Sex differences in the associations between adiposity distribution and cardiometabolic risk factors in overweight or obese individuals: a cross-sectional study

Abstract Background We aimed to assess the associations between adiposity distribution and cardiometabolic risk factors among overweight and obese adults in China, and to demonstrate the sex differences in these associations. Methods A total of 1221 participants (455 males and 766 females) were included in this study. Percentage of body fat (PBF) of the whole body and regional areas, including arm, thigh, trunk, android, and gynoid, were measured by the dual-energy X-ray absorptiometry method. Central adiposity was measured by waist circumference. Clustered cardiometabolic risk was defined as the presence of two or more of the six cardiometabolic risk factors, namely, high triglyceride, low high density lipoprotein, elevated glucose, elevated blood pressure, elevated high sensitivity C-reactive protein, and low adiponectin. Linear regression models and multivariate logistic regression models were used to assess the associations between whole body or regional PBF and cardiometabolic risk factors. Results In females, except arm adiposity, other regional fat (thigh, trunk, android, gynoid) and whole-body PBF are significantly associated with clustered cardiometabolic risk, adjusting for age, smoking, alcohol drinking, physical activity, and whole-body PBF. One-SD increase in Z scores of the thigh and gynoid PBF were significantly associated with 80 and 78% lower odds of clustered cardiometabolic risk (OR: 0.20, 95%CI: 0.12–0.35 and OR: 0.22, 95%CI: 0.12–0.41). Trunk, android and whole-body PBF were significantly associated with higher odds of clustered risk with OR of 1.90 (95%CI:1.02–3.55), 2.91 (95%CI: 1.75–4.85), and 2.01 (95%CI: 1.47–2.76), respectively. While in males, one-SD increase in the thigh and gynoid PBF are associated with 94% (OR: 0.06, 95%CI: 0.02–0.23) and 83% lower odds (OR: 0.17, 95%CI: 0.05–0.57) of clustered cardiometabolic risk, respectively. Android and whole-body PBF were associated with higher odds of clustered cardiometabolic risk (OR: 3.39, 95%CI: 1.42–8.09 and OR: 2.45, 95%CI: 1.53–3.92), but the association for trunk PBF was not statistically significant (OR: 1.16, 95%CI: 0.42–3.19). Conclusions Adiposity distribution plays an important role in the clustered cardiometabolic risk in participants with overweight and obese and sex differences were observed in these associations. In general, central obesity (measured by android PBF) could be the best anthropometric measurement for screening people at risk for CVD risk factors for both men and women. Upper body fat tends to be more detrimental to cardiometabolic health in women than in men, whereas lower body fat is relatively more protective in men than in women.

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Associations between trunk-to-peripheral fat ratio and cardiometabolic risk factors in elderly Japanese men: baseline data from the Fujiwara-kyo Osteoporosis Risk in Men (FORMEN) study

Environmental Health and Preventive Medicine ◽

10.1186/s12199-021-00959-9 ◽

2021 ◽

Vol 26 (1) ◽

Author(s):

Katsuyasu Kouda ◽

Yuki Fujita ◽

Kumiko Ohara ◽

Takahiro Tachiki ◽

Junko Tamaki ◽

...

Keyword(s):

