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Clinical Impact of Supplementation of Vitamins B1 and C on Patients with Sepsis-Related Acute Respiratory Distress Syndrome.
Yoo, JW, Kim, RB, Ju, S, Lee, SJ, Cho, YJ, Jeong, YY, Lee, JD, Kim, HC
Tuberculosis and respiratory diseases. 2020;83(3):248-254
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Acute respiratory distress syndrome (ARDS) is a life-threatening condition that commonly develops in patients with sepsis. Patients with ARDS require admission to intensive care and invasive mechanical ventilation. Vitamin B1 and C deficiencies have been reported in critically ill patients with sepsis. Vitamin B1 is involved in aerobic metabolism, and vitamin C has anti-inflammatory and anti-oxidative effects. The aim of this Korean retrospective cohort study was to evaluate the clinical impact of vitamin B1 and C supplementation in patients with sepsis-related ARDS. Patients with ARDS requiring invasive mechanical ventilation, admitted to an intensive care unit (ICU) were included in this study. Clinical outcomes were compared between patients administered with vitamin B1 (200 mg/day) and C (2 g/day) between June 2018-May 2019 (the supplementation group) and those who did not receive vitamin B1 and C administration between June 2017-May 2018 (the control group). Seventy-nine patients were included. Thirty-three patients received vitamin B1 and C, and 46 patients did not. There were no significant differences in the number of deaths between the patients who received vitamin B1 and C and those who did not. The mean number of days not requiring ICU admission or ventilation was greater in patients supplemented with vitamin B1 and C than that in the control patients, but the difference was not statistically significant. Steroid administration was more frequent in patients receiving vitamin B1 and C supplementation than in those without it. The authors concluded that Vitamin B1 and C supplementation at the doses used in this study did not reduce the death rates in ARDS patients.
Abstract
BACKGROUND Although few studies have reported improved clinical outcomes with the administration of vitamin B1 and C in critically ill patients with septic shock or severe pneumonia, its clinical impact on patients with sepsis-related acute respiratory distress syndrome (ARDS) remains unclear. The purpose of this study was to evaluate the association with vitamin B and C supplementation and clinical outcomes in patients with ARDS. METHODS Patients with ARDS requiring invasive mechanical ventilation, admitted to the medical intensive care unit (ICU) were included in this study. Clinical outcomes were compared between patients administered with vitamin B1 (200 mg/day) and C (2 g/day) June 2018-May 2019 (the supplementation group) and those who did not receive vitamin B1 and C administration June 2017-May 2018 (the control group). RESULTS Seventy-nine patients were included. Thirty-three patients received vitamin B1 and C whereas 46 patients did not. Steroid administration was more frequent in patients receiving vitamin B1 and C supplementation than in those without it. There were no significant differences in the mortality between the patients who received vitamin B1 and C and those who did not. There were not significant differences in ventilator and ICU-free days between each of the 21 matched patients. CONCLUSION Vitamin B1 and C supplementation was not associated with reduced mortality rates, and ventilator and ICU-free days in patients with sepsis-related ARDS requiring invasive mechanical ventilation.
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The Effect of Moderate Weight Loss on a Non-Invasive Biomarker of Liver Fibrosis: A Randomised Controlled Trial.
Koutoukidis, DA, Jebb, SA, Aveyard, P, Astbury, NM
Obesity facts. 2020;13(2):144-151
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Non-alcoholic fatty liver disease covers a range of conditions from excess fat in the liver through inflammation and fibrosis, to advanced fibrosis, and cirrhosis. The Enhanced Liver Fibrosis (ELF) score is emerging as a promising blood biomarker for fibrosis. The aim of this study was to examine whether a community weight loss programme reduces ELF score over 12 months compared with a weight-loss intervention which is less effective. This study is a secondary analysis of a published randomised controlled trial. Participants (n=73) were equally randomised to a community weight loss programme (WeightWatchers) or usual care. Results indicate that there was no evidence of an effect of a community weight loss programme on changes in the ELF score and no association between weight loss and the ELF score in people who had, on average, an ELF score compatible with moderate fibrosis. Authors conclude that using the ELF test to assess weight loss treatment efficacy in improving liver fibrosis may be of limited value, thus biopsy remains the gold-standard assessment for liver fibrosis.
