Nutrition & Metabolism最新文献

BACKGROUND: Current evidence on the association between food processing and metabolic dysfunction-associated steatotic liver disease (MASLD) is limited to the intake of ultra-processed food (UPF). We investigated the associations between different degrees of food processing and MASLD. METHODS: This cross-sectional study was conducted among 2,376 adults aged ≥ 18 years who participated in the third examination of the Tehran Lipid and Glucose Study. Food intake was assessed using a food frequency questionnaire and classified according to the NOVA definitions into unprocessed or minimally processed food (MPF), processed culinary ingredients (PCI), processed food (PF), and UPF. MASLD was defined as the fatty liver index combined with cardiometabolic criteria. Using logistic regression, we determined the odds of MASLD across age- and sex-specific tertiles of each food group. Substitution analyses were also conducted to estimate the odds of MASLD associated with the iso-caloric replacement of 10% of energy from one NOVA food group with 10% of energy from another food group. PF and UPF subgroup analyses were also performed. RESULTS: About one-third (29.8%) of the participants had MASLD. After adjusting for demographic, lifestyle, and eGFR variables, the highest tertile of MPF + PCI was associated with lower odds of MASLD ( (odds ratio (OR) = 0.77; 95% confidence interval (CI) = 0.61, 0.97), while the highest UPF tertile was associated with higher odds, compared to the lowst tertile (OR = 1.24; 95% CI = 1.00, 1.57). These associations were attenuated after inclusion of total energy intake and healthy-eating index score (OR = 0.78; 95% CI = 0.61, 1.00 for MPF + PCI and OR = 1.22; 95% CI = 0.97, 1.54 for UPF). Among the UPF subgroups, ready-to-eat foods, salty snacks, and soft drinks were associated with higher odds of MASLD, while sweets were associated with lower odds. No significant association was found between PF or its subtypes and MASLD. However, replacing MPF + PCI with PF was associated with a higher odds of MASLD (OR = 1.14; 95% CI = 1.03, 1.25). CONCLUSIONS: High consumption of MPF + PCI was associated with lower odds of MASLD, whereas high consumption of certain UPFs was associated with higher odds.

Obesity is a major health concern in today’s growing population, significantly raising the risk of disease and death. Bariatric surgery is the most effective treatment for obesity and its related conditions. However, weight recurrence remains a common issue post-surgery. This study aims to understand the mechanisms of Weight recurrence after Bariatric surgery, other than anatomic surgery failure. Weight recurrence may result from various factors, including genetic predisposition, psychological and behavioral influences, neuroendocrine changes, alterations in the gut microbiome, bile acid signaling, and post-surgery hypoglycemia. Prevention and management strategies include lifestyle modifications, mental health support, pharmacotherapy, and, in some cases, revision surgery. This study explores the controversial hormonal changes involved in weight recurrence, as well as the roles of gut microbiota, bile acid signaling, and genetic factors. Additionally, the study highlights several preventable factors that are crucial for maintaining long-term weight loss and minimizing weight recurrence after bariatric surgery. By gaining insight into these hormonal changes and other contributing factors, we can implement effective preventive measures and medical treatments to enhance long-term weight loss success and improve patients’ quality of life. Nonetheless, further research is needed to fully understand the contributions of bile acid signaling and gut microbiota in the process.