Risk Factors ◽

Body Mass ◽

Body Fat ◽

Cardiometabolic Risk ◽

Density Lipoprotein ◽

Cardiometabolic Risk Factors ◽

Lipoprotein Cholesterol ◽

Whole Body ◽

User Group ◽

Osteoporosis Risk

Abstract Background Body mass-independent parameters might be more appropriate for assessing cardiometabolic abnormalities than weight-dependent indices in Asians who have relatively high visceral adiposity but low body fat. Dual-energy X-ray absorptiometry (DXA)-measured trunk-to-peripheral fat ratio is one such body mass-independent index. However, there are no reports on relationships between DXA-measured regional fat ratio and cardiometabolic risk factors targeting elderly Asian men. Methods We analyzed cross-sectional data of 597 elderly men who participated in the baseline survey of the Fujiwara-kyo Osteoporosis Risk in Men (FORMEN) study, a community-based single-center prospective cohort study conducted in Japan. Whole-body fat and regional fat were measured with a DXA scanner. Trunk-to-appendicular fat ratio (TAR) was calculated as trunk fat divided by appendicular fat (sum of arm and leg fat), and trunk-to-leg fat ratio (TLR) as trunk fat divided by leg fat. Results Both TAR and TLR in the group of men who used ≥ 1 medication for hypertension, dyslipidemia, or diabetes (“user group”; N = 347) were significantly larger than those who did not use such medication (“non-user group”; N = 250) (P < 0.05). After adjusting for potential confounding factors including whole-body fat, both TAR and TLR were significantly associated with low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglyceride, fasting serum insulin, and the insulin resistance index in the non-user group and non-overweight men in the non-user group (N = 199). Conclusion The trunk-to-peripheral fat ratio was associated with cardiometabolic risk factors independently of whole-body fat mass. Parameters of the fat ratio may be useful for assessing cardiometabolic risk factors, particularly in underweight to normal-weight populations.

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Effects of Nine-Month Lifestyle Intervention on Cardiometabolic Risk Factors: Sex Differences in Obese Individuals

Obesities ◽

10.3390/obesities1010003 ◽

2021 ◽

Vol 1 (1) ◽

pp. 29-35

Author(s):

Florent Besnier ◽

Anil Nigam ◽

Martin Juneau ◽

Valérie Guilbeault ◽

Elise Latour ◽

...

Keyword(s):

Risk Factors ◽

Body Composition ◽

Sex Differences ◽

Body Mass ◽

Cardiometabolic Risk ◽

Interval Training ◽

Cardiometabolic Risk Factors ◽

Obese Women ◽

Baseline Values ◽

High Intensity Interval

Limited data is available on the sex differences and individual responses of cardiometabolic parameters adjusted with potential confounders (i.e. sex, age, baseline values) after a longer term Mediterranean diet (MedD) and high intensity interval training (HIIT) in obese subjects. The objective of this study was to compare the effects of nine-month MedD counseling and supervised HIIT on cardiometabolic risk factors and individual responses in obese women (n = 99) and obese men (n = 35). Body composition (body mass, fat mass, lean body mass, waist circumference), cardiorespiratory fitness (METs), and cardiometabolic risk factors (blood pressure, blood sample variables) were measured at baseline and after nine months of a program combining MedD and HIIT two to three times a week. When adjusted with sex, age, and baseline values, obese women similarly improved their body composition, METs, and cardiometabolic risk factors vs. obese men. The proportion of responders according to clinical cutoff levels were the same in obese women and men. A longer MedD and HIIT intervention similarly improves body composition, cardiometabolic risk factors, and individual responses in obese women and men, even after adjustment of confounders (sex, age, baseline value).

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Effects of Extreme Weight Loss on Cardiometabolic Health in Children With Metabolic Syndrome: A Metabolomic Study

Frontiers in Physiology ◽

10.3389/fphys.2021.731762 ◽

2021 ◽

Vol 12 ◽

Author(s):

Jingxin Liu ◽

Lin Zhu ◽

Jing Liao ◽

Xiaoguang Liu

Keyword(s):

