Cardiometabolic health improvements upon dietary intervention are driven by tissue-specific insulin resistance phenotype: A precision nutrition trial

Trouwborst, Inez; Gijbels, Anouk; Jardon, Kelly M; Siebelink, Els; Wanders, Lisa; Erdős, Balázs; Singh-Povel, Cécile M; Bosch, Johan de Vogel-van den; Adriaens, Michiel E.; Arts, Ilja C. W.; Thijssen, Dick H. J.; Feskens, Edith J. M.; Goossens, Gijs H.; Afman, Lydia A.; Blaak, Ellen E.

doi:10.1016/j.cmet.2022.12.002

Cited by 25 publications

(24 citation statements)

References 57 publications

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“…The LFHP diet resulted in a greater reduction in waist circumferences as compared to the HMUFA diet. The diet-induced changes in whole-body and tissue-specific insulin sensitivity in the current analyses were in line with changes found in the complete study population of the PERSON study [ 15 ] but did not reach statistical significance, which seems related to the smaller sample size in the present study. Despite this, the LFHP-induced reduction in VAT was associated with improved liver insulin sensitivity.…”

Section: Discussionsupporting

confidence: 80%

“…Future studies are warranted to investigate the relationship between body composition and insulin sensitivity in premenopausal women and age-matched men. Furthermore, we did not observe significant improvements in the Matsuda index, HIRI, and MISI following dietary intervention on a group level, as a result of limited power in this subset, since improvements were observed in the complete PERSON study population [ 15 ]. Despite this, we were still able to identify significant associations between changes in body composition and changes in insulin sensitivity.…”

Section: Discussionmentioning

confidence: 99%

“…Both quality and quantity of dietary protein, fat and carbohydrate seem to impact body composition, body fat distribution, and ectopic fat deposition [ 9 , 12 ], as well as affect insulin sensitivity and glucose control [ 14 ]. We have recently shown that two isocaloric diets within guidelines of healthy nutrition - a low-fat, high-protein, high-fiber diet (LFHP) and a high mono-unsaturated fatty acid diet (HMUFA) - can both elicit pronounced improvements in body composition and several cardiometabolic parameters [ 15 ]. Nevertheless, it is not yet clear what the effect of these two isocaloric healthy diets differing in macronutrient composition are on body composition and body fat distribution, measured with state-of-the-art methodology, including characterization of VAT and SAT, ectopic fat deposition, and skeletal muscle volume and whether these improvements are related to improvements in (whole-body and tissue-specific) insulin sensitivity.…”

Section: Introductionmentioning

confidence: 99%

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Body composition and body fat distribution in tissue-specific insulin resistance and in response to a 12-week isocaloric dietary macronutrient intervention

Trouwborst,

Jardon,

Gijbels

et al. 2024

Nutr Metab (Lond)

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Background Body composition and body fat distribution are important predictors of cardiometabolic diseases. The etiology of cardiometabolic diseases is heterogenous, and partly driven by inter-individual differences in tissue-specific insulin sensitivity. Objectives To investigate (1) the associations between body composition and whole-body, liver and muscle insulin sensitivity, and (2) changes in body composition and insulin sensitivity and their relationship after a 12-week isocaloric diet high in mono-unsaturated fatty acids (HMUFA) or a low-fat, high-protein, high-fiber (LFHP) diet. Methods This subcohort analysis of the PERSON study includes 93 individuals (53% women, BMI 25–40 kg/m2, 40–75 years) who participated in this randomized intervention study. At baseline and after 12 weeks of following the LFHP, or HMUFA diet, we performed a 7-point oral glucose tolerance test to assess whole-body, liver, and muscle insulin sensitivity, and whole-body magnetic resonance imaging to determine body composition and body fat distribution. Both diets are within the guidelines of healthy nutrition. Results At baseline, liver fat content was associated with worse liver insulin sensitivity (β [95%CI]; 0.12 [0.01; 0.22]). Only in women, thigh muscle fat content was inversely related to muscle insulin sensitivity (-0.27 [-0.48; -0.05]). Visceral adipose tissue (VAT) was inversely associated with whole-body, liver, and muscle insulin sensitivity. Both diets decreased VAT, abdominal subcutaneous adipose tissue (aSAT), and liver fat, but not whole-body and tissue-specific insulin sensitivity with no differences between diets. Waist circumference, however, decreased more following the LFHP diet as compared to the HMUFA diet (-3.0 vs. -0.5 cm, respectively). After the LFHP but not HMUFA diet, improvements in body composition were positively associated with improvements in whole-body and liver insulin sensitivity. Conclusions Liver and muscle insulin sensitivity are distinctly associated with liver and muscle fat accumulation. Although both LFHP and HMUFA diets improved in body fat, VAT, aSAT, and liver fat, only LFHP-induced improvements in body composition are associated with improved insulin sensitivity. Trial registration NCT03708419 (clinicaltrials.gov).

