Dietary Fat Intake Research Articles

The association between dietary fat and mineral intake with semen parameters: A cross-sectional study in infertile men.

Background Infertility has been a significant problem for couples in recent decades, and the issue can often lie with the male rather than the female.ObjectiveThis study aimed to investigate the effects of fats and minerals intake on semen parameters in infertile men.Materials and MethodsThis cross-sectional study was performed on 260 infertile men referred to Isfahan Infertility Clinic, Isfahan, Iran in the summer of 2018. Semen parameters regarding sperm concentration, total motility, normal morphology, and sperm volume were considered. To assess dietary intakes, a validated food frequency questionnaire was used.ResultsIn the adjusted model, the prevalence of abnormal concentration was 5.23 times higher in the top quartile of calcium intake, compared with the bottom quartile (p = 0.03). Also, the prevalence of abnormal morphology was 68% lower in the third quartile of calcium intake (p = 0.03). Additionally, the prevalence of abnormal concentration was 84% lower in the top quartile of folate intake in comparison to the bottom quartile (p = 0.01) and the prevalence of abnormal morphology was 70% lower in the top quartile of folate intake (p = 0.03). Additionally, the prevalence of abnormal concentration was 72% lower in the top quartile of selenium intake in comparison to the bottom quartile (p = 0.04). Furthermore, in the crude model, the prevalence of abnormal volume was 64% lower in the second quartile of linoleic acid intake rather than the first quartile (p = 0.01).Conclusion In conclusion, diets containing higher amounts of folate and selenium, and lower amounts of cholesterol, saturated fatty acid and calcium were associated with more favorable semen quality parameters.

A high-fat diet changes astrocytic metabolism to promote synaptic plasticity and behavior.

A high-fat diet (HFD) is generally considered to negatively influence the body, the brain, and cognition. Nonetheless, fat and fatty acids are essential for nourishing and constructing brain tissue. Astrocytes are central for lipolysis and fatty acids metabolism. We tested how HFD affects astrocyte metabolism, morphology, and physiology. We used Raman microspectroscopy to assess the redox state of mitochondria and lipid content in astrocytes and neurons in hippocampal slices of mice subjected to HFD. Astrocytes were loaded with fluorescent dye through patch pipette for morphological analysis. Whole-cell voltage-clamp recordings were performed to measure transporter and potassium currents. Western blot analysis quantified the expression of astrocyte-specific proteins. Field potential recordings measured the magnitude of long-term potentiation (LTP). Open filed test was performed to evaluate the effect of HFD on animal behavior. We found that exposure of young mice to 1 month of HFD increases lipid content and relative amount of reduced cytochromes in astrocytes but not in neurons. Metabolic changes were paralleled with an enlargement of astrocytic territorial domains due to an increased outgrowth of branches and leaflets. Astrocyte remodeling was associated with an increase in expression of ezrin and with no changes in glial fibrillary acidic protein (GFAP), glutamate transporter-1 (GLT-1), and glutamine synthetase (GS). Such physiological (non-reactive) enlargement of astrocytes in the brain active milieu promoted glutamate clearance and LTP and translated into behavioral changes. Dietary fat intake is not invariably harmful and might exert beneficial effects depending on the biological context.

1054-P: Dietary Fat Intake Is Not Associated with Increased Insulin Resistance among Pregnant Women

Background: Dietary modification in gestational diabetes (GDM) has focused on restricting carbohydrates. Some research suggests that increased dietary fat intake, which often occurs with carbohydrate restriction, may worsen insulin resistance in women with GDM. We tested for a relationship between dietary fat intake and insulin sensitivity in pregnant women. Methods: Pregnant women in the late 2nd trimester, (median [IQR] =26 [25-27] weeks’ gestation) completed a 75 g oral glucose tolerance test (OGTT) and a validated self-administered 24-hr dietary recall. We tested for an association between fat intake the day before the OGTT and insulin sensitivity (inverse of insulin resistance, measured using Matsuda index) using linear regression, adjusting for age, race, education, parity, BMI, gestational age, carbohydrate intake, and caloric intake. We also tested for associations with insulin secretion (measured using Stumvoll 1st phase estimate, with adjustment for insulin sensitivity) , and fasting, 1-hr and 2-hr OGTT glucose (mg/dl) . Results: Pregnant women (N=120, age 34 [31-36]) consumed 82 g of fat [62-101], 235 g of carbohydrate [195-298] and 78 g of protein [61-100] during a 24-hr period. Carbohydrate and fat intake were inversely related after adjusting for total caloric intake (0.3 fewer g of carbohydrate per additional g of fat, P <0.001) . We found no association between fat intake and insulin sensitivity (β=0.07, P=0.14) . There was no association between fat intake and insulin secretion (β=2.21, P=0.62) or OGTT glucose (fasting: β=0.03, P=0.67, 1-hr: β=-0.36, P=0.26, 2-hr: β=0.01, P=0.98) . Conclusion: Our results suggest that dietary fat intake does not increase insulin resistance in pregnant women. This may have implications for dietary recommendations in women with GDM. Disclosure E.A.Rosenberg: None. E.W.Seely: None. T.Thaweethai: None. K.James: None. C.Yu: None. M.J.Callahan: None. S.Nelson: None. C.E.Powe: None. Funding National Institutes of Health (1F32DK126343-01A1) ,Nation Institutes of Health (K23DK113218) , and the Robert Wood Johnson Foundation’s Harold Amos Medical Faculty Development Program