Risk Factors ◽

Metabolic Syndrome ◽

Weight Loss ◽

Body Composition ◽

Organic Acids ◽

Cardiometabolic Risk ◽

The Body ◽

Cardiometabolic Risk Factors ◽

Plasma Metabolites ◽

Cardiometabolic Health

Objectives: To evaluate the effect of extreme weight loss programs on circulating metabolites and their relationship with cardiometabolic health in children with metabolic syndrome.Methods: This study was a quasi-experimental design with a pretest and post-test. Thirty children with metabolic syndrome and aged 10–17years were recruited to an extreme weight loss program (i.e., exercise combined with diet control). The primary outcomes included plasma metabolites, body composition, and cardiometabolic risk factors. A total of 324 metabolites were quantitatively detected by an ultra-performance liquid chromatography coupled to tandem mass spectrometry system, and the variable importance in the projection (VIP) value of each metabolite was calculated by the orthogonal projection to latent structures discriminant analysis. The fold change (FC) and p value of each metabolite were used to screen differential metabolites with the following values: VIP>1, p value<0.05, and |log2FC|>0.25. Pathway enrichment and correlation analyses between metabolites and cardiometabolic risk factors were also performed.Result: A large effect size was observed, presenting a weight loss of −8.9kg (Cohen’s d=1.00, p<0.001), body mass index reduction of −3.3kg/m2 (Cohen’s d=1.47, p<0.001), and body fat percent reduction of −4.1 (%) (Cohen’s d=1.22, p<0.001) after the intervention. Similar improvements were found in total cholesterol (Cohen’s d=2.65, p<0.001), triglycerides (Cohen’s d=2.59, p<0.001), low-density lipoprotein cholesterol (Cohen’s d=2.81, p<0.001), glucose metabolism, and blood pressure. A total of 59 metabolites were changed after the intervention (e.g., aminoacyl-tRNA biosynthesis, glycine, serine, and threonine metabolism; nitrogen metabolism, tricarboxylic acid cycle, and phenylalanine, tyrosine, and tryptophan biosynthesis). The changes in metabolites (e.g., amino acids, fatty acids, organic acids, and carnitine) were related to lipid metabolism improvement (p<0.05). Organic acids and carnitines were associated with changes in the body composition (p<0.05).Conclusion: Exercise combined with dietary control improved the body composition and cardiometabolic health in children with metabolic syndrome, and these changes may be related to plasma metabolites.

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Baru Nut Intake and Resistance Training Practice Have Potential to Reduce the Cardiometabolic Risk Factors in Type 2 Diabetes

Current Nutrition & Food Science ◽

10.2174/1573401317666210420122023 ◽

2021 ◽

Vol 17 ◽

Author(s):

John Sebastião Cardoso da Silva ◽

Maria Sebastiana Silva ◽

Maria Margareth Veloso Naves

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Resistance Training ◽

Cardiometabolic Risk ◽

Nutritional Composition ◽

Cardiometabolic Risk Factors ◽

Cardiometabolic Health

Background: Type 2 diabetes mellitus (T2DM) is a disease associated with several cardiometabolic risk factors (CMRF). There is strong evidence about the benefits of oilseeds intake and the practice of resistance training (RT) in the prevention and treatment of T2DM and its associated CMRF. However, no study has evaluated the combination of these interventions yet. Baru nut, an oilseed native to the Brazilian Cerrado, stands out among oilseeds due to its healthy nutritional composition, which have the potential to reduce CMRF in T2DM. RT, in turn, provides positive changes in the composition and metabolism of muscle cells, which contributes to improving cardiometabolic health. Objective: This review aimed to summarize the effects and mechanisms related to the intake of baru nut and the practice of RT in reducing CMRF in T2DM. Method: Literature research was performed using the keywords "type 2 diabetes mellitus", "Dipteryx alata Vog", "nuts", "physical exercise" and "resistance training", isolated or associated, in Web of Science and Pubmed databases. Results: Baru nut is an oilseed with high density of nutrients and bioactive compounds with antioxidant and antihypercholesterolemic properties, and the RT is associated with beneficial effects on CMRF in T2DM individuals. Thus, the consumption of baru nut and the RT have potential to improve the insulin sensitivity, glycemic control, body composition, and serum lipid profile. Conclusion: The baru nut consumption and the RT have potential to reduce the cardiometabolic risk factors in T2DM. Both interventions are innovative and promising approaches to preserve the health of T2DM individuals.

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Abstract MP08: Higher Diet Quality is Associated with Lower Odds of Inflammation and Peripheral Artery Disease in the Hispanic Community Health Study/Study of Latinos

Circulation ◽

10.1161/circ.133.suppl_1.mp08 ◽

2016 ◽

Vol 133 (suppl_1) ◽

Author(s):

Josiemer Mattei ◽

Daniela Sotres-Alvarez ◽

Marc Gellman ◽

Sheila F Castaneda ◽

Frank B Hu ◽

...

