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Booranasuksakul U, Macdonald IA, Stephan BCM, Siervo M. Body Composition, Sarcopenic Obesity, and Cognitive Function in Older Adults: Findings From the National Health and Nutrition Examination Survey (NHANES) 1999-2002 and 2011-2014. J Am Nutr Assoc 2024:1-14. [PMID: 38564377 DOI: 10.1080/27697061.2024.2333310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 03/17/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVE Sarcopenic-obesity (SO) is characterized by the concomitant presence of low muscle mass and high adiposity. This study explores the association of body composition and SO phenotypes with cognitive function in older adults. METHODS Cross-sectional data in older adults (≥60 years) from NHANES 1999-2002 and 2011-2014 were used. In the 1999-2002 cohort, phenotypes were derived from body mass index (BMI) and dual-X-ray-absorptiometry, and cognition was assessed the by Digit-Symbol-Substitution-Test (DSST). In the 2011-2014 cohort, phenotypes were derived from BMI, waist-circumference (WC), and hand-grip-strength (HGS). Cognition was assessed using four tests: DSST, Animal Fluency, the Consortium-to-Establish-a-Registry-for-Alzheimer's-Disease-Delayed-Recall, and Word Learning. Mediation analysis was conducted to evaluate the contribution of inflammation (C-reactive-protein, CRP) and insulin resistance (Homeostatic-Model-Assessment-for-Insulin-Resistance, HOMA-IR) to the association between body composition and cognitive outcomes. RESULTS The SO phenotype had the lowest DSST mean scores (p < 0.05) and was associated with a significant risk of cognitive impairment [Odds Ratio (OR) = 1.9; 95%CI 1.0-3.7, p = 0.027] in the 1999-2002 cohort. A higher ratio of fat mass and fat free mass (FM/FFM) also showed a greater risk of cognitive impairment (OR = 2.0; 95%CI 1.3-3.1, p = 0.004). In the 2011-2014 cohort, the high WC-Low HGS group showed significantly lower scores on all four cognitive tests (p < 0.05) and a higher risk of cognitive impairment. CRP and HOMA-IR were significant partial mediators of the association between FM/FFM and DSST in the 1999-2002 cohort. CONCLUSIONS The SO phenotype was associated with a higher risk of cognitive impairment in older adults. Insulin resistance and inflammation may represent key mechanisms linking SO to the development of cognitive impairment.
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Affiliation(s)
- Uraiporn Booranasuksakul
- School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham, UK
| | - Ian A Macdonald
- School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham, UK
| | - Blossom C M Stephan
- Institute of Mental Health, The University of Nottingham Medical School, Nottingham, UK
- Faculty of Health Sciences, Curtin enAble Institute, Curtin University, Perth, Australia
| | - Mario Siervo
- School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham, UK
- Faculty of Health Sciences, Curtin enAble Institute, Curtin University, Perth, Australia
- School of Population Health, Curtin University, Perth, Australia
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Shur NF, Simpson EJ, Crossland H, Constantin D, Cordon SM, Constantin‐Teodosiu D, Stephens FB, Brook MS, Atherton PJ, Smith K, Wilkinson DJ, Mougin OE, Bradley C, Macdonald IA, Greenhaff PL. Bed-rest and exercise remobilization: Concurrent adaptations in muscle glucose and protein metabolism. J Cachexia Sarcopenia Muscle 2024; 15:603-614. [PMID: 38343303 PMCID: PMC10995277 DOI: 10.1002/jcsm.13431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 11/21/2023] [Accepted: 12/20/2023] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Bed-rest (BR) of only a few days duration reduces muscle protein synthesis and induces skeletal muscle atrophy and insulin resistance, but the scale and juxtaposition of these events have not been investigated concurrently in the same individuals. Moreover, the impact of short-term exercise-supplemented remobilization (ESR) on muscle volume, protein turnover and leg glucose uptake (LGU) in humans is unknown. METHODS Ten healthy males (24 ± 1 years, body mass index 22.7 ± 0.6 kg/m2) underwent 3 days of BR, followed immediately by 3 days of ESR consisting of 5 × 30 maximal voluntary single-leg isokinetic knee extensions at 90°/s each day. An isoenergetic diet was maintained throughout the study (30% fat, 15% protein and 55% carbohydrate). Resting LGU was calculated from arterialized-venous versus venous difference across the leg and leg blood flow during the steady-state of a 3-h hyperinsulinaemic-euglycaemic clamp (60 mU/m2/min) measured before BR, after BR and after remobilization. Glycogen content was measured in vastus lateralis muscle biopsy samples obtained before and after each clamp. Leg muscle volume (LMV) was measured using magnetic resonance imaging before BR, after BR and after remobilization. Cumulative myofibrillar protein fractional synthetic rate (FSR) and whole-body muscle protein breakdown (MPB) were measured over the course of BR and remobilization using deuterium oxide and 3-methylhistidine stable isotope tracers that were administered orally. RESULTS Compared with before BR, there was a 45% decline in insulin-stimulated LGU (P < 0.05) after BR, which was paralleled by a reduction in insulin-stimulated leg blood flow (P < 0.01) and removal of insulin-stimulated muscle glycogen storage. These events were accompanied by a 43% reduction in myofibrillar protein FSR (P < 0.05) and a 2.5% decrease in LMV (P < 0.01) during BR, along with a 30% decline in whole-body MPB after 2 days of BR (P < 0.05). Myofibrillar protein FSR and LMV were restored by 3 days of ESR (P < 0.01 and P < 0.01, respectively) but not by ambulation alone. However, insulin-stimulated LGU and muscle glycogen storage were not restored by ESR. CONCLUSIONS Three days of BR caused concurrent reductions in LMV, myofibrillar protein FSR, myofibrillar protein breakdown and insulin-stimulated LGU, leg blood flow and muscle glycogen storage in healthy, young volunteers. Resistance ESR restored LMV and myofibrillar protein FSR, but LGU and muscle glycogen storage remained depressed, highlighting divergences in muscle fuel and protein metabolism. Furthermore, ambulation alone did not restore LMV and myofibrillar protein FSR in the non-exercised contralateral limb, emphasizing the importance of exercise rehabilitation following even short-term BR.
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Affiliation(s)
- Natalie F. Shur
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, School of Life SciencesUniversity of Nottingham, Queen's Medical CentreNottinghamUK
- National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research CentreNottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical CentreNottinghamUK
| | - Elizabeth J. Simpson
- National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research CentreNottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical CentreNottinghamUK
- MRC/Versus Arthritis Centre for Musculoskeletal Ageing Research, Schools of Life Sciences and MedicineUniversity of Nottingham, Queen's Medical CentreNottinghamUK
| | - Hannah Crossland
- National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research CentreNottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical CentreNottinghamUK
- MRC/Versus Arthritis Centre for Musculoskeletal Ageing Research, Schools of Life Sciences and MedicineUniversity of Nottingham, Queen's Medical CentreNottinghamUK
| | - Despina Constantin
- National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research CentreNottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical CentreNottinghamUK
- MRC/Versus Arthritis Centre for Musculoskeletal Ageing Research, Schools of Life Sciences and MedicineUniversity of Nottingham, Queen's Medical CentreNottinghamUK
| | - Sally M. Cordon
- MRC/Versus Arthritis Centre for Musculoskeletal Ageing Research, Schools of Life Sciences and MedicineUniversity of Nottingham, Queen's Medical CentreNottinghamUK
| | - Dumitru Constantin‐Teodosiu
- MRC/Versus Arthritis Centre for Musculoskeletal Ageing Research, Schools of Life Sciences and MedicineUniversity of Nottingham, Queen's Medical CentreNottinghamUK
| | | | - Matthew S. Brook
- National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research CentreNottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical CentreNottinghamUK
- MRC/Versus Arthritis Centre for Musculoskeletal Ageing Research, Schools of Life Sciences and MedicineUniversity of Nottingham, Queen's Medical CentreNottinghamUK
| | - Philip J. Atherton
- National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research CentreNottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical CentreNottinghamUK
- MRC/Versus Arthritis Centre for Musculoskeletal Ageing Research, Schools of Life Sciences and MedicineUniversity of Nottingham, Queen's Medical CentreNottinghamUK
| | - Kenneth Smith
- National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research CentreNottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical CentreNottinghamUK
- MRC/Versus Arthritis Centre for Musculoskeletal Ageing Research, Schools of Life Sciences and MedicineUniversity of Nottingham, Queen's Medical CentreNottinghamUK
| | - Daniel J. Wilkinson
- National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research CentreNottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical CentreNottinghamUK
- MRC/Versus Arthritis Centre for Musculoskeletal Ageing Research, Schools of Life Sciences and MedicineUniversity of Nottingham, Queen's Medical CentreNottinghamUK
| | - Olivier E. Mougin
- National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research CentreNottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical CentreNottinghamUK
- Sir Peter Mansfield Imaging Centre, School of PhysicsUniversity of NottinghamNottinghamUK
| | - Christopher Bradley
- National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research CentreNottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical CentreNottinghamUK
- Sir Peter Mansfield Imaging Centre, School of PhysicsUniversity of NottinghamNottinghamUK
| | - Ian A. Macdonald
- National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research CentreNottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical CentreNottinghamUK
- MRC/Versus Arthritis Centre for Musculoskeletal Ageing Research, Schools of Life Sciences and MedicineUniversity of Nottingham, Queen's Medical CentreNottinghamUK
| | - Paul L. Greenhaff
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, School of Life SciencesUniversity of Nottingham, Queen's Medical CentreNottinghamUK
- National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research CentreNottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical CentreNottinghamUK
- MRC/Versus Arthritis Centre for Musculoskeletal Ageing Research, Schools of Life Sciences and MedicineUniversity of Nottingham, Queen's Medical CentreNottinghamUK
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Ali MA, Macdonald IA, Taylor MA. A systematic review of associations between day-to-day variability in meal pattern and body weight, components of the metabolic syndrome and cognitive function. J Hum Nutr Diet 2024; 37:316-353. [PMID: 37897307 DOI: 10.1111/jhn.13260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 10/26/2023] [Indexed: 10/30/2023]
Abstract
BACKGROUND Meal pattern is a potential health determinant. Previously, mean values for properties of meal pattern, such as daily meal frequency, have been considered. Means, however, obscure variability between-day (irregular or chaotic eating). This systematic review aimed to identify and critique published methods used to characterise between-day variability in meal pattern, and to explore relationships between this and obesity, as well as associated health outcomes. METHODS Using relevant databases, a systematic search was undertaken for studies with adults and children in which between-day variability in meal pattern was measured, and related to body weight, metabolic syndrome components and cognitive function. RESULTS In 34 papers identified (28 observational and six intervention studies), between-day variability in meal pattern was characterised by a variety of methods. These ranged from single questions about intake regularity to more complex methods quantifying the degree of variability. Assumptions were made, such as there being three main meals, resulting in dissociation from the "clock time" of eating. In 24 of the papers, between-day variability in meal pattern was associated with negative weight and health outcomes including higher weight, reduced thermogenic response to meals and poorer academic achievement. CONCLUSIONS Between-day variability in meal pattern is a promising research area that might inform low-cost public health interventions. However, current methods of characterising between-day variability tend to make assumptions and be inconsistent in the meal pattern properties considered. Well controlled dietary intervention studies are required to confirm causation.
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Affiliation(s)
- Midad A Ali
- Administration of Clinical Nutrition, King Abdullah Medical City, Makkah, Saudi Arabia
- The David Greenfield Human Physiology Unit, Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, Faculty of Medicine and Health Sciences, Nottingham, UK
| | - Ian A Macdonald
- Metabolic Physiology, University of Nottingham, Nottingham, UK
| | - Moira A Taylor
- The David Greenfield Human Physiology Unit, Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, Faculty of Medicine and Health Sciences, Nottingham, UK
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre at Nottingham University Hospitals NHS Trust, Nottingham, UK
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Aliyu AI, Nixon A, Hoad CL, Marciani L, Corsetti M, Aithal GP, Cordon SM, Macdonald IA, Alhussain MH, Inoue H, Yamada M, Taylor MA. A comparative, randomised MRI study of the physiological and appetitive responses to gelling (alginate) and non-gelling nasogastric tube feeds in healthy men. Br J Nutr 2023; 130:1316-1328. [PMID: 36746392 PMCID: PMC10511685 DOI: 10.1017/s0007114523000302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 01/13/2023] [Accepted: 01/25/2023] [Indexed: 02/08/2023]
Abstract
Inclusion in nasogastric tube feeds (NGTF) of acid-sensitive, seaweed-derived alginate, expected to form a reversible gel in the stomach, may create a more normal intragastric state and modified gastrointestinal responses. This may ameliorate NGTF-associated risk of diarrhoea, upper gastrointestinal symptoms and appetite suppression. In a randomised, crossover, comparison study, undertaken in twelve healthy males, an alginate-containing feed (F + ALG) or one that was alginate-free (F-ALG) (300 ml) was given over 1 h with a 7-14-d washout period between treatments. Baseline and for 4-h post-feed initiation, MRI measurements were made to establish small bowel water content (SBWC), gastric contents volume (GCV) and appearance, and superior mesenteric artery blood flux. Blood glucose and gut peptides were measured. Subjective appetite and upper gastrointestinal symptoms scores were obtained. Ad libitum pasta consumption 3-h post-feeding was measured. F + ALG exhibited a gastric appearance consistent with gelling surrounded by a freely mobile water halo. Significant main effects of feed were seen for SBWC (P = 0·03) and peptide YY (PYY) (P = 0·004) which were attributed to generally higher values for SBWC with F + ALG (max difference between adjusted means 72 ml at 210 min) and generally lower values for PYY with F + ALG. GCV showed a faster reduction with F + ALG, less between-participant variation and a feed-by-time interaction (P = 0·04). Feed-by-time interactions were also seen with glucagon-like-peptide 1 (GLP-1) (P = 0·02) and glucose-dependent insulinotropic polypeptide (GIP) (P = 0·002), both showing a blunted response with F + ALG. Apparent intragastric gelling with F + ALG and subsequent differences in gastrointestinal and endocrine responses have been demonstrated between an alginate-containing and alginate-free feed.
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Affiliation(s)
- Abdulsalam I. Aliyu
- Department of Human Physiology, College of Medical Sciences, Gombe State University, Gombe, Nigeria
- The David Greenfield Human Physiology Unit, Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - Aline Nixon
- The David Greenfield Human Physiology Unit, Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - Caroline L. Hoad
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre at Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK
| | - Luca Marciani
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre at Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK
- Nottingham Digestive Diseases Centre, Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, UK
| | - Maura Corsetti
- NIHR Nottingham Biomedical Research Centre at Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK
- Nottingham Digestive Diseases Centre, Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, UK
| | - Guruprasad P. Aithal
- NIHR Nottingham Biomedical Research Centre at Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK
- Nottingham Digestive Diseases Centre, Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, UK
| | - Sally M. Cordon
- The David Greenfield Human Physiology Unit, Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - Ian A. Macdonald
- The David Greenfield Human Physiology Unit, Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre at Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK
- Nestlé Institute of Health Sciences, Nestlé Research, Société des Produits Nestlé S.A, Lausanne, Switzerland
| | - Maha H. Alhussain
- Department of Food Science and Nutrition, King Saud University, Riyadh, Saudi Arabia
| | - Hiroaki Inoue
- Global Planning Group, Medical Solutions Vehicle, KANEKA CORPORATION, Osaka, Japan
| | - Masahiko Yamada
- Regenerative Medicine and Cell Therapy Laboratories, KANEKA CORPORATION, Kobe, Japan
| | - Moira A. Taylor
- The David Greenfield Human Physiology Unit, Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre at Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK
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Della Corte K, Jalo E, Kaartinen NE, Simpson L, Taylor MA, Muirhead R, Raben A, Macdonald IA, Fogelholm M, Brand-Miller J. Longitudinal Associations of Dietary Sugars and Glycaemic Index with Indices of Glucose Metabolism and Body Fatness during 3-Year Weight Loss Maintenance: A PREVIEW Sub-Study. Nutrients 2023; 15:2083. [PMID: 37432216 DOI: 10.3390/nu15092083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/21/2023] [Accepted: 04/22/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Dietary sugars are often linked to the development of overweight and type 2 diabetes (T2D) but inconsistencies remain. OBJECTIVE We investigated associations of added, free, and total sugars, and glycaemic index (GI) with indices of glucose metabolism (IGM) and indices of body fatness (IBF) during a 3-year weight loss maintenance intervention. DESIGN The PREVIEW (PREVention of diabetes through lifestyle Intervention and population studies in Europe and around the World) study was a randomised controlled trial designed to test the effects of four diet and physical activity interventions, after an 8-week weight-loss period, on the incidence of T2D. This secondary observational analysis included pooled data assessed at baseline (8), 26, 52, 104 and 156 weeks from 514 participants with overweight/obesity (age 25-70 year; BMI ≥ 25 kg⋅m-2) and with/without prediabetes in centres that provided data on added sugars (Sydney and Helsinki) or free sugars (Nottingham). Linear mixed models with repeated measures were applied for IBF (total body fat, BMI, waist circumference) and for IGM (fasting insulin, HbA1c, fasting glucose, C-peptide). Model A was adjusted for age and intervention centre and Model B additionally adjusted for energy, protein, fibre, and saturated fat. RESULTS Total sugars were inversely associated with fasting insulin and C-peptide in all centres, and free sugars were inversely associated with fasting glucose and HbA1c (Model B: all p < 0.05). Positive associations were observed between GI and IGM (Model B: fasting insulin, HbA1c, and C-peptide: (all p < 0.01), but not for added sugars. Added sugar was positively associated with body fat percentage and BMI, and GI was associated with waist circumference (Model B: all p < 0.01), while free sugars showed no associations (Model B: p > 0.05). CONCLUSIONS Our findings suggest that added sugars and GI were independently associated with 3-y weight regain, but only GI was associated with 3-y changes in glucose metabolism in individuals at high risk of T2D.
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Affiliation(s)
- Karen Della Corte
- School of Life and Environmental Sciences and Charles Perkins Centre, University of Sydney, Sydney, NSW 2006, Australia
| | - Elli Jalo
- Department of Food and Nutrition, University of Helsinki, 00014 Helsinki, Finland
| | - Niina E Kaartinen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, 00271 Helsinki, Finland
| | - Liz Simpson
- Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, Queen's Medical Centre, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham NG7 2RD, UK
| | - Moira A Taylor
- Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, Queen's Medical Centre, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham NG7 2RD, UK
| | - Roslyn Muirhead
- School of Life and Environmental Sciences and Charles Perkins Centre, University of Sydney, Sydney, NSW 2006, Australia
| | - Anne Raben
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, 1958 Copenhagen, Denmark
- Clinical Research, Copenhagen University Hospital-Steno Diabetes Center Copenhagen, 2730 Herlev, Denmark
| | - Ian A Macdonald
- Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham NG7 2RD, UK
| | - Mikael Fogelholm
- Department of Food and Nutrition, University of Helsinki, 00014 Helsinki, Finland
| | - Jennie Brand-Miller
- School of Life and Environmental Sciences and Charles Perkins Centre, University of Sydney, Sydney, NSW 2006, Australia
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Trim WV, Walhin JP, Koumanov F, Turner JE, Shur NF, Simpson EJ, Macdonald IA, Greenhaff PL, Thompson D. The impact of physical inactivity on glucose homeostasis when diet is adjusted to maintain energy balance in healthy, young males. Clin Nutr 2023; 42:532-540. [PMID: 36857962 DOI: 10.1016/j.clnu.2023.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/31/2023] [Accepted: 02/09/2023] [Indexed: 02/18/2023]
Abstract
BACKGROUND & AIMS It is unclear if dietary adjustments to maintain energy balance during reduced physical activity can offset inactivity-induced reductions in insulin sensitivity and glucose disposal to produce normal daily glucose concentrations and meal responses. Therefore, the aim of the present study was to examine the impact of long-term physical inactivity (60 days of bed rest) on daily glycemia when in energy balance. METHODS Interstitial glucose concentrations were measured using Continuous Glucose Monitoring Systems (CGMS) for 5 days before and towards the end of bed rest in 20 healthy, young males (Age: 34 ± 8 years; BMI: 23.5 ± 1.8 kg/m2). Energy intake was reduced during bed rest to match energy expenditure, but the types of foods and timing of meals was maintained. Fasting venous glucose and insulin concentrations were determined, as well as the change in whole-body glucose disposal using a hyperinsulinemic-euglycemic clamp (HIEC). RESULTS Following long-term bed rest, fasting plasma insulin concentration increased 40% (p = 0.004) and glucose disposal during the HIEC decreased 24% (p < 0.001). Interstitial daily glucose total area under the curve (tAUC) from pre-to post-bed rest increased on average by 6% (p = 0.041), despite a 20 and 25% reduction in total caloric and carbohydrate intake, respectively. The nocturnal period (00:00-06:00) showed the greatest change to glycemia with glucose tAUC for this period increasing by 9% (p = 0.005). CGMS measures of daily glycemic variability (SD, J-Index, M-value and MAG) were not changed during bed rest. CONCLUSIONS Reduced physical activity (bed rest) increases glycemia even when daily energy intake is reduced to maintain energy balance. However, the disturbance to daily glucose homeostasis was much more modest than the reduced capacity to dispose of glucose, and glycemic variability was not negatively affected by bed rest, likely due to positive mitigating effects from the contemporaneous reduction in dietary energy and carbohydrate intake. CLINICAL TRIALS RECORD NCT03594799 (registered July 20, 2018) (https://clinicaltrials.gov/ct2/show/NCT03594799).
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Affiliation(s)
- William V Trim
- University of Bath, Centre for Nutrition, Exercise and Metabolism (CNEM), Department for Health, United Kingdom
| | - Jean-Philippe Walhin
- University of Bath, Centre for Nutrition, Exercise and Metabolism (CNEM), Department for Health, United Kingdom
| | - Francoise Koumanov
- University of Bath, Centre for Nutrition, Exercise and Metabolism (CNEM), Department for Health, United Kingdom
| | - James E Turner
- University of Bath, Centre for Nutrition, Exercise and Metabolism (CNEM), Department for Health, United Kingdom
| | - Natalie F Shur
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, School of Life Sciences, The University of Nottingham, Nottingham, United Kingdom; National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, United Kingdom
| | - Elizabeth J Simpson
- National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, United Kingdom; MRC/Versus Arthritis Centre for Musculoskeletal Ageing Research, Schools of Life Sciences and Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Ian A Macdonald
- National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, United Kingdom; MRC/Versus Arthritis Centre for Musculoskeletal Ageing Research, Schools of Life Sciences and Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Paul L Greenhaff
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, School of Life Sciences, The University of Nottingham, Nottingham, United Kingdom; National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, United Kingdom; MRC/Versus Arthritis Centre for Musculoskeletal Ageing Research, Schools of Life Sciences and Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Dylan Thompson
- University of Bath, Centre for Nutrition, Exercise and Metabolism (CNEM), Department for Health, United Kingdom.