Novel Methods to Evaluate Functional Saliva Characteristics Related to Food Perception

ObjectivesSaliva is the first digestive fluid that food encounters, and likely influences oral sensations and gastrointestinal processing of food. Yet, the pandemic drastically altered risks associated with saliva analysis. Thus, we developed novel functional assays to assess saliva remotely. We aimed for assays that could be self-administered by participants and that would reflect functional characteristics (emulsion stability, starch digestion) of saliva.MethodsTwo assays were developed: stability of oil/water emulsions created with saliva, and digestion of starch by salivary amylase. In the saliva emulsion assay, 7.5 mL of water with 1% purple food color and 7.5 mL of vegetable oil were provided to participants. Participants swished the oil/water mixture for 30 s and expectorated. The expectorates were analyzed for emulsion stability (size of “cream” layer). This stability was compared with dietary intake of fat and sensory ratings of fatty acids. In the salivary amylase assay, saliva was collected by chewing wax for 30 s. Saliva was then mixed with a starch-thickened commercial pudding. The flow of pudding/saliva mixture through a 10 mL syringe was measured from 2–8 min after mixing. The flow rates are being compared to dietary intake of starch and sensory perception of starchy foods.ResultsIn the saliva emulsion assay, greater emulsion stability corresponded to more intense sensation for fatty acids, indicating smaller, more stable droplets cause greater fat taste sensation. In the salivary amylase pudding assay, analysis indicates wide variability in rate of starch digestion. Some participants’ saliva/pudding mixtures emptied almost completely from the syringe at 2 min, while others had almost no flow through the syringe after 8 min of digestion. Analyses of how the digestion rates compare to dietary starch and sensory perception is ongoing.ConclusionsThese relatively simple assays for saliva function could be useful in future studies aiming to understand how oral digestion influences sensory properties of food, such as thickness or fattiness. Additionally, relating dietary habits to these salivary characteristics may help understand how behavior could influence these functional aspects of saliva.Funding SourcesNIDCD R21DC017559, USDA Hatch Project 1,013,624.

Determinants of Anemia Among Adolescents Girls

ObjectivesTo assess the relative significance of various factors contributing to anemia in adolescent girls of lower socioeconomic status. MethodsA random sample of 100 adolescent girls (15 to 19 years), selected from 300 adolescents girls living in a poor urban settlement, of Navi Mumbai, India have participated in the study. An interviewer-administered questionnaire was used to collect data on sociodemography, anthropometry, three-day dietary intake, food frequency, blood hemoglobin, serum ferritin and stool parasites. ResultsThe prevalence rates of anemia was 30% and among them 95% of the anemic girls were iron deficient. The mean dietary iron intake was 9.4 mg per day, predominantly from the consumption of cereals, pulses, and vegetables. Intake of different nutrients were almost inadequate among the participants. Blood hemoglobin was significantly correlated with Body Mass Index, dietary intake of fat, protein, iron, folic acid and riboflavin. Serum ferritin was related with vitamin B12. The parasitic infestation was low among the study participants. ConclusionsAn inadequate intake of dietary iron, and concurrent inadequate intake of dietary micronutrients appear to be the primary factors responsible for anemia and iron deficiency in adolescent girls. Nutrition interventions on identified associated factors are important to reduce the burden of anemia among adolescents girls. Funding SourcesThe researcher had received funds from MGM Institute of Health Sciences, Navi Mumbai for research work.

Dietary Education Delivered by Digital Health for Improving Dietary Intake and Clinical Outcomes in Chronic Conditions: A Systematic Review and Meta-Analysis

