Genetics may put a person at risk of high triglycerides, but adopting a healthy diet can help

Triglycerides, a type of fat in the blood, are essential for good health. However, having high triglycerides might increase a person’s risk of heart disease, and could be a sign of metabolic syndrome, a combination of high blood pressure, high blood sugar, and too much fat accumulation at the waist. People with metabolic syndrome have increased risks for heart disease, diabetes, and stroke.

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A new study from nutrition researchers at the University of Illinois shows that some individuals with variations of a “gene of interest” may be at an even higher risk of developing high triglycerides. Specifically, researchers looked at genetics and risk in a group of young Mexican adults. Despite genetic predisposition, the study shows that maintaining healthy body weight or changing diet can help reverse the risk. Katie Robinson, a former doctoral student in the U of I Division of Nutritional Sciences and fellow of the I-TOPP program, explains that the study is a collaboration between the University of Illinois and the Autonomous University of San Luis Potosi in Mexico (UASLP), also known as UP AMIGOS. “Obesity is a growing problem in the U.S. and Mexico. In the U.S., obesity affects over a third of our population. We’re concerned because obesity is associated with other diseases such as diabetes, heart disease, and high triglycerides,” Robinson explains. Compared to Caucasian groups, Hispanics in the U.S. have higher rates of type 2 diabetes and other obesity-related diseases. Of all Hispanic subgroups, those of Mexican heritage have one of the highest risks for obesity and associated diseases.”

The UP AMIGOS project addresses genetic and environmental factors associated with obesity and related conditions among younger adults in Mexico. “A lot of existing data are from Caucasian cohorts, which means we needed to replicate and better understand those findings in groups with different ethnicities. That’s the main goal of the UP AMIGOS project. “It was a great opportunity that we were able to look at this rich data set from young Mexican adults because we know that this population has a greater likelihood of developing not only obesity but also high triglycerides and diabetes,” Robinson adds. For the current study, Robinson was interested in a protein made in the liver called fetuin-A (FetA). “It’s an interesting marker connecting inflammation with obesity and its associated diseases,” she says. “FetA is a protein that is released from adipose tissue and also the liver. We know FetA is integral to insulin sensitivity, and that’s where most of the research has been done to look at its function.

“We also know that FetA is elevated in obesity and diabetes. Therefore, we were interested in looking at the genetic implication. If there are alterations or single nucleotide polymorphisms within the gene that codes for FetA, does that change somebody’s risk for obesity or the associated diseases?” To answer that, the researchers looked at bloodwork from 641 young Mexican adults to analyze biomarkers and genotypes. They also checked body mass index (BMI), took measurements of fasting glucose levels, and had the participants report on their dietary habits. From the genotyping, they were explicitly looking for occurrences of two mutations of the gene, AHSG, a gene that influences the protein FetA. They were interested in the association of those gene mutations with dietary intake, weight, and also biological markers of health.

The AHSG polymorphisms were found to be associated with triglycerides. Robinson explains the most critical finding is that one of these polymorphisms, or mutations, was associated with higher circulating triglycerides, but that correlation was very dependent on BMI and dietary intake, the relationship was exaggerated in individuals who were overweight. “So with an elevated BMI, we saw greater disorder within those carrying the risk genotype. But if these individuals who had the high-risk AHSG genotype had a lower BMI, their triglycerides were lower. It suggests that even if you carry the high-risk genotype, you don’t have a greater risk of high triglycerides if you can maintain a normal BMI or a lower BMI, which I think is a positive finding when we look at genetics.”

Robinson says diet also played a role in higher triglycerides. “Higher carbohydrate intake, specifically sugar or sucrose intake, was associated with elevated triglycerides. This association was mainly in one genotype group. The thought was perhaps these individuals are more sensitive to certain diets than the other genotype groups.” Regardless of genotype, elevated BMI was associated with higher triglycerides. Due to the relationship between FetA and diabetes, the researchers also wanted to see if there was an association with AHSG mutations and glucose, but surprisingly, they did not find any.

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While the study looked at relatively healthy young adults in a Mexican population, results were different than what has been observed in previous research from Caucasian groups. Robinson explains that they might have seen different results if they had looked at older Mexican adults with poorer health. Some good news from the study’s findings is that maintaining a healthy body weight often can overcome the effects of gene related metabolic disease and type 2 diabetes. “We know that genes aren’t everything,” Robinson says. “There are a lot of things we can do, behaviorally, to change our individual risk. It’s a silver lining in our research. We can’t modify our genetics, but we can modify our epigenomes and some behaviors. You can still have positive health outcomes.”

