Indices Of Metabolic Health Research Articles

Accelerometer epoch setting is decisive for associations between physical activity and metabolic health in children

ABSTRACTWhen analysing physical activity (PA) levels using accelerometry, the epoch setting is critical to capture intensity-specific PA correctly. The aim of the present study was to investigate the PA intensity signatures related to metabolic health in children using different epoch settings. A sample of 841 Norwegian children (age 10.2 ± 0.3 years; BMI 18.0 ± 3.0; 50% boys) provided data on accelerometry (ActiGraph GT3X+) and several indices of metabolic health (aerobic fitness, abdominal fatness, insulin sensitivity, lipid metabolism, blood pressure) that were used to create a composite metabolic health score. We created intensity spectra from 0–99 to ≥ 10000 counts per minute (cpm) for files aggregated using 1, 10, and 60-second epoch periods and used multivariate pattern analysis to analyse the data. The association patterns with metabolic health differed substantially between epoch settings. The intensity intervals most strongly associated with metabolic health were 7000–8000 cpm for data analysed using 1-second epoch, 5500–6500 cpm for data analysed using 10-second epoch, and 4000–5000 cpm analysed using 60-second epoch. Aggregation of data over different epoch periods has a clear impact on how PA intensities in the moderate and vigorous range are associated with childhood metabolic health.

Is the Canadian Healthy Eating Index 2007 an Appropriate Diet Indicator of Metabolic Health? Insights from Dietary Pattern Analysis in the PREDISE Study.

The objective of this study was to identify key elements from the 2007 Canada’s Food Guide that should be included in a diet quality score aiming to reflect the risk of metabolic syndrome (MetS). Dietary intakes of 998 adults (mean age: 43.2 years, 50% women) were used to obtain the Canadian Healthy Eating Index 2007 (C-HEI 2007) and Alternative Healthy Eating Index 2010 (AHEI) scores, as well as a dietary pattern (DP) generated by the reduced rank regression (RRR) method. Based on these three scores, a modified version of the C-HEI 2007 (Modified C-HEI) was then proposed. The prevalence ratio (PR) of MetS was examined across diet quality scores using multivariate binomial regression analysis. A higher AHEI, Modified C-HEI, and a lower score for DP were all associated with a significantly lower prevalence of MetS (PR = 0.42; 95% confidence interval (CI) 0.28, 0.64; PR = 0.39; 95% CI 0.23, 0.63; and PR = 0.48; 95% CI 0.31, 0.74, respectively), whereas C-HEI 2007 was not (PR = 0.68; 95% CI 0.47, 1.00). Results suggest that a Modified C-HEI that considers key elements from the C-HEI 2007 and the AHEI, as well the DP, shows that participants with a higher score are less likely to have MetS.

The Triaxial Physical Activity Signature Associated with Metabolic Health in Children.

The use of uniaxial summary measures from accelerometry (i.e., counts per minute or minutes spent in moderate-to-vigorous intensity) substantially restricts information about physical activity (PA), and is probably a result of reliance on analytic approaches that cannot handle collinear variables. In the present study, we aimed to determine the multivariate triaxial PA intensity signature related to metabolic health in children, by investigating associations of the whole spectra of PA intensities from all axes using multivariate pattern analysis. We included 841 children (age, 10.2 ± 0.3 yr; body mass index, 18.0 ± 3.0; 50% boys) from the Active Smarter Kids study conducted in Norway 2014 to 2015 providing valid data on accelerometry (ActiGraph GT3X+) and several indices of metabolic health (aerobic fitness, abdominal fatness, insulin sensitivity, lipid metabolism, blood pressure) that were used to create a composite metabolic health score. We created intensity spectra from 0 to 100 to ≥10,000 counts per minute for separate axes and used multivariate pattern analysis to analyze the data. The explained variance of metabolic health was 3.2% for counts per minute from the vertical axis, 17.0% for the vertical axis intensity spectrum, and 29.5% for the full model including all axes. Thus, including full triaxial intensity spectra improved the model for metabolic health tenfold compared with using overall PA (counts per minute) from the vertical axis only. The intensity signature associated with metabolic health differed across the axes. Our findings show that the three different axes carry distinct information about children's PA and the relation of PA to their health and demonstrate a great potential for triaxial accelerometry and a multivariate analytic approach to advance the field of PA epidemiology.