BACKGROUND: Wrestling, characterized by high-intensity intermittent efforts, demands exceptional anaerobic power and recovery capacity. Nitrate-rich beetroot juice (BRJ), supplemented with vitamin C, has emerged as a potential ergogenic aid through increased nitric oxide bioavailability. However, limited data exists regarding its acute effects on anaerobic performance in combat sport athletes. This study investigated the acute effects of BRJ supplemented with vitamin C on upper- and lower-body anaerobic test performance and selected biochemical markers in collegiate wrestlers. METHODS: In a randomized, double-blind, placebo-controlled crossover trial, 28 collegiate male wrestlers (18–24 years) consumed a single 250-ml BRJ drink (8.4 mmol nitrate + 90 mg vitamin C) or an isocaloric nitrate-free placebo three hours prior to testing, with a 14-day washout between conditions. Participants performed sequential 30-second upper- and lower-body Wingate anaerobic test (WAnTs) separated by 90 s. Venous blood was collected pre-test, immediately post-test, and 24 h post-test and was analyzed for blood glucose, creatine kinase (CK), and lactate dehydrogenase (LDH). RESULTS: 24 completed the study. BRJ+vitamin C significantly increased upper-body WAnT peak power (419 ± 98 W vs. 403 ± 103 W, P < 0.001) and lower-body WAnT mean power (390 ± 89 W vs. 376 ± 89 W, P = 0.002) compared with placebo. Post-exercise blood glucose was significantly lower in the BRJ + vitamin C group (96.3 ± 19.2 mg/dl vs. 112.5 ± 20.4 mg/dl, P < 0.001). No significant differences were observed for CK (P = 0.59) or LDH (P = 0.27) at any measured time point. CONCLUSION: Acute BRJ + vitamin C supplementation improved anaerobic capacity and lowered post-exercise blood glucose in collegiate wrestlers, offering a potential ergogenic strategy for combat sports. Further studies with larger, diverse populations and chronic supplementation are needed to confirm and extend these findings. TRIAL REGISTRATION AND DATE: Iranian Registry of Clinical Trials (IRCT20240407061440N1); registration date: June 7, 2024.

Background: Obesity-related adipose tissue dysfunction leads to a chronic inflammatory state affecting distant organs and tissues. This metabolic inflammation has a detrimental impact on the expression of genes related to glucose metabolism, leading to systemic insulin resistance, which also affects the central nervous system and contributes to cognitive decline. Adipose tissue-derived microRNAs (miRNAs) have been implicated in this phenomenon. This study aimed to investigate whether the expression of genes critical for both insulin action and neuronal metabolism (APP, SOCS3, PTPN1, PTPN2) is altered in the adipose tissue of patients with obesity due to miRNA interference, predisposing them directly to the development of insulin resistance and metabolic inflammation, while indirectly leading to a decline in cognitive function.

Methods: The expression of mRNAs of the above-mentioned genes, selected adipokines (interleukins 1β, 6, 8, 15, tumor necrosis factor-alpha, resistin, adiponectin) and miRNAs was measured by real-time PCR in adipose tissue of 75 patients with obesity, 19 patients who successfully reduced body mass after metabolic surgery and 25 normal weight subjects, stratified by insulin sensitivity and diabetic status. The results were correlated with patients' clinical and biochemical parameters.

Results: mRNA levels of genes promoting insulin sensitivity, APP and PTPN2, were significantly (p < 0.05) decreased in adipose tissue from patients with obesity, in both visceral (VAT) and subcutaneous (SAT) depots. After stratification by the triglyceride/high-density lipoprotein ratio (an indirect marker of insulin sensitivity), we found that individuals diagnosed with insulin resistance had lower VAT and SAT APP and PTPN2 mRNA levels, whereas APP expression was significantly decreased in VAT from patients with both obesity and type 2 diabetes compared to normoglycemic individuals with obesity, too. We also observed significant positive correlations between the mRNA levels of these genes and the expression of the above-mentioned adipokines. Finally, we analysed the levels of miRNAs targeting the mRNAs of the genes studied and observed significant negative correlations between APP mRNA levels and hsa-miR-579-5p and hsa-miR-142-3p, and between PTPN2 mRNA levels and hsa-miR-142-3p.

Conclusion: Adipose tissues of patients with obesity are characterised by altered expression of genes that are key for both insulin action and neuronal metabolism, and miRNAs may be involved in this phenomenon. However, due to the descriptive nature of our experiments, these results require verification in functional studies.

