Impact of the Content of Fatty Acids of Oral Fat Tolerance Tests on Postprandial Triglyceridemia: Systematic Review and Meta-Analysis

Whether the content of saturated (SFA), monounsaturated (MUFA), and polyunsaturated fatty acids (PUFA) could differently influence postprandial triglycerides (TG) is unknown. We examined possible differences in the postprandial TG response to fat tolerance tests (FTTs), in which SFA or unsaturated fatty acids were used. Crossover clinical trials investigating the effects of FTTs containing SFA and unsaturated fats on postprandial triglyceridemia in databases from 1994 until 2016 were searched. Of 356 studies, 338 were excluded and 18 were considered. TG net incremental areas under the curve were calculated using time-points or changes from baseline. Pooled effects of standardized mean differences and I2 test were used. Results: In 12 studies, responses to SFA versus PUFA meals, and in 16 studies versus MUFA meals were compared. Over 4 hours, no differences between SFA and unsaturated fats were observed. Over 8 hours a lower response to PUFA (SMD −2.28; 95%CI −4.16, −0.41) and a trend to lower response to MUFA (SMD −0.89, 95%CI −1.82, 0.04) were detected. FTTs shorter than 8 hours may not be sufficient to differentiate postprandial TG after challenges with distinct fatty acids. Clinical significance of different postprandial TG responses on cardiovascular risk in the long-term deserves investigation

Distinct breakfast patterns on satiety perception in individuals with weight excess

ABSTRACT Objectives: Western dietary pattern predisposes to weight gain, insulin resistance and cardiometabolic diseases. Promoting satiety via modifications in diet composition could be useful to fight weight gain. Mediterranean diet which is recognized to be cardioprotective contains high fiber and unsaturated fat contents. We compared the effects of distinct breakfast patterns on satiety of individuals at cardiometabolic risk, and examined the correlation of satiety level after each breakfast intervention period with glucose parameters. Materials and methods: In this 10-week cross-over clinical trial, 54 individuals with weight excess were submitted to 2 types of 4-week isocaloric breakfasts (2-week washout), one typically Brazilian and a modified one, differing concerning fiber and types of fatty acids contents. Clinical data were collected before and after each breakfast. A satiety scale was applied at fasting and 10, 30 and 120' after breakfast consumption. Repeated measures ANOVA, Student t test or non-parametric correspondents were used; correlations were tested by Pearson or Spearman coefficients. Results: Anthropometric variations after breakfasts were not significant. Only after the modified breakfast, reduction in blood pressure levels was observed. The satiety level did not show significant variation across each period or between the breakfasts. Non-significant correlation between satiety and glucose, insulin and HOMA-IR values after each intervention period was observed. Conclusion: We conclude that different breakfast compositions do not alter satiety level, which is not correlated to glucose parameters in overweight individuals. Stronger modifications of daily meals might be necessary to differentiate satiety levels under distinct dietary patterns. Arch Endocrinol Metab. 2016;60(4):333-4

Distinct breakfast patterns on satiety perception in individuals with weight excess

ABSTRACT Objectives: Western dietary pattern predisposes to weight gain, insulin resistance and cardiometabolic diseases. Promoting satiety via modifications in diet composition could be useful to fight weight gain. Mediterranean diet which is recognized to be cardioprotective contains high fiber and unsaturated fat contents. We compared the effects of distinct breakfast patterns on satiety of individuals at cardiometabolic risk, and examined the correlation of satiety level after each breakfast intervention period with glucose parameters. Materials and methods: In this 10-week cross-over clinical trial, 54 individuals with weight excess were submitted to 2 types of 4-week isocaloric breakfasts (2-week washout), one typically Brazilian and a modified one, differing concerning fiber and types of fatty acids contents. Clinical data were collected before and after each breakfast. A satiety scale was applied at fasting and 10, 30 and 120' after breakfast consumption. Repeated measures ANOVA, Student t test or non-parametric correspondents were used; correlations were tested by Pearson or Spearman coefficients. Results: Anthropometric variations after breakfasts were not significant. Only after the modified breakfast, reduction in blood pressure levels was observed. The satiety level did not show significant variation across each period or between the breakfasts. Non-significant correlation between satiety and glucose, insulin and HOMA-IR values after each intervention period was observed. Conclusion: We conclude that different breakfast compositions do not alter satiety level, which is not correlated to glucose parameters in overweight individuals. Stronger modifications of daily meals might be necessary to differentiate satiety levels under distinct dietary patterns

