Kovanen
- Atherosclerosis Research Laboratory, Wihuri Research Institute, Haartmaninkatu 8, 00290 Helsinki, Finland
| | - Katariina Öörni
- Atherosclerosis Research Laboratory, Wihuri Research Institute, Haartmaninkatu 8, 00290 Helsinki, Finland.,Molecular and Integrative Biosciences Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Viikinkaari 1, P.O. Box 65, 00014 University of Helsinki, Finland
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7
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Tuomainen M, Kärkkäinen O, Leppänen J, Auriola S, Lehtonen M, Savolainen MJ, Hermansen K, Risérus U, Åkesson B, Thorsdottir I, Kolehmainen M, Uusitupa M, Poutanen K, Schwab U, Hanhineva K. Quantitative assessment of betainized compounds and associations with dietary and metabolic biomarkers in the randomized study of the healthy Nordic diet (SYSDIET). Am J Clin Nutr 2019; 110:1108-1118. [PMID: 31504116 DOI: 10.1093/ajcn/nqz179] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 07/10/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Recently, a group of betainized compounds have been suggested to play a role in health effects in relation to a whole-grain-rich diet. OBJECTIVES The aims of this study were to develop a quantitative mass spectrometric method for selected betainized compounds in human plasma, and to investigate their association with nutrient intake and measures of metabolic health in participants of the SYSDIET study. METHODS The SYSDIET study was a controlled randomized intervention including individuals with metabolic syndrome, where the healthy Nordic diet (HND) group increased intakes of whole grains, canola oil, berries, and fish, whereas the control diet (CD) group consumed low-fiber cereal products, milk fat, and restricted amounts of fish and berries. A quantitative LC combined with triple quadrupole MS method for betainized compounds was developed and applied to fasting plasma samples from baseline (week 0) and the end of the intervention (week 18 or 24). Concentrations of betainized compounds were correlated with intakes of selected nutrients and fiber and measures of metabolic health. RESULTS Pipecolic acid betaine (PAB) concentrations were significantly higher in the HND group than in the CD group (P = 0.00032) at the end of the intervention and correlated directly (P < 0.0001) with intakes of dietary fiber (r = 0.376) and a biomarker related to whole-grain rye intake, namely the ratio of alkylresorcinol C17:0 to C21:0 (r = 0.442). PAB was associated inversely with fasting plasma insulin consistently at the beginning and at the end of the intervention (P < 0.001, r = -0.300; P < 0.01, r = -0.250, respectively), as well as IL-1 receptor antagonist (P < 0.01, r = -0.232 at the beginning; P < 0.01, r = -0.236 at the end) and serum LDL/HDL cholesterol (P < 0.01, r = -0.239 at the beginning; P < 0.01, r = -0.241 at the end). CONCLUSIONS Among adults with the metabolic syndrome, PAB plasma concentrations were associated with fasting insulin, inflammation, and lipids and were significantly increased with adoption of the HND. Further studies are needed to clarify the biological functions of betainized compounds. This trial was registered at clinicaltrials.gov as NCT00992641.
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Affiliation(s)
- Marjo Tuomainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Olli Kärkkäinen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.,School of Pharmacy, University of Eastern Finland, Kuopio, Finland
| | - Jukka Leppänen
- School of Pharmacy, University of Eastern Finland, Kuopio, Finland
| | - Seppo Auriola
- School of Pharmacy, University of Eastern Finland, Kuopio, Finland.,LC-MS Metabolomics Center, Biocenter Kuopio, Kuopio, Finland
| | - Marko Lehtonen
- School of Pharmacy, University of Eastern Finland, Kuopio, Finland.,LC-MS Metabolomics Center, Biocenter Kuopio, Kuopio, Finland
| | - Markku J Savolainen
- Medical Research Center, Department of Internal Medicine, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Kjeld Hermansen
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Ulf Risérus
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - Björn Åkesson
- Biomedical Nutrition, Pure and Applied Biochemistry, Lund University, Lund, Sweden.,Department of Clinical Nutrition, Skåne University Hospital, Lund, Sweden
| | - Inga Thorsdottir
- Unit for Nutrition Research, University of Iceland and Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland
| | - Marjukka Kolehmainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Matti Uusitupa
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Kaisa Poutanen
- VTT Technical Research Centre of Finland, Espoo, Finland
| | - Ursula Schwab
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.,Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, Kuopio, Finland
| | - Kati Hanhineva
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
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8
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The healthy Nordic dietary pattern has no effect on inflammatory markers: A systematic review and meta-analysis of randomized controlled clinical trials. Nutrition 2019; 58:140-148. [DOI: 10.1016/j.nut.2018.06.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 05/18/2018] [Accepted: 06/11/2018] [Indexed: 01/05/2023]
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9
