Association of homocysteinemia with high concentrations of serum insulin and uric acid in Brazilian subjects with metabolic syndrome genotyped for C677T polymorphism in the methylenetetrahydrofolate reductase gene

Information on plasma homocysteine concentrations and their associated factors in Brazilian subjects with metabolic syndrome (MS) is nonexistent. Therefore, a cross-sectional study was conducted to investigate the association of homocysteinemia with MS components; folate and cobalamin biochemical and dietary indices of nutritional status; and genetic, anthropometric, and lifestyle factors in Brazilian subjects with MS. Waist circumference; body fat; body mass index; insulin resistance; lipid profiles; glycemia; uricemia; insulinemia; erythrocyte folate and plasma homocysteine; folate and cobalamin concentrations; C677T polymorphism in the methylenetetrahydrofolate reductase (MTHFR) gene; coffee and alcohol intake; and smoking were determined in 63 subjects (24 males and 39 females) with MS. No difference in homocysteine plasma was observed between sexes. Hyperhomocysteinemia (Hhcy) frequency was 49.2% (n = 31) in the group studied. The distribution of MTHFR genotypes was as follows: CC, 64% (n = 42); CT, 32% (n = 19); and TT, 4% (n = 2). No association was found between Hhcy and C677T polymorphism in the MTHFR gene. Plasma homocysteine concentrations showed no association with age; blood pressure; dietary intakes of folate, cobalamin, and pyridoxine; body mass index; waist circumference; body fat; glycemia; lipid profile; insulin resistance; and concentrations of folate erythrocyte and plasma folate and cobalamin. Also, there was no correlation between Hhcy, sex, and lifestyle factors. In this study, the variables uricemia (C = 0.67, χ² = 2.23, P = .27) and insulinemia (C = 0.86, χ² = 2.98, P = .07) were positively associated with homocysteinemia. In conclusion, our results suggest that high concentrations of serum insulin and uric acid are associated with an increased risk of developing Hhcy in subjects with MS.     

The Insulin Resistance Atherosclerosis Study (IRAS) : Objectives, design, and recruitment results

The Insulin Resistance Atherosclerosis Study (IRAS) is the first epidemiologic study designed to assess the relationships between insulin resistance, insulinemia, glycemia, other components of the insulin resistance syndrome, and prevalent cardiovascular disease (CVD) in a large multiethnic cohort. Over 1600 men and women were recruited from four geographic areas to represent a range of glucose tolerance (normal, impaired, and diabetic) and ethnicity (hispanic, non-Hispanic white, and African-American). Insulin resistance was assessed directly using the frequently sampled intravenous glucose tolerance test with minimal model analysis. Intimal-medial carotid artery wall thickness, an indicator of atherosclerosis, was measured using B-mode ultrasonography. Prevalent CVD was assessed by questionnaire and resting electrocardiography. This report describes the design of the study and provides the recruitment results. Forthcoming cross-sectional analyses will help to disentangle the association between insulin resistance and CVD, apart from the concomitant hyperinsulinemia and related CVD risk factors.     

Glycemic Control and Metabolic Adaptation in Response to High-Fat versus High-Carbohydrate Diets—Data from a Randomized Cross-Over Study in Healthy Subjects

Granular study of metabolic responses to alterations in the ratio of dietary macro-nutrients can enhance our understanding of how dietary modifications influence patients with impaired glycemic control. In order to study the effect of diets enriched in fat or carbohydrates, fifteen healthy, normal-weight volunteers received, in a cross-over design, and in a randomized unblinded order, two weeks of an iso-caloric high-fat diet (HFD: 60E% from fat) and a high-carbohydrate diet (HCD: 60E% from carbohydrates). A mixed meal test (MMT) was performed at the end of each dietary period to examine glucose clearance kinetics and insulin and incretin hormone levels, as well as plasma metabolomic profiles. The MMT induced almost identical glycemia and insulinemia following the HFD or HCD. GLP-1 levels were higher after the HFD vs. HCD, whereas GIP did not differ. The HFD, compared to the HCD, increased the levels of several metabolomic markers of risk for the development of insulin resistance, e.g., branched-chain amino acid (valine and leucine), creatine and α-hydroxybutyric acid levels. In normal-weight, healthy volunteers, two weeks of the HFD vs. HCD showed similar profiles of meal-induced glycemia and insulinemia. Despite this, the HFD showed a metabolomic pattern implying a risk for a metabolic shift towards impaired insulin sensitivity in the long run.     

