Biomarker of food intake for assessing the consumption of dairy and egg products

Foods of animal origin constitute one of the predominant food groups consumed in Western diets. They play an essential role in human nutrition as they represent an excellent source of high quality proteins, vitamins, minerals and fats. Foods of animal origin are highly diverse (e.g. meat, fish, dairy products and eggs) and their associations with a range of nutritional and health outcomes are therefore heterogeneous. Such associations are also often weak or debated due to the difficulty in establishing correct assessments of dietary intake. Therefore, in order to better characterize associations between the consumption of specific foods of animal origin and health outcomes, it is important to identify reliable biomarkers of food intake (BFIs). BFIs provide a more accurate measure of intake and are independent of the memory and sincerity of the subjects as well as of their knowledge about the consumed foods. To date, only a very limited number of compounds have been proposed as biomarkers of the intake of foods of animal origin and further studies are necessary to validate them and to discover new candidate BFIs. We have, therefore, conducted a systematic search of the scientific literature to evaluate the current status of potential BFIs for each category of foods of animal origin commonly consumed in Europe. This review reports on candidate biomarkers for dairy products and eggs intake, while biomarkers for fish and meat intake will be published separately. Remarkably, validated BFIs for dairy products and eggs are not available. A series of challenges hinders their identification and validation, in particular the heterogeneous composition of each food within a product category and the lack of specificity of the markers identified so far. Untargeted metabolomic strategies may allow the identification of novel food biomarkers, that, when taken separately or in combination, could be used to assess the intake of dairy products and eggs

Role of HDL function and LDL atherogenicity on cardiovascular risk: A comprehensive examination

Background High-density lipoprotein (HDL) functionality and low-density lipoprotein (LDL) atherogenic traits can describe the role of both particles on cardiovascular diseases more accurately than HDL- or LDL-cholesterol levels. However, it is unclear how these lipoprotein properties are particularly affected by different cardiovascular risk factors. Objective To determine which lipoprotein properties are associated with greater cardiovascular risk scores and each cardiovascular risk factor. Methods In two cross-sectional baseline samples of PREDIMED trial volunteers, we assessed the associations of HDL functionality (N = 296) and LDL atherogenicity traits (N = 210) with: 1) the 10-year predicted coronary risk (according to the Framingham-REGICOR score), and 2) classical cardiovascular risk factors. Results Greater cardiovascular risk scores were associated with low cholesterol efflux values; oxidized, triglyceride-rich, small HDL particles; and small LDLs with low resistance against oxidation (P-trend<0.05, all). After adjusting for the rest of risk factors; 1) type-2 diabetic individuals presented smaller and more oxidized LDLs (P<0.026, all); 2) dyslipidemic participants had smaller HDLs with an impaired capacity to metabolize cholesterol (P<0.035, all); 3) high body mass index values were associated to lower HDL and LDL size and a lower HDL capacity to esterify cholesterol (P<0.037, all); 4) men presented a greater HDL oxidation and lower HDL vasodilatory capacity (P<0.046, all); and 5) greater ages were related to small, oxidized, cytotoxic LDL particles (P<0.037, all). Conclusions Dysfunctional HDL and atherogenic LDL particles are present in high cardiovascular risk patients. Dyslipidemia and male sex are predominantly linked to HDL dysfunctionality, whilst diabetes and advanced age are associated with LDL atherogenicity. © 2019 Hernáez et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

Does Consumption of Ultra-Processed Foods Matter for Liver Health? Prospective Analysis among Older Adults with Metabolic Syndrome