Keyword(s):

Risk Factors ◽

High Risk ◽

Arterial Stiffness ◽

Diet Quality ◽

Cardiometabolic Risk ◽

Cardiometabolic Risk Factors ◽

Health Study ◽

Lower Odds ◽

Artery Disease ◽

Cardiometabolic Markers

Introduction: C-reactive protein (CRP; a marker of inflammation) and the ankle-brachial index (ABI; a marker of peripheral artery disease (PAD)) are considered emerging risk factors for cardiovascular disease (CVD) in addition to traditional cardiometabolic markers. Results on the association of a healthy diet and these emerging risk factors have been inconsistent, and few studies have been conducted on Hispanics/Latinos, who present high prevalence of cardiometabolic risk factors. Hypothesis: We hypothesized that higher diet quality as measured with the Alternate Healthy Eating Index (AHEI; range 0-110: lowest to highest quality) would be associated with lower odds of having high-risk levels of CRP and of ABI, independently from cardiometabolic risk factors. Methods: Baseline data were analyzed from US-Hispanics/Latinos aged 18-74y without previously-diagnosed CVD participating in the population-based Hispanic Community Health Study/Study of Latinos cohort. There were 14,623 participants with complete CRP data, and 7,892 with ABI data (measured only for those aged ≥45y). Food and nutrients components of AHEI were assessed from two 24-hour recalls. High-risk CRP was defined as >3.0 mg/L, and high-risk ABI was defined as <0.90 or >1.40, with further categorization into PAD (<0.90) and arterial stiffness (>1.40). Results: Nearly 35% of Hispanics/Latinos had high-risk CRP levels and 6.3% had high-risk ABI (4.2% had PAD and 2.1% had arterial stiffness). After adjusting for demographic, socioeconomic, and lifestyle factors, as well as cardiometabolic risk factors (diabetes, hypertension, obesity, or dyslipidemia), the odds (95% confidence interval) of having high-risk ABI were 36% (5, 43%) lower for each 10-unit increase in AHEI (p=0.020). The association remained significant for PAD alone, albeit attenuated (p=0.046), but not for arterial stiffness (p=0.210). Each 10-unit increase in AHEI was associated with 21% (10, 31%) lower odds of high-risk CRP(p=0.0003) after similar adjustments. There were no significant interactions between AHEI and sex, background, smoking, or cardiometabolic risk factors for the associations with ABI. The association of AHEI with high-risk CRP was stronger for those with diabetes (0.68 (0.52, 0.89) vs. 0.82 (0.71, 0.94) without diabetes; p-interaction=0.0002) and with obesity (0.70 (0.58, 0.85) vs. 0.86 (0.73, 1.01) without obesity; p-interaction=0.0001). Conclusions: A higher diet quality is associated with lower inflammation and PAD among Hispanics/Latinos, independently from traditional cardiometabolic risk factors. Promoting a healthy overall diet may benefit with further lowering CVD-risk related to emerging factors in a population that already presents high prevalence of cardiometabolic markers.

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Early Time-Restricted Feeding Improves 24-Hour Glucose Levels and Affects Markers of the Circadian Clock, Aging, and Autophagy in Humans

Nutrients ◽

10.3390/nu11061234 ◽

2019 ◽

Vol 11 (6) ◽

pp. 1234 ◽

Cited By ~ 61

Author(s):

Humaira Jamshed ◽

Robbie Beyl ◽

Deborah Della Manna ◽

Eddy Yang ◽

Eric Ravussin ◽

...

Keyword(s):