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The effect of healthy Nordic diet on cardio-metabolic markers: a systematic review and meta-analysis of randomized controlled clinical trials. Eur J Nutr 2018; 58:2159-2174. [DOI: 10.1007/s00394-018-1804-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 08/02/2018] [Indexed: 12/24/2022]
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10
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Biltoft-Jensen A, Damsgaard CT, Andersen EW, Ygil KH, Andersen R, Ege M, Christensen T, Thorsen AV, Tetens I, Wu H, Landberg R. Validation of Reported Whole-Grain Intake from a Web-Based Dietary Record against Plasma Alkylresorcinol Concentrations in 8- to 11-Year-Olds Participating in a Randomized Controlled Trial. J Nutr 2016; 146:377-83. [PMID: 26764319 DOI: 10.3945/jn.115.222620] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 12/08/2015] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Whole-grain (WG) intake is important for human health, but accurate intake estimation is challenging. Use of a biomarker for WG intake provides a possible way to validate dietary assessment methods. OBJECTIVE Our aim was to validate WG intake from 2 diets reported by children, using plasma alkylresorcinol (AR) concentrations, and to investigate the 3-mo reproducibility of AR concentrations and reported WG intake. METHODS AR concentrations were analyzed in fasting blood plasma samples, and WG intake was estimated in a 7-d web-based diary by 750 participants aged 8-11 y in a 2 school meal × 3 mo crossover trial. Reported WG intake and plasma AR concentrations were compared when children ate their usual bread-based lunch (UBL) and when served a hot lunch meal (HLM). Correlations and cross-classification were used to rank subjects according to intake. The intraclass correlation coefficients (ICCs) between subjects' measurements at baseline and after the UBL were used to assess reproducibility. RESULTS Correlations between reported WG wheat + rye intake and plasma AR were 0.40 and 0.37 (P < 0.001) for the UBL and the HLM diets, and 78% and 77% were classified in the same or adjacent quartiles for the UBL and HLM diets, respectively. The ICC over 3 mo was 0.47 (95% CI: 0.38, 0.55) for plasma total ARs and 0.64 (95% CI: 0.58, 0.70) for reported WG intake. Correlations were higher when using the AR C17:0 homolog as a biomarker, reflecting rye intake instead of plasma total ARs [UBL: r = 0.47; HLM: r = 0.43, P < 0.001; ICC = 0.51 (95% CI: 0.43, 0.59)]. CONCLUSIONS Self-reported WG wheat + rye intake among children showed moderate correlations with plasma AR concentrations. Substantial intraindividual variation was found in WG intake and plasma AR concentrations. The AR homolog C17:0 may be used as a biomarker for WG intake when the WG intake primarily comes from rye as in the present study. This trial was registered at clinicaltrials.gov as NCT01457794.
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Affiliation(s)
- Anja Biltoft-Jensen
- Division of Nutrition, National Food Institute, Technical University of Denmark, Søborg, Denmark;
| | - Camilla T Damsgaard
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Elisabeth W Andersen
- Department of Applied Mathematics and Computer Science, Technical University of Denmark, Lyngby, Denmark
| | - Karin H Ygil
- Division of Nutrition, National Food Institute, Technical University of Denmark, Søborg, Denmark
| | - Rikke Andersen
- Division of Nutrition, National Food Institute, Technical University of Denmark, Søborg, Denmark
| | - Majken Ege
- Division of Nutrition, National Food Institute, Technical University of Denmark, Søborg, Denmark
| | - Tue Christensen
- Division of Nutrition, National Food Institute, Technical University of Denmark, Søborg, Denmark
| | - Anne-Vibeke Thorsen
- Division of Nutrition, National Food Institute, Technical University of Denmark, Søborg, Denmark
| | - Inge Tetens
- Division of Nutrition, National Food Institute, Technical University of Denmark, Søborg, Denmark
| | - Huaxing Wu
- Department of Food Science, Swedish University of Agricultural Sciences, Uppsala, Sweden; and
| | - Rikard Landberg
- Department of Food Science, Swedish University of Agricultural Sciences, Uppsala, Sweden; and Nutritional Epidemiology Unit, Institute of Environmental Medicine, Karolinska Institutet, Solna, Sweden
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11
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Affiliation(s)
- U Risérus
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
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12
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Wu H, Kolehmainen M, Mykkänen H, Poutanen K, Uusitupa M, Schwab U, Wolk A, Landberg R. Alkylresorcinols in adipose tissue biopsies as biomarkers of whole-grain intake: an exploratory study of responsiveness to advised intake over 12 weeks. Eur J Clin Nutr 2015; 69:1244-8. [DOI: 10.1038/ejcn.2015.138] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 07/08/2015] [Accepted: 07/13/2015] [Indexed: 01/16/2023]
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McKeown NM, Marklund M, Ma J, Ross AB, Lichtenstein AH, Livingston KA, Jacques PF, Rasmussen HM, Blumberg JB, Chen CYO. Comparison of plasma alkylresorcinols (AR) and urinary AR metabolites as biomarkers of compliance in a short-term, whole-grain intervention study. Eur J Nutr 2015; 55:1235-44. [PMID: 26043861 DOI: 10.1007/s00394-015-0936-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Accepted: 05/20/2015] [Indexed: 02/05/2023]
Abstract
