Dietary Macronutrient Distribution Research Articles

Is Dietary Macronutrient Distribution Related to Serum Lipid Profiles in Children and Adolescents with Type 1 Diabetes?

Is Dietary Macronutrient Distribution Related to Serum Lipid Profiles in Children and Adolescents with Type 1 Diabetes?

Association of macronutrients intake distribution with osteoarthritis risk among adults in NHANES, 2013-2016.

The association between dietary macronutrient distribution and the risk of OA remains unknown. We aimed to evaluate how dietary macronutrient distribution was correlated with the risk of OA in US adults. We performed a cross-sectional study consisting of 7,725 participants from National Health and Nutrition Examination Survey (NHANES) 2013-2016. Dietary macronutrient intake and OA status were assessed by using dietary recall method and self-reported questionnaire, respectively. We evaluated the association between dietary macronutrient distribution and the risk of OA using multivariate regression models. We conducted the isocaloric substitution analysis using the multivariate nutrient density method. Higher percentage of energy intake from fat was associated with higher risk of OA [OR = 1.05 (95% CI, 1.00, 1.09); P = 0.034]. No significant correlation was observed between the percentage of energy intake from carbohydrate or protein and risk of OA. Isocaloric substitution analysis revealed that only the substitution between fat and carbohydrate was significantly associated with the risk of OA [OR = 1.05 (95% CI, 1.003 to 1.09); P = 0.037]. Our findings suggested that a diet with low percentage of energy intake from fat may be beneficial in the prevention of OA. Further prospective cohort studies are needed to assess our results.

Caloric Restriction per se Rather Than Dietary Macronutrient Distribution Plays a Primary Role in Metabolic Health and Body Composition Improvements in Obese Mice.

Caloric restriction (CR) is of key importance in combating obesity and its associated diseases. We aimed to examine effects of dietary macronutrient distribution on weight loss and metabolic health in obese mice exposed to CR. Male C57BL/6J mice underwent diet-induced obesity for 18 weeks. Thereafter mice were exposed to a 6-week CR for up to 40% on either low-fat diet (LFD; 20, 60, 20% kcal from protein, carbohydrate, fat), low-carb diet (LCD; 20, 20, 60% kcal, respectively) or high-pro diet (HPD; 35, 35, 30% kcal, respectively) (n = 16 each). Ten mice on the obesogenic diet served as age-matched controls. Body composition was evaluated by tissue dissections. Glucose tolerance, bloods lipids and energy metabolism were measured. CR-induced weight loss was similar for LFD and LCD while HPD was associated with a greater weight loss than LCD. The diet groups did not differ from obese controls in hindlimb muscle mass, but showed a substantial decrease in body fat without differences between them. Glucose tolerance and blood total cholesterol were weight-loss dependent and mostly improved in LFD and HPD groups during CR. Blood triacylglycerol was lowered only in LCD group compared to obese controls. Thus, CR rather than macronutrient distribution in the diet plays the major role for improvements in body composition and glucose control in obese mice. Low-carbohydrate-high-fat diet more successfully reduces triacylglycerol but not cholesterol levels compared to isocaloric high-carbohydrate-low-fat weight loss diets.

Dietary Macronutrient Distribution and Nutrition Outcomes in Persons with Cystic Fibrosis: An Evidence Analysis Center Systematic Review

Cystic fibrosis (CF) increases risk for undernutrition and malabsorption. Individuals with CF traditionally have been counseled to consume a high-fat diet. However, a new era of CF care has increased lifespan and decreased symptoms in many individuals with CF, necessitating a re-examination of the high-fat CF legacy diet. A literature search was conducted of Medline (Ovid), Embase, and CINAHL (EBSCO) databases to identify articles published from January 2002 to May 2018 in the English language examining the relationships between dietary macronutrient distribution and nutrition outcomes in individuals with CF. Articles were screened, risk of bias was assessed, data were synthesized narratively, and each outcome was graded for certainty of evidence. The databases search retrieved 2,519 articles, and 7 cross-sectional articles were included in the final narrative analysis. Three studies examined pediatric participants and 4 examined adults. None of the included studies reported on outcomes of mortality or quality of life. Very low certainty evidence described no apparent relationship between dietary macronutrient distribution and lung function, anthropometric measures, or lipid profile in individuals with CF. The current systematic review demonstrates wide ranges in the dietary macronutrient intakes of individuals with CF with little to no demonstrable relationship between macronutrient distribution and nutrition-related outcomes. No evidence is presented to substantiate an outcomes-related benefit to a higher fat-diet except in the context of achieving higher energy intakes in a lesser volume of food.