Non-alcoholic fatty liver disease (NAFLD) includes a spectrum of liver alterations that can result in severe disease and even death. Consumption of ultra-processed foods (UPF) has been associated with obesity and related comorbidities. However, the link between UPF and NAFLD has not been sufficiently assessed. We aimed to investigate the prospective association between UPF consumption and liver health biomarkers. Methods: We followed for 1 year 5867 older participants with overweight/obesity and metabolic syndrome (MetS) from the PREDIMED-Plus trial. A validated 143-item semi-quantitative food frequency questionnaire was used to evaluate consumption of UPF at baseline, 6, and 12 months. The degree of processing for foods and beverages (g/day) was established according to the NOVA classification system. The non-invasive fatty liver index (FLI) and hepatic steatosis index (HSI) were used to evaluate liver health at three points in time. The associations between changes in UPF consumption (percentage of total daily dietary intake (g)) and liver biomarkers were assessed using mixed-effects linear models with repeated measurements. Results: In this cohort, UPF consumption at baseline was 8.19% (SD 6.95%) of total daily dietary intake in grams. In multivariable models, each 10% daily increment in UPF consumption in 1 year was associated with significantly greater FLI (β 1.60 points, 95% CI 1.24;1.96 points) and HSI (0.43, 0.29; 0.57) scores (all p-values < 0.001). These associations persisted statistically significant after adjusting for potential dietary confounders and NAFLD risk factors. Conclusions: A higher UPF consumption was associated with higher levels of NAFLD-related biomarkers in older adults with overweight/obesity and MetS

Mediterranean, DASH, and MIND Dietary Patterns and Cognitive Function: The 2-Year Longitudinal Changes in an Older Spanish Cohort

Background and Aims: Plant-forward dietary patterns have been associated with cardiometabolic health benefits, which, in turn, have been related to cognitive performance with inconsistent findings. The objective of this study was to examine the relationship between baseline adherence to three a priori dietary patterns (Mediterranean, DASH, and MIND diets) with 2-year changes in cognitive performance in older adults with overweight or obesity and high cardiovascular disease risk. Methods: A prospective cohort analysis was conducted within the PREDIMED-Plus trial, involving 6,647 men and women aged 55-75 years with overweight or obesity and metabolic syndrome. Using a validated, semiquantitative 143-item food frequency questionnaire completed at baseline, the dietary pattern adherence scores were calculated. An extensive neuropsychological test battery was administered at baseline and 2-year follow-up. Multivariable-adjusted linear regression models were used to assess associations between 2-year changes in cognitive function z-scores across tertiles of baseline adherence to the a priori dietary patterns. Results: Adherence to the Mediterranean diet at baseline was associated with 2-year changes in the general cognitive screening Mini-Mental State Examination (MMSE, β: 0.070; 95% CI: 0.014, 0.175, P-trend = 0.011), and two executive function-related assessments: the Trail Making Tests Part A (TMT-A, β: −0.054; 95% CI: −0.110, − 0.002, P-trend = 0.047) and Part B (TMT-B, β: −0.079; 95% CI: −0.134, −0.024, P-trend = 0.004). Adherence to the MIND diet was associated with the backward recall Digit Span Test assessment of working memory (DST-B, β: 0.058; 95% CI: 0.002, 0.114, P-trend = 0.045). However, higher adherence to the DASH dietary pattern was not associated with better cognitive function over a period of 2 years. Conclusion: In older Spanish individuals with overweight or obesity and at high cardiovascular disease risk, higher baseline adherence to the Mediterranean dietary pattern may be associated with better cognitive performance than lower adherence over a period of 2 years

Role and predictive value of the HDL function for cardiovascular disease in a high risk population. HDL function-linked markers and mechanisms