PURPOSE Alkylresorcinols (AR) are phenolic lipids present in the bran of wheat and rye. Plasma AR and their urinary metabolites may be suitable biomarkers of whole-grain (WG) wheat and rye consumption. The objective of this study was to examine plasma AR and urinary AR metabolites in response to WG wheat consumption. METHODS In a randomized crossover study, 19 subjects (10 males, 9 females; BMI 22.0 kg/m(2); age 26 years) incorporated either 3 servings (48 g) or 6 servings (96 g) of WG wheat daily into their regular diet for 1 week. Subjects completed a 2-week washout period, abstaining from all WG consumption, before each intervention. Fasting blood and 24-h urine were collected before and after each intervention. Plasma AR homologues (C19:0, C21:0, C23:0) were quantified by GC-MS after diethyl ether and solid phase extraction and derivatization. Urinary AR metabolites [3,5-dihydroxybenzoic acid and 3-(3,5-dihydroxyphenyl)-propanoic acid] were determined using HPLC with electrochemical detection after enzymatic deconjugation and ethyl acetate extraction. RESULTS Urinary total AR metabolites were significantly higher after 6 compared with 3 servings of WG wheat (56 vs. 32 μmol/day, P < 0.001). This dose-response relationship was independent of age, sex, energy intake, and baseline urinary AR metabolite concentration. Plasma total AR tended to be higher after 6 compared with 3 servings of WG wheat (103.0 vs. 86.9 nmol/L), but this difference was not significant (P = 0.42). CONCLUSION The results suggest that urinary AR metabolites from 24-h urine collections may be useful as biomarkers of compliance in intervention studies of WG wheat.
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Affiliation(s)
- Nicola M McKeown
- Jean Mayer U.S. Department of Agriculture (USDA) Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, Boston, MA, 02111, USA. .,Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.
| | - Matti Marklund
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - Jiantao Ma
- Jean Mayer U.S. Department of Agriculture (USDA) Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, Boston, MA, 02111, USA
| | - Alastair B Ross
- Food and Nutritional Sciences, Department of Life Science Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Alice H Lichtenstein
- Jean Mayer U.S. Department of Agriculture (USDA) Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, Boston, MA, 02111, USA.,Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Kara A Livingston
- Jean Mayer U.S. Department of Agriculture (USDA) Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, Boston, MA, 02111, USA
| | - Paul F Jacques
- Jean Mayer U.S. Department of Agriculture (USDA) Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, Boston, MA, 02111, USA.,Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Helen M Rasmussen
- Jean Mayer U.S. Department of Agriculture (USDA) Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, Boston, MA, 02111, USA.,Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Jeffrey B Blumberg
- Jean Mayer U.S. Department of Agriculture (USDA) Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, Boston, MA, 02111, USA.,Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - C-Y Oliver Chen
- Jean Mayer U.S. Department of Agriculture (USDA) Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, Boston, MA, 02111, USA.,Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
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Plasma alkylresorcinols, biomarkers of whole-grain intake, are not associated with progression of coronary artery atherosclerosis in postmenopausal women with coronary artery disease. Public Health Nutr 2015; 19:326-31. [DOI: 10.1017/s1368980015001123] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjectiveThe objective of the present study was to examine the relationship between plasma alkyresorcinol (AR) concentrations, which are biomarkers of whole-grain intake, and atherosclerotic progression over 3 years in postmenopausal women with coronary artery disease.DesignPlasma AR concentrations were measured by a validated GC–MS method in fasting plasma samples. Atherosclerosis progression was assessed using change in mean minimal coronary artery diameter (MCAD) and percentage diameter stenosis (%ST), based on mean proximal vessel diameter across up to ten coronary segments. Dietary intake was estimated using a 126-item interviewer-administered FFQ.SettingA prospective study of postmenopausal women participating in the Estrogen Replacement and Atherosclerosis trial.SubjectsFor the analysis of plasma AR concentrations and atherosclerotic progression, plasma samples and follow-up data on angiography were available for 182 women.ResultsMean whole-grain intake was 9·6 (se 0·6) servings per week. After multivariate adjustment, no significant associations were observed between plasma AR concentrations and change in mean MCAD or progression of %ST. Plasma AR concentrations were significantly correlated with dietary whole grains (r=0·35, P<0·001), cereal fibre (r=0·33, P<0·001), bran (r=0·15, P=0·05), total fibre (r=0·22, P=0·003) and legume fibre (r=0·15, P=0·04), but not refined grains, fruit fibre or vegetable fibre.ConclusionsPlasma AR concentrations were not significantly associated with coronary artery progression over a 3-year period in postmenopausal women with coronary artery disease. A moderate association was observed between plasma AR concentrations and dietary whole grains and cereal fibre, suggesting it may be a useful biomarker in observational studies.
