Dietary patterns and their association with adiponectin and leptin concentrations throughout pregnancy: a prospective cohort.

The aim of this study was to evaluate the association of dietary patterns (DP) with maternal adiposity indicators, leptin, adiponectin and insulin concentrations during pregnancy. A prospective cohort of pregnant women followed up at the 5th-13th, 20th -26th and 30th-36th gestational weeks and 30-40 d postpartum was conducted in Rio de Janeiro. A FFQ was administered in the third trimester (30th-36th gestational weeks). The reduced rank regression procedure was used to identify DP that explain response variables (dietary fibre and total fat) related to indicators of maternal adiposity (postpartum weight retention and gestational weight gain (GWG) adequacy), and plasma leptin, adiponectin and insulin concentrations. The associations between tertiles of DP and the outcomes were determined using logistic regression or longitudinal linear mixed-effect regression models. The mean daily energy intake during pregnancy was 10 104 (sd 3234) kJ (2415 (sd 773) kcal), and GWG was 11·9 (sd 4·2) kg. In all, 40 % of women presented pre-gestational overweight/obesity. Excessive GWG occurred in 34·7 % of pregnant women and 56·6 % were overweight/obese at postpartum. The 'common-Brazilian' DP (characterised by higher intake of beans, rice and lower intake of fast food/snacks, candies/table sugar and processed meats/bacon) was positively associated with adiponectin (ß=1·07; 95 % CI 0·17, 1·98). The 'Western' DP (characterised by higher intake of fast food/snacks and processed meat/bacon and lower intake of noodles/pasta/roots/tubers and sodas) was negatively associated with adiponectin (ß=-1·11; 95 % CI -2·00, -0·22) and positively associated with leptin concentrations (ß=64·9; 95 % CI 22·8, 107·0) throughout pregnancy. It may be suggested that the 'common-Brazilian' is a healthy DP and beneficial for serum concentrations of adiponectin and leptin.

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.

Metabolic responses to high glycemic index and low glycemic index meals: a controlled crossover clinical trial.

BACKGROUND: The consumption of low glycemic index (LGI) foods before exercise results in slower and more stable glycemic increases. Besides maintaining an adequate supply of energy during exercise, this response may favor an increase in fat oxidation in the postprandial period before the exercise compared to high glycemic index (HGI) foods. The majority of the studies that evaluated the effect of foods differing in glycemic index on substrate oxidation during the postprandial period before the exercise are acute studies in which a single meal is consumed right before the exercise. The purpose of this study was to investigate the effect of consuming two daily HGI or LGI meals for five consecutive days on substrate oxidation before the exercise and in the concentrations of glucose, insulin and free fatty acids before and during a high intensity exercise. METHODS: Fifteen male cyclists, aged 24.4 ± 3.8 years, with body mass index of 21.9 ± 1.4 kg.m⁻² and a V(O2 max) of 70.0 ± 5.3 mL.kg⁻¹.min⁻¹, participated in this crossover study. All test meals were consumed in the laboratory. On days 1 and 5, substrate oxidation (30 minutes before and 90 minutes after breakfast (HGI or LGI)) and diet-induced thermogenesis (90 minutes postprandial) were assessed before the exercise. The levels of glucose, insulin, and free fatty acids were determined during 2 h after breakfast on these same days. Ninety minutes after breakfast, subjects completed a 30 min cycloergometric exercise at 85 to 95% of their maximum heart rate, during which lactate concentrations were assessed. RESULTS: The consumption of HGI meals resulted in higher areas under the glycemic and insulinemic curves in the postprandial period. However, glycemia did not differ by study treatment during exercise. There were no differences in free fatty acids in the postprandial period or in lactate levels during exercise. LGI meals resulted in lower fat oxidation and higher carbohydrate oxidation than the HGI meal in the postprandial period. CONCLUSIONS: The results do not support a differential glycemia according to glycemic index during exercise. The ingestion of LGI foods did not lead to higher fat oxidation relative to the ingestion of HGI foods.

Recruitment of low-income pregnant women into a dietary and dental care intervention: lessons from a feasibility trial.

