Dietary intake of specific amino acids and liver status in subjects with nonalcoholic fatty liver disease: fatty liver in obesity (FLiO) study.

PURPOSE: Identification of dietary factors involved in the development and progression of nonalcoholic fatty liver disease (NAFLD) is relevant to the current epidemics of the disease. Dietary amino acids appear to play a key role in the onset and progression of NAFLD. The aim of this study was to analyze potential associations between specific dietary amino acids and variables related to glucose metabolism and hepatic status in adults with overweight/obesity and NAFLD. METHODS: One hundred and twelve individuals from the Fatty Liver in Obesity (FLiO) study were evaluated. Liver assessment was carried out by ultrasonography, magnetic resonance imaging and analysis of biochemical parameters. Dietary amino acid intake (aromatic amino acids (AAA); branched-chain amino acids (BCAA); sulfur amino acids (SAA)) was estimated by means of a validated 137-item food frequency questionnaire. RESULTS: Higher consumption of these amino acids was associated with worse hepatic health. Multiple adjusted regression models confirmed that dietary AAA, BCAA and SAA were positively associated with liver fat content. AAA and BCAA were positively associated with liver iron concentration. Regarding ferritin levels, a positive association was found with BCAA. Dietary intake of these amino acids was positively correlated with glucose metabolism (glycated hemoglobin, triglyceride and glucose index) although the significance disappeared when potential confounders were included in the model. CONCLUSION: These findings suggest that the consumption of specific dietary amino acids might negatively impact on liver status and, to a lesser extent on glucose metabolism in subjects with overweight/obesity and NAFLD. A control of specific dietary amino acid composition should be considered in the management of NAFLD and associated insulin resistance. NCT03183193; June 2017.

Influence of dietary total antioxidant capacity on the association between smoking and hypertension in Brazilian graduates (CUME project).

BACKGROUND AND AIMS: Hypertension (HTN) is a chronic non-communicable disease influenced by non-modifiable risk factors, such as sex and age, as well as modifiable risk factors such as lifestyle, including diet and smoking. Moreover, diet quality among smokers is worse than that of non-smokers, mainly in terms of antioxidant content. Thus, the current study aimed to investigate whether dietary total antioxidant capacity (dTAC) influences the association between smoking and HTN. METHODS AND RESULTS: This cross-sectional study included 4303 graduates (69.35% women) from the Cohort of Minas Gerais Universities (CUME) project. An online food frequency questionnaire was administered to participants, and dTAC was estimated using the ferric reducing antioxidant power method. In the questionnaires, individuals reported smoking status, systolic and diastolic blood pressure values, previous HTN diagnosis, and use of antihypertensive drugs. Logistic regression models were used to estimate the odds ratio and 95% confidence interval between smoking and HTN, stratified by the median dTAC. Current and former smokers had higher dTAC values despite their lower fruit intake. Moreover, coffee was the main contributor to dTAC among them. Smoking was associated with a higher likelihood of HTN, mainly among individuals with a higher dTAC. However, after exclusion of coffee antioxidant capacity, there was an association between only smoking and HTN in individuals with lower dTAC. CONCLUSIONS: The controversial association between higher dTAC and HTN can result from high coffee intake. Higher dTAC without coffee intake may mitigate the association between smoking and HTN in this population.

Dietary inflammatory index scores are associated with atherogenic risk in Brazilian schoolchildren.