White button mushroom (Agaricus bisporus) lowers blood glucose and cholesterol levels in diabetic and hypercholesterolemic rats

Agaricus bisporus (white button mushroom; WBM) contains high levels of dietary fibers and antioxidants including vitamin C, D, and B₁₂; folates; and polyphenols that may provide beneficial effects on cardiovascular and diabetic diseases. The objective of this study was to examine the hypothesis that intake of the fruiting bodies of WBM regulates anticholesterolemic and antiglycemic responses in rats fed a hypercholesterolemic diet (0.5% cholesterol; 14% fat) and rats with type 2 diabetes induced by injection of streptozotocin (STZ) (50 mg/kg body weight), respectively. The STZ-induced diabetic male Sprague-Dawley rats fed the Agaricus bisporus powder (ABP; 200 mg/kg of body weight) for 3 weeks had significantly reduced plasma glucose and triglyceride (TG) concentrations (24.7% and 39.1%, respectively), liver enzyme activities, alanine aminotransferase and aspartate aminotransferase (11.7% and 15.7%, respectively), and liver weight gain (P < .05). In hypercholesterolemic rats, oral feeding of ABP for 4 weeks resulted in a significant decrease in plasma total cholesterol (TC) and low-density lipoprotein (LDL) (22.8% and 33.1%, respectively) (P < .05). A similar significant decrease in hepatic cholesterol and TG concentrations was observed (36.2% and 20.8%, respectively) (P < .05). Decrease in TC, LDL, and TG concentrations was accompanied by a significant increase in plasma high-density lipoprotein concentrations. It was concluded that A bisporus mushroom had both hypoglycemic and hypolipidemic activity in rats.     

Honey promotes lower weight gain, adiposity, and triglycerides than sucrose in rats

Various dietary carbohydrates have been linked to obesity and altered adipose metabolism; however, the influences of honey vs common sweeteners have not been fully explored. We hypothesized that in comparison with sucrose, a honey-based diet would promote lower weight gain, adiposity, and related biomarkers (leptin, insulin, and adiponectin) as well as a better blood lipid profile. Thirty-six male Sprague-Dawley rats (228.1 ± 12.5 g) were equally divided by weight into 2 groups (n = 18) and provided free access to 1 of 2 diets of equal energy densities differing only in a portion of the carbohydrate. Diets contained 20% carbohydrate (by weight of total diet) from either clover honey or sucrose. After 33 days, epididymal fat pads were excised and weighed, and blood was collected for analyses of serum concentrations of lipids, glucose, and markers of adiposity and inflammation. Body weight gain was 14.7% lower (P ≤ .05) for rats fed honey, corresponding to a 13.3% lower (P ≤ .05) consumption of food/energy, whereas food efficiency ratios were nearly identical. Epididymal fat weight was 20.1% lower (P ≤ .05) for rats fed honey. Serum concentrations of triglycerides and leptin were lower (P ≤ .05) by 29.6% and 21.6%, respectively, and non-high-density lipoprotein cholesterol was higher (P ≤ .05) by 16.8% for honey-fed rats. No significant differences in serum total cholesterol, high-density lipoprotein cholesterol, adiponectin, C-reactive protein, monocyte chemoattractant protein-1, glucose, or insulin were detected. These results suggest that in comparison with sucrose, honey may reduce weight gain and adiposity, presumably due to lower food intake, and promote lower serum triglycerides but higher non-high-density lipoprotein cholesterol concentrations.     