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15
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Lankinen M, Schwab U, Kolehmainen M, Paananen J, Nygren H, Seppänen-Laakso T, Poutanen K, Hyötyläinen T, Risérus U, Savolainen MJ, Hukkanen J, Brader L, Marklund M, Rosqvist F, Hermansen K, Cloetens L, Önning G, Thorsdottir I, Gunnarsdottir I, Åkesson B, Dragsted LO, Uusitupa M, Orešič M. A Healthy Nordic Diet Alters the Plasma Lipidomic Profile in Adults with Features of Metabolic Syndrome in a Multicenter Randomized Dietary Intervention. J Nutr 2015; 146:662-672. [PMID: 26962194 DOI: 10.3945/jn.115.220459] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 08/27/2015] [Accepted: 02/01/2016] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND A healthy Nordic diet is associated with improvements in cardiometabolic risk factors, but the effect on lipidomic profile is not known. OBJECTIVE The aim was to investigate how a healthy Nordic diet affects the fasting plasma lipidomic profile in subjects with metabolic syndrome. METHODS Men and women (n = 200) with features of metabolic syndrome [mean age: 55 y; body mass index (in kg/m2): 31.6] were randomly assigned to either a healthy Nordic (n = 104) or a control (n = 96) diet for 18 or 24 wk at 6 centers. Of the participants, 156 completed the study with plasma lipidomic measurements. The healthy Nordic diet consisted of whole grains, fruits, vegetables, berries, vegetable oils and margarines, fish, low-fat milk products, and low-fat meat. An average Nordic diet served as the control diet and included low-fiber cereal products, dairy fat-based spreads, regular-fat milk products, and a limited amount of fruits, vegetables, and berries. Lipidomic profiles were measured at baseline, week 12, and the end of the intervention (18 or 24 wk) by using ultraperformance liquid chromatography mass spectrometry. The effects of the diets on the lipid variables were analyzed with linear mixed-effects models. Data from centers with 18- or 24-wk duration were also analyzed separately. RESULTS Changes in 21 plasma lipids differed significantly between the groups at week 12 (false discovery rate P < 0.05), including increases in plasmalogens and decreases in ceramides in the healthy Nordic diet group compared with the control group. At the end of the study, changes in lipidomic profiles did not differ between the groups. However, when the intervention lasted 24 wk, changes in 8 plasma lipids that had been identified at 12 wk, including plasmalogens, were sustained. There were no differences in changes in plasma lipids between groups with an intervention of 18 wk. By the dietary biomarker score, adherence to diet did not explain the difference in the results related to the duration of the study. CONCLUSIONS A healthy Nordic diet transiently modified the plasma lipidomic profile, specifically by increasing the concentrations of antioxidative plasmalogens and decreasing insulin resistance-inducing ceramides. This trial was registered at clinicaltrials.gov as NCT00992641.
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Affiliation(s)
- Maria Lankinen
- Institutes of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Ursula Schwab
- Institutes of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.,Institute of Clinical Medicine, Internal Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Marjukka Kolehmainen
- Institutes of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Jussi Paananen
- Biomedicine, University of Eastern Finland, Kuopio, Finland
| | - Heli Nygren
- VTT Technical Research Centre of Finland, Espoo, Finland
| | | | - Kaisa Poutanen
- Institutes of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.,VTT Technical Research Centre of Finland, Espoo, Finland
| | - Tuulia Hyötyläinen
- VTT Technical Research Centre of Finland, Espoo, Finland.,Steno Diabetes Center, Gentofte, Denmark
| | - Ulf Risérus
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - Markku J Savolainen
- Research Center for Internal Medicine and Biocenter Oulu, University of Oulu, Oulu, Finland.,Department of Internal Medicine, Oulu University Hospital, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Janne Hukkanen
- Research Center for Internal Medicine and Biocenter Oulu, University of Oulu, Oulu, Finland.,Department of Internal Medicine, Oulu University Hospital, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Lea Brader
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Matti Marklund
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - Fredrik Rosqvist
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - Kjeld Hermansen
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Lieselotte Cloetens
- Biomedical Nutrition, Pure and Applied Biochemistry, Lund University, Lund, Sweden
| | - Gunilla Önning
- Biomedical Nutrition, Pure and Applied Biochemistry, Lund University, Lund, Sweden
| | - Inga Thorsdottir
- Unit for Nutrition Research, Faculty of Food Science and Nutrition, School of Health Sciences, University of Iceland and Landspitali - University Hospital, Reykjavik, Iceland
| | - Ingibjorg Gunnarsdottir
- Unit for Nutrition Research, Faculty of Food Science and Nutrition, School of Health Sciences, University of Iceland and Landspitali - University Hospital, Reykjavik, Iceland
| | - Björn Åkesson
- Biomedical Nutrition, Pure and Applied Biochemistry, Lund University, Lund, Sweden.,Department of Clinical Nutrition, Skåne University Hospital, Lund, Sweden
| | - Lars Ove Dragsted
- Faculty of Science, Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Matti Uusitupa