ObjectivesTo determine the effectiveness of dietary education delivered by digital health interventions for improving dietary intake and clinical outcomes in chronic conditions.MethodsCINAHL, Cochrane CENTRAL, Embase and MEDLINE databases were systematically searched. Controlled trials involving dietary education delivered via digital health interventions (mobile or electronic health technology) to adults with chronic conditions were included. The dietary intervention component must have been developed or delivered by health professionals, or in line with best practice guidelines. Data was meta-analyzed by a random effects model for diet quality, fruit and vegetable consumption, dietary intake of fat, sodium, protein, fibre and energy, and various clinical outcomes. Screening, data extraction and quality assessment were completed in duplicate.ResultsThirty-eight studies compromising 7,303 participants met the inclusion criteria. Digital health interventions included: mobile phone apps and messaging systems (n = 16), internet-based (n = 16), electronic software (n = 1) or a combination of these methods (n = 5). Studies showed digital health was effective at improving Mediterranean diet adherence score [standardized mean difference: 0.79; 95% confidence interval (CI): 0.18, 1.40] and overall fruit and vegetable intake [mean difference (MD): 0.58 serves per day; 95% CI: 0.01, 1.14]. However, no significant effects were found for other measures of diet quality, single food group intake, nutrients and energy intake. Digital health interventions significantly reduced waist circumference [MD: −2.34 cm; 95% CI: −4.29, −0.38cm), body weight [MD: −1.88; 95% CI: −2.60, −1.16 kg) and hemoglobin A1c levels [MD: −0.18%; 95% CI: −0.30, −0.05%). Overall the studies were rated as poor quality.ConclusionsDietary education delivered via digital health interventions significantly improved Mediterranean diet adherence, overall fruit and vegetable intake, waist circumference, weight and hemoglobin A1c levels. However, given the relatively poor quality of the studies, additional robust trials are needed to the guide implementation and scale-up of these interventions in health services.Funding SourcesNone.

Platycodi Radix Beverage Improves Postprandial Lipemic Response Associated With Plasma Bacteria-Derived Extracellular Vesicles in Healthy Adults With an Oral Fat Load

ObjectivesThis study aimed to examine the responsiveness of postprandial triglyceride-rich lipoprotein (TRL) metabolism to Platycodi radix beverage (PR) is associated with the alterations in plasma bacteria-derived extracellular vesicles (EVs) composition.MethodsNinety-six healthy and normolipidemic adults were randomly divided into two groups and consumed PR or placebo for 8 weeks. An oral fat tolerance test was performed before and after the 8-week intervention to access the postprandial lipid response. Plasma TG, chylomicron TG (CM-TG), and lipoprotein lipase (LPL) mass levels were measured at fasting, 3, and 6 hours during the oral fat tolerance test and summarized by computing the area under the curve (AUC). EVs isolated from fasting plasma samples were identified using 16S rRNA sequencing. A linear mixed-effect model was used to analyze the difference between the two groups. TLR clearance responder to PR consumption was defined by QUalitative INteraction Trees (QUINT). Lasso regularized generalized linear model (GLM) was used to find genera associated with the responsiveness.ResultsPR consumption for 8 weeks noticeably decreased AUC (0–3h) values for TG and CM-TG compared to the placebo group. Responders for TRL clearance were defined as subjects having higher LPL mass (150.6 ng/mL) and dietary fat intake (38.5 g/day) at baseline. Responders showed remarkable reductions in AUC (0–6h) values for TG and CM-TG in the PR group compared to the placebo group. Furthermore, GLM analysis demonstrated that the responsiveness of postprandial TRL clearance was accurately predicted by the model consisting of changes in the relative abundance of 16 genera, suggesting the close association between them.ConclusionsThese findings suggest that PR consumption modulates postprandial TRL clearance by altering plasma EV composition in normolipidemic adults with habitually higher fat intake over 38.5 g/day.Funding SourcesThis work was supported by the BK21 FOUR (Fostering Outstanding Universities for Research) funded by the Ministry of Education (MOE, Korea) and National Research Foundation of Korea (NRF), and the Bio & Medical Technology Development Program of the National Research Foundation (NRF), funded by the Ministry of Science & ICT (2012M3A9C4048761).

553-P: Changes in Circulating Bile Acids and the Improvements in Glucose and Insulin Metabolism in Response to Weight-Loss Diets: The POUNDS Lost Trial

Bile acids (BAs) are synthesized from cholesterol in the liver and are essential for nutrient absorption. The host-derived primary BAs are transformed into secondary BAs in the intestine. Various BA subtypes may play pivotal roles as endocrine molecules to affect glucose and insulin metabolism. We tested whether changes in distinct BA subtypes were associated with improved glucose and insulin metabolism among adults with overweight and obesity who participated in a weight-loss diet intervention trial. Circulating primary and secondary unconjugated BAs and their taurine-/glycine-conjugates were measured at baseline and 6 months after the intervention; 6-month changes in BAs were calculated (n=515) . When we analyzed associations of BA changes with changes in fasting glucose, insulin, and insulin resistance at 6 months, more decreases in several primary BAs (CDCA, taurocholate [TCA], and taurochenodeoxycholate [TCDCA]) and secondary TDCA were associated with larger reductions of glucose (PFDR <0.for all) , although the associations were dependent on concurrent weight changes. The decreases in primary BAs (including CA, CDCA, TCA, TCDCA) and secondary BAs (including DCA, GDCA, TDCA, GUDCA) were significantly related to improved hyperinsulinemia and insulin resistance, independent of weight changes. Also, we found significant interactions between dietary fat intake and changes in lithocholate and glycolithocholate for changes in insulin metabolism. Further, the initial changes in several primary and secondary BAs showed significant associations for 2-year improvements in glucose/insulin metabolism. In conclusion, decreases in distinct primary and secondary BAs during weight-loss dietary interventions were associated with improved glucose and insulin metabolism. Changes in various BA subtypes were related to the improved insulin metabolism independent of weight loss status during the interventions. Disclosure Y.Heianza: None. X.Wang: None. H.Ma: None. J.Rood: None. C.B.Clish: None. G.Bray: None. F.Sacks: None. L.Qi: None. Funding National Institutes of Health (DK091718, DK100383, DK115679)

Higher dietary total antioxidant capacity is inversely associated with Helicobacter pylori infection among adults: A case-control study.

