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Analysis of the SYSDIET Healthy Nordic Diet randomized trial based on metabolic profiling reveal beneficial effects on glucose metabolism and blood lipids

Analysis of the SYSDIET Healthy Nordic Diet randomized trial based on metabolic profiling reveal beneficial effects on glucose metabolism and blood lipids


Title: Analysis of the SYSDIET Healthy Nordic Diet randomized trial based on metabolic profiling reveal beneficial effects on glucose metabolism and blood lipids
Author: Gürdeniz, Gözde
Uusitupa, Matti
Hermansen, Kjeld
Savolainen, Markku J.
Schwab, Ursula
Kolehmainen, Marjukka
Brader, Lea
Cloetens, Lieselotte
Herzig, Karl Heinz
Hukkanen, Janne
... 9 more authors Show all authors
Date: 2022-02
Language: English
Scope: 11
University/Institute: Landspitali - The National University Hospital of Iceland
School: Health Sciences
Department: Faculty of Food Science and Nutrition
Other departments
Series: Clinical Nutrition; 41(2)
ISSN: 0261-5614
DOI: https://doi.org/10.1016/j.clnu.2021.12.031
Subject: Mataræði; Efnaskipti; Slembuð samanburðarrannsókn; Norðurlönd; SYSDIET Healthy Nordic Diet; Slembuð samanburðarrannsókn; Norðurlönd; SYSDIET Healthy Nordic Diet; Næringarfræðingar; Glucose and lipid metabolism; Healthy Nordic diet; LC–MS metabolomics; Plasma metabolite scores; Randomized controlled trial; Nutrition and Dietetics; Critical Care and Intensive Care Medicine
URI: https://hdl.handle.net/20.500.11815/3048

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Citation:

Gürdeniz , G , Uusitupa , M , Hermansen , K , Savolainen , M J , Schwab , U , Kolehmainen , M , Brader , L , Cloetens , L , Herzig , K H , Hukkanen , J , Rosqvist , F , Ulven , S M , Gunnarsdóttir , I , Þórsdóttir , I , Oresic , M , Poutanen , K S , Risérus , U , Åkesson , B & Dragsted , L O 2022 , ' Analysis of the SYSDIET Healthy Nordic Diet randomized trial based on metabolic profiling reveal beneficial effects on glucose metabolism and blood lipids ' , Clinical Nutrition , vol. 41 , no. 2 , pp. 441-451 . https://doi.org/10.1016/j.clnu.2021.12.031

Abstract:

Background & aims: Intake assessment in multicenter trials is challenging, yet important for accurate outcome evaluation. The present study aimed to characterize a multicenter randomized controlled trial with a healthy Nordic diet (HND) compared to a Control diet (CD) by plasma and urine metabolic profiles and to associate them with cardiometabolic markers. Methods: During 18–24 weeks of intervention, 200 participants with metabolic syndrome were advised at six centres to eat either HND (e.g. whole-grain products, berries, rapeseed oil, fish and low-fat dairy) or CD while being weight stable. Of these 166/159 completers delivered blood/urine samples. Metabolic profiles of fasting plasma and 24 h pooled urine were analysed to identify characteristic diet-related patterns. Principal components analysis (PCA) scores (i.e. PC1 and PC2 scores) were used to test their combined effect on blood glucose response (primary endpoint), serum lipoproteins, triglycerides, and inflammatory markers. Results: The profiles distinguished HND and CD with AUC of 0.96 ± 0.03 and 0.93 ± 0.02 for plasma and urine, respectively, with limited heterogeneity between centers, reflecting markers of key foods. Markers of fish, whole grain and polyunsaturated lipids characterized HND, while CD was reflected by lipids containing palmitoleic acid. The PC1 scores of plasma metabolites characterizing the intervention is associated with HDL (β = 0.05; 95% CI: 0.02, 0.08; P = 0.001) and triglycerides (β = −0.06; 95% CI: −0.09, −0.03; P < 0.001). PC2 scores were related with glucose metabolism (2 h Glucose, β = 0.1; 95% CI: 0.05, 0.15; P < 0.001), LDL (β = 0.06; 95% CI: 0.01, 0.1; P = 0.02) and triglycerides (β = 0.11; 95% CI: 0.06, 0.15; P < 0.001). For urine, the scores were related with LDL cholesterol. Conclusions: Plasma and urine metabolite profiles from SYSDIET reflected good compliance with dietary recommendations across the region. The scores of metabolites characterizing the diets associated with outcomes related with cardio-metabolic risk. Our analysis therefore offers a novel way to approach a per protocol analysis with a balanced compliance assessment in larger multicentre dietary trials. The study was registered at clinicaltrials.gov with NCT00992641.

Description:

Publisher Copyright: © 2022 The Authors Funding Systems biology in controlled dietary interventions and cohort studies (SYSDIET) is one of the three projects in the Nordic Centre of Excellence Programme on Food, Nutrition and Health nominated and funded by NordForsk for years 2007–2012 (SYSDIET; 070014). The SYSDIET intervention was also funded by the Academy of Finland, Finnish Diabetes Research Foundation, Finnish Foundation for Cardiovascular Research, The Sigfrid Juselius Foundation, and EVO funding from Kuopio University Hospital (Finland); the Druvan Foundation, ESPEN, Skåne County Council Research and Development Foundation, The Heart-Lung Foundation, Diabetesfonden, and Foundation Cerealia (Sweden), The Danish Obesity Research Centre (DanORC, www.danorc.dk), The Danish Council for Strategic Research (DairyHealth, BioFunCarb, FoodBAll) (Denmark), The Agricultural Productivity Fund, The Research Fund of the University of Iceland (Iceland). The metabolomics analysis was supported by a Semper Ardens grant on biomarkers from the Carlsberg Foundation to LOD.

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