Impact of rural-urban environment on metabolic profile and response to a 5-day high-fat diet

Dicky L Tahapary,Pradana Soewondo,Maria Yazdanbakhsh,Karin De Ruiter,Johannes W A Smit,Yanan Wang,Em Yunir,Siti M E Nurdin,Taniawati Supali,Dante S Harbuwono,Patrick C N Rensen,Yenny Djuardi,Elisa Iskandar,Erliyani Sartono,Farid Kurniawan,Dominggus Minggu,Bruno Guigas

doi:10.1038/s41598-018-25092-6

Abstract

Epidemiological studies have indicated that rural living might be protective against type 2 diabetes development. We compared the metabolic profile and response to a short-term high-fat high-calorie diet (HFD) of men with the same genetic background living in an urban and rural area of Indonesia. First, we recruited 154 Floresian male subjects (18–65 years old), of whom 105 lived in a rural area (Flores) and 49 had migrated and lived in urban area (Jakarta) for more than 1 year. The urban group had significantly higher whole-body insulin resistance (IR), as assessed by homeostatic-model-assessment of IR (HOMA-IR), [mean difference (95% CI), p-value: 0.10 (0.02–0.17), p = 0.01]. Next, we recruited 17 urban and 17 rural age-and-BMI-matched healthy-young-male volunteers for a 5-day HFD challenge. The HOMA-IR increased in both groups similarly −0.77 (−2.03–0.49), p = 0.22]. Neither rural living nor factors associated with rural living, such as current helminth infection or total IgE, were associated with protection against acute induction of IR by HFD.

Highlights

The prevalence of obesity and type 2 diabetes (T2D) is increasing worldwide, especially in low and middle-income countries (LMIC) that are currently facing rapid rates of urbanization[1,2]
In addition to changes towards a sedentary lifestyle and an increased dietary fat intake, migration to an urban environment is associated with a reduced exposure to microorganisms and parasites, such as helminth infections, which are still endemic in many rural areas of LMIC12
Other metabolic parameters, such as 2 hour-blood-glucose, hemoglobin A1c (HbA1c), body mass index (BMI), waist circumference, and leptin level were significantly higher in urban subjects (Table 1)

Summary

Introduction

The prevalence of obesity and type 2 diabetes (T2D) is increasing worldwide, especially in low and middle-income countries (LMIC) that are currently facing rapid rates of urbanization[1,2]. Rural-to-urban migration has been shown to be associated with increased obesity and other cardiovascular (CV) risk factors, such as dyslipidemia and hypertension[3,4,5,6,7,8,9,10,11], suggesting that living in rural environment might be protective against the development of T2D. In addition to changes towards a sedentary lifestyle and an increased dietary fat intake, migration to an urban environment is associated with a reduced exposure to microorganisms and parasites, such as helminth infections, which are still endemic in many rural areas of LMIC12. There has been no study comparing the metabolic response towards a short-term HFD in terms of changes in glucose homeostasis and inflammation, between people living in urban and rural areas

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