BACKGROUND: There are difficulties in carrying out research in low-income urban communities, but the methodological challenges and suggestions on how to deal with them are often undocumented. The aims of this study are to describe the challenges of recruiting and enrolling low-income pregnant women with periodontitis to a clinical trial on vitamin D/calcium milk fortification and periodontal therapy and also to describe the patient-, study protocol- and setting-related factors related to women's ineligibility and refusal to participate in the study. METHODS: A mixed-method sequential exploratory design was applied. Qualitative and quantitative data on recruitment to a 2 × 2 factorial feasibility clinical trial were used. Eighteen women attending the health centre in a low-income area in Duque de Caxias (Rio de Janeiro, Brazil) took part in focus group discussions, and the data were thematically analysed. Quantitative data were analysed using appropriate descriptive statistics, including absolute and relative frequencies. RESULTS: Of all referrals (767), 548 (78.5%) did not meet the initial eligibility criteria. The main reason for exclusion (58%) was advanced gestational age (> 20 weeks) at first prenatal appointment. In the periodontal examination (dental screen), the main reason for exclusion was the presence of extensive caries (64 out of 127 exclusions). Non-participation of those eligible after the periodontal examination was approximately 24% (22 out 92 eligible women) and predominantly associated with patient-related barriers (e.g. transportation barriers, family obligations, patients being unresponsive to phone calls and disconnected telephones). The study recruited 70 women with periodontitis in 53 weeks and did not reach the benchmark of 120 women in 36 weeks (58.3% of the original target). Recruitment was severely hindered by health centre closures due to general strikes. The recruitment yields were 9.1% (70/767) of all women contacted at first prenatal visit and 76.1% (70/92) of those screened eligible and enrolled in the trial. Women did not report concerns regarding random allocation and considered fortified milk as a healthful and safe food for pregnant women. Some women reported that financial constraints (e.g. transportation costs) could hinder participation in the study. CONCLUSION: Engagement between the research team and health centre staff (e.g. nurses) facilitated referral and recruitment, yet some pregnant women failed to participate in the study largely due to significant patient-related sociodemographic barriers and setting-related factors. Our data illustrate the complexity of overcoming recruitment and enrolment challenges for clinical trials in resource-limited settings. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03148483. Registered on 11 May 2017.

Accuracy of plasma interleukin-18 and adiponectin concentrations in predicting metabolic syndrome and cardiometabolic disease risk in middle-age Brazilian men.

The aims of this cross-sectional study were to explore the ability of serum interleukin 18 (IL-18) and adiponectin to identify metabolic syndrome (MetS), and to verify their association with an index of central lipid overaccumulation (lipid accumulation product (LAP)) and cardiometabolic risk factors in a population of middle-aged Brazilian men. A group of 218 apparently healthy middle-aged Brazilian men (age, 50.3 ± 4.97 years) underwent anthropometric, clinical, sociodemographic, and standard serum biochemical assessments. LAP was calculated and the study participants were categorized into 3 groups according to serum IL-18 and adiponectin cut-points tertiles to verify the association of these biomarkers with cardiometabolic risk factors. The MetS group had more less active (p = 0.03) and obese (p < 0.01) individuals who exhibited higher IL-18 (p < 0.01) and lower adiponectin (p < 0.01) than did those in the group with no MetS. After adjustments (age, smoking, alcohol consumption, physical activity level, and total body fat), serum IL-18 ≥ 336.4 pg/mL was an independent factor for MetS occurrence and it was directly associated with LAP (≥51.28), central obesity, hypertriglyceridemia, and hypertension (p < 0.05), but not with high-density lipoprotein cholesterol (HDL-C). Serum adiponectin ≥ 7.02 µg/mL was negatively associated with MetS occurrence, LAP, hypertriglyceridemia, and low HDL-C (p < 0.05), but not with central obesity and hypertension. In conclusion, both IL-18 and adiponectin demonstrated the ability to identify MetS in this population, with IL-18 being more accurate. The association of these biomamarkers with LAP and cardiometabolic risk factors highlights its relevance as a diagnostic tool.

Red but not white meat consumption is associated with metabolic syndrome, insulin resistance and lipid peroxidation in Brazilian middle-aged men.