Antioxidants appear to hinder the actions of Helicobacter pylori (H. pylori). The aim of this research was to evaluate the association between dietary total antioxidant capacity (DTAC) and H. pylori infection. A case-control study was carried out among 200 patients with H. pylori infection and 402 healthy subjects (18-55 years). Dietary data were collected using a validated 168-item quantitative food frequency questionnaire. DTAC was calculated based on the oxygen radical absorbance capacity of each food (except for coffee) reported by the US Department of Agriculture. Compared with participants in the lowest tertile of DTAC, those in the highest tertile had a significantly lower odds ratio (OR) in the crude model (OR, 0.29; 95% CI, 0.14-0.61; p for trend = 0.001), model 1 (adjustment for age and sex) (OR, 0.37; 95% CI, 0.24-0.58; p for trend < 0.001), and model 2 (adjustment for model 1 plus body mass index, waist circumference, physical activity, smoking, dietary intake of energy and fat) (OR, 0.20; 95% CI, 0.10-0.40; p for trend ≤ 0.001). A high DTAC is associated with a reduced risk of H. pylori infectionin adults. Further studies are mandatory to elucidate the mechanisms and a dose-effect relationship.

349-OR: ADA President's Select Abstract: Circulating Level of DNA Methylation Near CPT1A and Long-Term Changes in Triglycerides in Response to Diet Interventions: The POUNDS Lost Trial

Background: Epigenome-wide association studies identified DNA methylation (DNAm) at several CpG sites of the carnitine palmitoyltransferase-1A (CPT1A) gene to be associated with triglycerides (TG) . However, little is known about whether the pre-treatment DNAm level at CPT1A is associated with changes in TG in response to weight-loss diet interventions. Methods: We included 673 white participants with overweight or obesity, who were randomly assigned to 1 of 4 diets varying in macronutrients components. Blood DNAm levels were profiled by a high-resolution methyl-capture sequencing at baseline. We defined the regional DNAm at CPT1A as the average methylation level over CpGs within 500 bp of the 3 TG-related DNAm sites (cg00574958, cg09737197, and cg17058475) , which were closely located. Two-year changes in TG were calculated. Linear regression models were used to examine the associations between baseline DNAm at CPT1A and 2-year changes in TG. Results: Higher regional DNAm level at CPT1A was associated with lower TG at baseline (β=-2.21, SE=1.01, p=0.029) . We found that dietary fat intake significantly modified the association between baseline DNAm at CPT1A and 2-year changes in TG, independent of concurrent weight-loss (p-int=0.018) . In the low-fat diet group, a higher regional DNAm level was associated with a greater reduction in TG at 2 years, after adjustment for age, sex, baseline body mass index, use of lipid-lowering medication, baseline TG level, and concurrent weight-loss (p=0.01) , whereas no such association was observed in the high-fat diet group (p=0.64) . A similar interaction pattern was also found between dietary fat and baseline DNAm at CPT1A on 2-year changes of TG in very-low-density lipoprotein without apolipoprotein C-III (p-int=0.01) . Conclusion: Our data indicate that participants with a higher regional DNAm level at CPT1A benefited more in long-term improvement in TG when assigned a low-fat weight-loss diet. Disclosure X.Li: None. X.Shao: None. Q.Xue: None. E.Grundberg: None. G.Bray: None. F.Sacks: None. L.Qi: None. Funding The study was supported by grants from the National Heart, Lung, and Blood Institute (HL071981, HL034594, HL126024) , the National Institute of Diabetes and Digestive and Kidney Diseases (DK115679, DK091718, DK100383) , the Fogarty International Center (TW010790) , and Tulane Research Centers of Excellence Awards. Xiang Li was the recipient of the American Heart Association Predoctoral Fellowship Award (19PRE34380036) .

Closer to the Root: The Potential of Traditional Food Systems Interventions for Obesity Prevention

