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Comparative efficacy of a 12 week yoga-based lifestyle intervention and dietary intervention on adipokines, inflammation, and oxidative stress in adults with metabolic syndrome: a randomized controlled trial.
Yadav, R, Yadav, RK, Khadgawat, R, Pandey, RM
Translational behavioral medicine. 2019;(4):594-604
Abstract
The present randomized controlled trial (RCT) evaluated the comparative efficacy of 12 week yoga-based lifestyle intervention (YBLI) and dietary intervention (DI) alone on adipokines, inflammation, and oxidative stress in Indian adults with metabolic syndrome (Met S). A parallel, two arm, RCT was conducted in Integral Health Clinic (IHC), All India Institute of Medical Sciences, India from 2012 to 2014. IHC is an outpatient facility conducting YBLI programs for prevention and management of chronic diseases. Two hundred sixty men and women (20-45 years) visiting the outpatient department of a tertiary care hospital were diagnosed with Met S and randomized 1:1 to receive 12 week YBLI (n = 130) or DI (n = 130). Primary outcomes were change in plasma levels of adipokines (leptin, adiponectin, and leptin:adiponectin ratio), markers of inflammation (tumor necrosis factor [TNF]-α, interleukin [IL]-6), markers of oxidative stress (thiobarbituric acid reactive substances [TBARS], 8-hydroxy-2'-deoxyguanosine [8-OHdG], and superoxide dismutase [SOD]) measured at baseline, 2 weeks, and 12 weeks. YBLI group showed a significant decrease in leptin, leptin:adiponectin ratio, IL-6, 8-OHdG, and TBARS levels, whereas there was a significant increase in adiponectin and SOD levels. No significant changes were noticed in DI alone group. YBLI showed significantly greater reduction in TBARS levels than in DI group, suggestive of reduced oxidative stress in adults with Met S. A 12 week YBLI had a positive impact on oxidative stress versus DI alone in adults with Met S.
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Yoga training modulates adipokines in adults with high-normal blood pressure and metabolic syndrome.
Supriya, R, Yu, AP, Lee, PH, Lai, CW, Cheng, KK, Yau, SY, Chan, LW, Yung, BY, Siu, PM
Scandinavian journal of medicine & science in sports. 2018;(3):1130-1138
Abstract
Metabolic syndrome (MetS) is associated with diabetes mellitus and cardiovascular diseases. Our previous study indicated that people with MetS showed a decrease in waist circumference and a decreasing trend in blood pressure after 1-year yoga. This study investigated the effect of yoga on MetS people with high-normal blood pressure by exploring modulations in proinflammatory adipokines (leptin, chemerin, visfatin, and plasminogen activator inhibitor-1 or PAI-1) and an anti-inflammatory adipokine (adiponectin). A total of 97 Hong Kong Chinese individuals aged 57.6 ± 9.1 years with MetS and high-normal blood pressure were randomly assigned to control (n = 45) and yoga groups (n = 52). Participants in the control group were not given any intervention but were contacted monthly to monitor their health status. Participants in the yoga group underwent a yoga training program with three 1-hour yoga sessions weekly for 1 year. The participants' sera were harvested and assessed for adipokines. Generalized estimating equation (GEE) was used to examine the interaction effect between 1-year time (pre vs post), and intervention (control vs yoga). GEE analyses revealed significant interaction effects between 1-year time and yoga intervention for the decreases in leptin and chemerin and the increase in adiponectin concentration in the sera examined. These results demonstrated that 1-year yoga training decreased proinflammatory adipokines and increased anti-inflammatory adipokine in adults with MetS and high-normal blood pressure. These findings support the beneficial role of yoga in managing MetS by favorably modulating adipokines.
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Evaluation of Agraz Consumption on Adipocytokines, Inflammation, and Oxidative Stress Markers in Women with Metabolic Syndrome.