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P Silvestre M, Fogelholm M, Alves M, Papoila A, Adam T, Liu A, Brand-Miller J, Martinez JA, Westerterp-Plantenga M, Handjieva-Darlenska T, Macdonald IA, Zhu R, Jalo E, Muirhead R, Carretero SN, Handjiev S, Taylor MA, Raben A, Poppitt SD. Differences between HbA 1c and glucose-related variables in predicting weight loss and glycaemic changes in individuals with overweight and hyperglycaemia - The PREVIEW trial. Clin Nutr 2023; 42:636-643. [PMID: 36933350 DOI: 10.1016/j.clnu.2023.02.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 02/12/2023] [Accepted: 02/28/2023] [Indexed: 03/08/2023]
Abstract
AIMS To examine the differences between HbA1c and glucose related variables in predicting weight loss and glycaemic changes following 8 weeks of low energy diet (LED) in individuals with overweight and hyperglycaemia. RESEARCH DESIGN AND METHODS 2178 individuals with ADA-defined pre-diabetes - impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT) - who started an 8 week LED weight loss diet, were included in this analysis. Participants were enrolled in the PREVIEW (PREVention of diabetes through lifestyle interventions and population studies In Europe and around the World) clinical trial. Multivariable linear mixed effects regression models and generalised additive mixed effect logistic models were used. RESULTS Only 1 in 3 participants (33%) had HbA1c levels defined as pre-diabetes. Neither baseline HbA1c, IFG or IGT were associated with body weight change at 8 weeks. Higher baseline body weight, baseline fasting insulin and weight loss predicted normalisation of fasting plasma glucose (FPG), whilst higher baseline fasting insulin, C-reactive protein (hsCRP) and older age predicted normalisation of HbA1c. Additionally, male sex and higher baseline BMI, body fat and energy intake were positively associated with weight loss, whereas greater age and higher HDL-cholesterol predicted less weight loss. CONCLUSIONS Whilst neither HbA1c nor fasting glucose predicts short-term weight loss success, both may impact the metabolic response to rapid weight loss. We propose a role of inflammation versus total body adiposity since these variables are independent predictors of the normalisation of HbA1c and fasting glucose, respectively.
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Affiliation(s)
- Marta P Silvestre
- Human Nutrition Unit, School of Biological Sciences, Department of Medicine, University of Auckland, Auckland, New Zealand; CINTESIS, NOVA Medical School, NMS, Universidade Nova de Lisboa, 1169-056, Lisboa, Portugal.
| | - Mikael Fogelholm
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Marta Alves
- CEAUL, NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, 1169-056, Lisboa, Portugal
| | - Ana Papoila
- CEAUL, NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, 1169-056, Lisboa, Portugal
| | - Tanja Adam
- Department of Nutrition and Movement Sciences, NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
| | - Amy Liu
- Human Nutrition Unit, School of Biological Sciences, Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Jennie Brand-Miller
- School of Life and Environmental Sciences and Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - J Alfredo Martinez
- Center for Nutrition Research, University of Navarra, 31008, Pamplona, Spain
| | - Margriet Westerterp-Plantenga
- Department of Nutrition and Movement Sciences, NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
| | | | - Ian A Macdonald
- MRC/ARUK Centre for Musculoskeletal Ageing Research, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, School of Life Sciences, University of Nottingham Medical School, Nottingham, NG7 2UH, United Kingdom
| | - Ruixin Zhu
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Elli Jalo
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Roslyn Muirhead
- School of Life and Environmental Sciences and Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Santiago Navas Carretero
- Center for Nutrition Research, University of Navarra, 31008, Pamplona, Spain; CIBERObn, Instituto de Salud Carlos III, Madrid, Spain
| | - Svetoslav Handjiev
- Department of Pharmacology and Toxicology, Medical University of Sofia, Sofia, Bulgaria
| | - Moira A Taylor
- NIHR Nottingham Biomedical Research Centre at Nottingham University Hospitals NHS Trust and University of Nottingham, The David Greenfield Human Physiology Unit, Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - Anne Raben
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark; Clinical Research, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Sally D Poppitt
- Human Nutrition Unit, School of Biological Sciences, Department of Medicine, University of Auckland, Auckland, New Zealand
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8
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Simpson EJ, Mendis B, Dunlop M, Schroeter H, Kwik-Uribe C, Macdonald IA. Cocoa Flavanol Supplementation and the Effect on Insulin Resistance in Females Who Are Overweight or Obese: A Randomized, Placebo-Controlled Trial. Nutrients 2023; 15:nu15030565. [PMID: 36771271 PMCID: PMC9921219 DOI: 10.3390/nu15030565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 01/12/2023] [Accepted: 01/15/2023] [Indexed: 01/24/2023] Open
Abstract
There is interest in the impact that dietary interventions can have on preventing the transition from insulin resistance to type 2 diabetes, including a suggestion that the bioactive components of cocoa may enhance fasting insulin sensitivity. However, a role for cocoa flavanols (CF) in reducing insulin resistance in the insulin-stimulated state, an important risk factor for cardiovascular disease, is unresolved. This study investigated whether CF consumption improved whole-body insulin-mediated glucose uptake ('M') in females with overweight/obesity, using a randomized, double-blinded, placebo-controlled, parallel-group design. Thirty-two premenopausal females (19-49 years; 27-35 kg·m-2) with elevated HOMA-IR (HOMA-IR >1.5) supplemented their habitual diet with two servings/day of a high-flavanol cocoa drink (HFC; 609 mg CF/serving; n = 16) or low-flavanol cocoa drink (LFC; 13 mg CF/serving; n = 16) for 4 weeks. Assessment of HOMA-IR and 'M' during a 3-h, 60 mIU insulin·m-2·min-1 euglycemic clamp was performed before and after the intervention. Data are the mean (SD). Changes to HOMA-IR (HFC -0.003 (0.57); LFC -0.0402 (0.86)) and 'M' (HFC 0.99 (7.62); LFC -1.32 (4.88) µmol·kg-1·min-1) after the intervention were not different between groups. Four weeks' consumption of ~1.2 g CF/day did not improve indices of fasting insulin sensitivity or insulin-mediated glucose uptake. A recommendation for dietary supplementation with cocoa flavanols to improve glycemic control is therefore not established.
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Affiliation(s)
- Elizabeth J. Simpson
- MRC/ARUK Centre for Musculoskeletal Ageing Research, School of Life Sciences, Queen’s Medical Centre, University of Nottingham, Nottingham NG7 2UH, UK
- National Institute for Health and Care Research (NIHR), Nottingham Biomedical Research Centre, Queen’s Medical Centre, University of Nottingham, Nottingham NG7 2UH, UK
- Correspondence: ; Tel.: +44-115-8230128
| | - Buddhike Mendis
- MRC/ARUK Centre for Musculoskeletal Ageing Research, School of Life Sciences, Queen’s Medical Centre, University of Nottingham, Nottingham NG7 2UH, UK
- National Institute for Health and Care Research (NIHR), Nottingham Biomedical Research Centre, Queen’s Medical Centre, University of Nottingham, Nottingham NG7 2UH, UK
| | - Mandy Dunlop
- MRC/ARUK Centre for Musculoskeletal Ageing Research, School of Life Sciences, Queen’s Medical Centre, University of Nottingham, Nottingham NG7 2UH, UK
- National Institute for Health and Care Research (NIHR), Nottingham Biomedical Research Centre, Queen’s Medical Centre, University of Nottingham, Nottingham NG7 2UH, UK
| | - Hagen Schroeter
- Department of Nutrition, University of California, One Shields Avenue, 3150E Meyer Hall, Davis, CA 95616, USA
| | | | - Ian A. Macdonald
- MRC/ARUK Centre for Musculoskeletal Ageing Research, School of Life Sciences, Queen’s Medical Centre, University of Nottingham, Nottingham NG7 2UH, UK
- National Institute for Health and Care Research (NIHR), Nottingham Biomedical Research Centre, Queen’s Medical Centre, University of Nottingham, Nottingham NG7 2UH, UK
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9
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Horstman AM, Bawden SJ, Spicer A, Darwish N, Goyer A, Egli L, Rupp N, Minehira K, Gowland P, Breuillé D, Macdonald IA, Simpson EJ. Liver glycogen stores via 13C magnetic resonance spectroscopy in healthy children: randomized, controlled study. Am J Clin Nutr 2023; 117:709-716. [PMID: 36797201 DOI: 10.1016/j.ajcnut.2023.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 01/04/2023] [Accepted: 01/13/2023] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Owing to its role in glucose homeostasis, liver glycogen concentration ([LGly]) can be a marker of altered metabolism seen in disorders that impact the health of children. However, there is a paucity of normative data for this measure in children to allow comparison with patients, and time-course assessment of [LGly] in response to feeding has not been reported. In addition, carbon-13 magnetic resonance spectroscopy (13C-MRS) is used extensively in research to assess liver metabolites in adult health and disease noninvasively, but similar measurements in children are lacking. OBJECTIVES The main objectives were to quantify the depletion of [LGly] after overnight fasting and the subsequent response to feeding. METHODS In a randomly assigned, open-label, incomplete block design study, healthy, normal-weight children (8-12 y) attended 2 evening visits, each separated by ≥5 d and directly followed by a morning visit. An individually tailored, standardized meal was consumed 3-h prior to evening assessments. Participants then remained fasted until the morning visit. [LGly] was assessed once in the fed (20:00) and fasted state (08:00) using 13C-MRS. After the 8:00 assessment, 200 ml of a mixed-macronutrient drink containing 15.5 g (402 kJ) or 31 g carbohydrates (804 kJ), or water only, was consumed, with 13C-MRS measurements then performed hourly for 4 h. Each child was randomly assigned to 2 of 3 drink options across the 2 mornings. Data are expressed as mean (SD). RESULTS Twenty-four children including females and males (13F:11M) completed the study [9.9 (1.1) y, BMI percentile 45.7 (25.9)]. [LGly] decreased from 377.9 (141.3) to 277.3 (107.4) mmol/L overnight; depletion rate 0.14 (0.15) mmol/L min. Incremental responses of [LGly] to test drinks differed (P < 0.001), with incremental net area under the curve of [LGly] over 4 h being higher for 15.5 g [-67.1 (205.8) mmol/L·240 min; P < 0.01] and 31 g carbohydrates [101.6 (180.9) mmol/L·240 min; P < 0.005] compared with water [-253.1 (231.2) mmol/L·240 min]. CONCLUSIONS After overnight fasting, [LGly] decreased by 22.9 (25.1)%, and [LGly] incremental net area under the curve over 4 h was higher after subsequent consumption of 15.5 g and 31 g carbohydrates, compared to water. Am J Clin Nutr 20XX;xx:xx-xx.
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Affiliation(s)
- Astrid Mh Horstman
- Nestlé Institute of Health Sciences, Nestlé Research, EPFL Innovation Park, Lausanne, Switzerland
| | - Stephen J Bawden
- National Institute for Health Research Biomedical Research Centre, Queen's Medical Centre, Nottingham, United Kingdom; Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, United Kingdom
| | - Abi Spicer
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, United Kingdom
| | - Noura Darwish
- Nestlé Institute of Health Sciences, Nestlé Research, EPFL Innovation Park, Lausanne, Switzerland
| | - Amélie Goyer
- Nestlé Institute of Health Sciences, Nestlé Research, EPFL Innovation Park, Lausanne, Switzerland
| | - Léonie Egli
- Nestlé Institute of Health Sciences, Nestlé Research, EPFL Innovation Park, Lausanne, Switzerland
| | - Natacha Rupp
- Nestlé Institute of Health Sciences, Nestlé Research, EPFL Innovation Park, Lausanne, Switzerland
| | - Kaori Minehira
- Nestlé Institute of Health Sciences, Nestlé Research, EPFL Innovation Park, Lausanne, Switzerland
| | - Penny Gowland
- National Institute for Health Research Biomedical Research Centre, Queen's Medical Centre, Nottingham, United Kingdom; Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, United Kingdom
| | - Denis Breuillé
- Nestlé Institute of Health Sciences, Nestlé Research, EPFL Innovation Park, Lausanne, Switzerland
| | - Ian A Macdonald
- Nestlé Institute of Health Sciences, Nestlé Research, EPFL Innovation Park, Lausanne, Switzerland; David Greenfield Human Physiology Unit, MRC/ARUK Centre for Musculoskeletal Ageing Research, University of Nottingham School of Life Sciences, Queen's Medical Centre, Nottingham, United Kingdom
| | - Elizabeth J Simpson
- National Institute for Health Research Biomedical Research Centre, Queen's Medical Centre, Nottingham, United Kingdom; David Greenfield Human Physiology Unit, MRC/ARUK Centre for Musculoskeletal Ageing Research, University of Nottingham School of Life Sciences, Queen's Medical Centre, Nottingham, United Kingdom.
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10
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Macdonald IA, Binia A. Nutrition and the Metabolic Health of Children. Nestle Nutr Inst Workshop Ser 2023; 97:41-50. [PMID: 37023734 DOI: 10.1159/000529004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 09/23/2022] [Indexed: 04/08/2023]
Abstract
Overnutrition, expressed as overweight and obesity, sometimes combined with inadequate micronutrient intake, coexists together with undernutrition as the major threats of malnutrition in children. Appropriate growth and metabolism of children have been extensively studied as to their association with future metabolic diseases. It is appreciated that early growth is controlled via the biochemical pathways that support organ and tissue growth and development, energy release from dietary intake, and production and release of hormones and growth factors regulating the biochemical processes. Anthropometric measurements, body composition, and their trajectories have been the metrics to evaluate both age-appropriate growth and link to future metabolic disease risk. As factors associated with risk of metabolic disease like childhood obesity are fairly well known, a strategic framework that includes appropriate nutrition and healthy dietary habits, adoption of the right behavior, and healthy food choices from early infancy to childhood is necessary to decrease this risk. The role of industry in this is to provide foods rich in nutrients developmentally appropriate and to promote responsible consumption and age-adapted portion sizes.
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Affiliation(s)
- Ian A Macdonald
- Nestle Institute of Health Sciences, Nestlé Research, Lausanne, Switzerland
- Division of Metabolic Physiology, School of Life Sciences, University of Nottingham, Nottingham, UK
| | - Aristea Binia
- Metabolic Health Department, Nestlé Institute of Health Sciences, Nestlé Research, Lausanne, Switzerland
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11
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Shur NF, Simpson EJ, Crossland H, Chivaka PK, Constantin D, Cordon SM, Constantin-Teodosiu D, Stephens FB, Lobo DN, Szewczyk N, Narici M, Prats C, Macdonald IA, Greenhaff PL. Human adaptation to immobilization: Novel insights of impacts on glucose disposal and fuel utilization. J Cachexia Sarcopenia Muscle 2022; 13:2999-3013. [PMID: 36058634 PMCID: PMC9745545 DOI: 10.1002/jcsm.13075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 06/21/2022] [Accepted: 08/14/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Bed rest (BR) reduces whole-body insulin-stimulated glucose disposal (GD) and alters muscle fuel metabolism, but little is known about metabolic adaptation from acute to chronic BR nor the mechanisms involved, particularly when volunteers are maintained in energy balance. METHODS Healthy males (n = 10, 24.0 ± 1.3 years), maintained in energy balance, underwent 3-day BR (acute BR). A second cohort matched for sex and body mass index (n = 20, 34.2 ± 1.8 years) underwent 56-day BR (chronic BR). A hyperinsulinaemic euglycaemic clamp (60 mU/m2 /min) was performed to determine rates of whole-body insulin-stimulated GD before and after BR (normalized to lean body mass). Indirect calorimetry was performed before and during steady state of each clamp to calculate rates of whole-body fuel oxidation. Muscle biopsies were taken to determine muscle glycogen, metabolite and intramyocellular lipid (IMCL) contents, and the expression of 191 mRNA targets before and after BR. Two-way repeated measures analysis of variance was used to detect differences in endpoint measures. RESULTS Acute BR reduced insulin-mediated GD (Pre 11.5 ± 0.7 vs. Post 9.3 ± 0.6 mg/kg/min, P < 0.001), which was unchanged in magnitude following chronic BR (Pre 10.2 ± 0.4 vs. Post 7.9 ± 0.3 mg/kg/min, P < 0.05). This reduction in GD was paralleled by the elimination of the 35% increase in insulin-stimulated muscle glycogen storage following both acute and chronic BR. Acute BR had no impact on insulin-stimulated carbohydrate (CHO; Pre 3.69 ± 0.39 vs. Post 4.34 ± 0.22 mg/kg/min) and lipid (Pre 1.13 ± 0.14 vs. Post 0.59 ± 0.11 mg/kg/min) oxidation, but chronic BR reduced CHO oxidation (Pre 3.34 ± 0.18 vs. Post 2.72 ± 0.13 mg/kg/min, P < 0.05) and blunted the magnitude of insulin-mediated inhibition of lipid oxidation (Pre 0.60 ± 0.07 vs. Post 0.85 ± 0.06 mg/kg/min, P < 0.05). Neither acute nor chronic BR increased muscle IMCL content. Plentiful mRNA abundance changes were detected following acute BR, which waned following chronic BR and reflected changes in fuel oxidation and muscle glycogen storage at this time point. CONCLUSIONS Acute BR suppressed insulin-stimulated GD and storage, but the extent of this suppression increased no further in chronic BR. However, insulin-mediated inhibition of fat oxidation after chronic BR was less than acute BR and was accompanied by blunted CHO oxidation. The juxtaposition of these responses shows that the regulation of GD and storage can be dissociated from substrate oxidation. Additionally, the shift in substrate oxidation after chronic BR was not explained by IMCL accumulation but reflected by muscle mRNA and pyruvate dehydrogenase kinase 4 protein abundance changes, pointing to lack of muscle contraction per se as the primary signal for muscle adaptation.
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Affiliation(s)
- Natalie F Shur
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, School of Life Sciences, The University of Nottingham, Nottingham, UK.,National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK
| | - Elizabeth J Simpson
- National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK.,MRC/Versus Arthritis Centre for Musculoskeletal Ageing Research, Schools of Life Sciences and Medicine, University of Nottingham, Nottingham, UK
| | - Hannah Crossland
- National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK.,MRC/Versus Arthritis Centre for Musculoskeletal Ageing Research, Schools of Life Sciences and Medicine, University of Nottingham, Nottingham, UK
| | - Prince K Chivaka
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, School of Life Sciences, The University of Nottingham, Nottingham, UK
| | - Despina Constantin
- National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK.,MRC/Versus Arthritis Centre for Musculoskeletal Ageing Research, Schools of Life Sciences and Medicine, University of Nottingham, Nottingham, UK
| | - Sally M Cordon
- MRC/Versus Arthritis Centre for Musculoskeletal Ageing Research, Schools of Life Sciences and Medicine, University of Nottingham, Nottingham, UK
| | - Dumitru Constantin-Teodosiu
- MRC/Versus Arthritis Centre for Musculoskeletal Ageing Research, Schools of Life Sciences and Medicine, University of Nottingham, Nottingham, UK
| | | | - Dileep N Lobo
- National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK.,MRC/Versus Arthritis Centre for Musculoskeletal Ageing Research, Schools of Life Sciences and Medicine, University of Nottingham, Nottingham, UK
| | - Nate Szewczyk
- National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK.,MRC/Versus Arthritis Centre for Musculoskeletal Ageing Research, Schools of Life Sciences and Medicine, University of Nottingham, Nottingham, UK.,Ohio Musculoskeletal and Neurological Institute, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH, USA
| | - Marco Narici
- MRC/Versus Arthritis Centre for Musculoskeletal Ageing Research, Schools of Life Sciences and Medicine, University of Nottingham, Nottingham, UK.,Department of Biomedical Sciences, University of Padua, Padua, Italy
| | - Clara Prats
- Core Facility for Integrated Microscopy, The University of Copenhagen, Copenhagen, Denmark
| | - Ian A Macdonald
- National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK.,MRC/Versus Arthritis Centre for Musculoskeletal Ageing Research, Schools of Life Sciences and Medicine, University of Nottingham, Nottingham, UK
| | - Paul L Greenhaff
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, School of Life Sciences, The University of Nottingham, Nottingham, UK.,National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK.,MRC/Versus Arthritis Centre for Musculoskeletal Ageing Research, Schools of Life Sciences and Medicine, University of Nottingham, Nottingham, UK
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12
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Zhu R, Jalo E, Silvestre MP, Poppitt SD, Handjieva-Darlenska T, Handjiev S, Huttunen-Lenz M, Mackintosh K, Stratton G, Navas-Carretero S, Pietiläinen KH, Simpson E, Macdonald IA, Muirhead R, Brand-Miller J, Fogelholm M, Færch K, Martinez JA, Westerterp-Plantenga MS, Adam TC, Raben A. Does the Effect of a 3-Year Lifestyle Intervention on Body Weight and Cardiometabolic Health Differ by Prediabetes Metabolic Phenotype? A Post Hoc Analysis of the PREVIEW Study. Diabetes Care 2022; 45:2698-2708. [PMID: 35696263 DOI: 10.2337/dc22-0549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 04/25/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To examine whether the effect of a 3-year lifestyle intervention on body weight and cardiometabolic risk factors differs by prediabetes metabolic phenotype. RESEARCH DESIGN AND METHODS This post hoc analysis of the multicenter, randomized trial, PREVention of diabetes through lifestyle interventions and population studies In Europe and around the World (PREVIEW), included 1,510 participants with prediabetes (BMI ≥25 kg ⋅ m-2; defined using oral glucose tolerance tests). Of these, 58% had isolated impaired fasting glucose (iIFG), 6% had isolated impaired glucose tolerance (iIGT), and 36% had IFG+IGT; 73% had normal hemoglobin A1c (HbA1c; <39 mmol ⋅ mol-1) and 25% had intermediate HbA1c (39-47 mmol ⋅ mol-1). Participants underwent an 8-week diet-induced rapid weight loss, followed by a 148-week lifestyle-based weight maintenance intervention. Linear mixed models adjusted for intervention arm and other confounders were used. RESULTS In the available-case and complete-case analyses, participants with IFG+IGT had greater sustained weight loss after lifestyle intervention (adjusted mean at 156 weeks -3.5% [95% CI, -4.7%, -2.3%]) than those with iIFG (mean -2.5% [-3.6%, -1.3%]) relative to baseline (P = 0.011). Participants with IFG+IGT and iIFG had similar cardiometabolic benefits from the lifestyle intervention. The differences in cardiometabolic benefits between those with iIGT and IFG+IGT were minor or inconsistent in different analyses. Participants with normal versus intermediate HbA1c had similar weight loss over 3 years and minor differences in cardiometabolic benefits during weight loss, whereas those with normal HbA1c had greater improvements in fasting glucose, 2-h glucose (adjusted between-group difference at 156 weeks -0.54 mmol ⋅ L-1 [95% CI -0.70, -0.39], P < 0.001), and triglycerides (difference -0.07 mmol ⋅ L-1 [-0.11, -0.03], P < 0.001) during the lifestyle intervention. CONCLUSIONS Individuals with iIFG and IFG+IGT had similar improvements in cardiometabolic health from a lifestyle intervention. Those with normal HbA1c had greater improvements than those with intermediate HbA1c.
