Context Intermittent fasting (IF) is an effective strategy to the improvement of cardiometabolic health. Objective To examine the effects of IF on cardiometabolic risk factors and the gut microbiota in patients with metabolic syndrome (MS). Design Randomized clinical trial. Setting Community Health Service Center. Patients Adults with MS, 30-50 years of age. Intervention 8 weeks of “two-day” modified IF. Main Outcome Measure Cardiometabolic risk factors including body composition, oxidative stress, inflammatory cytokines, and endothelial function were assessed at baseline and 8 weeks. The diversity, composition, and functional pathways of the gut microbiota, as well as circulating gut-derived metabolites were also measured. Results 39 patients with MS were included: 21 in the IF group and 18 in the control group. On fasting days, participants in the IF group reduced 69% of the calorie intake compared to nonfasting days. The 8-week IF significantly reduced fat mass, ameliorated oxidative stress, modulated inflammatory cytokines, and improved the vasodilatory parameters. Furthermore, IF induced significant changes in gut microbiota communities, increased the production of short-chain fatty acids (SCFAs), and decreased the circulating levels of lipopolysaccharides (LPS). Gut microbiota alteration attributed to the IF was significantly associated with cardiovascular risk factors and resulted in distinct genetic shifts of carbohydrate metabolism in the gut community. Conclusion IF induces a significant alteration of the gut microbial community and functional pathways in a manner, which is closely associated with the mitigation of cardiometabolic risk factors. The study provides potential mechanistic insights into the prevention of adverse outcomes associated with MS.

BackgroundEpidemiological studies have demonstrated that high total protein intake was related to type 2 diabetes mellitus (T2DM) risks. However, few studies considered the impact of dietary pattern.ObjectiveWe examined the associations between protein intake and T2DM in different dietary patterns.MethodsWe used the demographic and dietary information of adults aged 18–75 years from the China Health and Nutrition Survey (2009), consisting of 4113 women and 4580 men. Dietary data was collected by using 24-h recalls combined with a food inventory for 3 consecutive days. Cluster analysis was used to classify subjects into groups, as determined by major sources of protein. Logistic regression models were used to calculate odds ratios (OR) and 95% confidence interval (95% CI) of T2DM according to the energy-adjusted protein intake.ResultsAll participants were divided into three patterns according to the dietary source of protein (legumes and seafood, red meat, refined grains). Overall, plant protein intake was significantly and inversely associated with T2DM. In the subgroup analysis by dietary patterns, extreme quartile of plant protein intake was also inversely related to T2DM in the “legumes and seafood” group [OR = 0.58, 95% CI (0.33–0.96)]. Total protein intake and animal protein intake were positively related to T2DM in the “red meat” group [OR: 3.12 (1.65–5.91) and 3.48 (1.87–6.60), respectively]. However, the association of animal protein intake was reversed in the “refined grains” group [OR = 0.55, 95% CI 0.32–0.89].ConclusionsThe association between protein intake and T2DM varies by dietary pattern. Dietary pattern may be considered into the recommendation of protein intake for diabetes prevention.

Background As a newly proposed diagnosis, data on the prevalence of metabolic dysfunction-associated fatty liver disease (MAFLD) is rare. We aimed to assess the prevalence and risk factors of MAFLD using new definition in the contemporary South China population. Methods In this population based, cross sectional study, a total of 5377 participants aged 30–79 years old were recruited from the South China between 2018 and 2019. MAFLD was diagnosed in subjects who have both hepatic steatosis and metabolic disorders according to the newly international expert consensus. The total prevalence of MAFLD and prevalence by sex and age was estimated. Demographic characteristics, history of disease, and lifestyle were recorded by participants on a questionnaire. Abdominal ultrasonography was performed and evaluated by experienced sonographers. Multivariable logistic regression was used to calculate the odds ratios (ORs) of MAFLD. Results Overall prevalence of MAFLD was 29.2% (95% confidence interval [CI] 28.0% to 30.5%). Prevalence was higher in women (31.7%) than in men (25.5%; p < 0.001 for sex difference) and in subjects aged 50 years or older (30.7%) than in those aged 30–49 years (19.8%; p < 0.001 for age difference). In participants diagnosed with MAFLD, the prevalence of overweight/obesity was up to 90.5%, type 2 diabetes (T2DM) and metabolic dysregulation were 25.0% and 62.2%, respectively. Risk factors for MAFLD included overweight/obesity (OR = 4.67; 95% CI, 3.76–5.83), T2DM (OR = 2.41, 95% CI, 1.68–3.47), hypertriglyceridemia (OR = 2.42, 95% CI, 2.03–2.87), high school education (OR = 1.50, 95% CI, 1.23–1.82), high income (OR = 1.22, 95% CI, 1.05–1.42). A lower risk of MAFLD was associated with high physical activity equivalent (OR = 0.71, 95% CI, 0.60–0.85). A U-shaped association of frequency of soups and ORs of MAFLD was found, the adjusted ORs (95% CI) of lower and higher frequency of soups were 1.58 (1.32–1.89) and 1.36 (1.13–1.63), respectively. Conclusions Our results showed a high prevalence of MAFLD in the general adult population in South China. Obesity has the greatest impact on MAFLD, physical activity and moderate consumption of soups might be the potential protective factors of MAFLD.