Espinosa-Moncada, J, Marín-Echeverri, C, Galvis-Pérez, Y, Ciro-Gómez, G, Aristizábal, JC, Blesso, CN, Fernandez, ML, Barona-Acevedo, J
Nutrients. 2018;(11)
Abstract
Metabolic syndrome (MetS) is characterized by increased oxidative stress and a pro-inflammatory state. Vaccinium meridionale Swartz (known as "agraz") is a berry rich in polyphenolic compounds with demonstrated antioxidant activity and anti-inflammatory effects in preclinical studies. The aim of this study was to evaluate the effects of agraz consumption on inflammatory and oxidative stress markers in women with MetS. Forty women with MetS (47 ± 9 years) were randomly assigned to consume daily either 200 mL of agraz nectar or placebo over four weeks in a double-blind, cross-over design study, separated by a 4-week washout period. Metabolic and inflammatory markers in serum and antioxidant/oxidative stress markers in serum and urine were assessed at the end of each period. Serum antioxidant capacity measured by the 2,2-diphenyl-1-picrylhydrazyl (DPPH) method was significantly higher (p = 0.028), while urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG) was lower (p = 0.041) after agraz consumption, compared to placebo. In conclusion, consumption of agraz during four weeks increased serum antioxidant capacity and decreased a marker of DNA oxidative damage in women with MetS, compared to placebo. These results suggest that agraz consumption may play a protective role in patients with MetS.
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Effects of supplementation with curcumin on serum adipokine concentrations: A randomized controlled trial.
Panahi, Y, Hosseini, MS, Khalili, N, Naimi, E, Soflaei, SS, Majeed, M, Sahebkar, A
Nutrition (Burbank, Los Angeles County, Calif.). 2016;(10):1116-22
Abstract
OBJECTIVE Previous experimental studies have suggested curcumin as a safe phytochemical that can improve insulin resistance through effects on adiponectin and leptin. This study aimed to investigate the effect of curcumin on circulating adiponectin and leptin concentrations in patients with metabolic syndrome. METHODS In this pilot, randomized, double-blind, placebo-controlled trial, subjects who met the criteria of metabolic syndrome according to the National Cholesterol Education Program Adult Treatment Panel III criteria were randomly assigned to curcumin (n = 59; 1000 mg/d) or a placebo (n = 58) for 8 wk. Serum adiponectin and leptin concentrations were determined before and after intervention. The pooled effect size for the impact of curcumin supplementation on serum adiponectin and leptin levels was also estimated using random-effects metaanalysis. RESULTS Eight-week supplementation with curcumin was associated with a significant increase in serum adiponectin levels (P < 0.001) and a reduction in serum leptin concentrations (P < 0.001). Serum leptin:adiponectin ratio was also improved by curcumin (P < 0.001). These beneficial effects of curcumin remained significant after adjustment for changes in serum lipids and glucose concentrations and baseline differences in body mass index and serum levels of glucose and glycated hemoglobin as potential confounders of treatment response. Metaanalysis suggested that curcumin supplementation can increase adiponectin levels by 76.78% (95% CI: 6.14-147.42; P = 0.0330), and reduce leptin by 26.49% (95% CI: -70.44 to 17.46), however this latter effect size did not reach statistical significance (P = 0.238). CONCLUSIONS Curcumin can improve serum levels of adiponectin and leptin in patients with metabolic syndrome. This trial was registered at the UMIN Clinical Trials Registry (http://www.umin.ac.jp/ctr/) under Trial No. UMIN000018339.
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Correcting vitamin D insufficiency improves insulin sensitivity in obese adolescents: a randomized controlled trial.
