Optimisation of a metabotype approach to deliver targeted dietary advice

Abstract Background Targeted nutrition is defined as dietary advice tailored at a group level. Groups known as metabotypes can be identified based on individual metabolic profiles. Metabotypes have been associated with differential responses to diet, which support their use to deliver dietary advice. We aimed to optimise a metabotype approach to deliver targeted dietary advice by encompassing more specific recommendations on nutrient and food intakes and dietary behaviours. Methods Participants (n = 207) were classified into three metabotypes based on four biomarkers (triacylglycerol, total cholesterol, HDL-cholesterol and glucose) and using a k-means cluster model. Participants in metabotype-1 had the highest average HDL-cholesterol, in metabotype-2 the lowest triacylglycerol and total cholesterol, and in metabotype-3 the highest triacylglycerol and total cholesterol. For each participant, dietary advice was assigned using decision trees for both metabotype (group level) and personalised (individual level) approaches. Agreement between methods was compared at the message level and the metabotype approach was optimised to incorporate messages exclusively assigned by the personalised approach and current dietary guidelines. The optimised metabotype approach was subsequently compared with individualised advice manually compiled. Results The metabotype approach comprised advice for improving the intake of saturated fat (69% of participants), fibre (66%) and salt (18%), while the personalised approach assigned advice for improving the intake of folate (63%), fibre (63%), saturated fat (61%), calcium (34%), monounsaturated fat (24%) and salt (14%). Following the optimisation of the metabotype approach, the most frequent messages assigned to address intake of key nutrients were to increase the intake of fruit and vegetables, beans and pulses, dark green vegetables, and oily fish, to limit processed meats and high-fat food products and to choose fibre-rich carbohydrates, low-fat dairy and lean meats (60–69%). An average agreement of 82.8% between metabotype and manual approaches was revealed, with excellent agreements in metabotype-1 (94.4%) and metabotype-3 (92.3%). Conclusions The optimised metabotype approach proved capable of delivering targeted dietary advice for healthy adults, being highly comparable with individualised advice. The next step is to ascertain whether the optimised metabotype approach is effective in changing diet quality.

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The Mediterranean Eating in Scotland Experience project: evaluation of an Internet-based intervention promoting the Mediterranean diet

British Journal Of Nutrition ◽

10.1079/bjn20051476 ◽

2005 ◽

Vol 94 (2) ◽

pp. 290-298 ◽

Cited By ~ 39

Author(s):

Angeliki Papadaki ◽

Jane A. Scott

Keyword(s):

Nutrition Education ◽

Mediterranean Diet ◽

Intervention Group ◽

Saturated Fat ◽

Hdl Cholesterol ◽

Control Group ◽

Monounsaturated Fat ◽

Feedback Intervention ◽

Intention To Treat ◽

The Mediterranean

A 6-month intervention study with a quasi-experimental design was conducted to evaluate the effectiveness of an Internet-based, stepwise, tailored-feedback intervention promoting four key components of the Mediterranean diet. Fifty-three (intervention group) and nineteen (control group) healthy females were recruited from the Universities of Glasgow and Glasgow Caledonian, Scotland, respectively. Participants in the intervention group received tailored dietary and psychosocial feedback and Internet nutrition education over a 6-month period, while participants in the control group were provided with minimal dietary feedback and general healthy-eating brochures. Internet education was provided via an innovative Mediterranean Eating Website. Dietary changes were assessed with 7 d estimated food diaries at baseline and 6 months, and data were analysed to calculate the Mediterranean Diet Score, a composite score based on the consumption of eight components of the traditional Mediterranean diet. The ‘intention-to-treat’ analyses showed that, at 6 months, participants in the intervention group had significantly increased their intake of vegetables, fruits and legumes, as well as the MUFA:saturated fatty acid ratio in their diet, and had significantly increased plasma HDL-cholesterol levels and a reduced ratio of total:HDL-cholesterol. Participants in the control group increased their intake of legumes but showed no other favourable significant changes compared with baseline. This Internet-based, tailored-feedback intervention promoting components of the Mediterranean diet holds promise in encouraging a greater consumption of plant foods, as well as increasing monounsaturated fat and decreasing saturated fat in the Scottish diet; it also shows that the Mediterranean diet can be adopted by healthy individuals in northern European countries.