Gene Expression ◽

Risk Factors ◽

Circadian Clock ◽

Cardiometabolic Risk ◽

Cardiometabolic Risk Factors ◽

Cardiometabolic Health ◽

Intermittent Fasting ◽

Restricted Feeding ◽

Glucose Levels ◽

Diurnal Patterns

Time-restricted feeding (TRF) is a form of intermittent fasting that involves having a longer daily fasting period. Preliminary studies report that TRF improves cardiometabolic health in rodents and humans. Here, we performed the first study to determine how TRF affects gene expression, circulating hormones, and diurnal patterns in cardiometabolic risk factors in humans. Eleven overweight adults participated in a 4-day randomized crossover study where they ate between 8 am and 2 pm (early TRF (eTRF)) and between 8 am and 8 pm (control schedule). Participants underwent continuous glucose monitoring, and blood was drawn to assess cardiometabolic risk factors, hormones, and gene expression in whole blood cells. Relative to the control schedule, eTRF decreased mean 24-hour glucose levels by 4 ± 1 mg/dl (p = 0.0003) and glycemic excursions by 12 ± 3 mg/dl (p = 0.001). In the morning before breakfast, eTRF increased ketones, cholesterol, and the expression of the stress response and aging gene SIRT1 and the autophagy gene LC3A (all p < 0.04), while in the evening, it tended to increase brain-derived neurotropic factor (BNDF; p = 0.10) and also increased the expression of MTOR (p = 0.007), a major nutrient-sensing protein that regulates cell growth. eTRF also altered the diurnal patterns in cortisol and the expression of several circadian clock genes (p < 0.05). eTRF improves 24-hour glucose levels, alters lipid metabolism and circadian clock gene expression, and may also increase autophagy and have anti-aging effects in humans.

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Late eating is associated with cardiometabolic risk traits, obesogenic behaviors, and impaired weight loss

American Journal of Clinical Nutrition ◽

10.1093/ajcn/nqaa264 ◽

2020 ◽

Vol 113 (1) ◽

pp. 154-161 ◽

Cited By ~ 1

Author(s):

Hassan S Dashti ◽

Puri Gómez-Abellán ◽

Jingyi Qian ◽

Alberto Esteban ◽

Eva Morales ◽

...

Keyword(s):

Risk Factors ◽

Weight Loss ◽

Cardiometabolic Risk ◽

Cardiometabolic Risk Factors ◽

Cardiometabolic Health ◽

Activity Levels ◽

Weight Loss Intervention ◽

Meal Intake ◽

Intervention Protocol ◽

Obesogenic Behaviors

ABSTRACT Background There is a paucity of evidence regarding the role of food timing on cardiometabolic health and weight loss in adults. Objectives To determine whether late eating is cross-sectionally associated with obesity and cardiometabolic risk factors at baseline; and whether late eating is associated with weight loss rate and success following a weight loss intervention protocol. Also, to identify obesogenic behaviors and weight loss barriers associated with late eating. Methods Participants were recruited from a weight-loss program in Spain. Upon recruitment, the midpoint of meal intake was determined by calculating the midway point between breakfast and dinner times, and dietary composition was determined from diet recall. Population median for the midpoint of meal intake was used to stratify participants into early (before 14:54) and late (after 14:54) eaters. Cardiometabolic and satiety hormonal profiles were determined from fasting blood samples collected prior to intervention. Weekly weight loss and barriers were evaluated during the ∼19-wk program. Linear and logistic regression models were used to assess differences between late and early eaters in cardiometabolic traits, satiety hormones, obesogenic behaviors, and weight loss, adjusted for age, sex, clinic site, year of recruitment, and baseline BMI. Results A total of 3362 adults [mean (SD): age: 41 (14) y; 79.2% women, BMI: 31.05 (5.58) kg/m2] were enrolled. At baseline, no differences were observed in energy intake or physical activity levels between early and late eaters (P >0.05). Late eaters had higher BMI, higher concentrations of triglycerides, and lower insulin sensitivity compared with early eaters (all P <0.05) prior to intervention. In addition, late eaters had higher concentrations of the satiety hormone leptin in the morning (P = 0.001). On average, late eaters had an average 80 g lower weekly rate of weight loss [early, 585 (667) g/wk; late, 505 (467) g/wk; P = 0.008], higher odds of having weight-loss barriers [OR (95% CI): 1.22 (1.03, 1.46); P = 0.025], and lower odds of motivation for weight loss [0.81 (0.66, 0.99); P = 0.044] compared with early eaters. Conclusion Our results suggest that late eating is associated with cardiometabolic risk factors and reduced efficacy of a weight-loss intervention. Insights into the characteristics and behaviors related to late eating may be useful in the development of future interventions aimed at advancing the timing of food intake.

