Association of Dietary Inflammatory Potential in Metabolically Healthy and Metabolically Unhealthy Obese Individuals

Abstract Introduction: Currently, two types of phenotypes have been recognized in individuals who are obese. Among the factors related to lifestyle, diet has a relevant influence, although there is no consensus regarding the role of diet in metabolic phenotypes; furthermore, diet is a strong moderator of chronic systemic inflammation. Objective: Investigate dietary inflammatory potential between metabolic phenotypes and to compare the differences between anti-inflammatory and pro-inflammatory diets in individuals with the same phenotype. Methods: This is a cross-sectional observational study that utilized the database of 533 individuals divided into 4 groups, according to metabolic phenotype and dietary inflammatory characteristic. Sociodemographic, clinical, anthropometric and biochemical characteristics were evaluated and the inflammatory index of the diet was calculated. Results: The mean Dietary Inflammatory index (DII) of the total sample was 0.974±1.02, with a maximum of 4.34 and a minimum of −1.74. In the metabolically unhealthy groups, we found a statistical difference in relation to systolic blood pressure when comparing the anti-inflammatory [median 120 (110.0-130.0)] and pro-inflammatory diets [median 130 (120.0-140.0); p = 0.022], and mean isoprostane concentrations were lower in the metabolically healthy group with anti-inflammatory diet. In regression analysis, the only variable that demonstrated a higher risk of alterations in all groups when compared to the metabolically healthy and anti-inflammatory group were isoprostane concentrations. Conclusion: We are able to conclude that an anti-inflammatory diet is associated with lower oxidative stress in metabolically healthy obese, and a pro-inflammatory diet is associated with higher systolic blood pressure values.

One Size Does Not Fit All: The Need to Rethink the Metabolic Syndrome in Women

Abstract Metabolic syndrome (MetS) is increasing at epidemic proportions worldwide. MetS and its components are frequent among Brazilian women (41.8%). Women are affected by changes in adipose tissue distribution, lipid profile, insulin resistance (IR), and vascular remodeling during their lives. These changes result from the lack of estrogen after menopause. There have been various attempts to propose a uniform origin for the clustering of the MetS components, including genetics, IR, obesity, lifestyle, sleep disturbances, inflammation, fetal and neonatal programming, and disturbed circadian rhythm of the body functions. The proinflammatory and prothrombotic state in MetS is well-defined. Socioeconomic and lifestyle-related factors are also essential triggers of MetS, which is associated with a higher risk for coronary artery diseases (CAD) and stroke in women. Population measures in health and community medicine, such as continuing education on the importance of lifestyle change to reduce cardiovascular risks from early childhood, are fundamental strategies. Statins reduce high-sensitivity C-reactive protein blood levels and treat high cholesterol. According to the patient, hypoglycemic agents, such as dipeptidyl peptidase-4 (DPP-4) inhibitors, glucagon-like peptide-1(GLP-1a), and sodium-glucose transport protein 2 (SGLT2) inhibitors, in addition to metformin, have their indication due to their beneficial cardiometabolic and vascular effects. Angiotensin-converting enzyme inhibitor (ACEI) and angiotensin-receptor blocker (ARB) should be the first choice to treat hypertension in postmenopausal womem. The recognition of the different gender- and age-specific risk factors, allowing for specific and targeted interventions, is fundamental, especially for women.

Food Consumption and Health Outcomes in Women During the COVID-19 Pandemic

Abstract Background The COVID-19 pandemic has changed food consumption. Objective Evaluate the association between metabolic phenotypes, changes in food consumption during the pandemic, and health outcomes in obese women. Methods Cross-sectional observational study including 491 women without previous diagnosis of chronic diseases, evaluated according to metabolic phenotype. During the pandemic, a subsample was re-evaluated by online questionnaires via Google Forms. Analyzed anthropometric, biochemical, and dietary data as well as health outcomes (coronary artery disease, type 2 diabetes, hypertension, dyslipidemia or death). Information on mortality was collected from the Internal Affairs Office of the State of Rio de Janeiro and the Health Department of the State of Rio de Janeiro. Statistical analysis was performed using the statistical program SPSS 21, with Mann-Whitney test, Pearson's chi-squared, Spearman correlation, and binary logistic regression, at a significance level of 5%. Results The anthropometric, glucose, and lipid profiles showed significant differences between the metabolically healthy and metabolically unhealthy groups (p = 0.00). Before the pandemic, women in the metabolically unhealthy group had higher dietary intakes of lipids (p = 0.01), saturated fat (p = 0.01) and sodium (p = 0.04), during the pandemic, they consumed more energy (p = 0.04), lipids (p = 0.02), saturated fat (p = 0.02), proteins (p = 0.03) and sodium from ultra-processed foods (p = 0.03). Consequently, health outcomes were more prevalent in the metabolically unhealthy group (p = 0.00). Conclusion Observed that metabolically healthy women had qualitatively better food intake and fewer health outcomes throughout the study.