Belenchia, AM, Tosh, AK, Hillman, LS, Peterson, CA
The American journal of clinical nutrition. 2013;(4):774-81
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Abstract
BACKGROUND Obese adolescents are at a greater risk of vitamin D deficiency because vitamin D is thought to be sequestered by excess adipose tissue. Poor vitamin D status has been associated with a higher prevalence of the metabolic syndrome, type 2 diabetes, or both in adults and adolescents. OBJECTIVE The objective was to determine in obese adolescents the efficacy and safety of 4000 IU vitamin D3/d and whether subsequent increased circulating concentrations of 25-hydroxyvitamin D [25(OH)D] are associated with improved markers of insulin sensitivity and resistance and reduced inflammation. DESIGN Obese adolescent patients [n = 35; mean ± SD age: 14.1 ± 2.8 y; BMI (in kg/m(2)): 39.8 ± 6.1; 25(OH)D: 19.6 ± 7.1 ng/mL] were recruited from the University of Missouri Adolescent Diabetes and Obesity Clinic and were randomly assigned to receive either vitamin D3 (4000 IU/d) or placebo as part of their standard care. Anthropometric measurements, inflammatory markers (IL-6, TNF-α, C-reactive protein), adipokines (leptin, adiponectin), fasting glucose, fasting insulin, and HOMA-IR values were measured at baseline and at 2 follow-up visits (3 and 6 mo). RESULTS After 6 mo, there were no significant differences in BMI, serum inflammatory markers, or plasma glucose concentrations between groups. Participants supplemented with vitamin D3 had increases in serum 25(OH)D concentrations (19.5 compared with 2.8 ng/mL for placebo; P < 0.001), fasting insulin (-6.5 compared with +1.2 μU/mL for placebo; P = 0.026), HOMA-IR (-1.363 compared with +0.27 for placebo; P = 0.033), and leptin-to-adiponectin ratio (-1.41 compared with +0.10 for placebo; P = 0.045). Inflammatory markers remained unchanged. CONCLUSION The correction of poor vitamin D status through dietary supplementation may be an effective addition to the standard treatment of obesity and its associated insulin resistance. This trial was registered at clinicaltrials.gov as NCT00994396.
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Comparative effects of carbohydrate versus fat restriction on serum levels of adipocytokines, markers of inflammation, and endothelial function among women with the metabolic syndrome: a randomized cross-over clinical trial.
Rajaie, S, Azadbakht, L, Saneei, P, Khazaei, M, Esmaillzadeh, A
Annals of nutrition & metabolism. 2013;(1-2):159-67
Abstract
BACKGROUND AND AIMS Despite the efficacy of low-carbohydrate diets in the management of metabolic syndrome (MetS), it remains unknown if these favorable effects are mediated through changes in inflammation and endothelial dysfunction. We aimed to assess the effects of moderate substitution of dietary fats for carbohydrates on serum levels of adipocytokines, inflammatory indices, and biomarkers of endothelial function among women with the MetS. METHODS In a randomized cross-over clinical trial, 30 overweight or obese (BMI >25) women with the MetS were randomly allocated to follow either a high-carbohydrate (HC) (60-65% carbohydrates, 20-25% fats) diet or a moderately restricted carbohydrate (MRC) (43-47% carbohydrate, 36-40% fats) diet, each for 6 weeks. After a 2-week washout period, individuals were switched to the alternate diet for an additional 6 weeks. In a fasted state, markers of inflammation [high-sensitivity C-reactive protein (hs-CRP), high-sensitivity interleukin-6 (hs-IL-6), high-sensitivity tumor necrosis factor-α (hs-TNF-α), and serum amyloid A (SAA)], endothelial function [E-selectin, serum intercellular adhesion molecule 1 (sICAM-1), and serum vascular cell adhesion molecule 1 (sVCAM-1)], and adipocytokines (leptin and adiponectin) were measured in both study arms at baseline and after 6 weeks. RESULTS Consumption of an HC diet was associated with increased levels of SAA (3.27 ± 1.22 μg/ml) and decreased levels of adiponectin (-1.68 ± 2.30 ng/ml), while consumption of an MRC diet did not result in such unfavorable effects. Serum concentrations of leptin were reduced by the HC diet (p = 0.02), while they were not affected by the MRC diet. Changes in serum leptin levels were not significant between the two diets (p = 0.09). Serum concentrations of hs-CRP, hs-TNF-α, and IL-6 were not influenced by either diet. No significant differences between the two diets were found in terms of their effect on sICAM-1 and sVCAM-1 concentrations. Adherence to both diets resulted in a 9 ng/ml decrease in serum E-selectin levels (p < 0.05 for both). CONCLUSIONS Partial replacement of dietary carbohydrates by unsaturated fats prevents the increased levels of markers of systemic inflammation among women with the MetS.