Contribution of macronutrients to obesity: implications for precision nutrition.

The specific metabolic contribution of consuming different energy-yielding macronutrients (namely, carbohydrates, protein and lipids) to obesity is a matter of active debate. In this Review, we summarize the current research concerning associations between the intake of different macronutrients and weight gain and adiposity. We discuss insights into possible differential mechanistic pathways where macronutrients might act on either appetite or adipogenesis to cause weight gain. We also explore the role of dietary macronutrient distribution on thermogenesis or energy expenditure for weight loss and maintenance. On the basis of the data discussed, we describe a novel way to manage excessive body weight; namely, prescribing personalized diets with different macronutrient compositions according to the individual's genotype and/or enterotype. In this context, the interplay of macronutrient consumption with obesity incidence involves mechanisms that affect appetite, thermogenesis and metabolism, and the outcomes of these mechanisms are altered by an individual's genotype and microbiota. Indeed, the interactions of the genetic make-up and/or microbiota features of a person with specific macronutrient intakes or dietary pattern consumption help to explain individualized responses to macronutrients and food patterns, which might represent key factors for comprehensive precision nutrition recommendations and personalized obesity management.

New insights into the association of mid-childhood macronutrient intake to pubertal development in adolescence using nutritional geometry.

Nutritional geometry (NG) is a novel dietary analysis approach that considers nutrient balance, rather than single nutrient effects, on health and behaviour. Through NG, recent animal experiments have found that lifespan and reproduction are differentially altered by dietary macronutrient distribution. Epidemiological research using NG reports similar findings for human ageing. Yet, the relation of macronutrient balance to human reproduction, especially reproductive maturation, remains undefined. We studied the impact of childhood macronutrient intake on pubertal maturation, by applying NG to an Australian longitudinal adolescent dataset. Food records, collected at age 8 years from 142 pre-pubertal children (females, 92; males, 50), were analysed for absolute energy, percentage energy and energy-adjusted residuals from protein, carbohydrate and fat. Pubertal stage change (assessed at 8, 13 and 15 years) was modelled to obtain individual mathematical estimates of pubertal timing and tempo. Timing of menarche was recorded. The association of macronutrients to pubertal timing/tempo was assessed via NG, involving generalised additive models and heat maps to aid interpretation. Results showed lower dietary protein (relative to carbohydrate and fat) in girls consistently predicted earlier pubertal timing and menarche, and was related to faster pubertal tempo (all P < 0·05). No significant associations were identified in boys for both timing and tempo. Results suggest a role of non-protein macronutrients in facilitating female maturation; corroborating feeding and reproductive behaviour patterns observed in earlier NG studies of primates. Application of NG to other adolescent datasets is required to confirm the present findings. Such work would advance understanding of how nutrient balance shapes human development and health.

Dietary Macronutrient Distribution and Nutrition-Related Outcomes in Cystic Fibrosis: A Systematic Review (P12-016-19)