Abstract
BACKGROUND Referral to weight loss programmes is the only effective treatment for non-alcoholic fatty liver disease (NAFLD). Clinicians should advise weight loss and screen for liver fibrosis using the Enhanced Liver Fibrosis (ELF) score. AIM: To examine if the ELF score changes with weight loss. DESIGN AND SETTING Randomised controlled trial (ISRCTN85485463) in UK primary care during 2007-2008. METHOD Adults with a BMI of 27-35 kg/m2 and ≥1 risk factor for obesity-related disease were randomised to attend a community weight loss programme (n = 45) or receive usual weight loss advice from a practice nurse (n = 28). Weight and the ELF score were measured at baseline and 1 year. Analysis of covariance examined mean changes in the ELF score between groups and its relationship with weight loss. RESULTS Mean (SD) BMI was 31.10 kg/m2 (2.55) with evidence of moderate levels of liver fibrosis at baseline (mean ELF score: 8.93 [0.99]). There was no evidence that the community weight loss programme reduced the ELF score compared with usual care (difference +0.13 points, 95% CI: -0.25 to 0.52) despite greater weight loss (difference: -2.66 kg, 95% CI: -5.02 to -0.30). Mean weight loss in the whole cohort was 7.8% (5.9). There was no evidence of an association between weight change and change in ELF; the coefficient for a 5% weight loss was -0.15 (95% CI: -0.30 to 0.0002). CONCLUSION We found no evidence that the ELF score changed meaningfully following moderate weight loss. Clinicians should not use the ELF score to measure improvements in NAFLD fibrosis following weight loss programmes.
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Stratifying cellular metabolism during weight loss: an interplay of metabolism, metabolic flexibility and inflammation.
Tareen, SHK, Kutmon, M, de Kok, TM, Mariman, ECM, van Baak, MA, Evelo, CT, Adriaens, ME, Arts, ICW
Scientific reports. 2020;10(1):1651
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Obesity is a public health concern as it has been linked to cardiovascular diseases, type 2 diabetes and metabolic syndrome. The aim of this study was to identify and analyse expression profiles of individuals clustered by cellular metabolism centring on metabolic flexibility. This study clustered gene expression samples from a weight loss study (Yoyo study’ - Clinical Trial ID: NCT01559415) into two clusters, based on 291 genes associated with cellular metabolic fexibility. The study covers two diets: a low-calorie diet (LCD) and a very low-calorie diet (VLCD). All the participants of the study were Caucasian with a BMI between 28kg/m2 and 35 kg/m2, aged between 32 and 67 years old. Findings showed that the majority of the individuals had their metabolism associated genes downregulated after weight loss and weight maintenance, but also had an upregulation of immune system associated genes. Furthermore, individuals who had changed their metabolic profiles in response to caloric restriction had a significant retention of lost weight compared to individuals which had not changed their cluster membership. Authors conclude that their findings indicate possible cross-talk between cellular metabolism and inflammation.
Abstract
Obesity is a global epidemic, contributing significantly to chronic non-communicable diseases, such as type 2 diabetes mellitus, cardiovascular diseases and metabolic syndrome. Metabolic flexibility, the ability of organisms to switch between metabolic substrates, is found to be impaired in obesity, possibly contributing to the development of chronic illnesses. Several studies have shown the improvement of metabolic flexibility after weight loss. In this study, we have mapped the cellular metabolism of the adipose tissue from a weight loss study to stratify the cellular metabolic processes and metabolic flexibility during weight loss. We have found that for a majority of the individuals, cellular metabolism was downregulated during weight loss, with gene expression of all major cellular metabolic processes (such as glycolysis, fatty acid β-oxidation etc.) being lowered during weight loss and weight maintenance. Parallel to this, the gene expression of immune system related processes involving interferons and interleukins increased. Previously, studies have indicated both negative and positive effects of post-weight loss inflammation in the adipose tissue with regards to weight loss or obesity and its co-morbidities; however, mechanistic links need to be constructed in order to determine the effects further. Our study contributes towards this goal by mapping the changes in gene expression across the weight loss study and indicates possible cross-talk between cellular metabolism and inflammation.
