RESUMO
Adipose tissue total amount, distribution, and phenotype influence metabolic health. This may be partially mediated by the metabolic effects that these adipose tissue characteristics exert on the nearby and distant tissues. Thus, adipose tissue may influence the capacity of cells, tissues, and the organism to adapt fuel oxidation to fuel availability, i.e., their metabolic flexibility (MetF). Our aim was to systematically review the evidence for an association between adipose tissue characteristics and MetF in response to metabolic challenges in human adults. We searched in PubMed (last search on September 4, 2021) for reports that measured adipose tissue characteristics (total amount, distribution, and phenotype) and MetF in response to metabolic challenges (as a change in respiratory quotient) in humans aged 18 to <65 years. Any study design was considered, and the risk of bias was assessed with a checklist for randomized and non-randomized studies. From 880 records identified, 22 remained for the analysis, 10 of them measured MetF in response to glucose plus insulin stimulation, nine in response to dietary challenges, and four in response to other challenges. Our main findings were that: (a) MetF to glucose plus insulin stimulation seems inversely associated with adipose tissue total amount, waist circumference, and visceral adipose tissue; and (b) MetF to dietary challenges does not seem associated with adipose tissue total amount or distribution. In conclusion, evidence suggests that adipose tissue may directly or indirectly influence MetF to glucose plus insulin stimulation, an effect probably explained by skeletal muscle insulin sensitivity. Systematic Review Registration: PROSPERO [CRD42020167810].
RESUMO
RESUMEN La alimentación es un factor de riesgo modificable para el desarrollo de cáncer. El consumo de alimentos procesados y ultraprocesados se ha asociado a mayor riesgo de enfermedades crónicas no transmisibles. El objetivo de esta revisión es evaluar sistemáticamente la evidencia publicada sobre la relación entre el consumo de alimentos procesados y ultraprocesados con el desarrollo de distintos tipos de cáncer. Se realizó una búsqueda sistemática en la base de datos de Pubmed en los últimos 10 años. Se incluyeron estudios de cohorte, caso control o transversales que evaluaran riesgo de cáncer, no recidiva, en adultos y midieron la alimentación a través de encuestas o patrones dietarios. Dos autores revisaron de forma independiente títulos y resúmenes para seleccionar los artículos, posteriormente ambos realizaron una revisión de texto completo, extrajeron los datos y analizaron la calidad metodológica de los estudios incluidos. Los resultados contemplan las conclusiones de 18 estudios, cuatro estudios de cohorte, 13 caso-control y uno transversal. Catorce de los estudios incluidos asocian positivamente la ingesta de alimentos procesados y ultraprocesados con el desarrollo de algunos tipos de cáncer.
ABSTRACT Diet is a modifiable risk factor for the development of cancer. Consumption of processed and ultra-processed foods has been associated with an increased risk of chronic non-communicable diseases. The objective of this review is to systematically evaluate the published evidence on the relationship between the consumption of processed and ultra-processed foods with the development of different types of cancer. A systematic review of the Pubmed database was carried out for articles published in the last 10 years. Cohort, case-control or cross-sectional studies that evaluated cancer risk in adults, no cancer recurrence, and studies that evaluated diet through surveys or dietary patterns were included. Two authors independently reviewed titles and abstracts to select articles, and subsequently carried out a text review. Data was extracted and the methodological quality was analyzed of the included studies. The results contemplate the conclusions of 18 studies, four cohort studies, 13 case-control and one cross-sectional. Fourteen of the included studies showed a positive association between the intake of processed and ultra-processed foods and the development of cancer.
