Pre-pregnancy BMI is associated with offspring body composition in adulthood before adiposity-related disorders: a retrospective cohort.

OBJECTIVE: To investigate the association between maternal pre-pregnancy BMI and offspring body composition in adulthood. DESIGN: Retrospective cohort. Undergraduates of nutrition or nutritionists were recruited at the baseline of the Nutritionists' Health Study between 2014 and 2017. Maternal pre-pregnancy BMI and current life aspects were self-reported through online questionnaires. Three body compartments were dual-energy x-ray absorptiometry-determined. The following variables were obtained: body fat (%), fat mass index (FMI) (kg/m2), android-to-gynoid fat ratio, visceral adipose tissue (VAT) (cm3), appendicular skeletal muscle mass index (ASMI) (kg/m2), total bone and femur mineral content (g) and density (g/cm2). Linear regression adjusted according to directed acyclic graphs recommendation was performed. SETTING: São Paulo, Brazil. PARTICIPANTS: Healthy non-pregnant women (aged 20-45 years) (n 150). RESULTS: Median age and BMI were 22 years (IQR = 20, 29) and 22·3 kg/m2 (IQR = 20·4, 25·3), respectively. Pre-pregnancy BMI ≥ 25 kg/m2 was reported by 14·7 % of mothers. In fully adjusted models, maternal pre-pregnancy BMI was associated with their daughters' body fat % (ß = 0·31; 95 % CI 0·0004, 0·63), FMI (ß = 0·17; 95 % CI 0·03, 0·30), android-to-gynoid ratio (ß = 0·01; 95 % CI 0·004, 0·02) and VAT (ß = 0·09; 95 % CI 0·02, 0·16), but not with total bone density (ß = 0·001; 95 % CI -0·003, 0·006) and content (ß = 7·13; 95 % CI -4·19, 18·46). Direct association with ASMI was also detected, but lost statistical significance when participants whose mothers were underweight were excluded. CONCLUSIONS: Maternal pre-pregnancy BMI was directly associated with offspring general and visceral adiposity but seems not to be associated with bone mass. Results reinforce importance of avoiding excess of maternal adiposity, as an attempt to break the vicious cycle of obesity transmission.

Early life feeding and current dietary patterns are associated with biomarkers of glucose and lipid metabolism in young women from the Nutritionist's Health Study.

BACKGROUND/OBJECTIVES: We investigated if breastfeeding duration and current dietary patterns (DP) were associated with glucose and lipid metabolism biomarkers in women from the Nutritionist's Health Study. SUBJECTS/METHODS: This is a cross-sectional analysis of 200 healthy undergraduates and nutrition graduates aged ≤45 years. Total [<6; ≥6 months] and predominant [<3; ≥3 months] breastfeeding were recalled using questionnaires. Diet were assessed using a food frequency questionnaire. DP obtained by factor analysis by principal component were categorized into tertiles of adherence (T1 = reference). Glucose and lipid biomarkers were categorized into tertiles (T1 + T2 = reference). Logistic regression was applied considering minimal sufficient adjustment recommended by directed acyclic graphs. RESULTS: Median (interquartile range) age and BMI were 23.0 (20.0; 28.5) years and 22.6 (20.7; 25.4) kg/m2, respectively. Mean ± SD values of glucose, LDL-c and HDL-c were 82.0 ± 9.0, 101.1 ± 29.6 and 54.4 ± 12.4 mg/dL, respectively. Women breastfed for <6 months had higher chance of being classified into T3 of insulin (OR = 2.87; 95%CI = 1.28-6.40). Predominant breastfeeding < 3 months was associated with insulin levels (OR = 2.27; 95%CI = 1.02-5.02) and HOMA-IR (OR = 2.36; 95%CI = 1.06-5.26). Breastfeeding was not associated with lipids. The Processed pattern was directly associated with LDL-c (T3: OR 6.08; 95%CI 1.80-20.58; P-trend = 0.004), while the Prudent pattern was inversely associated with LDL-c (T3: OR 0.26; 95%CI 0.08-0.87; P-trend = 0.029) and LDL-c/HDL-c ratio (T3: OR 0.28; 95%CI 0.08-0.97; P-trend = 0.046). CONCLUSION: Early feeding could be a protective factor against insulin resistance development, while current DP were associated with lipid profile. This evidence indicates that from early life until early adulthood, dietary habits might influence women's cardiometabolic risk profile.

Breastfeeding duration is associated with offspring's adherence to prudent dietary pattern in adulthood: results from the Nutritionist's Health Study.