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Significant Impact of the Ketogenic Diet on Low-Density Lipoprotein Cholesterol Levels.
Salas Noain, J, Minupuri, A, Kulkarni, A, Zheng, S
Cureus. 2020;12(7):e9418
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Ketogenic diet includes food with a very low-carbohydrate and high-fat content that aims to drastically reduce carbohydrate intake and replace it with fat, hence inducing ketosis. This study is a case report which presents a case of a rapid increase, followed by a rapid correction of low-density lipoprotein cholesterol (LDL-C) in a patient following a ketogenic diet. The patient is a 56-year-old Hispanic female who showed a rapid increase in LDL-C and total cholesterol after only 30-40 days of following a ketogenic diet. She was directed to follow a balanced diet and take statin medication. Results showed that the patient's BMI, four weeks after the discontinuation of ketogenic diet, did not change despite a marked improvement in her LDL-C. Authors conclude that due to the unpredictable response of LDL-C levels to a ketogenic diet, close monitoring of patients with a high risk of cardiovascular disease should be considered.
Abstract
It is well known, based on the previous research, that a ketogenic diet leads to an improvement in the lipid profile and decreases cardiovascular risk factors such as hypertension. However, recent studies have also reported increased levels of total cholesterol and low-density lipoprotein cholesterol (LDL-C) as a result of this diet. It has been postulated that this elevation in LDL-C would not likely increase cardiovascular complications due to the large LDL-C particle size. In this case report, we present a case of a rapid increase, followed by a rapid correction of LDL-C, in a patient following a ketogenic diet. A 56-year-old Hispanic female with a past medical history of hypertension and fibromyalgia presented to the outpatient clinic for evaluation of fatigue. She reported that she had been following a strict ketogenic diet along with daily regular exercise for approximately 30-40 days prior to this visit. Her diet consisted of low-carbohydrate vegetables, seafood, avocados, eggs, and coconut oil. The patient's physical exam was unremarkable. At the time of the visit, her BMI was calculated at 28 kg/m2, with a weight loss of approximately six to seven pounds since starting the ketogenic diet. Her fasting lipid profile showed a total cholesterol of 283 mg/dl, LDL-C of 199 mg/dl, high-density lipoprotein cholesterol (HDL-C) of 59 mg/dl, and triglycerides levels of 124 mg/dl. She was instructed to stop the ketogenic diet and to incorporate a balanced diet, which includes a higher amount of carbohydrates and lower fat. She was also started on high-intensity atorvastatin. However, she reported experiencing myalgias soon after initiating atorvastatin; therefore, the medication was switched to rosuvastatin 10 mg at bedtime. During her follow-up appointment, she reported not having consistently taken rosuvastatin due to the concern of worsening myalgias. Her lipid profile, after four weeks of ketogenic diet discontinuation and inconsistent use of statins, showed significant improvement resulting in a total cholesterol level of 190 mg/dl and LDL-C of 106 mg/dl. Statin therapy was discontinued, and the patient maintained optimal LDL-C levels on subsequent testing. This patient showed a rapid increase in LDL-C and total cholesterol after only 30-40 days of the ketogenic diet. Her drastic elevation in LDL-C could also be explained due to the rapid weight loss, as cholesterol in the adipose tissue is known to mobilize as the fat cells shrink. Interestingly, her BMI four weeks after the discontinuation of the ketogenic diet did not change despite a marked improvement in her LDL-C. Therefore, we believe the acute onset and resolution of hyperlipidemia was secondary to the ketogenic diet itself. This study helps to better understand expectations when recommending a ketogenic diet to patients and its consequences. There is currently no statistically significant study that proves this elevation of LDL-C would not increase cardiovascular risks. Furthermore, the necessity for statin therapy in a ketogenic diet-induced hyperlipidemia remains unknown.