Phase angle and metabolic equivalents as predictors of frailty transitions in advanced age.

The aim of this prospective study was to investigate whether two cellular and metabolic health indices, phase angle (PhA) and metabolic equivalents (METs), can predict changes in frailty states in fit community-dwelling older people. A sample of 118 individuals aged ≥65 years who attended a twice-weekly mild fitness program of aerobic and/or resistance exercises was enrolled in the study. At baseline and after three years, individuals underwent a clinical examination, biochemical determinations, bioelectrical impedance analysis, body composition assessment with dual energy X-ray absorptiometry, physical performance tests, and frailty and sarcopenia assessment. In 78 participants was executed indirect calorimetry, too. Based on frailty transitions during the follow-up between non-frailty, pre-frailty and frailty, participants were categorized as improved, stable (non-frail or pre-frail), and worsened or remaining frail. The chances to experience different frailty changes by baseline PhA and METs were explored through multinomial regression analysis and expressed as odds ratios (OR) and 95% Confidence intervals (95%CI). During the follow-up, 8 participants improved in frailty status, 84 were stable and 26 worsened or remained frail. For each one-unit increase in PhA, the odds of improving in frailty increased by 4.53 times (95%CI:1.18-17.46); while for each one-unit increase in METs, the odds of worsening in frailty decreased by 65% (95%CI:0.16-0.79). PhA and METs may be indirect measures of functional reserve, with lower values being potential biomarkers of evolving frailty.

Running wheel access fails to resolve impaired sustainable health in mice feeding a high fat sucrose diet.

Diet and physical activity are thought to affect sustainable metabolic health and survival. To improve understanding, we studied survival of mice feeding a low-fat (LF) or high-saturated fat/high sugar (HFS) diet, each with or without free running wheel (RW) access. Additionally several endocrine and metabolic health indices were assessed at 6, 12, 18 and 24 months of age. As expected, HFS feeding left-shifted survival curve of mice compared to LF feeding, and this was associated with increased energy intake and increased (visceral/total) adiposity, liver triglycerides, and increased plasma cholesterol, corticosterone, HOMA-IR, and lowered adiponectin levels. Several of these health parameters improved (transiently) by RW access in HFS and LF fed mice (i.e., HOMA-IR, plasma corticosterone), others however deteriorated (transiently) by RW access only in HFS-fed mice (i.e., body adiposity, plasma resistin, and free cholesterol levels). Apart from these multiple and sometimes diverging health effects of RW access, RW access did not affect survival curves. Important to note, voluntary RW activity declined with age, but this effect was most pronounced in the HFS fed mice. These results thus challenge the hypothesis that voluntary wheel running can counteract HFS-induced deterioration of survival and metabolic health.

A 10-Week Pedometer-Based Walking Program Induced Weight Loss and Improved Metabolic Health in Community-Dwelling Adults

Walking 10,000 steps daily is associated with beneficial health outcomes. Recent systematic reviews have suggested that pedometers may be an effective motivational tool to promote walking. The aim of this study was to study the effectiveness of a 10-week, pedometer-based walking intervention to improve physical activity, body composition and metabolic health indices in a sample of suburban community-dwelling adults not meeting current physical activity recommendations. After screening, 34 overweight/obese individuals (mean age: 46 ± 8 years, mean BMI: 28.3 ± 4.2 kg/m 2 ) were accepted into the walking program conducted by the Health Promotion Community Centre, Bangi. Subjects were instructed to increase their steps by 3000 steps daily above their baseline values for 10 weeks. Daily step count, body weight, BMI, waist circumference, as well as blood pressure, fasting glucose and lipids were evaluated at baseline and following the 10-week intervention. Thirty-one participants completed the program with 100% adherence. The average daily steps recorded during the 10-week intervention was 9693 ± 2196 steps per day. Mean daily steps increased from 8679 ± 2567 steps in Week 1 to 10,766 ± 3200 steps in Week 10 (p=0.040). Overall, there were reductions in body weight (-1.13%, p=0.010), waist circumference (-3.5%, p=0.001) and BMI (-1.41%, p=0.008) as well as fasting blood glucose (-8.5%, p=0.003) and systolic blood pressure (-4.8%, p=0.007) following the intervention. The findings of this study demonstrated that a goal-driven, pedometer-based walking intervention for 10 weeks resulted in a modest reduction in body weight and improved metabolic health outcomes in overweight/obese, community-dwelling adults. DOI : http://dx.doi.org/10.17576/JSKM-2019-1701-04

Is normal body mass index a good indicator of metabolic health in Azar cohort population?

