A 4-Week Diet Low or High in Advanced Glycation Endproducts Has Limited Impact on Gut Microbial Composition in Abdominally Obese Individuals: The deAGEing Trial.

Dietary advanced glycation endproducts (AGEs), abundantly present in Westernized diets, are linked to negative health outcomes, but their impact on the gut microbiota has not yet been well investigated in humans. We investigated the effects of a 4-week isocaloric and macronutrient-matched diet low or high in AGEs on the gut microbial composition of 70 abdominally obese individuals in a double-blind parallel-design randomized controlled trial (NCT03866343). Additionally, we investigated the cross-sectional associations between the habitual intake of dietary dicarbonyls, reactive precursors to AGEs, and the gut microbial composition, as assessed by 16S rRNA amplicon-based sequencing. Despite a marked percentage difference in AGE intake, we observed no differences in microbial richness and the general community structure. Only the Anaerostipes spp. had a relative abundance >0.5% and showed differential abundance (0.5 versus 1.11%; p = 0.028, after low- or high-AGE diet, respectively). While the habitual intake of dicarbonyls was not associated with microbial richness or a general community structure, the intake of 3-deoxyglucosone was especially associated with an abundance of several genera. Thus, a 4-week diet low or high in AGEs has a limited impact on the gut microbial composition of abdominally obese humans, paralleling its previously observed limited biological consequences. The effects of dietary dicarbonyls on the gut microbiota composition deserve further investigation.

Association of artificially sweetened and sugar-sweetened soft drinks with ß-cell function, insulin sensitivity, and type 2 diabetes: the Maastricht Study.

PURPOSE: Artificially sweetened and sugar-sweetened beverage consumptions have both been reported to be associated with type 2 diabetes mellitus (T2D) risk. The aim of the current study was to investigate the potential underlying associations with dynamic pancreatic ß-cell function (BCF) and insulin sensitivity. METHODS: We evaluated cross-sectional associations in 2240 individuals (mean ± SD age 59.6 ± 8.18, 49.4% male, 21.9% T2D) participating in a diabetes-enriched population-based cohort. Artificially sweetened and sugar-sweetened soft drinks and juice consumption were assessed by a food-frequency questionnaire. Glucose metabolism status, insulin sensitivity, and BCF were measured by a seven-point oral glucose tolerance test. Regression analyses were performed to assess associations of artificially and sugar-sweetened beverage consumption with measures of glucose homeostasis. Associations were adjusted for potential confounders, and additionally with and without total energy intake and BMI, as these variables could be mediators. RESULTS: Moderate consumption of artificially sweetened soft drink was associated with lower ß-cell glucose sensitivity [standardized beta (95% CI), - 0.06 (- 0.11, - 0.02)], total insulin secretion [ß - 0.06 (- 0.10, - 0.02)], and with lower ß-cell rate sensitivity [odds ratio (95% CI), 1.29 (1.03, 1.62)] compared to abstainers. Daily artificially sweetened soft drink consumption was associated with lower ß-cell glucose sensitivity [ß - 0.05 (- 0.09, 0.00)], and total insulin secretion [ß - 0.05 - 0.09, - 0.01)] compared to abstainers. CONCLUSIONS: Moderate and daily consumption of artificially sweetened soft drinks was associated with lower BCF, but not with insulin sensitivity. No evidence was found for associations of sugar-sweetened soft drink and juice consumption with BCF or insulin sensitivity in this middle-aged population. Prospective studies are warranted to further investigate the associations of artificially and sugar-sweetened beverage consumption with non-fasting insulin sensitivity and multiple BCF aspects.

Associations of Dietary Glucose, Fructose, and Sucrose with ß-Cell Function, Insulin Sensitivity, and Type 2 Diabetes in the Maastricht Study.

The associations of glucose, fructose, and sucrose intake with type 2 diabetes mellitus (T2DM) have been inconsistent. Furthermore, there is a lack of studies focusing on early markers of T2DM that provide insight into the process of T2DM progression: impaired pancreatic ß-cell function (BCF) and insulin sensitivity. This study evaluated associations cross-sectionally in a population-based cohort consisting of 2818 individuals (mean ± SD age 59.7 ± 8.18, 49.5% male, n = 120 newly diagnosed T2DM). Glucose, fructose, and sucrose intake were assessed by a food frequency questionnaire. Glucose metabolism status, insulin sensitivity, and BCF were measured by a seven-points oral glucose tolerance test. Linear regression analysis revealed a positive association of glucose intake with insulin sensitivity in the fully adjusted model (standardized beta (95% CI) 0.07 (0.05, 0.14) SD for ≥23 g vs. <10 g of glucose). Fructose and sucrose intake were not associated with insulin sensitivity after full adjustments. In addition, no associations of dietary glucose, fructose, and sucrose with BCF were detected. In conclusion, higher intake of glucose, not fructose and sucrose, was associated with higher insulin sensitivity, independent of dietary fibre. No convincing evidence was found for associations of dietary glucose, fructose, and sucrose with BCF in this middle-aged population.

