Background
Diets high in acid load may contribute to kidney function impairment. This study aimed to investigate the association between dietary acid load and 1-year changes in glomerular filtration ...rate (eGFR) and urine albumin/creatinine ratio (UACR).
Methods
Older adults with overweight/obesity and metabolic syndrome (mean age 65 ± 5 years, 48% women) from the PREDIMED-Plus study who had available data on eGFR (
n
= 5,874) or UACR (
n
= 3,639) at baseline and after 1 year of follow-up were included in this prospective analysis. Dietary acid load was estimated as potential renal acid load (PRAL) and net endogenous acid production (NEAP) at baseline from a food frequency questionnaire. Linear and logistic regression models were fitted to evaluate the associations between baseline tertiles of dietary acid load and kidney function outcomes. One year-changes in eGFR and UACR were set as the primary outcomes. We secondarily assessed ≥ 10% eGFR decline or ≥10% UACR increase.
Results
After multiple adjustments, individuals in the highest tertile of PRAL or NEAP showed higher one-year changes in eGFR (PRAL, β: –0.64 ml/min/1.73 m
2
; 95% CI: –1.21 to –0.08 and NEAP, β: –0.56 ml/min/1.73 m
2
; 95% CI: –1.13 to 0.01) compared to those in the lowest category. No associations with changes in UACR were found. Participants with higher levels of PRAL and NEAP had significantly higher odds of developing ≥10% eGFR decline (PRAL, OR: 1.28; 95% CI: 1.07–1.54 and NEAP, OR: 1.24; 95% CI: 1.03–1.50) and ≥10 % UACR increase (PRAL, OR: 1.23; 95% CI: 1.04–1.46) compared to individuals with lower dietary acid load.
Conclusions
Higher PRAL and NEAP were associated with worse kidney function after 1 year of follow-up as measured by eGFR and UACR markers in an older Spanish population with overweight/obesity and metabolic syndrome.
Los objetivos de este trabajo son desarrollar una adaptación española para jóvenes del Cuestionario de Actitudes ante Situaciones de Agravio en su versión familia (CASA-F; Moreno y Pereyra, 2000), ...analizar las diferencias en las actitudes ante el agravio en función del género y la creencia religiosa y establecer el poder predictivo del género, la creencia religiosa y el clima social familiar sobre las actitudes ante la ofensa de personas significativas. Los participantes fueron 230 jóvenes (edad media= 21.2), 130 mujeres y 100 hombres, quienes cumplimentaron el cuestionario CASA-F y la escala de Clima Social Familiar de Moos, Moos y Trickett (1995). Respecto al primer objetivo, los resultados apoyaron la estructural factorial del CASA-F alcanzándose adecuados criterios psicométricos. Respecto al segundo objetivo, se obtuvieron diferencias en las actitudes ante el agravio en función del género y la creencia religiosa. Por último, los análisis de regresión múltiple confirmaron la capacidad predictiva del género, la creencia religiosa y el clima social familiar sobre las actitudes prosociales de perdón y explicación.