Introduction: Metabolic syndrome (Mets) has become most important public health problem in the world. We examined the association between Mets and different cardiometabolic phenotype in Azar cohort population. Methods: In the present study, the data of 13099 subjects who participated in Azar cohort study were cross-sectionally analyzed. Mets was defined according to the National Cholesterol Education Program’s Adult Treatment Panel III report (ATPIII) criteria. Participants were categorized into four cardiometabolic phenotypes including metabolically healthy Lean (MHL), metabolically unhealthy lean (MUHL), metabolically healthy Obese (MHO), metabolically unhealthy obese (MUHO) according to BMI cut–off point (25 kg/m2 ), and the presence of Mets. Results: Totally, the prevalence of Mets was 33.20% with the higher prevalence in women (40.1%). About 46.7% of participants were MHO and 1.6% of them were MHL. In both genders, MUHL had the highest prevalence of hyperglycemia, hypertrigliceridemia, hypo-HDL-cholestrolemia and Frahmingham 10-year CVD risk. In both MUHL and MUHO phenotypes, hypertriglyceridemia (OR: 31.97 [95% CI: 22.31, 45.81] and OR: 20.28 [95% CI: 17.32, 23.75]) and hypo-HDL cholestrolemia (OR:27.97 [95% CI: 17.35, 45.09] and OR:11.0 [95% CI: 9.62, 12.58]) are the strongest predictor of incidence of Mets. Also, the results of multinominal regression analyses indicated that in all cardiometabolic phenotypes, Framingham 10- year CVD risks had the lowest power for predicting of Mets incidence. Conclusion: Based on the results, in addition to obese individuals, multiple metabolic abnormalities were seen in normal weight individuals and these subjects are even at higher risk of developing Mets compared with metabolically obese individuals. So, it seems that decision on initiation of lifestyle interventions should not be only based on the BMI; rather metabolic status seems to be even more important.

Review of Rationale, Design, and Initial Findings: Tehran Lipid and Glucose Study.

In the late 1990s the non-communicable diseases were becoming increasingly more prevalent and a significant proportion of evidence in this regard had originated from industrialized “Western” countries. This had led to a landscape where most national and local health decisions regarding non-communicable diseases (NCDs) were informed by data generated elsewhere. Iran, as a large country in the Middle East was no exception and was going through significant population growth and urban development at the time. An initiative by the Iranian National Scientific Research Council funded an idea that was aimed at delineating the local epidemiology of NCDs and their risk factors in a manner that was unprecedented. The result was Tehran Lipid and Glucose Study (TLGS), the first and longest running cohort of its sort in Iran.Initial data out of TLGS reported the characteristics of 15005 people aged over 3 years in a representative population of Tehranians. Additionally, distribution and prevalence of cardiovascular risk factors among the study population were characterized. This population was selected through a multistage stratified cluster random sampling technique from the population of district 13 in Tehran. In addition, TLGS gave rise to a great deal of important and highly effective initial findings on national cut-off points for various variables, information about nutrition, hypertension, dyslipoproteinemia, and metabolic syndrome. TLGS also generated information about metabolic health indicators among children and adolescents. Here we present a brief overview of rationale, design, and initial findings of TLGS.

The multivariate physical activity signature associated with metabolic health in children