ObjectivesConduct a systematic review (SR) to determine the relationship between dietary macronutrient distribution and nutrition-related outcomes in pediatric and adult participants with cystic fibrosis (CF). MethodsA literature search of Medline, CINAHL and Embase databases was conducted to identify peer-reviewed articles published from January 2002- May 2018 that examined human participants with CF and addressed the research objective. Articles were screened for relevance, data was extracted and summarized, and risk of bias was assessed by a multidisciplinary team of researchers, practitioners, patient advocates and SR methodologists. ResultsA total of 2409 articles were identified in the search and eight cross-sectional studies and one case-control study met inclusion criteria (N = 4 in pediatrics, N = 4 in adults, N = 1 combined). Evidence quality was low due to weak study designs, small samples size and inconsistent outcome reporting. Available studies did not show statistically significant relationships between dietary macronutrient distribution and lung function (FEV1%) (3 studies) when estimated protein intake ranged from 10–23% of energy, fat intake from 20–46% of energy and carbohydrate intake from 32–67% of energy. Macronutrient distribution was not significantly associated with anthropometric measurements/growth (3 studies), gastrointestinal symptoms (2 studies), glucose fluctuations (1 study) or lipid profile (1 study) in this SR. There were no studies identified examining the relationship between macronutrient distribution and mortality or Quality of Life. Meta-analysis was not possible due to the low quality of data reported. ConclusionsRecent evidence describing the relationship between dietary macronutrient distribution and nutrition-related outcomes in participants with CF is sparse and low in quality. The evidence reviewed does not suggest that dietary macronutrient distribution is related to key clinical CF outcomes. Higher-quality trials and longitudinal studies are needed to confirm these findings. The need for updated dietary studies is particularly important in light of recent therapeutic advances that are changing the clinical course of individuals with CF. Funding SourcesAcademy of Nutrition and Dietetics and the Medical Nutrition Practice Group DPG.

Optimal dietary macronutrient distribution in China (ODMDC): a randomised controlled-feeding trial protocol.

Findings from observational studies in China show that increased dietary fat consumption might be a contributor to the developing obesity epidemic. However, some cohort studies suggest that carbohydrate intake, especially from white rice, is a risk factor for obesity, type 2 diabetes and coronary heart disease in China. Our study aims to determine whether the traditional lower-fat, higher-carbohydrate Chinese or the Western higher-fat, lower-carbohydrate dietary pattern is more effective for weight control and the related cardiometabolic profiles increasingly found among contemporary Chinese. The Optimal Dietary Macronutrient Distribution in China (ODMDC) trial is a 6-month, multi-centre, three-arm controlled feeding study. Based on the macronutrient transition in the past 30 years in China, three isoenergetic diets with a spectrum of fat and carbohydrate intake, but same protein contents, have been formulated. Percentages of fat, carbohydrate, and protein energy are one of 20, 66 and 14%; 30, 56 and 14%; 40, 46 and 14%, respectively. Participants will be provided with all their food and most beverages for 6 months. The study population is planned to be 300 healthy non-obese adults aged 18 to 35 years. The primary outcome is body weight and the secondary variables are waist circumference and cardiometabolic risk factors. The ODMDC trial will have implications for nutrition policy in regard to weight control and related cardiometabolic disturbances among otherwise healthy non-obese Chinese.

Dietary macronutrient distribution influences post-exercise substrate utilization in women: A cross-sectional evaluation of metabolic flexibility

Dietary macronutrient distribution influences post-exercise substrate utilization in women: A cross-sectional evaluation of metabolic flexibility

Macronutrient and alcohol intake is associated with intermuscular adipose tissue in a randomly selected group of younger and older men and women

Alcohol and macronutrient intake have been found to be related to general and central body fat distribution. Intermuscular adipose tissue (IMAT) is a small ectopic fat depot located within the muscle bundles. IMAT is important for muscle function, mobility and energy homeostasis and also associated with cardiovascular- and diabetes-related risk factors. To test the hypothesis that macronutrient and alcohol intake is associated with IMAT. 50 men and 50 women, randomly selected from the general population formed height- and weight-representative age groups of 50 younger (27-31 years) and 50 older (57-61 years) subjects. A dietary questionnaire was used to estimate habitual intake of foods and beverages. Body composition including IMAT was measured with computed tomography. Energy percent (E%) carbohydrates were negatively associated with IMAT in men (β:-0.6234, P<0.05) and in younger subjects (β:-0.792, P<0.05). E% alcohol was positively associated with IMAT in women (β: 2.3663, P<0.01) and in older subjects (β: 1.232, P<0.01). In younger individuals, E% protein was positively associated with IMAT (β: 1.840, P<0.05). Centralized and general body fat distributions were positively associated with IMAT. S- (serum) cholesterol was positively associated with IMAT in men (β: 0.05177, P<0.01) and younger individuals (β: 0.06701, P<0.01). These cross-sectional analyses showed associations between measures of body fat distribution and IMAT as well as associations between macronutrient- and alcohol intake and IMAT. Since IMAT is situated within the energy demanding striated muscles, our data could suggest that changes in dietary energy intake and macronutrient distribution may induce changes in IMAT in both normal weight and obese subjects.

