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Hernando-Redondo J, Toloba A, Benaiges D, Salas-Salvadó J, Martínez-Gonzalez MA, Corella D, Estruch R, Tinahones FJ, Ros E, Goday A, Castañer O, Fitó M. Mid- and long-term changes in satiety-related hormones, lipid and glucose metabolism, and inflammation after a Mediterranean diet intervention with the goal of losing weight: A randomized, clinical trial. Front Nutr 2022; 9:950900. [PMID: 36466401 DOI: 10.3389/fnut.2022.950900] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 09/13/2022] [Indexed: 11/19/2022] Open
Abstract
BackgroundObesity is produced by the enlargement of the adipose tissue. Functioning as an endocrine organ, it releases and receives information through a complex network of cytokines, hormones, and substrates contributing to a low-chronic inflammation environment. Diet and healthy habits play key roles in the prevention of obesity and its related pathologies. In this regard, there is a need to switch to healthier and more appetizing diets, such as the Mediterranean one.ObjectiveTo compare the mid-and long-term effects of two Mediterranean diet (MedDiet) interventions, one energy-reduced plus physical activity promotion versus a non-restrictive diet, on peripheral satiety-related hormones, weight loss, glucose/lipid metabolism, and pro-inflammatory markers in subjects with obesity/overweight and metabolic syndrome.Materials and methodsA randomized, lifestyle intervention was conducted in 23 Spanish centers, with a large cohort of patients presenting metabolic syndrome. Our study is a subproject set in IMIM (Hospital del Mar Research Institute). Participants were men and women, aged 55–75 and 60–75, respectively, who at baseline met at least three metabolic syndrome components. Subjects were assigned to two intervention groups: (1) an intensive lifestyle intervention with an energy-reduced MedDiet and physical activity promotion (intervention group) with the aim of weight loss; and (2) a normocaloric MedDiet (control). We quantified in a subsample of 300 volunteers from Hospital del Mar Research Institute (Barcelona), following analytes at baseline, 6 months, and 1 year: glucose, HbA1c, triglycerides, total cholesterol, high-density lipoprotein cholesterol, LDL cholesterol, C-peptide, ghrelin, GLP-1, glucagon, insulin, leptin, PAI-1, resistin, and visfatin. Anthropometric and classical cardiovascular risk factors were also determined. A multivariate statistical model was employed to compare the two groups. Linear mixed-effect models were performed to compare changes in risk factors and biomarkers between intervention groups and over time.ResultsCompared to participants in the control group, those in intervention one showed greater improvements in weight, waist circumference, insulin (P < 0.001), glucose metabolism-related compounds (P < 0.05), triglyceride-related lipid profile (P < 0.05), leptin, blood pressure, and pro-inflammatory markers such as PAI-1 (P < 0.001) at mid-and/or long-term. High-sensitivity C-reactive protein, resistin, and vifastin also decreased in both groups.ConclusionA weight loss intervention employing a hypocaloric MedDiet and physical activity promotion has beneficial effects on adiposity, glucose metabolism, lipid profile, leptin, and pro-inflammatory markers, such as PAI-1 in both mid-and long-term.
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Affiliation(s)
- J Hernando-Redondo
- Consorcio CIBER, Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
- Unit of Cardiovascular Risk and Nutrition, Hospital del Mar Medical Research Institute, Barcelona, Spain
- Ph.D. Program in Food Science and Nutrition, Universitat de Barcelona, Barcelona, Spain
| | - A Toloba
- Unit of Cardiovascular Risk and Nutrition, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - D Benaiges
- Consorcio CIBER, Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
- Unit of Cardiovascular Risk and Nutrition, Hospital del Mar Medical Research Institute, Barcelona, Spain
- Department of Endocrinology, Hospital Universitario del Mar, Barcelona, Spain
- Medicine Department and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - J Salas-Salvadó
- Consorcio CIBER, Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
- Departament de Bioquímica i Biotecnologia, Universitat Rovira i Virgili, Unitat de Nutrició Humana, Reus, Spain
- Institut d'Investigació Pere Virgili, Hospital Universitari Sant Joan de Reus, Reus, Spain
| | - M A Martínez-Gonzalez
- Consorcio CIBER, Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - D Corella
- Consorcio CIBER, Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
- Department of Preventive Medicine, Universidad de Valencia, Valencia, Spain
| | - R Estruch
- Consorcio CIBER, Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
- August Pi i Sunyer Biomedical Research Institute, Barcelona, Spain