[eng] Cardiovascular disease remains the first cause of death worldwide. Pharmacological trials and Mendelian randomization studies have failed to unequivocally prove an inverse association between HDL-C levels and the risk of cardiac outcomes. Interest is now focused on the atheroprotective functions of the HDL particle. The aim of the present thesis was to evaluate the predictive role for cardiovascular diseases of a battery of HDL properties and components. Moreover, we evaluated the relationships among major CVD risk factors, 10-year CVD risk, and HDL-functionality and low-density lipoprotein (LDL) atherogenicity. We conducted a meta-analysis to obtain an updated record of the available published literature in this field. To assess the prognostic value for CVD of a set of novel surrogates of HDL-functionality and composition, we analyzed cholesterol efflux capacity (CEC), HDL oxidative-inflammatory index (HOII), platelet activating factor acetylhydrolase (PAF-AH) activity bound to HDL, and the concentrations of apolipoprotein (Apo) A-I and ApoA-IV, serum amyloid A (SAA), component Complement C3, and sphingosine-1-phosphate (S1P) in ApoB depleted plasmain a nested case-control study with volunteers at high cardiovascular risk from the PreDiMed Study (Effects of Mediterranean Diet on the Primary Prevention of Cardiovascular Disease). Samples were matched in a 1:2 fashion by age, sex, body mass index, intervention group, and follow-up time in the study at event occurrence. Finally, we analyzed the relationships among HDL function, LDL atherogenicity, and the risk for cardiovascular disease and classical risk factors. We used data from two representative subsamples of volunteers from the PreDiMed trial. Meta-analysis of data from the 25 studies revealed an inverse association for cholesterol efflux and antioxidant/anti-inflammatory capacities with the risk of major adverse cardiac outcomes. The association was confirmed for the risk of all-cause mortality and cholesterol efflux and antioxidant capacity. Findings from the case-control study display HDL-related function and its main protein, ApoA-I, as promising biomarkers of cardiovascular outcomes. Higher CEC, HOII, and ApoA-I levels are strong, independent surrogates of acute coronary syndrome (ACS). Moreover, S1P almost reached statistical significance, with a p-value=0.056, in the model including HDL-C as confounder. CEC and ApoA-I were both associated with a greater risk for acute myocardial infarction (AMI) independent of classical cardiovascular risk factors. Finally, higher HOII and lower ApoA-I (irrespective of type 2 diabetes mellitus, hypercholesterolemia, hypertension, and smoking habit) increased the risk of unstable angina (UA). High cardiovascular risk was related to low HLD-C and ApoA-I, poor CEC, and a dysfunctional HDL profile (higher content in triglyceride, more oxidized and smaller in size) and with high levels of ApoB and pro-atherogenic LDL (smaller and less resistant to oxidation). Volunteers with type-2 diabetes had low levels of HDL-C, ApoA-I, low-density lipoprotein cholesterol (LDL-C), and ApoB, and smaller, more oxidized LDL. Systemic hypercholesterolemia was related to greater HDL-C, LDL-C, ApoA-I, and ApoB levels and to small HDL size, higher CETP activity, and lower HDL capacity to esterify cholesterol. Each increase of 1 kg/m2 in body mass index was associated with low HDL-C, lower size of both HDL and LDL, and decreased HDL capacity to esterify cholesterol. Finally, men presented lower HDL-C and ApoA-I levels, greater HDL oxidation and HDL impaired vasodilatory capacity, and higher cholesterol content in LDL particles. Age was related to greater triglyceride content in the HDL core. In summary, the meta-analysis study showed that CEC, and the anti-inflammatory and antioxidant capacities of HDL, are inverse predictors of CVD. The association persisted with CEC and antioxidant capacity for all-cause mortality risk. These results were further confirmed in the case-cohort study, in which CEC at baseline showed a strong and independent inverse association with the risk of ACS and AMI. ApoA-I had the ability to predict ACS, AMI, and US. HOII proved to be a predictive index for ACS and UA. Finally, high cardiovascular risk scores and classical risk factors for cardiovascular disease were associated with impaired HDL regarding its components, particle size, and function, and with a more pro-atherogenic LDL

Does consumption of ultra-processed foods matter for liver health? Prospective analysis among older adults with metabolic syndrome