Dietary macronutrient distribution influences postexercise substrate utilization in women: a cross-sectional evaluation of metabolic flexibility.

Metabolic flexibility is the ability to alter substrate utilization in response to substrate availability, which may influence health and performance. The current study evaluated the effects of habitual macronutrient distribution on energy expenditure (EE) and metabolic flexibility in physically active women. Participants (N.=20) completed a 3-day food log and a standardized bout of high-intensity interval training to determine EE and respiratory exchange ratio (RER). EE and RER were measured via indirect calorimetry at rest (PRE) and immediately (IP), 30 minutes (30 min), and 60 minutes postexercise (60 min). To evaluate metabolic flexibility, RER changes were calculated from PRE to IP, IP to 30 min, and IP to 60 min. For each macronutrient, participants were categorized into high- and low-intake groups using a median split. No significant correlations were observed between macronutrient distribution and EE when covaried for lean mass (all P≥0.232), and ANCOVAs revealed no significant group × time interactions (all P≥0.241). Fat intake was not associated with ∆RER (all P≥0.477). Correlations between PRO intake and ∆RER approached significance (r=0.373-0.411; P=0.079-0.115), as did inverse associations between CHO and ∆RER (r=-0.404 - -0.409; P=0.084-0.087). Lower RER values were observed in the low-CHO group at 30 min and 60 min (P=0.030) compared to high-CHO. Higher RER values were observed in the high-PRO group at IP (P=0.042) compared to low-PRO. Estradiol was not correlated with RER at any time point, or different between diet groups (all P≥0.401). Results suggest that high PRO and low CHO intakes are associated with greater metabolic flexibility in women.

Effects of dietary macronutrient distribution on resting and post-exercise metabolism

Background Previous research has demonstrated that habitual dietary macronutrient distribution affects energy substrate utilization at rest and during exercise. The primary purpose of the current study was to examine the relationships between habitual baseline macronutrient intakes, expressed relative to bodyweight and percentage of total energy intake, and metabolism at rest and after exercise in women. Methods Twenty recreationally active women (Mean ± SD; Age 24.6 ± 3.9 yrs; Height 164.4 ± 6.6 cm; Weight 62.7 ± 6.6 kg; BF% 28.2 ± 4.8%) volunteered for the current study. Prior to metabolic testing, participants completed strength testing to determine their 1RM for six resistance exercises and completed a 3-day dietary log. Participants were provided with detailed instructions for accurately logging food intake and portion sizes, and instructed to record their regular food intake on two week days and one weekend day. Logs were analyzed using The Food Processor software (ESHA Research, Salem, OR, USA). Body composition was determined using dual-energy X-ray absorptiometry (DXA). Exercise was prescribed using baseline strength data and heart rate reserve calculations. Respiratory exchange ratio (RER) and resting energy expenditure (REE) were analyzed via indirect calorimetry (Parvomedics TrueOne 2400) before exercise (PRE), and during minutes 0-10 (IP), 25-35 (30min), and 50-60 (60min) post-exercise. Bivariate correlations and independent samples t-tests were completed using SPSS software (Version 19.0; IBM, Somers, NY, USA). Participants were stratified based on fat intake as a percentage of total caloric intake (high fat > 35% of total kcals, n=11; low fat 1.3 g/kg, n=11; low fat 35% of kilocalories from fat had a significantly higher bench press 1RM (p=0.048) and lower RER at 30min (p=0.033) and 60 min (p=0.033). Participants consuming > 1.3 g/kg of fat per day trended toward lower fat mass (p=0.09) and BF% (p=0.07). Conclusions Results indicate that baseline macronutrient distribution impacts post-exercise energy metabolism in women. Higher fat and lower CHO intake was associated with greater post-exercise REE and lower post-exercise RER, indicating greater fat utilization. Higher fat intakes may also influence resistance exercise performance and body composition; participants with higher fat intake had a greater bench press 1RM and trended towards lower indices of adiposity. These results suggest that the relative contributions of CHO and fat to total caloric intake may have significant implications for metabolism and body composition in women. Future research should evaluate the effects of modulating habitual macronutrient distribution to impart favorable effects on energy metabolism, body composition, and resistance exercise performance in women.