OBJECTIVE: To investigate the association between the Children's Dietary Inflammatory Index (C-DIITM) scores and atherogenic risk in Brazilian schoolchildren. DESIGN: A cross-sectional representative study. Three 24-h dietary recalls were performed to evaluate food consumption and to calculate C-DII scores. Blood samples were collected for the lipid profile analysis (serum total cholesterol (TC), HDL-cholesterol, LDL-cholesterol, VLDL-cholesterol and triglycerides (TAG)) and to determine atherogenic indexes (Castelli risk indexes I and II, lipoprotein combined index (LCI), and atherogenic index of plasma and atherogenic coefficient (AC)). A semi-structured questionnaire was used to obtain sociodemographic characteristics and screen time. Body fat was assessed by dual-energy X-ray absorptiometry. We compared the distributions of outcomes by C-DII categories using multivariable linear regression. SETTING: Viçosa, Minas Gerais, Brazil. PARTICIPANTS: Three hundred seventy-eight children between the ages of 8 and 9 years. RESULTS: The mean C-DII score was 0·60 ± 0·94, and the prevalence of dyslipidaemia was 70 %. Children with hypercholesterolaemia and hypertriglyceridaemia had higher C-DII scores. The C-DII was directly associated with atherogenic risk. Every 1 sd of C-DII was associated with a 0·07 (0·01, 0·13), 1·94 (0·20, 3·67), 0·06 (0·002, 0·12) and 0·12 (0·02, 0·22) units higher TC:HDL cholesterol ratio, LCI, AC and accumulation of altered dyslipidaemia markers (high TC + high LDL-cholesterol + high TAG + low HDL-cholesterol), respectively. CONCLUSIONS: Dietary inflammatory potential, as estimated by the C-DII, is directly associated with atherogenic risk in Brazilian schoolchildren. This results reinforce the importance of effective nutritional policies to promote healthy eating habits and improve children's lipid profiles.

High-saturated fatty meals with orange juice intake have subjective appetite sensations suppressed: Acute, postprandial study.

OBJECTIVE: To elucidate the acute effect of different high-fat meals accompanied by water or orange juice on subjective appetite sensations. METHODS: This acute, postprandial study included 39 healthy women (aged 20 to 40 years): 22 participants received a high-monounsaturated fat meal (MUFA) (≈1000 kcal, 56.3% Energy from MUFA) and 17 participants received a high-saturated fat meal (SFA) (≈1000 kcal, 37.6% Energy from SFA). Both interventions were accompanied by 500 ml of water or orange juice. The subjective appetite sensations were evaluated before (fasting) and 1, 2, 3, 4, and 5 hours after the meal intake using the visual analog scale. RESULTS: The subjective area under curve (AUC) appetite sensations and AUC appetite scores were equal after the consumption of high-fat meals from SFA and MUFA. Moreover, the consumption of a high-SFA meal raises the prospective desire to eat something fatty. In addition, the high-SFA meal consumption reduces subjective AUC appetite sensations and AUC appetite scores along the time, compared to a high-MUFA meal, when orange juice consumption followed those meals. CONCLUSION: Our results demonstrate that high-MUFA meal consumption decreased the desire to intake something fatty, and the high-SFA meal, when followed by orange juice intake, has postprandial appetite sensations suppressed.

LINE-1 in Obesity and Cardiometabolic Diseases: A Systematic Review.

Epigenetic mechanisms may play an important role in the etiology of obesity and cardiometabolic diseases, by activating or silencing the related-genes. Scientific evidence has suggested that LINE-1 methylation is associated with body composition and obesity-related diseases, including insulin resistance, type 2 diabetes mellitus, and cardiovascular disease (CVD). It also has been evaluated as predictor of weight loss. The studies' results are still conflicting, and positive and negative associations have been found to LINE-1 methylation regarding adiposity and cardiometabolic markers. Overall, this review presents observational (cross-sectional and longitudinal) studies and interventions (diet, exercises, and bariatric surgery) that evaluated the relationship of the LINE-1 methylation with obesity, weight loss, dyslipidemias, hypertension, insulin resistance, CVD, and metabolic syndrome. TEACHING POINTS Epigenetic mechanisms may play an important role in the etiology of obesity and cardiometabolic diseases. Many studies have related methylation of LINE-1 with cardiometabolic diseases; however, the results are still controversial. The relationship between the etiology of chronic diseases and the methylation of LINE-1 is not fully elucidated. With advances in epigenetic studies, related mechanisms may be early biomarkers in weight change and cardiometabolic risk.

Postprandial Lipid Response to High-Saturated and High-Monounsaturated Fat Meals in Normal-Weight or Overweight Women.