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Body composition and body fat distribution in tissue-specific insulin resistance and in response to a 12-week isocaloric dietary macronutrient intervention

Trouwborst,

Jardon,

Gijbels

et al. 2024

Nutr Metab (Lond)

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“…Additionally, modulation of gut microbiota by fiber administration has an impact on metabolic health and insulin sensitivity, which is partly driven by the metabolic phenotype. A recent study conducted in a cohort of adult and older patients with wither liver- or muscle specific insulin resistance demonstrated that the latter group showed the highest benefit from a dietary intervention based on macronutrient manipulation, including high fiber intake [ 105 ]. These findings emphasize the complexity and heterogeneity of the interindividual metabolic and antiinflammatory responses to dietary fiber and justify the lack of data in the acute care setting.…”

Section: Discussionmentioning

confidence: 99%

Impact of Dietary Fiber on Inflammation and Insulin Resistance in Older Patients: A Narrative Review

et al. 2023

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The beneficial impact of dietary fiber on the prevention and management of several chronic conditions associated with aging, including diabetes, neurodegenerative, cardiovascular diseases, and cancer, is well-known. High fiber intake has been associated with reduced inflammatory mediators counteracting the low-grade chronic inflammation typical of older age. In addition, dietary fiber improves postprandial glucose response and insulin resistance. In contrast, during acute diseases, its effects on insulin resistance and modulation of immune response are unclear. The aim of this narrative is to summarize the evidence for the potential impact of dietary fiber on inflammation and insulin resistance in older adults, with a particular focus on those acutely ill. Available evidence suggests that dietary fiber has the potential to counteract acute inflammation and to improve metabolic health. In addition, modulation of gut microbiota composition may contribute to improved immune function, particularly in the setting of aging-associated dysbiosis. This phenomenon has relevant implications in those acutely ill, in whom dysbiosis can be exacerbated. Our review leads to the conclusion that dietary interventions based on fiber manipulation could exploit its beneficial effects on inflammation and insulin resistance, if conducted from a precision nutrition perspective. This could also be true for the acutely ill patient, even though strong evidence is lacking.

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“…For example, the graded diagnosis and comprehensive evaluation of clinical malnutrition, determining the priority of driving and reversible factors of malnutrition for guiding formulation and implementation of clinical nutrition management [94][95][96] ; the precision nutritional gene and metabolic testing, determination of special genetic and metabolic phenotypes, for guiding individualized precision nutrition care [97] ; and the detection and assessment of insulin resistance and chronic systemic inflammation in addition to routine body composition analysis for guiding the prevention and treatment of obesityrelated metabolic disorders and NCDs. [98] Therefore, nutritional diagnosis is a highly professional task involving a wide range of fields, including diets, diseases, genomics, and metabolomics. It is suggested to establish an independent medical technology department for nutritional diagnosis in order to conduct effective and refined nutritional diagnosis.…”

Section: Outlook and Future Perspectivesmentioning

confidence: 99%

Nutritional care is the first-line therapy for many conditions

Hu,

Barazzoni,

Shi

2023

Precision Nutrition

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Cardiometabolic health improvements upon dietary intervention are driven by tissue-specific insulin resistance phenotype: A precision nutrition trial

Cited by 25 publications

References 57 publications

Body composition and body fat distribution in tissue-specific insulin resistance and in response to a 12-week isocaloric dietary macronutrient intervention

Body composition and body fat distribution in tissue-specific insulin resistance and in response to a 12-week isocaloric dietary macronutrient intervention

Impact of Dietary Fiber on Inflammation and Insulin Resistance in Older Patients: A Narrative Review

Nutritional care is the first-line therapy for many conditions

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