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The objective of the study was to assess associations of the rs9939609 FTO allele to glucose tolerance, hepatic and total insulin sensitivity (IS) in individuals with obesity. From a low-dose hyperinsulinemic euglycemic clamp with glucose-tracer, hepatic IS was assessed by rates of basal and suppressed glucose appearance (Ra), a measure of endogenous glucose production (EGP), and the hepatic insulin resistance index (HIR). Total IS was assessed by rates of glucose infusion (GIR), disappearance (Rd), and metabolic clearance (MCR). From a meal test we assessed IS by the Matsuda index and glucose tolerance by glucose and insulin measurements in the fasted state and postprandially for 2.5 h. The meal test was performed in 97 healthy individuals with BMI ≥35 in similar-sized risk-allele groups (n = 32 T/T, 31 A/T, and 34 A/A), and 79 of them performed the clamp. We analyzed outcomes separately for males and females, and adjusted glucose Ra, Rd, MCR, GIR, and HIR for fat mass. We did not find genotype effects on EGP. Among males, genotype A/A was associated with a significantly lower glucose Rd, MCR, and Matsuda index score relative to genotype T/T. Glucose tolerance was significantly lower in males with genotype A/T vs. T/T and A/A. For females, there were no genotype effects on hepatic or total IS, or on glucose tolerance. Independently of genotypes, females displayed a significantly better hepatic and total IS, and better glucose tolerance than males. We conclude that in subjects with similar obesity we did not register any FTO risk-allele effect on hepatic IS. A FTO risk-allele effect on total IS was registered in males only, findings which need to be reproduced in further studies. Results confirm marked differences in IS between the biological sexes and extend present knowledge by demonstrating a lower endogenous glucose production in females vs. males in uniformly obese individuals. Copyright: © 2021 de Soysa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Purpose The metabolic consequences of carrying a FTO obesity-promoting risk allele have not been fully elucidated and may be confounded by obesity per se. Against this background, we investigated the impact of FTO allele (SNP rs9939609) on fasting and postprandial energy expenditure and fasting substrate expenditure in a study population of uniformly and similarly obese individuals. Procedures We studied a similar number of participants with BMI classes 2–3 (median BMI 42.8 kg/m2) who were either homozygote for the non-risk allele TT (n = 33, numbers increased by enrichment), heterozygote (AT) (n = 32), or homozygote for the risk allele AA (n = 35). Major findings Basal metabolic rate and postprandial energy expenditure did not differ between FTO-groups. However, fasting respiratory quotient (RQ) was increased in those carrying ≥1 risk allele (p = 0.008), whereas postprandial RQ was not. Conclusion In this study population, the FTO-risk allele associates with fasting reduced fat and increased carbohydrate oxidation., Highlights • Fasting RQ associates with FTO risk allele in comparably obese subjects. • The association remained after adjusting for gender effects. • FTO risk not associated with meal-related energy utilization.

Gestational diabetes mellitus (GDM) is associated with maternal diet, however, findings are inconsistent. The aims of the present study were to assess whether intakes of foods and beverages during pregnancy differed between women who developed GDM and non-GDM women, and to compare dietary intakes with dietary recommendations of pregnancy. This is a longitudinal study using participants of a randomized controlled trial. Women with complete measurements of a 75 g oral glucose tolerance test (OGTT) at 18&ndash, 22 and 32&ndash, 36 weeks gestation were included in the cohort (n = 702). Women were diagnosed for GDM according to the simplified International Association of Diabetes and Pregnancy Study Group criteria at 32&ndash, 36 weeks (GDM women: n = 40, non-GDM women: n = 662). Dietary data (food frequency questionnaire) was collected at both time points and compared between GDM and non-GDM women. Variability in OGTT values was assessed in a general linear model. Marginal differences between GDM and non-GDM women in intakes of food groups were found. No associations were found between dietary variables and OGTT values. Not all dietary recommendations were followed in the cohort, with frequently reported alcohol consumption giving largest cause for concern. This study did not find dietary differences that could help explain why 40 women developed GDM.

Background Android fat distribution (abdominal obesity) is associated with insulin resistance, hepatic steatosis, and greater secretion of large very low‐density lipoprotein ( VLDL ) particles in men. Since abdominal obesity is becoming increasingly prevalent in women, we aimed to investigate the relationship between android fat and hepatic lipid metabolism in pre‐ and postmenopausal women. Methods and Results We used a combination of stable isotope tracer techniques to investigate intrahepatic fatty acid synthesis and partitioning in 29 lean and 29 abdominally obese women (android fat/total fat 0.065 [0.02 to 0.08] and 0.095 [0.08 to 0.11], respectively). Thirty women were premenopausal aged 35 to 45 and they were matched for abdominal obesity with 28 postmenopausal women aged 55 to 65. As anticipated, abdominal obese women were more insulin resistant with enhanced hepatic secretion of large (404±30 versus 268±26 mg/kg lean mass, P VLDL (160±11 versus 142±13). However, postmenopausal status had a pronounced effect on the characteristics of small VLDL particles, which were considerably triglyceride‐enriched (production ratio of VLDL 2 ‐ triglyceride:apolipoprotein B 30±5.3 versus 19±1.6, P r s =−0.49, P =0.006), de novo lipogenesis ( r s =0.55, P =0.003), and desaturation ( r s =0.48, P =0.012) were closely correlated with abdominal obesity‐driven large VLDL ‐triglyceride secretion rate. Conclusions In women, abdominal obesity is a major driver of hepatic large VLDL particle secretion, whereas postmenopausal status was characterized by increased small VLDL particle size. These data provide a mechanistic basis for the hyperlipidemia observed in postmenopausal obesity.