Abstract only Introduction: Short sleep duration is associated with increased cardiometabolic risk. DNA methylation plays a critical role in the regulation of gene expression and studies suggest that ...sleep deprivation may alter DNA-methylation patterns. However, most findings are from acute sleep deprivation or short duration studies. Hypothesis: Prolonged sleep restriction study that mimics real-life situations is associated with differentially methylated CpG loci (DML) in the core clock candidate genes and across the epigenome in an epigenome-wide association study (EWAS) Methods: Sixty participants (65% women) aged 21-73 y were included in randomized crossover studies with 2 phases of 6 weeks each. Phases differed in sleep duration: either adequate sleep (AS; sleep ≥7h/night) or sleep restriction (SR; -1.5h/night relative to AS). DNA was isolated from whole blood at wk 0 and wk 6 of each phase. DNA methylation (DNAm) was quantified the Illumina Infinium MethylationEPIC BeadChip array v.2.0 (>900K methylation sites) and Partek Genomic Suite v.720.0831. After quality control and normalization, several global and stratified EWASs were performed to test the impact of sleep condition on DNAm. Analyses were adjusted for week, phase, sex, age, BMI and cell type composition. We also focused on methylation changes of the selected core-clock candidate genes ( RORA, CRY1, NR1D2, TIMELESS, NPAS2, NFIL3, RORB, PER3, CSNK1E, ARNTL2, CRY2, CLOCK, ARNTL, RORC, PER2, BHLHE40, NR1D1, CSNK1D, BHLHE41 and PER1 ). Results: In the candidate gene approach, we detected several significant DML. Top-ranked DML in selected core clock genes with significant interactions between condition and time were: cg02394126 at ARNTL (p<0.001), cg23506964 at CLOCK (p=0.001), cg03701037 at NPAS2 (p=0.009), cg06606972 at NPAS2 (p=0.009), and cg13576304 at RORA (p=0.008). Hypermethylation was primarily observed after 6 wk of SR vs AS for cg02394126, cg23506964, cg03701037, and cg06606972, while hypomethylation was observed cg13576304 ( RORA ). In our EWAS, we detected some suggestive significant condition x time interactions in cg23738833 at SNHG3-RCC1 (p=1,34E-06), cg13280380 in the FAF1 gene (p=2,25E-05), cg03179866 in the MMP12 gene (p=2,78E-05), and cg13063696 (p=3,21E-05). All but cg23738833 ( SNHG3-RCC1 ) showed hypermethylation after 6 wk of SR vs AS. Conclusion: Six weeks of mild SR was associated with changes in DNAm in core-clock candidate genes and in other genes in the EWAS. However, further studies are needed to confirm these findings and determine the functional pathways.
Abstract only Background: Eating behavior is an important construct with predictive value for energy intake and is associated with health. Two characteristics of eating behavior, eating window and ...eating frequency, are consistently associated with cardiometabolic risk across populations and have been shown to be related to sleep patterns. Both lifestyle factors have been related to cardiometabolic diseases but no long-term study has analyzed the association between sleep and eating behavior. Objective: To analyze the link between eating behavior and diet quality in a randomized, crossover study of sleep restriction (SR) vs adequate sleep (AS). Methods: Sixty-one participants (68% women, 20-73y) underwent 2 phases of 6 wk each, AS (sleep ≥7 h/night) and SR (-1.5 h/night relative to AS). Energy intake, diet quality, number of eating occasions (any eating/drinking episode providing at least 210kJ separated by >15min) and eating window (time elapsed between the first and last eating occasion) were assessed at baseline, wk 3 and wk 6 of each phase using 3-d food records. Linear regression models were used to evaluate associations of eating behavior with diet quality by sleep condition, adjusting for confounding variables. Results: Participants had more eating occasions during SR compared to AS (β= 0.27±0.12, P=0.028). Duration of eating window also tended to be longer during SR compared to AS (β= 0.38±0.22, P=0.090). We then assessed the impact of these dietary behaviors on diet quality separately by condition. During AS, greater number of eating occasions was associated with greater energy intakes (β= 106.5±41.8, P=0.013), carbohydrates (β= 14.0±5.5, P=0.013), protein (β= 4.6±2.2, P=0.040), monounsaturated fat (β= 1.9±0.9, P=0.028), and fiber intakes (β= 2.1±0.8, P=0.010). Dietary glycemic index was also higher in those with greater eating occasions (β= 70.9±27.9, P=0.013). During SR, greater number of eating occasions was associated with greater energy intakes (β= 168.5±36.8, P<0.001), fat (β= 6.3±2.1, P=0.004), carbohydrates (β= 19.7±4.7, P<0.001), protein (β= 6.9±2.0, P<0.001), saturated fat (β= 1.6±0.8, P=0.043), monounsaturated fat (β= 2.9±0.9, P=0.002), sugar (β= 6.5±1.8, P<0.001), and fiber intakes (β= 2.2±0.7, P=0.003). Dietary glycemic index was also higher in those with greater eating occasions (β= 92.8±23.7, P<0.001). Findings were similar but less pronounced for eating window duration. Conclusions: Higher eating frequency is associated with higher intakes of energy and several macronutrients. However, in the context of SR, more frequent eating occasions is associated with a worse dietary profile, namely greater intakes of saturated fat and sugar.
