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Sowah SA, Milanese A, Schübel R, Wirbel J, Kartal E, Johnson TS, Hirche F, Grafetstätter M, Nonnenmacher T, Kirsten R, López-Nogueroles M, Lahoz A, Schwarz KV, Okun JG, Ulrich CM, Nattenmüller J, von Eckardstein A, Müller D, Stangl GI, Kaaks R, Kühn T, Zeller G. Calorie restriction improves metabolic state independently of gut microbiome composition: a randomized dietary intervention trial. Genome Med 2022; 14:30. [PMID: 35287713 PMCID: PMC8919571 DOI: 10.1186/s13073-022-01030-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [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] [Received: 03/01/2021] [Accepted: 02/14/2022] [Indexed: 12/12/2022] Open
Abstract
Background The gut microbiota has been suggested to play a significant role in the development of overweight and obesity. However, the effects of calorie restriction on gut microbiota of overweight and obese adults, especially over longer durations, are largely unexplored. Methods Here, we longitudinally analyzed the effects of intermittent calorie restriction (ICR) operationalized as the 5:2 diet versus continuous calorie restriction (CCR) on fecal microbiota of 147 overweight or obese adults in a 50-week parallel-arm randomized controlled trial, the HELENA Trial. The primary outcome of the trial was the differential effects of ICR versus CCR on gene expression in subcutaneous adipose tissue. Changes in the gut microbiome, which are the focus of this publication, were defined as exploratory endpoint of the trial. The trial comprised a 12-week intervention period, a 12-week maintenance period, and a final follow-up period of 26 weeks. Results Both diets resulted in ~5% weight loss. However, except for Lactobacillales being enriched after ICR, post-intervention microbiome composition did not significantly differ between groups. Overall weight loss was associated with significant metabolic improvements, but not with changes in the gut microbiome. Nonetheless, the abundance of the Dorea genus at baseline was moderately predictive of subsequent weight loss (AUROC of 0.74 for distinguishing the highest versus lowest weight loss quartiles). Despite the lack of consistent intervention effects on microbiome composition, significant study group-independent co-variation between gut bacterial families and metabolic biomarkers, anthropometric measures, and dietary composition was detectable. Our analysis in particular revealed associations between insulin sensitivity (HOMA-IR) and Akkermansiaceae, Christensenellaceae, and Tanerellaceae. It also suggests the possibility of a beneficial modulation of the latter two intestinal taxa by a diet high in vegetables and fiber, and low in processed meat. Conclusions Overall, our results suggest that the gut microbiome remains stable and highly individual-specific under dietary calorie restriction. Trial registration The trial, including the present microbiome component, was prospectively registered at ClinicalTrials.govNCT02449148 on May 20, 2015. Supplementary Information The online version contains supplementary material available at 10.1186/s13073-022-01030-0.