- Internal Medicine Service, Hospital Clinic, Barcelona, Spain
| | - F J Tinahones
- Consorcio CIBER, Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology, Biomedical Research Institute of Málaga, Virgen de la Victoria Hospital, University of Málaga (IBIMA), Málaga, Spain
| | - E Ros
- Consorcio CIBER, Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
- August Pi i Sunyer Biomedical Research Institute, Barcelona, Spain
- Department of Endocrinology and Nutrition, Lipid Clinic, IDIBAPS, Hospital Clínic, Barcelona, Spain
| | - A Goday
- Consorcio CIBER, Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
- Unit of Cardiovascular Risk and Nutrition, Hospital del Mar Medical Research Institute, Barcelona, Spain
- Department of Endocrinology, Hospital Universitario del Mar, Barcelona, Spain
- Medicine Department and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - O Castañer
- Consorcio CIBER, Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
- Unit of Cardiovascular Risk and Nutrition, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - M Fitó
- Consorcio CIBER, Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
- Unit of Cardiovascular Risk and Nutrition, Hospital del Mar Medical Research Institute, Barcelona, Spain
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Oristrell J, Oliva JC, Casado E, Subirana I, Domínguez D, Toloba A, Balado A, Grau M. Vitamin D supplementation and COVID-19 risk: a population-based, cohort study. J Endocrinol Invest 2022; 45:167-179. [PMID: 34273098 PMCID: PMC8285728 DOI: 10.1007/s40618-021-01639-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 07/12/2021] [Indexed: 12/15/2022]
Abstract
PURPOSE To analyze the associations between cholecalciferol or calcifediol supplementation, serum 25-hydroxyvitamin D (25OHD) levels and COVID-19 outcomes in a large population. METHODS All individuals ≥ 18 years old living in Barcelona-Central Catalonia (n = 4.6 million) supplemented with cholecalciferol or calcifediol from April 2019 to February 2020 were compared with propensity score-matched untreated controls. Outcome variables were SARS-CoV2 infection, severe COVID-19 and COVID-19 mortality occuring during the first wave of the pandemic. Demographical data, comorbidities, serum 25OHD levels and concomitant pharmacological treatments were collected as covariates. Associations between cholecalciferol or calcifediol use and outcome variables were analyzed using multivariate Cox proportional regression. RESULTS Cholecalciferol supplementation (n = 108,343) was associated with slight protection from SARS-CoV2 infection (n = 4352 [4.0%] vs 9142/216,686 [4.2%] in controls; HR 0.95 [CI 95% 0.91-0.98], p = 0.004). Patients on cholecalciferol treatment achieving 25OHD levels ≥ 30 ng/ml had lower risk of SARS-CoV2 infection, lower risk of severe COVID-19 and lower COVID-19 mortality than unsupplemented 25OHD-deficient patients (56/9474 [0.6%] vs 96/7616 [1.3%]; HR 0.66 [CI 95% 0.46-0.93], p = 0.018). Calcifediol use (n = 134,703) was not associated with reduced risk of SARS-CoV2 infection or mortality in the whole cohort. However, patients on calcifediol treatment achieving serum 25OHD levels ≥ 30 ng/ml also had lower risk of SARS-CoV2 infection, lower risk of severe COVID-19, and lower COVID-19 mortality compared to 25OHD-deficient patients not receiving vitamin D supplements (88/16276 [0.5%] vs 96/7616 [1.3%]; HR 0.56 [CI 95% 0.42-0.76], p < 0.001). CONCLUSIONS In this large, population-based study, we observed that patients supplemented with cholecalciferol or calcifediol achieving serum 25OHD levels ≥ 30 ng/ml were associated with better COVID-19 outcomes.
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Affiliation(s)
- J Oristrell
- Internal Medicine Service, Corporació Sanitària Parc Taulí, Parc Taulí s/n, 08208, Sabadell, Barcelona, Catalonia.
- Institut d'Investigació i Innovació I3PT, Sabadell, Catalonia.
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia.
| | - J C Oliva
- Institut d'Investigació i Innovació I3PT, Sabadell, Catalonia
| | - E Casado
- Rheumatology Service, Corporació Sanitària Parc Taulí, Parc Taulí s/n, 08208, Sabadell, Barcelona, Catalonia.
| | - I Subirana
- CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Catalonia
- Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Catalonia
| | - D Domínguez
- Agència de Qualitat i Avaluació Sanitària, Generalitat de Catalunya, Barcelona, Catalonia
| | - A Toloba
- Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Catalonia
| | - A Balado
- Internal Medicine Service, Corporació Sanitària Parc Taulí, Parc Taulí s/n, 08208, Sabadell, Barcelona, Catalonia
| | - M Grau
- CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Catalonia
- Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Catalonia
- Department of Medicine, University of Barcelona, Barcelona, Catalonia
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