Validation of a food-frequency questionnaire for Flemish and Italian-native subjects in Belgium: The IMMIDIET study.

OBJECTIVE: To validate an integrated food-frequency questionnaire (FFQ) developed to assess habitual food intake of Flemish and Italian-native subjects in Belgium as part of the European Collaborative Dietary Habit Profile in European Communities With Different Risk of Myocardial Infarction: the Impact of Migration as a Model of Gene/Environment Interaction (IMMIDIET Project). METHODS: The semiquantitative FFQ contained 322 items on food and food preparation. FFQs filled by a sample (n = 70) of the Flemish-Flemish and Flemish-Italian IMMIDIET subpopulations were randomly selected. Five 24-h recalls, administered over a period of 1 y by the same sample, served for validation. Energy and macronutrients were calculated using the Dutch NEVO and the Belgian NUBEL food composition tables. Intakes of energy and macronutrients estimated by the FFQ and repeated 24-h recall, respectively, were compared by means of correlation coefficients, classification into quartiles, and Bland-Altman plotting. RESULTS: The FFQ overestimated intake of energy and most macronutrients by 40-70%. This overestimation largely disappeared when values were expressed as energy percentage. Correlations ranked from 0.40 to 0.60 for energy and most macronutrients (median 0.53); correlations were lower (null to 0.41) for fat and higher (up to 0.90) for alcohol. Classification in quartiles of intake showed good agreement: 83% were classified in the same or adjacent quartile of energy, and 66-90% for macronutrients. Correlations and classification of macronutrient intake into quartiles remained similar when macronutrients were expressed as energy percentage. Stratification according to ethnic subgroup, age, body mass index, or social status showed no differences. CONCLUSION: The IMMIDIET FFQ is a valuable tool for studies of the role of energy and macronutrients in disease etiology or outcome, but less suitable for estimating absolute intake levels.

Randomized clinical trial on the effects of adenosine 5'-triphosphate infusions on quality of life, functional status, and fatigue in preterminal cancer patients.

CONTEXT: One potential agent to improve symptoms and quality of life (QoL) in advanced cancer patients is adenosine 5'-triphosphate (ATP). Several reports suggest that ATP may positively affect QoL and survival in patients with advanced non-small-cell lung cancer. OBJECTIVES: To investigate the effects of ATP infusions on QoL parameters in patients with preterminal cancer of mixed tumor types. METHODS: Ninety-nine preterminal cancer patients were randomly allocated to receive either ATP intravenously weekly (8-10 hours/week, with maximum 50 µg/kg.minute) for eight weeks or receive no ATP (control group). QoL parameters were assessed until eight weeks and analyzed by repeated-measures analysis of covariance. RESULTS: Fifty-one patients were randomized to the ATP group and 48 to the control group. Unexpectedly, in the untreated control group, most of the outcome parameters did not deteriorate but remained stable or even significantly improved over time. Between the ATP and control groups, no statistically significant differences were observed for the large majority of outcome parameters, except for the strength of elbow flexor muscles in favor of the control group. CONCLUSION: ATP infusions, at the dose and schedule studied, did not have a significant effect on QoL, functional status, or fatigue in preterminal cancer patients of mixed tumor types.

Treatment adherence and patients' acceptance of home infusions with adenosine 5'-triphosphate (ATP) in palliative home care.

GOALS OF WORK: In preterminal cancer patients, provision of palliative care in the patients' own environment is preferred. The aim of the present study was to evaluate patients' and caregivers' treatment adherence and patients' acceptance of home infusions with adenosine 5'-triphosphate (ATP). PATIENTS AND METHODS: Preterminal cancer patients (life expectancy <6 months) with mixed tumor types were eligible for the study. Patients received a maximum of eight weekly intravenous 8-10 h ATP infusions. Evaluation of treatment adherence was based on registration of protocol deviations and patients' acceptance by structured interviews with patients. MAIN RESULTS: Fifty-one patients received a total of 266 intravenous ATP infusions. The infusion protocol was well executed: mean duration approximately 8.30 h, stepwise achievement of the maximum infusion rate within 30 min in 65% of the infusions, and almost no delay in weekly administration. All except one patient were not burdened by the administration of the infusions at home and none of them had felt afraid. The majority of patients found the advantages of the ATP infusions outweighing the disadvantages. However, an important bottleneck in the administration of ATP infusions at home was difficulty in establishing venous access. CONCLUSION: ATP infusions at home are well accepted by patients. Difficulties in establishing venous access might be reduced by composing specialized home infusion teams working both at the day care center and at home or by adopting an alternative route of venous access.