PURPOSE: We evaluated postprandial response of the lipid metabolism markers after the intake of a high-saturated fat (HSM) or high-monounsaturated fat meal (HMM). METHODS: A randomized, controlled and acute intervention study included 63 women (age 26.9 ± 6.1 years): 35 normal weight (NW) and 28 overweight (OW) (total body fat [TBF] 24.7 ± 3.9% and 36.6 ± 3.9%, respectively). After 12 hours of fasting, each subject was given one of the two test meals standardized, including 2 muffins and water (HSM, 42.1% of saturated fat acid, or HMM, 34.5% of monounsaturated fat acid). Plasma fatty acid profile and concentrations of apolipoproteins A1 and B100, complement C3, and triacylglycerols were analyzed during fasting and at 2, 3, and 5 postprandial hours. RESULTS: Among the markers studied, the triacylglycerol (TAG) and complement C3 were significantly higher in the OW group, compared to NW. The increment in the C3 concentration was higher after HSM intake, compared with HMM (iAUC = 4365.5 ± 5477.4 vs. 1215.2 ± 882.4; p = 0.006), with no differences between groups. After 5 hours postprandial, plasma oleic acid values remained high compared with the fasting value in the NW group, but not in the OW group (26.0 ± 4.2 vs 23.7 ± 3.9%; p < 0.001). Women with high percentage of total plasma saturated fatty acids (SFA) at the beginning of the intervention had higher incremental area under the curve (iAUC) for the palmitic, stearic, and total fatty acids (p < 0.005). Those women with a high percentage of monounsaturated fatty acids (MUFA) showed lower iAUC values for the same fatty acid profile (p < 0.005). CONCLUSION: This study demonstrated the effect of the HSM on postprandial increment of C3 concentration, suggesting another mechanism for saturated fat metabolism. The postprandial response to HSM appears to be the mediated by baseline lipid profile of the individuals, while the response to HMM was correlated to the weight status.

Waist circumference measures: cutoff analyses to detect obesity and cardiometabolic risk factors in a Southeast Brazilian middle-aged men population--a cross-sectional study.

BACKGROUND: Low-cost practical and reliable tools to evaluated obesity-related cardiometabolic diseases are of clinical practice and public heath relevance worldwide. The aims of this cross-sectional study were to determine the anatomical point of waist circumference that best identify overweight, obesity and central obesity in Southeast Brazilian middle-aged men and to test the relationships of its cutoff points with metabolic syndrome (MetS), insulin resistance (IR) and cardiometabolic risk factors. METHODS: Three hundred men [age: 51 (47-54)] underwent anthropometric, body composition, clinical, sociodemographic and blood plasma biochemical evaluations. RESULTS: The umbilical line circumference (WCUL) was the best predictor for overweight (total body fat ≥ 20%; cutoff point: 88.8 cm), obesity (total body fat ≥ 25%; cutoff point: 93.4 cm) and central obesity (abdominal area fat ≥ 34.6%; cutoff point: 95.6 cm) as measured by dual beam X-ray absorptiometry. Subjects with WCUL ≥ 88.8 cm or ≥ 93.4 cm showed significantly higher values for MetS, IR and cardiometabolic risk factors (i.e. glucose and lipid profiles, blood pressure). The occurrence of WCUL ≥ 88.8 cm was positively associated (p <0.01) with the prevalence of MetS and cardiometabolic risk factors and increased the central obesity prevalence by 19.3% while that of WCUL ≥ 93.4 cm was associated with the prevalence of MetS, IR and cardiometabolic risk factors. CONCLUSIONS: WCUL measure seems to be the best predictor for overweight, obesity and central obesity in urban residents Southeast Brazilian middle-aged men; and the WCUL cutoff point (88.8 cm) is significantly associated with MetS, IR and cardiometabolic risk factors in the studied population.

Anti-inflammatory properties of orange juice: possible favorable molecular and metabolic effects.