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Affiliation(s)
- Ruixin Zhu
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Elli Jalo
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Marta P Silvestre
- Human Nutrition Unit, Department of Medicine, School of Biological Sciences, University of Auckland, Auckland, New Zealand.,Center for Health Technology and Services Research (CINTESIS), NOVA Medical School (NMS), Universidade Nova de Lisboa, Lisboa, Portugal
| | - Sally D Poppitt
- Human Nutrition Unit, Department of Medicine, School of Biological Sciences, University of Auckland, Auckland, New Zealand
| | | | - Svetoslav Handjiev
- Department of Pharmacology and Toxicology, Medical University of Sofia, Sofia, Bulgaria
| | - Maija Huttunen-Lenz
- Institute for Nursing Science, University of Education Schwäbisch Gmünd, Schwäbisch Gmünd, Germany
| | - Kelly Mackintosh
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea, U.K
| | - Gareth Stratton
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea, U.K
| | - Santiago Navas-Carretero
- Centre for Nutrition Research, University of Navarra, Pamplona, Spain.,Centro de Investigacion Biomedica en Red Area de Fisiologia de la Obesidad y la Nutricion (CIBEROBN), Madrid, Spain.,Instituto de Investigación Sanitaria de Navarra (IdiSNA) Instituto for Health Research, Pamplona, Spain
| | - Kirsi H Pietiläinen
- Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Abdominal Center, Endocrinology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Elizabeth Simpson
- Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, Queen's Medical Centre, Medical Research Council (MRC)/Alzheimer's Research UK (ARUK) Centre for Musculoskeletal Ageing Research, ARUK Centre for Sport, Exercise and Osteoarthritis, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, U.K
| | - Ian A Macdonald
- Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, Queen's Medical Centre, Medical Research Council (MRC)/Alzheimer's Research UK (ARUK) Centre for Musculoskeletal Ageing Research, ARUK Centre for Sport, Exercise and Osteoarthritis, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, U.K
| | - Roslyn Muirhead
- School of Life and Environmental Sciences and Charles Perkins Centre, The University of Sydney, Sydney, Australia
| | - Jennie Brand-Miller
- School of Life and Environmental Sciences and Charles Perkins Centre, The University of Sydney, Sydney, Australia
| | - Mikael Fogelholm
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Kristine Færch
- Clinical Research, Copenhagen University Hospital-Steno Diabetes Center Copenhagen, Herlev, Denmark.,Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - J Alfredo Martinez
- Centro de Investigacion Biomedica en Red Area de Fisiologia de la Obesidad y la Nutricion (CIBEROBN), Madrid, Spain.,Department of Nutrition and Physiology, University of Navarra, Pamplona, Spain.,Precision Nutrition and Cardiometabolic Health Program, IMDEA-Food Institute (Madrid Institute for Advanced Studies), Campus of International Excellence (CEI) Universidad Autónoma de Madrid (UAM) + Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain
| | - Margriet S Westerterp-Plantenga
- Department of Nutrition and Movement Sciences, NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
| | - Tanja C Adam
- Department of Nutrition and Movement Sciences, NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
| | - Anne Raben
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.,Clinical Research, Copenhagen University Hospital-Steno Diabetes Center Copenhagen, Herlev, Denmark
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13
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Zhu R, Craciun I, Bernhards-Werge J, Jalo E, Poppitt SD, Silvestre MP, Huttunen-Lenz M, McNarry MA, Stratton G, Handjiev S, Handjieva-Darlenska T, Navas-Carretero S, Sundvall J, Adam TC, Drummen M, Simpson EJ, Macdonald IA, Brand-Miller J, Muirhead R, Lam T, Vestentoft PS, Færch K, Martinez JA, Fogelholm M, Raben A. Age- and sex-specific effects of a long-term lifestyle intervention on body weight and cardiometabolic health markers in adults with prediabetes: results from the diabetes prevention study PREVIEW. Diabetologia 2022; 65:1262-1277. [PMID: 35610522 PMCID: PMC9283166 DOI: 10.1007/s00125-022-05716-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 03/31/2022] [Indexed: 02/05/2023]
Abstract
AIMS/HYPOTHESIS Lifestyle interventions are the first-line treatment option for body weight and cardiometabolic health management. However, whether age groups or women and men respond differently to lifestyle interventions is under debate. We aimed to examine age- and sex-specific effects of a low-energy diet (LED) followed by a long-term lifestyle intervention on body weight, body composition and cardiometabolic health markers in adults with prediabetes (i.e. impaired fasting glucose and/or impaired glucose tolerance). METHODS This observational study used longitudinal data from 2223 overweight participants with prediabetes in the multicentre diabetes prevention study PREVIEW. The participants underwent a LED-induced rapid weight loss (WL) period followed by a 3 year lifestyle-based weight maintenance (WM) intervention. Changes in outcomes of interest in prespecified age (younger: 25-45 years; middle-aged: 46-54 years; older: 55-70 years) or sex (women and men) groups were compared. RESULTS In total, 783 younger, 319 middle-aged and 1121 older adults and 1503 women and 720 men were included in the analysis. In the available case and complete case analyses, multivariable-adjusted linear mixed models showed that younger and older adults had similar weight loss after the LED, whereas older adults had greater sustained weight loss after the WM intervention (adjusted difference for older vs younger adults -1.25% [95% CI -1.92, -0.58], p<0.001). After the WM intervention, older adults lost more fat-free mass and bone mass and had smaller improvements in 2 h plasma glucose (adjusted difference for older vs younger adults 0.65 mmol/l [95% CI 0.50, 0.80], p<0.001) and systolic blood pressure (adjusted difference for older vs younger adults 2.57 mmHg [95% CI 1.37, 3.77], p<0.001) than younger adults. Older adults had smaller decreases in fasting and 2 h glucose, HbA1c and systolic blood pressure after the WM intervention than middle-aged adults. In the complete case analysis, the above-mentioned differences between middle-aged and older adults disappeared, but the direction of the effect size did not change. After the WL period, compared with men, women had less weight loss (adjusted difference for women vs men 1.78% [95% CI 1.12, 2.43], p<0.001) with greater fat-free mass and bone mass loss and smaller improvements in HbA1c, LDL-cholesterol and diastolic blood pressure. After the WM intervention, women had greater fat-free mass and bone mass loss and smaller improvements in HbA1c and LDL-cholesterol, while they had greater improvements in fasting glucose, triacylglycerol (adjusted difference for women vs men -0.08 mmol/l [-0.11, -0.04], p<0.001) and HDL-cholesterol. CONCLUSIONS/INTERPRETATION Older adults benefited less from a lifestyle intervention in relation to body composition and cardiometabolic health markers than younger adults, despite greater sustained weight loss. Women benefited less from a LED followed by a lifestyle intervention in relation to body weight and body composition than men. Future interventions targeting older adults or women should take prevention of fat-free mass and bone mass loss into consideration. CLINICAL TRIAL REGISTRATION NUMBER ClinicalTrials.gov NCT01777893.
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Affiliation(s)
- Ruixin Zhu
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Ionut Craciun
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Jan Bernhards-Werge
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Elli Jalo
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Sally D Poppitt
- Human Nutrition Unit, School of Biological Sciences, Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Marta P Silvestre
- Human Nutrition Unit, School of Biological Sciences, Department of Medicine, University of Auckland, Auckland, New Zealand
- CINTESIS, NOVA Medical School (NMS), Universidade Nova de Lisboa, Lisboa, Portugal
| | - Maija Huttunen-Lenz
- Institute for Nursing Science, University of Education Schwäbisch Gmünd, Schwäbisch Gmünd, Germany
| | - Melitta A McNarry
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea, UK
| | - Gareth Stratton
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea, UK
| | - Svetoslav Handjiev
- Department of Pharmacology and Toxicology, Medical University of Sofia, Sofia, Bulgaria
| | | | - Santiago Navas-Carretero
- Centre for Nutrition Research, University of Navarra, Pamplona, Spain
- Centro de Investigacion Biomedica en Red Area de Fisiologia de la Obesidad y la Nutricion (CIBEROBN), Instituto de Salud Carlos III (ISCII), Madrid, Spain
- IdisNA Instituto for Health Research, Pamplona, Spain
| | - Jouko Sundvall
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Tanja C Adam
- Department of Nutrition and Movement Sciences, NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
| | - Mathijs Drummen
- Department of Nutrition and Movement Sciences, NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
| | - Elizabeth J Simpson
- MRC/ARUK Centre for Musculoskeletal Ageing Research, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, School of Life Sciences, University of Nottingham, Nottingham, UK
| | - Ian A Macdonald
- MRC/ARUK Centre for Musculoskeletal Ageing Research, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, School of Life Sciences, University of Nottingham, Nottingham, UK
| | - Jennie Brand-Miller
- School of Life and Environmental Sciences and Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Roslyn Muirhead
- School of Life and Environmental Sciences and Charles Perkins Centre, University of Sydney, Sydney, Australia
| | | | - Pia S Vestentoft
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Kristine Færch
- Clinical Research, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - J Alfredo Martinez
- Centro de Investigacion Biomedica en Red Area de Fisiologia de la Obesidad y la Nutricion (CIBEROBN), Instituto de Salud Carlos III (ISCII), Madrid, Spain
- Department of Nutrition and Physiology, University of Navarra, Pamplona, Spain
- Precision Nutrition and Cardiometabolic Health Program, IMDEA-Food Institute, Madrid Institute for Advanced Studies, CEI UAM + CSIC, Madrid, Spain
| | - Mikael Fogelholm
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland.
| | - Anne Raben
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.
- Clinical Research, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark.
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14
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Jacob P, Nwokolo M, Cordon SM, Macdonald IA, Zelaya FO, Amiel SA, O'Daly O, Choudhary P. Altered functional connectivity during hypoglycaemia in type 1 diabetes. J Cereb Blood Flow Metab 2022; 42:1451-1462. [PMID: 35209745 PMCID: PMC9274862 DOI: 10.1177/0271678x221082911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Behavioural responses to hypoglycaemia require coordinated recruitment of broadly distributed networks of interacting brain regions. We investigated hypoglycaemia-related changes in brain connectivity in people without diabetes (ND) and with type 1 diabetes with normal (NAH) or impaired (IAH) hypoglycaemia awareness. Two-step hyperinsulinaemic hypoglycaemic clamps were performed in 14 ND, 15 NAH and 22 IAH participants. BOLD timeseries were acquired at euglycaemia (5.0 mmol/L) and hypoglycaemia (2.6 mmol/L), with symptom and counter-regulatory hormone measurements. We investigated hypoglycaemia-related connectivity changes using established seed regions for the default mode (DMN), salience (SN) and central executive (CEN) networks and regions whose activity is modulated by hypoglycaemia: the thalamus and right inferior frontal gyrus (RIFG). Hypoglycaemia-induced changes in the DMN, SN and CEN were evident in NAH (all p < 0.05), with no changes in ND or IAH. However, in IAH there was a reduction in connectivity between regions within the RIFG (p = 0.001), not evident in the ND or NAH groups. We conclude that hypoglycaemia induces coordinated recruitment of the DMN and SN in diabetes with preserved hypoglycaemia awareness which is absent in IAH and ND. Changes in connectivity in the RIFG, a region associated with attentional modulation, may be key in impaired hypoglycaemia awareness.
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Affiliation(s)
- Peter Jacob
- Diabetes Research Group (Denmark Hill), Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Munachiso Nwokolo
- Diabetes Research Group (Denmark Hill), Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Sally M Cordon
- School of Life Sciences, MRC-ARUK Centre of Excellence in Musculoskeletal Ageing, Nottingham University Medical School, Queen's Medical Centre, Nottingham, UK
| | - Ian A Macdonald
- School of Life Sciences, MRC-ARUK Centre of Excellence in Musculoskeletal Ageing, Nottingham University Medical School, Queen's Medical Centre, Nottingham, UK
| | - Fernando O Zelaya
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Stephanie A Amiel
- Diabetes Research Group (Denmark Hill), Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Owen O'Daly
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Pratik Choudhary
- Diabetes Research Group (Denmark Hill), Faculty of Life Sciences and Medicine, King's College London, London, UK
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15
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Shur NF, Simpson EJ, Chivaka PK, Crossland H, Constantin D, Cordon SM, Constantin-Teodosiu D, Stephens FB, Lobo DN, Szewczyk N, Narici M, Pratts C, Macdonald IA, Greenhaff PL. O105 Human adaptation to immobilisation: novel insights of impacts on glucose disposal and fuel utilization. Br J Surg 2022. [DOI: 10.1093/bjs/znac242.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Abstract
Introduction
Bed-rest (BR) reduces whole-body insulin-stimulated glucose disposal (GD) and alters muscle fuel metabolism. However, little is known about metabolic adaptation from acute to chronic BR, particularly when volunteers are maintained in energy balance.
Methods
Healthy males (n=10, 24±1.25 years) maintained in energy balance underwent 3 days of BR (acute BR; ABR). A second cohort matched for gender and body mass index (n=20, 34±1.8 years) underwent 56 days of BR (chronic BR; CBR). A hyperinsulinaemic euglycaemic clamp (60 mU/kg lean mass/min) was performed before and after BR. Indirect calorimetry was performed before and during the clamp steady-state to calculate rates of whole-body fuel oxidation. Vastus Lateralis muscle biopsies were taken before and after each clamp. Two-way repeated measures ANOVA was used to detect differences in end-point measures.
Results
ABR reduced insulin-mediated glucose disposal (GD; p<0.001), which was unchanged in magnitude following CBR (p<0.05). This reduction in GD following both acute and CBR was paralleled by the elimination of a 35% increase in insulin-stimulated muscle glycogen storage seen Pre BR. ABR had no impact on insulin-stimulated carbohydrate (CHO) and lipid oxidation, but CBR reduced CHO oxidation (p<0.05) and blunted the magnitude of insulin-mediated inhibition of lipid oxidation (p<0.05). Neither acute nor CBR increased muscle intramyocellular lipid content.
Conclusion
ABR suppressed insulin-stimulated GD and glycogen storage, and the extent of suppression increased no further after CBR. However, GD and storage were dissociated from substrate oxidation during CBR. Moreover, the shift in substrate oxidation after CBR was not explained by IMCL accumulation.
Take home message
Acute bed rest impairs insulin-stimulated glucose disposal and glycogen storage which is the same magnitude as that seen in chronic bed rest.
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Affiliation(s)
- NF Shur
- MRC/ARUK Centre for Musculoskeletal Ageing Research, ARUK Centre for Sport, Exercise and Osteoarthritis, NIHR Nottingham Biomedical Research Centre, University of Nottingham , UK
| | - EJ Simpson
- MRC/ARUK Centre for Musculoskeletal Ageing Research, ARUK Centre for Sport, Exercise and Osteoarthritis, NIHR Nottingham Biomedical Research Centre, University of Nottingham , UK
| | - PK Chivaka
- MRC/ARUK Centre for Musculoskeletal Ageing Research, ARUK Centre for Sport, Exercise and Osteoarthritis, NIHR Nottingham Biomedical Research Centre, University of Nottingham , UK
| | - H Crossland
- MRC/ARUK Centre for Musculoskeletal Ageing Research, ARUK Centre for Sport, Exercise and Osteoarthritis, NIHR Nottingham Biomedical Research Centre, University of Nottingham , UK
| | - D Constantin
- MRC/ARUK Centre for Musculoskeletal Ageing Research, ARUK Centre for Sport, Exercise and Osteoarthritis, NIHR Nottingham Biomedical Research Centre, University of Nottingham , UK
| | - SM Cordon
- MRC/ARUK Centre for Musculoskeletal Ageing Research, ARUK Centre for Sport, Exercise and Osteoarthritis, NIHR Nottingham Biomedical Research Centre, University of Nottingham , UK
| | - D Constantin-Teodosiu
- MRC/ARUK Centre for Musculoskeletal Ageing Research, ARUK Centre for Sport, Exercise and Osteoarthritis, NIHR Nottingham Biomedical Research Centre, University of Nottingham , UK
| | - FB Stephens
- MRC/ARUK Centre for Musculoskeletal Ageing Research, ARUK Centre for Sport, Exercise and Osteoarthritis, NIHR Nottingham Biomedical Research Centre, University of Nottingham , UK
| | - DN Lobo
- MRC/ARUK Centre for Musculoskeletal Ageing Research, ARUK Centre for Sport, Exercise and Osteoarthritis, NIHR Nottingham Biomedical Research Centre, University of Nottingham , UK
| | - N Szewczyk
- MRC/ARUK Centre for Musculoskeletal Ageing Research, ARUK Centre for Sport, Exercise and Osteoarthritis, NIHR Nottingham Biomedical Research Centre, University of Nottingham , UK
| | - M Narici
- MRC/ARUK Centre for Musculoskeletal Ageing Research, ARUK Centre for Sport, Exercise and Osteoarthritis, NIHR Nottingham Biomedical Research Centre, University of Nottingham , UK
| | - C Pratts
- MRC/ARUK Centre for Musculoskeletal Ageing Research, ARUK Centre for Sport, Exercise and Osteoarthritis, NIHR Nottingham Biomedical Research Centre, University of Nottingham , UK
| | - IA Macdonald
- MRC/ARUK Centre for Musculoskeletal Ageing Research, ARUK Centre for Sport, Exercise and Osteoarthritis, NIHR Nottingham Biomedical Research Centre, University of Nottingham , UK
| | - PL Greenhaff
- MRC/ARUK Centre for Musculoskeletal Ageing Research, ARUK Centre for Sport, Exercise and Osteoarthritis, NIHR Nottingham Biomedical Research Centre, University of Nottingham , UK
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16
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Mekjavic IB, Amon M, Simpson EJ, Kölegård R, Eiken O, Macdonald IA. Energy Intake of Men With Excess Weight During Normobaric Hypoxic Confinement. Front Physiol 2022; 12:801833. [PMID: 35095562 PMCID: PMC8790566 DOI: 10.3389/fphys.2021.801833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 12/16/2021] [Indexed: 11/13/2022] Open
Abstract
Due to the observations of weight loss at high altitude, normobaric hypoxia has been considered as a method of weight loss in obese individuals. With this regard, the aim of the present study was to determine the effect of hypoxia per se on metabolism in men with excess weight. Eight men living with excess weight (125.0 ± 17.7 kg; 30.5 ± 11.1 years, BMI: 37.6 ± 6.2 kg⋅m-2) participated in a randomized cross-over study comprising two 10-day confinements: normobaric (altitude of facility ≃ 940 m) normoxia (NORMOXIA; P I O2 = 133 mmHg), and normobaric hypoxia (HYPOXIA). The P I O2 in the latter was reduced from 105 (simulated altitude of 2,800 m) to 98 mmHg (simulated altitude of 3,400 m over 10 days. Before, and at the end of each confinement, participants completed a meal tolerance test (MTT). Resting energy expenditure (REE), circulating glucose, GLP-1, insulin, catecholamines, ghrelin, peptide-YY (PYY), leptin, gastro-intestinal blood flow, and appetite sensations were measured in fasted and postprandial states. Fasting REE increased after HYPOXIA (+358.0 ± 49.3 kcal⋅day-1, p = 0.03), but not after NORMOXIA (-33.1 ± 17.6 kcal⋅day-1). Postprandial REE was also significantly increased after HYPOXIA (p ≤ 0.05), as was the level of PYY. Furthermore, a tendency for decreased energy intake was concomitant with a significant body weight reduction after HYPOXIA (-0.7 ± 0.2 kg) compared to NORMOXIA (+1.0 ± 0.2 kg). The HYPOXIA trial increased the metabolic requirements, with a tendency toward decreased energy intake concomitant with increased PYY levels supporting the notion of a hypoxia-induced appetite inhibition, that could potentially lead to body weight reduction. The greater postprandial blood-glucose response following hypoxic confinement, suggests the potential development of insulin resistance.
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Affiliation(s)
- Igor B. Mekjavic
- Department of Automation, Biocybernetics and Robotics, Jozef Stefan Institute, Ljubljana, Slovenia
| | - Mojca Amon
- Department of Automation, Biocybernetics and Robotics, Jozef Stefan Institute, Ljubljana, Slovenia
| | - Elizabeth J. Simpson
- Metabolic and Molecular Physiology Group, Faculty of Medicine and Health Sciences University of Nottingham Queen’s Medical Centre, Nottingham, United Kingdom
| | - Roger Kölegård
- Division of Environmental Physiology, School of Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Ola Eiken
- Division of Environmental Physiology, School of Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Ian A. Macdonald
- Metabolic and Molecular Physiology Group, Faculty of Medicine and Health Sciences University of Nottingham Queen’s Medical Centre, Nottingham, United Kingdom
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Alhussain MH, Macdonald IA, Taylor MA. Impact of isoenergetic intake of irregular meal patterns on thermogenesis, glucose metabolism, and appetite: a randomized controlled trial. Am J Clin Nutr 2022; 115:284-297. [PMID: 34555151 DOI: 10.1093/ajcn/nqab323] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 09/21/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Evidence is emerging that interdaily meal pattern variability potentially affects response such as thermic effect of food (TEF), macronutrient metabolism, and appetite. OBJECTIVES To investigate the effect of irregular meal pattern on TEF, glucose, insulin, lipid profile, and appetite regulation in women who are overweight or with obesity and confirmed insulin resistance. DESIGN In a randomized crossover trial, 9 women [mean ± SD BMI (in kg/m2): 33.3 ± 3.1] with confirmed insulin resistance consumed a regular (14 d; 6 meals/d) and an irregular (14 d; 3-9 meals/d) meal pattern separated by a 14-d washout interval. Identical foods were provided during the interventions, and at the start and end of each meal pattern, participants attended the laboratory after an overnight fast. Energy expenditure, glucose, insulin, lipids, adiponectin, leptin, glucagon-like peptide 1 (GLP-1), peptide YY (PYY), and ghrelin were measured at baseline and for 3 h after consumption of a test drink, after which an ad libitum test meal was offered. Subjective appetite ratings were recorded before and after the test drink, after the ad libitum meal, and during the intervention. Continuous interstitial glucose monitoring was undertaken for 7 consecutive days during each intervention. RESULTS TEF (over 3 h) was significantly lower postirregular intervention compared with postregular (97.7 ± 19.2 kJ*3 h in postregular visit and 76.7 ± 35.2 kJ*3 h in postirregular visit, paired t test, P = 0.048). Differences in HOMA-IR between the 2 interventions (3.3 ± 1.7 and 3.6 ± 1.6 in postregular and postirregular meal pattern, respectively) were not significant. Net incremental AUC for GLP-1 concentrations (over 3 h) for the postregular meal pattern were higher (864.9 ± 456.1 pmol/L*3 h) than the postirregular meal pattern (487.6 ± 271.7 pmol/L*3 h, paired t test, P = 0.005). CONCLUSIONS Following a 14-d period of an irregular meal pattern, TEF was significantly less than following a regular meal pattern, potentially compromising weight management if sustained long term. This study was registered at www.clinicaltrials.gov as NCT02582606.
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Affiliation(s)
- Maha H Alhussain
- Department of Food Science and Nutrition, College of Food and Agriculture Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Ian A Macdonald
- MRC/ARUK Centre for Musculoskeletal Ageing Research, National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre, Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, University of Nottingham, Nottingham, UK
| | - Moira A Taylor
- MRC/ARUK Centre for Musculoskeletal Ageing Research, National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre, Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, University of Nottingham, Nottingham, UK
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18
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Tremblay A, Fogelholm M, Jalo E, Westerterp-Plantenga MS, Adam TC, Huttunen-Lenz M, Stratton G, Lam T, Handjieva-Darlenska T, Handjiev S, Martinez JA, Macdonald IA, Simpson EJ, Brand-Miller J, Muirhead R, Poppitt SD, Silvestre MP, Larsen TM, Vestentoft PS, Schlicht W, Drapeau V, Raben A. What Is the Profile of Overweight Individuals Who Are Unsuccessful Responders to a Low-Energy Diet? A PREVIEW Sub-study. Front Nutr 2021; 8:707682. [PMID: 34796192 PMCID: PMC8593278 DOI: 10.3389/fnut.2021.707682] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 09/17/2021] [Indexed: 12/29/2022] Open
Abstract
This study was performed to evaluate the profile of overweight individuals with pre-diabetes enrolled in PREVIEW who were unable to achieve a body weight loss of ≥8% of the baseline value in response to a 2-month low-energy diet (LED). Their baseline profile reflected potential stress-related vulnerability that predicted a reduced response of body weight to a LED programme. The mean daily energy deficit maintained by unsuccessful weight responders of both sexes was less than the estimated level in successful female (656 vs. 1,299 kcal, p < 0.01) and male (815 vs. 1,659 kcal, p < 0.01) responders. Despite this smaller energy deficit, unsuccessful responders displayed less favorable changes in susceptibility to hunger and appetite sensations. They also did not benefit from the intervention regarding the ability to improve sleep quality. In summary, these results show that some individuals display a behavioral vulnerability which may reduce the ability to lose weight in response to a diet-based weight loss program. They also suggest that this vulnerability may be accentuated by a prolonged diet restriction.