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Metabolic Syndrome—Role of Dietary Fat Type and Quantity

Nutrients ◽

10.3390/nu11071438 ◽

2019 ◽

Vol 11 (7) ◽

pp. 1438 ◽

Cited By ~ 7

Author(s):

Peter Clifton

Keyword(s):

Blood Pressure ◽

Metabolic Syndrome ◽

Dietary Fat ◽

Saturated Fat ◽

Density Lipoprotein ◽

Hdl Cholesterol ◽

Fasting Insulin ◽

Polyunsaturated Fat ◽

Monounsaturated Fat ◽

The Impact

Background: Metabolic syndrome increases the risk of cardiovascular disease (CVD) over and above that related to type 2 diabetes. The optimal diet for the treatment of metabolic syndrome is not clear. Materials and Methods: A review of dietary interventions in volunteers with metabolic syndrome as well as studies examining the impact of dietary fat on the separate components of metabolic syndrome was undertaken using only recent meta-analyses, if available. Results: Most of the data suggest that replacing carbohydrates with any fat, but particularly polyunsaturated fat, will lower triglyceride(TG), increase high density lipoprotein (HDL) cholesterol, and lower blood pressure, but have no effects on fasting glucose in normal volunteers or insulin sensitivity, as assessed by euglycemic hyperinsulinemic clamps. Fasting insulin may be lowered by fat. Monounsaturated fat (MUFA) is preferable to polyunsaturated fat (PUFA) for fasting insulin and glucose lowering. The addition of 3–4 g of N3 fats will lower TG and blood pressure (BP) and reduce the proportion of subjects with metabolic syndrome. Dairy fat (50% saturated fat) is also related to a lower incidence of metabolic syndrome in cohort studies.

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Clues for the development of food-based dietary guidelines: how are dietary targets being achieved by UK consumers?

British Journal Of Nutrition ◽

10.1017/s0007114599000963 ◽

1999 ◽

Vol 81 (S1) ◽

pp. S119-S126 ◽

Cited By ~ 26

Author(s):

Steven J. Wearne ◽

Michael J. L. Day

Keyword(s):

Eating Habits ◽

Food Selection ◽

Saturated Fat ◽

Population Based ◽

Dietary Guidelines ◽

Dietary Advice ◽

Study Population ◽

Total Fat ◽

The Uk ◽

Starchy Foods

Expert scientific advice to the UK Government has been translated into eight general dietary guidelines, which form the core of population-based dietary advice in the UK and are supplemented by a food selection guide showing the types and proportions of foods needed for a balanced and healthy diet. Data from the Dietary and Nutritional Survey of British Adults were used to identify statistically significant differences between subgroups of the study population that met, or failed to meet, population nutritional goals for intakes of total fat, saturated fat and dietary fibre. Several eating habits — including greater consumption of starchy foods (particularly wholemeal varieties), greater consumption of fruit and the substitution of reduced-fat milk for whole-fat milk — were shared by the subgroups that met each of the nutritional goals. This analysis provides clues for any future refinement of food-based dietary guidelines.

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Dietary patterns among British adults: compatibility with dietary guidelines for salt/sodium, fat, saturated fat and sugars

Public Health Nutrition ◽

10.1017/s1368980011000875 ◽

2011 ◽

Vol 14 (8) ◽

pp. 1323-1336 ◽

Cited By ~ 15

Author(s):

Sigrid Gibson ◽

Margaret Ashwell

Keyword(s):