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An Isocaloric Nordic Diet Modulates RELA and TNFRSF1A Gene Expression in Peripheral Blood Mononuclear Cells in Individuals with Metabolic Syndrome-A SYSDIET Sub-Study.
Ulven, SM, Holven, KB, Rundblad, A, Myhrstad, MCW, Leder, L, Dahlman, I, Mello, VD, Schwab, U, Carlberg, C, Pihlajamäki, J, et al
Nutrients. 2019;11(12)
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Metabolic syndrome (MetS) alongside other related risk factors has been implicated as increasing an individual’s risk for cardiovascular disease and type 2 diabetes. MetS is associated with chronic low-grade inflammation and raised blood lipid levels, which have been shown to improve in individuals when put on a Nordic diet (ND). In this sub-study of the SYSDIET study, which was a 18-24 week randomised controlled multi centre study, the aim was to examine the effect of a ND compared to a control diet (CD) on genes that are involved in the production of inflammatory molecules and lipids. Blood samples of 88 obese participants from the SYSDIET study were analysed for various inflammatory molecule producing genes and lipid molecule producing genes. The results showed that compared to CD, ND increased the presence of the inflammatory gene RELA, but decreased the presence of inflammatory gene TNFRSF1A. No differences were observed in other inflammatory genes and no differences were observed in lipid producing genes. It was concluded that consuming a ND compared to a CD may affect the production of inflammatory genes; however further studies are required to determine if the ND improves the amount of blood lipids because of an altered presence of lipid producing genes. The implication of this for practitioners is that further research of the SYSDIET is needed. In addition, a Nordic diet may improve inflammation in obese individuals because of a reduction in the production of inflammatory genes.
Abstract
A healthy dietary pattern is associated with a lower risk of metabolic syndrome (MetS) and reduced inflammation. To explore this at the molecular level, we investigated the effect of a Nordic diet (ND) on changes in the gene expression profiles of inflammatory and lipid-related genes in peripheral blood mononuclear cells (PBMCs) of individuals with MetS. We hypothesized that the intake of an ND compared to a control diet (CD) would alter the expression of inflammatory genes and genes involved in lipid metabolism. The individuals with MetS underwent an 18/24-week randomized intervention to compare a ND with a CD. Eighty-eight participants (66% women) were included in this sub-study of the larger SYSDIET study. Fasting PBMCs were collected before and after the intervention and changes in gene expression levels were measured using TaqMan Array Micro Fluidic Cards. Forty-eight pre-determined inflammatory and lipid related gene transcripts were analyzed. The expression level of the gene tumor necrosis factor (TNF) receptor superfamily member 1A (TNFRSF1A) was down-regulated (p = 0.004), whereas the nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) subunit, RELA proto-oncogene, was up-regulated (p = 0.016) in the ND group compared to the CD group. In conclusion, intake of an ND in individuals with the MetS may affect immune function.
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Dietary Fat Intake and Metabolic Syndrome in Older Adults.