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Affiliation(s)
- Angelo Tremblay
- Department of Kinesiology, Faculty of Medicine, Laval University, Quebec, QC, Canada
| | - Mikael Fogelholm
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Elli Jalo
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | | | - Tanja C Adam
- Department of Nutrition and Movement Sciences, Maastricht University, Maastricht, Netherlands
| | - Maija Huttunen-Lenz
- Institute of Nursing Science, University of Education, Schwäbisch Gmünd, Germany
| | - Gareth Stratton
- School of Sport and Exercise Sciences A-STEM Research Centre, Swansea University, Swansea, United Kingdom
| | - Tony Lam
- NetUnion sarl, Lausanne, Switzerland
| | | | - Svetoslav Handjiev
- Department of Pharmacology and Toxicology, Medical University of Sofia, Sofia, Bulgaria
| | - J Alfredo Martinez
- Department of Nutrition Research, University of Navarra, Pamplona, Spain.,CIBERobn, Instituto de Salude Carlos III, Madrid Spain and IMDEA Madrid, Madrid, Spain
| | - Ian A Macdonald
- School of Life Sciences, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Elizabeth J Simpson
- School of Life Sciences, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Jennie Brand-Miller
- Charles Perkins Centre and School of Life and Environmental Sciences, University of Sydney, Sydney, NSW, Australia
| | - Roslyn Muirhead
- Charles Perkins Centre and School of Life and Environmental Sciences, University of Sydney, Sydney, NSW, Australia
| | - Sally D Poppitt
- Human Nutrition Unit, School of Biological Sciences, University of Auckland, Auckland, New Zealand
| | - Marta P Silvestre
- Human Nutrition Unit, School of Biological Sciences, University of Auckland, Auckland, New Zealand.,Centro de Investigaçao em Tecnologias e Serciços de Saûde (CINTESIS), NOVA Medical School NOVA University of Lisbon, Lisbon, Portugal
| | - Thomas M Larsen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Pia Siig Vestentoft
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Wolfgang Schlicht
- Exercise and Health Sciences, University of Stuggart, Stuggart, Germany
| | - Vicky Drapeau
- Department of Physical Education, Faculty of Educational Sciences, Laval University, Quebec, QC, Canada
| | - Anne Raben
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen and Steno Diabetes Center, Gentofte, Denmark
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19
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Navas-Carretero S, San-Cristobal R, Siig Vestentoft P, Brand-Miller JC, Jalo E, Westerterp-Plantenga M, Simpson EJ, Handjieva-Darlenska T, Stratton G, Huttunen-Lenz M, Lam T, Muirhead R, Poppitt S, Pietiläinen KH, Adam T, Taylor MA, Handjiev S, McNarry MA, Hansen S, Brodie S, Silvestre MP, Macdonald IA, Boyadjieva N, Mackintosh KA, Schlicht W, Liu A, Larsen TM, Fogelholm M, Raben A, Martinez JA. Appraisal of Triglyceride-Related Markers as Early Predictors of Metabolic Outcomes in the PREVIEW Lifestyle Intervention: A Controlled Post-hoc Trial. Front Nutr 2021; 8:733697. [PMID: 34790686 PMCID: PMC8592084 DOI: 10.3389/fnut.2021.733697] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 09/24/2021] [Indexed: 12/19/2022] Open
Abstract
Background: Individuals with pre-diabetes are commonly overweight and benefit from dietary and physical activity strategies aimed at decreasing body weight and hyperglycemia. Early insulin resistance can be estimated via the triglyceride glucose index {TyG = Ln [TG (mg/dl) × fasting plasma glucose (FPG) (mg/dl)/2]} and the hypertriglyceridemic-high waist phenotype (TyG-waist), based on TyG x waist circumference (WC) measurements. Both indices may be useful for implementing personalized metabolic management. In this secondary analysis of a randomized controlled trial (RCT), we aimed to determine whether the differences in baseline TyG values and TyG-waist phenotype predicted individual responses to type-2 diabetes (T2D) prevention programs. Methods: The present post-hoc analyses were conducted within the Prevention of Diabetes through Lifestyle intervention and population studies in Europe and around the world (PREVIEW) study completers (n = 899), a multi-center RCT conducted in eight countries (NCT01777893). The study aimed to reduce the incidence of T2D in a population with pre-diabetes during a 3-year randomized intervention with two sequential phases. The first phase was a 2-month weight loss intervention to achieve ≥8% weight loss. The second phase was a 34-month weight loss maintenance intervention with two diets providing different amounts of protein and different glycemic indices, and two physical activity programs with different exercise intensities in a 2 x 2 factorial design. On investigation days, we assessed anthropometrics, glucose/lipid metabolism markers, and diet and exercise questionnaires under standardized procedures. Results: Diabetes-related markers improved during all four lifestyle interventions. Higher baseline TyG index (p < 0.001) was associated with greater reductions in body weight, fasting glucose, and triglyceride (TG), while a high TyG-waist phenotype predicted better TG responses, particularly in those randomized to physical activity (PA) of moderate intensity. Conclusions: Two novel indices of insulin resistance (TyG and TyG-waist) may allow for a more personalized approach to avoiding progression to T2D. Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT01777893 reference, identifier: NCT01777893.
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Affiliation(s)
- Santiago Navas-Carretero
- Center for Nutrition Research, University of Navarra, Pamplona, Spain.,Centro de Investigación Biomédica en Red (CIBER) obn, Instituto de Salud Carlos III, Madrid, Spain.,IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | | | - Pia Siig Vestentoft
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Jennie C Brand-Miller
- School of Life and Environmental Sciences and Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Elli Jalo
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Margriet Westerterp-Plantenga
- Department of Nutrition and Movement Sciences, NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands
| | - Elizabeth J Simpson
- Division of Physiology, Pharmacology and Neuroscience, MRC/ARUK Centre for Musculoskeletal Ageing Research, ARUK Centre for Sport, Exercise and Osteoarthritis, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, School of Life Sciences, Queen's Medical Centre, Nottingham, United Kingdom
| | | | - Gareth Stratton
- Applied Sports Technology, Exercise and Medicine (A-STEM) Research Centre, College of Engineering, Swansea, United Kingdom
| | - Maija Huttunen-Lenz
- Institute of Nursing Science, University of Education, Schwäbisch Gmünd, Germany
| | - Tony Lam
- NetUnion Sarl, Lausanne, Switzerland
| | - Roslyn Muirhead
- School of Life and Environmental Sciences and Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Sally Poppitt
- Human Nutrition Unit, Department of Medicine, School of Biological Sciences, University of Auckland, Auckland, New Zealand
| | - Kirsi H Pietiläinen
- Obesity Research Unit, Diabetes and Obesity Research Program, University of Helsinki and Endocrinology, Helsinki, Finland.,Abdominal Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Tanja Adam
- Department of Nutrition and Movement Sciences, NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands
| | - Moira A Taylor
- Division of Physiology, Pharmacology and Neuroscience, MRC/ARUK Centre for Musculoskeletal Ageing Research, ARUK Centre for Sport, Exercise and Osteoarthritis, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, School of Life Sciences, Queen's Medical Centre, Nottingham, United Kingdom
| | - Svetoslav Handjiev
- Department of Pharmacology and Toxicology, Medical University of Sofia, Sofia, Bulgaria
| | - Melitta A McNarry
- Applied Sports Technology, Exercise and Medicine (A-STEM) Research Centre, College of Engineering, Swansea, United Kingdom
| | - Sylvia Hansen
- Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health, University of Cologne, Cologne, Germany
| | - Shannon Brodie
- School of Life and Environmental Sciences and Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Marta P Silvestre
- Human Nutrition Unit, Department of Medicine, School of Biological Sciences, University of Auckland, Auckland, New Zealand.,Center for Health Technology Services Research (CINTESIS), NOVA Medical School, NMS, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Ian A Macdonald
- Division of Physiology, Pharmacology and Neuroscience, MRC/ARUK Centre for Musculoskeletal Ageing Research, ARUK Centre for Sport, Exercise and Osteoarthritis, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, School of Life Sciences, Queen's Medical Centre, Nottingham, United Kingdom
| | - Nadka Boyadjieva
- Department of Pharmacology and Toxicology, Medical University of Sofia, Sofia, Bulgaria
| | - Kelly A Mackintosh
- Applied Sports Technology, Exercise and Medicine (A-STEM) Research Centre, College of Engineering, Swansea, United Kingdom
| | - Wolfgang Schlicht
- Exercise and Health Sciences, University of Stuttgart, Nobelstraße, Germany
| | - Amy Liu
- Human Nutrition Unit, Department of Medicine, School of Biological Sciences, University of Auckland, Auckland, New Zealand
| | - Thomas M Larsen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Mikael Fogelholm
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Anne Raben
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.,Steno Diabetes Centre Copenhagen, Gentofte, Denmark
| | - J Alfredo Martinez
- Center for Nutrition Research, University of Navarra, Pamplona, Spain.,Centro de Investigación Biomédica en Red (CIBER) obn, Instituto de Salud Carlos III, Madrid, Spain.,IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
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20
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Drummen M, Adam TC, Macdonald IA, Jalo E, Larssen TM, Martinez JA, Handjiev-Darlenska T, Brand-Miller J, Poppitt SD, Stratton G, Pietiläinen KH, Taylor MA, Navas-Carretero S, Handjiev S, Muirhead R, Silvestre MP, Swindell N, Huttunen-Lenz M, Schlicht W, Lam T, Sundvall J, Raman L, Feskens E, Tremblay A, Raben A, Westerterp-Plantenga MS. Associations of changes in reported and estimated protein and energy intake with changes in insulin resistance, glycated hemoglobin, and BMI during the PREVIEW lifestyle intervention study. Am J Clin Nutr 2021; 114:1847-1858. [PMID: 34375397 PMCID: PMC8574694 DOI: 10.1093/ajcn/nqab247] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 06/30/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Observed associations of high-protein diets with changes in insulin resistance are inconclusive. OBJECTIVES We aimed to assess associations of changes in both reported and estimated protein (PRep; PEst) and energy intake (EIRep; EIEst) with changes in HOMA-IR, glycated hemoglobin (HbA1c), and BMI (in kg/m2), in 1822 decreasing to 833 adults (week 156) with overweight and prediabetes, during the 3-y PREVIEW (PREVention of diabetes through lifestyle intervention and population studies In Europe and around the World) study on weight-loss maintenance. Eating behavior and measurement errors (MEs) of dietary intake were assessed. Thus, observational post hoc analyses were applied. METHODS Associations of changes in EIEst, EIRep, PEst, and PRep with changes in HOMA-IR, HbA1c, and BMI were determined by linear mixed-model analysis in 2 arms [high-protein-low-glycemic-index (GI) diet and moderate-protein-moderate-GI diet] of the PREVIEW study. EIEst was derived from energy requirement: total energy expenditure = basal metabolic rate × physical activity level; PEst from urinary nitrogen, and urea. MEs were calculated as [(EIEst - EIRep)/EIEst] × 100% and [(PRep - PEst)/PEst] × 100%. Eating behavior was determined using the Three Factor Eating Questionnaire, examining cognitive dietary restraint, disinhibition, and hunger. RESULTS Increases in PEst and PRep and decreases in EIEst and EIRep were associated with decreases in BMI, but not independently with decreases in HOMA-IR. Increases in PEst and PRep were associated with decreases in HbA1c. PRep and EIRep showed larger changes and stronger associations than PEst and EIEst. Mean ± SD MEs of EIRep and PRep were 38% ± 9% and 14% ± 4%, respectively; ME changes in EIRep and En% PRep were positively associated with changes in BMI and cognitive dietary restraint and inversely with disinhibition and hunger. CONCLUSIONS During weight-loss maintenance in adults with prediabetes, increase in protein intake and decrease in energy intake were not associated with decrease in HOMA-IR beyond associations with decrease in BMI. Increases in PEst and PRep were associated with decrease in HbA1c.This trial was registered at clinicaltrials.gov as NCT01777893.
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Affiliation(s)
- Mathijs Drummen
- Department of Nutrition and Movement Sciences, NUTRIM—School of Nutrition and Translational Research in Metabolism, Maastricht University,
Maastricht, Netherlands
| | - Tanja C Adam
- Department of Nutrition and Movement Sciences, NUTRIM—School of Nutrition and Translational Research in Metabolism, Maastricht University,
Maastricht, Netherlands
| | - Ian A Macdonald
- MRC/Arthritis Research UK (ARUK) Centre for Musculoskeletal Ageing Research, ARUK Centre for Sport, Exercise, and Osteoarthritis, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Division of Physiology, Pharmacology, and Neuroscience, School of Life Sciences, Queen's Medical Centre, University of Nottingham, Nottingham, United Kingdom
| | - Elli Jalo
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Thomas M Larssen
- Department of Nutrition, Exercise, and Sports, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark
| | - J Alfredo Martinez
- Department of Physiology and Nutrition, University of Navarra, Pamplona, Spain,Biomedical Research Networking Center for Physiopathology of Obesity and Nutrition (CIBEROBN),
Madrid, Spain,IdisNA Institute for Health Research, Pamplona, Spain,Precision Nutrition and Cardiometabolic Health Program, IMDEA-Food Institute (Madrid Institute for Advanced Studies), Campus of International Excellence (CEI) UAM + CSIC, Madrid, Spain
| | | | - Jennie Brand-Miller
- School of Life and Environmental Sciences, The University of Sydney, Sydney, New South Wales, Australia,Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Sally D Poppitt
- Human Nutrition Unit, School of Biological Sciences, Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Gareth Stratton
- Applied Sports Technology, Exercise, and Medicine (A-STEM), College of Engineering Research Centre, Swansea University, Swansea, United Kingdom
| | - Kirsi H Pietiläinen
- Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland,Obesity Center, Abdominal Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Moira A Taylor
- MRC/Arthritis Research UK (ARUK) Centre for Musculoskeletal Ageing Research, ARUK Centre for Sport, Exercise, and Osteoarthritis, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Division of Physiology, Pharmacology, and Neuroscience, School of Life Sciences, Queen's Medical Centre, University of Nottingham, Nottingham, United Kingdom
| | - Santiago Navas-Carretero
- Biomedical Research Networking Center for Physiopathology of Obesity and Nutrition (CIBEROBN), Madrid, Spain,IdisNA Institute for Health Research, Pamplona, Spain,Centre for Nutrition Research, University of Navarra, Pamplona, Spain
| | - Svetoslav Handjiev
- Department of Pharmacology and Toxicology, Medical University of Sofia, Sofia, Bulgaria
| | - Roslyn Muirhead
- School of Life and Environmental Sciences, The University of Sydney, Sydney, New South Wales, Australia,Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Marta P Silvestre
- Human Nutrition Unit, School of Biological Sciences, Department of Medicine, University of Auckland, Auckland, New Zealand,Center for Research in Health Technologies and Services (CINTESIS), NOVA Medical School, NOVA University of Lisbon, Lisbon, Portugal
| | - Nils Swindell
- Applied Sports Technology, Exercise, and Medicine (A-STEM), College of Engineering Research Centre, Swansea University, Swansea, United Kingdom
| | - Maija Huttunen-Lenz
- Exercise and Health Sciences, University of Stuttgart, Stuttgart, Germany,Institute of Nursing Science, Schwäbisch Gmünd University of Education, Schwäbisch Gmünd, Germany
| | - Wolfgang Schlicht
- Exercise and Health Sciences, University of Stuttgart, Stuttgart, Germany
| | - Tony Lam
- NetUnion sarl, Lausanne, Switzerland
| | - Jouko Sundvall
- Biochemistry Laboratory, Forensic Toxicology Unit, Department of Government Services, National Institute for Health and Welfare, Helsinki, Finland
| | - Laura Raman
- Biochemistry Laboratory, Forensic Toxicology Unit, Department of Government Services, National Institute for Health and Welfare, Helsinki, Finland
| | - Edith Feskens
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, Netherlands
| | - Angelo Tremblay
- Department of Kinesiology, Laval University, Quebec City, Quebec, Canada
| | - Anne Raben
- Department of Nutrition, Exercise, and Sports, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark,Steno Diabetes Center, Copenhagen, Denmark
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21
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Zhu R, Fogelholm M, Larsen TM, Poppitt SD, Silvestre MP, Vestentoft PS, Jalo E, Navas-Carretero S, Huttunen-Lenz M, Taylor MA, Stratton G, Swindell N, Kaartinen NE, Lam T, Handjieva-Darlenska T, Handjiev S, Schlicht W, Martinez JA, Seimon RV, Sainsbury A, Macdonald IA, Westerterp-Plantenga MS, Brand-Miller J, Raben A. Corrigendum: A High-Protein, Low Glycemic Index Diet Suppresses Hunger but Not Weight Regain After Weight Loss: Results From a Large, 3-Years Randomized Trial (PREVIEW). Front Nutr 2021; 8:736531. [PMID: 34368215 PMCID: PMC8344043 DOI: 10.3389/fnut.2021.736531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 07/06/2021] [Indexed: 11/16/2022] Open
Affiliation(s)
- Ruixin Zhu
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Mikael Fogelholm
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Thomas M Larsen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Sally D Poppitt
- Human Nutrition Unit, School of Biological Sciences, Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Marta P Silvestre
- Human Nutrition Unit, School of Biological Sciences, Department of Medicine, University of Auckland, Auckland, New Zealand.,Center for Health Technology Services Research, NOVA Medical School, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Pia S Vestentoft
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Elli Jalo
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Santiago Navas-Carretero
- Centre for Nutrition Research, University of Navarra, Pamplona, Spain.,Centro de Investigacion Biomedica en Red Area de Fisiologia de la Obesidad y la Nutricion (CIBEROBN), Madrid, Spain.,IdisNA Instituto for Health Research, Pamplona, Spain
| | - Maija Huttunen-Lenz
- Institute for Nursing Science, University of Education Schwäbisch Gmünd, Schwäbisch Gmünd, Germany
| | - Moira A Taylor
- Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, Queen's Medical Centre, Nottingham, United Kingdom.,National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, United Kingdom
| | - Gareth Stratton
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea, United Kingdom
| | - Nils Swindell
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea, United Kingdom
| | - Niina E Kaartinen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Tony Lam
- NetUnion sarl, Lausanne, Switzerland
| | | | - Svetoslav Handjiev
- Department of Pharmacology and Toxicology, Medical University of Sofia, Sofia, Bulgaria
| | - Wolfgang Schlicht
- Exercise and Health Sciences, University of Stuttgart, Stuttgart, Germany
| | - J Alfredo Martinez
- Centro de Investigacion Biomedica en Red Area de Fisiologia de la Obesidad y la Nutricion (CIBEROBN), Madrid, Spain.,IdisNA Instituto for Health Research, Pamplona, Spain.,Department of Nutrition and Physiology, University of Navarra, Pamplona, Spain.,Precision Nutrition and Cardiometabolic Health Program, IMDEA (Madrid Institute for Advanced Studies)-Food Institute, CEI UAM + CSIC (Campus de Excelencia Internacional, Universidad Autónoma de Madrid + Consejo Superior de Investigaciones Científicas), Madrid, Spain
| | - Radhika V Seimon
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Amanda Sainsbury
- School of Human Sciences (Exercise and Sports Science), Faculty of Science, The University of Western Australia, Crawley, WA, Australia
| | - Ian A Macdonald
- Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, Queen's Medical Centre, MRC/ARUK Centre for Musculoskeletal Ageing Research, ARUK Centre for Sport, Exercise and Osteoarthritis, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, United Kingdom
| | - Margriet S Westerterp-Plantenga
- Department of Nutrition and Movement Sciences, NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands
| | - Jennie Brand-Miller
- School of Life and Environmental Sciences and Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Anne Raben
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.,Steno Diabetes Center Copenhagen, Gentofte, Denmark
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22
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Fernandez-Gonzalo R, McDonnell AC, Simpson EJ, Macdonald IA, Rullman E, Mekjavic IB. Substantial and Reproducible Individual Variability in Skeletal Muscle Outcomes in the Cross-Over Designed Planica Bed Rest Program. Front Physiol 2021; 12:676501. [PMID: 34335293 PMCID: PMC8322684 DOI: 10.3389/fphys.2021.676501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 06/25/2021] [Indexed: 12/21/2022] Open
Abstract
To evaluate the individual responses in skeletal muscle outcomes following bed rest, data from three studies (21-day PlanHab; 10-day FemHab and LunHab) were combined. Subjects (n = 35) participated in three cross-over campaigns within each study: normoxic (NBR) and hypoxic bed rest (HBR), and hypoxic ambulation (HAMB; used as control). Individual variability (SDIR) was investigated as √(SDExp 2 -SDCon 2 ), where SDExp and SDCon are the standard deviations of the change score (i.e., post - pre) in the experimental (NBR and HBR) and the control (HAMB) groups, respectively. Repeatability and moderators of the individual variability were explored. Significant SDIR was detected for knee extension torque, and thigh and calf muscle area, which translated into an individual response ranging from 3 to -17% for knee extension torque, -2 to -12% for calf muscle area, and -1 to -8% for thigh muscle area. Strong correlations were found for changes in NBR vs. HBR (i.e., repeatability) in thigh and calf muscle area (r = 0.65-0.75, P < 0.0001). Change-scores in knee extension torque, and thigh and calf muscle area strongly correlated with baseline values (P < 0.001; r between -0.5 and -0.9). Orthogonal partial least squares regression analysis explored if changes in the investigated variables could predict calf muscle area alterations. This analysis indicated that 43% of the variance in calf muscle area could be attributed to changes in all of the other variables. This is the first study using a validated methodology to report clinically relevant individual variability after bed rest in knee extension torque, calf muscle area, and (to a lower extent) thigh muscle area. Baseline values emerged as a moderator of the individual response, and a global bed rest signature served as a moderately strong predictor of the individual variation in calf muscle area alterations.
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Affiliation(s)
- Rodrigo Fernandez-Gonzalo
- Department of Laboratory Medicine, Division of Clinical Physiology, Karolinska Institutet, and Unit of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden
| | - Adam C. McDonnell
- Department of Automation, Biocybernetics and Robotics, Jozef Stefan Institute, Ljubljana, Slovenia
| | - Elizabeth J. Simpson
- MRC Arthritis Research UK Centre for Musculoskeletal Ageing Research, School of Life Sciences, University of Nottingham Medical School, Nottingham, United Kingdom
| | - Ian A. Macdonald
- MRC Arthritis Research UK Centre for Musculoskeletal Ageing Research, School of Life Sciences, University of Nottingham Medical School, Nottingham, United Kingdom
| | - Eric Rullman
- Department of Laboratory Medicine, Division of Clinical Physiology, Karolinska Institutet, and Unit of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden
| | - Igor B. Mekjavic
- Department of Automation, Biocybernetics and Robotics, Jozef Stefan Institute, Ljubljana, Slovenia
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada
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23
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Zhu R, Larsen TM, Fogelholm M, Poppitt SD, Vestentoft PS, Silvestre MP, Jalo E, Navas-Carretero S, Huttunen-Lenz M, Taylor MA, Stratton G, Swindell N, Drummen M, Adam TC, Ritz C, Sundvall J, Valsta LM, Muirhead R, Brodie S, Handjieva-Darlenska T, Handjiev S, Martinez JA, Macdonald IA, Westerterp-Plantenga MS, Brand-Miller J, Raben A. Dose-Dependent Associations of Dietary Glycemic Index, Glycemic Load, and Fiber With 3-Year Weight Loss Maintenance and Glycemic Status in a High-Risk Population: A Secondary Analysis of the Diabetes Prevention Study PREVIEW. Diabetes Care 2021; 44:1672-1681. [PMID: 34045241 PMCID: PMC8323188 DOI: 10.2337/dc20-3092] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 03/29/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To examine longitudinal and dose-dependent associations of dietary glycemic index (GI), glycemic load (GL), and fiber with body weight and glycemic status during 3-year weight loss maintenance (WLM) in adults at high risk of type 2 diabetes. RESEARCH DESIGN AND METHODS In this secondary analysis we used pooled data from the PREVention of diabetes through lifestyle Intervention and population studies in Europe and around the World (PREVIEW) randomized controlled trial, which was designed to test the effects of four diet and physical activity interventions. A total of 1,279 participants with overweight or obesity (age 25-70 years and BMI ≥25 kg ⋅ m-2) and prediabetes at baseline were included. We used multiadjusted linear mixed models with repeated measurements to assess longitudinal and dose-dependent associations by merging the participants into one group and dividing them into GI, GL, and fiber tertiles, respectively. RESULTS In the available-case analysis, each 10-unit increment in GI was associated with a greater regain of weight (0.46 kg ⋅ year-1; 95% CI 0.23, 0.68; P < 0.001) and increase in HbA1c. Each 20-unit increment in GL was associated with a greater regain of weight (0.49 kg ⋅ year-1; 0.24, 0.75; P < 0.001) and increase in HbA1c. The associations of GI and GL with HbA1c were independent of weight change. Compared with those in the lowest tertiles, participants in the highest GI and GL tertiles had significantly greater weight regain and increases in HbA1c. Fiber was inversely associated with increases in waist circumference, but the associations with weight regain and glycemic status did not remain robust in different analyses. CONCLUSIONS Dietary GI and GL were positively associated with weight regain and deteriorating glycemic status. Stronger evidence on the role of fiber is needed.
