Polymorphic appetite effects on waist circumference depend on rs3749474 CLOCK gene variant

Chronobiological aspects controlled by CLOCK genes may influence obesity incidence. Although there are studies that show an association between the expression of these genes and energy intake, waist circumference or abdominal obesity phenotypes, interactions with appetite have been insufficiently investigated in relation to chrononutrition. The objective was to identify interactions between CLOCK genetic variants involved in appetite status. A total of 442 subjects (329 women, 113 men; aged 18 to 65 years) were recruited. Anthropometric, dietary and lifestyle data were collected by trained nutritionists. Participants were classified according to their appetite feelings with a Likert scale. Multiple linear regression models were used to examine associations of the type genotype x appetite status on adiposity-related variables. p values were corrected by the Bonferroni method. A significant influence was found concerning the effects of appetite on waist circumference with respect to rs3749474 CLOCK polymorphism (p < 0.001). An additive model analysis (adjusted by age, gender, exercise and energy intake) showed that risk allele carriers, increased the waist circumference around 14 cm (β = 14.1, CI = 6.3–22.0) by each increment in the level of appetite. The effects of appetite on waist circumference may be partly modulated by the rs3749474 CLOCK polymorphism

Cambios alimentarios y de estilo de vida como estrategia en la prevención del síndrome metabólico y la diabetes mellitus tipo 2: hitos y perspectivas

El elevado aporte calórico de la alimentación actual y el sedentarismo, son los principales causantes del notable incremento de la obesidad en nuestra sociedad. A su vez, esto conlleva un aumento de las patologías asociadas a ella, como pueden ser el síndrome metabólico y la diabetes tipo 2. En el presente trabajo, han sido revisados los estudios y programas más recientes y significativos en cuanto a su tamaño muestral y a su diversidad geográfica, poniendo de manifiesto que los cambios en la alimentación y en los estilos de vida, son un instrumento efectivo para combatir o retrasar la aparición de estas enfermedades. En este sentido, la prevención también es clave para evitar las graves consecuencias, relacionadas con la diabetes y el síndrome metabólico, que pueden afectar a la calidad de vida de la población.A high caloric intake in today’s nutrition and a sedentary lifestyle are the main causes of the notable increase in obesity in our society. In turn, this results in an increase in associated pathologies, such as metabolic syndrome and diabetes type 2. In the present work we review most recent studies and programs, which are significant due to their sample size and geographical diversity. It clearly shows that changes in alimentation and lifestyles are an effective instrument for combatting or delaying the onset of these diseases. In this sense, prevention is also key to avoiding serious consequences related to diabetes and metabolic syndrome, which can affect the life of the population

A dietary feedback system for the delivery of consistent personalized dietary advice in the web-based multicenter Food4Me study

Background: Despite numerous healthy eating campaigns, the prevalence of diets high in saturated fatty acids, sugar, and salt and low in fiber, fruit, and vegetables remains high. With more people than ever accessing the Internet, Web-based dietary assessment instruments have the potential to promote healthier dietary behaviors via personalized dietary advice. Objective: The objectives of this study were to develop a dietary feedback system for the delivery of consistent personalized dietary advice in a multicenter study and to examine the impact of automating the advice system. Methods: The development of the dietary feedback system included 4 components: (1) designing a system for categorizing nutritional intakes; (2) creating a method for prioritizing 3 nutrient-related goals for subsequent targeted dietary advice; (3) constructing decision tree algorithms linking data on nutritional intake to feedback messages; and (4) developing personal feedback reports. The system was used manually by researchers to provide personalized nutrition advice based on dietary assessment to 369 participants during the Food4Me randomized controlled trial, with an automated version developed on completion of the study. Results: Saturated fatty acid, salt, and dietary fiber were most frequently selected as nutrient-related goals across the 7 centers. Average agreement between the manual and automated systems, in selecting 3 nutrient-related goals for personalized dietary advice across the centers, was highest for nutrient-related goals 1 and 2 and lower for goal 3, averaging at 92%, 87%, and 63%, respectively. Complete agreement between the 2 systems for feedback advice message selection averaged at 87% across the centers. Conclusions: The dietary feedback system was used to deliver personalized dietary advice within a multi-country study. Overall, there was good agreement between the manual and automated feedback systems, giving promise to the use of automated systems for personalizing dietary advice

Association between diet-quality scores, adiposity, total cholesterol and markers of nutritional status in European adults: findings from the Food4Me study