Association of fruits and vegetables consumption and related-vitamins with inflammatory and oxidative stress markers in prediabetic individuals

Abstract\ud \ud Background\ud Dietary guidelines of 5 servings per day of fruits and vegetables (FV) offer a reasonable amount of vitamins to control organic processes, which may contribute to a favorable cardiometabolic profile. This study aimed at investigating whether the intake of the FV group as well as pro-vitamin A carotenoids and vitamins C and E were associated with circulating markers of oxidative stress, inflammation and insulin resistance in Brazilians individuals at cardiometabolic risk.\ud \ud \ud Methods\ud This cross-sectional study included 205 individuals screened for diabetes prevention program in a healthcare center from the School of Public Health, University of São Paulo, conducted in 2008. Possible associations of consumption of FV group, as well as pro-vitamin A carotenoids and vitamins C and E, with circulating markers of oxidative stress (superoxide dismutase – SOD and oxidized LDL – oxLDL), inflammation (C reactive protein, TNF-α and adiponectin) and insulin resistance (HOMA-IR) were investigated. Pearson correlation coefficient, ANOVA and multiple linear regression were employed.\ud \ud \ud Results\ud The sample (64.7% women) had a mean age of 54.1 ± 12.7 years and body mass index of 30.7 ± 5.7 kg/m2. Dietary, physical activity, anthropometric and laboratory data were obtained. Participants consumed a mean of 3.8 servings/day of FV; their FV intake was categorized into three groups: <2.5, 2.5-5.0 and >5.0 servings/day. Significant trends for lower waist circumference (103.4 ± 13.6 vs. 100.1 ± 12.2 vs. 98.2 ± 12.7 cm, p-trend <0.05) and higher adiponectin concentrations (10.4 ± 1.8 vs. 11.9 ± 1.9 vs. 13.6 ± 2.1 ng/mL, p-trend <0.05) were detected across categories. Associations between SOD concentrations (β 0.172 [0.110-0.688]) with FV consumption and between oxLDL concentrations with vitamins C (β -0.333 [−2.568 – -0.218]) and E (β -0.354 [−1.131– -0.110]) intakes, adjusted for age, gender, BMI, saturated fat intake, smoking and physical activity were found. Similar results were observed for the associations between oxLDL and FV intake, but significance disappeared adding adjustment for saturated fat, smoking and physical activity.\ud \ud \ud Conclusion\ud Our data suggest that the intake of FV or selected vitamins may be useful for identifying the oxidative stress and inflammation involved in the genesis of cardiometabolic diseases and for motivating at-risk patients for changing dietary habits.This work was supported by a grant from The São Paulo Foundation for\ud Research Support – FAPESP and from Coordination for Improvement of\ud Graduate Personnel – CAPES (Brazil)

Índice de Qualidade da Dieta Revisado para população brasileira

El Índice de Calidad de la Dieta Revisado es un indicador de calidad de la dieta desarrollado cónsono con las recomendaciones nutricionales vigentes. Los datos dietéticos fueron provenientes del estudio de base poblacional Inquérito de Saúde e Alimentação (ISA - Pesquisa de Salud y Alimentación)-Capital-2003. El Índice contiene 12 componentes, siendo nueve fundamentados en los grupos de alimentos de la Guía Alimentaria Brasileña de 2006, cuyas porciones diarias son expresadas en densidad energética; dos nutrientes (sodio y grasa saturada); y Gord_AA (calorías provenientes de grasa sólida, alcohol y azúcar de adición). El Índice de Calidad de la Dieta Revisado propicia medir varios factores de riesgos dietéticos para enfermedades crónicas, permitiendo, simultáneamente, evaluar y monitorear la dieta en nivel individual o poblacional.O Índice de Qualidade da Dieta Revisado é um indicador de qualidade da dieta desenvolvido consoante com as recomendações nutricionais vigentes. Os dados dietéticos foram provenientes do estudo de base-populacional, Inquérito de Saúde e Alimentação (ISA)-Capital-2003. O Índice contém 12 componentes, sendo nove fundamentados nos grupos de alimentos do Guia Alimentar Brasileiro de 2006, cujas porções diárias são expressas em densidade energética; dois nutrientes (sódio e gordura saturada); e Gord_AA (calorias provenientes de gordura sólida, álcool e açúcar de adição). O Índice de Qualidade da Dieta Revisado propicia mensurar variados fatores de riscos dietéticos para doenças crônicas, permitindo, simultaneamente, avaliar e monitorar a dieta em nível individual ou populacional.The revised version of the Brazilian Healthy Eating Index is an indicator of dietary quality developed according to current nutritional recommendations. Dietary data were obtained from a population-based survey, the 2003 Inquérito de Saúde e Alimentação (ISA - Health and Diet Survey)-Capital. The Revised Index consists of 12 components: nine food groups included in the 2006 Brazilian Dietary Guidelines, in which daily portions are expressed in terms of energy density; two nutrients (sodium and saturated fats), and SoFAAS (calories from solid fat, alcohol and added sugar). The Revised Brazilian Healthy Eating Index allows for the measurement of dietary risk factors for chronic diseases, evaluating and monitoring the diet at both individual and population levels