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Association between Circulating Osteocalcin and Cardiometabolic Risk Factors following a 4-Week Leafy Green Vitamin K-Rich Diet

Annals of Nutrition and Metabolism ◽

10.1159/000511660 ◽

2020 ◽

Vol 76 (5) ◽

pp. 361-367

Author(s):

Alexander Tacey ◽

Marc Sim ◽

Cassandra Smith ◽

Mary N. Woessner ◽

Elizabeth Byrnes ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Arterial Stiffness ◽

Plasma Glucose ◽

Cardiometabolic Risk ◽

Cardiometabolic Risk Factors ◽

Cardiometabolic Health ◽

Vitamin K1 ◽

Low Responders ◽

High Responders

Background: Evidence suggests that lower serum undercarboxylated osteocalcin (ucOC) may be negatively associated with cardiometabolic health. We investigated whether individuals with a suppression of ucOC following an increase in dietary vitamin K1 exhibit a relative worsening of cardiometabolic risk factors. Materials and Methods: Men (n = 20) and women (n = 10) aged 62 ± 10 years participated in a randomized, controlled, crossover study. The primary analysis involved using data obtained from participants following a high vitamin K1 diet (HK; 4-week intervention of increased leafy green vegetable intake). High and low responders were defined based on the median percent reduction (30%) in ucOC following the HK diet. Blood pressure (resting and 24 h), arterial stiffness, plasma glucose, lipid concentrations, and serum OC forms were assessed. Results: Following the HK diet, ucOC and ucOC/tOC were suppressed more (p < 0.01) in high responders (41 and 29%) versus low responders (12 and 10%). The reduction in ucOC and ucOC/tOC was not associated with changes in blood pressure, arterial stiffness, plasma glucose, or lipid concentrations in the high responders (p > 0.05). Discussion/Conclusion: Suppression of ucOC via consumption of leafy green vegetables has no negative effects on cardiometabolic health, perhaps, in part, because of cross-talk mechanisms.

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Does dog acquisition improve physical activity, sedentary behaviour and biological markers of cardiometabolic health? Results from a three-arm controlled study

BMJ Open Sport & Exercise Medicine ◽

10.1136/bmjsem-2019-000703 ◽

2020 ◽

Vol 6 (1) ◽

pp. e000703

Author(s):

Lauren Powell ◽

Kate M Edwards ◽

Adrian Bauman ◽

Paul McGreevy ◽

Anthony Podberscek ◽

...

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Cardiometabolic Risk ◽

Community Dwelling ◽

Cardiometabolic Risk Factors ◽

Analysis Of Covariance ◽

Controlled Study ◽

Cardiometabolic Health ◽

Community Control ◽

Sit To Stand

ObjectivesDog ownership has been associated with improved cardiometabolic risk factors, including physical activity. Most of the evidence originates from cross-sectional studies or populations with established disease. This study investigated changes in physical activity and other cardiometabolic risk factors following dog acquisition in a sample of 71 community-dwelling adults.MethodsParticipants self-allocated to three groups: 17 individuals acquired a dog within 1 month of baseline (dog acquisition), 29 delayed dog acquisition until study completion (lagged control) and 25 had no interest in dog acquisition (community control). Self-reported and thigh-worn accelerometer-based physical activity patterns, systolic and diastolic blood pressures, resting heart rate and VO2max were measured three times: baseline, 3 months and 8 months. Data were analysed using repeated measures analysis of covariance with owner age, season, sex and education included as covariates. Post hoc between-group tests were performed where there were significant overall effects (p<0.05).ResultsWe found significant effects in mean daily steps (F(4,64)=3.02, p=0.02) and sit-to-stand transitions (F(4,66)=3.49, p=0.01). The dog acquisition group performed an additional 2589 steps (p=0.004) and 8.2 sit-to-stand transitions (p=0.03) per day at 3 months, although these effects were not maintained at 8 months. We found a significant effect in self-reported weekly walking duration (F(4,130)=2.84, p=0.03) among the lagged control group with an 80 min increase between 3 and 8 months (p=0.04). Other cardiometabolic risk factors were unchanged following dog acquisition.ConclusionOur study provides encouraging results that suggest a positive influence of dog acquisition on physical activity in the short term but larger and more generalisable controlled studies are needed.Trial registration numberACTRN12617000967381.

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