Non-alcoholic fatty liver disease (NAFLD) includes a spectrum of liver alterations that can result in severe disease and even death. Consumption of ultra-processed foods (UPF) has been associated with obesity and related comorbidities. However, the link between UPF and NAFLD has not been sufficiently assessed. We aimed to investigate the prospective association between UPF consumption and liver health biomarkers. Methods: We followed for 1 year 5867 older participants with overweight/obesity and metabolic syndrome (MetS) from the PREDIMED-Plus trial. A validated 143-item semi-quantitative food frequency questionnaire was used to evaluate consumption of UPF at baseline, 6, and 12 months. The degree of processing for foods and beverages (g/day) was established according to the NOVA classification system. The non-invasive fatty liver index (FLI) and hepatic steatosis index (HSI) were used to evaluate liver health at three points in time. The associations between changes in UPF consumption (percentage of total daily dietary intake (g)) and liver biomarkers were assessed using mixed-effects linear models with repeated measurements. Results: In this cohort, UPF consumption at baseline was 8.19% (SD 6.95%) of total daily dietary intake in grams. In multivariable models, each 10% daily increment in UPF consumption in 1 year was associated with significantly greater FLI (β 1.60 points, 95% CI 1.24;1.96 points) and HSI (0.43, 0.29; 0.57) scores (all p-values < 0.001). These associations persisted statistically significant after adjusting for potential dietary confounders and NAFLD risk factors. Conclusions: A higher UPF consumption was associated with higher levels of NAFLD-related biomarkers in older adults with overweight/obesity and MetS.This work was supported by the European Research Council (Advanced Research Grant 2014–2019; agreement #340918) granted to MÁM-G and the Spanish National Health Institute of Health Carlos III (ISCIII), through CIBEROBN and “Fondo de Investigación para la Salud” (FIS), which is co-funded by the European Regional Development Fund (six coordinated FIS projects led by JS-S and JVi, including the following projects: PI13/00673, PI13/00492, PI13/00272, PI13/01123, PI13/00462, PI13/00233, PI13/02184, PI13/00728, PI13/01090, PI13/01056, PI14/01722, PI14/00636, PI14/00618, PI14/00696, PI14/01206, PI14/01919, PI14/00853, PI14/01374, PI14/00972, PI14/00728, PI14/01471, PI16/00473, PI16/00662, PI16/01873, PI16/01094, PI16/00501, PI16/00533, PI16/00381, PI16/00366, PI16/01522, PI16/01120, PI17/00764, PI17/01183, PI17/00855, PI17/01347, PI17/00525, PI17/01827, PI17/00532, PI17/00215, PI17/01441, PI17/00508, PI17/01732, PI17/00926, PI19/00957, PI19/00386, PI19/00309, PI19/01032, PI19/00576, PI19/00017, PI19/01226, PI19/00781, PI19/01560, PI19/01332, PI20/01802, PI20/00138, PI20/01532, PI20/00456, PI20/00339, PI20/00557, PI20/00886, PI20/01158, PI21/00465); the Especial Action Project entitled: Implementación y evaluación de una intervención intensiva sobre la actividad física Cohorte PREDIMED-Plus grant to JS-S; the Recercaixa (number 2013ACUP00194) grant to JS-S; grants from the Consejería de Salud de la Junta de Andalucía (PI0458/2013, PS0358/2016, PI0137/2018, RH-0024-2021); the PROMETEO/2017/017 grant from the Generalitat Valenciana; and the SEMERGEN grant; Juan de la Cierva-Incorporación research grant (IJC2019-042420-I) of the Spanish Ministry of Economy, Industry and Competitiveness and European Social Funds to JK; Miguel Servet Tipo 2 research grant (CPII20/00014) of the Spanish National Health Institute of Health Carlos III (ISCIII) to MRBL This work was also partially supported by ICREA under the ICREA Academia programme. None of the funding sources took part in the design, collection, analysis, interpretation of the data, or writing the report, or in the decision to submit the manuscript for publication

A lifestyle intervention with an energy-restricted Mediterranean diet and physical activity enhances HDL function : a substudy of the PREDIMED-Plus randomized controlled trial

BACKGROUND: Consumption of a Mediterranean diet, adequate levels of physical activity, and energy-restricted lifestyle interventions have been individually associated with improvements in HDL functions. Evidence of intensive interventions with calorie restriction and physical activity is, however, scarce. OBJECTIVES: To determine whether an intensive lifestyle intervention with an energy-restricted Mediterranean diet plus physical activity enhanced HDL function compared to a non-hypocaloric Mediterranean eating pattern without physical activity. METHODS: In 391 older adults with metabolic syndrome (mean age, 65 years; mean BMI, 33.3 kg/m2) from 1 of the Prevención con Dieta Mediterránea-Plus trial centers, we evaluated the impact of a 6-month intervention with an energy-restricted Mediterranean diet plus physical activity (intensive lifestyle; n = 190) relative to a nonrestrictive Mediterranean diet without physical activity (control; n = 201) on a set of HDL functional traits. These included cholesterol efflux capacity, HDL oxidative/inflammatory index, HDL oxidation, and levels of complement component 3, serum amyloid A, sphingosine-1-phosphate, triglycerides, and apolipoproteins A-I, A-IV, C-III, and E in apoB-depleted plasma. RESULTS: The intensive-lifestyle intervention participants displayed greater 6-month weight reductions (-3.83 kg; 95% CI: -4.57 to -3.09 kg) but no changes in HDL cholesterol compared with control-diet participants. Regarding HDL functional traits, the intensive lifestyle decreased triglyceride levels (-0.15 mg/g protein; 95% CI: -0.29 to -0.014 mg/g protein) and apoC-III (-0.11 mg/g protein; 95% CI: -0.18 to -0.026 mg/g protein) compared to the control diet, with weight loss being the essential mediator (proportions of mediation were 77.4% and 72.1% for triglycerides and apoC-III levels in HDL, respectively). CONCLUSIONS: In older adults with metabolic syndrome, an energy-restricted Mediterranean diet plus physical activity improved the HDL triglyceride metabolism compared with a nonrestrictive Mediterranean diet without physical activity. This trial is registered at isrctn.com as ISRCTN89898870