ObjectivesWe review the project design, implementation experiences, and study findings from obesity prevention trials (OPTs) in Native American communities to identify future directions for obesity and chronic disease prevention. MethodsWe use a case study methodology to highlight three OPTs and identify themes across studies. We included three OPTs: Navajo Healthy Stores (NHS), OPREVENT1, and OPREVENT2. NHS was a food-store based environmental intervention, while OPREVENT1 and OPREVENT2 were multi-level, multi-component interventions with store, school, worksite, and media components (OPREVENT1) and combined with a policy-based component (OPREVENT2). ResultsAll studies showed mixed success in achieving behavioral and health outcomes. NHS intervention exposure was associated with reduced BMI, and found improvements in intentions, cooking methods, and food getting comparing intervention with control regions. The program was sustained for several years after the trial was completed. OPREVENT1 trial resulted in significant reductions in waist circumference, reduced soda consumption, and increased physical activity (PA) comparing intervention and comparison communities. The OPREVENT2 trial had significant reductions in PA, calorie intake, carbohydrate, and dietary fat intake comparing intervention and comparison communities. ConclusionsWorking with health staff can enhance intervention sustainability, which is also impacted by health center capacity and funding. All studies had strong evaluation designs, with high retention and low refusal rates. All studies included store components that aimed to improve healthy food access on-reservation and point-of-purchase promotion. Although all studies demonstrated impacts on behaviors and modest impacts on health outcomes, taking a food-systems approach could increase the likelihood of improved outcomes by addressing the root of healthy food access and obesity: diminished traditional food systems. These interventions hold great potential for supporting significant health outcomes by supporting traditional food-getting practices, preparation, and intake. Such interventions require strong community-academic partnerships since these food systems and knowledge belong to tribal nations and communities. Funding SourcesNHLBI & USDA.

1169-P: Circulating MicroRNA-378a-5p and Improvement in Glucose Homeostasis in Response to Weight-Loss Diets: The Preventing Overweight Using Novel Dietary Strategies (POUNDS LOST) Trial

Background: MicroRNA-378a (MiR-378a) has been identified as a key regulator of glucose homeostasis and emerging as a promising target for the improvement of glycemic dysregulation including type 2 diabetes. Hypothesis: We assessed associations of circulating miR-378a-5p with improvements in insulin sensitivity and glucose metabolism in a 2-year dietary intervention trial. Methods: Circulating miR-378a-5p levels were measured at baseline and 6 months among 5participants with overweight or obesity. Outcome measurements including fasting glucose, hemoglobin A1c (HbA1c) , fasting insulin, and homeostasis model assessment-of-insulin resistance (HOMA-IR) were assessed at baseline, 6 and 24 months. Results: Higher level of miR-378a-5p was associated with greater fasting glucose (p =0.031) at baseline. Greater decrease in miR-378a-5p was significantly associated with greater improvements in fasting insulin (p =0.012) and HOMA-IR (p =0.017) over 6 months. The initial (6-months) decrease of miR-378a-5p was also significantly related to long-term (24-months) improvements in glucose, insulin, and HOMA-IR (p &amp;lt;0.for all) . Individuals in the lowest tertile group of the baseline miR-378a-5p showed consistently improved fasting insulin and HOMA-IR over 2 years, as compared to those with higher levels of miR-378a-5p (p time*miR-378a-5p =0.015 and 0.007, respectively) . We also found significant interactions between baseline miR-378a-5p and dietary fat in the 6-months change in HbA1c (p = 0.003) ; a lower level of baseline miR-378a-5p showed a greater reduction of HbA1c at 6 months among participants who consumed a low-fat diet. Conclusions: In conclusion, decreased circulating miR-378a-5p levels were related to significant improvements in insulin sensitivity and glucose metabolism in response to dietary weight-loss interventions; and dietary fat intake modified such associations. Disclosure Q.Xue: None. Y.Heianza: None. X.Li: None. H.Deng: None. J.Rood: None. G.Bray: None. F.Sacks: None. L.Qi: None. Funding National Heart, Lung, and Blood Institute (HL071981, HL034594, and HL126024) ;National Institute of Diabetes and Digestive and Kidney Diseases (DK115679, DK091718, and DK100383) ;Fogarty International Center (TW010790)

The relationship between physical activity, body fatness and metabolic syndrome in urban South African school teachers: The sympathetic activity and ambulatory blood pressure in Africans study.

BackgroundGlobally, the prevalence of metabolic syndrome (MS) is rising because of increased levels of physical inactivity and obesity. In South Africa, information about teachers’ physical activity (PA), body fatness and MS is limited.AimTo assess the relationship between PA, body fatness and MS in urban South African teachers.SettingThe study setting was in Dr Kenneth Kaunda District in the North West province of South Africa.MethodsA cross-sectional study was conducted using secondary data drawn from the sympathetic activity and ambulatory blood pressure in Africans (SABPA) study of 216 teachers (aged 25–65 years). Variables included anthropometry, biochemical measurements, objectively measured PA and lifestyle behaviours.ResultsTwenty-nine percent of the total participants were classified with MS, with 46% in men compared to 13% in women; 33% were sedentary and 67% participated in light activity. A weak significant negative relationship was found between the mean 7-day awake metabolic equivalent of tasks (METs) and triglycerides (r = −0.29; p = 0.02) and gamma-glutamyl transferase (r = −0.25; p = 0.06), activity energy expenditure (r = −0.24; p = 0.06) and PA level (r = −0.23; p = 0.07). After adjusting for age, self-reported smoking and alcohol use or consumption, a weak significant negative relationship between mean 7-day awake METs and triglycerides (r = −0.28; p < 0.01) was observed.ConclusionIn the teachers with MS, only one MS marker (triglycerides) showed a negative association with PA. Physical activity could therefore be beneficial in the regulation of triglycerides. Participation in regular PA could be beneficial in the regulation of triglycerides. Focused PA interventions in school teachers that advocate the benefits of PA and healthy lifestyle choices to reduce dietary fat intake (and alcohol) are recommended.