Postprandial hyperglycemia and insulin sensitivity differ among lean young adults of different ethnicities

Both postprandial hyperglycemia and insulin resistance (IR) have implications for the development of cardiovascular disease. The present study was designed to examine differences in postprandial glycemia and insulin sensitivity among young adults of different ethnic origins. Lean, healthy subjects (n = 60) from five ethnic groups [20 European Caucasians, 10 Chinese, 10 South East (SE) Asians, 10 Asian Indians and 10 Arabic Caucasians] were matched for age, body mass index, waist circumference, birth weight and current diet. A 75-g white bread carbohydrate challenge was fed to assess postprandial glycemia and insulinemia. Insulin sensitivity was assessed in three groups by the euglycemic-hyperinsulinemic clamp and in all subjects by homeostasis model assessment (HOMA) modeling. Postprandial hyperglycemia (incremental area under the curve) and insulin sensitivity (M-value) both showed a twofold variation among the groups (P < 0.001) and were significantly related to each other (R(2) = 56%, P < 0.001). Young SE Asians had the highest postprandial glycemia and lowest insulin sensitivity, whereas European and Arabic Caucasian subjects were the most insulin sensitive and carbohydrate tolerant. These findings suggest that IR is evident even in lean, young adults of some ethnic groups and is associated with significant increases in postprandial glycemia and insulinemia in response to a realistic carbohydrate load.     

Effect of Diets Differing in Glycemic Index and Glycemic Load on Cardiovascular Risk Factors: Review of Randomized Controlled-Feeding Trials

Despite a considerable amount of data available on the relationship between dietary glycemic index (GI) or load (GL) and cardiovascular disease (CVD) risk factors, in aggregate, the area remains unsettled. The aim of the present review was to summarize the effect of diets differing in GI/GL on CVD risk factors, by examining randomized controlled-feeding trials that provided all food and beverages to adult participants. The studies included a low and high GI/GL diet phase for a minimum of four weeks duration, and reported at least one outcome related to CVD risk; glucose homeostasis, lipid profile or inflammatory status. Ten publications representing five trials were identified. The low GI/GL compared to the high GI/GL diet unexpectedly resulted in significantly higher fasting glucose concentrations in two of the trials, and a lower area under the curve for glucose and insulin in one of the two studies during an oral glucose tolerance test. Response of plasma total, low density lipoprotein and high density lipoprotein cholesterol concentrations was conflicting in two of the studies for which data were available. There was either weak or no effect on inflammatory markers. The results of the five randomized controlled trials satisfying the inclusion criteria suggest inconsistent effects of the GI/GL value of the diet on CVD risk factors.     

Green tea extract reduces blood pressure,inflammatory biomarkers,and oxidative stress and improves parameters associated with insulin resistance in obese,hypertensive patients

Green tea (GT) consumption is known to be associated with enhanced cardiovascular and metabolic health. The purpose of this study is to examine the hypothesis that supplementation with GT alters insulin resistance and associated cardiovascular risk factors in obese, hypertensive patients. In a double-blind, placebo-controlled trial, 56 obese, hypertensive subjects were randomized to receive a daily supplement of 1 capsule that contained either 379 mg of GT extract (GTE) or a matching placebo, for 3 months. At baseline and after 3 months of treatment, the anthropometric parameters, blood pressure, plasma lipid levels, glucose levels, creatinine levels, tumor necrosis factor α levels, C-reactive protein levels, total antioxidant status, and insulin levels were assessed. Insulin resistance was evaluated according to the homeostasis model assessment–insulin resistance protocol. After 3 months of supplementation, both systolic and diastolic blood pressures had significantly decreased in the GTE group as compared with the placebo group (P < .01). Considerable (P < .01) reductions in fasting serum glucose and insulin levels and insulin resistance were observed in the GTE group when compared with the placebo group. Serum tumor necrosis factor α and C-reactive protein were significantly lower, whereas total antioxidant status increased in the GTE group compared with the placebo (P < .05). Supplementation also contributed to significant (P < .05) decreases in the total and low-density lipoprotein cholesterol and triglycerides, but an increase in high-density lipoprotein cholesterol. In conclusion, daily supplementation with 379 mg of GTE favorably influences blood pressure, insulin resistance, inflammation and oxidative stress, and lipid profile in patients with obesity-related hypertension.     