Dietary Patterns ◽

Meat Products ◽

Saturated Fat ◽

Principal Component ◽

Dietary Guidelines ◽

Dietary Advice ◽

Nutrition Survey ◽

Breakfast Cereals ◽

Dietary Records ◽

Males And Females

AbstractObjectiveTo examine dietary patterns among British adults, associations with Na and macronutrient intakes, and implications for dietary advice.DesignPrincipal component analysis of 7 d weighed dietary records.SubjectsAdults aged 19–64 years (n 1724).SettingNational Diet and Nutrition Survey (2000/2001).ResultsHigh Na intake was associated with more energy-dense diets, higher in fat and SFA (percentage of energy) but lower in non-milk extrinsic sugars (NMES). Eight patterns (PC1 to PC8) explained 40 % of the total variance in food intakes. Three patterns – PC3 (high loadings on bread, fats and cheese), PC2 (meat products, eggs and chips) and PC7 (red meat, sauces and alcohol) – were associated with high Na intake. Of these, PC3 correlated with high Na density and Na:K ratio, while PC2 correlated with fat. By contrast, three patterns – ‘health-conscious’ (PC1; vegetables, fruit, fruit juice, fish), ‘breakfast cereals and milk’ (PC6) and ‘chicken and rice’ (PC8) – were associated with modest Na intake, lower Na density and lower fat and SFA. PC2 was positively correlated, and PC1 was negatively correlated, with adding salt to food. Other patterns were ‘tea/coffee and cakes’ (PC4; associated with high SFA and NMES) and ‘soft drinks and snacks’ (PC5; associated with high NMES but not fat or SFA). The dietary patterns of males and females differed slightly.ConclusionsDietary patterns PC1, PC6, PC8 (vegetables, fruit, fish, milk, breakfast cereals, poultry) were broadly compatible with guidelines for salt, fat, SFA and NMES. However, other patterns tended to be high in either salt or NMES.

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Metabotyping for the development of tailored dietary advice solutions in a European population: the Food4Me study

British Journal Of Nutrition ◽

10.1017/s0007114517002069 ◽

2017 ◽

Vol 118 (8) ◽

pp. 561-569 ◽

Cited By ~ 13

Author(s):

Clare B. O’Donovan ◽

Marianne C. Walsh ◽

Clara Woolhead ◽

Hannah Forster ◽

Carlos Celis-Morales ◽

...

Keyword(s):

Saturated Fat ◽

Population Group ◽

Healthcare Setting ◽

European Population ◽

Dietary Advice ◽

Omega 3 ◽

Metabolic Markers ◽

Personalised Nutrition ◽

Individual Level ◽

Using Data

AbstractTraditionally, personalised nutrition was delivered at an individual level. However, the concept of delivering tailored dietary advice at a group level through the identification of metabotypes or groups of metabolically similar individuals has emerged. Although this approach to personalised nutrition looks promising, further work is needed to examine this concept across a wider population group. Therefore, the objectives of this study are to: (1) identify metabotypes in a European population and (2) develop targeted dietary advice solutions for these metabotypes. Using data from the Food4Me study (n 1607), k-means cluster analysis revealed the presence of three metabolically distinct clusters based on twenty-seven metabolic markers including cholesterol, individual fatty acids and carotenoids. Cluster 2 was identified as a metabolically healthy metabotype as these individuals had the highest Omega-3 Index (6·56 (sd 1·29) %), carotenoids (2·15 (sd 0·71) µm) and lowest total saturated fat levels. On the basis of its fatty acid profile, cluster 1 was characterised as a metabolically unhealthy cluster. Targeted dietary advice solutions were developed per cluster using a decision tree approach. Testing of the approach was performed by comparison with the personalised dietary advice, delivered by nutritionists to Food4Me study participants (n 180). Excellent agreement was observed between the targeted and individualised approaches with an average match of 82 % at the level of delivery of the same dietary message. Future work should ascertain whether this proposed method could be utilised in a healthcare setting, for the rapid and efficient delivery of tailored dietary advice solutions.