BACKGROUND: The Dietary Approaches to Stop Hypertension (DASH) diet has been associated with reduced cardiovascular risk, but its impact on mortality in individuals with chronic kidney disease (CKD) remains uncertain. METHODS: We analyzed data from 37,827 adults in the NHANES 1999–2014 cycles (without diabetes). Participants were stratified by CKD status (eGFR < 60 mL/min/1.73 m²) and DASH adherence (above or below median score). Mortality outcomes were assessed via the National Death Index. Multivariable Cox regression models, adjusted for demographics, comorbidities, and diet, were used to evaluate associations with all-cause, cardiovascular (CV), and cancer mortality. RESULTS: High DASH adherence was associated with healthier metabolic profiles and lower blood pressure. Among non-CKD participants, higher DASH scores were linked to significantly lower composite CV or cancer mortality (HR 0.896; 95% CI, 0.806–0.997; p = 0.0431), but not to all-cause, CV, or cancer mortality individually. No significant mortality associations were observed in participants with CKD, and interaction effects between DASH and CKD status were non-significant. Higher intake of dietary fiber, magnesium, and potassium was associated with reduced mortality in the overall and non-CKD populations. However, in CKD participants, high magnesium and potassium intake were paradoxically associated with increased cancer mortality. CONCLUSION: Greater adherence to the DASH diet is associated with lower CV and cancer-related mortality among individuals without CKD. In CKD patients, the benefits are less clear, and some nutrients may have differential effects. Personalized dietary strategies based on kidney function may be warranted.

BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is a major global health challenge, yet culturally tailored dietary interventions for Chinese populations remain understudied. This study aimed to evaluate the benefits of an isocaloric-restricted traditional Jiangnan diet (TJD) compared to a control diet (CD), with or without moderate-intensity physical exercise, on NAFLD. METHODS: In this 6-month randomized controlled trial, 228 overweight/obese patients with MRI-confirmed NAFLD recruited from Wannan Medical College Yijishan Hospital were randomly assigned to four groups: CD, CD-PA, TJD, or TJD-PA. The exercise protocol consisted of 35-minute moderate-intensity interval training (50%–70% heart rate range) performed 3–5 times per week. The primary outcome was the absolute percentage change in body weight. Secondary outcomes included changes in liver steatosis and stiffness measured by FibroScan. Data were analyzed using linear mixed-effects models following an intention-to-treat principle. RESULTS: After 6 months of interventions, weight loss was significant across all groups (Ptime < 0.001), with no significant group differences. Although no differences were observed among the four groups in glucose metabolism or lipid profile changes, the TJD-PA group showed significantly greater improvements in liver stiffness measurement (LSM, -0.38 kPa, 95% CI, -0.41 to -0.36), controlled attenuation parameter (CAP, -34.39 dB/m, 95% CI, -40.07 to -28.71), waist circumference (-5.20 cm, 95% CI, -5.32 to -5.09), and body fat percentage (-1.35%, 95% CI, -1.43 to -1.26) compared to the other three groups. CONCLUSION: These findings suggest that while isocaloric restriction effectively drives weight loss, the synergy between TJD and physical activity provides superior benefits in mitigating hepatic steatosis, fibrosis, and abdominal adiposity, offering a potent lifestyle strategy for NAFLD management in Chinese adults. TRIAL REGISTRATION: Chinese Clinical Trial Registry (ChiCTR) under registration (ChiCTR2500106462).

The global prevalence of metabolic diseases (MetDs) is rising annually and poses a major challenge to public health. Paeoniflorin(PF), a naturally occurring phytochemical, considerably improves insulin sensitivity, glucose and lipid metabolism, bile acid metabolism, inflammation and oxidative stress. This article comprehensively reviews recent research on the role of PF in the treatment of six common MetDs: diabetes mellitus and its complications, non-alcoholic fatty liver, non-alcoholic steatohepatitis, atherosclerosis, cholestasis, and polycystic ovary syndrome, along with its potential molecular mechanisms. In addition, we summarize the pharmacological and toxicological properties of PF and propose strategies to enhance its bioavailability, opening new avenues for its clinical application. Overall, this study demonstrates that PF exhibits therapeutic potential against various MetDs and may serve as a promising candidate for the treatment of metabolic disorders.