High Fat Diet Exposure during Fetal Life Enhances Plasma and Hepatic Omega-6 Fatty Acid Profiles in Fetal Wistar Rats

Pregnant rats were fed a high fat diet (HFD) for the first (HF1), second (HF2), third (HF3) or all three weeks (HFG) of gestation. Maintenance on a HFD during specific periods of gestation was hypothesized to alter fetal glycemia, insulinemia, induce insulin resistance; and alter fetal plasma and hepatic fatty acid (FA) profiles. At day 20 of gestation, fetal plasma and hepatic FA profiles were determined by gas chromatography; body weight, fasting glycemia, insulinemia and the Homeostasis Model Assessment (HOMA-insulin resistance) were also determined. HF3 fetuses were heaviest concomitant with elevated glycemia and insulin resistance (p < 0.05). HFG fetuses had elevated plasma linoleic (18:2 n-6) and arachidonic (20:4 n-6) acid proportions (p < 0.05). In the liver, HF3 fetuses displayed elevated linoleic, eicosatrienoic (20:3 n-6) and arachidonic acid proportions (p < 0.05). HFG fetuses had reduced hepatic docosatrienoic acid (22:5 n-3) proportions (p < 0.05). High fat maintenance during the final week of fetal life enhances hepatic omega-6 FA profiles in fetuses concomitant with hyperglycemia and insulin resistance thereby presenting a metabolically compromised phenotype.     

Aqueous extract of tamarind seeds selectively increases glucose transporter-2, glucose transporter-4, and islets' intracellular calcium levels and stimulates β-cell proliferation resulting in improved glucose homeostasis in rats with streptozotocin-induced diabetes mellitus

Tamarindus indica Linn. has been in use for a long time in Asian food and traditional medicine for different diseases including diabetes and obesity. However, the molecular mechanisms of these effects have not been fully understood. In view of the multidimensional activity of tamarind seeds due to their having high levels of polyphenols and flavonoids, we hypothesized that the insulin mimetic effect of aqueous tamarind seed extract (TSE) might increase glucose uptake through improvement in the expression of genes of the glucose transporter (GLUT) family and sterol regulatory element-binding proteins (SREBP) 1c messenger RNA (mRNA) in the liver. Daily oral administration of TSE to streptozotocin (STZ)–induced (90 mg/kg intraperitoneally) type 2 diabetic male Wistar rats at different doses (120 and 240 mg/kg body weight) for 4 weeks showed positive correlation with intracellular calcium and insulin release in isolated islets of Langerhans. Tamarind seed extract supplementation significantly improved the GLUT-2 protein and SREBP-1c mRNA expression in the liver and GLUT-4 protein and mRNA expression in the skeletal muscles of diabetic rats. The elevated levels of serum nitric oxide (NO), glycosylated hemoglobin level (hemoglobin _A1c) and tumor necrosis factor α (TNF-α) decreased after TSE administration. Immunohistochemical findings revealed that TSE abrogated STZ-induced apoptosis and increased β-cell neogenesis, indicating its effect on islets and β-cell mass. In conclusion, it was found that the antidiabetic effect of TSE on STZ-induced diabetes resulted from complex mechanisms of β-cell neogenesis, calcium handling, GLUT-2, GLUT-4, and SREBP-1c. These findings show the scope for formulating a new herbal drug for diabetes therapy.     