The low-grade inflammation has been recognized as the link between adiposity and the risk of chronic metabolic disorders. Thus, increased concentrations of inflammatory markers, such as interleukins and tumor necrosis factor alpha have been found in obese individuals. In turn, diet can positively or negatively influence on the risk of chronic metabolic diseases by modulating the inflammatory status. In this context, orange juice consumption can play a role in modulation of inflammatory markers through bioactive compounds, such as the flavonoids (hesperidin, naringenin). According to this review, orange juice appears to mediate the inflammatory response in plasma level and gene expression, and in postprandial and chronic (≥7 consecutive days) periods. The current findings suggest that orange juice could be a dietary feature for prevention and treatment of chronic diseases, although more studies are necessary to evaluate the physiological and molecular mechanisms involved.

Contribution of gender and body fat distribution to inflammatory marker concentrations in apparently healthy young adults.

OBJECTIVE: This cross-sectional study assessed the potential contribution of gender, body fat distribution, and their interactions to some inflammatory marker concentrations [C-reactive protein (CRP), complement factor 3 (C3), and ceruloplasmin (Cp)] in young adults. METHODS: Measurements included body composition, lifestyle features, blood biochemical and selected inflammatory markers on 317 healthy subjects [122 males/195 females; 22 ± 3 years; 22.1 ± 2.8 kg/m(2) (mean ± SD)]. RESULTS: Women had significantly higher CRP and Cp concentrations than men. No gender difference was noted in C3 concentrations. In a multivariate model of the whole sample, body fat (BF), waist circumference (WC) and the sex × WC interaction term presented the highest R (2) for variance of CRP (11%), C3 (2%), and Cp (12%), respectively. In regression models separated by sex, BF was the adiposity indicator that explained the variability of CRP in men (13%) and women (7%). WC was the only variable significantly associated with C3 concentrations in women (3%). BF presented the highest partial R (2) for Cp in men (8%) and WC in women (16%). CONCLUSION: Our findings indicate a relevant interaction between gender and body fat distribution on the variance of CRP, C3, and Cp concentrations in apparently healthy young adults.

Vitamin C and fibre consumption from fruits and vegetables improves oxidative stress markers in healthy young adults.

The aim of the present cross-sectional study was to assess the potential relationships between fruit and vegetable (FV) consumption and some oxidative stress markers in young adults, with particular emphasis on fibre and vitamin C intake. The study enrolled 246 healthy subjects (eighty-eight men and 158 women), with a mean age of 22 (sd 3) years and a mean BMI of 21·9 (sd 2·8) kg/m2. Dietary intake, anthropometry, blood pressure, lifestyle features and blood biochemical data were assessed with validated procedures. Those subjects in the highest tertile (T) of FV consumption ( ≥ 705 g/d) had statistically lower oxidised LDL (ox-LDL) concentrations as well as higher plasma total antioxidant capacity (TAC) and glutathione peroxidase (GPx) activity (P for trend <0·05), after adjusting for sex, age, energy intake, physical activity, smoking, BMI, vitamin supplement use and other confounding factors. Moreover, plasma ox-LDL concentrations showed a decreasing trend and TAC an increasing trend across tertiles of fibre (T3: ≥14 g/d) and vitamin C (T3: ≥150 mg/d) from FV intake, while GPx activity was positively associated with vitamin C intake (P for trend < 0·05). In conclusion, greater FV consumption was independently associated with reduced ox-LDL as well as increased TAC and GPx activity in healthy young adults, with dietary fibre and vitamin C from FV clearly being implicated in this beneficial relationship.

Effects of Regular Brazil Nut (Bertholletia excelsa H.B.K.) Consumption on Health: A Systematic Review of Clinical Trials.