The aim of this study was to examine the association of circulating retinol-binding protein 4 (RBP4) levels with b-cell function across the spectrum of glucose tolerance from normal to overt type 2 diabetes. RESEARCH DESIGN AND METHODSA total of 291 subjects aged 35-60 years with normal glucose tolerance (NGT), newly diagnosed impaired fasting glucose or glucose tolerance (IFG/IGT), or type 2 diabetes were screened by a standard 2-h oral glucose tolerance test (OGTT) with the use of traditional measures to evaluate b-cell function. From these participants, 74 subjects were recruited for an oral minimal model test, and b-cell function was assessed with model-derived indices. Circulating RBP4 levels were measured by a commercially available ELISA kit. RESULTSCirculating RBP4 levels were significantly and inversely correlated with b-cell function indicated by the Stumvoll first-phase and second-phase insulin secretion indices, but not with HOMA of b-cell function, calculated from the 2-h OGTT in 291 subjects across the spectrum of glycemia. The inverse association was also observed in subjects involved in the oral minimal model test with b-cell function assessed by both direct measures and model-derived measures, after adjustment for potential confounders. Moreover, RBP4 emerged as an independent factor of the disposition index-total insulin secretion. CONCLUSIONSCirculating RBP4 levels are inversely and independently correlated with b-cell function across the spectrum of glycemia, providing another possible explanation of the linkage between RBP4 and the pathogenesis of type 2 diabetes.Retinol-binding protein 4 (RBP4), a 21-kDa protein that belongs to the lipocalin family, is primarily known as the principal retinol transporter in plasma. It is encoded by the RBP4 gene that maps to chromosome 10q23-q24, a region that has been shown to be associated with an increased risk of type 2 diabetes (1,2). Controversy still exists about the origin of the increased circulating RBP4 levels. RBP4 was originally recognized as an adipokine, with adipocytes being the main source expressing a considerable amount of RBP4 (3). In contrast, other studies identified RBP4 as a hepatokine, with hepatocytes being the major site for the synthesis and secretion of the circulating

The dietary supplementation of vegetable oils is known to improve the dietary energy density as well as milk fatty acid profile; however, the impacts on the milk foodome is largely unknown. This study investigated the effect of two different sources of unsaturated fatty acids, rapeseed oil and sunflower oil, as a feeding supplement on the milk foodome from dairy goats. Nine Danish Landrace goats at 42 ± 5 days in milk were allocated to three treatment groups for 42 days with three animals per group. A control group received a basal diet made of forage and concentrate at an 85:15 ratio. On top of the basal diet, the second and third groups received rapeseed oil or sunflower oil supplements at 4% of dry matter, respectively. Goat milk was sampled on days 14, 21, and 42. The milk foodome was measured using gas chromatography–mass spectrometry and proton nuclear magnetic resonance spectroscopy. The milk levels of 2-hydroxyisovaleric acid, oxaloacetic acid, and taurine were higher in the milk from goats fed with sunflower oil compared to the control group. More glucose-1-phosphate was found in the milk from goats fed with rapeseed oil compared to the control group. Amino acids, valine and tyrosine, and 2-hydroxyisovaleric acid and oxaloacetic acid were higher in the sunflower group compared to the rapeseed group, while the milk from the rapeseed-fed goats had greater levels of ethanol and 2-oxoglutaric acid compared to the sunflower group. Thus, results show that foodomics is suitable for studying how milk chemistry changes as a function of feeding regime.