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Abstract MP12: Dietary Fatty Acids and Risk of Incident Atrial Fibrillation in the Women’s Health Study

Circulation ◽

10.1161/circ.129.suppl_1.mp12 ◽

2014 ◽

Vol 129 (suppl_1) ◽

Author(s):

Stephanie E Chiuve ◽

Roopinder K Sandhu ◽

M. V Moorthy ◽

Robert J Glynn ◽

Christine M Albert

Keyword(s):

Atrial Fibrillation ◽

Women’S Health ◽

Women's Health ◽

Dietary Fat ◽

Saturated Fat ◽

Dietary Guidelines ◽

Dietary Fatty Acids ◽

Dietary Fats ◽

Health Study ◽

Monounsaturated Fat

Background: Atrial fibrillation (AF) is the most common cardiac arrhythmia and a major risk factor for stroke, heart failure and mortality. Dietary fats may have effects on biologic pathways involved in inflammation, fibrosis, and cellular electrophysiology that influence the development and maintenance of AF. Prior studies evaluating the relationship between N-3 polyunsaturated fats and total AF events have had inconsistent results. Furthermore, few studies have reported the association between other dietary fats and incident AF or whether associations might differ by AF pattern. Methods: We followed 33,041 initially healthy women from the Women's Health Study, who were >45 years and free of AF at baseline in 1993. Intake of individual fats was calculated from a food frequency questionnaire administered at baseline. Self-reported AF was confirmed by EKG and medical record review. We defined AF patterns as paroxysmal (self-terminating for <7 days and no cardioversion), persistent (sustained >7 days and/or required cardioversion) and chronic (cardioversion failed / not attempted). Patterns were classified according to the most severe pattern within 2 years of AF onset and we combined persistent and chronic AF for analysis. We used isocaloric multivariable Cox proportional hazards models, adjusting for diet, lifestyle and clinical CVD risk factors, with a competing risk framework to evaluate whether dietary fats share equal associations across various AF patterns. Results: We documented 1286 cases of AF (821 paroxysmal & 423 persistent/chronic) over a median follow-up of 17.4 years. There was no significant association between any dietary fat and risk of incident AF. Saturated fat was associated with higher risk, and monounsaturated fat with lower risk of persistent/chronic AF. The RR (95%CI) for a substitution of 5% of energy from saturated fat for an equal percentage of energy from carbohydrates was 1.47 (1.02, 2.12) for persistent/chronic AF and 0.84 (0.64, 1.10) for paroxysmal AF (p, diff = 0.01). For monounsaturated fat, the RR for a 5% increment was 0.67 (0.45, 0.98) for persistent/chronic AF and 0.86 (0.73, 1.27) for paroxysmal AF, although the difference between patterns did not reach significance (p, diff = 0.12). Intake of N-3 and n-6 polyunsaturated fat and trans fat were not differentially associated with risk of paroxysmal or persistent/chronic AF. Conclusions: We observed no association between subclasses of dietary fat intake and total AF risk. Saturated fat was positively and monounsaturated fat was inversely associated with risk of persistent/chronic AF. Thus, improving dietary fat quality may help in the prevention of sustained forms of AF, which are often less amenable to treatment and associated with higher rates of morbidity. These results support AHA dietary guidelines to decrease intake of saturated fat for overall cardiovascular health.

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Milk minerals modify the effect of fat intake on serum lipid profile: results from an animal and a human short-term study

British Journal Of Nutrition ◽

10.1017/s0007114513003826 ◽

2013 ◽

Vol 111 (8) ◽

pp. 1412-1420 ◽

Cited By ~ 24

Author(s):

Janne K. Lorenzen ◽

Søren K. Jensen ◽

Arne Astrup

Keyword(s):