Classification of Common Food Lipid Sources Regarding Healthiness Using Advanced Lipidomics: A Four-Arm Crossover Study

publishedVersio

Realistic changes in monounsaturated fatty acids and soluble fibers are able to improve glucose metabolism

Abstract\ud \ud Background/objectives\ud Cardioprotective effects of Mediterranean-style diet have been shown. Instead of excluding foods, replacement or addition may facilitate compliance with impact on glucose metabolism of individuals at cardiometabolic risk. This study investigated the effect of changing selected nutrients intake on glucose metabolism during a lifestyle intervention tailored to living conditions of prediabetic Brazilians.\ud \ud \ud Subjects/methods\ud 183 prediabetic adults treated under the Brazilian public health system underwent an 18-month intervention on diet and physical activity. Dietary counseling focused on reducing saturated fat replaced by unsaturated fatty acids. Data were collected at baseline and after follow-up. ANOVA and multiple linear regression were used to test association of changes in nutrients intake with changes in plasma glucose.\ud \ud \ud Results\ud Changes in fasting and 2-h plasma glucose but not in weight, HOMA-IR or C-reactive protein decreased after intervention across tertiles of MUFA changes (p-trend 0.017 and 0.024, respectively). Regression models showed that increase in MUFA intake was independently associated with reduction in fasting (β -1.475, p = 0.008) and 2-h plasma glucose (β -3.321, p = 0.007). Moreover, increase in soluble fibers intake was associated with decrease in fasting plasma glucose (β -1.579, p = 0.038). Adjustment for anthropometric measurements did not change the results but did after including change in insulin in the models.\ud \ud \ud Conclusions\ud Increases of MUFA and soluble fibers intakes promote benefits on glucose metabolism, independently of adiposity, during a realistic lifestyle intervention in at-risk individuals. Mechanisms mediating these processes may include mainly insulin sensitivity improvement.Research supported by FAPESP (# 07/55120-0)

Brown fat triglyceride content is associated with cardiovascular risk markers in adults from a tropical region

Brown adipose tissue (BAT) is regarded as an interesting potential target for the treatment of obesity, diabetes, and cardiovascular diseases, and the detailed characterization of its structural and functional phenotype could enable an advance in these fields. Most studies evaluating BAT structure and function were performed in temperate climate regions, and we are yet to know how these findings apply to the 40% of the world's population living in tropical areas. Here, we used F-18-fluorodeoxyglucose positron emission tomography - magnetic resonance imaging to evaluate BAT in 45 lean, overweight, and obese volunteers living in a tropical area in Southeast Brazil. We aimed at investigating the associations between BAT activity, volume, metabolic activity, and BAT content of triglycerides with adiposity and cardiovascular risk markers in a sample of adults living in a tropical area and we showed that BAT glucose uptake is not correlated with leanness; instead, BAT triglyceride content is correlated with visceral adiposity and markers of cardiovascular risk. This study expands knowledge regarding the structure and function of BAT in people living in tropical areas. In addition, we provide evidence that BAT triglyceride content could be an interesting marker of cardiovascular risk

Brown fat triglyceride content is associated with cardiovascular risk markers in adults from a tropical region