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Affiliation(s)
- Solomon A Sowah
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany.,Medical Faculty, Heidelberg University, Heidelberg, Germany.,European Molecular Biology Laboratory (EMBL), Structural and Computational Biology Unit, Heidelberg, Germany
| | - Alessio Milanese
- European Molecular Biology Laboratory (EMBL), Structural and Computational Biology Unit, Heidelberg, Germany
| | - Ruth Schübel
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany
| | - Jakob Wirbel
- European Molecular Biology Laboratory (EMBL), Structural and Computational Biology Unit, Heidelberg, Germany
| | - Ece Kartal
- European Molecular Biology Laboratory (EMBL), Structural and Computational Biology Unit, Heidelberg, Germany.,Molecular Medicine Partnership Unit, Heidelberg, Germany
| | - Theron S Johnson
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany
| | - Frank Hirche
- Institute of Agricultural and Nutritional Sciences, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Mirja Grafetstätter
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany
| | - Tobias Nonnenmacher
- Heidelberg University Hospital, Diagnostic and Interventional Radiology, Heidelberg, Germany
| | - Romy Kirsten
- Biobank of the National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
| | - Marina López-Nogueroles
- Analytical Unit, Biomarkers and Precision Medicine Unit, Health Research Institute Hospital La Fe, Valencia, Spain
| | - Agustín Lahoz
- Analytical Unit, Biomarkers and Precision Medicine Unit, Health Research Institute Hospital La Fe, Valencia, Spain
| | - Kathrin V Schwarz
- Department of General Paediatrics, Division of Neuropediatrics and Metabolic Medicine, University Hospital Heidelberg, Dietmar-Hopp Metabolic Center, Heidelberg, Germany
| | - Jürgen G Okun
- Department of General Paediatrics, Division of Neuropediatrics and Metabolic Medicine, University Hospital Heidelberg, Dietmar-Hopp Metabolic Center, Heidelberg, Germany
| | - Cornelia M Ulrich
- Huntsman Cancer Institute and Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Johanna Nattenmüller
- Heidelberg University Hospital, Diagnostic and Interventional Radiology, Heidelberg, Germany
| | | | - Daniel Müller
- Institute of Clinical Chemistry (IGFS), University Hospital Zurich, Zurich, Switzerland
| | - Gabriele I Stangl
- Institute of Agricultural and Nutritional Sciences, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Rudolf Kaaks
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany
| | - Tilman Kühn
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany. .,Institute for Global Food Security, Queen's University Belfast, Belfast, Northern Ireland, UK. .,Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg, Germany.
| | - Georg Zeller
- European Molecular Biology Laboratory (EMBL), Structural and Computational Biology Unit, Heidelberg, Germany.
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Pannen ST, Maldonado SG, Nonnenmacher T, Sowah SA, Gruner LF, Watzinger C, Nischwitz K, Ulrich CM, Kaaks R, Schübel R, Grafetstätter M, Kühn T. Adherence and Dietary Composition during Intermittent vs. Continuous Calorie Restriction: Follow-Up Data from a Randomized Controlled Trial in Adults with Overweight or Obesity. Nutrients 2021; 13:nu13041195. [PMID: 33916366 PMCID: PMC8067073 DOI: 10.3390/nu13041195] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/25/2021] [Accepted: 04/02/2021] [Indexed: 01/30/2023] Open
Abstract
Although intermittent calorie restriction (ICR) has become popular as an alternative weight loss strategy to continuous calorie restriction (CCR), there is insufficient evidence on diet quality during ICR and on its feasibility over longer time periods. Thus, we compared dietary composition and adherence between ICR and CCR in a follow-up analysis of a randomized trial. A total of 98 participants with overweight or obesity [BMI (kg/m2) 25-39.9, 35-65 years, 49% females] were randomly assigned to ICR, operationalized as a "5:2 diet" (energy intake: ~100% on five non-restricted (NR) days, ~25% on two restricted (R) days), or CCR (daily energy intake: ~80%). The trial included a 12-week (wk) intervention phase, and follow-up assessments at wk24, wk50 and wk102. Apart from a higher proportion of energy intake from protein with ICR vs. CCR during the intervention (wk2: p < 0.001; wk12: p = 0.002), there were no significant differences with respect to changes in dietary composition over time between the groups, while overall adherence to the interventions appeared to be good. No significant difference between ICR and CCR regarding weight change at wk102 was observed (p = 0.63). However, self-reported adherence was worse for ICR than CCR, with 71.1% vs. 32.5% of the participants reporting not to or only rarely have followed the regimen to which they were assigned between wk50 and wk102. These results indicate that within a weight management setting, ICR and CCR were equivalent in achieving modest weight loss over two years while affecting dietary composition in a comparable manner.
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Affiliation(s)
- Sarah T. Pannen
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; (S.G.M.); (T.N.); (S.A.S.); (L.F.G.); (C.W.); (K.N.); (R.K.); (R.S.); (M.G.)