BACKGROUND: Coronary vascular disease (CVD) is the leading cause of mortality worldwide, while type 2 diabetes mellitus (T2DM) coexists in up to 40% of patients with established CVD and nearly doubles the risk of death. Heart rate recovery (HRR) is a recognized predictor of adverse cardiovascular outcomes, but the specific influence of T2DM on HRR remains incompletely understood. Metabolic inflexibility—reflected by a reduced peak respiratory exchange ratio (RER)—is characteristic of T2DM and may mediate its impact on HRR. We investigated this potential mediation relationship in post-percutaneous coronary intervention (PCI) patients. METHODS: We performed a single-center, retrospective cross-sectional study of 275 post-PCI patients at Beijing Anzhen Hospital from September 2023 to August 2024. Demographics, traditional cardiovascular risk factors, and physical activity status were recorded. Cardiopulmonary exercise testing (CPET) provided peak RER (RERpeak), ΔRER, and first-minute after peak exercise HRR (HRR1). Using multivariate regression, we assessed associations among T2DM, RER parameters, and HRR1, while adjusting for potential confounders. Mediation analysis evaluated whether RER parameters mediated the relationship between T2DM and HRR1. Subgroup analyses were conducted according to β-blocker use. RESULTS: A total of 275 post-PCI patients were included (198 without T2DM, 77 with T2DM). Compared with non-diabetic participants, those with T2DM exhibited significantly lower RERpeak (1.12 ± 0.07 vs. 1.17 ± 0.08; p < 0.001) and ΔRER (0.27 ± 0.08 vs. 0.31 ± 0.10; p = 0.001). T2DM was independently associated with worse HRR1 (β = − 2.47, 95% CI: − 4.53 to − 0.41, p = 0.0197) after adjustment. Both RERpeak and ΔRER were negatively correlated with T2DM and positively correlated with HRR1. Mediation analysis showed that RERpeak partially mediated 25.06% of T2DM’s adverse effect on HRR1, while ΔRER accounted for 17.62%. Subgroup analyses revealed that in patients not receiving β-blockers, RERpeak mediated 28.46% of the T2DM-HRR1 association, while ΔRER accounted for 13.51%; however, this mediation effect was not evident in β-blocker users. CONCLUSION: In this post-PCI population, metabolic inflexibility partially mediated the negative association between T2DM and impaired post-exercise HRR. These findings highlight the need to improve metabolic flexibility in diabetic patients as part of risk stratification and targeted therapeutic interventions.

BACKGROUND & AIMS: Chronic low-grade inflammation is implicated in sarcopenic obesity (SO); however, the relevance of routinely available blood cell inflammatory indices in SO remains unclear. This study aimed to examine the association between these indices and SO. METHODS: This cross-sectional study included 1,009 participants aged ≥ 50 years. SO was defined by the presence of both sarcopenia (defined based on sex-specific muscle mass percentage cutoffs: muscle mass < 39.3% for men or < 33.9% for women) and obesity [defined as body mass index (BMI) ≥ 28 kg/m², body fat percentage (PBF) ≥ 30% for men or ≥ 40% for women, visceral fat area (VFA) ≥ 100 cm², or waist circumference (WC) ≥ 80 cm for women and ≥ 90 cm for men]. Inflammatory indices, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-white blood cell ratio (PWR), systemic immune-inflammatory index (SII), systemic inflammation response index (SIRI), and aggregate inflammation systemic index (AISI), were calculated from routine blood tests. Multivariable logistic regression models were used to examine the associations between these indices and SO, with adjustments for potential confounders. RESULTS: When the WC classification was used, risk of SO was significantly associated with SIRI (OR = 1.361, 95% CI: 1.057–1.753; P = 0.017) and AISI (OR = 1.248, 95% CI: 1.022–1.524; P = 0.029), but inversely associated with PWR (OR = 0.621, 95% CI: 0.390–0.988; P = 0.040). Similar modest associations were observed under the VFA classification. Under the BMI ≥ 28 kg/m² definition, SIRI (OR = 1.539, 95% CI: 1.133–2.092; P = 0.006) and AISI (OR = 1.374, 95% CI: 1.066–1.771; P = 0.014) remained significantly associated with SO, with effect sizes in the modest-to-moderate range. However, no significant associations were observed when SO was defined using PBF, suggesting that inflammatory indices may be more closely related to central rather than generalized adiposity. CONCLUSIONS: The association between systemic immune inflammation indices and SO varied according to the obesity classification method. Given the cross-sectional design, these findings reflect associations rather than causality. SIRI, AISI, and PWR may have potential value in risk stratification, particularly under WC, VFA, or BMI ≥ 28 kg/m² definitions. Prospective studies with external validation are needed to confirm their clinical utility.