The Brazil nut (BN) is a promising food due to its numerous health benefits, but it is still necessary to systematically review the scientific evidence on these benefits. Thus, we examined the effects of regular BN consumption on health markers in humans according to the health state (with specific diseases or not) of the subjects. PubMed, Embase®, and Scielo databases were used to search for clinical trials. The PRISMA guideline was used to report the review, and the risk of bias for all studies was assessed. Twenty-four studies were included in the present review, of which fifteen were non-randomized. BNs were consumed in the context of a habitual free-living diet in all studies. Improvement in antioxidant status through increased levels of selenium and/or glutathione peroxidase activity in plasma, serum, whole blood, and/or erythrocytes was observed in all studies that evaluated antioxidant status, regardless of the health state of the sample. In addition, healthy subjects improved lipid markers and fasting glucose. Subjects with obesity had improvement in markers of lipid metabolism. Subjects with type 2 diabetes mellitus or dyslipidemia improved oxidative stress or DNA damage. Subjects undergoing hemodialysis benefited greatly from BN consumption, as they improved lipid profile markers, oxidative stress, inflammation, and thyroid function. Older adults with mild cognitive impairment improved verbal fluency and constructional praxis, and controversial results regarding the change in a marker of lipid peroxidation were observed in subjects with coronary artery disease. In conclusion, the benefits of BN consumption were found in different pathways of action and study populations.

Relative validity and reproducibility of food frequency questionnaire for individuals on hemodialysis (NUGE-HD study).

INTRODUCTION: Adequate assessment of food intake is essential to establish the magnitude and direction of the relationship of food, nutrients, and bioactive compounds with clinical outcomes of individuals in hemodialysis. We evaluated the relative validity and reproducibility of a specific food frequency questionnaire for individuals on hemodialysis (FFQ-HD). METHODS: Eighty-two participants (57.3% male, 57.5 ± 14.4 years) from the open cohort Nutrition and Genetics in Hemodialysis Outcomes participated in this study. The relative validity of the FFQ-HD was assessed using the mean of two 24-h food recall (24hR) adjusted for within-subject variability as a reference method. We also performed Pearson correlations, and agreement between tertile, kappa statistics, and Bland-Altman scatter plots were validated. Reproducibility was assessed after 1 year using intraclass correlation coefficient (ICC). FINDINGS: Daily energy intake was not different between FFQ-HD and 24hR (mean difference of 50.1 kcal). Intake of protein, linolenic acid, fiber, phosphorus, potassium, sodium, calcium, and sugar showed a moderate correlation (r between 0.4 and 0.5) among instruments, while mean correlation coefficient was r = 0.38 to food group intake. Bland-Altman plots showed good agreement for micronutrients, phosphorus, sodium, and potassium and for the groups "flour, bread, and pasta" and "processed, canned meat, salts, and seasonings". The reproducibility of FFQ-HD for nutrients and food groups was satisfactory, reaching a maximum ICC of 0.72 and 0.59, respectively. DISCUSSION: The FFQ-HD showed moderate validity and reproducibility for calories, nutrients, and food groups of clinical and nutritional interest for HD subjects so that it can be a useful tool in epidemiological studies in this population.

A legume-based hypocaloric diet reduces proinflammatory status and improves metabolic features in overweight/obese subjects.

BACKGROUND: The nutritional composition of the dietary intake could produce specific effects on metabolic variables and inflammatory marker concentrations. This study assessed the effects of two hypocaloric diets (legume-restricted- vs. legume-based diet) on metabolic and inflammatory changes, accompanying weight loss. METHODS: Thirty obese subjects (17 M/13F; BMI: 32.5 ± 4.5 kg/m(2); 36 ± 8 years) were randomly assigned to one of the following hypocaloric treatments (8 weeks): Calorie-restricted legume-free diet (Control: C-diet) or calorie-restricted legume-based diet (L-diet), prescribing 4 weekly different cooked-servings (160-235 g) of lentils, chickpeas, peas or beans. Body composition, blood pressure (BP), blood biochemical and inflammatory marker concentrations as well as dietary intake were measured at baseline and after the nutritional intervention. RESULTS: The L-diet achieved a greater body weight loss, when compared to the C-diet (-7.8 ± 2.9% vs. -5.3 ± 2.7%; p = 0.024). Total and LDL cholesterol levels and systolic BP were improved only when consuming the L-diet (p < 0.05). L-diet also resulted in a significant higher reduction in C-reactive protein (CRP) and complement C3 (C3) concentrations (p < 0.05), compared to baseline and C-diet values. Interestingly, the reduction in the concentrations of CRP and C3 remained significantly higher to L-diet group, after adjusting by weight loss (p < 0.05). In addition, the reduction (%) in CRP concentrations was positively associated with decreases (%) in systolic BP and total cholesterol concentration specifically in the L-diet group, independent from weight loss (p < 0.05). CONCLUSION: The consumption of legumes (4 servings/week) within a hypocaloric diet resulted in a specific reduction in proinflammatory markers, such as CRP and C3 and a clinically significant improvement of some metabolic features (lipid profile and BP) in overweight/ obese subjects, which were in some cases independent from weight loss.