Abstract only Introduction: Circadian rhythms regulate key physiological processes, including sleep-wake. Alterations in the circadian rhythm have been associated with greater risk of metabolic ...diseases. Genome-wide association studies (GWAS) have revealed genes variants associated with sleep phenotypes. Hypothesis: Polygenic risk scores (PRS) for significant SNPs reported in GWAS of chronotype (C), sleep duration (SD), and short sleep (SS, <7/h) are associated with metabolic parameters. Methods: We carried out a longitudinal analysis in 6,814 adults (aged 45-84 y at baseline) from the Multi-Ethnic Study of Atherosclerosis (MESA). Glucose, insulin, insulin resistance (HOMA-IR), body mass index (BMI) and waist circumference (WC) were assessed at baseline (2000-2002) and 16-18 y follow-up (Exam 6, N=3,303). DNA was extracted from whole blood, and genotyping data were obtained by the Affymetrix 6.0 SNP array. PRS for the following phenotypes were constructed as weight sum of genoma-wide significant alleles: 1) chronotype PRS-C; 2) continuous SD PRS-SD; and 3) SS duration PRS-SS. Multivariable linear regression models adjusted by sociodemographic, obesity, smoking, Mediterranean diet, physical activity and antidiabetic drugs were performed to assess associations between PRS and study outcomes (fasting glucose and insulin, HOMA-IR, hemoglobin A1c, BMI, and WC) cross-sectionally and longitudinally. Results: At baseline, none of the PRS were associated with glucose, insulin or HOMA-IR (p>0.05). A significant positive association was detected for PRS-C with BMI and WC: greater genetically determined morningness was associated with lower BMI (β=-20.0±3.0; p<0.001) and smaller WC (β=-44.1±8.0; p<0.001). Similar results were observed with PRS-SD (BMI: β=-0.1±0.0; p=0.005; WC: β=-0.3±0.1; p=0.008) and PRS-SS (BMI: β=9.3±2.8; p<0.001; WC: β=19.8±7.4; p=0.007). In longitudinal analyses, we observed prospective associations between PRS-C with BMI (β=-43.5±12.2; p<0.001), WC (β=-116.0.1±29.1; p<0.001), and glucose (β=-204.7±90.0; p=0.024). PRS-SS was longitudinally associated with HOMA-IR (β=214.1±88.0; p=0.017) and a trend was observed for hemoglobin A1c (β=-6.6±3.4; p=0.053), but not with anthropometrics parameters. No associations were noted for PRS-SD with obesity and glycemic outcomes in longitudinal analyses. Conclusion: In the MESA population, PRS for chronotype, sleep duration, and short sleep are associated with anthropometric but not with glycemic measures in cross-sectional analyses. However, PRS for chronotype and short sleep was associated with anthropometric and glycemic parameters in longitudinal analyses, suggesting the importance of genetic predisposition for morningness and adequate sleep duration for metabolic health.