Biomarker of food intake for assessing the consumption of dairy and egg products

Abstract Dairy and egg products constitute an important part of Western diets as they represent an excellent source of high-quality proteins, vitamins, minerals and fats. Dairy and egg products are highly diverse and their associations with a range of nutritional and health outcomes are therefore heterogeneous. Such associations are also often weak or debated due to the difficulty in establishing correct assessments of dietary intake. Therefore, in order to better characterize associations between the consumption of these foods and health outcomes, it is important to identify reliable biomarkers of their intake. Biomarkers of food intake (BFIs) provide an accurate measure of intake, which is independent of the memory and sincerity of the subjects as well as of their knowledge about the consumed foods. We have, therefore, conducted a systematic search of the scientific literature to evaluate the current status of potential BFIs for dairy products and BFIs for egg products commonly consumed in Europe. Strikingly, only a limited number of compounds have been reported as markers for the intake of these products and none of them have been sufficiently validated. A series of challenges hinders the identification and validation of BFI for dairy and egg products, in particular, the heterogeneous composition of these foods and the lack of specificity of the markers identified so far. Further studies are, therefore, necessary to validate these compounds and to discover new candidate BFIs. Untargeted metabolomic strategies may allow the identification of novel biomarkers, which, when taken separately or in combination, could be used to assess the intake of dairy and egg products

Role of HDL function and LDL atherogenicity on cardiovascular risk: A comprehensive examination

Background: High-density lipoprotein (HDL) functionality and low-density lipoprotein (LDL) atherogenic traits can describe the role of both particles on cardiovascular diseases more accurately than HDL- or LDL-cholesterol levels. However, it is unclear how these lipoprotein properties are particularly affected by different cardiovascular risk factors. Objective: To determine which lipoprotein properties are associated with greater cardiovascular risk scores and each cardiovascular risk factor. Methods: In two cross-sectional baseline samples of PREDIMED trial volunteers, we assessed the associations of HDL functionality (N = 296) and LDL atherogenicity traits (N = 210) with: 1) the 10-year predicted coronary risk (according to the Framingham-REGICOR score), and 2) classical cardiovascular risk factors. Results: Greater cardiovascular risk scores were associated with low cholesterol efflux values; oxidized, triglyceride-rich, small HDL particles; and small LDLs with low resistance against oxidation (P-trend<0.05, all). After adjusting for the rest of risk factors; 1) type-2 diabetic individuals presented smaller and more oxidized LDLs (P<0.026, all); 2) dyslipidemic participants had smaller HDLs with an impaired capacity to metabolize cholesterol (P<0.035, all); 3) high body mass index values were associated to lower HDL and LDL size and a lower HDL capacity to esterify cholesterol (P<0.037, all); 4) men presented a greater HDL oxidation and lower HDL vasodilatory capacity (P<0.046, all); and 5) greater ages were related to small, oxidized, cytotoxic LDL particles (P<0.037, all). Conclusions: Dysfunctional HDL and atherogenic LDL particles are present in high cardiovascular risk patients. Dyslipidemia and male sex are predominantly linked to HDL dysfunctionality, whilst diabetes and advanced age are associated with LDL atherogenicity