- Correspondence: (S.T.P.); (T.K.)
| | - Sandra González Maldonado
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; (S.G.M.); (T.N.); (S.A.S.); (L.F.G.); (C.W.); (K.N.); (R.K.); (R.S.); (M.G.)
| | - Tobias Nonnenmacher
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; (S.G.M.); (T.N.); (S.A.S.); (L.F.G.); (C.W.); (K.N.); (R.K.); (R.S.); (M.G.)
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Solomon A. Sowah
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; (S.G.M.); (T.N.); (S.A.S.); (L.F.G.); (C.W.); (K.N.); (R.K.); (R.S.); (M.G.)
- Medical Faculty, Heidelberg University, 69120 Heidelberg, Germany
| | - Laura F. Gruner
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; (S.G.M.); (T.N.); (S.A.S.); (L.F.G.); (C.W.); (K.N.); (R.K.); (R.S.); (M.G.)
| | - Cora Watzinger
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; (S.G.M.); (T.N.); (S.A.S.); (L.F.G.); (C.W.); (K.N.); (R.K.); (R.S.); (M.G.)
| | - Karin Nischwitz
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; (S.G.M.); (T.N.); (S.A.S.); (L.F.G.); (C.W.); (K.N.); (R.K.); (R.S.); (M.G.)
| | - Cornelia M. Ulrich
- Huntsman Cancer Institute and Department of Population Health Sciences, University of Utah, Salt Lake City, UT 84112, USA;
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; (S.G.M.); (T.N.); (S.A.S.); (L.F.G.); (C.W.); (K.N.); (R.K.); (R.S.); (M.G.)
| | - Ruth Schübel
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; (S.G.M.); (T.N.); (S.A.S.); (L.F.G.); (C.W.); (K.N.); (R.K.); (R.S.); (M.G.)
| | - Mirja Grafetstätter
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; (S.G.M.); (T.N.); (S.A.S.); (L.F.G.); (C.W.); (K.N.); (R.K.); (R.S.); (M.G.)
- Medical Faculty, Heidelberg University, 69120 Heidelberg, Germany
| | - Tilman Kühn
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; (S.G.M.); (T.N.); (S.A.S.); (L.F.G.); (C.W.); (K.N.); (R.K.); (R.S.); (M.G.)
- Institute for Global Food Security, Queen’s University Belfast, Belfast BT9 5DL, UK
- Heidelberg Institute of Global Health, Heidelberg University, 69120 Heidelberg, Germany
- Correspondence: (S.T.P.); (T.K.)
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Pletsch-Borba L, Grafetstätter M, Hüsing A, Johnson T, González Maldonado S, Groß ML, Kloss M, Hoffmeister M, Bugert P, Kaaks R, Kühn T. Vascular injury biomarkers and stroke risk. Neurology 2020; 94:e2337-e2345. [DOI: 10.1212/wnl.0000000000009391] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 11/27/2019] [Indexed: 01/02/2023] Open
Abstract
ObjectiveBecause little is known about associations between biomarkers of vascular injury and stroke risk, we evaluated associations between plasma concentrations of 6 novel biomarkers of vascular injury and stroke risk in a population-based study.MethodsA case–cohort subset of EPIC-Heidelberg (European Prospective Investigation for Cancer and Nutrition–Heidelberg) including incident stroke cases (n = 335) and a random subcohort (n = 2,418) was selected. Concentrations of intercellular adhesion molecule 3 (ICAM3), soluble E-selectin and P-selectin, soluble thrombomodulin (sTM), thrombopoietin, and glycoprotein IIb/IIIa were measured in baseline plasma samples. Weighted Cox regression analyses were used to assess associations between biomarker levels and stroke risk.ResultsMedian follow-up in the subcohort and among cases was 9.8 (range, 0.1–12.5) years and 6.2 (range, 0.01–12.1) years, respectively. ICAM3 levels were associated with increased risk of incident stroke after multivariable adjustment (hazard ratio, highest vs lowest quartile: 1.64 [95% confidence interval, 1.15–2.32]; plinear trend < 0.001). This association was more apparent for ischemic (1.65 [1.12–2.45]; plinear trend < 0.01) than for hemorrhagic stroke (1.29 [0.60–2.78]; plinear trend = 0.3). We further observed a borderline significant trend for a positive association between sTM and overall stroke risk (1.47 [0.99–2.19]; plinear trend = 0.05).ConclusionsIn this population-based study, circulating levels of ICAM3, an adhesion molecule shed by leukocytes, were associated with increased risk of incident stroke. Further mechanistic studies are needed to elucidate the pathophysiology underlying this association.Classification of evidenceThis study provides Class II evidence that plasma levels of ICAM3 are associated with increased stroke risk.