Abstract only Introduction: Short sleep duration is associated with an increased risk of cardiovascular disease (CVD). Dyslipidemia is one of the main risk factors for CVD but the influence of sleep ...duration on this risk factor is, for the moment, inconclusive. Objective: The goal of this study is to test the impact of mild sleep restriction (SR), sustained for 6 wk, on the lipid profile of participants at risk of CVD. Methods: A randomized crossover study was carried out in 64 adults (68% women) aged 20-73 y with a BMI between 19.2-29.9 kg/m 2 . Participants habitually slept ≥7 h/night, verified by 2 wk of wrist actigraphy during screening. Participants underwent 2 sleep conditions of 6 wk each: AS and SR (a reduction of 1.5 h/night relative to AS). Lipid profile was determined from fasted blood samples collected at baseline, wk 3, wk 4 and wk 6 of each phase. In a subset of 34 women, we analyzed inflammatory markers: interleukin- 6 (IL-6), C-reactive protein (CRP) and tumor necrosis factor α (TNF-α). Linear mixed models were used to test the influence of sleep condition on change in lipid profile over time. We further performed Pearson correlations between change in inflammatory markers over each of the the 6-wk phases with lipids measures assessed at endpoint of the respective condition. Results: No effect of sleep condition on change in total cholesterol and triglyceride concentrations (β=0.40±1.80; p=0.83; β=0.43±2.38; p=0.86, respectively) was observed. LDL-C decreased over time, and this was more pronounced in SR compared to AS (β=-3.75±1.59; p=0.019). Similarly, HDL-C decreased over time, and this was less pronounced in SR compared to AS (β=1.78±0.64; p=0.006). Findings were similar in sub-group analyses by sex and menopausal status. Correlation analyses revealed trends for inverse correlations between IL-6 and total cholesterol (r=-0.299; p= 0.096), and LDL-C (r=-0.344; p=0.054) during SR. Also, a decrease in CRP during SR was correlated with higher HDL-C levels at endpoint (r=-0.545; p= 0.002). Conversely, in AS, we only detected a positive correlation between change in CRP and LDL-C at endpoint (r=0.354; p= 0.037). Conclusions: Six weeks of mild sleep restriction does not adversely impact lipid profile. However, this may be a maladaptive response to increases in inflammatory markers after a period of mild sleep restriction. Further studies are needed to confirm these findings.
Abstract
Introduction
Poor sleep health is a key determinant of obesity risk, largely explained by overconsumption of energy. Eating behavior characteristics are predictive of energy intake and ...weight change and may link sleep with risk factors for obesity. However, the relationships between sleep and dimensions of eating behavior, and potential individual differences in these relations, are not well characterized. Elucidating these relations may aid in the development of targeted strategies to mitigate obesity risk. Therefore, we aimed to 1) evaluate whether associations of sleep were related with eating behavior characteristics, 2) explore if these associations differed by sex.
Methods
This was a cross-sectional analysis of 179 adults aged 20–73 y (68.7% women; 64.8% with BMI≥25 kg/m2; 27.4% minority). Sleep was assessed over 2 wk using wrist actigraphy; eating behavior characteristics (dietary restraint, disinhibition and hunger) were measured with the Three-Factor Eating Questionnaire. Linear regression models were used to evaluate associations of sleep with eating behavior characteristics, adjusting for confounding variables. In separate models, sex was added as an interaction term and analyses were stratified when interactions were significant (p<0.10).
Results
Variable (sleep midpoint standard deviation >60 min) vs. stable sleep timing was associated with greater tendency towards hunger (β=0.84 ± 0.39, p=0.03). When evaluated on the continuous scale, lower sleep efficiency (β=-0.13 ± 0.05; p=0.01), longer wake after sleep onset (β=0.03 ± 0.01; p=0.01) and higher sleep fragmentation index (β=0.074 ± 0.036; p=0.041) were associated with higher dietary restraint. Sex influenced associations of sleep efficiency, sleep onset latency, and sleep fragmentation index with hunger. In men, but not women, lower sleep efficiency (β=-0.15 ± 0.05; p<0.01), longer sleep onset latency (β=0.17 ± 0.07; p=0.02) and higher sleep fragmentation index (β=0.11 ± 0.04; p<0.01) were associated with greater hunger.
Conclusion
Objective measures of sleep were associated with eating behaviors previously linked with obesity and its risk factors. Moreover, we provide evidence of sex-specific associations between poor sleep and tendency towards hunger. Our results suggest that, particularly in men, differences in eating behavior traits may underlie susceptibility to overeating in response to poor sleep.