BackgroundPhysical activity is a cornerstone for promoting good metabolic health in children, but it is heavily debated which intensities (including sedentary time) are most influential. A fundamental limitation to current evidence for this relationship is the reliance on analytic approaches that cannot handle collinear variables. The aim of the present study was to determine the physical activity signature related to metabolic health in children, by investigating the association pattern for the whole spectrum of physical activity intensities using multivariate pattern analysis.MethodsWe used a sample of 841 children (age 10.2 ± 0.3 years; BMI 18.0 ± 3.0; 50% boys) from the Active Smarter Kids study, who provided valid data on accelerometry (ActiGraph GT3X+) and several indices of metabolic health (aerobic fitness, abdominal fatness, insulin sensitivity, lipid metabolism, blood pressure) that were used to create a composite metabolic health score. We created 16 physical activity variables covering the whole intensity spectrum (from 0–100 to ≥ 8000 counts per minute) and used multivariate pattern analysis to analyze the data.ResultsPhysical activity intensities in the vigorous range (5000–7000 counts per minute) were most strongly associated with metabolic health. Moderate intensity physical activity was weakly related to health, and sedentary time and light physical activity were not related to health.ConclusionsThis study is the first to determine the multivariate physical activity signature related to metabolic health in children across the whole intensity spectrum. This novel approach shows that vigorous physical activity is strongest related to metabolic health. We recommend future studies adapt a multivariate analytic approach to further develop the field of physical activity epidemiology.Trial registrationThe study was registered in Clinicaltrials.gov (www.clinicaltrials.gov) 7th of April 2014 with identification number NCT02132494.

Associations of volumes and patterns of physical activity with metabolic health in children: A multivariate pattern analysis approach

Physical activity (PA) favorably affects metabolic health in children, but it is unclear how total volumes versus patterns (bouts and breaks) of PA relate to health. By means of multivariate pattern analysis that can handle collinear variables, we determined the associations of PA volumes and patterns with children's metabolic health using different epoch settings. A sample of 841 Norwegian children (age 10.2 ± 0.3 years) provided in 2014 data on accelerometry (ActiGraph GT3X+), using epoch settings of 1, 10, and 60 s and several indices of metabolic health used to create a composite metabolic health score. We created 355 PA indices covering the whole intensity and bout duration spectrum, and used multivariate pattern analysis to analyze the data. Findings showed that bouts of PA added information about childhood health beyond total volumes of PA for all epoch settings. Yet, associations of PA patterns with metabolic health were completely dependent on the epoch settings used. Vigorous PA was strongly associated with metabolic health, while associations of light and moderate PA were weak to moderate, and associations of sedentary time with metabolic health was non-existing. Short intermittent bursts of PA were favorably associated with children's metabolic health, whereas associations of prolonged bouts were weak. This study is the first to determine the multivariate physical activity association pattern related to metabolic health in children across the whole PA intensity and bout duration spectrum. The findings challenge our understanding of PA patterns, and are of major importance for the analysis of accelerometry data.

High Prevalence of Hepatic Fibrosis, Measured by Elastography, in a Population-Based Study of Mexican Americans

Hepatic fibrosis is a primary risk factor for cirrhosis and hepatocellular carcinoma, which affect a disproportionate number of Hispanics in the United States. We aimed to determine the prevalence of significant fibrosis, measured by point shear-wave elastography (pSWE), and determine characteristics of hepatic fibrosis and simple steatosis in a population-based study of Mexican American Hispanics in south Texas. Liver stiffness was measured by pSWE, performed by 2 separate operators, for 406 participants in the Cameron County Hispanic Cohort from 2015 through 2017. Significant fibrosis (F2-F4) was defined as median stiffness > 1.34 m/s. Steatosis was determined by ultrasound. All participants underwent a clinical examination that included a comprehensive laboratory analysis and standardized interview about their medical and social history. We calculated weighted prevalence of fibrosis and determined clinical and demographic associations with significant fibrosis (with or without steatosis) and simple steatosis with no/minimal fibrosis using multinomial logistic regression. Fifty-nine participants were excluded due to unreliable pSWE findings or inconclusive ultrasound results, for a final analysis of 347 participants. The prevalence of significant fibrosis was 13.8%; most of these participants (37/42, 88.1%) had no evidence of viral hepatitis or heavy drinking. Levels of liver enzymes were associated with fibrosis and simple steatosis. Indicators of metabolic health (insulin resistance, triglycerides, and cholesterol) were significantly associated with simple steatosis. Fibrosis, but not simple steatosis, was significantly associated with of antibodies against HCV in plasma (odds ratio, 18.9; P = .0138) and non-significantly associated with reduced platelet count (odds ratio, 0.8 per 50x103/μL; 95% CI, 0.5-1.1). Multivariable analyses, as well as sensitivity analyses removing F4 fibrosis and viral or alcoholic etiologies, confirmed our results. We estimated the prevalence of fibrosis in a large population of Mexican American Hispanics using pSWE measurements. We found Mexican American Hispanics to have a higher prevalence of fibrosis compared to European and Asian populations, primarily attributable to metabolic disease.