Hypoglycemic and hypolipidemic effects of Saururus chinensis Baill in streptozotocin-induced diabetic rats

Saururus chinensis Baill was reported to inhibit α-glucosidase in vitro and flatten postprandial increase in blood glucose in streptozotocin (STZ)-induced diabetic rats. We studied the effect of chronic consumption of S. chinensis Baill on blood glucose and lipid profile in STZ-induced diabetic male rats fed high fat diet. Male rats weighing 100-120 g were fed 30% fat diet with and without 10% freeze-dried leaves of S. chinensis Baill for 7 weeks after 1 week of adaptation. The rats were rendered diabetic by intravenous injection of STZ (60 mg/kg) after 6-week feeding of the assigned diets. At 1 week after the injection, the rats were sacrificed after an overnight fast. Plasma glucose (380.2 ± 14.4 mg/dL), total cholesterol (93.9 ± 7.9 mg/dL) and triglyceride levels (123.6 ± 7.5 mg/dL) of the S. chinensis Baill group were significantly lower than those of the control group (418.1 ± 12.0 mg/dL, 119.9 ± 9.4 mg/dL, 152.0 ± 10.3 mg/dL, respectively, p<0.05). Chronic consumption of S. chinesis Baill significantly decreased maltase activity of the small intestinal mucosa (120.1 ± 8.7 U/g protein) compared with the control group (96.8 ± 7.0 U/g protein, p<0.05). These results suggest that S. chinensis Baill have hypoglycemic and hypolipidemic effects by inhibiting α-glucosidase activity in the animal model of diabetes mellitus.     

Inclusion of Atlantic salmon in the Chinese diet reduces cardiovascular disease risk markers in dyslipidemic adult men

Although the beneficial effects of n-3 fatty acids on several physiologic functions have been widely reported, information about the effects of oily fish in the Asian diet on cardiovascular disease (CVD) risk is diminutive. We hypothesize that daily inclusion of oily fish for 8 weeks in the Chinese diet will elevate serum eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) levels and reduce CVD risk markers in dyslipidemic adult men, comparable with the effects generally observed by inclusion of oily fish in the Western diet. In this 8-week randomized, parallel-arm, food-based intervention study, lunches were prepared with 500 g pork/chicken/beef, typically consumed fish (hairtail and freshwater carp), or oily fish (salmon). Male subjects aged between 35 and 70 years with hyperlipidemia were randomly assigned to eat lunches with pork/chicken/beef (n = 30 subjects at 8 weeks), freshwater fish (n = 30), or oily fish (n = 32). Circulating markers were measured at baseline and at 8 weeks. In the oily fish diet, dietary EPA and DHA levels were significantly increased as compared with other diets; and the n-6:n-3 polyunsaturated fatty acid ratio was decreased (P < .05). Thus, the oily fish diet significantly elevated serum EPA and DHA concentrations (P < .01) and lowered serum n-6:n-3 ratio at 8 weeks (P < .05). Furthermore, oily fish intake significantly reduced serum levels of triglycerides (P < .05) and interleukin-6 (P < .01) and increased levels of high-density lipoprotein cholesterol (P < .01). In conclusion, daily inclusion of oily fish as part of the Chinese diet for 8 weeks is sufficient to significantly increase the serum content of long-chain n-3 polyunsaturated fatty acids and reduce levels of CVD risk markers in dyslipidemic adult men.     

A mixture of Salacia reticulata (Kotala himbutu) aqueous extract and cyclodextrin reduces body weight gain,visceral fat accumulation,and total cholesterol and insulin increases in male Wistar fatty rats