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Affiliation(s)
- Ruixin Zhu
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Thomas M Larsen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Mikael Fogelholm
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Sally D Poppitt
- Human Nutrition Unit, School of Biological Sciences, Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Pia S Vestentoft
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Marta P Silvestre
- Human Nutrition Unit, School of Biological Sciences, Department of Medicine, University of Auckland, Auckland, New Zealand
- CINTESIS, Nova Medical School, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Elli Jalo
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Santiago Navas-Carretero
- Centre for Nutrition Research, University of Navarra, Pamplona, Spain
- Centro de Investigacion Biomedica en Red Area de Fisiologia de la Obesidad y la Nutricion (CIBEROBN), Madrid, Spain
- IdisNA Instituto for Health Research, Pamplona, Spain
| | - Maija Huttunen-Lenz
- Institute for Nursing Science, University of Education Schwäbisch Gmünd, Schwäbisch Gmünd, Germany
| | - Moira A Taylor
- Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, Queen's Medical Centre, Nottingham, U.K
| | - Gareth Stratton
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea, U.K
| | - Nils Swindell
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea, U.K
| | - Mathijs Drummen
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
| | - Tanja C Adam
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
| | - Christian Ritz
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Jouko Sundvall
- Department of Government Services, Forensic Toxicology Unit, Biochemistry Laboratory, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Liisa M Valsta
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Roslyn Muirhead
- School of Life and Environmental Sciences and Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Shannon Brodie
- School of Life and Environmental Sciences and Charles Perkins Centre, University of Sydney, Sydney, Australia
| | | | - Svetoslav Handjiev
- Department of Pharmacology and Toxicology, Medical University of Sofia, Sofia, Bulgaria
| | - J Alfredo Martinez
- Centro de Investigacion Biomedica en Red Area de Fisiologia de la Obesidad y la Nutricion (CIBEROBN), Madrid, Spain
- IdisNA Instituto for Health Research, Pamplona, Spain
- Department of Nutrition and Physiology, University of Navarra, Pamplona, Spain
- Precision Nutrition and Cardiometabolic Health Program, IMDEA-Food Institute (Madrid Institute for Advanced Studies), CEI UAM + CSIC, Madrid, Spain
| | - Ian A Macdonald
- Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, Queen's Medical Centre, MRC/ARUK Centre for Musculoskeletal Ageing Research, ARUK Centre for Sport, Exercise and Osteoarthritis, National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham, U.K
| | - Margriet S Westerterp-Plantenga
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
| | - Jennie Brand-Miller
- School of Life and Environmental Sciences and Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Anne Raben
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
- Steno Diabetes Center Copenhagen, Gentofte, Denmark
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24
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Zhu R, Fogelholm M, Larsen TM, Poppitt SD, Silvestre MP, Vestentoft PS, Jalo E, Navas-Carretero S, Huttunen-Lenz M, Taylor MA, Stratton G, Swindell N, Kaartinen NE, Lam T, Handjieva-Darlenska T, Handjiev S, Schlicht W, Martinez JA, Seimon RV, Sainsbury A, Macdonald IA, Westerterp-Plantenga MS, Brand-Miller J, Raben A. A High-Protein, Low Glycemic Index Diet Suppresses Hunger but Not Weight Regain After Weight Loss: Results From a Large, 3-Years Randomized Trial (PREVIEW). Front Nutr 2021; 8:685648. [PMID: 34141717 PMCID: PMC8203925 DOI: 10.3389/fnut.2021.685648] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 04/27/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Previous studies have shown an increase in hunger during weight-loss maintenance (WLM) after diet-induced weight loss. Whether a combination of a higher protein, lower glycemic index (GI) diet and physical activity (PA) can counteract this change remains unclear. Aim: To compare the long-term effects of two diets [high protein (HP)-low GI vs. moderate protein (MP)-moderate GI] and two PA programs [high intensity (HI) vs. moderate intensity (MI)] on subjective appetite sensations during WLM after ≥8% weight loss (WL). Methods: Data derived from the 3-years PREVIEW randomized intervention study. An 8-weeks WL phase using a low-energy diet was followed by a 148-weeks randomized WLM phase. For the WLM phase, participants were assigned to one of the four groups: HP-MI, HP-HI, MP-MI, and MP-HI. Available data from 2,223 participants with overweight or obesity (68% women; BMI ≥ 25 kg/m2). Appetite sensations including satiety, hunger, desire to eat, and desire to eat something sweet during the two phases (at 0, 8 weeks and 26, 52, 104, and 156 weeks) were assessed based on the recall of feelings during the previous week using visual analogue scales. Differences in changes in appetite sensations from baseline between the groups were determined using linear mixed models with repeated measures. Results: There was no significant diet × PA interaction. From 52 weeks onwards, decreases in hunger were significantly greater in HP-low GI than MP-moderate GI (P time × diet = 0.018, P dietgroup = 0.021). Although there was no difference in weight regain between the diet groups (P time × diet = 0.630), hunger and satiety ratings correlated with changes in body weight at most timepoints. There were no significant differences in appetite sensations between the two PA groups. Decreases in hunger ratings were greater at 52 and 104 weeks in HP-HI vs. MP-HI, and greater at 104 and 156 weeks in HP-HI vs. MP-MI. Conclusions: This is the first long-term, large-scale randomized intervention to report that a HP-low GI diet was superior in preventing an increase in hunger, but not weight regain, during 3-years WLM compared with a MP-moderate GI diet. Similarly, HP-HI outperformed MP-HI in suppressing hunger. The role of exercise intensity requires further investigation. Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT01777893.
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Affiliation(s)
- Ruixin Zhu
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Mikael Fogelholm
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Thomas M Larsen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Sally D Poppitt
- Human Nutrition Unit, School of Biological Sciences, Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Marta P Silvestre
- Human Nutrition Unit, School of Biological Sciences, Department of Medicine, University of Auckland, Auckland, New Zealand.,Center for Health Technology Services Research, NOVA Medical School, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Pia S Vestentoft
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Elli Jalo
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Santiago Navas-Carretero
- Department of Nutrition, University of Navarra, Pamplona, Spain.,CIBERobn, Instituto de Salud Carlos III, Madrid, Spain.,Precision Nutrition Program, IMDEA Food, Campus de Excelencia Internacional, Universidad Autónoma de Madrid + Consejo Superior de Investigaciones Científicas, Madrid, Spain
| | - Maija Huttunen-Lenz
- Institute for Nursing Science, University of Education Schwäbisch Gmünd, Schwäbisch Gmünd, Germany
| | - Moira A Taylor
- Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, Queen's Medical Centre, Nottingham, United Kingdom.,National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, United Kingdom
| | - Gareth Stratton
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea, United Kingdom
| | - Nils Swindell
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea, United Kingdom
| | - Niina E Kaartinen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Tony Lam
- NetUnion sarl, Lausanne, Switzerland
| | | | - Svetoslav Handjiev
- Department of Pharmacology and Toxicology, Medical University of Sofia, Sofia, Bulgaria
| | - Wolfgang Schlicht
- Exercise and Health Sciences, University of Stuttgart, Stuttgart, Germany
| | - J Alfredo Martinez
- Department of Nutrition, University of Navarra, Pamplona, Spain.,CIBERobn, Instituto de Salud Carlos III, Madrid, Spain.,Precision Nutrition Program, IMDEA Food, Campus de Excelencia Internacional, Universidad Autónoma de Madrid + Consejo Superior de Investigaciones Científicas, Madrid, Spain
| | - Radhika V Seimon
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Amanda Sainsbury
- School of Human Sciences (Exercise and Sports Science), Faculty of Science, The University of Western Australia, Crawley, WA, Australia
| | - Ian A Macdonald
- Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, Queen's Medical Centre, MRC/ARUK Centre for Musculoskeletal Ageing Research, ARUK Centre for Sport, Exercise and Osteoarthritis, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, United Kingdom
| | - Margriet S Westerterp-Plantenga
- Department of Nutrition and Movement Sciences, NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands
| | - Jennie Brand-Miller
- School of Life and Environmental Sciences and Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Anne Raben
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.,Steno Diabetes Center Copenhagen, Gentofte, Denmark
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25
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Gao Y, Tsintzas K, Macdonald IA, Cordon SM, Taylor MA. Effects of intermittent (5:2) or continuous energy restriction on basal and postprandial metabolism: a randomised study in normal-weight, young participants. Eur J Clin Nutr 2021; 76:65-73. [PMID: 34040199 PMCID: PMC8766278 DOI: 10.1038/s41430-021-00909-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 03/01/2021] [Accepted: 03/19/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND/OBJECTIVES Intermittent energy restriction (IER) may overcome poor long-term adherence with continuous energy restriction (CER), for weight reduction. We compared the effects of IER with CER for fasting and postprandial metabolism and appetite in metabolically healthy participants, in whom excess weight would not confound intrinsic metabolic differences. SUBJECTS/METHODS In a 2-week randomised, parallel trial, 16 young, healthy-weight participants were assigned to either CER (20% below estimated energy requirements (EER)) or 5:2 IER (70% below EER on 2 non-consecutive days; 5 days at EER, per week). Metabolic and appetite regulation markers were assessed before and for 3 h after a liquid breakfast; followed by an ad libitum lunch; pre- and post-intervention. RESULTS Weight loss was similar in both groups: -2.5 (95% CI, -3.4, -1.6) kg for 5:2 IER vs. -2.3 (-2.9, -1.7) kg for CER. There were no differences between groups for postprandial incremental area under the curve for serum insulin, blood glucose or subjective appetite ratings. Compared with CER, 5:2 IER led to a reduction in fasting blood glucose concentrations (treatment-by-time interaction, P = 0.018, η2p = 0.14). Similarly, compared with CER, there were beneficial changes in fasting composite appetite scores after 5:2 IER (treatment-by-time interaction, P = 0.0003, η2p = 0.35). CONCLUSIONS There were no significant differences in postprandial insulinaemic, glycaemic or appetite responses between treatments. However, 5:2 IER resulted in greater improvements in fasting blood glucose, and beneficial changes in fasting subjective appetite ratings.
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Affiliation(s)
- Yangfan Gao
- Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, UK.,National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK.,MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, Nottingham, UK
| | - Kostas Tsintzas
- Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, UK.,National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK.,MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, Nottingham, UK
| | - Ian A Macdonald
- Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, UK.,National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK.,MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, Nottingham, UK
| | - Sally M Cordon
- Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, UK.,National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK.,MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, Nottingham, UK
| | - Moira A Taylor
- Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, UK. .,National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK.
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26
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Nwokolo M, Amiel SA, O'Daly O, Macdonald IA, Zelaya FO, Choudhary P. Restoration of Hypoglycemia Awareness Alters Brain Activity in Type 1 Diabetes. Diabetes Care 2021; 44:533-540. [PMID: 33328282 DOI: 10.2337/dc20-1250] [Citation(s) in RCA: 6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 11/12/2020] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Impaired awareness of hypoglycemia (IAH) in type 1 diabetes (T1D) is a major risk factor for severe hypoglycemia (SH) and is associated with atypical responses to hypoglycemia in brain regions involved in arousal, decision making, and memory. Whether restoration of hypoglycemia awareness alters these responses is unknown. We sought to investigate the impact of awareness restoration on brain responses to hypoglycemia. RESEARCH DESIGN AND METHODS Twelve adults with T1D and IAH underwent pseudocontinuous arterial spin labeling functional MRI during a hypoglycemic clamp (5-2.6 mmol/L) before and after a hypoglycemia avoidance program of structured education (Dose Adjustment for Normal Eating), specialist support, and sensor-augmented pump therapy (Medtronic MiniMed 640G). Hypoglycemic cerebral blood flow (CBF) responses were compared pre- and postintervention using predefined region-of-interest analysis of the thalamus, anterior cingulate cortex (ACC), orbitofrontal cortex (OFC), and hippocampus. RESULTS Postintervention, Gold and Clarke scores fell (6.0 ± 1.0 to 4.0 ± 1.6, P = 0.0002, and 5.7 ± 1.7 to 3.4 ± 1.8, P = 0.0008, respectively), SH rates reduced (1.5 ± 2 to 0.3 ± 0.5 episodes per year, P = 0.03), hypoglycemic symptom scores increased (18.8 ± 6.3 to 27.3 ± 12.7, P = 0.02), and epinephrine responses did not change (P = 0.2). Postintervention, hypoglycemia induced greater increases in ACC CBF (P = 0.01, peak voxel coordinates [6, 40, -2]), while thalamic and OFC activity did not change. CONCLUSIONS Increased blood flow is seen within brain pathways involved in internal self-awareness and decision making (ACC) after restoration of hypoglycemia awareness, suggesting partial recovery of brain responses lost in IAH. Resistance of frontothalamic networks, involved in arousal and emotion processing, may explain why not all individuals with IAH achieve awareness restoration with education and technology alone.
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Affiliation(s)
- Munachiso Nwokolo
- Department of Diabetes, School of Life Course Sciences, King's College London, London, U.K. .,King's College Hospital NHS Foundation Trust, London, U.K
| | - Stephanie A Amiel
- Department of Diabetes, School of Life Course Sciences, King's College London, London, U.K.,King's College Hospital NHS Foundation Trust, London, U.K
| | - Owen O'Daly
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, U.K
| | - Ian A Macdonald
- School of Life Sciences, MRC-Arthritis Research UK Centre of Excellence in Musculoskeletal Ageing, Nottingham University Medical School, Queen's Medical Centre, Nottingham, U.K
| | - Fernando O Zelaya
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, U.K
| | - Pratik Choudhary
- Department of Diabetes, School of Life Course Sciences, King's College London, London, U.K.,King's College Hospital NHS Foundation Trust, London, U.K
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27
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Raben A, Vestentoft PS, Brand‐Miller J, Jalo E, Drummen M, Simpson L, Martinez JA, Handjieva‐Darlenska T, Stratton G, Huttunen‐Lenz M, Lam T, Sundvall J, Muirhead R, Poppitt S, Ritz C, Pietiläinen KH, Westerterp‐Plantenga M, Taylor MA, Navas‐Carretero S, Handjiev S, McNarry MA, Hansen S, Råman L, Brodie S, Silvestre MP, Adam TC, Macdonald IA, San‐Cristobal R, Boyadjieva N, Mackintosh KA, Schlicht W, Liu A, Larsen TM, Fogelholm M. The PREVIEW intervention study: Results from a 3-year randomized 2 x 2 factorial multinational trial investigating the role of protein, glycaemic index and physical activity for prevention of type 2 diabetes. Diabetes Obes Metab 2021; 23:324-337. [PMID: 33026154 PMCID: PMC8120810 DOI: 10.1111/dom.14219] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 09/16/2020] [Accepted: 10/02/2020] [Indexed: 12/22/2022]
Abstract
AIM To compare the impact of two long-term weight-maintenance diets, a high protein (HP) and low glycaemic index (GI) diet versus a moderate protein (MP) and moderate GI diet, combined with either high intensity (HI) or moderate intensity physical activity (PA), on the incidence of type 2 diabetes (T2D) after rapid weight loss. MATERIALS AND METHODS A 3-year multicentre randomized trial in eight countries using a 2 x 2 diet-by-PA factorial design was conducted. Eight-week weight reduction was followed by a 3-year randomized weight-maintenance phase. In total, 2326 adults (age 25-70 years, body mass index ≥ 25 kg/m2 ) with prediabetes were enrolled. The primary endpoint was 3-year incidence of T2D analysed by diet treatment. Secondary outcomes included glucose, insulin, HbA1c and body weight. RESULTS The total number of T2D cases was 62 and the cumulative incidence rate was 3.1%, with no significant differences between the two diets, PA or their combination. T2D incidence was similar across intervention centres, irrespective of attrition. Significantly fewer participants achieved normoglycaemia in the HP compared with the MP group (P < .0001). At 3 years, normoglycaemia was lowest in HP-HI (11.9%) compared with the other three groups (20.0%-21.0%, P < .05). There were no group differences in body weight change (-11% after 8-week weight reduction; -5% after 3-year weight maintenance) or in other secondary outcomes. CONCLUSIONS Three-year incidence of T2D was much lower than predicted and did not differ between diets, PA or their combination. Maintaining the target intakes of protein and GI over 3 years was difficult, but the overall protocol combining weight loss, healthy eating and PA was successful in markedly reducing the risk of T2D. This is an important clinically relevant outcome.
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Affiliation(s)
- Anne Raben
- Department of Nutrition, Exercise and Sports, Faculty of ScienceUniversity of CopenhagenFrederiksbergDenmark
| | - Pia Siig Vestentoft
- Department of Nutrition, Exercise and Sports, Faculty of ScienceUniversity of CopenhagenFrederiksbergDenmark
| | - Jennie Brand‐Miller
- School of Life and Environmental Sciences and Charles Perkins CentreThe University of SydneySydneyNew South WalesAustralia
| | - Elli Jalo
- Department of Food and NutritionUniversity of HelsinkiHelsinkiFinland
| | - Mathjis Drummen
- Department of Nutrition and Movement Sciences, NUTRIM, School of Nutrition and Translational Research in MetabolismMaastricht UniversityMaastrichtthe Netherlands
| | - Liz Simpson
- Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, Queen's Medical CentreMRC/ARUK Centre for Musculoskeletal Ageing Research, ARUK Centre for Sport, Exercise and Osteoarthritis, National Institute for Health Research (NIHR) Nottingham Biomedical Research CentreNottinghamUK
| | - J. Alfredo Martinez
- Centre for Nutrition ResearchUniversity of NavarraPamplonaSpain
- Centro de Investigacion Biomedica en Red Area de Fisiologia de la Obesidad y la Nutricion (CIBEROBN)MadridSpain
- IdisNA Instituto for Health ResearchPamplonaSpain
- Precision Nutrition and Cardiometabolic Health Program. IMDEA‐Food Institute (Madrid Institute for Advanced Studies), CEI UAM + CSICMadridSpain
| | | | - Gareth Stratton
- College of EngineeringApplied Sports, Technology, Exercise and Medicine (A‐STEM) Research CentreSwanseaUK
| | - Maija Huttunen‐Lenz
- Exercise and Health SciencesUniversity of StuttgartStuttgartGermany
- Institute of Nursing ScienceUniversity of Education Schwäbisch GmündSchwäbisch GmündGermany
| | - Tony Lam
- NetUnion sarlLausanneSwitzerland
| | - Jouko Sundvall
- Department of Government Services, Forensic Toxicology Unit, Biochemistry LaboratoryNational Institute for Health and WelfareHelsinkiFinland
| | - Roslyn Muirhead
- School of Life and Environmental Sciences and Charles Perkins CentreThe University of SydneySydneyNew South WalesAustralia
| | - Sally Poppitt
- Human Nutrition Unit, School of Biological Sciences, Department of MedicineUniversity of AucklandAucklandNew Zealand
| | - Christian Ritz
- Department of Nutrition, Exercise and Sports, Faculty of ScienceUniversity of CopenhagenFrederiksbergDenmark
| | - Kirsi H. Pietiläinen
- Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of MedicineUniversity of Helsinki and Obesity Centre, Endocrinology, Abdominal Center, Helsinki University Hospital and University of HelsinkiHelsinkiFinland
| | - Margriet Westerterp‐Plantenga
- Department of Nutrition and Movement Sciences, NUTRIM, School of Nutrition and Translational Research in MetabolismMaastricht UniversityMaastrichtthe Netherlands
| | - Moira A. Taylor
- Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, Queen's Medical CentreNational Institute for Health Research (NIHR) Nottingham Biomedical Research CentreNottinghamUK
| | - Santiago Navas‐Carretero
- Centre for Nutrition ResearchUniversity of NavarraPamplonaSpain
- Centro de Investigacion Biomedica en Red Area de Fisiologia de la Obesidad y la Nutricion (CIBEROBN)MadridSpain
- IdisNA Instituto for Health ResearchPamplonaSpain
| | - Svetoslav Handjiev
- Department of Pharmacology and ToxicologyMedical University of SofiaSofiaBulgaria
| | - Melitta A. McNarry
- College of EngineeringApplied Sports, Technology, Exercise and Medicine (A‐STEM) Research CentreSwanseaUK
| | - Sylvia Hansen
- Exercise and Health SciencesUniversity of StuttgartStuttgartGermany
| | - Laura Råman
- Department of Government Services, Forensic Toxicology Unit, Biochemistry LaboratoryNational Institute for Health and WelfareHelsinkiFinland
| | - Shannon Brodie
- School of Life and Environmental Sciences and Charles Perkins CentreThe University of SydneySydneyNew South WalesAustralia
| | - Marta P. Silvestre
- Human Nutrition Unit, School of Biological Sciences, Department of MedicineUniversity of AucklandAucklandNew Zealand
- CINTESIS ‐ Centro de Investigação em Tecnologias e Serviços de Saúde NOVA Medical SchoolNOVA University of LisbonLisbonPortugal
| | - Tanja C. Adam
- Department of Nutrition and Movement Sciences, NUTRIM, School of Nutrition and Translational Research in MetabolismMaastricht UniversityMaastrichtthe Netherlands
| | - Ian A. Macdonald
- Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, Queen's Medical CentreMRC/ARUK Centre for Musculoskeletal Ageing Research, ARUK Centre for Sport, Exercise and Osteoarthritis, National Institute for Health Research (NIHR) Nottingham Biomedical Research CentreNottinghamUK
| | - Rodrigo San‐Cristobal
- Centre for Nutrition ResearchUniversity of NavarraPamplonaSpain
- Precision Nutrition and Cardiometabolic Health Program. IMDEA‐Food Institute (Madrid Institute for Advanced Studies), CEI UAM + CSICMadridSpain
| | - Nadka Boyadjieva
- Department of Pharmacology and ToxicologyMedical University of SofiaSofiaBulgaria
| | - Kelly A. Mackintosh
- College of EngineeringApplied Sports, Technology, Exercise and Medicine (A‐STEM) Research CentreSwanseaUK
| | | | - Amy Liu
- Human Nutrition Unit, School of Biological Sciences, Department of MedicineUniversity of AucklandAucklandNew Zealand
| | - Thomas M. Larsen
- Department of Nutrition, Exercise and Sports, Faculty of ScienceUniversity of CopenhagenFrederiksbergDenmark
| | - Mikael Fogelholm
- Department of Food and NutritionUniversity of HelsinkiHelsinkiFinland
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28
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Martinez De La Cruz B, Markus R, Malla S, Haig MI, Gell C, Sang F, Bellows E, Sherif MA, McLean D, Lourdusamy A, Self T, Bodi Z, Smith S, Fay M, Macdonald IA, Fray R, Knight HM. Modifying the m 6A brain methylome by ALKBH5-mediated demethylation: a new contender for synaptic tagging. Mol Psychiatry 2021; 26:7141-7153. [PMID: 34663904 PMCID: PMC8872986 DOI: 10.1038/s41380-021-01282-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 08/02/2021] [Accepted: 08/25/2021] [Indexed: 02/08/2023]
Abstract
Synaptic plasticity processes, which underlie learning and memory formation, require RNA to be translated local to synapses. The synaptic tagging hypothesis has previously been proposed to explain how mRNAs are available at specific activated synapses. However how RNA is regulated, and which transcripts are silenced or processed as part of the tagging process is still unknown. Modification of RNA by N6-methyladenosine (m6A/m) influences the cellular fate of mRNA. Here, by advanced microscopy, we showed that m6A demethylation by the eraser protein ALKBH5 occurs at active synaptic ribosomes and at synapses during short term plasticity. We demonstrated that at activated glutamatergic post-synaptic sites, both the YTHDF1 and YTHDF3 reader and the ALKBH5 eraser proteins increase in co-localisation to m6A-modified RNAs; but only the readers showed high co-localisation to modified RNAs during late-stage plasticity. The YTHDF1 and YTHFDF3 readers also exhibited differential roles during synaptic maturation suggesting that temporal and subcellular abundance may determine specific function. m6A-sequencing of human parahippocampus brain tissue revealed distinct white and grey matter m6A methylome profiles indicating that cellular context is a fundamental factor dictating regulated pathways. However, in both neuronal and glial cell-rich tissue, m6A effector proteins are themselves modified and m6A epitranscriptional and posttranslational modification processes coregulate protein cascades. We hypothesise that the availability m6A effector protein machinery in conjunction with RNA modification, may be important in the formation of condensed synaptic nanodomain assemblies through liquid-liquid phase separation. Our findings support that m6A demethylation by ALKBH5 is an intrinsic component of the synaptic tagging hypothesis and a molecular switch which leads to alterations in the RNA methylome, synaptic dysfunction and potentially reversible disease states.