Brown adipose tissue (BAT) is regarded as an interesting potential target for the treatment of obesity, diabetes, and cardiovascular diseases, and the detailed characterization of its structural and functional phenotype could enable an advance in these fields. Most studies evaluating BAT structure and function were performed in temperate climate regions, and we are yet to know how these findings apply to the 40% of the world’s population living in tropical areas. Here, we used 18F-fluorodeoxyglucose positron emission tomography – magnetic resonance imaging to evaluate BAT in 45 lean, overweight, and obese volunteers living in a tropical area in Southeast Brazil. We aimed at investigating the associations between BAT activity, volume, metabolic activity, and BAT content of triglycerides with adiposity and cardiovascular risk markers in a sample of adults living in a tropical area and we showed that BAT glucose uptake is not correlated with leanness; instead, BAT triglyceride content is correlated with visceral adiposity and markers of cardiovascular risk. This study expands knowledge regarding the structure and function of BAT in people living in tropical areas. In addition, we provide evidence that BAT triglyceride content could be an interesting marker of cardiovascular risk

Modification of a Brazilian meal including Mediterranean components induces cardiometabolic benefits

Introdução: Mudanças na alimentação e atividade física das populações elevaram a incidência de doenças crônicas não-transmissíveis associadas à adiposidade corporal. Este quadro contribui para mortalidade cardiovascular, motivando iniciativas em saúde pública visando à prevenção. Há evidências de que populações que consomem a dieta mediterrânea apresentam menor mortalidade por todas as causas, inclusive cardiovasculares. Os benefícios desta dieta, rica em fibras, gorduras insaturadas e polifenóis, parecem decorrer da atenuação da inflamação, envolvida na gênese de doenças cardiometabólicas. Objetivo: Este estudo investigou os efeitos da modificação de uma refeição diária, o desjejum, de forma a incluir alimentos mediterrâneos, sobre o metabolismo lipídico, glicídico, inflamação subclínica e expressão de genes inflamatórios. Métodos: Foi um ensaio clínico cruzado com duração total de 10 semanas, incluindo 80 adultos com excesso de peso, não-diabéticos. Os participantes passaram por 2 intervenções de 4 semanas no desjejum, com wash-out de 2 semanas entre elas. Os desjejuns, brasileiro e modificado, foram isocalóricos, diferindo quanto ao conteúdo de fibras e tipos de ácidos graxos. Antes e após cada intervenção foi realizado teste de sobrecarga de gorduras (FTT) com refeição rica em gorduras (saturadas e insaturadas MUFA e PUFA, dependendo da intervenção) e coletas sanguíneas seriadas até 240 minutos para determinação de glicose, insulina, lípides e marcadores inflamatórios. Foram também analisadas as expressões de genes inflamatórios, antes e após cada intervenção. Para comparar as respostas às intervenções foram usados teste t de Student ou os correspondentes não-paramétricos e ANOVA para medidas repetidas. Para as expressões dos genes foi utilizado o método delta ct e a expressão relativa calculada tendo como base valores de jejum e pré-intervenção. Valor de p <0,05 foi considerado significante. Resultados: No Artigo 1 (Modification in a single meal is sufficient to provoke benefits in inflammatory responses of individuals at low-tomoderate cardiometabolic risk), o FTT com desjejum brasileiro comparada ao modificado provocou maiores concentrações de IL-6 e IL-8, e esta resposta se acentuou após intervenção. As concentrações de selectina E, TNF-, IFN-, IL-10 e IL-17 se elevaram apenas após intervenção brasileira. No Artigo 2 (Inflammatory and metabolic response to dietary intervention differs among individuals at distinct cardiometabolic risk levels), a intervenção com desjejum modificado reduziu (p<0.05) a circunferência da cintura e pressão arterial e aumentou as concentrações de HDL. Indivíduos com síndrome metabólica melhoraram fatores clássicos (pressão arterial e glicemia, além de apolipoproteína B) após desjejum modificado, enquanto aqueles sem a síndrome melhoraram marcadores inflamatórios. O Artigo 3 (Comparison of inflammatory genes expression and their circulating products after short-term fatty acids interventions in humans) mostrou que o FTT com desjejum rico em gordura saturada induziu maior expressão pós-prandial de IL-1 quando comparado ao rico em insaturadas, antes e após as intervenções. Houve tendência à maior expressão de IFN- e IL-6 após intervenção com desjejum brasileiro. Na metanálise do Artigo 4 (Impact of the content of fatty acids of oral fat tolerance tests on postprandial triglyceridemia: systematic review and meta-analysis) foram incluídos 18 estudos buscando comparar as respostas dos triglicérides a ácidos graxos saturados e insaturados. Verificou-se que após 