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Metabolic syndrome, adipokines and ghrelin in overweight and obese schoolchildren: results of a 1-year lifestyle intervention programme.
Pedrosa, C, Oliveira, BM, Albuquerque, I, Simões-Pereira, C, Vaz-de-Almeida, MD, Correia, F
European journal of pediatrics. 2011;(4):483-92
Abstract
The aim of this study was to evaluate the effect of a lifestyle intervention programme (nutrition and exercise counselling) on metabolic syndrome (MS) components, adipokines (leptin, adiponectin) and ghrelin levels in overweight children. A total of 61 overweight children aged 7-9 years (≥ 85th body mass index (BMI) percentile; 27 boys/34 girls) were randomly assigned and completed a 1-year individual (IT) or group-based treatment (GT). Anthropometric and biochemical parameters were assessed at baseline, at 6 months and at 1 year. Twenty-two normal weight children (<85th BMI percentile; 7-9 years old; 13 boys/nine girls) were also evaluated at baseline. Insulin resistance (IR) was determined by the homeostasis model assessment of IR (HOMA-IR). Overweight children presented significantly higher blood pressure, triglycerides, apolipoprotein B, insulin, HOMA-IR, leptin, C-reactive protein and homocysteine levels, while apolipoprotein A-I was significantly lower. At baseline, MS was present in ten overweight children, of which only five maintained it at 1 year. Leptin and ghrelin levels were associated with IR and MS components. MS was predicted by apolipoprotein A-I, insulin and pre-puberty. The lifestyle intervention led to a significant improvement in standard deviation score of BMI, waist circumference/height ratio and lipid profile. Changes in insulin, HOMA-IR, leptin and adiponectin were not significant. Ghrelin behaved differently between IT and GT. The GT intervention seems to be more successful, with a decrease in BMI Z-score and an improvement of metabolic parameters. In conclusion, overweight children have multiple risk factors associated with MS. A lifestyle intervention programme seems to be an effective mean for reducing obesity and MS components and improving adipokines concentrations.
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Greater weight loss and hormonal changes after 6 months diet with carbohydrates eaten mostly at dinner.
Sofer, S, Eliraz, A, Kaplan, S, Voet, H, Fink, G, Kima, T, Madar, Z
Obesity (Silver Spring, Md.). 2011;(10):2006-14
Abstract
This study was designed to investigate the effect of a low-calorie diet with carbohydrates eaten mostly at dinner on anthropometric, hunger/satiety, biochemical, and inflammatory parameters. Hormonal secretions were also evaluated. Seventy-eight police officers (BMI >30) were randomly assigned to experimental (carbohydrates eaten mostly at dinner) or control weight loss diets for 6 months. On day 0, 7, 90, and 180 blood samples and hunger scores were collected every 4 h from 0800 to 2000 hours. Anthropometric measurements were collected throughout the study. Greater weight loss, abdominal circumference, and body fat mass reductions were observed in the experimental diet in comparison to controls. Hunger scores were lower and greater improvements in fasting glucose, average daily insulin concentrations, and homeostasis model assessment for insulin resistance (HOMA(IR)), T-cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) levels were observed in comparison to controls. The experimental diet modified daily leptin and adiponectin concentrations compared to those observed at baseline and to a control diet. A simple dietary manipulation of carbohydrate distribution appears to have additional benefits when compared to a conventional weight loss diet in individuals suffering from obesity. It might also be beneficial for individuals suffering from insulin resistance and the metabolic syndrome. Further research is required to confirm and clarify the mechanisms by which this relatively simple diet approach enhances satiety, leads to better anthropometric outcomes, and achieves improved metabolic response, compared to a more conventional dietary approach.