- Institutes of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.,Research Unit, Kuopio University Hospital, Kuopio, Finland
| | - Matej Orešič
- VTT Technical Research Centre of Finland, Espoo, Finland.,Steno Diabetes Center, Gentofte, Denmark
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Metabolomics for Biomarkers of Type 2 Diabetes Mellitus: Advances and Nutritional Intervention Trends. CURRENT CARDIOVASCULAR RISK REPORTS 2015. [DOI: 10.1007/s12170-015-0440-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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17
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Magnusdottir OK, Landberg R, Gunnarsdottir I, Cloetens L, Åkesson B, Rosqvist F, Schwab U, Herzig KH, Hukkanen J, Savolainen MJ, Brader L, Hermansen K, Kolehmainen M, Poutanen K, Uusitupa M, Risérus U, Thorsdottir I. Whole grain rye intake, reflected by a biomarker, is associated with favorable blood lipid outcomes in subjects with the metabolic syndrome--a randomized study. PLoS One 2014; 9:e110827. [PMID: 25340768 PMCID: PMC4207773 DOI: 10.1371/journal.pone.0110827] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 08/30/2014] [Indexed: 01/26/2023] Open
Abstract
Background and Aim Few studies have explored the possible plasma cholesterol lowering effects of rye consumption. The aim of this secondary analysis in the SYSDIET study was to investigate the association between plasma alkylresorcinols (AR), a biomarker for whole grain wheat and rye intake, and blood lipid concentrations in a population with metabolic syndrome. Furthermore, we analyzed the associations between the AR C17∶0/C21∶0 ratio, a suggested marker of the relative intake of whole grain/bran rye, and blood lipid concentrations. Methods Participants were 30–65 years of age, with body mass index (BMI) 27–40 kg/m2 and had metabolic syndrome. Individuals were recruited through six centers in the Nordic countries and randomized either to a healthy Nordic diet (ND, n = 93), rich in whole grain rye and wheat, as well as berries, fruits and vegetables, rapeseed oil, three fish meals per week and low-fat dairy products, or a control diet (n = 65) for 18/24 weeks. Associations between total plasma AR concentration and C17∶0/C21∶0 homologue ratio and blood lipids were investigated in pooled (ND + control group) regression analyses at 18/24 weeks adjusted for baseline value for the dependent variable, age, BMI and statin use. Results When adjusted for confounders, total plasma AR at 18/24 weeks was not significantly associated with blood lipids but the AR ratio C17∶0/C21∶0 was inversely associated with LDL cholesterol concentrations (B (95% CI): −0.41 (−0.80 to −0.02)), log LDL/HDL cholesterol ratio (−0.20 (−0.37 to −0.03)), log non-HDL cholesterol (−0.20 (−0.37 to −0.03)), log apolipoprotein B (−0.12 (−0.24 to 0.00)) and log triglyceride concentrations (−0.35 (−0.59 to −0.12)). Discussion Increased proportion of whole grain rye, reflected by a biomarker, in the diet is associated with favorable blood lipid outcomes, a relationship that should be further investigated. Trial Registration ClinicalTrials.gov NCT00992641
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Affiliation(s)
- Ola Kally Magnusdottir
- Unit for Nutrition Research, Landspitali -The National University Hospital of Iceland and Faculty of Food Science and Nutrition, School of Health Sciences, University of Iceland, Reykjavík, Iceland
- * E-mail:
| | - Rikard Landberg
- Department of Food Science, BioCenter, Swedish University of Agricultural Sciences, Uppsala, Sweden
- Division of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Ingibjorg Gunnarsdottir
- Unit for Nutrition Research, Landspitali -The National University Hospital of Iceland and Faculty of Food Science and Nutrition, School of Health Sciences, University of Iceland, Reykjavík, Iceland
| | - Lieselotte Cloetens
- Biomedical Nutrition, Pure and Applied Biochemistry, Lund University, Lund, Sweden
| | - Björn Åkesson
- Biomedical Nutrition, Pure and Applied Biochemistry, Lund University, Lund, Sweden
- Department of Clinical Nutrition, Skåne University Hospital, Lund, Sweden
| | - Fredrik Rosqvist
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - Ursula Schwab
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Institute of Clinical Medicine, Internal Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Karl-Heinz Herzig
- Institute of Biomedicine, Department of Physiology and Biocenter, Oulu University, Oulu, Finland and Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland
| | - Janne Hukkanen
- Department of Internal Medicine and Biocenter, Institute of Clinical Medicine, University of Oulu, Oulu, Finland and Clinical Research Center, Oulu University Hospital, Oulu, Finland
| | - Markku J. Savolainen
- Department of Internal Medicine and Biocenter, Institute of Clinical Medicine, University of Oulu, Oulu, Finland and Clinical Research Center, Oulu University Hospital, Oulu, Finland
| | - Lea Brader
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Kjeld Hermansen
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Marjukka Kolehmainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- VTT Technical Research Centre of Finland, Espoo and Kuopio, Finland
| | - Kaisa Poutanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- VTT Technical Research Centre of Finland, Espoo and Kuopio, Finland
| | - Matti Uusitupa
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Research Unit, Kuopio University Hospital, Kuopio, Finland
| | - Ulf Risérus
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - Inga Thorsdottir