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Watzinger C, Nonnenmacher T, Grafetstätter M, Sowah SA, Ulrich CM, Kauczor HU, Kaaks R, Schübel R, Nattenmüller J, Kühn T. Dietary Factors in Relation to Liver Fat Content: A Cross-sectional Study. Nutrients 2020; 12:nu12030825. [PMID: 32244908 PMCID: PMC7146233 DOI: 10.3390/nu12030825] [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] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 03/15/2020] [Accepted: 03/16/2020] [Indexed: 12/17/2022] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) can lead to functional liver impairment and severe comorbidities. Beyond energy balance, several dietary factors may increase NAFLD risk, but human studies are lacking. The aim of this cross-sectional study was to investigate the associations between food consumption (47 food groups, derived Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diet quality scores) and liver fat content (continuous scale and NAFLD, i.e., >5% liver fat content). Liver fat content was measured by magnetic resonance imaging (MRI) in 136 individuals (BMI: 25–40 kg/m2, age: 35–65, 50.7% women) and food intake was recorded by food frequency questionnaires (FFQs). Associations between food items and liver fat were evaluated by multi-variable regression models. Intakes of cake and cookies as well legumes were inversely associated with liver fat content, while positive associations with intakes of high-fat dairy and cheese were observed. Only cake and cookie intake also showed an inverse association with NAFLD. This inverse association was unexpected, but not affected by adjustment for reporting bias. Both diet quality scores were inversely associated with liver fat content and NAFLD. Thus, as smaller previous intervention studies, our results suggest that higher diet quality is related to lower liver fat, but larger trials with iso-caloric interventions are needed to corroborate these findings.
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Affiliation(s)
- Cora Watzinger
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Im Neuenheimer Feld 581, 69120 Heidelberg, Germany; (M.G.); (S.A.S.); (R.K.); (R.S.)
- Correspondence: (C.W.); (T.K.)
| | - Tobias Nonnenmacher
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany; (T.N.); (H.-U.K.); (J.N.)
| | - Mirja Grafetstätter
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Im Neuenheimer Feld 581, 69120 Heidelberg, Germany; (M.G.); (S.A.S.); (R.K.); (R.S.)
| | - Solomon A. Sowah
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Im Neuenheimer Feld 581, 69120 Heidelberg, Germany; (M.G.); (S.A.S.); (R.K.); (R.S.)
- Medical Faculty, Heidelberg University, 69120 Heidelberg, Germany
| | - Cornelia M. Ulrich
- Huntsman Cancer Institute and University of Utah, Department of Population Health Sciences, Salt Lake City, UT 84112-5550, USA;
| | - Hans-Ullrich Kauczor
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany; (T.N.); (H.-U.K.); (J.N.)
| | - Rudolf Kaaks
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Im Neuenheimer Feld 581, 69120 Heidelberg, Germany; (M.G.); (S.A.S.); (R.K.); (R.S.)
| | - Ruth Schübel
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Im Neuenheimer Feld 581, 69120 Heidelberg, Germany; (M.G.); (S.A.S.); (R.K.); (R.S.)
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany; (T.N.); (H.-U.K.); (J.N.)
| | - Johanna Nattenmüller
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany; (T.N.); (H.-U.K.); (J.N.)
| | - Tilman Kühn
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Im Neuenheimer Feld 581, 69120 Heidelberg, Germany; (M.G.); (S.A.S.); (R.K.); (R.S.)