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Nutrition education guided by Dietary Guidelines for Chinese Residents on metabolic syndrome characteristics, adipokines and inflammatory markers.
Zhang, SX, Guo, HW, Wan, WT, Xue, K
Asia Pacific journal of clinical nutrition. 2011;(1):77-86
Abstract
OBJECTIVE The objective of this study was to test whether "Dietary Guidelines for Chinese Residents" have beneficial effects on anthropometric and metabolic variables, adipokines and inflammatory markers in metabolic syndrome patients. METHODS AND PROCEDURES A multi-stage sampling method was applied to select metabolic syndrome patients in two districts of Shanghai. Two hundred and seventy-two metabolic syndrome patients were divided into control and intervention groups according to their district. Nutrition education guided by "Dietary Guidelines for Chinese Residents" was performed in the intervention group for one year. RESULTS Nutrition-related knowledge, attitudes and behavior were improved in the intervention group. Potassium intake and food to total energy ratio for grain, vegetable and fruit increased while sodium intake as well as fat to total energy ratio decreased in the intervention group compared to the control group (p<0.05). Correspondently, the intervention group significantly improved its waist circumference, waist to hip ratio, high-density lipoprotein cholesterol, adiponectin, leptin and tumor necrosis factor-α compared to the control group (p<0.05). Waist circumference changes from baseline to end of the study in the intervention and the control groups were -3.9±0.3 and -2.3±0.4 cm respectively. There was a significant difference between the two groups (p=0.004). Means of waist circumference, waist to hip ratio, leptin and tumor necrosis factor-α were lower, and high density lipoprotein-cholesterol was higher in the intervention group than the control group (p<0.05). CONCLUSION This study confirmed "Dietary Guidelines for Chinese Residents" had beneficial effects on anthropometric, lipids, adipokines and inflammatory markers in metabolic syndrome patients.
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Association of 1-y changes in diet pattern with cardiovascular disease risk factors and adipokines: results from the 1-y randomized Oslo Diet and Exercise Study.
Jacobs, DR, Sluik, D, Rokling-Andersen, MH, Anderssen, SA, Drevon, CA
The American journal of clinical nutrition. 2009;(2):509-17
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BACKGROUND We hypothesized that favorable changes in dietary patterns would lead to a reduction in body size and an improvement in metabolic status. OBJECTIVE The objective was to study changes in diet patterns relative to changes in body size, blood pressure, and circulating concentrations of lipids, glucose, insulin, adiponectin, and other cytokines in the context of a 1-y randomized intervention study. DESIGN For 1 y, 187 men aged 45 +/- 2 y, approximately 50% of whom met the criteria of the metabolic syndrome, were randomly assigned to a diet protocol (n = 45), an exercise protocol (n = 48), a protocol of diet plus exercise (n = 58), or a control protocol (n = 36). A previously defined a priori diet score was created by summing tertile rankings of 35 food group variables; a higher score generally reflected recommended dietary changes in the trial (mean +/- SD at baseline: 31 +/- 6.5; range: 15-47). RESULTS Over the study year, the diet score increased by approximately 2 +/- 5.5 in both diet groups, with a decrease of an equivalent amount in the exercise and control groups. The weight change was -3.5 +/- 0.6 kg/10-point change in diet score (P < 0.0001), similarly within each intervention group, independently of the change in energy intake or baseline age and smoking status. Weight change was attenuated but remained significant after adjustment for intervention group and percentage body fat. Subjects with an increased diet score had more favorable changes in other body size variables, systolic blood pressure, and blood lipid, glucose, insulin, and adiponectin concentrations. Change in diet score was unrelated to resistin and several cytokines. CONCLUSION The change toward a more favorable diet pattern was associated with improved body size and metabolic profile.