Cord blood insulin, IGF‐I, IGF‐II, leptin, adiponectin and ghrelin, and their associations with insulin sensitivity, β‐cell function and adiposity in infancy

Vulnerability to insulin resistance and Type 2 diabetes may originate in early life, but little is known about whether any perinatal biomarkers are predictive of later metabolic health. We sought to assess whether cord blood insulin, insulin-like growth factor (IGF)-I, IGF-II, leptin, adiponectin and ghrelin are associated with metabolic health indicators in infancy. In a prospective singleton birth cohort, we assessed cord blood insulin, IGF-I, IGF-II, leptin, adiponectin and ghrelin concentrations in relation to the homeostasis model assessment of insulin resistance (HOMA-IR), β-cell function (HOMA-β), fasting proinsulin-to-insulin ratio, BMIz-score, and the sum of triceps and subscapular skinfold thickness (an indicator of adiposity) in infants at age 1year (n=185). Adjusting for maternal and infant characteristics, one standard deviation (sd) increase in cord blood adiponectin was associated with an 11.1% (95% confidence interval 1.8-19.5%) decrease in HOMA-β (P=0.02) and a 13.6% (1.8-26.8%) increase in proinsulin-to-insulin ratio (P=0.02), indicating worse β-cell function in infants at age 1year. One sd increase in cord blood insulin was associated with a 0.5 (0.1-1.0)mm increase in skinfold thickness (P=0.01). One sd increase in cord blood ghrelin was associated with a 0.2 (0.02-0.3) decrease in BMIz-score (P=0.02) and a 0.5 (0.1-0.9)mm decrease (P=0.02) in skinfold thickness. Cord blood IGF-I and IGF-II were not associated with the observed metabolic health indicators at age 1year. The study is the first to show that cord blood adiponectin may be negatively predictive of β-cell function, whereas cord blood ghrelin may be negatively predictive of adiposity in infancy.

The combined effect of high-intensity intermittent training and vitamin D supplementation on glycemic control in overweight and obese adults.

High‐intensity intermittent training (HIIT) has been shown to reduce the risk of chronic conditions including the development of type 2 diabetes mellitus (T2DM). Independently, a low vitamin D status has also been linked to the prevalence of T2DM. The aim of this study was to investigate if there was a synergistic metabolic effect of HIIT and vitamin D supplementation on glycemic control. A total of 20 male and female participants (age, 34 ± 9 year; BMI, 31.4 ± 2.8 kg·m−2) completed 6 weeks HIIT, and were randomized to ingest 100 μg·day‐1 of vitamin D3 or placebo. Response to an oral glucose tolerance test (OGTT) was determined at baseline and at 72 h postintervention. Glucose tolerance was improved as a result of the HIIT intervention, shown through a reduction in glucose and insulin concentrations during the OGTT, accompanied by a decrease in glucose (829 ± 110 to 786 ± 139 mmol·h−1·L−1; P = 0.043) and insulin (8101 ± 4755–7024 ± 4489 mU·h−1·L−1; P = 0.049) area under the curve (AUC). Supplementation increased 25‐hydroxyvitamin D3 concentration by 120% to a sufficiency status (P < 0.001). However, the consumption of vitamin D3 seemed to attenuate the glucose response during an OGTT. Triglyceride content was lowered following the intervention (P = 0.025). There was no effect of the intervention on insulin sensitivity (IS) indices: ISIM atsuda and HOMA‐IR. Our findings demonstrate that HIIT improves glucose tolerance in nondiabetic overweight and obese adults; however vitamin D3 supplementation did not proffer any additional positive effects on the measured indices of metabolic health.