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Affiliation(s)
- Braulio Martinez De La Cruz
- grid.4563.40000 0004 1936 8868Division of Cells, Organisms and Molecular Genetics, School of Life Sciences, University of Nottingham, Nottingham, UK ,grid.415971.f0000 0004 0605 8588Present Address: MRC Laboratory of Molecular Cell Biology, UCL, London, UK
| | - Robert Markus
- grid.4563.40000 0004 1936 8868School of Life Sciences Imaging Facility, University of Nottingham, Nottingham, UK
| | - Sunir Malla
- grid.4563.40000 0004 1936 8868Deep Seq: Next Generation Sequencing Facility, University of Nottingham, Nottingham, UK
| | - Maria Isabel Haig
- grid.4563.40000 0004 1936 8868Division of Cells, Organisms and Molecular Genetics, School of Life Sciences, University of Nottingham, Nottingham, UK
| | - Chris Gell
- grid.4563.40000 0004 1936 8868School of Life Sciences Imaging Facility, University of Nottingham, Nottingham, UK
| | - Fei Sang
- grid.4563.40000 0004 1936 8868Deep Seq: Next Generation Sequencing Facility, University of Nottingham, Nottingham, UK
| | - Eleanor Bellows
- grid.4563.40000 0004 1936 8868Division of Cells, Organisms and Molecular Genetics, School of Life Sciences, University of Nottingham, Nottingham, UK
| | - Mahmoud Awad Sherif
- grid.4563.40000 0004 1936 8868Division of Cells, Organisms and Molecular Genetics, School of Life Sciences, University of Nottingham, Nottingham, UK
| | - Denise McLean
- grid.4563.40000 0004 1936 8868School of Life Sciences Imaging Facility, University of Nottingham, Nottingham, UK
| | - Anbarasu Lourdusamy
- grid.4563.40000 0004 1936 8868Children’s Brain Tumour Research Centre, School of Medicine, University of Nottingham, Nottingham, UK
| | - Tim Self
- grid.4563.40000 0004 1936 8868School of Life Sciences Imaging Facility, University of Nottingham, Nottingham, UK
| | - Zsuzsanna Bodi
- grid.4563.40000 0004 1936 8868Division of Plant Sciences, School of Biosciences, University of Nottingham, Nottingham, UK
| | - Stuart Smith
- grid.4563.40000 0004 1936 8868Children’s Brain Tumour Research Centre, School of Medicine, University of Nottingham, Nottingham, UK
| | - Michael Fay
- grid.4563.40000 0004 1936 8868Nanoscale and Microscale Research Centre, University of Nottingham, Nottingham, UK
| | - Ian A. Macdonald
- grid.4563.40000 0004 1936 8868Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, University of Nottingham, Nottingham, UK
| | - Rupert Fray
- grid.4563.40000 0004 1936 8868Division of Plant Sciences, School of Biosciences, University of Nottingham, Nottingham, UK
| | - Helen Miranda Knight
- Division of Cells, Organisms and Molecular Genetics, School of Life Sciences, University of Nottingham, Nottingham, UK.
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29
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Tsofliou F, Pitsiladis YP, Lara J, Hadjicharalambous M, Macdonald IA, Wallace MA, Lean MEJ. The effects of moderate alterations in adrenergic activity on acute appetite regulation in obese women: A randomised crossover trial. Nutr Health 2020; 26:311-322. [PMID: 32729763 PMCID: PMC7534026 DOI: 10.1177/0260106020942117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Previous evidence has demonstrated that serum leptin is correlated with appetite in combination with, but not without, modest exercise. Aim: The present experiments investigated the effects of exogenous adrenaline and α/β adrenoceptor blockade in combination with moderate exercise on serum leptin concentrations, appetite/satiety sensations and subsequent food intake in obese women. Methods: A total of 10 obese women ((mean ± SEM), age: 50 (1.9) years, body mass index 36 (4.1) kg/m2, waist 104.8 (4.1) cm) participated in two separate, double-blind randomised experimental trials. Experiment 1: moderate exercise after α/β adrenergic blocker (labetalol, 100 mg orally) versus moderate exercise plus placebo; experiment 2: adrenaline infusion for 20 minutes versus saline infusion. Appetite/satiety and biochemistry were measured at baseline, pre- and immediately post-intervention, then 1 hour post-intervention (i.e., before dinner). Food intake was assessed via ad libitum buffet-style dinner. Results: No differences were found in appetite/satiety, subsequent food intake or serum leptin in any of the studies (experiment 1 or experiment 2). In experiment 1, blood glucose was higher (p < 0.01) and plasma free fatty acids lower (p = 0.04) versus placebo. In experiment 2, plasma free fatty acids (p < 0.05) increased after adrenaline versus saline infusion. Conclusions: Neither inhibition of exercise-induced adrenergic activity by combined α/β adrenergic blockade nor moderate increases in adrenergic activity induced by intravenous adrenaline infusion affected acute appetite regulation.
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Affiliation(s)
- Fotini Tsofliou
- Human Nutrition, School of Medicine, 3526University of Glasgow, United Kingdom.,Department of Rehabilitation and Sport Sciences, Faculty of Health and Social Sciences, 375756Bournemouth University, United Kingdom
| | - Yannis P Pitsiladis
- College of Medical Veterinary and Life Science, Institute of Cardiovascular & Medical Sciences, 3526University of Glasgow, United Kingdom.,Centre for Sport and Exercise Science and Medicine, University of Brighton, United Kingdom
| | - Jose Lara
- Department of Applied Sciences, Faculty of Health and Life Sciences, 5995Northumbria University, United Kingdom
| | - Marios Hadjicharalambous
- College of Medical Veterinary and Life Science, Institute of Cardiovascular & Medical Sciences, 3526University of Glasgow, United Kingdom.,Human Performance Laboratory, Department of Life & Health Sciences, School of Sciences and Engineering, 121343University of Nicosia, Cyprus
| | - Ian A Macdonald
- School of Life Sciences, 6123University of Nottingham Medical School, Queen's Medical Centre, United Kingdom
| | - Mike A Wallace
- University Department of Pathological Biochemistry, Glasgow Royal Infirmary, United Kingdom
| | - Mike E J Lean
- Human Nutrition, School of Medicine, 3526University of Glasgow, United Kingdom
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Bradley CR, Bragg DD, Cox EF, El-Sharkawy AM, Buchanan CE, Chowdhury AH, Macdonald IA, Francis ST, Lobo DN. A randomized, controlled, double-blind crossover study on the effects of isoeffective and isovolumetric intravenous crystalloid and gelatin on blood volume, and renal and cardiac hemodynamics. Clin Nutr 2020; 39:2070-2079. [PMID: 31668721 PMCID: PMC7359406 DOI: 10.1016/j.clnu.2019.09.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 09/09/2019] [Accepted: 09/30/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND & AIMS Blood volume expanding properties of colloids are superior to crystalloids. In addition to oncotic/osmotic properties, the electrolyte composition of infusions may have important effects on visceral perfusion, with infusions containing supraphysiological chloride causing hyperchloremic acidosis and decreased renal blood flow. In this non-inferiority study, a validated healthy human subject model was used to compare effects of colloid (4% succinylated gelatin) and crystalloid fluid regimens on blood volume, renal function, and cardiac output. METHODS Healthy male participants were given infusions over 60 min > 7 days apart in a randomized, crossover manner. Reference arm (A): 1.5 L of Sterofundin ISO, isoeffective arm (B): 0.5 L of 4% Gelaspan®, isovolumetric arm (C): 0.5 L of 4% Gelaspan® and 1 L of Sterofundin ISO (all B. Braun, Melsungen, Germany). Participants were studied over 240 min. Changes in blood volume were calculated from changes in weight and hematocrit. Renal volume, renal artery blood flow (RABF), renal cortex perfusion and diffusion, and cardiac index were measured with magnetic resonance imaging. RESULTS Ten of 12 males [mean (SE) age 23.9 (0.8) years] recruited, completed the study. Increase in body weight and extracellular fluid volume were significantly less after infusion B than infusions A and C, but changes in blood volume did not significantly differ between infusions. All infusions increased renal volume, with no significant differences between infusions. There was no significant difference in RABF across the infusion time course or between infusion types. Renal cortex perfusion decreased during the infusion (mean 18% decrease from baseline), with no significant difference between infusions. There was a trend for increased renal cortex diffusion (4.2% increase from baseline) for the crystalloid infusion. All infusions led to significant increases in cardiac index. CONCLUSIONS A smaller volume of colloid (4% succinylated gelatin) was as effective as a larger volume of crystalloid at expanding blood volume, increasing cardiac output and changing renal function. Significantly less interstitial space expansion occurred with the colloid. TRIAL REGISTRATION The protocol was registered with the European Union Drug Regulating Authorities Clinical Trials Database (https://eudract.ema.europa.eu) (EudraCT No. 2013-003260-32).
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Affiliation(s)
- Christopher R Bradley
- Gastrointestinal Surgery, Nottingham Digestive Diseases Centre and National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK; Sir Peter Mansfield Imaging Centre, University Park, University of Nottingham, NG7 2RD, UK
| | - Damian D Bragg
- Gastrointestinal Surgery, Nottingham Digestive Diseases Centre and National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK
| | - Eleanor F Cox
- Gastrointestinal Surgery, Nottingham Digestive Diseases Centre and National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK; Sir Peter Mansfield Imaging Centre, University Park, University of Nottingham, NG7 2RD, UK
| | - Ahmed M El-Sharkawy
- Gastrointestinal Surgery, Nottingham Digestive Diseases Centre and National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK
| | - Charlotte E Buchanan
- Sir Peter Mansfield Imaging Centre, University Park, University of Nottingham, NG7 2RD, UK
| | - Abeed H Chowdhury
- Gastrointestinal Surgery, Nottingham Digestive Diseases Centre and National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK
| | - Ian A Macdonald
- School of Life Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK; MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK
| | - Susan T Francis
- Gastrointestinal Surgery, Nottingham Digestive Diseases Centre and National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK; Sir Peter Mansfield Imaging Centre, University Park, University of Nottingham, NG7 2RD, UK
| | - Dileep N Lobo
- Gastrointestinal Surgery, Nottingham Digestive Diseases Centre and National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK; MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK.
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31
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Bernjak A, Chow E, Robinson EJ, Freeman J, Marques JLB, Macdonald IA, Sheridan PJ, Heller SR. Influence of cardiac autonomic neuropathy on cardiac repolarisation during incremental adrenaline infusion in type 1 diabetes. Diabetologia 2020; 63:1066-1071. [PMID: 32030469 PMCID: PMC7145773 DOI: 10.1007/s00125-020-05106-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 01/13/2020] [Indexed: 11/01/2022]
Abstract
AIMS/HYPOTHESIS We examined the effect of a standardised sympathetic stimulus, incremental adrenaline (epinephrine) infusion on cardiac repolarisation in individuals with type 1 diabetes with normal autonomic function, subclinical autonomic neuropathy and established autonomic neuropathy. METHODS Ten individuals with normal autonomic function and baroreceptor sensitivity tests (NAF), seven with subclinical autonomic neuropathy (SAN; normal standard autonomic function tests and abnormal baroreceptor sensitivity tests); and five with established cardiac autonomic neuropathy (CAN; abnormal standard autonomic function and baroreceptor tests) underwent an incremental adrenaline infusion. Saline (0.9% NaCl) was infused for the first hour followed by 0.01 μg kg-1 min-1 and 0.03 μg kg-1 min-1 adrenaline for the second and third hours, respectively, and 0.06 μg kg-1 min-1 for the final 30 min. High resolution ECG monitoring for QTc duration, ventricular repolarisation parameters (T wave amplitude, T wave area symmetry ratio) and blood sampling for potassium and catecholamines was performed every 30 min. RESULTS Baseline heart rate was 68 (95% CI 60, 76) bpm for the NAF group, 73 (59, 87) bpm for the SAN group and 84 (78, 91) bpm for the CAN group. During adrenaline infusion the heart rate increased differently across the groups (p = 0.01). The maximum increase from baseline (95% CI) in the CAN group was 22 (13, 32) bpm compared with 11 (7, 15) bpm in the NAF and 10 (3, 18) bpm in the SAN groups. Baseline QTc was 382 (95% CI 374, 390) ms in the NAF, 378 (363, 393) ms in the SAN and 392 (367, 417) ms in the CAN groups (p = 0.31). QTc in all groups lengthened comparably with adrenaline infusion. The longest QTc was 444 (422, 463) ms (NAF), 422 (402, 437) ms (SAN) and 470 (402, 519) ms (CAN) (p = 0.09). T wave amplitude and T wave symmetry ratio decreased and the maximum decrease occurred earlier, at lower infused adrenaline concentrations in the CAN group compared with NAF and SAN groups. AUC for the symmetry ratio was different across the groups and was lowest in the CAN group (p = 0.04). Plasma adrenaline rose and potassium fell comparably in all groups. CONCLUSIONS/INTERPRETATION Participants with CAN showed abnormal repolarisation in some measures at lower adrenaline concentrations. This may be due to denervation adrenergic hypersensitivity. Such individuals may be at greater risk of cardiac arrhythmias in response to physiological sympathoadrenal challenges such as stress or hypoglycaemia.
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Affiliation(s)
- Alan Bernjak
- Department of Oncology & Metabolism, University of Sheffield, Medical School, Beech Hill Road, Sheffield, UK
- INSIGNEO Institute for in silico Medicine, University of Sheffield, Sheffield, UK
| | - Elaine Chow
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
- Department of Medicine and Therapeutics, the Chinese University of Hong Kong, Hong Kong, China
| | - Emma J Robinson
- Department of Oncology & Metabolism, University of Sheffield, Medical School, Beech Hill Road, Sheffield, UK
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Jenny Freeman
- Leeds Institute of Life Sciences, University of Leeds, Leeds, UK
| | - Jefferson L B Marques
- Department of Oncology & Metabolism, University of Sheffield, Medical School, Beech Hill Road, Sheffield, UK
- Institute of Biomedical Engineering, Department of Electrical and Electronic Engineering, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Ian A Macdonald
- School of Life Sciences, Queen's Medical Centre, University of Nottingham, Nottingham, UK
| | - Paul J Sheridan
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Simon R Heller
- Department of Oncology & Metabolism, University of Sheffield, Medical School, Beech Hill Road, Sheffield, UK.
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
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32
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Nwokolo M, Amiel SA, O'Daly O, Byrne ML, Wilson BM, Pernet A, Cordon SM, Macdonald IA, Zelaya FO, Choudhary P. Hypoglycemic thalamic activation in type 1 diabetes is associated with preserved symptoms despite reduced epinephrine. J Cereb Blood Flow Metab 2020; 40:787-798. [PMID: 31006309 PMCID: PMC7168783 DOI: 10.1177/0271678x19842680] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Brain responses to low plasma glucose may be key to understanding the behaviors that prevent severe hypoglycemia in type 1 diabetes. This study investigated the impact of long duration, hypoglycemia aware type 1 diabetes on cerebral blood flow responses to hypoglycemia. Three-dimensional pseudo-continuous arterial spin labeling magnetic resonance imaging was performed in 15 individuals with type 1 diabetes and 15 non-diabetic controls during a two-step hyperinsulinemic glucose clamp. Symptom, hormone, global cerebral blood flow and regional cerebral blood flow responses to hypoglycemia were measured. Epinephrine release during hypoglycemia was attenuated in type 1 diabetes, but symptom score rose comparably in both groups. A rise in global cerebral blood flow did not differ between groups. Regional cerebral blood flow increased in the thalamus and fell in the hippocampus and temporal cortex in both groups. Type 1 diabetes demonstrated lesser anterior cingulate cortex activation; however, this difference did not survive correction for multiple comparisons. Thalamic cerebral blood flow change correlated with autonomic symptoms, and anterior cingulate cortex cerebral blood flow change correlated with epinephrine response across groups. The thalamus may thus be involved in symptom responses to hypoglycemia, independent of epinephrine action, while anterior cingulate cortex activation may be linked to counterregulation. Activation of these regions may have a role in hypoglycemia awareness and avoidance of problematic hypoglycemia.
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Affiliation(s)
- Munachiso Nwokolo
- Department of Diabetes, School of Life Course Sciences, King's College London, London, UK.,King's College Hospital, NHS Foundation Trust, London, UK
| | - Stephanie A Amiel
- Department of Diabetes, School of Life Course Sciences, King's College London, London, UK.,King's College Hospital, NHS Foundation Trust, London, UK
| | - Owen O'Daly
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Megan L Byrne
- Department of Diabetes, School of Life Course Sciences, King's College London, London, UK
| | - Bula M Wilson
- Department of Diabetes, School of Life Course Sciences, King's College London, London, UK
| | - Andrew Pernet
- Department of Diabetes, School of Life Course Sciences, King's College London, London, UK
| | - Sally M Cordon
- School of Life Sciences, MRC-ARUK Centre of Excellence in Musculoskeletal Ageing, Nottingham University Medical School, Queen's Medical Centre, Nottingham, UK
| | - Ian A Macdonald
- School of Life Sciences, MRC-ARUK Centre of Excellence in Musculoskeletal Ageing, Nottingham University Medical School, Queen's Medical Centre, Nottingham, UK
| | - Fernando O Zelaya
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Pratik Choudhary
- Department of Diabetes, School of Life Course Sciences, King's College London, London, UK.,King's College Hospital, NHS Foundation Trust, London, UK
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33
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Nwokolo M, Amiel SA, O'Daly O, Byrne ML, Wilson BM, Pernet A, Cordon SM, Macdonald IA, Zelaya FO, Choudhary P. Impaired Awareness of Hypoglycemia Disrupts Blood Flow to Brain Regions Involved in Arousal and Decision Making in Type 1 Diabetes. Diabetes Care 2019; 42:2127-2135. [PMID: 31455689 DOI: 10.2337/dc19-0337] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 08/07/2019] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Impaired awareness of hypoglycemia (IAH) affects one-quarter of adults with type 1 diabetes and significantly increases the risk of severe hypoglycemia. Differences in regional brain responses to hypoglycemia may contribute to the susceptibility of this group to problematic hypoglycemia. This study investigated brain responses to hypoglycemia in hypoglycemia aware (HA) and IAH adults with type 1 diabetes, using three-dimensional pseudo-continuous arterial spin labeling (3D pCASL) functional MRI to measure changes in regional cerebral blood flow (CBF). RESEARCH DESIGN AND METHODS Fifteen HA and 19 IAH individuals underwent 3D pCASL functional MRI during a two-step hyperinsulinemic glucose clamp. Symptom, hormone, global, and regional CBF responses to hypoglycemia (47 mg/dL [2.6 mmol/L]) were measured. RESULTS In response to hypoglycemia, total symptom score did not change in those with IAH (P = 0.25) but rose in HA participants (P < 0.001). Epinephrine, cortisol, and growth hormone responses to hypoglycemia were lower in the IAH group (P < 0.05). Hypoglycemia induced a rise in global CBF (HA P = 0.01, IAH P = 0.04) but was not different between groups (P = 0.99). IAH participants showed reduced regional CBF responses within the thalamus (P = 0.002), right lateral orbitofrontal cortex (OFC) (P = 0.002), and right dorsolateral prefrontal cortex (P = 0.036) and a lesser decrease of CBF in the left hippocampus (P = 0.023) compared with the HA group. Thalamic and right lateral OFC differences survived Bonferroni correction. CONCLUSIONS Responses to hypoglycemia of brain regions involved in arousal, decision making, and reward are altered in IAH. Changes in these pathways may disrupt IAH individuals' ability to recognize hypoglycemia, impairing their capacity to manage hypoglycemia effectively and benefit fully from conventional therapeutic pathways to restore awareness.