Effect of Hypoenergetic Diet Combined With Pumpkin Seed Flour Consumption on Obese Women

Abstract Background Dietary treatment containing fiber-rich foods may contribute to lowering weight in obese women. Objective To investigate the effect of a hypoenergetic diet combined with pumpkin seed flour (PSF) consumption on diet quality, anthropometric indices, and glucose and lipid metabolism in obese women. Methods We conducted a randomized, double-blind, placebo-controlled, 90-day clinical trial with obese women, distributed into the following two groups: hypoenergetic diet + placebo (PG) and hypoenergetic diet + pumpkin seed flour (PSFG). A total of 100 participants were included in the PSFG (n = 47) and PG (n = 53). We evaluated neck circumference (NC); waist to height ratio; conicity index; fat mass (FM); lipid profile; blood concentrations of glucose and insulin; homeostatic model assessment for insulin resistance (HOMA-IR); quantitative insulin sensitivity check index (QUICKI); and blood pressure at baseline, 30, 60, and 90 days. Dietary analysis was determined by differences between diet quality indices before and after prescribing the experimental diet. Chi-squared, Student's t-tests and analysis for repeated measures were used, and values were considered significant at p < 0.05. Results The dietary pattern improved after 90 days in both groups. The PSFG presented lower NC (p < 0.001), FM (p = 0.010), triglycerides (TG) (p = 0.025), insulin (p = 0.003), and HOMA-IR (p = 0.018). The PG presented a lower diastolic blood pressure (p = 0.004) and low-density lipoprotein cholesterol (LDL-c) (p = 0.056). Conclusion A hypoenergetic diet combined with PSF consumption contributes to lowering NC, FM, HOMA-IR, TG, and insulin concentrations.

Vegetarian Diets and Cardiovascular Risk in Women

Abstract Introduction: Vegetarian diets have favorable effects on cardiovascular risk, provided that they do not contain ultra-processed foods (UPF). Objective: To compare the metabolic profile, cardiovascular risk, body composition, and food consumption in vegan (VEG), lacto-ovo vegetarian (LOV), and omnivorous (OMNI) women. To verify the association between UPF consumption and cardiovascular risk. Methods: Cross-sectional study with 119 VEG (n = 43), LOV (n = 38), and OMNI (n = 38) women. Anthropometric and biochemical parameters and the Framingham risk score were assessed. Food consumption was assessed by means of a 3-day food register, and intake of macronutrients, micronutrients, and UPF was estimated. The correlation between UPF consumption and cardiovascular risk was assessed using Spearman's coefficient, with a significance level of 5%. Results: The groups showed low cardiovascular risk, without significant difference between them. The VEG and LOV groups had lower body mass index, neck circumference, body shape index, and systolic blood pressure (p < 0.05) than the OMNI group; greater consumption of carbohydrates, sugars, dietary fibers, micronutrients, beta-carotene, and carotenoids; and lower consumption of total fat, saturated fatty acids, and cholesterol (p < 0.05). Consumption of UPF was lower in the LOV group (5.7 [0.0- 19.8]) than in the OMNI group (14.9 [5.1 - 22.3]; p < 0.05). UPF consumption was associated with SBP (ρ = 0.439; p = 0.007) and blood sugar (ρ = 0.422; p = 0.010) in the VEG group, and in the LOV group it was inversely associated with LDL-c (ρ = −0.456; p = 0.010). Conclusion: Vegetarian women showed better body composition and dietary quality than OMNI women. It is important to take consumption of UPF in vegetarians into consideration, in order to improve cardiovascular risk in women.