Vitamin D, Gut Microbiota, and Cardiometabolic Diseases: A Possible Three-Way Axis

Metabolic syndrome (MetSyn) is a precursor for several cardiometabolic diseases such as obesity, type-2 diabetes mellitus (T2DM), and cardiovascular diseases. Emerging evidence suggests that vitamin D deficiency links to cardiometabolic diseases through microbiota. A combination of poor vitamin D status and dysbiosis may contribute to the progression of cardiometabolic diseases. Therefore, in this review, we present the relationship among vitamin D, microbiota, and cardiometabolic diseases with a focus on MetSyn. We searched major databases for reports on vitamin D, microbiota, and MetSyn until June 2022. We reviewed 13 reports on the relation between vitamin D and MetSyn (6 randomized controlled and 7 cross-sectional studies) and 6 reports on the effect of vitamin D on the gut microbiome. Adequate vitamin D status has a beneficial effect on gut microbiota, therefore preventing the progression of MetSyn. Further, well-controlled studies are needed for a better understanding of the mechanisms of action involving vitamin D and microbiota in the pathogenesis of cardiometabolic diseases.Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha, Qata

Muscle Strength and Glycaemic Control among Patients with Type 2 Diabetes.

Poor glycaemic control is associated with chronic life-threatening complications. This cross-sectional study examined whether there is an association between handgrip strength and glycaemic control among patients with diabetes. Data on 1058 participants aged 40 and older were collected from the National Health and Nutritional Examination Survey (NHANES). Muscle strength was assessed using a handgrip dynamometer, and glycaemic control was assessed using HbA1c. Handgrip strength was presented as age- and gender-specific quartiles, with participants in quartile 1 having the lowest handgrip strength and participants in quartile 4 having the highest handgrip strength. Logistic regression analyses were used to assess the association between handgrip strength and poor glycaemic control among participants with diabetes. Three models, each adjusted to include different variables, were employed. Odds ratio (OR) values revealed no association between handgrip strength and glycaemic control after adjusting for age, gender, and race in model 1. With further adjustment for sedentary activity, income-to-poverty ratio, education, and smoking, patients in quartile 4 of handgrip strength had 0.51 odds of poor glycaemic control (95% CI: 0.27-0.99). However, the reported association above vanished when further adjusted for insulin use (OR = 0.67; 95% CI: 0.35-1.28). In conclusion, findings may indicate an association between glycaemic control and muscle strength. This association may be altered by insulin use; further investigations are required.Qatar University (project No. QUST-1-CHS-2020-11

Associations of the MIND Diet with Cardiometabolic Diseases and Their Risk Factors: A Systematic Review

Purpose: Recent studies have expanded the scope of research on the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet beyond its impact on cognitive performance. These investigations have specifically explored its potential to provide protection against cardiometabolic diseases and associated risk factors, including obesity and dyslipidemia. Methods: We systematically summarized and evaluated all existing observational and trial evidence for the MIND diet in relation to cardiometabolic diseases and their risk factors in adults. PubMed, Embase, CINAHL and Cochrane Library databases were systematically searched to extract original studies on humans published until September 2023, without date restrictions. A total of 491 studies were initially retrieved, out of which 23 met the eligibility criteria and were included in the final review. Duplicated and irrelevant studies were screened out by five independent reviewers using the Rayyan platform. Quality assessment was ascertained using the Newcastle-Ottawa scale for observational studies and the Cochrane risk-of-bias tool (RoB 2) for randomized trials. Results: Across the different study designs, the MIND diet was generally associated with an improvement in anthropometric measures and other cardiometabolic outcomes, such as blood pressure, glycemic control, lipid profile, inflammation and stroke. The effects of the MIND eating pattern on some cardiovascular diseases are less conclusive. Conclusion: The findings of this systematic review support the recommendation of the MIND diet as a strategy to reduce cardiometabolic risk in adults. Further well-designed and long-term studies are warranted

Muscle Strength and Glycaemic Control among Patients with Type 2 Diabetes

Background: The prevalence of diabetes has been rising sharply since 1980, reaching 422 million cases worldwide in 2014. Physical activity and handgrip strength may be associated with good glycaemic control among patients with diabetes Objective: We tested the association between handgrip strength and glycemic control in type 2 diabetes patients, from National Health and Nutritional Examination Survey NHANES 2011-2014 and the contribution of the study covariates to this association. Hypothesis: Muscle strength is positively associated with glycemic control in type two diabetes. Methodology: This cross-sectional study examined the association between handgrip strength and glycaemic control among patients with diabetes. Data on 1058 participants aged 40 and older were collected from the NHANES. Muscle strength was assessed using a handgrip dynamometer, and blood samples were obtained to observe the glycaemic control values. Height, body weight, physical activity, insulin use, smoking status, alcohol use, participant demographics, and income-to-poverty ratio were all considered in the study. Result: logistic regression analysis was used to assess the association between handgrip strength and poor glycaemic control among participants with diabetes. Three models were used, each model adjusted to include different variables. OR values revealed no association between handgrip strength and glycaemic control. However, model 2, which was adjusted for sedentary activity, income-to-poverty ratio, education, and smoking, shows a trend towards an association. Patients in quartile 4 of handgrip had 0.59 odds of poor glycaemic control, OR = 0.59 (95% CI: 0.34-1.02). However, in model 3 this effect was diluted when further adjusted for insulin use, OR = 0.81 (95% CI: 0.47-1.38). Further analysis was performed to examine the mean decline in handgrip strength among non-insulin and insulin users. Non-insulin users, both men and women, have higher handgrip strength as compared to insulin users. Conclusion: there was no association found between handgrip and glycaemic control among patients with diabete

The impact of health status, diet and lifestyle on non-alcoholic fatty liver disease: Narrative review

Non-alcoholic fatty liver disease (NAFLD) is defined as the abnormal accumulation of triglycerides in the liver. NAFLD has a global prevalence of almost 30%, while incidence is rising with increasing levels of obesity, type 2 diabetes mellitus (T2DM) and metabolic syndrome. Nutrition plays a significant role in both the prevention and treatment of NAFLD. Therefore, the aim of this literature review is to explore the associations between dietary, lifestyle and other risk factors and the risk for developing NAFLD. Dietary patterns, lifestyle behaviours, comorbidities, or a combination of any may contribute to either the progression or prevention of NAFLD. Having diabetes, hypertension, or having obesity might increase the progression of NAFLD if not well treated and controlled. Diet influences the progression of NAFLD; following a western diet or simply a high-fat diet may contribute to the worsening of NAFLD and further progression to non-alcoholic steatohepatitis (NASH) and cirrhosis in later stages. On the other hand, the Mediterranean diet is the gold standard for both the treatment and prevention of NAFLD. Social behaviours, such as smoking, caffeine consumption and physical activity also play a role in the pathophysiology of NAFLD. Nutrition contributes significantly to the prevention or treatment of NAFLD, since this disease can be managed by diet and physical activity. However, further studies are still needed for a better understanding of the mechanisms of action. Randomized control trials are also needed to confirm findings in observational studies