1. Analysis of the SYSDIET Healthy Nordic Diet randomized trial based on metabolic profiling reveal beneficial effects on glucose metabolism and blood lipids
- Author
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Gözde Gürdeniz, Matti Uusitupa, Kjeld Hermansen, Markku J. Savolainen, Ursula Schwab, Marjukka Kolehmainen, Lea Brader, Lieselotte Cloetens, Karl-Heinz Herzig, Janne Hukkanen, Fredrik Rosqvist, Stine Marie Ulven, Ingibjörg Gunnarsdóttir, Inga Thorsdottir, Matej Oresic, Kaisa S. Poutanen, Ulf Risérus, Björn Åkesson, and Lars Ove Dragsted
- Subjects
Blood Glucose ,Male ,Lipoproteins ,Scandinavian and Nordic Countries ,Critical Care and Intensive Care Medicine ,Fasting/blood ,Overweight/complications ,Eating ,Glucose and lipid metabolism ,Healthy Nordic diet ,Lipoproteins/blood ,Faculty of Science ,Metabolomics/methods ,Humans ,Metabolomics ,Triglycerides ,Randomized Controlled Trials as Topic ,Eating/physiology ,Metabolic Syndrome ,Principal Component Analysis ,Nutrition and Dietetics ,Blood Glucose/metabolism ,LC–MS metabolomics ,Lipids/blood ,Cardiometabolic Risk Factors ,Fasting ,Middle Aged ,Overweight ,Plasma metabolite scores ,Lipids ,LC-MS metabolomics ,Metabolic Syndrome/complications ,Näringslära ,Triglycerides/blood ,Nutrition Assessment ,Randomized controlled trial ,Inflammation Mediators/blood ,Area Under Curve ,Female ,Diet, Healthy ,Inflammation Mediators ,Biomarkers/blood ,Diet, Healthy/methods ,Biomarkers - Abstract
Background & aims: Intake assessment in multicenter trials is challenging, yet important for accurate outcome evaluation. The present study aimed to characterize a multicenter randomized controlled trial with a healthy Nordic diet (HND) compared to a Control diet (CD) by plasma and urine metabolic profilesand to associate them with cardiometabolic markers. Methods: During 18e24 weeks of intervention, 200 participants with metabolic syndrome were advised at six centres to eat either HND (e.g. whole-grain products, berries, rapeseed oil, fish and low-fat dairy) or CD while being weight stable. Of these 166/159 completers delivered blood/urine samples. Metabolicprofiles of fasting plasma and 24 h pooled urine were analysed to identify characteristic diet-related patterns. Principal components analysis (PCA) scores (i.e. PC1 and PC2 scores) were used to test their combined effect on blood glucose response (primary endpoint), serum lipoproteins, triglycerides, andinflammatory markers.Results: The profiles distinguished HND and CD with AUC of 0.96 ± 0.03 and 0.93 ± 0.02 for plasma and urine, respectively, with limited heterogeneity between centers, reflecting markers of key foods. Markers of fish, whole grain and polyunsaturated lipids characterized HND, while CD was reflected by lipidscontaining palmitoleic acid. The PC1 scores of plasma metabolites characterizing the intervention is associated with HDL (β = 0.05; 95% CI: 0.02, 0.08; P = 0.001) and triglycerides (β = 0.06; 95% CI: -0.09, -0.03; P < 0.001). PC2 scores were related with glucose metabolism (2 h Glucose, β = 0.1; 95% CI: 0.05, 0.15; P < 0.001), LDL (β = 0.06; 95% CI: 0.01, 0.1; P = 0.02) and triglycerides (β 0.11; 95% CI: 0.06, 0.15; P < 0.001). For urine, the scores were related with LDL cholesterol. Conclusions: Plasma and urine metabolite profiles from SYSDIET reflected good compliance with dietary recommendations across the region. The scores of metabolites characterizing the diets associated with outcomes related with cardio-metabolic risk. Our analysis therefore offers a novel way to approach a per protocol analysis with a balanced compliance assessment in larger multicentre dietary trials.The study was registered at clinicaltrials.gov with NCT00992641.
- Published
- 2022