Relationship of oxidized low density lipoprotein with lipid profile and oxidative stress markers in healthy young adults: a translational study.

BACKGROUND: Despite oxidized low density lipoprotein (ox-LDL) plays important roles in the pro-inflammatory and atherosclerotic processes, the relationships with metabolic and oxidative stress biomarkers have been only scarcely investigated in young adult people. Thus, the aim of this study was to assess plasma ox-LDL concentrations and the potential association with oxidative stress markers as well as with anthropometric and metabolic features in healthy young adults. METHODS: This study enrolled 160 healthy subjects (92 women/68 men; 23±4 y; 22.0±2.9 kg/m2). Anthropometry, body composition, blood pressure, lifestyle features, biochemical data, and oxidative stress markers were assessed with validated tools. Selenium, copper, and zinc nail concentrations were measured by atomic absorption spectrophotometry. RESULTS: Total cholesterol (TC), LDL-c and uric acid concentrations, TC-to-HDL-c ratio, and glutathione peroxidase (GPx) activity were positive predictors of ox-LDL concentrations, while nail selenium level (NSL) was a negative predictor, independently of gender, age, smoking status, physical activity. Those individuals included in the highest tertile of GPx activity (≥611 nmol/[mL/min]) and of NSL (≥430 ng/g of nail) had higher and lower ox-LDL concentrations, respectively, independently of the same covariates plus truncal fat or body mass index, and total cholesterol or LDL-c concentrations. CONCLUSIONS: Ox-LDL concentrations were significantly associated with lipid biomarkers, GPx activity, uric acid concentration, and NSL, independently of different assayed covariates, in young healthy adults. These findings jointly suggest the early and complex relationship between lipid profile and redox status balance.

Dietary fatty acids as nutritional modulators of sirtuins: a systematic review.

CONTEXT: The sirtuins (SIRT1 to SIRT7) constitute a family of highly conserved nicotinamide adenine dinucleotide-dependent proteins. When activated, sirtuins control essential cellular processes to maintain metabolic homeostasis, while lack of expression of sirtuins has been related to chronic disease. OBJECTIVE: The aim of this systematic review is to analyze the role of fat consumption as a modulator of human sirtuins. DATA SOURCES: This review was conducted according to PRISMA guidelines. Studies were identified by searches of the electronic databases PubMed/MEDLINE, Scopus, and Web of Science. STUDY SELECTION: Randomized clinical trials assessing the effect of fatty acid consumption on sirtuin mRNA expression, sirtuin protein expression, or sirtuin protein activity were eligible for inclusion. DATA EXTRACTION: Two authors screened and determined the quality of the studies; disagreements were resolved by the third author. All authors compared the compiled data. RESULTS: Seven clinical studies with 3 different types of interventions involving healthy and nonhealthy participants were selected. Only SIRT1 and SIRT3 were evaluated. Overall, the evidence from clinical studies to date is insufficient to understand how lipid consumption modulates sirtuins in humans. The best-characterized mechanism highlights oleic acid as a natural activator of SIRT1. CONCLUSION: These results draw attention to a new field of interest in nutrition science. The possible activation of sirtuins by dietary fat manipulation may represent an important nutritional strategy for management of chronic and metabolic disease. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration number CRD42018114456.

Association of dietary total antioxidant capacity with depression, anxiety, and sleep disorders: A systematic review of observational studies.