- Unit for Nutrition Research, Landspitali -The National University Hospital of Iceland and Faculty of Food Science and Nutrition, School of Health Sciences, University of Iceland, Reykjavík, Iceland
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18
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Marklund M, Magnusdottir OK, Rosqvist F, Cloetens L, Landberg R, Kolehmainen M, Brader L, Hermansen K, Poutanen KS, Herzig KH, Hukkanen J, Savolainen MJ, Dragsted LO, Schwab U, Paananen J, Uusitupa M, Åkesson B, Thorsdottir I, Risérus U. A dietary biomarker approach captures compliance and cardiometabolic effects of a healthy Nordic diet in individuals with metabolic syndrome. J Nutr 2014; 144:1642-9. [PMID: 25080537 DOI: 10.3945/jn.114.193771] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Assessment of compliance with dietary interventions is necessary to understand the observed magnitude of the health effects of the diet per se. To avoid reporting bias, different dietary biomarkers (DBs) could be used instead of self-reported data. However, few studies investigated a combination of DBs to assess compliance and its influence on cardiometabolic risk factors. The objectives of this study were to use a combination of DBs to assess compliance and to investigate how a healthy Nordic diet (ND) influences cardiometabolic risk factors in participants with high apparent compliance compared with the whole study population. From a recently conducted isocaloric randomized trial, SYSDIET (Systems Biology in Controlled Dietary Interventions and Cohort Studies), in 166 individuals with metabolic syndrome, several DBs were assessed to reflect different key components of the ND: canola oil (serum phospholipid α-linolenic acid), fatty fish [eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)], vegetables (plasma β-carotene), and whole grains (plasma alkylresorcinols). High-fat dairy intake (expectedly low in the ND) was reflected by serum pentadecanoic acid. All participants with biomarker data (n = 154) were included in the analyses. Biomarkers were combined by using a biomarker rank score (DB score) and principal component analysis (PCA). The DB score was then used to assess compliance. During the intervention, median concentrations of alkylresorcinols, α-linolenic acid, EPA, and DHA were >25% higher in the ND individuals than in the controls (P < 0.05), whereas median concentrations of pentadecanoic acid were 14% higher in controls (P < 0.05). Median DB score was 57% higher in the ND than in controls (P < 0.001) during the intervention, and participants were ranked similarly by DB score and PCA score. Overall, estimates of group difference in cardiometabolic effects generally appeared to be greater among compliant participants than in the whole study population (e.g., estimates of treatment effects on blood pressure and lipoproteins were ∼1.5- to 2-fold greater in the most compliant participants), suggesting that poor compliance attenuated the dietary effects. With adequate consideration of their limitations, DB combinations (e.g., DB score) could be useful for assessing compliance in intervention studies investigating cardiometabolic effects of healthy dietary patterns. The study was registered at clinicaltrials.gov as NCT00992641.
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Affiliation(s)
- Matti Marklund
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - Ola K Magnusdottir
- Unit for Nutrition Research, Landspitali, The National University of Iceland, Reykjavík, Iceland Faculty of Food Science and Nutrition and School of Health Sciences, University of Iceland, Reykjavík, Iceland
| | - Fredrik Rosqvist
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - Lieselotte Cloetens
- Biomedical Nutrition, Pure and Applied Biochemistry, Lund University, Lund, Sweden
| | - Rikard Landberg
- Department of Food Science, BioCenter, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Marjukka Kolehmainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland VTT Technical Research Centre of Finland, Espoo, Finland
| | - Lea Brader
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Kjeld Hermansen
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Kaisa S Poutanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland VTT Technical Research Centre of Finland, Espoo, Finland
| | - Karl-Heinz Herzig
- Institute of Biomedicine, Department of Physiology and Medical Research Center Oulu and
| | - Janne Hukkanen
- Institute of Clinical Medicine, Department of Internal Medicine, Biocenter Oulu, University of Oulu, Oulu, Finland Department of Internal Medicine, Oulu University Hospital, Oulu, Finland
| | - Markku J Savolainen
- Institute of Clinical Medicine, Department of Internal Medicine, Biocenter Oulu, University of Oulu, Oulu, Finland Department of Internal Medicine, Oulu University Hospital, Oulu, Finland
| | - Lars O Dragsted
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Ursula Schwab
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland Institute of Clinical Medicine, Internal Medicine and
| | - Jussi Paananen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Matti Uusitupa
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland Research Unit, Kuopio University Hospital, Kuopio, Finland
| | - Björn Åkesson
- Biomedical Nutrition, Pure and Applied Biochemistry, Lund University, Lund, Sweden
| | - Inga Thorsdottir
- Unit for Nutrition Research, Landspitali, The National University of Iceland, Reykjavík, Iceland Faculty of Food Science and Nutrition and School of Health Sciences, University of Iceland, Reykjavík, Iceland
| | - Ulf Risérus
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