Total Cholesterol ◽

High Fat Diet ◽

Ldl Cholesterol ◽

Control Period ◽

Saturated Fat ◽

Hdl Cholesterol ◽

Cholesterol Concentration ◽

Control Group ◽

High Fat ◽

Milk Minerals

Despite a high content of saturated fat, evidence from observational studies indicates that the consumption of dairy products may have a neutral effect or may be inversely associated with the risk of CVD. We aimed to examine whether milk minerals modify the effect of saturated fat on serum lipid profile. We present data from two studies. Study I had a randomised, blinded, parallel design (n 24 pigs) with a 10 d adaptation period during which a high-fat diet was fed to the pigs and a 14 d intervention period during which the same diet either enriched with milk minerals (MM group) or placebo (control group) was fed to the pigs. Study II had a randomised cross-over design (n 9 men) where the subjects were fed either a high-fat diet enriched with milk minerals (MM period) or a regular diet (control period). In both the studies, blood variables were measured before and after the intervention and faecal and urine samples were collected at the end of the dietary periods. The increase in plasma total cholesterol and LDL-cholesterol concentrations but not in HDL-cholesterol concentration was markedly lowered by milk minerals in both the studies. In the animal study, baseline adjusted total cholesterol and LDL-cholesterol concentrations in the MM group were 11 % (P= 0·004) and 13 % (P= 0·03) lower compared with those in the control group after the intervention. Similarly in the human study, baseline adjusted total cholesterol and LDL-cholesterol concentrations were 6 % (P= 0·002) and 9 % (P= 0·03) lower after the MM period compared with those in the control period. HDL-cholesterol concentration was not lowered by milk minerals. These short-term studies indicate that the addition of milk minerals to a high-fat diet to some extent attenuates the increase in total cholesterol and LDL-cholesterol concentrations, without affecting HDL-cholesterol concentration.

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Can metabotyping help deliver the promise of personalised nutrition?

Proceedings of The Nutrition Society ◽

10.1017/s0029665115002347 ◽

2015 ◽

Vol 75 (1) ◽

pp. 106-114 ◽

Cited By ~ 18

Author(s):

Clare B. O'Donovan ◽

Marianne C. Walsh ◽

Michael J. Gibney ◽

Eileen R. Gibney ◽

Lorraine Brennan

Keyword(s):

Behaviour Change ◽

Population Level ◽

Dietary Advice ◽

Group Level ◽

Metabolic Phenotyping ◽

Personalised Nutrition ◽

Individual Level ◽

Tailored Interventions ◽

Novel Strategy ◽

Future Work

Over a decade since the completion of the human genome sequence, the promise of personalised nutrition available to all has yet to become a reality. While the definition was originally very gene-focused, in recent years, a model of personalised nutrition has emerged with the incorporation of dietary, phenotypic and genotypic information at various levels. Developing on from the idea of personalised nutrition, the concept of targeted nutrition has evolved which refers to the delivery of tailored dietary advice at a group level rather than at an individual level. Central to this concept is metabotyping or metabolic phenotyping, which is the ability to group similar individuals together based on their metabolic or phenotypic profiles. Applications of the metabotyping concept extend from the nutrition to the medical literature. While there are many examples of the metabotype approach, there is a dearth in the literature with regard to the development of tailored interventions for groups of individuals. This review will first explore the effectiveness of personalised nutrition in motivating behaviour change and secondly, examine potential novel ways for the delivery of personalised advice at a population level through a metabotyping approach. Based on recent findings from our work, we will demonstrate a novel strategy for the delivery of tailored dietary advice at a group level using this concept. In general, there is a strong emerging evidence to support the effectiveness of personalised nutrition; future work should ascertain if targeted nutrition can motivate behaviour change in a similar manner.

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US dietary guidelines: is saturated fat a nutrient of concern?

British Journal of Sports Medicine ◽

10.1136/bjsports-2018-099420 ◽

2018 ◽

Vol 53 (22) ◽

pp. 1393-1396 ◽

Cited By ~ 8

Author(s):

Zoe Harcombe

Keyword(s):