Impact of dietary macronutrient distribution on BMI and cardiometabolic outcomes in overweight and obese children and adolescents: a systematic review

The present systematic review examined the effectiveness of weight management interventions comparing diets with varying macronutrient distributions on BMI and cardiometabolic risk factors in overweight or obese children and adolescents. A systematic search of seven databases for the period 1975-2013 identified 14 eligible randomized or quasi-randomized controlled trials conducted with 6-18-year-old subjects. Seven trials compared a low-fat (≤ 33% energy or < 40 g/day) to an isocaloric (n = 2) or ad libitum (n = 5) low-carbohydrate diet (< 20% energy or < 60 g/day). Meta-analysis indicated a greater reduction in BMI in the low-carbohydrate group immediately after dietary intervention; however, the quality of the studies was limited and cardiometabolic benefits were inconsistent. Six trials compared increased-protein diets (19-30% energy) to isocaloric standard-protein diets (15-20% energy) and one compared an increased-fat diet (40% energy) to an isocaloric standard-fat diet (27% energy); there were no differences in outcomes in these studies. Current evidence suggests that improved weight status can be achieved in overweight or obese children and adolescents irrespective of the macronutrient distribution of a reduced-energy diet. Tailoring the macronutrient content to target specific cardiometabolic risk factors, such as a low-carbohydrate diet to treat insulin resistance, may be possible, but further research is needed before specific recommendations can be made.

High fat diets are associated with higher abdominal adiposity regardless of physical activity in adolescents; the HELENA study

Failure to attain fat balance may contribute to obesity development even without excessive energy intake. The objective of this study was to examine the associations of dietary macronutrient distribution with abdominal adiposity in adolescents and to evaluate whether these relationships were attenuated by physical activity. A total of 224 Spanish adolescents (51% females, 14.9 ± 1.2 years) were included in the study. Abdominal adiposity in three regions, truncal and total body fat mass (FM) and lean mass (LM) were measured by dual-energy X-ray absorptiometry and thereafter FM index (FMI = FM/height(2)) and FMI/LMI ratio were calculated. The energy derived from fat intake was assessed by two non-consecutive 24 h recalls. Total physical activity (PA) and time spent in moderate-to-vigorous PA (MVPA) and vigorous PA were objectively measured by accelerometry. We observed that the percent of energy derived from fat intake was significantly associated with FMI and FMI/LMI ratio (Ps = 0.001) and greater amounts of truncal (P = 0.001) and abdominal adiposity in the three regions regardless of age, sex and height (all P ≤ 0.005). The strength of the relationships was not substantially altered by further adjustment for PA, vigorous PA or moderate-to-vigorous PA (Ps ≤ 0.005). The percent of energy derived from dietary fat intake is strongly and linearly associated with total, truncal and abdominal adiposity independently of PA in adolescents. These observations implicate the amount of dietary fat intake as a specific risk factor in the excess of abdominal adiposity in adolescence.

Effects of dietary macronutrient distribution on vascular integrity in obesity and metabolic syndrome

Metabolic syndrome is a condition characterized by a clustering of risk factors for cardiovascular disease. Emerging data suggest vascular integrity is disrupted in metabolic syndrome. Vascular integrity may be determined using several measurements, including pulse wave velocity, augmentation index, and flow-mediated dilation. Arterial stiffness has become an important clinical indicator of cardiovascular disease risk. Several circulating inflammatory peptides also impact vascular integrity. The present review examines the efficacy of nutritional interventions aimed at improving vascular integrity and reducing levels of associated inflammatory peptides in individuals with metabolic syndrome, with a specific focus on the effect of dietary macronutrient redistribution on these factors.