Diet-quality scores (DQS), which are developed across the globe, are used to define adherence to specific eating patterns and have been associated with risk of coronary heart disease and type-II diabetes. We explored the association between five diet-quality scores (Healthy Eating Index, HEI; Alternate Healthy Eating Index, AHEI; MedDietScore, MDS; PREDIMED Mediterranean Diet Score, P-MDS; Dutch Healthy Diet-Index, DHDI) and markers of metabolic health (anthropometry, objective physical activity levels (PAL), and dried blood spot total cholesterol (TC), total carotenoids, and omega-3 index) in the Food4Me cohort, using regression analysis. Dietary intake was assessed using a validated Food Frequency Questionnaire. Participants (n = 1480) were adults recruited from seven European Union (EU) countries. Overall, women had higher HEI and AHEI than men (p < 0.05), and scores varied significantly between countries. For all DQS, higher scores were associated with lower body mass index, lower waist-to-height ratio and waist circumference, and higher total carotenoids and omega-3-index (p trends < 0.05). Higher HEI, AHEI, DHDI, and P-MDS scores were associated with increased daily PAL, moderate and vigorous activity, and reduced sedentary behaviour (p trend < 0.05). We observed no association between DQS and TC. To conclude, higher DQS, which reflect better dietary patterns, were associated with markers of better nutritional status and metabolic health

Analysis of dietary pattern impact on weight status for personalised nutrition through on-line advice: The food4Me Spanish cohort

Obesity prevalence is increasing. The management of this condition requires a detailed analysis of the global risk factors in order to develop personalised advice. This study is aimed to identify current dietary patterns and habits in Spanish population interested in personalised nutrition and investigate associations with weight status. Self-reported dietary and anthropometrical data from the Spanish participants in the Food4Me study, were used in a multidimensional exploratory analysis to define specific dietary profiles. Two opposing factors were obtained according to food groups’ intake: Factor 1 characterised by a more frequent consumption of traditionally considered unhealthy foods; and Factor 2, where the consumption of “Mediterranean diet” foods was prevalent. Factor 1 showed a direct relationship with BMI (β = 0.226; r2 = 0.259; p < 0.001), while the association with Factor 2 was inverse (β = −0.037; r2 = 0.230; p = 0.348). A total of four categories were defined (Prudent, Healthy, Western, and Compensatory) through classification of the sample in higher or lower adherence to each factor and combining the possibilities. Western and Compensatory dietary patterns, which were characterized by high-density foods consumption, showed positive associations with overweight prevalence. Further analysis showed that prevention of overweight must focus on limiting the intake of known deleterious foods rather than exclusively enhance healthy products

Profile of European adults interested in internet-based personalized nutrition: The Food4Me Study

Purpose Personalised intervention may have greater potential for reducing the global burden of non-communicable diseases and for promoting better health and wellbeing across the life-span than the conventional “one size fits all” approach. However, the characteristics of individuals interested in personalised nutrition (PN) are unclear. Therefore, the aim of this study was to describe the characteristics of European adults interested in taking part in an internet-based PN study. Methods Individuals from seven European countries (UK, Ireland, Germany, the Netherlands, Spain, Greece and Poland) were invited to participate in the study via the Food4Me website (http://www.food4me.org). Two screening questionnaires were used to collect data on socio-demographic, anthropometric and health characteristics as well as dietary intakes. Results A total of 5662 individuals expressed an interest in the study (mean age 40 ± 12.7; range 15-87 years). Of these 64.6% were female and 96.9% were Caucasian. Overall, 12.9% were smokers and 46.8% reported the presence of a clinically diagnosed disease. Furthermore, 46.9% were overweight or obese and 34.9% were sedentary during leisure time. Assessment of dietary intakes showed that 54.3% of individuals reported consuming at least 5 portions of fruit and vegetables per day, 45.9% consumed more than 3 servings of wholegrains and 37.2% limited their salt intake to less than 5.75g per day. Conclusions Our data indicate that individuals volunteering to participate in an internet-based PN study are broadly representative of the European adult population, most of whom had adequate nutrient intakes but who could benefit from improved dietary choices and greater physical activity. Future use of internet-based PN approaches is thus relevant to a wide target audience

Mediterranean Diet Adherence and Genetic Background Roles within a Web-Based Nutritional Intervention: The Food4Me Study