- Correspondence: (C.W.); (T.K.)
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Sowah SA, Hirche F, Milanese A, Johnson TS, Grafetstätter M, Schübel R, Kirsten R, Ulrich CM, Kaaks R, Zeller G, Kühn T, Stangl GI. Changes in Plasma Short-Chain Fatty Acid Levels after Dietary Weight Loss Among Overweight and Obese Adults over 50 Weeks. Nutrients 2020; 12:nu12020452. [PMID: 32053988 PMCID: PMC7071291 DOI: 10.3390/nu12020452] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 02/05/2020] [Accepted: 02/06/2020] [Indexed: 12/14/2022] Open
Abstract
Gut microbial-derived short-chain fatty acids (SCFAs) may regulate energy homeostasis and exert anti-carcinogenic, immunomodulatory and anti-inflammatory effects. Smaller trials indicate that dietary weight loss may lead to decreased SCFA production, but findings have been inconclusive. SCFA concentrations were measured by HPLC-MS/MS in plasma samples of 150 overweight or obese adults in a trial initially designed to evaluate the metabolic effects of intermittent (ICR) versus continuous (CCR) calorie restriction (NCT02449148). For the present post hoc analyses, participants were classified by quartiles of weight loss, irrespective of the dietary intervention. Linear mixed models were used to analyze weight-loss-induced changes in SCFA concentrations after 12, 24 and 50 weeks. There were no differential changes in SCFA levels across the initial study arms (ICR versus CCR versus control) after 12 weeks, but acetate concentrations significantly decreased with overall weight loss (mean log-relative change of −0.7 ± 1.8 in the lowest quartile versus. −7.6 ± 2 in the highest, p = 0.026). Concentrations of propionate, butyrate and other SCFAs did not change throughout the study. Our results show that weight-loss, achieved through calorie restriction, may lead to smaller initial decreases in plasma acetate, while plasma SCFAs generally remain remarkably stable over time.
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Affiliation(s)
- Solomon A. Sowah
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Im Neuenheimer Feld 581, 69120 Heidelberg, Germany; (T.S.J.); (M.G.); (R.S.); (R.K.); (T.K.)
- Medical Faculty, Heidelberg University, 69120 Heidelberg, Germany
- Correspondence:
| | - Frank Hirche
- Institute of Agricultural and Nutritional Sciences, Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany; (F.H.); (G.I.S.)
| | - Alessio Milanese
- European Molecular Biology Laboratory (EMBL), Structural and Computational Biology Unit, 69117 Heidelberg, Germany; (A.M.); (G.Z.)
| | - Theron S. Johnson
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Im Neuenheimer Feld 581, 69120 Heidelberg, Germany; (T.S.J.); (M.G.); (R.S.); (R.K.); (T.K.)
| | - Mirja Grafetstätter
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Im Neuenheimer Feld 581, 69120 Heidelberg, Germany; (T.S.J.); (M.G.); (R.S.); (R.K.); (T.K.)
- Medical Faculty, Heidelberg University, 69120 Heidelberg, Germany
| | - Ruth Schübel
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Im Neuenheimer Feld 581, 69120 Heidelberg, Germany; (T.S.J.); (M.G.); (R.S.); (R.K.); (T.K.)
| | - Romy Kirsten
- Biobank of the National Center for Tumor Diseases (NCT) Heidelberg, 69120 Heidelberg, Germany;
| | - Cornelia M. Ulrich
- Huntsman Cancer Institute and Department of Population Health Sciences, University of Utah, Salt Lake City, UT 84112-5550, USA;
| | - Rudolf Kaaks
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Im Neuenheimer Feld 581, 69120 Heidelberg, Germany; (T.S.J.); (M.G.); (R.S.); (R.K.); (T.K.)
| | - Georg Zeller
- European Molecular Biology Laboratory (EMBL), Structural and Computational Biology Unit, 69117 Heidelberg, Germany; (A.M.); (G.Z.)
| | - Tilman Kühn
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Im Neuenheimer Feld 581, 69120 Heidelberg, Germany; (T.S.J.); (M.G.); (R.S.); (R.K.); (T.K.)
| | - Gabriele I. Stangl
- Institute of Agricultural and Nutritional Sciences, Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany; (F.H.); (G.I.S.)