Weight gain induced by an isocaloric pair-fed high fat diet: A nutriepigenetic study on FASN and NDUFB6 gene promoters

Experimental studies have demonstrated that dietary macronutrient distribution plays an important role in insulin regulation, a risk factor associated to obesity, diabetes and other metabolic disorders. To assess whether the macronutrient composition of the diet could be related to obesity onset by affecting the epigenetic regulation of gene expression, we investigated in rats the metabolic effects of two pair-fed isocaloric diets: control (rich in carbohydrates) and high fat diet (rich in fat; HFD). Compared to controls, HFD induced higher weight gain and adiposity and impaired glucose tolerance, which was accompanied by a slight increase in adiponectin levels and liver steatosis. Epididymal adipose tissue expression of the fatty acid synthase (FASN) gene and NADH dehydrogenase (ubiquinone) 1β-subcomplex 6 (NDUFB6) were significantly reduced in HFD group. These variations in mRNA levels were accompanied by changes in the methylation patterns of several CpG islands located in the promoter region of these genes. However, no correlations were found between gene expression and the methylation status. These results suggest that high fat intake produces overweighted rats independently of total energy intake. These diets could also induce some epigenetic changes in the promoters of key genes that could influence gene expression and may be behind metabolic alterations.

Obesity and the metabolic syndrome: role of different dietary macronutrient distribution patterns and specific nutritional components on weight loss and maintenance

Weight loss and subsequent body weight maintenance are difficult for obese individuals despite the wide variety of dietary regimens and approaches. A substantial body of scientific evidence has shown that by simply varying the macronutrient distribution and composition of dietary factors, weight losses of varying amounts, longer-term body weight maintenance periods, better appetite regulation, and changes in features of the metabolic syndrome can be achieved. At present, renewed efforts are underway to increase the protein content of weight-loss diets, simultaneously restrict fat consumption to no more than 30%, favor polyunsaturated fat, have carbohydrates account for between 40 and 50% of total energy intake, and promote the consumption of low-glycemic foods. The present article reviews the scientific evidence for the effects of several dietary manipulations and sustainable strategies for weight loss and body weight stability as well as for treating specific features of the metabolic syndrome.

Responses to Dietary Macronutrient Distribution of Overweight Rats under Restricted Feeding

Changes in protein and amino acid balance after energy-restricted feeding have scarcely been studied, although it has been suggested that protein utilization may depend on the macronutrient composition of the restricted diet. The aim of this study is to investigate the influence of dietary fat quality and content, during an energy-restricted regime, on body composition and protein metabolism. Therefore, diet-induced overweight rats were divided into three dietary groups: one group was fed on a control diet ad libitum (control) and the other two groups were fed energy-restricted diets (about 60% of control group), which provided a standard amount (20%) of fat (SFR), based on olive oil, or a high amount (60%) of saturated fat (HFR), based on coconut oil. Measurements of body weight, body composition, serum biochemical parameters and the assessment of the hepatic and muscular protein response were performed. Similar results were found comparing weight losses and serum parameters in both deprived groups, although the high-fat-restricted rats (HFR group) showed a greater reduction in the subcutaneous fat depot and of total body fat. After both energy-restricted treatments, the serum amino acid concentration was reduced while the urinary amino acid excretion increased. Muscle and liver protein metabolism was affected by energy restriction, which produced a decrease in protein synthesis capacity (RNA content) in both tissues and a higher muscle proteolysis (catepsin activity), more marked in the SFR group, while no changes were found in liver protein breakdown. Hepatic glycogen and glycogenic amino acid were also altered, reaching significant differences in the HFR group. Thus, dietary macronutrient composition during energy restriction seems to be involved in the metabolic adaptative response.