Cardiovascular disease risk factors and lifestyle modification strategies after pediatric kidney transplantation: what are we dealing with, and what can we target?

Kidney transplantation in pediatric patients can lead to partial improvement of some of the cardiometabolic parameters that increase the risk for cardiovascular disease (CVD) in patients with chronic kidney disease. However, even after restoration of kidney function, transplant recipients remain at risk for CVD due to the continual presence of traditional and non-traditional risk factors, including the side effects of immunosuppression and chronic inflammation. This educational review describes the prevalence of CVD risk factors in pediatric kidney transplant recipients and presents available evidence for therapeutic lifestyle changes and other non-pharmacologic strategies that can be used to improve traditional and modifiable CVD risk factors. Although trial-grade evidence for interventions that improve CVD in pediatric kidney transplant recipients is limited, potential strategies include lowering dietary sodium and saturated fat intake and increasing physical activity levels. Intensive follow-up may help patients achieve guideline-recommended goals for reducing their overall CVD risk.

Comparison of clinical characteristics, eating behaviors, and clinical symptoms following fat intake in functional dyspepsia with functional dyspepsia with pancreatic enzyme abnormalities between Singapore and Japan.

To clarify whether there were any significant differences in clinical symptoms and eating patterns between functional dyspepsia (FD) patients and FD with pancreatic enzyme abnormalities (FD-P) patients as refractory FD, we compared these factors in multicenter studies in Singapore and Japan. One hundred ninety-eight consecutive patients presenting with FD (n=88), FD-P patients (n=81) based on Rome III classification and controlled group (n=39) recruited from six institutions in Singapore and Japan. Clinical characteristics, clinical symptoms for dietary fat intake, and eating behaviors were estimated using questionnaires. Anxiety and health-related quality of life were determined by STAI-state/-trait and SF-8, respectively. There were no significant differences in age, sex, BMI, smoking, alcohol intake, past medical history, and history of allergy in FD and FD-P patients between Singapore and Japan. There were no significant differences in FD subtypes, gastrointestinal symptom rating scale score, severity of FD symptoms, and eating pattern in Singapore and Japan. Moreover, there were significant differences in certain eating behaviors between FD and FD-P patients in Singapore and Japan. Interestingly, epigastric pain and early satiety following fat meals in FD-P patients were significantly (P=0.003 and P=0.008, respectively) higher compared with those in FD patients in Japan. Physical component score in FD-P patients was significantly (P=0.019) disturbed compared with those in FD patients in Japan. Epigastric pain and early satiety following fat meals in FD-P patients may be useful tools to differentiate FD-P patients from FD patients in Japan.

Implementation of an Appointment-Based Cardiac Rehabilitation Approach: A Single-Center Experience.

BackgroundThere has been a focus on alternative cardiac rehabilitation (CR) delivery models aimed at improving CR adherence and completion. We examined pre‐ and post‐CR health outcomes, reasons for discharge, and predictors of completion using a patient‐driven appointment‐based CR approach that uses center‐scheduled class start times.Methods and ResultsData were used from an urban single‐center CR program at Yale New Haven Health (2012–2017) that enrolled 2135 patients. We evaluated pre‐ and post‐CR outcomes (12 weeks) using paired t tests and used a multivariable logistic regression model to examine predictors of CR completion (≥36 sessions) for the overall cardiovascular disease population. The mean age of participants was 65±12 years, 27.9% were women, and 5.1% were Black patients, and patients completed a median of 30 of 36 sessions. Patients achieved significant improvements in health outcomes, including across age and sex subgroups. The primary reason for discharge was completion of all 36 sessions of CR (46.4%). The final logistic regression model contained 12 predictors: age, sex, Black race, marital status, employment, number of physician‐reported risk factors, dietary fat intake >30%, obesity, lack of exercise, benign prostatic hyperplasia, and self‐reported stress and physical activity.ConclusionsWe demonstrated that patients participating in an appointment‐based CR program achieved significant improvements in health outcomes and across sex/age subgroups. In addition, older individuals were more likely to complete CR. An appointment‐based approach could be a viable alternative CR method to aid in optimizing the dose‐response benefit of CR for patients with cardiovascular disease.