This study examined the effects of a mixture of an aqueous extract of Salacia reticulata (Kotala himbutu) and cyclodextrin (SRCD) on various metabolic parameters and cecal fermentation in obese fa/fa male Wistar fatty rats, a model of type 2 diabetes mellitus. Wistar fatty rats were fed 0% (control group) or 0.2% SRCD-supplemented diets and weighed weekly. The plasma glucose, triacylglycerol, total cholesterol, insulin, and adiponectin concentrations were measured at weeks 0, 2, 4, and 5. SRCD supplementation suppressed the time-dependent increase in the plasma total cholesterol and insulin concentrations. After 6 weeks of a 0.2% SRCD-supplemented diet, the body weight gain, food intake, visceral fat mass, liver mass, and liver triacylglycerol content of the rats were significantly lower, whereas the plasma adiponectin concentrations were significantly higher than those of the control group. SRCD supplementation had no significant effect on plasma glucose and triacylglycerol concentrations. SRCD supplementation significantly increased cecum mass, whereas it significantly decreased the cecal butyrate and short-chain fatty acid (sum of the acetate, butyrate, and propionate) concentrations. All of the rats were subjected to an oral glucose tolerance test at the beginning of week 6. The area under the curve for insulin was significantly smaller with SRCD supplementation and showed no change in glucose tolerance compared to that of the control group. These results suggest that bioactive compounds in SRCD may suppress the development of type 2 diabetes mellitus by influencing glucose and lipid metabolism in male Wistar fatty rats and that SRCD may influence cecal fermentation.     

The lipid accumulation product is highly related to serum alanine aminotransferase level in male adults

Studies confirm that the lipid accumulation product (LAP), which is based on the waist circumference and fasting serum triglycerides, is highly related to cardiovascular and metabolic diseases. Nonalcoholic fatty liver disease is a hepatic manifestation of metabolic syndrome and closely correlated with the alanine aminotransferase (ALT) elevation. Abdominal obesity and dyslipidemia are the important risk factors for nonalcoholic fatty liver disease. Our aim was to examine the correlation between the LAP and ALT in apparently healthy adults. We conducted a cross-sectional study of 587 adults. The blood pressure, anthropometric measurements, fasting and postload glucose, insulin, fasting lipid profile, and liver enzymes were measured. The LAP was calculated. For each gender, the subjects were divided into 3 groups according to the ALT level. The correlation between the LAP and ALT was analyzed. The LAP increased progressively across the ALT tertiles. A Pearson correlation analysis demonstrated that the LAP positively associated with the ALT in men and women (both P < .05) but independently related to the ALT only in men. Furthermore, after adjusting for the other confounding factors, the subjects in the upper quartile of LAP was 3.61 times more likely to show ALT elevation compared with those in the lower quartiles in men. In addition, in men, the LAP was considered as the best marker to predict increased ALT. Our findings suggested that the LAP was independently correlated with the ALT but only in men. The LAP was the main risk marker and might be superior to other variables in recognizing increased ALT.     

Low protein diet changes the energetic balance and sympathetic activity in brown adipose tissue of growing rats

ObjectiveThe aim of this study was to assess the effects of protein restriction in growing rats.MethodsRats (approximate weight, 100 g) were maintained with low-protein (LP; 6%) or normoproteic (control; 17%) diets, and at the end of the 15th day, hormonal and biochemistry parameters and energetic balance were evaluated. Data were analyzed using Student's t test (with statistical significance set at P ≤ .05).ResultsLP animals were hyperphagic and showed increased energetic gain (24%) and energy expenditure (EE) compared with controls. The increase in EE was followed by increased sympathetic activity in brown adipose tissue, evidenced by increased norepinephrine turnover, suggesting increased thermogenesis. In spite of hyperphagia, protein ingestion in LP animals was lower than that of controls (P < 0.01). The LP diet impaired body growth and caused deep alterations in body chemical composition, with an increase in carcass lipid content (64%) and reductions of protein and water. In LP animals, postprandial glycemia was unchanged, and insulinemia was lower than in controls (P ≤ .01). Reduction in fasting glycemia without changes in insulinemia also was detected (P < .01), suggesting increased insulin sensitivity. The LP diet caused a 100% increase in serum leptin (P < .01).ConclusionsProtein restriction led to an increase in EE, with probable activation of thermogenesis in brown adipose tissue, evidenced by an increase in catecholamines levels. Despite the higher EE, energetic gain and lipids increased. The high level of leptin associated with hyperphagia led to the supposition that these animals are leptin resistant, and the increase in insulin sensitivity, suggested by the relation between insulin and glycemia in fasting and fed animals, might contribute to lipid accumulation.     