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Kyrø C, Olsen A, Bueno-de-Mesquita HBA, Skeie G, Loft S, Åman P, Leenders M, Dik VK, Siersema PD, Pischon T, Christensen J, Overvad K, Boutron-Ruault MC, Fagherazzi G, Cottet V, Kühn T, Chang-Claude J, Boeing H, Trichopoulou A, Naska A, Oikonomidou D, Masala G, Pala V, Tumino R, Vineis P, Mattiello A, Peeters PH, Bakken T, Weiderpass E, Asli LA, Sánchez S, Jakszyn P, Sánchez MJ, Amiano P, Huerta JM, Barricarte A, Ljuslinder I, Palmqvist R, Khaw KT, Wareham N, Key TJ, Travis RC, Slimani N, Freisling H, Ferrari P, Gunter MJ, Murphy N, Riboli E, Tjønneland A, Landberg R. Plasma alkylresorcinol concentrations, biomarkers of whole-grain wheat and rye intake, in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Br J Nutr 2014; 111:1881-90. [PMID: 24521535 DOI: 10.1017/s0007114513004388] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Whole-grain intake has been reported to be associated with a lower risk of several lifestyle-related diseases such as type 2 diabetes, CVD and some types of cancers. As measurement errors in self-reported whole-grain intake assessments can be substantial, dietary biomarkers are relevant to be used as complementary tools for dietary intake assessment. Alkylresorcinols (AR) are phenolic lipids found almost exclusively in whole-grain wheat and rye products among the commonly consumed foods and are considered as valid biomarkers of the intake of these products. In the present study, we analysed the plasma concentrations of five AR homologues in 2845 participants from ten European countries from a nested case-control study in the European Prospective Investigation into Cancer and Nutrition. High concentrations of plasma total AR were found in participants from Scandinavia and Central Europe and lower concentrations in those from the Mediterranean countries. The geometric mean plasma total AR concentrations were between 35 and 41 nmol/l in samples drawn from fasting participants in the Central European and Scandinavian countries and below 23 nmol/l in those of participants from the Mediterranean countries. The whole-grain source (wheat or rye) could be determined using the ratio of two of the homologues. The main source was wheat in Greece, Italy, the Netherlands and the UK, whereas rye was also consumed in considerable amounts in Germany, Denmark and Sweden. The present study demonstrates a considerable variation in the plasma concentrations of total AR and concentrations of AR homologues across ten European countries, reflecting both quantitative and qualitative differences in the intake of whole-grain wheat and rye.
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Affiliation(s)
- Cecilie Kyrø
- Danish Cancer Society Research Center, Strandboulevarden 49, Copenhagen Ø 2100, Denmark
| | - Anja Olsen
- Danish Cancer Society Research Center, Strandboulevarden 49, Copenhagen Ø 2100, Denmark
| | | | - Guri Skeie
- Department of Community Medicine, University of Tromsø, Tromsø, Norway
| | - Steffen Loft
- Section of Environmental Health, Department of Public Health, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Per Åman
- Department of Food Science, BioCenter, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Max Leenders
- Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Vincent K Dik
- Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Peter D Siersema
- Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Tobias Pischon
- Molecular Epidemiology Group, Max-Delbrück-Center for Molecular Medicine Berlin-Buch, Berlin, Germany
| | - Jane Christensen
- Danish Cancer Society Research Center, Strandboulevarden 49, Copenhagen Ø 2100, Denmark
| | - Kim Overvad
- Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | | | - Guy Fagherazzi
- INSERM, Centre for Research in Epidemiology and Population Health (CESP), Villejuif Cedex, France
| | - Vanessa Cottet
- INSERM, Centre for Research in Epidemiology and Population Health (CESP), Villejuif Cedex, France
| | - Tilman Kühn
- Division of Cancer Epidemiology, German Cancer Research Center, DKFZ, Heidelberg, Germany
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center, DKFZ, Heidelberg, Germany
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | | | | | | | - Giovanna Masala
- Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute - ISPO, Florence, Italy
| | - Valeria Pala
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Rosario Tumino
- Cancer Registry and Histopathology Unit, "Civile - M.P. Arezzo" Hospital, ASP Ragusa, Italy
| | - Paolo Vineis
- MRC/HPA Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Amalia Mattiello
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
| | - Petra H Peeters
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Toril Bakken
- Department of Community Medicine, University of Tromsø, Tromsø, Norway
| | | | - Lene Angell Asli
- Department of Community Medicine, University of Tromsø, Tromsø, Norway
| | | | - Paula Jakszyn
- Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Barcelona, Spain
| | | | - Pilar Amiano
- Public Health Division of Guipuzkoa, Basque Regional Health Department, San Sebastian, Spain
| | | | | | - Ingrid Ljuslinder
- Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden
| | - Richard Palmqvist
- Department of Medical Biosciences, Pathology, Umeå University, Umeå, Sweden
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Nick Wareham
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Timothy J Key
- Cancer Epidemiology Unit, University of Oxford, Oxford, UK
| | - Ruth C Travis
- Cancer Epidemiology Unit, University of Oxford, Oxford, UK
| | - Nadia Slimani
- International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Heinz Freisling