Little is known about the long-term effect of breastfeeding on dietary habits. We examined the association between breastfeeding duration and adherence to current dietary patterns of young women. This was a cross-sectional analysis of 587 healthy women aged ≤45 years, undergraduates or nutrition graduates. Maternal characteristics and breastfeeding duration [<6; 6-<12; ≥12 months (reference)] were recalled. Diet was assessed using a food frequency questionnaire and patterns were identified using factor analysis by principal component. Adherence to patterns was categorized in tertiles; the first (T1 = reference) was compared to T2 + T3 (moderate-to-high adherence). Logistic regression was performed considering the minimal sufficient adjustment recommended by the directed acyclic graph. Median age was 22 (interquartile range (IQR) 20; 27) years and body mass index (BMI) 22.2 (IQR 20.4; 25.0) kg/m2. The four dietary patterns identified (Processed, Prudent, Brazilian and Lacto-vegetarian) explained 27% of diet variance. Women breastfed for <6 months showed lower chance of moderate-to-high adherence to the Prudent pattern (odds ratio (OR) = 0.53, p = 0.04). Breastfeeding was not associated with the other patterns. Maternal pre-pregnancy BMI was directly associated with moderate-to-high adherence to the Processed pattern (OR = 2.01, p = 0.03) and inversely to the Prudent pattern (OR = 0.52, p = 0.02). Higher adherence to the Brazilian pattern was associated with proxies of low socioeconomic status and the Lacto-vegetarian pattern with the opposite. Confirmation in prospective studies of the association found in this study between breastfeeding with the Prudent pattern in adult offspring could suggest that early feeding practices influence long-term dietary habits, which could then affect the risk of nutrition-related diseases.

Association of fruits and vegetables consumption and related-vitamins with inflammatory and oxidative stress markers in prediabetic individuals.

BACKGROUND: Dietary guidelines of 5 servings per day of fruits and vegetables (FV) offer a reasonable amount of vitamins to control organic processes, which may contribute to a favorable cardiometabolic profile. This study aimed at investigating whether the intake of the FV group as well as pro-vitamin A carotenoids and vitamins C and E were associated with circulating markers of oxidative stress, inflammation and insulin resistance in Brazilians individuals at cardiometabolic risk. METHODS: This cross-sectional study included 205 individuals screened for diabetes prevention program in a healthcare center from the School of Public Health, University of São Paulo, conducted in 2008. Possible associations of consumption of FV group, as well as pro-vitamin A carotenoids and vitamins C and E, with circulating markers of oxidative stress (superoxide dismutase - SOD and oxidized LDL - oxLDL), inflammation (C reactive protein, TNF-α and adiponectin) and insulin resistance (HOMA-IR) were investigated. Pearson correlation coefficient, ANOVA and multiple linear regression were employed. RESULTS: The sample (64.7% women) had a mean age of 54.1 ± 12.7 years and body mass index of 30.7 ± 5.7 kg/m2. Dietary, physical activity, anthropometric and laboratory data were obtained. Participants consumed a mean of 3.8 servings/day of FV; their FV intake was categorized into three groups: <2.5, 2.5-5.0 and >5.0 servings/day. Significant trends for lower waist circumference (103.4 ± 13.6 vs. 100.1 ± 12.2 vs. 98.2 ± 12.7 cm, p-trend <0.05) and higher adiponectin concentrations (10.4 ± 1.8 vs. 11.9 ± 1.9 vs. 13.6 ± 2.1 ng/mL, p-trend <0.05) were detected across categories. Associations between SOD concentrations (ß 0.172 [0.110-0.688]) with FV consumption and between oxLDL concentrations with vitamins C (ß -0.333 [-2.568 - -0.218]) and E (ß -0.354 [-1.131- -0.110]) intakes, adjusted for age, gender, BMI, saturated fat intake, smoking and physical activity were found. Similar results were observed for the associations between oxLDL and FV intake, but significance disappeared adding adjustment for saturated fat, smoking and physical activity. CONCLUSION: Our data suggest that the intake of FV or selected vitamins may be useful for identifying the oxidative stress and inflammation involved in the genesis of cardiometabolic diseases and for motivating at-risk patients for changing dietary habits.

Realistic changes in monounsaturated fatty acids and soluble fibers are able to improve glucose metabolism.