Olive leaf extract suppresses messenger RNA expression of proinflammatory cytokines and enhances insulin receptor substrate 1 expression in the rats with streptozotocin and high-fat diet–induced diabetes

Type 2 diabetes, characterized by hyperglycemia and hyperlipidemia, is a metabolic disease resulting from defects in both insulin secretion and insulin resistance. Recently, olive leaf has been reported as an anti-inflammatory, antioxidant, and antidiabetic agent. This study sought to investigate whether olive leaf extract can improve the insulin resistance and inflammation response in rats with type 2 diabetes induced by high-fat diet and streptozotocin. After administering olive leaf extract for 8 weeks (200 and 400 mg/kg body weight), rats given the higher dose showed significantly lower blood glucose, serum total cholesterol, and triglyceride levels compared with those of diabetic control rats (P < .05). Results of oral glucose tolerance tests, homeostasis model assessment of insulin resistance, and messenger RNA (mRNA) expression of tumor necrosis factor α and interleukin (IL) 6 in the liver show significantly decreased glucose level in rats given either dose of olive leaf extract (P < .05). Both olive leaf extract–treated groups showed significantly increased insulin receptor substrate 1 expression (P < .05). Tumor necrosis factor α, IL-6 and IL-1β mRNA expressions in epididymis adipose tissue were significantly lower in rats that received higher dose of olive leaf extract (P < .05). Lymphocyte infiltration was not observed in these rats. The results suggest that olive leaf extract may attenuate insulin resistance by suppressing mRNA expression of proinflammatory cytokines and elevating of insulin receptor substrate 1 expression.     

Brazilian nut consumption improves selenium status and glutathione peroxidase activity and reduces atherogenic risk in obese women

Studies have shown that there are inverse relationships between nut consumption and the reduction of cardiovascular risk. This study tested the hypothesis that daily consumption of Brazilian nuts would have a positive effect upon selenium (Se) status, erythrocyte glutathione peroxidase activity, lipid profile, and atherogenic risk in severely obese women. Thirty-seven severely obese women each consumed 1 Brazilian nut a day (290 μg of Se a day) for 8 weeks. Blood Se concentrations, total erythrocyte glutathione peroxidase activity, lipid profile, and Castelli I and II indexes were evaluated before and after the nuts consumption. All the patients were Se deficient at baseline; this deficiency was remedied by the consumption of the Brazilian nut (P < .0001). The intake of Brazilian nuts promoted a significant increase in high-density lipoprotein cholesterol concentrations (P < .00001), which then resulted in a significant improvement of the Castelli I (P < .0002) and II (P < .0004) indexes. This study shows that obese people who implement daily consumption of Brazilian nuts can improve both Se status and lipid profile, especially high-density lipoprotein cholesterol levels, thereby reducing cardiovascular risks.     

Cardiovascular risk factors in young,overweight, and obese European adults and associations with physical activity and omega-3 index

Excess body fat is associated with increased cardiovascular disease (CVD) risk. The hypothesis of the study was that physical activity and omega-3 index, a marker of past long chain n-3 polyunsaturated fatty acids consumption, counteract the negative associations between fatness and CVD risk factors in young overweight and obese adults. A total of 324 subjects (20-40 years, body mass index [BMI], 27.5-32.5 kg/m², from Iceland, Spain, and Ireland) were investigated cross-sectionally. Dietary intake, anthropometric measurements, blood pressure, CVD risk factors, and fatty acids in erythrocyte membrane were analyzed. Information on physical activity was collected. Linear models were constructed to find out the associations of BMI, physical activity (quartiles), and omega-3 index with CVD risk factors. The most frequently increased risk factors were blood lipids (41.4%) and blood pressure (32.1%); fewer participants experienced disturbed glucose metabolism (11.8%). Body mass index was significantly associated with increased CVD risk factors (P = .001-.029), with the exception of total cholesterol, low-density lipoprotein, and high-density lipoprotein. The highest physical activity quartile had a lower fat mass (P = .005, at a given BMI), leptin (P = .008, in male participants only), and interleukin 6 (P = .021) but higher high-density lipoprotein (P = .020) than other quartiles; however, an approximate dose-response relationship could only be observed for leptin. The omega-3 index was not associated with lower low-density lipoprotein (P = .056), but docosahexaenoic acid in erythrocyte membrane was associated to it (P = .016). It is concluded that physical activity and docosahexaenoic acid diminish some of the negative health effects associated with overweight and obesity; however, body fatness remains the most important variable associated with increased CVD risk factors in young overweight and obese adults.     