Julibert, A, Bibiloni, MDM, Mateos, D, Angullo, E, Tur, JA
Nutrients. 2019;11(8)
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Metabolic syndrome (MetS) is an umbrella term for a cluster of conditions that can increase your chance of developing heart disease, type 2 diabetes and cancer. Growing evidence points to a role of the diet and nutrients in the development of MetS. This cross-sectional nutritional survey of 477 older male and female adults aimed to assess fat intake in older adults with or without MetS. The intake of many different nutrients were analysed for relationships with MetS, however of note the results showed that individuals with MetS consumed significantly higher total fat intake but lower energy, carbohydrate and fibre intake. Part of the analysis showed that hypertension is associated with lower polyunsaturated fat intake, however stomach obesity was associated with high polyunsaturated fat and vegetable fat intake. Interestingly men with MetS reported lower consumption of ready to eat meals. It was concluded that individuals with MetS are less likely to meet recommendations for fat, carbohydrate and protein consumption than those without MetS. This study could be used by clinicians to emphasise the need for individuals with MetS to consume a variety of fruits, vegetables, fish, nuts and whole grains as part of a balanced nutrient rich diet.
Abstract
BACKGROUND Metabolic Syndrome (MetS) is associated with higher rates of cardiovascular disease (CVD), type 2 diabetes mellitus, and cancer worldwide. OBJECTIVE To assess fat intake in older adults with or without MetS. DESIGN Cross-sectional nutritional survey in older adults living in the Balearic Islands (n = 477, 48% women, 55-80 years old) with no previous CVD. METHODS Assessment of fat (total fat, MUFA, PUFA, SFA, TFA, linoleic acid, α-linolenic acid, marine and non-marine ω-3 FA, animal fat and vegetable fat, cholesterol) and macronutrient intake using a validated food frequency questionnaire, and its comparison with recommendations of the US Institute of Medicine (IOM) and the Spanish Society of Community Nutrition (SENC). RESULTS Participants with MetS showed higher BMI, lower physical activity, higher total fat and MUFA intake, and lower intake of energy, carbohydrates, and fiber than participants without MetS. Men and women with MetS were below the Acceptable Macronutrient Distribution Range (AMDR) proposed by IOM for carbohydrates and above the AMDR for total fat and MUFAs, and women were below the AMDR proposed for α-linolenic acid (ALA) compared with participants without MetS. CONCLUSIONS Subjects with MetS were less likely to meet IOM and SENC recommendations for fat and macronutrient intakes as compared to non-MetS subjects.
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Visceral obesity, skeletal muscle mass and resistin in metabolic syndrome development.
Rodríguez-López, CP, González-Torres, MC, Cruz-Bautista, I, Nájera-Medina, O
Nutricion hospitalaria. 2019;36(1):43-50
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Obesity is a growing public health problem at a national and global level. Visceral adipose tissue (VAT) is the most bioactive component that is related with the release of inflammatory mediators which gives rise to insulin resistance, mainly local, and subsequently in liver and skeletal muscle. The aim of this study was to determine the relationship of body components with the concentration of resistin as an inflammatory marker in patients with overweight and obesity. The study is an observational, cross-sectional clinical study which analysed 40 participants with an age range between 18 and 40 years. Results indicate that: - as body mass index and VAT increased, anthropometric measurements, body composition, and biochemical indicators were altered. - persons with obesity and increased VAT had the highest proportions of metabolic syndrome (MS). - an increase in skeletal muscle is related with increased BMI and with the presence of increased VAT. - there was a significant increase in resistin concentration in individuals without MS and increased VAT compared to those without MS and normal VAT. Authors conclude that resistin might be acting as an inflammatory adipocytokine [a bioactive product produced by adipose tissue], contributing to the increase in frequency of MS in those persons who present increased levels of this cytokine.