- International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Pietro Ferrari
- International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Marc J Gunter
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Neil Murphy
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Anne Tjønneland
- Danish Cancer Society Research Center, Strandboulevarden 49, Copenhagen Ø 2100, Denmark
| | - Rikard Landberg
- Department of Food Science, BioCenter, Swedish University of Agricultural Sciences, Uppsala, Sweden
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Magnusdottir OK, Landberg R, Gunnarsdottir I, Cloetens L, Akesson B, Landin-Olsson M, Rosqvist F, Iggman D, Schwab U, Herzig KH, Savolainen MJ, Brader L, Hermansen K, Kolehmainen M, Poutanen K, Uusitupa M, Thorsdottir I, Risérus U. Plasma alkylresorcinols C17:0/C21:0 ratio, a biomarker of relative whole-grain rye intake, is associated to insulin sensitivity: a randomized study. Eur J Clin Nutr 2014; 68:453-8. [PMID: 24549027 DOI: 10.1038/ejcn.2014.12] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Revised: 12/06/2013] [Accepted: 01/04/2014] [Indexed: 12/11/2022]
Abstract
BACKGROUND/OBJECTIVES Few studies have used biomarkers of whole-grain intake to study its relation to glucose metabolism. We aimed to investigate the association between plasma alkylresorcinols (AR), a biomarker of whole-grain rye and wheat intake, and glucose metabolism in individuals with metabolic syndrome (MetS). SUBJECTS/METHODS Participants were 30-65 years of age, with body mass index 27-40 kg/m(2) and had MetS without diabetes. Individuals were recruited through six centers in the Nordic countries and randomized to a healthy Nordic diet (ND, n=96), rich in whole-grain rye and wheat, or a control diet (n=70), for 18-24 weeks. In addition, associations between total plasma AR concentration and C17:0/C21:0 homolog ratio as an indication of the relative whole-grain rye intake, and glucose metabolism measures from oral glucose tolerance tests were investigated in pooled (ND+control) regression analyses at 18/24 weeks. RESULTS ND did not improve glucose metabolism compared with control diet, but the AR C17:0/C21:0 ratio was inversely associated with fasting insulin concentrations (P=0.002) and positively associated with the insulin sensitivity indices Matsuda ISI (P=0.026) and disposition index (P=0.022) in pooled analyses at 18/24 weeks, even after adjustment for confounders. The AR C17:0/C21:0 ratio was not significantly associated with insulin secretion indices. Total plasma AR concentration was not related to fasting plasma glucose or fasting insulin at 18/24 weeks. CONCLUSIONS The AR C17:0/C21:0 ratio, an indicator of relative whole-grain rye intake, is associated with increased insulin sensitivity in a population with MetS.
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Affiliation(s)
- O K Magnusdottir
- 1] Unit for Nutrition Research, Landspitali-The National University Hospital of Iceland, Reykjavík, Iceland [2] Faculty of Food Science and Nutrition and School of Health Sciences, University of Iceland, Reykjavík, Iceland
| | - R Landberg
- 1] Department of Food Science, BioCenter, Swedish University of Agricultural Sciences, Uppsala, Sweden [2] Division of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - I Gunnarsdottir
- 1] Unit for Nutrition Research, Landspitali-The National University Hospital of Iceland, Reykjavík, Iceland [2] Faculty of Food Science and Nutrition and School of Health Sciences, University of Iceland, Reykjavík, Iceland
| | - L Cloetens
- Biomedical Nutrition, Pure and Applied Biochemistry, Lund University, Lund, Sweden
| | - B Akesson
- 1] Biomedical Nutrition, Pure and Applied Biochemistry, Lund University, Lund, Sweden [2] Department of Clinical Nutrition, Skåne University Hospital, Lund, Sweden
| | - M Landin-Olsson
- Department of Endocrinology, Skåne University Hospital, Lund, Sweden
| | - F Rosqvist
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - D Iggman
- 1] Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden [2] Center for Clinical Research Dalarna, Falun, Sweden
| | - U Schwab
- 1] Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland [2] Institute of Clinical Medicine, Internal Medicine, Kuopio University Hospital, Kuopio, Finland
| | - K-H Herzig
- 1] Department of Physiology and Biocenter of Oulu, Institute of Biomedicine, Oulu University, Oulu, Finland [2] Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland
| | - M J Savolainen
- 1] Department of Internal Medicine and Biocenter Oulu, Institute of Clinical Medicine, University of Oulu, Oulu, Finland [2] Clinical Research Center, Oulu University Hospital, Oulu, Finland
| | - L Brader
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - K Hermansen
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - M Kolehmainen
- 1] Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland [2] VTT, Technical Research Centre of Finland, Espoo and Kuopio, Kuopio, Finland
| | - K Poutanen
- 1] Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland [2] VTT, Technical Research Centre of Finland, Espoo and Kuopio, Kuopio, Finland
| | - M Uusitupa
- 1] Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland [2] Research Unit, Kuopio University Hospital, Kuopio, Finland
| | - I Thorsdottir
- 1] Unit for Nutrition Research, Landspitali-The National University Hospital of Iceland, Reykjavík, Iceland [2] Faculty of Food Science and Nutrition and School of Health Sciences, University of Iceland, Reykjavík, Iceland
| | - U Risérus
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
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