Soy Protein Isolate Suppresses Bone Resorption and Improves Trabecular Microarchitecture in Spontaneously Hyperphagic, Rapidly Growing Male OLETF Rats

BackgroundTraditionally, milk proteins have been recommended for skeletal health; recently, soy proteins have emerged as popular alternatives. Excess adiposity appears detrimental to skeletal health, as obese adolescents have increased fracture rates compared with healthy controls. However, soy protein effects on skeletal health during excess adiposity remain unknown. ObjectiveThe study objective was to examine the effects of isocaloric diets containing milk protein isolate (MPI), soy protein isolate (SPI), or a 50/50 combination (MIX) as the sole protein source on metabolic health indicators and bone outcomes in rapidly growing, hyperphagic, male Otsuka Long Evans Tokushima Fatty (OLETF) rats. MethodsOLETF rats, aged 4 wk, were randomly assigned to 3 treatment groups (MPI, SPI, or MIX, n = 20 per group) and provided with access to experimental diets ad libitum for 16 wk. ResultsBody mass did not differ between the groups, but SPI had lower percentage body fat than MPI (P = 0.026). Insulin was lower in MPI than in MIX (P = 0.033) or SPI (P = 0.044), but fasting blood glucose was not different between the groups. SPI significantly reduced serum cholesterol compared with MPI (P = 0.001) and MIX (P = 0.002). N-terminal propeptide of type I collagen (P1NP) was higher in MIX than MPI (P = 0.05); C-terminal telopeptide of type 1 collagen (CTx) was higher in MPI than SPI (P < 0.001) and MIX (P < 0.001); the P1NP to CTx ratio was significantly higher in SPI and MIX than in MPI (P < 0.001). Trabecular separation was reduced in SPI compared with MPI (P = 0.030) and MIX (P = 0.008); trabecular number was increased in SPI compared with MIX (P = 0.038). No differences were seen in cortical geometry and biomechanical properties. ConclusionsIn the context of excess adiposity, soy- and milk-based proteins have comparable effects on cortical bone geometry and biomechanical properties, whereas soy-based proteins favorably affect the trabecular microarchitecture, and the combination of both proteins may offer additional benefits to bone remodeling in rapidly growing male OLETF rats.

Early and Late Postnatal Accelerated Growth Have Distinct Effects on Metabolic Health in Normal Birth Weight Infants.

Accelerated growth in postnatal life in low birth weight infants has been associated with insulin resistance and metabolic syndrome-related disorders in later life. Postnatal accelerated growth in also common in normal birth weight infants, but little is known about the impact on metabolic health. In a prospective cohort study of 203 term normal birth weight infants, we evaluated the impacts of accelerated (Δweight Z score > 0.5) or decelerated (Δweight ΔZ < −0.5) growth during early (0–3 months) and late (3–12 months) postnatal life on metabolic health indicators at age 1-year. The primary outcomes were homeostasis model assessment of insulin resistance (HOMA-IR), β-cell function [homeostasis model assessment of β-cell function (HOMA-β)], and fasting plasma lipids. Adjusting for maternal, paternal, and infant characteristics, accelerated growth during the first 3 months of life was associated with a 41.6% (95% confidence interval 8.9–84.2%) increase in HOMA-β, and a 8.3% (0.7–15.4%) decrease in fasting plasma total cholesterols, and was not associated with HOMA-IR in infants at age 1-year. Accelerated growth during 3–12 months was associated with a 30.9% (3.3–66.0%) increase in HOMA-IR and was not associated with HOMA-β. Neither accelerated nor decelerated growth was associated with fasting plasma triglycerides, high-density lipoprotein or low-density lipoprotein cholesterol concentrations in infants at age 1-year. Accelerated growth during early postnatal life may be beneficial for β-cell function, but during late postnatal life harmful for insulin sensitivity in normal birth weight infants.