Abstract
INTRODUCTION Background: obesity implies an increase in the visceral adipose tissue (VAT), which is a risk factor for various metabolic diseases. VAT releases proinflammatory mediators, like resistin. In addition, it has been noted that the skeletal muscle mass (SMM) is involved in the development of metabolic syndrome (MS). Objective: this study was designed to determine the relationship of body components (VAT and SMM) with MS and resistin in patients with obesity. Methods: body composition and anthropometric and biochemical measurements to assess MS, and ELISA tests for resistin were carried out in 40 patients aged 18-40 years. Results: overweight and obesity were observed in 72% of patients; visceral obesity was found in 53% and 35% had MS. A positive correlation between VAT and SMM in patients with MS was detected. In the entire population, an increase of 1 kg of SMM was found to be associated with an increase of 3 cm2 of VAT, and an increase of 4 cm2 of VAT was observed in individuals with MS. According to resistin, people with increased VAT had higher concentration than persons with normal VAT. Furthermore, an increase of 1 cm2 of VAT accounted for a person entertaining a 3.3 fold greater risk of MS for different values of SMM and resistin. Conclusion: the transcendence and significance of VAT as a main factor in triggering the chronic inflammatory process and MS, the SMM and resistin were also related. INTRODUCCIÓN: Introducción: la obesidad implica un aumento del tejido adiposo visceral (TAV), el cual es un factor de riesgo para varias enfermedades metabólicas. El VAT se relaciona con mediadores proinflamatorios, como la resistina. Además, se ha observado que la masa musculoesquelética (MME) interviene en el desarrollo del síndrome metabólico (SM). Objetivo: este estudio fue diseñado para determinar la relación de la composición corporal (TAV y MME) con el SM y la resistina en pacientes con obesidad. Métodos: se realizaron medidas antropométricas, de composición corporal y bioquímica para determinar el SM y prueba de ELISA para resistina en 40 pacientes de 18 a 40 años de edad. Resultados: se observó sobrepeso y obesidad en el 72% de los participantes, obesidad visceral en el 53% y el 35% presentó SM. Se detectó una correlación positiva entre el TAV y la MME en pacientes con SM. En el grupo de estudio encontramos que un aumento de un 1 kg de MME se asociaba con un incremento de 3 cm2 de TAV y en individuos con SM, con un incremento de 4 cm2 de TAV. En relación con la resistina, las personas con TAV incrementado presentan concentraciones más altas que las personas con TAV normal. Además, se observó que un aumento de 1 cm2 de TAV representa un riesgo 3,3 veces mayor que para las personas de padecer SM para diferentes valores de MME y de resistina. Conclusión: además de la trascendencia y la importancia del TAV como factor principal para desencadenar el proceso inflamatorio crónico y el SM, se observó que la MME y la resistina también están relacionadas.
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Whole grain-rich diet reduces body weight and systemic low-grade inflammation without inducing major changes of the gut microbiome: a randomised cross-over trial.
Roager, HM, Vogt, JK, Kristensen, M, Hansen, LBS, Ibrügger, S, Mærkedahl, RB, Bahl, MI, Lind, MV, Nielsen, RL, Frøkiær, H, et al
Gut. 2019;68(1):83-93
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Whole grain consumption has been linked with decreased risk of lifestyle-related diseases. While animal studies have shown the gut microbiome to be a mediator of metabolic health, human studies examining the effect of whole grain intake of the gut remain inconclusive. The aim of this study was to investigate the effects of a whole grain diet on the gut microbiome, gut functionality and biomarkers of metabolic health. In this randomised, controlled, crossover study, 50 participants completed two 8-week dietary intervention periods comprising of a whole grain diet and a refined grain diet with a 6-week washout period. Examinations were done at the beginning and end of each intervention period to assess anthropometry and various plasma and gut markers. This study found that a whole grain diet as compared with a refined grain diet reduced energy intake and body weight as well as circulating markers of inflammation. Contrary to the hypothesis, these benefits were all observed independent of changes in the gut microbiome. Based on these results, the authors conclude higher intake of whole grains should be recommended to those at risk of inflammation-related disease.