BACKGROUND AND AIM: We aimed to systematically review observational studies that evaluated the potential association of the dietary total antioxidant capacity (dTAC) with common mental disorders (depression and anxiety) and sleep disorders. METHODS: Studies with an observational design that evaluated the association between the dTAC and common mental disorders and sleep disorders were identified using the PubMed and Scopus databases. The meta-analysis guideline of observational studies in epidemiology and the preferred reporting items for systematic reviews and meta-analysis were used to conduct and report the data of this systematic review. RESULTS: Of the 439 records, seven studies were included in this review. There was a sample variation of 41-3297 participants. We highlight that five of the studies analyzed were conducted in the Iranian population. Four studies analyzed only women, and three studies were conducted with postmenopausal or climacteric women. Four cross-sectional studies showed inverse associations between the dTAC and depression, anxiety, and sleep disorders in Iranians. CONCLUSION: The consumption of a diet rich in antioxidants, characterized by high dTAC scores, seems to be inversely associated with depression, anxiety, and sleep disorders. However, further studies with different populations and designs are necessary for a better understand this relationship. RELEVANCE TO PATIENTS: This review assesses the association of the dTAC with common mental disorders (depression and anxiety) with sleep disorders. This will help guide further studies on the relationship between diet and mental disorders and sleep disorders. Knowledge about these relationships is essential for the creation of non-pharmacological practices for the prevention of these disorders.

Relationship between the FTO Genotype and Early Chronic Kidney Disease in Type 2 Diabetes: The Mediating Role of Central Obesity, Hypertension, and High Albuminuria.

INTRODUCTION: Single nucleotide polymorphisms (SNP) in the fat mass and obesity-associated (FTO) gene have been associated with type 2 diabetes (T2D) and its complications. The aim of the present research was to investigate which and how (directly or indirectly) clinical and metabolic variables mediate the association between fat mass and the FTO gene and early chronic kidney disease (CKD) in individuals with T2D. METHODS: This cross-sectional study was conducted in a sample of 236 participants with T2D (53.4% women, mean age 60 ± 10 years). DNA samples were genotyped for the rs7204609 polymorphism (C/T) in the FTO gene. Clinical, anthropometric, and metabolic data were collected. Path analysis was used to evaluate the associations. RESULTS: Of the sample, 78 individuals with T2D had CKD (33%). Presence of the risk allele (C) was higher among participants with CKD (21.8 vs. 10.8%; p = 0.023). This polymorphism was positively associated with higher waist circumference, which in turn was associated with higher glycated hemoglobin and higher blood pressure. A higher blood-pressure level was associated with higher urinary albumin excretion (UAE) and as expected, higher UAE was associated with CKD. Path analysis showed an indirect relationship between the FTO gene and early CKD, mediated by waist circumference, blood-pressure levels, and UAE. CONCLUSIONS: These findings suggest that the C allele may contribute to genetic susceptibility to CKD in individuals with T2D through the presence of central obesity, hypertension, and high albuminuria.

Dietary total antioxidant capacity is inversely associated with cardiovascular events and cardiometabolic risk factors: A cross-sectional study.

OBJECTIVES: Dietary total antioxidant capacity (dTAC) has been introduced as a useful tool to quantify the antioxidant content of a diet. However, few studies have evaluated the association of dTAC with cardiovascular disease (CVD) occurrence and cardiometabolic risk factors in people with established CVD events. Thus, we aimed to investigate the presence of an association between dTAC values, cardiovascular events, and cardiometabolic risk factors in individuals with previous CVD in a Brazilian multicenter study. METHODS: This study has a cross-sectional design. We evaluated baseline data from the Brazilian Cardioprotective Nutritional Program Trial. Sociodemographic, anthropometric, clinical, and food-consumption data were collected in face-to-face interviews. We estimated dTAC from the mean of two 24-h dietary recalls by values of ferric-reducing antioxidant power. RESULTS: We evaluated 2346 participants, most of whom were men (58.4%), older adults (64.2%), and overweight (68.6%), and had coronary artery disease (92.4%). The mean dTAC was equal to 5.6 (interquartile range, 3.9-7.8) mmol/1000 kcal. Participants in the third dTAC tertile (9.2 mmol/1000 kcal) had a 22%, 59%, and 69% lower chance, respectively, of having hypertriglyceridemic waist phenotype, abdominal aortic aneurysm, and amputation due to arterial disease in comparison to the first tertile (3.4 mmol/1000 kcal). CONCLUSIONS: The dTAC was inversely associated with hypertriglyceridemic waist phenotype, abdominal aortic aneurysm, and amputation due to arterial disease in individuals undergoing secondary care for CVD. Our results can guide strategies for the prevention of new CVD and its consequences.