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Affiliation(s)
- Munachiso Nwokolo
- Department of Diabetes, School of Life Course Sciences, King's College London, London, U.K. .,King's College Hospital NHS Foundation Trust, London, U.K
| | - Stephanie A Amiel
- Department of Diabetes, School of Life Course Sciences, King's College London, London, U.K.,King's College Hospital NHS Foundation Trust, London, U.K
| | - Owen O'Daly
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, U.K
| | - Megan L Byrne
- Department of Diabetes, School of Life Course Sciences, King's College London, London, U.K
| | - Bula M Wilson
- Department of Diabetes, School of Life Course Sciences, King's College London, London, U.K
| | - Andrew Pernet
- Department of Diabetes, School of Life Course Sciences, King's College London, London, U.K
| | - Sally M Cordon
- School of Life Sciences, MRC Arthritis Research UK Centre of Excellence in Musculoskeletal Ageing, University of Nottingham Medical School, Queen's Medical Centre, Nottingham, U.K
| | - Ian A Macdonald
- School of Life Sciences, MRC Arthritis Research UK Centre of Excellence in Musculoskeletal Ageing, University of Nottingham Medical School, Queen's Medical Centre, Nottingham, U.K
| | - Fernando O Zelaya
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, U.K
| | - Pratik Choudhary
- Department of Diabetes, School of Life Course Sciences, King's College London, London, U.K.,King's College Hospital NHS Foundation Trust, London, U.K
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Flitton M, Rielly N, Warman R, Warden D, Smith AD, Macdonald IA, Knight HM. Interaction of nutrition and genetics via DNMT3L-mediated DNA methylation determines cognitive decline. Neurobiol Aging 2019; 78:64-73. [DOI: 10.1016/j.neurobiolaging.2019.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 01/31/2019] [Accepted: 02/01/2019] [Indexed: 01/29/2023]
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Madjd A, Taylor MA, Delavari A, Malekzadeh R, Macdonald IA, Farshchi HR. Effect of a Long Bout Versus Short Bouts of Walking on Weight Loss During a Weight-Loss Diet: A Randomized Trial. Obesity (Silver Spring) 2019; 27:551-558. [PMID: 30737894 DOI: 10.1002/oby.22416] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 12/06/2018] [Indexed: 11/12/2022]
Abstract
OBJECTIVE This study aimed to evaluate the effect of different daily physical activity (PA) frequencies, while maintaining the same daily volume of PA, on weight loss, carbohydrate metabolism, and lipid metabolism in women with overweight or obesity throughout a 24-week intervention. METHODS During their weight-loss plan, 65 women (BMI = 27-35 kg/m2 ; age = 18-40 years) who had a sedentary lifestyle were randomly allocated to the following groups: diet plus a long bout of moderate physical activity (LBP) (one 50-minute bout of moderate-intensity PA) 6 d/wk or diet plus short bouts of moderate physical activity (SBP) (two 25-minute bouts of moderate-intensity PA) 6 d/wk. Anthropometric and blood measurements were taken at baseline and at 24 weeks. RESULTS Compared with the LBP group, the SBP group had a greater decrease in weight (SBP: -8.08 ± 2.20 kg; LBP: -6.39 ± 2.28 kg; P = 0.019), BMI (SBP: -3.11 ± 0.87 kg/m2 ; LBP: -2.47 ± 0.86 kg/m2 ; P = 0.027), and waist circumference (SBP: -8.78 ± 2.62 cm; LBP: -5.76 ± 2.03 cm; P = 0.026). No significant differences were seen in carbohydrate and lipid metabolism characteristics after 24 weeks. CONCLUSIONS PA undertaken in two shorter bouts per day could be more effective for weight loss than PA undertaken in a daily long bout in adult women in a 24-week weight-loss program.
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Affiliation(s)
- Ameneh Madjd
- Medical Research Council/Arthritis Research UK Centre for Musculoskeletal Ageing Research, National Institute for Health Research Nottingham Biomedical Research Centre, School of Life Sciences, Nottingham Medical School, Nottingham, UK
- NovinDiet Clinic, Tehran, Iran
| | - Moira A Taylor
- Medical Research Council/Arthritis Research UK Centre for Musculoskeletal Ageing Research, National Institute for Health Research Nottingham Biomedical Research Centre, School of Life Sciences, Nottingham Medical School, Nottingham, UK
| | - Alireza Delavari
- Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Malekzadeh
- Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ian A Macdonald
- Medical Research Council/Arthritis Research UK Centre for Musculoskeletal Ageing Research, National Institute for Health Research Nottingham Biomedical Research Centre, School of Life Sciences, Nottingham Medical School, Nottingham, UK
| | - Hamid R Farshchi
- Medical Research Council/Arthritis Research UK Centre for Musculoskeletal Ageing Research, National Institute for Health Research Nottingham Biomedical Research Centre, School of Life Sciences, Nottingham Medical School, Nottingham, UK
- NovinDiet Clinic, Tehran, Iran
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36
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Iqbal A, Prince LR, Novodvorsky P, Bernjak A, Thomas MR, Birch L, Lambert D, Kay LJ, Wright FJ, Macdonald IA, Jacques RM, Storey RF, McCrimmon RJ, Francis S, Heller SR, Sabroe I. Effect of Hypoglycemia on Inflammatory Responses and the Response to Low-Dose Endotoxemia in Humans. J Clin Endocrinol Metab 2019; 104:1187-1199. [PMID: 30252067 PMCID: PMC6391720 DOI: 10.1210/jc.2018-01168] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 09/19/2018] [Indexed: 12/20/2022]
Abstract
CONTEXT Hypoglycemia is emerging as a risk for cardiovascular events in diabetes. We hypothesized that hypoglycemia activates the innate immune system, which is known to increase cardiovascular risk. OBJECTIVE To determine whether hypoglycemia modifies subsequent innate immune system responses. DESIGN AND SETTING Single-blinded, prospective study of three independent parallel groups. PARTICIPANTS AND INTERVENTIONS Twenty-four healthy participants underwent either a hyperinsulinemic-hypoglycemic (2.5 mmol/L), euglycemic (6.0 mmol/L), or sham-saline clamp (n = 8 for each group). After 48 hours, all participants received low-dose (0.3 ng/kg) intravenous endotoxin. MAIN OUTCOME MEASURES We studied in-vivo monocyte mobilization and monocyte-platelet interactions. RESULTS Hypoglycemia increased total leukocytes (9.98 ± 1.14 × 109/L vs euglycemia 4.38 ± 0.53 × 109/L, P < 0.001; vs sham-saline 4.76 ± 0.36 × 109/L, P < 0.001) (mean ± SEM), mobilized proinflammatory intermediate monocytes (42.20 ± 7.52/μL vs euglycemia 20.66 ± 3.43/μL, P < 0.01; vs sham-saline 26.20 ± 3.86/μL, P < 0.05), and nonclassic monocytes (36.16 ± 4.66/μL vs euglycemia 12.72 ± 2.42/μL, P < 0.001; vs sham-saline 19.05 ± 3.81/μL, P < 0.001). Following hypoglycemia vs euglycemia, platelet aggregation to agonist (area under the curve) increased (73.87 ± 7.30 vs 52.50 ± 4.04, P < 0.05) and formation of monocyte-platelet aggregates increased (96.05 ± 14.51/μL vs 49.32 ± 6.41/μL, P < 0.05). Within monocyte subsets, hypoglycemia increased aggregation of intermediate monocytes (10.51 ± 1.42/μL vs euglycemia 4.19 ± 1.08/μL, P < 0.05; vs sham-saline 3.81± 1.42/μL, P < 0.05) and nonclassic monocytes (9.53 ± 1.08/μL vs euglycemia 2.86 ± 0.72/μL, P < 0.01; vs sham-saline 3.08 ± 1.01/μL, P < 0.05), with platelets compared with controls. Hypoglycemia led to greater leukocyte mobilization in response to subsequent low-dose endotoxin challenge (10.96 ± 0.97 vs euglycemia 8.21 ± 0.85 × 109/L, P < 0.05). CONCLUSIONS Hypoglycemia mobilizes monocytes, increases platelet reactivity, promotes interaction between platelets and proinflammatory monocytes, and potentiates the subsequent immune response to endotoxin. These changes may contribute to increased cardiovascular risk observed in people with diabetes.
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Affiliation(s)
- Ahmed Iqbal
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - Lynne R Prince
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Peter Novodvorsky
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom
| | - Alan Bernjak
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom
- INSIGNEO Institute for In Silico Medicine, University of Sheffield, Sheffield, United Kingdom
| | - Mark R Thomas
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Lewis Birch
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Danielle Lambert
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Linda J Kay
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Fiona J Wright
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Ian A Macdonald
- MRC/ARUK Centre for Musculoskeletal Ageing Research, National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham, United Kingdom
- Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, University Nottingham, Nottingham, United Kingdom
| | - Richard M Jacques
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Robert F Storey
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - Rory J McCrimmon
- Division of Molecular and Clinical Medicine, University of Dundee, Dundee, United Kingdom
| | - Sheila Francis
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Simon R Heller
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom
- Correspondence and Reprint Requests: Simon R. Heller, DM, Department of Oncology and Metabolism, University of Sheffield, Medical School, Beech Hill Road, Sheffield S10 2RX, United Kingdom. E-mail:
| | - Ian Sabroe
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
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Rollins KE, Awwad A, Macdonald IA, Lobo DN. A comparison of two different software packages for analysis of body composition using computed tomography images. Nutrition 2019; 57:92-96. [PMID: 30153585 PMCID: PMC6269124 DOI: 10.1016/j.nut.2018.06.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 05/16/2018] [Accepted: 06/19/2018] [Indexed: 12/19/2022]
Abstract
OBJECTIVES The analysis of body composition from computed tomography (CT) imaging has become widespread. However, the methodology used is far from established. Two main software packages are commonly used for body composition analysis, with results used interchangeably. However, the equivalence of these has not been well established. The aim of this study was to compare the results of body composition analysis performed using the two software packages to assess their equivalence. METHODS Triphasic abdominal CT scans from 50 patients were analyzed for a range of body composition measures at the third lumbar vertebral level using OsiriX (v7.5.1, Pixmeo, Switzerland) and SliceOmatic (v5.0, TomoVision, Montreal, Canada) software packages. Measures analyzed were skeletal muscle index (SMI), fat mass (FM), fat-free mass (FFM), and mean skeletal muscle Hounsfield Units (SMHU). RESULTS The overall mean SMI calculated using the two software packages was significantly different (SliceOmatic 51.33 versus OsiriX 53.77, P < 0.0001), and this difference remained significant for non-contrast and arterial scans. When FM and FFM were considered, again the results were significantly different (SliceOmatic 33.7 versus OsiriX 33.1 kg, P < 0.0001; SliceOmatic 52.1 versus OsiriX 54.2 kg, P < 0.0001, respectively), and this difference remained for all phases of CT. Finally, when analyzed, mean SMHU was also significantly different (SliceOmatic 32.7 versus OsiriX 33.1 HU, P = 0.046). CONCLUSIONS All four body composition measures were statistically significantly different by the software package used for analysis; however, the clinical significance of these differences is doubtful. Nevertheless, the same software package should be used if serial measurements are being performed.
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Affiliation(s)
- Katie E Rollins
- Gastrointestinal Surgery, Nottingham Digestive Diseases Centre, National Institute for Health (NIHR) Research Nottingham Biomedical Research Centre, Nottingham University Hospitals and University of Nottingham, Queen's Medical Centre, Nottingham United Kingdom
| | - Amir Awwad
- Sir Peter Mansfield Imaging Centre (SPMIC), University of Nottingham, University Park, Nottingham, United Kingdom
| | - Ian A Macdonald
- School of Life Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, United Kingdom; MRC/ARUK Centre for Musculoskeletal Ageing Research, School of Life Sciences, University of Nottingham, Queen's Medical Centre, Nottingham United Kingdom
| | - Dileep N Lobo
- Gastrointestinal Surgery, Nottingham Digestive Diseases Centre, National Institute for Health (NIHR) Research Nottingham Biomedical Research Centre, Nottingham University Hospitals and University of Nottingham, Queen's Medical Centre, Nottingham United Kingdom; MRC/ARUK Centre for Musculoskeletal Ageing Research, School of Life Sciences, University of Nottingham, Queen's Medical Centre, Nottingham United Kingdom.
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Buyken AE, Mela DJ, Dussort P, Johnson IT, Macdonald IA, Stowell JD, Brouns FJPH. Dietary carbohydrates: a review of international recommendations and the methods used to derive them. Eur J Clin Nutr 2018; 72:1625-1643. [PMID: 29572552 PMCID: PMC6281563 DOI: 10.1038/s41430-017-0035-4] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 09/18/2017] [Accepted: 10/05/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND/OBJECTIVES Renewed dietary recommendations for carbohydrates have recently been published by various international health authorities. The present work (1) reviews the methods and processes (systematic approach/review, inclusion of public consultation) used to identify, select and grade the evidence underpinning the recommendations, particularly for total carbohydrate (CHO), fibre and sugar consumption, and (2) examines the extent to which variation in the methods and processes applied relates to any differences in the final recommendations. SUBJECTS/METHODS A search of WHO, US, Canada, Australia and European sources identified 19 documents from 13 authorities with the desired detailed information. Processes and methods applied to derive recommendations were compiled and compared. RESULTS (1) A relatively high total CHO and fibre intake and limited intake of (added or free) sugars are generally recommended. (2) Even where recommendations are similar, the specific justifications for quantitative/qualitative recommendations differ across authorities. (3) Differences in recommendations mainly arise from differences in the underlying definitions of CHO exposure and classifications, the degree to which specific CHO-providing foods and food components were considered, and the choice and number of health outcomes selected. (4) Differences in the selection of source material, time frames or data aggregation and grading methods appeared to have minor influence. CONCLUSIONS Despite general consistency, apparent differences among the recommendations of different authorities would likely be minimized by: (1) More explicit quantitative justifications for numerical recommendations and communication of uncertainty, and (2) greater international harmonization, particularly in the underlying definitions of exposures and range of relevant nutrition-related outcomes.
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Affiliation(s)
- A E Buyken
- Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, University Paderborn, Paderborn, Germany
- DONALD Study Dortmund, Department of Nutritional Epidemiology, University of Bonn, Bonn, Germany
| | - D J Mela
- Unilever R&D Vlaardingen, Vlaardingen, The Netherlands
| | - P Dussort
- International Life Sciences Institute-ILSI Europe a.i.s.b.l., Avenue E. Mounier 83, Box 6, Brussels, Belgium.
| | - I T Johnson
- Quadram Institute Bioscience, Norwich Research Park, Norfolk, NR4 7UA, UK
| | - I A Macdonald
- School of Life Sciences, Queen's Medical Centre, University of Nottingham, Nottingham, UK
| | - J D Stowell
- DuPont Nutrition & Health, Danisco Ltd, Reigate, UK
| | - F J P H Brouns
- Faculty of Health, Medicine and Life Sciences, Department of Human Biology, Maastricht University, Maastricht, The Netherlands
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Chow E, Iqbal A, Walkinshaw E, Phoenix F, Macdonald IA, Storey RF, Ajjan R, Heller SR. Prolonged Prothrombotic Effects of Antecedent Hypoglycemia in Individuals With Type 2 Diabetes. Diabetes Care 2018; 41:2625-2633. [PMID: 30327358 DOI: 10.2337/dc18-0050] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 09/17/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Hypoglycemia has been linked to persistent increases in cardiovascular (CV) mortality in type 2 diabetes after the event. Our aim was to examine acute and downstream effects of hypoglycemia on markers of thrombosis risk and inflammation in type 2 diabetes. RESEARCH DESIGN AND METHODS Twelve individuals with type 2 diabetes with no history of CV disease and 11 age- and BMI-matched volunteers without diabetes underwent paired hyperinsulinemic-euglycemic (glucose 6 mmol/L for two 60-min periods) and hypoglycemic (glucose 2.5 mmol/L for two 60-min periods) clamps on separate occasions on day 0. Fibrin clot properties, platelet reactivity, and inflammatory markers were measured at baseline, end of and after recovery from the initial clamp, day 1, and day 7 using validated assays and electron microscopy. RESULTS Euglycemic hyperinsulinemia reduced platelet reactivity, decreased fibrin clot density, and improved fibrinolytic efficiency in both groups. Platelet reactivity and aggregation increased during acute hypoglycemia in both groups, resolving at recovery. In type 2 diabetes, clot lysis times and clot maximum absorbance increased up to day 7 (P = 0.002 and 0.001 vs. euglycemia, respectively), but clots from control subjects without diabetes showed limited changes. Fibrin network density increased Δ 1.15 ± 0.28 fibers/μm2 at day 7 after the hypoglycemic clamp (P < 0.01 for glycemic arm), whereas fibrinogen and complement C3 increased after hypoglycemia up to day 7 in type 2 diabetes only. CONCLUSIONS Antecedent hypoglycemia has acute and persistent prothrombotic effects, lasting at least 7 days, that were enhanced in individuals with type 2 diabetes. These findings identify mechanisms by which hypoglycemia might increase short- and medium-term risk of CV mortality.
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Affiliation(s)
- Elaine Chow
- Department of Infection Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, U.K.,Department of Oncology and Metabolism, University of Sheffield, Sheffield, U.K
| | - Ahmed Iqbal
- Department of Infection Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, U.K.,Department of Oncology and Metabolism, University of Sheffield, Sheffield, U.K
| | - Emma Walkinshaw
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, U.K.,Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, U.K
| | - Fladia Phoenix
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, U.K
| | - Ian A Macdonald
- School of Life Sciences, University of Nottingham, Nottingham, U.K
| | - Robert F Storey
- Department of Infection Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, U.K.,Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, U.K
| | - Ramzi Ajjan
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, U.K
| | - Simon R Heller
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, U.K. .,Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, U.K
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Huttunen-Lenz M, Hansen S, Christensen P, Meinert Larsen T, Sandø-Pedersen F, Drummen M, Adam TC, Macdonald IA, Taylor MA, Martinez JA, Navas-Carretero S, Handjiev S, Poppitt SD, Silvestre MP, Fogelholm M, Pietiläinen KH, Brand-Miller J, Berendsen AA, Raben A, Schlicht W. PREVIEW study-influence of a behavior modification intervention (PREMIT) in over 2300 people with pre-diabetes: intention, self-efficacy and outcome expectancies during the early phase of a lifestyle intervention. Psychol Res Behav Manag 2018; 11:383-394. [PMID: 30254498 PMCID: PMC6143124 DOI: 10.2147/prbm.s160355] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
PURPOSE Onset of type 2 diabetes (T2D) is often gradual and preceded by impaired glucose homeostasis. Lifestyle interventions including weight loss and physical activity may reduce the risk of developing T2D, but adherence to a lifestyle change is challenging. As part of an international T2D prevention trial (PREVIEW), a behavior change intervention supported participants in achieving a healthier diet and physically active lifestyle. Here, our aim was to explore the influence of this behavioral program (PREMIT) on social-cognitive variables during an 8-week weight loss phase. METHODS PREVIEW consisted of an initial weight loss, Phase I, followed by a weight- maintenance, Phase II, for those achieving the 8-week weight loss target of ≥ 8% from initial bodyweight. Overweight and obese (BMI ≥25 kg/m2) individuals aged 25 to 70 years with confirmed pre-diabetes were enrolled. Uni- and multivariate statistical methods were deployed to explore differences in intentions, self-efficacy, and outcome expectancies between those who achieved the target weight loss ("achievers") and those who did not ("non-achievers"). RESULTS At the beginning of Phase I, no significant differences in intentions, self-efficacy and outcome expectancies between "achievers" (1,857) and "non-achievers" (163) were found. "Non-achievers" tended to be younger, live with child/ren, and attended the PREMIT sessions less frequently. At the end of Phase I, "achievers" reported higher intentions (healthy eating χ2(1)=2.57; P <0.008, exercising χ2(1)=0.66; P <0.008), self-efficacy (F(2; 1970)=10.27, P <0.005), and were more positive about the expected outcomes (F(4; 1968)=11.22, P <0.005). CONCLUSION Although statistically significant, effect sizes observed between the two groups were small. Behavior change, however, is multi-determined. Over a period of time, even small differences may make a cumulative effect. Being successful in behavior change requires that the "new" behavior is implemented time after time until it becomes a habit. Therefore, having even slightly higher self-efficacy, positive outcome expectancies and intentions may over time result in considerably improved chances to achieve long-term lifestyle changes.
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Affiliation(s)
- Maija Huttunen-Lenz
- Department of Exercise and Health Sciences, University of Stuttgart, Stuttgart, Germany,
| | - Sylvia Hansen
- Department of Exercise and Health Sciences, University of Stuttgart, Stuttgart, Germany,
| | - Pia Christensen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Meinert Larsen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Finn Sandø-Pedersen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Mathijs Drummen
- Department of Nutrition and Movement Sciences, Maastricht University, Maastricht, the Netherlands
| | - Tanja C Adam
- Department of Nutrition and Movement Sciences, Maastricht University, Maastricht, the Netherlands
| | - Ian A Macdonald
- MRC/ARUK Centre for Musculoskeletal Ageing Research, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, School of Life Sciences, University of Nottingham, Nottingham, UK
- School of Life Sciences, University of Nottingham Medical School, Nottingham, UK
| | - Moira A Taylor
- School of Life Sciences, University of Nottingham Medical School, Nottingham, UK
| | - J Alfredo Martinez
- Center for Nutrition Research at the University of Navarra, Pamplona, Spain
- Madrid Institute of Advanced Studies (IMDEA Food), Madrid, Spain
- Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Carlos III Institute, Madrid, Spain
| | - Santiago Navas-Carretero
- Center for Nutrition Research at the University of Navarra, Pamplona, Spain
- Madrid Institute of Advanced Studies (IMDEA Food), Madrid, Spain
- Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Carlos III Institute, Madrid, Spain
| | - Svetoslav Handjiev
- Department of Pharmacology and Toxicology, Medical University - Sofia, Sofia, Bulgaria
| | - Sally D Poppitt
- Human Nutrition Unit, School of Biological Sciences, University of Auckland, Auckland, New Zealand
| | - Marta P Silvestre
- Human Nutrition Unit, School of Biological Sciences, University of Auckland, Auckland, New Zealand
| | - Mikael Fogelholm
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Kirsi H Pietiläinen
- Obesity Research Unit, Research Program Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland
- Abdominal Center, Endocrinology, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland
| | - Jennie Brand-Miller
- Charles Perkins Centre and School of Life and Environmental Biosciences, University of Sydney, Camperdown, NSW, Australia
| | - Agnes Am Berendsen
- Division of Human Nutrition & Health, Wageningen University & Research, Wageningen, the Netherlands
| | - Anne Raben
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Wolfgang Schlicht
- Department of Exercise and Health Sciences, University of Stuttgart, Stuttgart, Germany,
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Chakera AJ, Hurst PS, Spyer G, Ogunnowo-Bada EO, Marsh WJ, Riches CH, Yueh CY, Markkula SP, Dalley JW, Cox RD, Macdonald IA, Amiel SA, MacLeod KM, Heisler LK, Hattersley AT, Evans ML. Molecular reductions in glucokinase activity increase counter-regulatory responses to hypoglycemia in mice and humans with diabetes. Mol Metab 2018; 17:17-27. [PMID: 30146176 PMCID: PMC6197723 DOI: 10.1016/j.molmet.2018.08.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 08/02/2018] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE Appropriate glucose levels are essential for survival; thus, the detection and correction of low blood glucose is of paramount importance. Hypoglycemia prompts an integrated response involving reduction in insulin release and secretion of key counter-regulatory hormones glucagon and epinephrine that together promote endogenous glucose production to restore normoglycemia. However, specifically how this response is orchestrated remains to be fully clarified. The low affinity hexokinase glucokinase is found in glucose-sensing cells involved in glucose homeostasis including pancreatic β-cells and in certain brain areas. Here, we aimed to examine the role of glucokinase in triggering counter-regulatory hormonal responses to hypoglycemia, hypothesizing that reduced glucokinase activity would lead to increased and/or earlier triggering of responses. METHODS Hyperinsulinemic glucose clamps were performed to examine counter-regulatory responses to controlled hypoglycemic challenges created in humans with monogenic diabetes resulting from heterozygous glucokinase mutations (GCK-MODY). To examine the relative importance of glucokinase in different sensing areas, we then examined responses to clamped hypoglycemia in mice with molecularly defined disruption of whole body and/or brain glucokinase. RESULTS GCK-MODY patients displayed increased and earlier glucagon responses during hypoglycemia compared with a group of glycemia-matched patients with type 2 diabetes. Consistent with this, glucagon responses to hypoglycemia were also increased in I366F mice with mutated glucokinase and in streptozotocin-treated β-cell ablated diabetic I366F mice. Glucagon responses were normal in conditional brain glucokinase-knockout mice, suggesting that glucagon release during hypoglycemia is controlled by glucokinase-mediated glucose sensing outside the brain but not in β-cells. For epinephrine, we found increased responses in GCK-MODY patients, in β-cell ablated diabetic I366F mice and in conditional (nestin lineage) brain glucokinase-knockout mice, supporting a role for brain glucokinase in triggering epinephrine release. CONCLUSIONS Our data suggest that glucokinase in brain and other non β-cell peripheral hypoglycemia sensors is important in glucose homeostasis, allowing the body to detect and respond to a falling blood glucose.