BACKGROUND/OBJECTIVES: Cardioprotective effects of Mediterranean-style diet have been shown. Instead of excluding foods, replacement or addition may facilitate compliance with impact on glucose metabolism of individuals at cardiometabolic risk. This study investigated the effect of changing selected nutrients intake on glucose metabolism during a lifestyle intervention tailored to living conditions of prediabetic Brazilians. SUBJECTS/METHODS: 183 prediabetic adults treated under the Brazilian public health system underwent an 18-month intervention on diet and physical activity. Dietary counseling focused on reducing saturated fat replaced by unsaturated fatty acids. Data were collected at baseline and after follow-up. ANOVA and multiple linear regression were used to test association of changes in nutrients intake with changes in plasma glucose. RESULTS: Changes in fasting and 2-h plasma glucose but not in weight, HOMA-IR or C-reactive protein decreased after intervention across tertiles of MUFA changes (p-trend 0.017 and 0.024, respectively). Regression models showed that increase in MUFA intake was independently associated with reduction in fasting (ß -1.475, p = 0.008) and 2-h plasma glucose (ß -3.321, p = 0.007). Moreover, increase in soluble fibers intake was associated with decrease in fasting plasma glucose (ß -1.579, p = 0.038). Adjustment for anthropometric measurements did not change the results but did after including change in insulin in the models. CONCLUSIONS: Increases of MUFA and soluble fibers intakes promote benefits on glucose metabolism, independently of adiposity, during a realistic lifestyle intervention in at-risk individuals. Mechanisms mediating these processes may include mainly insulin sensitivity improvement.

Healthy Eating Index is associated with certain markers of inflammation and insulin resistance but not with lipid profile in individuals at cardiometabolic risk.

Eating habits may influence inflammatory status and insulin resistance, both involved in the genesis of cardiometabolic diseases; an index of overall diet quality may be useful to identify risk for these diseases. We investigated whether the Healthy Eating Index (HEI-2005), adapted to Brazilian habits (B-HEI), was associated with markers of inflammation, insulin resistance and lipid profile in individuals at cardiometabolic risk. Two hundred and four prediabetic individuals (64.7% women) were enrolled in this cross-sectional study. Anthropometric measurements, 24-h dietary recalls used to calculate the B-HEI, and blood samples were collected. ANOVA was used for comparisons of clinical variables across the B-HEI tertiles and multiple linear regressions employed to test associations between clinical variables and B-HEI total score. Significant trends to decrease mean values of body mass index (BMI) (p = 0.03) and C-reactive protein concentrations (p = 0.02) across the tertiles of B-HEI, but not other biomarkers, were observed. Waist circumference, HOMA-IR and C-reactive protein were inversely associated with the B-HEI (p < 0.05), after adjusting for age, sex, BMI, and physical activity level. Also, a direct association of adiponectin concentrations with B-HEI was detected after adjustments (p = 0.001). Data from this study indicate that the B-HEI may be useful to identify the body adiposity-induced pro-inflammatory status and insulin resistance in individuals at cardiometabolic risk.

Análise da associação do consumo de frutas, legumes e verduras e de micronutrientes com marcadores de estado oxidativo, inflamatório e de resistência á insulina em indivíduos de risco cardiometabólico / Analysis of the association of fruits and vegetables and micronutrients intakes with markers of oxidative and inflammatory status and insulin resistance in individuals at cardiometabolic risk

dietéticos, nível de atividade física (AF), uso de tabaco e estresse psicossocial, os quais predispõem ao aumento de doenças crônicas não-transmissíveis. Dieta rica em frutas, legumes e verduras (FLV) pode atenuar os efeitos sobre o risco cardiometabólico, havendo evidências consistentes de benefícios na prevenção da obesidade, dislipidemia e diabetes tipo 2. O consumo de FLV, fontes de vitaminas e minerais essenciais para a homeostase corporal está aquém do desejado. Estes alimentos contribuem para um perfil cardiometabólico favorável, atenuando o estresse oxidativo, inflamação e resistência à insulina. Objetivo: Este estudo analisou a associação entre o consumo FLV e de certos micronutrientes com marcadores do estado oxidativo, inflamatório e de resistência à insulina em indivíduos de risco cardiometabólico. Métodos:Nesta análise transversal foram incluídos 205 participantes (65 por cento mulheres; média de idade de 54,1 anos) do Estudo de Prevenção de Diabetes do CS-Escola da FSP-USP, com pré-diabetes ou de síndrome metabólica sem diabetes. Foram submetidos a questionários e coletas de sangue. Entre as dosagens, a superóxido dismutase (SOD) e a LDL oxidada (LDLox) serviram para indicar o estado anti/pró-oxidativo. O nível de AF foi medido pela versão longa do IPAQ. Três recordatórios alimentares de 24h foram empregados para cálculo da ingestão de micronutrientes e de FLV. Três categorias de consumo de FLV consumidas foram criadas considerando-se a recomendação internacional e a ingestão de micronutrientes estratificada segundo tercis de consumo, analisados por ANOVA. Coeficiente de Pearson e regressão linear múltipla foram também empregados. Resultados: Os participantes consumiram uma média de 1800 kcal/dia e 3,7 porções/1000 kcal de FLV. Ao longo das categorias de ingestão de FLV, os valores médios de circunferência da cintura (p=0,06) e pressão arterial diastólica (p=0,05) tenderam a diminuir e adiponectina (p=0,05) a aumentar. Indivíduos no tercil mais ...