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Grafetstätter M, Pletsch-Borba L, Sookthai D, Karavasiloglou N, Johnson T, Katzke VA, Hoffmeister M, Bugert P, Kaaks R, Kühn T. Thrombomodulin and Thrombopoietin, Two Biomarkers of Hemostasis, Are Positively Associated with Adherence to the World Cancer Research Fund/American Institute for Cancer Research Recommendations for Cancer Prevention in a Population-Based Cross-Sectional Study. Nutrients 2019; 11:nu11092067. [PMID: 31484340 PMCID: PMC6770787 DOI: 10.3390/nu11092067] [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] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 08/22/2019] [Accepted: 08/27/2019] [Indexed: 01/08/2023] Open
Abstract
A pro-coagulative state is related to increased risk of cardiovascular diseases but also certain cancers. Since experimental and smaller human studies suggest that diet, physical activity, and body weight may all affect coagulation, we evaluated associations between these lifestyle factors and hemostatic biomarkers in a population-based study. Cross-sectional baseline data from 2267 randomly selected participants of EPIC-Heidelberg (age range 35–65 years) was used. Fibrinogen, glycoprotein IIb/IIIa, P-selectin, thrombomodulin (TM), and thrombopoietin (TPO) were measured in baseline plasma samples. A score reflecting adherence to the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) recommendations for cancer prevention was created. Associations between the WCRF/AICR score as well as its individual components and hemostatic biomarkers were analyzed by linear regression models. Multivariable-adjusted geometric means (95% confidence intervals) of TM and TPO were higher with greater adherence to the WCRF/AICR recommendations (TM, lowest vs. highest score category: 2.90 (2.7,3.1) vs. 3.10 (2.9,3.3) ng/mL, plinear trend = 0.0001; TPO: 328 (302,356) vs. 348 (321,378) pg/mL, plinear trend = 0.0007). These associations were driven by lower alcohol and meat consumption among persons with higher WCRF/AICR scores. Our results indicate that lifestyle factors favorably affect TM and TPO, two hemostatic factors implicated in chronic disease development.
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Affiliation(s)
- Mirja Grafetstätter
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany.
| | - Laura Pletsch-Borba
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany
| | - Disorn Sookthai
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany
| | - Nena Karavasiloglou
- Division of Chronic Disease Epidemiology, Institute for Epidemiology, Biostatistics and Prevention, University of Zürich, 8001 Zürich, Switzerland
| | - Theron Johnson
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany
| | - Verena A Katzke
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany
| | - Michael Hoffmeister
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany
| | - Peter Bugert
- Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, and German Red Cross Blood Service, Friedrich-Ebert-Str. 107, 68167 Mannheim, Germany
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany
| | - Tilman Kühn
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany
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Grafetstätter M, Hüsing A, González Maldonado S, Sookthai D, Johnson T, Pletsch-Borba L, Katzke VA, Hoffmeister M, Bugert P, Kaaks R, Kühn T. Plasma Fibrinogen and sP-Selectin are Associated with the Risk of Lung Cancer in a Prospective Study. Cancer Epidemiol Biomarkers Prev 2019; 28:1221-1227. [DOI: 10.1158/1055-9965.epi-18-1285] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 03/08/2019] [Accepted: 04/11/2019] [Indexed: 11/16/2022] Open