Dietary total antioxidant capacity: a novel indicator of diet quality in healthy young adults.

BACKGROUND: Overall diet quality measurements have been suggested as a useful tool to assess diet-disease relationships. Oxidative stress has been related to the development of obesity and other chronic diseases. Furthermore, antioxidant intake is being considered as protective against cell oxidative damage and related metabolic complications. OBJECTIVE: To evaluate potential associations between the dietary total antioxidant capacity of foods (TAC), the energy density of the diet, and other relevant nutritional quality indexes in healthy young adults. METHODS: Several anthropometric variables from 153 healthy participants (20.8 +/- 2.7 years) included in this study were measured. Dietary intake was assessed by a validated food-frequency questionnaire, which was also used to calculate the dietary TAC and for daily energy intake adjustment. RESULTS: Positive significant associations were found between dietary TAC and Mediterranean energy density hypothesis-oriented dietary scores (Mediterranean Diet Score, Alternate Mediterranean Diet Score, Modified Mediterranean Diet Score), non-Mediterranean hypothesis-oriented dietary scores (Healthy Eating Index, Alternate Healthy Eating Index, Diet Quality Index-International, Diet Quality Index-Revised), and diversity of food intake indicators (Recommended Food Score, Quantitative Index for Dietary Diversity in terms of total energy intake). The Mediterranean Diet Quality Index and Diet Quality Index scores (a Mediterranean and a non-Mediterranean hypothesis-oriented dietary score, respectively), whose lower values refer to a higher diet quality, decreased with higher values of dietary TAC. Energy density was also inversely associated with dietary TAC. CONCLUSION: These data suggest that dietary TAC, as a measure of antioxidant intake, may also be a potential marker of diet quality in healthy subjects, providing a novel approach to assess the role of antioxidant intake on health promotion and diet-based therapies.

Dietary Folate Intake Is Negatively Associated with Excess Body Weight in Brazilian Graduates and Postgraduates (CUME Project).

Folate, vitamin B6, and vitamin B12 intake can be important regulators for obesity development. Thus, we investigated the possible association between the intake of these vitamins and the excess body weight or obesity prevalence in the participants of the Cohort of Universities in Minas Gerais (CUME project). This study analyzed cross-sectional data of 2695 graduates and postgraduates from universities in the state of Minas Gerais (801 men, 1894 women, ages 36.2 ± 9.4). The first step consisted of collecting data online, and the second step consisted of blood collecting in the subsample living in the city of Viçosa and its region (Minas Gerais). Excess body weight and obesity prevalence were 38.1% and 10.1%, respectively. Inadequate intake of folate, B6, and B12 were 12, 6.3, and 11.1%, respectively. Beans/lentils and French bread presented the highest contribution to folate intake (23.45% and 10.01%, respectively). Those individuals in the third tertile for folate intake (≥511.12 µg/d) had a lower excess body weight [prevalence ratio (PR): 0.79, confidence interval (CI): 0.71⁻0.8] and obesity prevalence (PR: 0.60, CI: 0.45⁻0.78). These associations were maintained when the sample was categorized by sex. In addition, serum folate was positively associated with dietary folate (p for trend = 0.032) and negatively associated with serum homocysteine (p for trend = 0.003) in the subsample. Dietary folate intake was negatively associated with excess body weight and obesity in CUME participants, indicating the relevance of this vitamin dietary assessment.