Mediterranean Diet (MedDiet) adherence has been proven to produce numerous health benefits. In addition, nutrigenetic studies have explained some individual variations in the response to specific dietary patterns. The present research aimed to explore associations and potential interactions between MedDiet adherence and genetic background throughout the Food4Me web-based nutritional intervention. Dietary, anthropometrical and biochemical data from volunteers of the Food4Me study were collected at baseline and after 6 months. Several genetic variants related to metabolic risk features were also analysed. A Genetic Risk Score (GRS) was derived from risk alleles and a Mediterranean Diet Score (MDS), based on validated food intake data, was estimated. At baseline, there were no interactions between GRS and MDS categories for metabolic traits. Linear mixed model repeated measures analyses showed a significantly greater decrease in total cholesterol in participants with a low GRS after a 6-month period, compared to those with a high GRS. Meanwhile, a high baseline MDS was associated with greater decreases in Body Mass Index (BMI), waist circumference and glucose. There also was a significant interaction between GRS and the MedDiet after the follow-up period. Among subjects with a high GRS, those with a high MDS evidenced a highly significant reduction in total carotenoids, while among those with a low GRS, there was no difference associated with MDS levels. These results suggest that a higher MedDiet adherence induces beneficial effects on metabolic outcomes, which can be affected by the genetic background in some specific markers

Precision Nutrition through dietary, behavioural, phenotypic and nutrigenetic information in an internet-based personalised intervention

Obesity is characterised by an increase of body weight, due to a chronic imbalance between energy intake and expenditure. Sustained accumulation of excessive adipose tissue has been described to be associated with an increased risk of type 2 diabetes, hypertension, blood disorders, cardiovascular diseases, certain cancers, as well as a wide range of psychological problems. Strategies struggling the obesogenic environmental factors through the improvement of lifestyle habits and nutritional behaviour are being carried out worldwide to prevent the increase of obesity. At the same time, the advances and the increasing interest on omic sciences are promoting the perspectives on the application of Precision Nutrition based on environmental, dietary, phenotypic and genotypic information. Furthermore, the widespread use of on-line services, has enabled internet-based personalised counselling in order to achieve changes in healthy behaviour. Based on this evidence, the present dissertation aims to evaluate the feasibility of internet-based nutritional advice and to design accurate and fast tools to help health professionals to provide specific diagnostics and personalised nutritional advices in an European population interested in Precision Nutrition. First of all, a prospective exploration of commercial panels of genetic tests concerning obesity and related metabolic traits was performed in Chapter 1. Heterogeneity of analytical techniques, as well as in the number of genes analysed and the price of the products were exhibited at the moment of the research, however variations in 22 obesity-related genes were observed to be shared in at least two laboratories. Subsequently, different approaches for the nutritional status assessment were carried out in the Food4Me participants. A shortened questionnaire of 9 items (NPSQ9) was derived in Chapter 2 through multifactorial analysis from questions linked to the self-perception towards healthy eating. The score obtained from the NPSQ9 exhibited to be associated with nutritional status and with greater dietary improvements during the nutritional intervention. Furthermore, in Chapter 3, an isocaloric substitution regression model showed a reduction in the presence of obesity when dietary vegetable protein sources were increased instead of animal protein and simple sugars. According to this result, in Chapter 4 a retrospective multivariate analysis of dietary intake revealed the existence of 4 dietary patterns ( Prudent , Healthy , Western and Compensatory ), which were differently associated with the prevalence of obesity. These results highlighted the importance of reducing unhealthy food choices in addition to enhancing healthy eating behaviours for the prevention of obesity. Finally, behavioural eating patterns were analysed to determine the associations with phenotypic and genotypic variables throughout the personalised intervention. Hence, in Chapter 5 it was found that received Personalised Nutrition advice was associated with higher adherence to Mediterranean diet after 6 months of intervention and the addition of genotypic information achieved larger improvements. On the other hand, Chapter 6 showed that individuals presenting risk alleles in the FTO gene and unhealthy dietary behaviours were related to present greater ponderal status. Finally, Chapter 7 demonstrated that an elevated adherence to Mediterranean diet might overcome some of the adverse effects associated to the genetic make-up on anthropometrics. However, a modulating effect was reflected in lipid metabolism-related traits by the genetic background. In addition, buccal swab samples as a surrogated non-invasive tissue were analysed in Chapter 8 for the identification of epigenetic marks concerning obesity and related traits. The results presented the parallelism between buccal and blood samples in the methylation levels of obesity-related genes, exhibiting the potential use of buccal sample in clinical practice

Precision Nutrition through dietary, behavioural, phenotypic and nutrigenetic information in an internet-based personalised intervention