A 100-Year Review: Metabolic health indicators and management of dairy cattle

Our aim in this Journal of Dairy Science centennial review is to describe the evolution of focus on metabolic indicators, from discovery and description to evaluation at the individual cow and subsequently herd levels, over the past 100 yr. Furthermore, we discuss current and future technologies that will be used in the dairy industry to utilize these indicators widely going forward. Knowledge of chemical changes in various fluids (e.g., blood, urine, and milk) accompanying numerous metabolic disease states in the dairy cow has existed since almost the beginning of the Journal of Dairy Science 100 yr ago. However, only during the last 25 yr have these metabolic indicators been developed into useful tools for cow- and herd-level monitoring for disease and management. From the 1920s through the 1940s, our understanding of the changes in blood chemistry accompanying milk fever and ketosis increased, as did our understanding of the underlying biology. In the 1950s and 1960s, workers studying ketosis and energy metabolism began to evaluate changes in lipid metabolism reflected by concentrations of circulating nonesterified fatty acids; furthermore, initial development occurred for on-farm tests of milk ketones. During the 1970s, blood metabolic profiling was applied to dairy farms but found to be of varied and limited usefulness. The turning point occurred when large epidemiologic studies of periparturient cow disease were pioneered in the United States, Canada, and Europe in the 1980s; these studies further solidified our understanding of risk factors and epidemiological interrelationships among disease, production, and reproduction. In the early 1990s, scientists first incorporated indicators of metabolic health into large observational studies and determined important epidemiological relationships between these indicators and outcomes of interest. This field of study blossomed during the 2000s as several research groups conducted multiple investigations into metabolic indicators related to energy metabolism and began to develop cow-level thresholds and herd-level alarms for use in monitoring and management. This work was accompanied by additional studies to validate point-of-care instruments that could be used to implement these strategies at the cow and herd levels. Work in the 2000s continued to identify and evaluate other physiological indicators of inflammation and oxidative stress; however, these have yet to be incorporated into large-scale cohort studies. Finally, use of technology (e.g., activity monitoring, cow-monitoring collars and tags, milk-based analysis using Fourier transform infrared spectroscopy) continues to receive significant attention going forward to eventually allow for real-time and automatic monitoring of metabolic indicators and improved health and herd management on dairy farms.

Inadequate Vitamin C Status in Prediabetes and Type 2 Diabetes Mellitus: Associations with Glycaemic Control, Obesity, and Smoking.

Vitamin C (ascorbate) is an essential micronutrient in humans, being required for a number of important biological functions via acting as an enzymatic cofactor and reducing agent. There is some evidence to suggest that people with type 2 diabetes mellitus (T2DM) have lower plasma vitamin C concentrations compared to those with normal glucose tolerance (NGT). The aim of this study was to investigate plasma vitamin C concentrations across the glycaemic spectrum and to explore correlations with indices of metabolic health. This is a cross-sectional observational pilot study in adults across the glycaemic spectrum from NGT to T2DM. Demographic and anthropometric data along with information on physical activity were collected and participants were asked to complete a four-day weighed food diary. Venous blood samples were collected and glycaemic indices, plasma vitamin C concentrations, hormone tests, lipid profiles, and high-sensitivity C-reactive protein (hs-CRP) were analysed. A total of 89 participants completed the study, including individuals with NGT (n = 35), prediabetes (n = 25), and T2DM managed by diet alone or on a regimen of Metformin only (n = 29). Plasma vitamin C concentrations were significantly lower in individuals with T2DM compared to those with NGT (41.2 µmol/L versus 57.4 µmol/L, p < 0.05) and a higher proportion of vitamin C deficiency (i.e. <11.0 µmol/L) was observed in both the prediabetes and T2DM groups. The results showed fasting glucose (p = 0.001), BMI (p = 0.001), smoking history (p = 0.003), and dietary vitamin C intake (p = 0.032) to be significant independent predictors of plasma vitamin C concentrations. In conclusion, these results suggest that adults with a history of smoking, prediabetes or T2DM, and/or obesity, have greater vitamin C requirements. Future research is required to investigate whether eating more vitamin C rich foods and/or taking vitamin C supplements may reduce the risk of progression to, and/or complications associated with, T2DM.

Impact of nurse-led behavioural counselling to improve metabolic health and physical activity among adults with mental illness.

The life expectancy of adults with mental illness is significantly less than that of the general population, and this is largely due to poor physical health. Behavioural counselling can improve physical health indicators among people with non-communicable disease. This repeated-measures, single-group intervention trial evaluated the effects of a 19-week behavioural counselling programme on metabolic health indicators and physical activity levels of outpatient adults with mental illness. Sixteen participants completed the intervention that comprised individual face-to-face counselling sessions with a registered nurse every 3weeks, and progress reviews with a medical practitioner every 6weeks. Assessment included self-report and objective measurement of physical activity, and measures of blood pressure and anthropometry. Statistically-significant changes were demonstrated between baseline and post intervention for participants' waist circumference (P=0.035) and waist-to-height ratio (P=0.037). Non-significant improvements were demonstrated in weight and physical activity. The findings indicated that adults with mental illness can engage in a nurse-led behavioural counselling intervention, with improvements in some metabolic health measures after 19weeks. It is recommended that behavioural counselling programmes for adults with mental illness be sustained over time and have an 'open door' policy to allow for attendance interruptions, such as hospitalization.