Abstract
OBJECTIVE To investigate whether a whole grain diet alters the gut microbiome and insulin sensitivity, as well as biomarkers of metabolic health and gut functionality. DESIGN 60 Danish adults at risk of developing metabolic syndrome were included in a randomised cross-over trial with two 8-week dietary intervention periods comprising whole grain diet and refined grain diet, separated by a washout period of ≥6 weeks. The response to the interventions on the gut microbiome composition and insulin sensitivity as well on measures of glucose and lipid metabolism, gut functionality, inflammatory markers, anthropometry and urine metabolomics were assessed. RESULTS 50 participants completed both periods with a whole grain intake of 179±50 g/day and 13±10 g/day in the whole grain and refined grain period, respectively. Compliance was confirmed by a difference in plasma alkylresorcinols (p<0.0001). Compared with refined grain, whole grain did not significantly alter glucose homeostasis and did not induce major changes in the faecal microbiome. Also, breath hydrogen levels, plasma short-chain fatty acids, intestinal integrity and intestinal transit time were not affected. The whole grain diet did, however, compared with the refined grain diet, decrease body weight (p<0.0001), serum inflammatory markers, interleukin (IL)-6 (p=0.009) and C-reactive protein (p=0.003). The reduction in body weight was consistent with a reduction in energy intake, and IL-6 reduction was associated with the amount of whole grain consumed, in particular with intake of rye. CONCLUSION Compared with refined grain diet, whole grain diet did not alter insulin sensitivity and gut microbiome but reduced body weight and systemic low-grade inflammation. TRIAL REGISTRATION NUMBER NCT01731366; Results.
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Effects of Mediterranean Diet and Physical Activity on Pulmonary Function: A Cross-Sectional Analysis in the ILERVAS Project.
Gutiérrez-Carrasquilla, L, Sánchez, E, Hernández, M, Polanco, D, Salas-Salvadó, J, Betriu, À, Gaeta, AM, Carmona, P, Purroy, F, Pamplona, R, et al
Nutrients. 2019;11(2)
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The Mediterranean diet is characterised by an abundant consumption of extra-virgin olive oil, fruits, vegetables, nuts, and legumes, a moderate consumption of fish and seafood, poultry, fermented dairy products, and red wine with meals, and low intakes of sweetened beverages, red meat and ready meals. The aim of the study was to evaluate the association between adherence to a Mediterranean diet and physical activity on pulmonary function in a large middle-aged population at low-to-moderate cardiovascular risk. The study is an ongoing study that between 2015 and 2017 enrolled a total of 3020 subjects – women aged between 50 to 70 years and men aged between 45 to 65 years – with the presence of at least one cardiovascular risk factor. Results indicate that a low adherence to the Mediterranean diet was linked with impaired breathing patterns and higher prevalence of abnormal lung function when compared to participants with a higher adherence to this dietary pattern. Additionally, vigorous physical activity was accompanied by better results in lung function than that observed in inactive subjects. The study provides initial clinical evidence about the independent and deleterious effect of both low adherence to the Mediterranean diet and low physical activity practice on lung function in participants without known pulmonary disease.
Abstract
A few studies showed that both adherence to Mediterranean diet (MedDiet) and physical activity practice have a positive impact on pulmonary function in subjects with lung disease. These associations are not well studied in subjects free from lung disease. In a cross-sectional study conducted in 3020 middle-aged subjects free of lung disease, adherence to the MedDiet using the Mediterranean Diet Adherence Screener, and physical activity practice using the International Physical Activity Questionnaire short form were recorded. Respiratory function was assessed using forced spirometry and the results were evaluated according to the Global initiative for Chronic Obstructive Lung Disease. Logistic regression models were used to analyze the associations between adherence to the MedDiet and physical activity practice with the presence of ventilatory defects. Participants with a high adherence to MedDiet, in comparison to those with low adherence, had both higher forced vital capacity (FVC; 100 (87⁻109) vs. 94 (82⁻105) % of predicted, p = 0.003) and forced expired volume in the first second (FEV1; 100 (89⁻112) vs. 93 (80⁻107) % of predicted, p < 0.001). According to their degree of physical activity, those subjects with a high adherence also had both higher FVC (100 (88⁻107) vs. 94 (83⁻105) % of predicted, p = 0.027) and FEV1 (100 (89⁻110) vs. 95 (84⁻108) % of predicted, p = 0.047) in comparison with those with low adherence. The multivariable logistic regression models showed a significant and independent association between both low adherence to MedDiet and low physical activity practice, and the presence of altered pulmonary patterns, with differences between men and women. However, no joint effect between adherence to MedDiet and physical activity practice on respiratory function values was observed. Low adherence to MedDiet and low physical activity practice were independently associated with pulmonary impairment. Therefore, the lung mechanics seem to benefit from heart-healthy lifestyle behaviors.