BACKGROUND: The influence of diet on metabolic syndrome and oxidative stress are not completely known. DESIGN: This cross-sectional study assessed the association of red meat and white meat consumption with metabolic syndrome, insulin resistance and lipid peroxidation in Brazilian middle-aged men. METHODS: A total of 296 subjects (age: 50.5 ± 5.0 years, body mass index: 25.8 ± 3.5 kg/m(2)) were evaluated. Anthropometry, lifestyle features, blood biochemical parameters, diagnosis of metabolic syndrome, homeostatic model assessment for insulin resistance, a lipid peroxidation marker (oxidized low-density lipoprotein) and triglycerides:high-density lipoprotein cholesterol ratio were assessed. Dietary intake was estimated by a food frequency questionnaire. RESULTS: The subjects included in the highest tertile red meat (≥81.5 g/d) and saturated fatty acid from red meat consumption (≥4.3 g/d) had higher occurrence of central obesity (nearly 60%, p < 0.01), hypertriglyceridaemia (nearly 43%, p < 0.01) and metabolic syndrome (35%, p < 0.01). They also had higher values of homeostatic model assessment for insulin resistance, oxidized low-density lipoprotein, and triglycerides:high-density lipoprotein cholesterol ratio, regardless of interfering factors. There were no associations of highest white meat tertile (≥39.4 g/d) and saturated fatty acid from white meat (≥1.0 g/d) consumption with the assessed parameters (p > 0.05). CONCLUSIONS: Red meat consumption was cross-sectionally associated with the occurrence of central obesity, hypertriglyceridaemia, and metabolic syndrome as well as with higher homeostatic model assessment for insulin resistance, oxidized low-density lipoprotein concentrations and triglycerides:high-density lipoprotein cholesterol ratio. The content of saturated fatty acid from red meat consumption may be a factor that contributed to this relationship, while white meat consumption was not associated with metabolic syndrome and the assessed biomarkers.

Usual dietary glycemic load is associated with cardiometabolic risk factors in physically active Brazilian middle-aged men.

INTRODUCTION: The effects of dietary glycemic load (GL) on cardiometabolic risk factors in physically active subjects are not completely known. OBJECTIVE: This cross-sectional study assessed the association of habitual dietary GL with cardiometabolic risk factors in physically active Brazilian middle-aged men. METHODS: One-hundred seventy-six subjects (Age: 50.6 ± 5.0 years, BMI: 25.5 ± 3.6 kg/m2) were evaluated. Anthropometry, lifestyle features, insulin resistance, oxidative stress biomarkers (8-iso-prostaglandin F2α; 8-iso-PGF2α and 8- hydroxydeoxyguanosine; 8-OHdG) and lipid profile were assessed. Dietary intake was estimated through a quantitative food frequency questionnaire. RESULTS: The dietary GL was positively associated with free fatty acid concentrations (ß= 0.311, r2 = 0.13, P-value = 0.034) and triglycerides/HDL cholesterol ratio (ß = 0.598, r2 = 0.19, P-value = 0.028) regardless of confounding factors (central obesity, red meat consumption, age and energy intake). The oxidative stress biomarker, 8-OHdG, was associated with habitual dietary GL (ß = 0.432, r2 = 0.11, P-value = 0.004), regardless of previous confounding factors plus excessive alcohol consumption, iron intake and current smoking status. CONCLUSIONS: The dietary GL was positively associated with lipid profile (free fatty acid concentrations and triglyce rides/HDL cholesterol ratio) and oxidative stress biomarker (8-OHdG). These results indicate potential harmfulness of diet with higher GL to cardiometabolic risk factors in middle-aged men, even in physically active individuals.

Introducción: Los efectos de la carga glucémica (CG) de la dieta sobre los factores de riesgo cardiometabólico en sujetos físicamente activos no están establecidos por completo. Objetivo: Este estudio transversal evaluó la asociación entre la CG de la dieta habitual y los factores de riesgo cardiometabólico en hombres brasileños de mediana edad físicamente activos. Métodos: Ciento setenta y seis sujetos (índice de masa corporal: 25,5 ± 3,6 kg/m2; edad: 50,6 ± 5,0 años) fueron evaluados. Antropometría, características del estilo de vida, la resistencia a la insulina, biomarcadores del estrés oxidativo (8-iso-prostaglandina F2, 8-iso-PGF2y 8 hidroxideoxiguanosina, 8-OHdG) y el perfil lipídico fueron evaluados. La ingesta dietética se estimó por medio de un cuestionario cuantitativo de frecuencia de consumo. Resultados: La CG de la dieta se asoció positivamente con las concentraciones de ácidos grasos libres (= 0,311, r2 = 0,13, P = 0,034) y la razón triglicéridos/colesterol HDL (= 0,598, r2 = 0,19, P = 0,028), independientemente de los factores de confusión (obesidad central, consumo de carne roja, edad e ingesta calórica). El biomarcador del estrés oxidativo, 8-OHdG, también se asoció con CG de la dieta habitual (= 0,432, r2 = 0,11, P = 0,004), independientemente de los factores de confusión anteriores más el consumo excesivo de alcohol, la ingesta de hierro y tabaquismo actual. Conclusiones: La CG de la dieta se asoció positivamente con el perfil lipídico (concentraciones de ácidos grasos libres y razón triglicéridos/HDL colesterol) y el biomarcador de estrés oxidativo 8-OHdG. Estos resultados indican el potencial de nocividad de una dieta con mayor CG respecto a los factores de riesgo cardiometabólico en hombres de mediana edad, incluso en aquellos físicamente activos.