Modeling the shape and composition of the human body using dual energy X-ray absorptiometry images.

There is growing evidence that body shape and regional body composition are strong indicators of metabolic health. The purpose of this study was to develop statistical models that accurately describe holistic body shape, thickness, and leanness. We hypothesized that there are unique body shape features that are predictive of mortality beyond standard clinical measures. We developed algorithms to process whole-body dual-energy X-ray absorptiometry (DXA) scans into body thickness and leanness images. We performed statistical appearance modeling (SAM) and principal component analysis (PCA) to efficiently encode the variance of body shape, leanness, and thickness across sample of 400 older Americans from the Health ABC study. The sample included 200 cases and 200 controls based on 6-year mortality status, matched on sex, race and BMI. The final model contained 52 points outlining the torso, upper arms, thighs, and bony landmarks. Correlation analyses were performed on the PCA parameters to identify body shape features that vary across groups and with metabolic risk. Stepwise logistic regression was performed to identify sex and race, and predict mortality risk as a function of body shape parameters. These parameters are novel body composition features that uniquely identify body phenotypes of different groups and predict mortality risk. Three parameters from a SAM of body leanness and thickness accurately identified sex (training AUC = 0.99) and six accurately identified race (training AUC = 0.91) in the sample dataset. Three parameters from a SAM of only body thickness predicted mortality (training AUC = 0.66, validation AUC = 0.62). Further study is warranted to identify specific shape/composition features that predict other health outcomes.

A Diet Containing Soy Protein Isolate is Not Detrimental to Skeletal Development in Spontaneously Hyperphagic, Adolescent Male OLETF Rats

Obesity and its associated metabolic dysfunction are associated with increased fracture risk in children and adolescents, suggesting excess adiposity negatively impacts skeletal development. Although the consumption of milk‐based proteins has been recommended for normal skeletal development, soy‐based proteins have emerged as popular plant‐based dairy alternatives. However, the effect of soy protein on bone health during adolescent skeletal development has not been studied. The purpose of this study was to examine the effects of isocaloric diets containing milk protein isolate (MPI), soy protein isolate (SPI), or a 50/50 combination of the two (MIX) on metabolic health indicators and bone outcomes in adolescent, hyperphagic, male Otsuka Long Evans Tokushima Fatty (OLETF) rats. At 4 weeks of age, rats were randomized to three treatment groups (MPI, SPI, and MIX) and provided ad libitum access to the diets until 20 weeks of age, at which time animals were fasted overnight, euthanized, and blood and hind limbs collected. Fasting glucose, insulin, lipids, and bone formation (N‐terminal propeptide of type 1 procollagen, P1NP) and resorption (C‐terminal telopeptide of type I collagen, CTx) markers were measured using commercially available ELISA kits. Tibial trabecular microarchitecture and cortical geometry were measured by micro‐computed tomography (μCT); and, biomechanical properties were measured by torsional loading to failure. Femoral calcium and phosphorus content were measured using Inductive Coupled Plasma‐Optical Emission Spectroscopy. One‐way ANOVA was used to test for significant differences among groups for metabolic outcomes and bone turnover markers. One‐way ANCOVA, with final body weight as a covariate, was used to determine differences among groups for all bone outcomes. At 20 weeks of age, there were no group differences in body weight or body fat. Animals in all groups were insulin resistant based on fasting glucose and insulin. MPI reduced fasting insulin compared to MIX and SPI. SPI reduced total serum cholesterol compared to MPI and MIX. P1NP was greater in MIX than MPI, but CTx was not different among groups. Trabecular spacing was reduced in SPI compared to MIX, while cortical geometry and biomechanical properties were not different among groups. MPI had higher calcium and phosphorus content than MIX. In conclusion, these results suggest that a diet containing soy protein is not detrimental to skeletal development in spontaneously hyperphagic, adolescent male OLETFs rats, and may benefit trabecular microarchitecture. In addition, these results suggest that a diet containing a combination of milk‐ and plant‐based proteins might promote bone formation during skeletal growth.Support or Funding InformationSupport: DuPont Nutrition &amp; Health, NIH R01DK088940 (JPT) and VHA‐CDA2 IK2BX001299 (RSR).