8 horas de refeição rica em MUFA há menor trigliceridemia. As menores concentrações observadas após ingestão de PUFA em relação à de saturados não atingiu significância. Conclusões: Pequenas modificações na dieta podem, em período relativamente curto, promover benefícios ao perfil de risco cardiometabólico. Tais benefícios foram evidentes em parâmetros clínicos habituais e reforçados pelos efeitos na expressão de genes inflamatórios e em marcadores circulantes. Vislumbra-se potencial de aceitação da introdução de componentes da dieta mediterrânea em população não-mediterrânea como a brasileira, o que poderia melhorar o perfil de risco cardiometabólico no longo prazo.Introduction: Changes in dietary pattern and physical activity of populations have elevated the incidence of chronic non-communicable diseases associated with increased adiposity. Evidence has shown that populations consuming Mediterranean diets have lower mortality from all causes, including cardiovascular diseases. The benefits of this diet rich in fiber and unsaturated fats, derived in part on the effects of these nutrients on inflammatory condition that triggers cardiometabolic diseases. Objective: This study investigated the effects of changing a meal of Brazilian menu, the breakfast, in order to approximate it to the Mediterranean pattern on lipid and glucose metabolism, subclinical inflammation and also on the expression of inflammatory genes. Methods: This study was a crossover trial lasting a total of 10 weeks, including 80 overweight adults, nondiabetic without drug treatment for dyslipidemia. Participants who met the inclusion criteria underwent two 4-week interventions in breakfast, with wash-out of two weeks between them. The breakfasts (Brazilian and modified) were isocaloric, differing according to fiber and types of fatty acids contents. Before and after each intervention, fat tolerance tests with meals rich in fat (saturated and unsaturated depending on the intervention) were perfomed, with blood sample collections for glucose, insulin, lipids and inflammatory markers up to 240 minutes. Also, expression of inflammatory genes before and after each intervention was analyzed. To compare the acute and sub-acute responses to interventions were used Student t test or the corresponding nonparametric test and ANOVA for repeated measures. For expression of the genes, delta CT method was used and the relative expression calculated based on fasting and pre-intervention values. P value <0.05 was considered significant. Results: In Article 1 (Modification in a single meal is sufficient to provoke benefits in inflammatory responses of Individuals at low-to-moderate cardiometabolic risk), we observed higher IL-6 and IL- 8 concentrations after ingestion of the Brazilian FTT compared with the modified one, whose elevations were even more pronounced after the intervention period. Higher concentrations of E-selectin, TNF-, IFN-, IL-10 and IL-17 were found at fasting and in postprandial state only after the Brazilian intervention. In Article 2 (Inflammatory and metabolic response to dietary intervention Differs Among Individuals at distinct cardiometabolic risk levels), the intervention with the modified breakfast decreased waist circumference and blood pressure and increased the concentrations HDL (p <0.05). Participants with metabolic syndrome showed improvements in traditional risk factors (blood pressure and plasma glucose and apolipoprotein B) whit the modified breakfast, while those without the syndrome improved inflammatory markers. Article 3 (Comparison of inflammatory gene expression and their circulating products after short-term interventions fatty acids in humans) showed that the Brazilian FTT induced higher expression of IL-1 compared to the modified one, before and after the interventions. A tendency for higher postprandial expression of IFN- and increased IL-6 expression after intervention with Brazilian breakfast were also detected. In the meta-analysis of Article 4 (Impact of the content of fatty acids in oral fat tolerance tests on postprandial triglyceridemia: systematic review and metaanalysis) a total of 18 studies were included. When comparing the triglycerides responses to saturated and unsaturated fatty acids, lower areas under the curve with the meals rich in MUFA were observed. Postprandial triglyceridemia after PUFA was lower, but not significantly different from meals rich in saturated fat. Conclusions: Small changes in diet are able to induce benefits in cardiometabolic risk profile in a relatively short period. Such benefits are seen in routine clinical parameters, which are compatible with the favorable effects on the expression of inflammatory genes and circulating biomarkers. There is a potential acceptance of introducing components of the Mediterranean diet in non-Mediterranean populations like Brazil, which could improve the cardiometabolic risk profile in the long term