Obesity is characterised by an increase of body weight, due to a chronic imbalance between energy intake and expenditure. Sustained accumulation of excessive adipose tissue has been described to be associated with an increased risk of type 2 diabetes, hypertension, blood disorders, cardiovascular diseases, certain cancers, as well as a wide range of psychological problems. Strategies struggling the obesogenic environmental factors through the improvement of lifestyle habits and nutritional behaviour are being carried out worldwide to prevent the increase of obesity. At the same time, the advances and the increasing interest on omic sciences are promoting the perspectives on the application of Precision Nutrition based on environmental, dietary, phenotypic and genotypic information. Furthermore, the widespread use of on-line services, has enabled internet-based personalised counselling in order to achieve changes in healthy behaviour. Based on this evidence, the present dissertation aims to evaluate the feasibility of internet-based nutritional advice and to design accurate and fast tools to help health professionals to provide specific diagnostics and personalised nutritional advices in an European population interested in Precision Nutrition. First of all, a prospective exploration of commercial panels of genetic tests concerning obesity and related metabolic traits was performed in Chapter 1. Heterogeneity of analytical techniques, as well as in the number of genes analysed and the price of the products were exhibited at the moment of the research, however variations in 22 obesity-related genes were observed to be shared in at least two laboratories. Subsequently, different approaches for the nutritional status assessment were carried out in the Food4Me participants. A shortened questionnaire of 9 items (NPSQ9) was derived in Chapter 2 through multifactorial analysis from questions linked to the self-perception towards healthy eating. The score obtained from the NPSQ9 exhibited to be associated with nutritional status and with greater dietary improvements during the nutritional intervention. Furthermore, in Chapter 3, an isocaloric substitution regression model showed a reduction in the presence of obesity when dietary vegetable protein sources were increased instead of animal protein and simple sugars. According to this result, in Chapter 4 a retrospective multivariate analysis of dietary intake revealed the existence of 4 dietary patterns ( Prudent , Healthy , Western and Compensatory ), which were differently associated with the prevalence of obesity. These results highlighted the importance of reducing unhealthy food choices in addition to enhancing healthy eating behaviours for the prevention of obesity. Finally, behavioural eating patterns were analysed to determine the associations with phenotypic and genotypic variables throughout the personalised intervention. Hence, in Chapter 5 it was found that received Personalised Nutrition advice was associated with higher adherence to Mediterranean diet after 6 months of intervention and the addition of genotypic information achieved larger improvements. On the other hand, Chapter 6 showed that individuals presenting risk alleles in the FTO gene and unhealthy dietary behaviours were related to present greater ponderal status. Finally, Chapter 7 demonstrated that an elevated adherence to Mediterranean diet might overcome some of the adverse effects associated to the genetic make-up on anthropometrics. However, a modulating effect was reflected in lipid metabolism-related traits by the genetic background. In addition, buccal swab samples as a surrogated non-invasive tissue were analysed in Chapter 8 for the identification of epigenetic marks concerning obesity and related traits. The results presented the parallelism between buccal and blood samples in the methylation levels of obesity-related genes, exhibiting the potential use of buccal sample in clinical practice

Cambios alimentarios y de estilo de vida como estrategia en la prevención del síndrome metabólico y la diabetes mellitus tipo 2: hitos y perspectivas

El elevado aporte calórico de la alimentación actual y el sedentarismo, son los principales causantes del notable incremento de la obesidad en nuestra sociedad. A su vez, esto conlleva un aumento de las patologías asociadas a ella, como pueden ser el síndrome metabólico y la diabetes tipo 2. En el presente trabajo, han sido revisados los estudios y programas más recientes y significativos en cuanto a su tamaño muestral y a su diversidad geográfica, poniendo de manifiesto que los cambios en la alimentación y en los estilos de vida, son un instrumento efectivo para combatir o retrasar la aparición de estas enfermedades. En este sentido, la prevención también es clave para evitar las graves consecuencias, relacionadas con la diabetes y el síndrome metabólico, que pueden afectar a la calidad de vida de la población.A high caloric intake in today’s nutrition and a sedentary lifestyle are the main causes of the notable increase in obesity in our society. In turn, this results in an increase in associated pathologies, such as metabolic syndrome and diabetes type 2. In the present work we review most recent studies and programs, which are significant due to their sample size and geographical diversity. It clearly shows that changes in alimentation and lifestyles are an effective instrument for combatting or delaying the onset of these diseases. In this sense, prevention is also key to avoiding serious consequences related to diabetes and metabolic syndrome, which can affect the life of the population