The results are also significant for the future of developing personalized nutrition as interventions for disease, Robinson says. “In practical terms, it would be ideal to start by understanding someone’s basic biology, which may influence how they’re metabolizing and utilizing the nutrients they are eating. It would be great to bring people in, find out where their biology is at, and then tailor a diet for them, but we need a lot more research before we get to that point.” Margarita Teran-Garcia, assistant professor in the Division of Nutritional Sciences and the Department of Human Development and Family Studies at U of I adds, “In order to advance the full potential of precision medical and nutritional sciences, there is a need to invest and create new sustained resources, financial and technological, to build the evidence base needed to guide clinical practice and strategic planning in public health.”

Adapted from:  Katie N. Robinson, Itzel Vazquez-Vidal, Courtney Marques, Flavia Cristina Drumond Andrade, Celia Aradillas-Garcia, Margarita Teran-Garcia. Circulating Triglycerides and the Association of Triglycerides with Dietary Intake Are Altered by Alpha-2-Heremans-Schmid Glycoprotein PolymorphismsJournal of Nutrigenetics and Nutrigenomics, 2017; 75 DOI: 10.1159/00047

Nutrition Nugget

Model healthy habits! Adults who choose low-fat or fat-free milk or yogurt show kids that dairy is an important part of a healthy eating style. When kids model this behavior, their growing bones will thank you.

WOD Nugget

Bitts: A pair of posts on the deck of a ship for fastening mooring lines or cables.

Inspiration Nugget

Sometimes all it takes is one small prayer to change someone's life.

 “When you come from the view that you’re fundamentally good rather than fundamentally flawed, as you see yourself speak or act out, as you see yourself repress, you will have a growing understanding that you’re not a bad person who needs to shape up but a good person with temporary, malleable habits that are causing you a lot of suffering. And then, in that spirit, you can become very familiar with these temporary but strongly embedded habits. We all carry around trunk loads of old habits, but very fortunately for us, they’re removable.”

~Pema ChÖdrÖn

 

 

GP referral to Weight Watchers avoided type 2 diabetes in third of patients (UK)

More than a third of patients at risk of developing type 2 diabetes who reside in the UK avoided developing the condition after they were referred by their family doctor (GP) to a diabetes prevention program delivered by the commercial weight management provider, Weight Watchers, finds research published in BMJ Open Diabetes Research & Care.

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The initiative also helped more than half of those referred either to reduce their risk of developing diabetes or to get their blood sugar levels back to normal. The number of people diagnosed with type 2 diabetes in the UK has increased from 1.4 to 2.9 million since 1996. An even more substantial increase can be seen in the United States (U.S.) with a rise from 7.6 to 23.4 million. A new diagnosis is made every 2 minutes, and by 2025, an estimated 5 million people in the UK and 53 million in the U.S. will have the condition. Horrifying statistics! Risk of developing type 2 diabetes is strongly influenced by lifestyle factors but can be significantly reduced by weight loss, achieved by eating less and exercising more.

The UK’s national health and social care guidance organization, the National Institute for Health and Care Excellence (NICE) says that certain commercial weight management providers, such as Weight Watchers, can help obese people shed pounds. A U.S. study showed that participation in a commercial weight management program succeeded in reversing progression to type 2 diabetes. However, the effectiveness of this approach in UK primary care has not been thoroughly evaluated. Therefore, the researchers identified 166 patients from 14 general practice surgeries at high risk of developing type 2 diabetes: Those with impaired glucose regulation known as pre-diabetes or non-diabetic hyperglycemia and with a body mass index (BMI) above 30 kg/m2.

These patients were then invited to contact Weight Watchers to book a place on their diabetes prevention program, which included a 90-minute induction session followed by 48 weekly group meetings. From among the 166 primary care referrals, 149 patients were eligible. Some 117 attended the induction, and 115 started the weekly sessions, representing a take-up rate of 70%, which is high for a lifestyle intervention, according to the researchers. The program focused on improving diet quality, reducing portion size, increasing physical activity levels, as well as boosting confidence in the ability to change and a commitment to the process.