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Effect of Fish Oil Supplementation on Hepatic and Visceral Fat in Overweight Men: A Randomized Controlled Trial.
Parker, HM, Cohn, JS, O'Connor, HT, Garg, ML, Caterson, ID, George, J, Johnson, NA
Nutrients. 2019;11(2)
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Being overweight increases the risk of the development of metabolic conditions such as non-alcoholic fatty liver disease (NAFLD). Omega-3 polyunsaturated fatty acid (PUFA) supplementation is recommended for prevention of chronic disease, and is thought to reduce liver fat, but there have been few randomised controlled trials that accurately measure liver fat. The aim of this double-blind randomised controlled trial was to assess the effect of 12 weeks of supplementation with omega-3 PUFA from fish oil on liver fat, liver tests, and body composition. Fifty healthy overweight men were given either fish oil (1,728 mg marine triglycerides, of which 588 mg EPA and 412 mg DHA, combined with 200 mg antioxidant, coenzyme Q10) or placebo (capsules containing 2g olive oil) daily for 12 weeks. Participants were assessed at the beginning of the study, and following 6 and 12 weeks of supplementation. At the start of the study, 16 (32%) participants met the criteria for NAFLD (>5.5% liver fat). There were no significant changes in liver fat, liver function or body composition in either of the groups over 12 weeks. When the researchers looked at the results for those participants with NAFLD at the start of the study, there were no significant changes here either. The authors concluded that omega-3 PUFA did not appear to be an effective agent for reducing liver fat in overweight men. The factors determining the health benefits of omega-3 PUFA supplementation on an individual level need to be clarified.
Abstract
Being overweight increases the risk of the development of metabolic conditions such as non-alcoholic fatty liver disease (NAFLD), which is itself an independent predictor of cardiovascular disease. Omega-3 polyunsaturated fatty acid (PUFA) supplementation is recommended for prevention of chronic disease, and is thought to reduce raised liver fat, yet there have been few randomized controlled trials with accurate measurement of liver fat. We assessed the effect of 12 weeks of supplementation with omega-3 PUFA from fish oil versus placebo on quantified liver fat, liver tests, and body composition including visceral adipose tissue (VAT) in a double-blind randomized controlled trial. Fifty apparently healthy overweight men (BMI 25.0⁻29.9 kg/m²; waist > 94 cm) were randomly allocated to consume fish oil (total daily dose: 1728 mg marine triglycerides, of which 588 mg EPA and 412 mg DHA, combined with 200 mg antioxidant, coenzyme Q10) or placebo (olive oil capsules) daily for 12 weeks. Liver fat was assessed using proton magnetic resonance spectroscopy. All outcomes were assessed at baseline and following 6 and 12 weeks of supplementation. Baseline liver fat was 4.6 ± 0.5% (range: 0.6 to 18.2%); 16 (32%) participants met the criteria for NAFLD (>5.5% liver fat). Repeated measures ANOVA revealed no significant time or group × time effect for fish oil versus placebo for liver fat, liver enzymes, anthropometry, or body composition including VAT (p > 0.05 for all), with similar finding for sub-analysis of participants with NAFLD. Omega-3 PUFA did not appear to be an effective agent for reducing liver fat in overweight men. The factors determining the health benefits of omega-3 PUFA supplementation on an individual level need to be clarified.