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Affiliation(s)
- Ali J Chakera
- Institute of Clinical and Biomedical Sciences, University of Exeter, United Kingdom
| | - Paul S Hurst
- Wellcome Trust/ MRC Institute of Metabolic Science and Department of Medicine, University of Cambridge, United Kingdom
| | - Gill Spyer
- Institute of Clinical and Biomedical Sciences, University of Exeter, United Kingdom
| | - Emmanuel O Ogunnowo-Bada
- Wellcome Trust/ MRC Institute of Metabolic Science and Department of Medicine, University of Cambridge, United Kingdom
| | - William J Marsh
- Wellcome Trust/ MRC Institute of Metabolic Science and Department of Medicine, University of Cambridge, United Kingdom
| | - Christine H Riches
- Wellcome Trust/ MRC Institute of Metabolic Science and Department of Medicine, University of Cambridge, United Kingdom
| | - Chen-Yu Yueh
- Wellcome Trust/ MRC Institute of Metabolic Science and Department of Medicine, University of Cambridge, United Kingdom
| | - S Pauliina Markkula
- Wellcome Trust/ MRC Institute of Metabolic Science and Department of Medicine, University of Cambridge, United Kingdom
| | - Jeffrey W Dalley
- Behavioural and Clinical Neuroscience Institute and Departments of Psychology and Psychiatry, University of Cambridge, United Kingdom
| | - Roger D Cox
- MRC Harwell Institute, Mammalian Genetics Unit, Harwell Oxford, United Kingdom
| | - Ian A Macdonald
- MRC-ARUK Centre for Musculoskeletal Ageing and NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust/ University of Nottingham, Nottingham, United Kingdom
| | - Stephanie A Amiel
- Division of Diabetes and Nutritional Sciences, King's College London, United Kingdom
| | - Kenneth M MacLeod
- Institute of Clinical and Biomedical Sciences, University of Exeter, United Kingdom
| | - Lora K Heisler
- Rowett Institute, University of Aberdeen, United Kingdom
| | - Andrew T Hattersley
- Institute of Clinical and Biomedical Sciences, University of Exeter, United Kingdom.
| | - Mark L Evans
- Wellcome Trust/ MRC Institute of Metabolic Science and Department of Medicine, University of Cambridge, United Kingdom.
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Atkinson RL, Macdonald IA. Editors' note: Omitting obesity treatment leads to poor outcomes, even in those who appear to be metabolically healthy. Int J Obes (Lond) 2018; 42:285. [PMID: 29595196 DOI: 10.1038/ijo.2017.311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- R L Atkinson
- Virginia Commonwealth University, Richmond, VA, USA
| | - I A Macdonald
- School of Life Sciences, Queen's Medical Centre, University of Nottingham, Nottingham NG7 2UH, UK
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Tewari N, Awad S, Macdonald IA, Lobo DN. A comparison of three methods to assess body composition. Nutrition 2018; 47:1-5. [PMID: 29429527 DOI: 10.1016/j.nut.2017.09.005] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 07/24/2017] [Accepted: 09/17/2017] [Indexed: 01/23/2023]
Abstract
OBJECTIVE The aim of this study was to compare the accuracy of measurements of body composition made using dual x-ray absorptiometry (DXA), analysis of computed tomography (CT) scans at the L3 vertebral level, and bioelectrical impedance analysis (BIA). METHODS DXA, CT, and BIA were performed in 47 patients recruited from two clinical trials investigating metabolic changes associated with major abdominal surgery or neoadjuvant chemotherapy for esophagogastric cancer. DXA was performed the week before surgery and before and after commencement of neoadjuvant chemotherapy. BIA was performed at the same time points and used with standard equations to calculate fat-free mass (FFM). Analysis of CT scans performed within 3 mo of the study was used to estimate FFM and fat mass (FM). RESULTS There was good correlation between FM on DXA and CT (r2 = 0.6632; P < 0.0001) and FFM on DXA and CT (r2 = 0.7634; P < 0.0001), as well as FFM on DXA and BIA (r2 = 0.6275; P < 0.0001). Correlation between FFM on CT and BIA also was significant (r2 = 0.2742; P < 0.0001). On Bland-Altman analysis, average bias for FM on DXA and CT was 0.2564 with 95% limits of agreement (LOA) of -9.451 to 9.964. For FFM on DXA and CT, average bias was -0.1477, with LOA of -8.621 to 8.325. For FFM on DXA and BIA, average bias was -3.792, with LOA of -15.52 to 7.936. For FFM on CT and BIA, average bias was -2.661, with LOA of -22.71 to 17.39. CONCLUSION Although a systematic error underestimating FFM was demonstrated with BIA, it may be a useful modality to quantify body composition in the clinical situation.
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Affiliation(s)
- Nilanjana Tewari
- Gastrointestinal Surgery, Nottingham Digestive Diseases Centre, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals and University of Nottingham, Queen's Medical Centre, Nottingham, United Kingdom
| | - Sherif Awad
- The East-Midlands Bariatric & Metabolic Institute, Royal Derby Hospital, Derby Hospitals NHS Foundation Trust, Derby, United Kingdom
| | - Ian A Macdonald
- Metabolic Physiology Group, School of Life Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Dileep N Lobo
- Gastrointestinal Surgery, Nottingham Digestive Diseases Centre, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals and University of Nottingham, Queen's Medical Centre, Nottingham, United Kingdom.
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Tewari N, Awad S, Duška F, Williams JP, Bennett A, Macdonald IA, Lobo DN. Postoperative inflammation and insulin resistance in relation to body composition, adiposity and carbohydrate treatment: A randomised controlled study. Clin Nutr 2018; 38:204-212. [PMID: 29454501 PMCID: PMC6380471 DOI: 10.1016/j.clnu.2018.01.032] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 01/25/2018] [Indexed: 12/17/2022]
Abstract
Background & aims The aims of this study were to identify whether differences in distribution of adipose tissue and skeletal muscle in obese and non-obese individuals contribute to the magnitude of the postoperative inflammatory response and insulin resistance, with and without preoperative treatment with carbohydrate drinks. Methods Thirty-two adults (16 obese/16 non-obese) undergoing elective major open abdominal surgery participated in this 2 × 2 factorial, randomised, double-blind, placebo-controlled study. Participants received Nutricia preOp® or placebo (800 ml on the night before surgery/400 ml 2–3 h preoperatively) after stratifying for obesity. Insulin sensitivity was measured using the hyperinsulinaemic-euglycaemic clamp preoperatively and on the 1st postoperative day. Vastus lateralis, omental and subcutaneous fat biopsies were taken pre- and postoperatively and analysed after RNA extraction. The primary endpoint was within subject differences in insulin sensitivity. Results Major abdominal surgery was associated with a 42% reduction in insulin sensitivity from mean(SD) M value of 37.3(11.8) μmol kg−1 fat free mass (FFM) to 21.7(7.4) μmol kg−1 FFM, but this was not influenced by obesity or preoperative carbohydrate treatment. Activation of the triggering receptor expressed on myeloid cells (TREM1) pathway was seen in response to surgery in omental fat samples. In postoperative muscle samples, gene expression differences indicated activation of the peroxisome proliferator-activated receptor (PPAR-α)/retinoid X-receptor (RXR-α) pathway in obese but not in non-obese participants. There were no significant changes in gene expression pathways associated with carbohydrate treatment. Conclusion The reduction in insulin sensitivity associated with major abdominal surgery was confirmed but there were no differences associated with preoperative carbohydrates or obesity.
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Affiliation(s)
- Nilanjana Tewari
- Gastrointestinal Surgery, Nottingham Digestive Diseases Centre, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical Centre, Nottingham NG7 2UH, UK
| | - Sherif Awad
- Gastrointestinal Surgery, Nottingham Digestive Diseases Centre, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical Centre, Nottingham NG7 2UH, UK; The East-Midlands Bariatric and Metabolic Institute (EMBMI), Derby Teaching Hospitals NHS Foundation Trust, Royal Derby Hospital, Derby DE22 3NE, UK
| | - František Duška
- Department of Anaesthesia and Intensive Care, Kralovske Vinohrady University Hospital and The Third Faculty of Medicine, Prague, Czech Republic; Department of Critical Care, Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham NG7 2UH, UK
| | - Julian P Williams
- Gastrointestinal Surgery, Nottingham Digestive Diseases Centre, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical Centre, Nottingham NG7 2UH, UK
| | - Andrew Bennett
- FRAME Laboratory, School of Life Sciences, University of Nottingham, Queen's Medical Centre, Nottingham NG7 2UH, UK; School of Life Sciences, University of Nottingham, Queen's Medical Centre, Nottingham NG7 2UH, UK
| | - Ian A Macdonald
- School of Life Sciences, University of Nottingham, Queen's Medical Centre, Nottingham NG7 2UH, UK; MRC/ARUK Centre for Musculoskeletal Ageing Research, University of Nottingham, Queen's Medical Centre, Nottingham NG7 2UH, UK
| | - Dileep N Lobo
- Gastrointestinal Surgery, Nottingham Digestive Diseases Centre, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical Centre, Nottingham NG7 2UH, UK; MRC/ARUK Centre for Musculoskeletal Ageing Research, University of Nottingham, Queen's Medical Centre, Nottingham NG7 2UH, UK.
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Alyami J, Ladd N, Pritchard SE, Hoad CL, Sultan AA, Spiller RC, Gowland PA, Macdonald IA, Aithal GP, Marciani L, Taylor MA. Glycaemic, gastrointestinal and appetite responses to breakfast porridges from ancient cereal grains: A MRI pilot study in healthy humans. Food Res Int 2017; 118:49-57. [PMID: 30898352 DOI: 10.1016/j.foodres.2017.11.071] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 11/06/2017] [Accepted: 11/27/2017] [Indexed: 12/19/2022]
Abstract
Cereal grain based porridges are commonly consumed throughout the world. Whilst some data are available for varieties that are popular in the Western world such as oats and rye, other 'ancient' grains used in the East and in Africa such as millets are thought to have beneficial health effects, such as a suppression of post prandial hunger and circulating glucose levels. These grains, a sustainable food source due to their tolerance of extreme weather and growing conditions, are commonly found throughout Asia and Africa. However, knowledge of the physiological responses to these grain varieties is very limited. This study aimed to collect initial pilot data on the physiological and gastrointestinal responses to breakfast porridges made with two millet varieties and oats and rye grains. A total of n=15 completed the oats and rye, n=9 the finger millet n=12 the pearl millet meals. MRI scans were undertaken at baseline, immediately after consumption and then hourly postprandially. Blood glucose was measured at baseline, immediately after consumption and then every 15min until t=80min, then every 20min until t=120min, followed on each occasion by completion of VAS. Seven participants completed the entire protocol and were included in the final analysis. A subgroup analysis with the n=10 paired comparison between the same individuals that completed the oats, rye and pearl millet was also considered. The gastric volume AUC was higher for pearl millet than oats and rye (n=10, p<0.001). The incremental area under the curve (iAUC) for blood glucose was not significantly different between the meals although this showed a trend to be lower for pearl millet. Hunger was lower for pearl millet compared to oats and rye (n=10, p=0.01). There was a significant correlation between total gastric volume AUC and average appetite AUC r=-0.47, p<0.010. Isoenergetic breakfast porridges from 'ancient' varieties of millet grains showed physiological responses that were comparable with those from common Western varieties known to have beneficial health effects. Pearl millet appeared to induce lower postprandial blood glucose response and appetite scores though the differences were not conclusive compared with the other porridges and further work is needed. Improved knowledge of the effects of different cereal grains could help direct dietary advice and ultimately improve health outcomes in the general population worldwide.
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Affiliation(s)
- Jaber Alyami
- Deaprtment of Diagnostic Radiology, Faculty of Applied Medical Science, King Abdulaziz University(KAU), Jeddah, Saudi Arabia; Nottingham Digestive Diseases Centre and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, UK; Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, UK
| | - Nidhi Ladd
- Nottingham Digestive Diseases Centre and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, UK
| | - Susan E Pritchard
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, UK
| | - Caroline L Hoad
- Nottingham Digestive Diseases Centre and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, UK; Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, UK
| | - Alyshah Abdul Sultan
- Nottingham Digestive Diseases Centre and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, UK
| | - Robin C Spiller
- Nottingham Digestive Diseases Centre and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, UK
| | - Penny A Gowland
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, UK
| | - Ian A Macdonald
- School of Life Sciences, University of Nottingham, Nottingham, UK
| | - Guruprasad P Aithal
- Nottingham Digestive Diseases Centre and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, UK
| | - Luca Marciani
- Nottingham Digestive Diseases Centre and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, UK
| | - Moira A Taylor
- Nottingham Digestive Diseases Centre and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, UK; School of Life Sciences, University of Nottingham, Nottingham, UK.
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Flitton M, Macdonald IA, Knight HM. Vitamin intake is associated with improved visuospatial and verbal semantic memory in middle-aged individuals. Nutr Neurosci 2017; 22:401-408. [PMID: 29098943 DOI: 10.1080/1028415x.2017.1395550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Factors maintaining cognitive health are still largely unknown. In particular, the cognitive benefits associated with vitamin intake and vitamin supplementation are disputed. We investigated self-reported vitamin intake and serum vitamin levels with performance in cognitive factors sensitive to dementia progression in two large middle-aged general population cohorts. METHODS Survey data were used to assess regular vitamin intake in 4400 NCDS 1958 and 1177 TwinsUK cohort members, and serum homocysteine and B vitamin levels were measured in 675 individuals from the TwinsUK study. Principal component analysis was applied to cognitive test performance from both cohorts resulting in two dementia-sensitive cognitive factors reflecting visuospatial associative memory and verbal semantic memory. RESULTS In both cohorts, individuals who reported regular intake of vitamins, particularly B vitamins, showed significantly better performance in visuospatial associative memory and verbal semantic memory (P < 0.001). A significant association was also found between homocysteine levels, vitamin serum concentration and visuospatial associative memory performance which indicated that individuals with high B vitamin and homocysteine levels showed better visuospatial associative memory performance than individuals with low vitamin B levels (P < 0.05). DISCUSSION The findings demonstrate that early dementia-sensitive cognitive changes can be identified in middle-aged asymptomatic individuals and that regular vitamin intake is associated with improved cognitive performance. These findings reinforce the potential cognitive benefits of regular vitamin intake, which should be considered as an economically viable therapeutic strategy for maintaining cognitive health.
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Affiliation(s)
- Miles Flitton
- a School of Life Sciences , University of Nottingham , Nottingham NG7 2UH , UK
| | - Ian A Macdonald
- a School of Life Sciences , University of Nottingham , Nottingham NG7 2UH , UK
| | - Helen M Knight
- a School of Life Sciences , University of Nottingham , Nottingham NG7 2UH , UK
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Affiliation(s)
- R L Atkinson
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - I A Macdonald
- School of Life Sciences, University of Nottingham, Nottingham, UK
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Baldry EL, Aithal GP, Kaye P, Idris IR, Bennett A, Leeder PC, Macdonald IA. Effects of short-term energy restriction on liver lipid content and inflammatory status in severely obese adults: Results of a randomized controlled trial using 2 dietary approaches. Diabetes Obes Metab 2017; 19:1179-1183. [PMID: 28230324 DOI: 10.1111/dom.12918] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 02/15/2017] [Accepted: 02/20/2017] [Indexed: 02/02/2023]
Abstract
Short-term very-low-energy diets (VLEDs) are used in clinical practice prior to bariatric surgery, but regimens vary and outcomes of a short intervention are unclear. We examined the effect of 2 VLEDs, a food-based diet (FD) and a meal-replacement plan (MRP; LighterLife UK Limited, Harlow, UK), over the course of 2 weeks in a randomized controlled trial. We collected clinical and anthropometric data, fasting blood samples, and dietary evaluation questionnaires. Surgeons took liver biopsies and made a visual assessment of the liver. We enrolled 60 participants of whom 54 completed the study (FD, n = 26; MRP, n = 28). Baseline demographic features, reported energy intake, dietary evaluation and liver histology were similar in the 2 groups. Both diets induced significant weight loss. Perceived difficulty of surgery correlated significantly with the degree of steatosis on histology. There were reductions in the circulating inflammatory mediators C-reactive protein, fetuin-A and interleukin-6 between baseline (pre-diet) and post-diet. The diets achieved similar weight loss and reduction in inflammatory biomarkers. There were no significant differences in perceived operative difficulty or between patients' evaluation of diet satisfaction, ease of use or hunger frequency. Non-alcoholic fatty liver disease histology assessments post-diet were also not significantly different between diets. The results of this study show the effectiveness of short-term VLEDs and energy restriction, irrespective of macronutrient composition, although the small sample size precluded detection of subtle differences between interventions.
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Affiliation(s)
- Emma L Baldry
- Faculty of Medicine and Health Sciences, University of Nottingham Medical School, University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | - Guruprasad P Aithal
- National Institute for Health Research, Nottingham Digestive Diseases Biomedical Research Unit, University of Nottingham Medical School, Nottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | - Philip Kaye
- Department of Cellular Pathology, Nottingham Digestive Diseases Centre Biomedical Research Unit, Nottingham University Hospitals NHS Trust, University of Nottingham, Queens Medical Centre, Nottingham, UK
| | - Iskandar R Idris
- MRC Musculoskeletal Physiology and Ageing, Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Derby Teaching Hospitals NHS Foundation Trust, Derby, UK
| | - Andrew Bennett
- Faculty of Medicine and Health Sciences, University of Nottingham Medical School, University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | - Paul C Leeder
- East-Midlands Bariatric and Metabolic Institute, Derby Teaching Hospitals NHS Foundation Trust, Royal Derby Hospital, Derby, UK
| | - Ian A Macdonald
- Faculty of Medicine and Health Sciences, University of Nottingham Medical School, University of Nottingham, Queen's Medical Centre, Nottingham, UK
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49
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Chow E, Bernjak A, Walkinshaw E, Lubina-Solomon A, Freeman J, Macdonald IA, Sheridan PJ, Heller SR. Cardiac Autonomic Regulation and Repolarization During Acute Experimental Hypoglycemia in Type 2 Diabetes. Diabetes 2017; 66:1322-1333. [PMID: 28137792 PMCID: PMC5860266 DOI: 10.2337/db16-1310] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 01/25/2017] [Indexed: 02/03/2023]
Abstract
Hypoglycemia is associated with increased cardiovascular mortality in trials of intensive therapy in type 2 diabetes mellitus (T2DM). We previously observed an increase in arrhythmias during spontaneous prolonged hypoglycemia in patients with T2DM. We examined changes in cardiac autonomic function and repolarization during sustained experimental hypoglycemia. Twelve adults with T2DM and 11 age- and BMI-matched control participants without diabetes underwent paired hyperinsulinemic clamps separated by 4 weeks. Glucose was maintained at euglycemia (6.0 mmol/L) or hypoglycemia (2.5 mmol/L) for 1 h. Heart rate, blood pressure, and heart rate variability were assessed every 30 min and corrected QT intervals and T-wave morphology every 60 min. Heart rate initially increased in participants with T2DM but then fell toward baseline despite maintained hypoglycemia at 1 h accompanied by reactivation of vagal tone. In control participants, vagal tone remained depressed during sustained hypoglycemia. Participants with T2DM exhibited greater heterogeneity of repolarization during hypoglycemia as demonstrated by T-wave symmetry and principal component analysis ratio compared with control participants. Epinephrine levels during hypoglycemia were similar between groups. Cardiac autonomic regulation during hypoglycemia appears to be time dependent. Individuals with T2DM demonstrate greater repolarization abnormalities for a given hypoglycemic stimulus despite comparable sympathoadrenal responses. These mechanisms could contribute to arrhythmias during clinical hypoglycemic episodes.
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Affiliation(s)
- Elaine Chow
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, U.K
| | - Alan Bernjak
- INSIGNEO Institute for In Silico Medicine, University of Sheffield, Sheffield, U.K
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, U.K
| | - Emma Walkinshaw
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, U.K
| | | | - Jenny Freeman
- Leeds Institute of Health Sciences, University of Leeds, Leeds, U.K
| | - Ian A Macdonald
- School of Life Sciences, University of Nottingham, Nottingham, U.K
| | - Paul J Sheridan
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, U.K
| | - Simon R Heller
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, U.K.
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50
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Rusavy Z, Macdonald IA, Sramek V, Lacigova S, Tesinsky P, Novak I. Glycemia Influences on Glucose Metabolism in Sepsis During Hyperinsulinemic Clamp. JPEN J Parenter Enteral Nutr 2017; 29:171-5. [PMID: 15837776 DOI: 10.1177/0148607105029003171] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND We investigated glucose metabolism in septic patients during hyperglycemic clamps and compared the different levels of insulinemia and glycemia. METHODS In 10 non-diabetic stable septic patients on mechanical ventilation with baseline glycemia >6 mmol/L and continuous insulin infusion, 3 steps of hyperinsulinemic clamp were performed after 8 hours without caloric intake. In step 1, the targets were insulinemia of 250 mIU/L and glycemia of 5 mmol/L; in step 2, insulinemia of 250 mIU/L and glycemia of 10 mmol/L; in step 3, insulinemia of 1250 mIU/L and glycemia of 5 mmol/L. Glucose uptake was calculated as the amount of glucose per time needed to maintain the target level of glycemia. Glucose oxidation was calculated from indirect calorimetry and urinary nitrogen losses. Values are provided as means +/- SD. A two-way analysis of variance and Scheffe's method were used for statistical analysis and p < .05 was considered significant. RESULTS At step 1, glucose uptake was lower than at step 2 (3.8 +/- 2.48 mg/kg/min and 7.9 +/- 3.45 mg/kg/min, respectively; p < .001). Glucose oxidation was also lower at step 1 (2.6 +/- 0.98 and 4.2 +/- 1.85 mg/kg/min, respectively; p < .01). Glucose storage was low at step 1 (0.7 +/- 1.39) and increased at step 2 (3.5 +/- 2.18; p < .05). In step 3, glucose uptake was 7.0 +/- 2.1, oxidation was 3.6 +/- 1.37, and storage was 2.9 +/- 2.79. There was no significant difference in all these parameters between steps 2 and 3. Energy expenditure between steps 1, 2 and 3 did not change (2294 + 307.42, 2334 + 341.53, and 2342 + 426.67 kcal/day, respectively). Alanine in plasma dropped significantly (p < .05): 10 mmol/L (311 +/- 55.88 mmol/L) at glycemia compared with 5 mmol/L (390 +/- 76 micromol/L) at insulinemia 250 mIU/L. It did not differ significantly from the values obtained at glycemia 5 mmol/L and insulinemia 1250 mIU/L (348 +/- 70.68 mmol/L). Even if the level of cytokines in sepsis was higher, there was no correlation between the insulin level in plasma (250 and 1250 mIU/L), glycemia (5 and 10 mmol/L) and cytokine level (IL-1beta, IL-2, IL-6, IL-8 and TNFalpha). CONCLUSION At insulinemia 250 mIU/L, a glucose level of 10 mmol/L seems to increase glucose uptake, oxidation, and storage compared with glycemia 5 mmol/L. This glucose uptake and oxidation at glycemia 10 mmol/L is comparable with the effect of extremely high insulinemia (1250 mIU/L) clamped at glycemia 5 mmol/L. A higher level of blood glucose or a high level of insulinemia significantly increases glucose uptake but not energy expenditure.
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Affiliation(s)
- Zdenek Rusavy
- Department of Medicine I, University Hospital Plzen, Alej Svobody 80, 304 60 Plzen, Czech Republic.
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