Blood tests were repeated at 6 and 12 months to check risk factors, and any changes in weight were recorded by trained Weight Watcher staff. Analysis of the results showed that the initiative led to an average fall in HbA1c (a measure of average blood glucose levels over several weeks) of 2.84 mmol/mol after 12 months to levels regarded as standard. Blood glucose levels also returned to normal in more than a third (38%) of the patients and only 3% developed type 2 diabetes after 12 months. The average weight loss amounted to 10 kg (22lb) at the 12 month time point (a reduction in BMI of 3.2kg/m2).

The researchers acknowledge that not all patients at high risk go on to develop type 2 diabetes, added to which the referral numbers were low, based on the funding available, with few black or minority ethnic participants, men, or those on low incomes. Nevertheless, they conclude that the initiative has the potential to have considerable impact. “A UK primary care referral route partnered with this commercial weight management provider can deliver an effective diabetes prevention programme,” they write. “The lifestyle changes and weight loss achieved in the intervention translated into considerable reductions in diabetes risk, with an immediate and significant public health impact.”

Adapted from: Carolyn Piper, Agnes Marossy, Zoe Griffiths, Amanda Adegboye. Evaluation of a type 2 diabetes prevention program using a commercial weight management provider for non-diabetic hyperglycemic patients referred by primary care in the UKBMJ Open Diabetes Research & Care, 2017; 5 (1): e000418 DOI: 10.1136/bmjdrc-2017-000418

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Daily Nutrition Nugget

Add Protein To Your Breakfast! A protein-packed breakfast will reduce hunger later in the day. This doesn’t mean load up on three kinds of breakfast meats, instead add a hard-boiled egg or some Greek yogurt to your first meal of the day. Try a cup of plain Greek yogurt with some sliced almonds, mixed berries, honey and chia seeds mixed together.

Daily Inspiration Nugget 

People change for two main reasons: either their minds have been opened, or their hearts have been broken.

 

Too much sugar? Even ‘healthy people’ are at risk of developing heart disease

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Healthy people who consume high levels of sugar are at an increased risk of developing cardiovascular disease. A ground-breaking study from the University of Surrey found that a subject group of otherwise healthy men had increased levels of fat in their blood and fat stored in their livers after they had consumed a high sugar diet. The study, which has been published in Clinical Science, looked at two groups of men with either high or low levels of liver fat, and fed them a high or low sugar diet to find out if the amount of liver fat influences the impact of sugar on their cardiovascular health. The low sugar diet contained no more than 140 calories a day worth of sugar, an amount close to the recommended intake, while the high sugar diet contained 650 calories worth.

After 12 weeks on the high sugar diet, the men with a high level of liver fat, a condition known as non-alcoholic fatty liver disease (NAFLD), showed changes in their fat metabolism that are associated with an increased risk of cardiovascular disease, heart attacks and strokes. Fat metabolism is the biochemical process by which fats are transported and broken down in the blood, and used by the cells of the body. The results also revealed that when the group of healthy men with a low level of liver fat consumed a high amount of sugar, their liver fat increased and their fat metabolism became similar to that of the men with NAFLD.

Professor of Nutritional Metabolism, Bruce Griffin, said: “Our findings provide new evidence that consuming high amounts of sugar can alter your fat metabolism in ways that could increase your risk of cardiovascular disease. “While most adults don’t consume the high levels of sugar we used in this study, some children and teenagers may reach these levels of sugar intake by over-consuming fizzy drinks and sweets. This raises concern for the future health of the younger population, especially in view of the alarmingly high prevalence of NAFLD in children and teenagers, and exponential rise of fatal liver disease in adults.”

Adapted from: A. Margot Umpleby, Fariba Shojaee-Moradie, Barbara Fielding, Xuefei Li, Andrea Marino, Najlaa Alsini, Cheryl Isherwood, Nicola Jackson, Aryati Ahmad, Michael Stolinski, Julie Anne Lovegrove, Sigurd Johnsen, Jeewaka Mendis, John Wright, Malgorzata E Wilinska, Roman Hovorka, Jimmy Bell, Louise E Thomas, Gary Frost, Bruce Arthur Griffin. Impact of liver fat on the differential partitioning of hepatic triacylglycerol into VLDL subclasses on high and low sugar diets. Clinical Science, 2017; CS20171208 DOI: 10.1042/CS20171208

Nutrition Tip of the Day

Use fresh or dried herbs and spices or a salt-free seasoning blend in place of salt when cooking. Add a squeeze of fresh lemon or lime to add flavor to cooked foods.

Daily Inspiration 

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