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Schübel R, Nonnenmacher T, Sookthai D, Gonzalez Maldonado S, Sowah SA, von Stackelberg O, Schlett CL, Grafetstätter M, Nabers D, Johnson T, Kirsten R, Ulrich CM, Kaaks R, Kauczor HU, Kühn T, Nattenmüller J. Similar Weight Loss Induces Greater Improvements in Insulin Sensitivity and Liver Function among Individuals with NAFLD Compared to Individuals without NAFLD. Nutrients 2019; 11:nu11030544. [PMID: 30836637 PMCID: PMC6471668 DOI: 10.3390/nu11030544] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 02/19/2019] [Accepted: 02/25/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Preliminary evidence suggests that weight loss among obese has differential metabolic effects depending on the presence of non-alcoholic fatty liver disease (NAFLD). We assessed whether NAFLD predisposes to differential changes in liver fat content, liver function, and metabolic parameters upon diet-induced weight loss in a 50-week intervention trial. METHODS 143 overweight and obese non-smokers underwent a 12-week dietary intervention and a 38-week follow-up. Diet-induced changes in anthropometric measures, circulating biomarkers, and magnetic resonance (MR)-derived liver fat content and adipose tissue volumes were evaluated by mixed linear models stratifying by NAFLD at baseline. RESULTS The prevalence of NAFLD at baseline was 52%. Diet-induced weight loss after 12 (NAFLD: 4.8 ± 0.5%, No NAFLD: 5.1 ± 0.5%) and 50 weeks (NAFLD: 3.5 ± 0.7%, No NAFLD: 3.5 ± 0.9%) was similar in both groups, while the decrease in liver fat was significantly greater in the NAFLD group (week 12: 32.9 ± 9.5% vs. 6.3 ± 4.0%; week 50: 23.3 ± 4.4% vs. 5.0 ± 4.2%). Decreases in biomarkers of liver dysfunction (GGT, ALT, AST) and HOMA IR were also significantly greater in the NAFLD group. Other metabolic parameters showed no significant differences. CONCLUSION Our data suggest that individuals with NAFLD show greater improvements of liver function and insulin sensitivity after moderate diet-induced weight loss than individuals without NAFLD.
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Affiliation(s)
- Ruth Schübel
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Im Neuenheimer Feld 581, 69120 Heidelberg, Germany.
- Heidelberg University Hospital, Diagnostic and Interventional Radiology, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany.
| | - Tobias Nonnenmacher
- Heidelberg University Hospital, Diagnostic and Interventional Radiology, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany.
| | - Disorn Sookthai
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Im Neuenheimer Feld 581, 69120 Heidelberg, Germany.
| | - Sandra Gonzalez Maldonado
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Im Neuenheimer Feld 581, 69120 Heidelberg, Germany.
| | - Solomon A Sowah
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Im Neuenheimer Feld 581, 69120 Heidelberg, Germany.
| | - Oyunbileg von Stackelberg
- Heidelberg University Hospital, Diagnostic and Interventional Radiology, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany.
| | - Christopher L Schlett
- Heidelberg University Hospital, Diagnostic and Interventional Radiology, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany.
| | - Mirja Grafetstätter
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Im Neuenheimer Feld 581, 69120 Heidelberg, Germany.
| | - Diana Nabers
- German Cancer Research Center (DKFZ), Division of Medical and Biological Informatics, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany.
| | - Theron Johnson
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Im Neuenheimer Feld 581, 69120 Heidelberg, Germany.
| | - Romy Kirsten
- National Center for Tumor Diseases (NCT), Liquid Biobank, Im Neuenheimer Feld 460, 69120 Heidelberg, Germany.
| | - Cornelia M Ulrich
- Huntsman Cancer Institute and Department of Population Health Sciences, University of Utah, 2000 Circle of Hope, Salt Lake City, UT 84112-5550, USA.
| | - Rudolf Kaaks
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Im Neuenheimer Feld 581, 69120 Heidelberg, Germany.
| | - Hans-Ulrich Kauczor
- Heidelberg University Hospital, Diagnostic and Interventional Radiology, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany.
| | - Tilman Kühn
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Im Neuenheimer Feld 581, 69120 Heidelberg, Germany.
| | - Johanna Nattenmüller
- Heidelberg University Hospital, Diagnostic and Interventional Radiology, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany.
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