Dietary Impacts on Changes in Diversity and Abundance of the Murine Microbiome During Progression and Treatment of Cancer

The microbiome has been recognized as being highly impactful for cancer outcomes, both with respect to the diversity and composition of the microbial population, as well as overall abundance. Presence or absence of certain microbial species has been correlated to improved cancer outcomes, in concert with specific treatments. However, little research has been performed to consider the reciprocal of this relationship: how different treatments, or the progression of disease, impact the microbiome. Further, though correlations have been demonstrated between dietary intake of both fats and carbohydrates and the composition and breadth of the microbiome, no studies have investigated the microbiome population as it is impacted by cancer and therapeutic treatments under different dietary regiments.This study aims to investigate how dietary patterns, in concert with progression of cancer and both surgical and therapeutic interventions, impact the diversity and abundance of the murine microbiome.A total of 116 c57BI/6 female mice (7‐8 weeks old) were randomized into four groups (n=29/group, each) one week post ovariectomy. Mice received a specific, semi‐purified diet consisting of A) low sucrose, high omega 3 fatty acid; B) low sucrose, low omega 3 fatty acid; C) high sucrose, high omega 3 fatty acid; or D) high sucrose, high omega 3 fatty acid. For high omega 3 fatty acid groups, 2% of daily calories were supplied to the mice as EPA and DHA in a 1.5:1 ratio. One week after implementation of diets all mice were inoculated with E0771 breast cancer cells. Twelve days following inoculation all mice were subject to lumpectomy. Eight days following, measurement procedures were repeated, as at baseline. Ten days following lumpectomy, half of the mice from each dietary cohort were treated with saline, while the other half were treated with a chemotherapeutic agent (9 mg/kg body weight doxorubicin and 90 mg/kg body weight cyclophosphamide). Six days later, the experiment ended, and mice were sacrificed following IACUC guidelines. Fecal samples, which had been collected at each time point noted above, were processed using QIAmp® PowerFecal® DNA isolation kit and were sent to MCIC (OSU Wooster Campus) for 16S ribosomal genetic profiling. A genomic library was generated, using previously validated primers for the V4 region. FASTQ files were filtered, trimmed, dereplicated, and denoised. Cleaned FASTQ files were then used to infer ASVs.Over the progression of cancer, there has been a consistent decrease in the alpha diversity of the microbiome. The effect of diet was mitigated by introduction of chemotherapeutic agents, though the significance of this effect is yet to be determined. While the analysis is still ongoing, it has been determined that there is a clear dietary effect which interacts with abundance. Multiple ASVs have been shown to be positively associated with high fat consumption, though inverse effects, as well as timepoint and treatment effects, have also been noted. Akkermansia muciniphila was a highly present bacterial species in all treatments, despite it usually being noted only as a minor resident of the gut.

Intake of High Fat Diet leads to Over‐expression of CD36, QRFP and QRFPr in the Gustatory Neural Circuit

Taste is a primary sensory modality that guides food preferences. Orosensory fat perception, which is mediated by lingual CD36, contributes to the intake and preference of dietary fat. Our previous studies indicate that feeding patterns differentially affect lingual CD36 mRNA expression and expression of homeostatic and hedonic markers in the brain. QRFP, an orexigenic peptide expressed primarily in the mediobasal hypothalamus (MBH), selectively increases the intake of high fat diet (HFD). The relationship between lingual CD36 and hypothalamic QRFP has yet to be investigated. Therefore, the goal of the current study was to conduct a time course analysis of continuous access to HFD on neural markers of food intake, including QRFP in the MBH and its receptor, QRFPr, in the nucleus accumbens (NAc). Male Sprague‐Dawley rats were fed a low fat diet (LFD, 10% kcal from fat) or HFD (55% kcal from fat) for 1 day, 3 days or 14 days. Body weight, food intake, and body adiposity were assessed. Real time PCR was used to determine the expression of CD36 mRNA on the circumvallate papillae of the tongue, expression of prepro‐QRFP, prepro‐NPY, and AgRP mRNA in the MBH, and dopamine receptor 1 (D1), 2 (D2) and QRFPr mRNA levels in the NAc. Rats fed HFD consumed more kilocalories than rats consuming the LFD, and gained more body adiposity, but not body weight, after 14 days of HFD intake. Lingual expression of CD36 mRNA was increased after 3 and 14 days of HFD intake. Intake of HFD increased hypothalamic expression of prepro‐QRFP mRNA but did not alter AgRP or prepro‐NPY mRNA levels. QRFPr expression in the NAc was significantly elevated by HFD intake, while D1 and D2 mRNA levels were differentially altered across days of HFD intake, with D1 levels decreasing after 14 days and D2 levels decreasing following 3 days access to HFD. Lingual CD36 mRNA was positively correlated with body weight gain and body adiposity and negatively correlated with AgRP mRNA levels. Hypothalamic prepro‐QRFP levels were positively correlated with kilocalorie intake. QRFPr mRNA levels in the NAc were positively correlated with body adiposity and negatively correlated with D1 and D2 mRNA levels. Prepro‐NPY and AgRP mRNA levels were negatively correlated with weight gain, body adiposity and QRFPr expression and AgRP levels were positively correlated with prepro‐NPY and D2 expression. Hypothalamic neuropeptides regulate food intake, particularly homeostatic eating. In this study, a time course analysis of HFD‐induced changes in gene expression suggest that while prepro‐NPY and AgRP levels were not altered, prepro‐QRFP mRNA levels were elevated. In the NAc, a brain region regulating hedonic eating, expression of D1 and D2, regulators of dopamine signaling, decreased, while QRFPr expression increased with HFD intake. These data, combined with the positive relationship between QRFP and kilocalories consumed and negative relationships between prepro‐NPY and AgRP and weight gain, suggest that CD36, QRFP and its receptor, QRFPr, may serve as positive regulators of caloric intake and weight gain by mediating the continued overconsumption of dietary fat.