Public Health ◽

Total Energy ◽

Energy Intake ◽

Saturated Fat ◽

Total Energy Intake ◽

Dietary Guidelines ◽

Dietary Advice ◽

Fat Consumption ◽

Dietary Guidelines For Americans ◽

Total Fat

US public health dietary advice was announced by the Select Committee on Nutrition and Human needs in 1977 and was followed by UK public health dietary advice issued by the National Advisory Committee on Nutritional Education in 1983. Dietary recommendations in both cases focused on reducing dietary fat intake; specifically to (i) reduce overall fat consumption to 30% of total energy intake and (ii) reduce saturated fat consumption to 10% of total energy intake. The recommendations were an attempt to address the incidence of coronary heart disease. These guidelines have been reiterated in the Dietary Guidelines for Americans since the first edition in 1980. The most recent edition has positioned the total fat guideline with the use of ‘Acceptable Macronutrient Distribution Ranges’. The range given for total fat is 20%–35% and the AMDR for saturated fat is given as <10%—both as a percentage of daily calorie intake. In February 2018, the Center for Nutrition Policy and Promotion announced ‘The US Departments of Agriculture and Health and Human Services currently are asking for public comments on topics and supporting scientific questions to inform our development of the 2020–2025 Dietary Guidelines for Americans’. Public comments were invited on a number of nutritional topics. The question asked about saturated fats was: ‘What is the relationship between saturated fat consumption (types and amounts) during adulthood and risk of cardiovascular disease?’ This article is a response to that question.

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The role of unprocessed beef and lamb in the diets of Irish children and teenagers (5–17 years)

Proceedings of The Nutrition Society ◽

10.1017/s0029665120004012 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Jacqueline Lyons ◽

Christopher Cocking ◽

Laura Kehoe ◽

Breige McNulty ◽

Anne Nugent ◽

...

Keyword(s):

Vitamin D ◽

Dietary Intake ◽

Vitamin B12 ◽

Saturated Fat ◽

Dietary Guidelines ◽

Monounsaturated Fat ◽

Nutrient Intakes ◽

Food Composition Tables ◽

Total Fat ◽

Daily Intakes

AbstractIntroductionMeat is a nutrient-dense food that plays a central role in the diets of many children globally, contributing significantly to intakes of energy, protein and a number of essential micronutrients. However, nutritive quality is variable across meat types and cuts, and dietary guidelines across Europe typically encourage the consumption of lean meats whilst limiting the consumption of processed meats. The current work aimed to estimate intakes of unprocessed beef and lamb and their contribution to nutrient intakes in Irish children and teenagers.MethodsAnalyses were based on data from the Irish National Children's Food Survey (NCFS) (2003–2004; 5–12 years; n 594) and National Teens’ Food Survey (NTFS) (2005–2006; 13–17 years; n 441) (www.iuna.net). Both surveys used a 7-day weighed (NCFS) or semi-weighed (NTFS) food record to collect dietary intake data from nationally representative samples of Irish children. Dietary intake data were converted to nutrient data using WISP©, based on UK and Irish food composition tables. Unprocessed beef and lamb was defined as beef or lamb that had not undergone any preserving process other than chilling, freezing or salting, and included beef or lamb dishes that were wrapped in a controlled atmosphere. Meat intakes from composite dishes (e.g. beef lasagne) were estimated following disaggregation of the non-meat components. Statistical analyses were carried out using SPSS© v23.0.ResultsUnprocessed beef was consumed by 79% of children and 83% of teenagers, while unprocessed lamb was consumed by 19% of children and 20% of teenagers. Mean daily intakes of unprocessed beef were 21 g and 34 g in children and teenagers (consumers only), while mean daily intakes of unprocessed lamb were 14 g and 23 g. Unprocessed beef and lamb contributed 5–6% to mean daily energy intakes and contributed the following proportions to daily nutrient intakes in children and teenagers, respectively: protein (11%, 15%), total fat (7%, 9%), saturated fat (7%, 10%), monounsaturated fat (9%, 11%), iron (7%, 10%), zinc (18%, 23%), vitamin A (7%, 7%), vitamin D (12%, 16%), total niacin (9%, 13%), vitamin B6 (6%, 9%), vitamin B12 (15%, 22%), sodium (6%, 7%).DiscussionUnprocessed beef and lamb are valuable sources of nutrients for Irish children and teenagers. Relative to their energy contribution, they contribute higher proportions of a number of important nutrients, such as protein, zinc, vitamin D, vitamin B12 and total niacin, while contributing relatively small proportions of total fat, saturated fat and sodium. This research was funded by Meat Technology Ireland.

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