Fruit and vegetable intake and related nutrients are associated with oxidative stress markers in middle-aged men.

OBJECTIVE: The aim of this cross-sectional study was to assess the potential relationships between fruit and vegetable (FV) intake and oxidative stress markers in middle-aged men, with an emphasis on vitamin C, fiber, and magnesium content. METHODS: The study was conducted with 296 healthy men, age 50.5 ± 5.0 y, and body mass index (BMI) of 25.8 ± 3.5 kg/m(2). Dietary intake, anthropometry, blood pressure, lifestyle features, and blood and urine biochemical data were assessed with validated procedures. The oxidative stress markers selected were plasma oxidized low-density lipoprotein (ox-LDL), urinary 8-iso-prostaglandin F2 α (8-iso-PGF2 α) and 8-hydroxy-2'-deoxyguanosine (8-OHdG). RESULTS: The men included in the highest tertile of FV intake (≥341.1 g/d) displayed lower concentrations of ox-LDL, 8-iso-PGF2 α and 8-OHdG (P for trend < 0.05), regardless of confounding factors. Concentrations of ox-LDL were negatively associated with fiber from the FV intake (P for trend < 0.05) regardless of confounding factors. ox-LDL and 8-OHdG concentrations tended to be lower in the higher tertile of magnesium (P for trend = 0.06) and vitamin C from FV intake (P for trend = 0.05), respectively. Additionally, concentrations of 8-iso-PGF2 α were lower in men in the highest tertile of fiber (≥6.5 g/d; P for trend = 0.034), vitamin C (≥98.0 mg/d; P for trend = 0.007), and magnesium (≥48.9 mg/d; P for trend = 0.018) from the FV-group intake. CONCLUSIONS: Greater FV intake was independently associated with reduced ox-LDL, 8-OHdG, and 8-iso-PGF2 α in middle-aged men. Fiber, vitamin C, and magnesium from FV seem to contribute to this beneficial relationship.

Benefits and relationship of steps walked per day to cardiometabolic risk factor in Brazilian middle-aged men.

OBJECTIVES: We evaluated the benefits and relationship of the number of steps per day to the cardiometabolic risk factors: adiposity indicators; insulin resistance; and metabolic syndrome (MetS) in apparently healthy Brazilian middle-aged men. DESIGN: Cross-sectional. METHODS: Apparently healthy men (age: 50 ± 5 years; n=299) were studied. The number of steps per day was measured by pedometer. The adiposity indicators (waist circumference, total body fat, android and gynoid body fat), serum insulin, glucose and triglycerides, triglycerides/high-density lipoprotein cholesterol (HDL-c) ratio, homeostasis model assessment of insulin resistance (HOMA-IR) and MetS were assessed. Subjects were placed in groups to reflect different levels of steps per day (average of 7 consecutive days): Group 1<10,000 and Group 2 ≥ 10,000. Relationships among variables were measured by multiple linear regressions and the Spearman correlation coefficient as appropriate (p<0.05). RESULTS: The cardiometabolic risk factors were lower (p<0.05) in Group 2 than in Group 1. The number of steps per day was a negative predictive factor for total body fat, android and gynoid body fat and HOMA-IR independent of age, working position, android fat, overweight/obesity prevalence, and triglycerides/HDL-c ratio. Moreover, there was a negative correlation between the number of steps and total body fat, android and gynoid body fat, HOMA-IR and MetS. CONCLUSIONS: Brazilian middle-aged men performing more than 10,000 steps per day have better cardiometabolic conditions than those walking fewer than 10,000 steps. The number of steps per day is inversely related to the indicators of total and regional adiposity, insulin resistance and MetS.