Intakes of energy and macronutrient from Chinses 15 provinces (autonomous regions, municipalities) adults aged 18 to 35 in 1989-2018

To analyze the dietary energy and macronutrient intake status and changing trends of adults aged 18 to 35 in 15 provinces(autonomous regions, municipalities) in China from 1989 to 2018. Based on the data from 11 rounds of follow-up survey conducted by "China Health and Nutrition Survey" between 1989 and 2018, a multi-stage stratified cluster sampling method was used to analyze the dietary data of 25 400 adults aged 18 to 35. The dietary survey was conducted by using 24-hour dietary recall in three consecutive days and household weighing accounting. The food consumption was converted into energy and nutrient intake by using the food nutrient data in the food composition list. The dietary energy intake of adults aged 18 to 35 in China showed an overall downward trend. The intake of dietary fat showed an upward trend, while the intake of protein and carbohydrate showed a downward trend. From the perspective of the macronutrients energize, the contribution of carbohydrates had gradually decreased while the contribution of protein and fat increased. Meanwhile, among the surveyed population, the proportion of dietary protein intake below estimated average requirement, the proportion of fat energize contribution higher than 30%, and the proportion of carbohydrate energize contribution less than 50% were gradually increasing. The dietary macronutrient structure of Chinese adults aged 18 to 35 is becoming more and more reasonable, but there is still a gap with the recommended intake.

Differential regulation of IGF‐1 pathway and accelerated bone elongation in pre‐obese juvenile mice

INTRODUCTIONChildhood obesity is driven, in large part, by increased dietary fat intake. Accelerated bone growth, a hallmark of juvenile obesity but one of its most overlooked complications, can lead to irreversible skeletal damage and chronic adult disability. Paradoxically, obese children typically have low to normal circulating levels of the growth promoting hormone insulin‐like growth factor‐1 (IGF‐1), despite their accelerated growth rate. However, IGF‐1 is both an endocrine and paracrine hormone that is essential for endochondral ossification, the process by which bones lengthen in cartilaginous growth plates at the ends of long bones. We previously reported that pre‐obese juvenile mice on a high‐fat diet have increased cell proliferation in growth plates without changes in serum IGF‐1, and before significant changes in body mass were evident. Our goal was to determine whether a high‐fat diet alters local IGF‐1 activity in growth plates by using gene set enrichment analysis on RNA sequencing (RNA‐Seq) data. We tested theHYPOTHESISthat juvenile mice on a high‐fat diet will exhibit an upregulation of IGF‐1 pathways in the growth plate.METHODSMale and female 3‐week old C57BL/6 mice were weaned on to high‐fat diet (60% kCal of fat) or control diets (10% kCal of fat) for 2 weeks and examined at 5‐weeks age when bones are elongating faster in high‐fat diet mice. We developed and validated a manual dissection technique to isolate proximal tibial growth plates from surrounding bone for RNA and protein analyses on cartilage. RNA was isolated from pooled left and right tibial growth plates and sent to the Marshall Genomics Core for next generation sequencing using an Illumina NextSeq 2000 Sequencer. Data were analyzed using fast gene set enrichment analysis (version 1.20.0) along with the reactome pathway database (version 78). Enrichment scores were calculated based on the degree to which genes in a given pathway were up‐ or down‐regulated in the RNA‐Seq data set. These scores are then normalized to account for the different number of genes involved in each pathway set and compared between diets.RESULTSOur data show that pathways regulating IGF‐1 transport and uptake by insulin‐like growth factor binding proteins (IGFBPs) were upregulated in mice on a high‐fat diet with a normalized enrichment score (NES) of 2.17 (Benjamini‐Hochberg adjusted p‐value&lt;0.01). Components of this pathway included, among others, individual IGFBPs (Igfbp4 and Igfbp5) and an IGFBP protease inhibitor (Stc2).DISCUSSIONSignificant changes in the IGF‐1 pathway closely followed those involved in cell metabolism and muscle contraction, suggesting that regulating IGF‐1 activity could be a main driver of diet‐induced growth acceleration. These data are consistent with our hypothesis that a high‐fat diet increases local IGF‐1 activity in growth plates even though systemic IGF‐1 remains unchanged.SIGNIFICANCEThese data are relevant for understanding mechanisms of diet‐induced growth acceleration and provide important groundwork for subsequent efforts to identify specific components of the IGF‐1 pathway that could underlie rapid skeletal growth in juvenile obesity.