All-population and area-based investigations of diet in central obesity are scarce. We used cross-sectional data from 50 339 individuals who responded to the HUNT3 survey of 2006–2008, which recruited from all county-residing adults 20 years and older, to investigate whether those with central obesity eat and drink differently than others. Answers to dietary questions were recoded and analyzed with multiple linear regression, using waist/hip ratio (WHR), age, and sex as explanatory variables. Frequencies of consumption or amounts of food, beverages, and meals were compared among WHR quartiles. Central obesity was present in the quartile with the highest WHR, WHR4 (WHR ≥ 0.917 for women and 0.981 for men) but not in the quartile with the lowest WHR, WHR1 (WHR < 0.817 for women and 0.895 for men). Dietary variables differed markedly by age and sex. After adjustment for these factors and for multiple testing, we found significant differences between WHR4 and WHR1 for 19 of 30 dietary variables. Central obesity was associated with a lower intake of any bread, and of whole-grain bread in particular. Intake of fruits and berries, vegetables, and pasta and rice was less, and intake of sausages and hamburgers and boiled potatoes was more frequent. Intake of alcohol, tea, and fruit juice was lower in those with central obesity, whereas intake of sugar-free soft drinks and coffee was higher. The frequency of breakfast and lunch was lower and of nightly meals was higher in those with central obesity. In conclusion, in this large area-based population, central obesity was associated with differences in dietary habits, some of which (such as decreased consumption of whole-grain bread and increased intake of sugar-free drinks) are of possible clinical significance.

Objective: Review current knowledge about dietary habits among people with diabetes in Norway compared with the general population and nutrient- and food-based dietary recommendations. Method: Baseline dietary data from four intervention studies in subjects with type 2 diabetes, were merged (n=92) and compared with data extracted from a nationwide dietary survey, NORKOST, where participants with diabetes (n=115) were compared with a gender and age matched control group (n=575). A validated food frequency questionnaire was used for dietary assessment. An overview of previously published data from two studies among young people with type 1 diabetes was included for comparison. Results: Subjects with diabetes had an intake of carbohydrates in the lower recommended range and lower than the controls, which was reflected in a lower intake of added sugar, sweets, potatoes, sugar-sweetened beverages, and fruit juices. Subjects with diabetes had a fiber intake which was similar or higher than controls, but below the recommended intake. They reported a higher proportion of energy from protein and fat than controls, reflecting the higher intake of meat, fish, edible fats, and high-fat meat products. There was a higher intake of vegetables, fruits and whole grain among subjects with diabetes compared with controls, but also a higher intake of red meat. Conclusion: Compared with the recommendations, people with diabetes had a low intake of carbohydrates and a high intake of protein and fat, but they made more healthy choices regarding intake of selected food groups compared with the control groups. Copyright (c) 2015 Norsk epidemiologi Creative Commons License This work is licensed under a Creative Commons Attribution 4.0 International License.

Background Appetite-regulating hormones seem to play an important role in weight loss after bariatric surgery. Less is known regarding long-term weight loss maintenance. The objective of the study was to evaluate ghrelin and obestatin levels following long-term weight loss achieved through bariatric surgery or a lifestyle intervention in morbidly obese patients. Methods The study was cross-sectional in design carried out in a university research center setting. The participants were weight-stable morbidly obese patients who had undergone, on average, 3 years ago, Roux-en-Y gastric bypass (RYGB) surgery (n = 9) or a lifestyle weight loss intervention (n = 8), and patients on a waiting list for bariatric surgery (control group; n = 9). The main outcome measures were fasting/postprandial plasma levels of total ghrelin and obestatin and ghrelin/obestatin ratio. Results Fasting ghrelin and obestatin plasma levels were significantly elevated in the RYGB, but not in the lifestyle group, as compared with the control group. There was no statistical significant difference in fasting ghrelin/obestatin ratio among study groups. Ghrelin levels were suppressed after breakfast in all groups, with no significant differences in postprandial levels overtime between them. Obestatin levels did not change postprandially in any of the groups, but the area under the curve was significantly higher in the RYGB than in the control group. Conclusions Sustained weight loss maintenance seems to be associated with increased fasting levels of ghrelin and obestatin after RYGB surgery, but not after a lifestyle intervention, while maintaining ghrelin/obestatin ratio. Ghrelin is, therefore, unlikely to contribute to weight loss maintenance after RYGB, and other mechanisms are probably involved.