Support (if any)
Supported by NIH grants R01HL128226 and R01HL142648 and AHA grant 16SFRN27950012 (PI: St-Onge).
Abstract only Introduction: Emerging evidence suggests that differences in the ability to perceive individual tastes; sweet, salt, sour, bitter and umami, may influence food intake - amount and ...variety, thereby influencing diet quality, energy balance and cardiometabolic disorders. Objective: To explore the relationship between perception of each taste and intake of different categories of fruits and vegetables. We hypothesized that greater perception of each taste will be inversely associated with amount consumed. Methods: A cross-sectional analysis was performed on baseline data from participants (N=379) in the University of Valencia center of the PREDIMED-PLUS Clinical Trial; a multi-center weight-loss primary prevention trial of cardiovascular disease, among community-dwelling adults in Spain aged 55-75y diagnosed with metabolic syndrome. Taste perception was determined by challenging subjects with solutions of standard tastants representing sweet, salt, sour, bitter, and umami (400 mM sucrose, 200 mM NaCl, 34 mM citric acid, 5.6 mM phenylthiocarbamide PTC, 200 mM monopotassium glutamate, respectively). Taste perception intensities were evaluated on a 0-5 scale. Food intake was assessed using a validated food frequency questionnaire. Outcomes included fruit and vegetable intake (servings/week), total and sub-groups (citrus and non-citrus fruits; cruciferous and non-cruciferous vegetables). Multivariable linear regression models were used to assess relationships between perception of each tastant and number of servings/week consumed, for total and square root-transformed sub-groups. Results: In the fully-adjusted models, controlling for sex, age, diabetes, smoking status, daily physical activity and weekly energy intake, there were inverse associations between sweet perception and intake of citrus fruit (β=-0.5; p<0.01) and total vegetables (β=-1.1; 95% CI -2.0, -0.2), particularly non-cruciferous vegetables (β=-1.0; p=0.02); and positive associations between salt perception and intake of total fruit (β=0.9; 95% CI 0.02, 1.7), particularly non-citrus fruit (β=0.6; p=0.03), sour perception and intake of cruciferous vegetables (β=0.1; p=0.04) and umami perception and intake of non-cruciferous vegetables (β=0.7; p=0.04). No significant associations were observed between bitter taste perception and fruit or vegetable intake. Conclusion: This marks the first exploration of taste perception as a determinant of fruit and vegetable intake among community-dwelling adults. Perception for each tastant differentially affected the amount and type of fruits and vegetables consumed, with sweet, salt, sour and umami perception emerging as significant predictors. These findings support a role of taste perception in guiding the amount and type of foods consumed, albeit in a more complex manner than originally hypothesized.
Dietary polyphenol intake is associated with improvement of metabolic disturbances. The aims of the present study are to describe dietary polyphenol intake in a population with metabolic syndrome ...(MetS) and to examine the association between polyphenol intake and the components of MetS. This cross-sectional analysis involved 6633 men and women included in the PREDIMED (PREvención con DIeta MEDiterranea-Plus) study. The polyphenol content of foods was estimated from the Phenol-Explorer 3.6 database. The mean of total polyphenol intake was 846 ± 318 mg/day. Except for stilbenes, women had higher polyphenol intake than men. Total polyphenol intake was higher in older participants (>70 years of age) compared to their younger counterparts. Participants with body mass index (BMI) >35 kg/m
reported lower total polyphenol, flavonoid, and stilbene intake than those with lower BMI. Total polyphenol intake was not associated with a better profile concerning MetS components, except for high-density lipoprotein cholesterol (HDL-c), although stilbenes, lignans, and other polyphenols showed an inverse association with blood pressure, fasting plasma glucose, and triglycerides. A direct association with HDL-c was found for all subclasses except lignans and phenolic acids. To conclude, in participants with MetS, higher intake of several polyphenol subclasses was associated with a better profile of MetS components, especially HDL-c.
PDF