Higher Serum Total Cholesterol to High-Density Lipoprotein Cholesterol Ratio Is Associated with Increased Mortality among Incident Peritoneal Dialysis Patients

This study evaluated the association of the serum total cholesterol to high-density lipoprotein cholesterol ratio (TC/HDL-C) with mortality in incident peritoneal dialysis (PD) patients. We performed a multi-center, prospective cohort study of 630 incident PD patients from 2008 to 2015 in Korea. Participants were stratified into quintiles according to baseline TC, HDL-C, LDL-C and TC/HDL-C. The association between mortality and each lipid profile was evaluated using multivariate Cox regression analysis. During a median follow-up period of 70.3 ± 25.2 months, 185 deaths were recorded. The highest TC/HDL-C group had the highest body mass index, percentage of diabetes and serum albumin level. Multivariate analysis demonstrated that the highest quintile of TC/HDL-C was associated with increased risk of all-cause mortality (hazard ratio 1.69, 95% confidence interval 1.04–2.76; p = 0.036), whereas TC, HDL-C and LDL-C were not associated with mortality. Linear regression analysis showed a positive correlation between TC/HDL-C and body mass index. Increased serum TC/HDL-C was an independent risk factor for mortality in the subgroup of old age, female, cardiovascular disease and low HDL-C. The single lipid marker of TC or HDL-C was not able to predict mortality in PD patients. However, increased serum TC/HDL-C was independently associated with all-cause mortality in PD patients.     

Increased interleukin-10 but unchanged insulin sensitivity after 4 weeks of (1, 3)(1, 6)-β-glycan consumption in overweight humans

Obesity-induced insulin resistance has been suggested to be a systemic inflammatory condition with activation of the innate immune system. Animal studies indicate that certain dietary fibers such as (1,3)(1,6)-β-d-glycans (BDG) have potent effects on immune activity such as increasing the antiinflammatory cytokine interleukin-10 (IL-10) and reducing the secretion of inflammatory factors. Therefore, we hypothesized that BDG consumption improves inflammatory markers and insulin sensitivity in overweight and obese subjects with moderately increased levels of C-reactive protein, indicating subclinical inflammation. We screened 180 overweight and obese subjects for moderately increased C-reactive protein levels on 2 or more occasions, in the absence of any signs of acute infection. Twelve of the subjects met all inclusion criteria and were investigated in a randomized, double-blind, placebo-controlled, crossover design for 2 × 4 weeks (washout ≥4 weeks). Subjects ingested capsules containing 3 × 0.5 g of highly purified BDG or 3 × 0.5 g of placebo (waxy maize starch) daily. Maintenance of the normal diet of the participants and the correct intake of the capsules were monitored, using 6 × 3-day food recording and counting of the provided capsules. Predefined outcome measures were BDG-induced changes in pro and antiinflammatory markers in circulating blood and gene expression in adipose tissue and peripheral insulin sensitivity expressed as M value. The BDG consumption for 4 weeks significantly increased both circulating levels and adipose tissue messenger RNA (mRNA) expression of the antiinflammatory cytokine IL-10 in overweight and obese humans. Insulin sensitivity as well as circulating levels and mRNA expression of proinflammatory cytokines were unaffected by BDG treatment. Increased IL-10 after BDG consumption might be a contributing factor to the known beneficial effects of dietary fiber intake.