Could a popular food ingredient raise the risk for diabetes and obesity?

Consumption of propionate, a food ingredient that’s widely used in baked goods, animal feeds, and artificial flavorings, appears to increase levels of several hormones that are associated with risk of obesity and diabetes, according to new research led by Harvard T.H. Chan School of Public Health in collaboration with researchers from Brigham and Women’s Hospital and Sheba Medical Center in Israel.

The study, which combined data from a randomized placebo-controlled trial in humans and mouse studies, indicated that propionate can trigger a cascade of metabolic events that leads to insulin resistance and hyperinsulinemia—a condition marked by excessive levels of insulin. The findings also showed that in mice, chronic exposure to propionate resulted in weight gain and insulin resistance.

The study was published online in Science Translational Medicine on April 24, 2019.

“Understanding how ingredients in food affect the body’s metabolism at the molecular and cellular level could help us develop simple but effective measures to tackle the dual epidemics of obesity and diabetes,” said Gökhan S. Hotamışlıgil, James Stevens Simmons Professor of Genetics and Metabolism and Director of the Sabri Ülker Center for Metabolic Research at Harvard Chan School.

More than 400 million people worldwide suffer from diabetes, and the rate of diabetes incidence is projected to increase 40% by 2040 despite extensive efforts to curb the disease. The surging rates of diabetes, as well as obesity, in the last 50 years indicate that environmental and dietary factors must be influencing the growth of this epidemic. Researchers have suggested that dietary components including ingredients used for preparation or preservation of food may be a contributing factor, but there is little research evaluating these molecules.

For this study, the researchers focused on propionate, a naturally occurring short-chain fatty acid that helps prevents mold from forming on foods. They first administered this short chain fatty acid to mice and found that it rapidly activated the sympathetic nervous system, which led to a surge in hormones, including glucagon, norepinephrine, and a newly discovered gluconeogenic hormone called fatty acid-binding protein 4 (FABP4). This in turn led the mice to produce more glucose from their liver cells, leading to hyperglycemia—a defining trait of diabetes. Moreover, the researchers found that chronic treatment of mice with a dose of propionate that was equivalent to the amount typically consumed by humans led to significant weight gain in the mice, as well as insulin resistance.

To determine how the findings in mice may translate to humans, the researchers established a double-blinded placebo-controlled study that included 14 healthy participants. The participants were randomized into two groups: One group received a meal that contained one gram of propionate as an additive and the other group was given a meal that contained a placebo. Blood samples were collected before the meal, within 15 minutes of eating the meal, and every 30 minutes thereafter for four hours.

The researchers found that people who consumed the meal containing propionate had significant increases in norepinephrine as well as increases in glucagon and FABP4 soon after eating the meal. The findings indicate that propionate may act as a “metabolic disruptor” that potentially increases the risk for diabetes and obesity in humans. The researchers noted that while propionate is generally recognized as safe by the U.S. Food and Drug Administration, these new findings warrant further investigation into propionate and potential alternatives that could be used in food preparation.

“The dramatic increase in the incidence of obesity and diabetes over the past 50 years suggests the involvement of contributing environmental and dietary factors. One such factor that warrants attention is the ingredients in common foods. We are exposed to hundreds of these chemicals on a daily basis, and most have not been tested in detail for their potential long-term metabolic effects,” said Amir Tirosh, associate professor of medicine at Tel-Aviv University’s Sackler School of Medicine, director of the Division of Endocrinology at Sheba Medical Center in Israel, and research fellow at Harvard Chan School.

Other Harvard Chan School authors included Ediz Calay, Gurol Tuncman, Kathryn Claiborn, Karen Inouye, Kosei Eguchi, and Michael Alcala.

Funding for this study came from National Institutes of Health’s National Institute of Diabetes and Digestive and Kidney Diseases grant K08 DK097145, as well as the Nutrition Obesity Research Center at Harvard grant P30-DK040561, the Cardiovascular, Diabetes and Metabolic Disorder Research Center of the Brigham Research Institute, and the Israeli Ministry of Health Research and Fellowship Fund.

Gout treatment may help prevent obesity-related type 2 diabetes, suggests small NIH study

The drug colchicine, used to treat the arthritic condition gout, could potentially reduce complications accompanying metabolic syndrome, a combination of high blood pressure, high blood sugar and other conditions that increase the risk of heart disease and type 2 diabetes, according to researchers at the National Institutes of Health. Their study appears in Diabetes, Endocrinology, and Metabolism.

Photo credit: WebMD

Previous studies have indicated that the system-wide inflammation that occurs in obesity plays a role in the development of type 2 diabetes. In the current study, researchers led by Jack A. Yanovski, M.D., Ph.D., of NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) randomly assigned 21 study participants to received colchicine twice a day for 3 months, while 19 participants received a placebo. Colchicine suppresses a multi-protein complex called NLRP3, which triggers the inflammation seen in obesity.

Researchers looked at several measures that reflect how well insulin works in the body to clear sugar from the blood (insulin resistance). There was no difference between the two groups in insulin resistance determined by one measure of insulin use (the frequently sampled, insulin-modified intravenous glucose tolerance test). However, the colchicine group showed improvement on the Homeostatic Model Assessment of Insulin Resistance test, which also estimates how much insulin is needed to keep blood sugar at a normal level while fasting. Those in the colchicine group also scored lower on a blood test of C-reactive protein and other tests that indicate inflammation. The authors concluded that larger studies are needed to determine if colchicine could prevent the development of type 2 diabetes in people with metabolic syndrome.

The research was also supported by the Intramural Research Program of the National Institute of Diabetes and Digestive and Kidney Diseases.

Gene mutation points to new way to fight diabetes, obesity, heart disease

Researchers say they have discovered a gene mutation that slows the metabolism of sugar in the gut, giving people who have the mutation a distinct advantage over those who do not.

HeartThose with the mutation have a lower risk of diabetes, obesity, heart failure, and even death. The researchers say their finding could provide the basis for drug therapies that could mimic the workings of this gene mutation, offering a potential benefit for the millions of people who suffer with diabetes, heart disease, and obesity.

The study, which is largely supported by the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health, appears in the Journal of the American College of Cardiology(link is external).

“We’re excited about this study because it helps clarify the link between what we eat, what we absorb, and our risk for disease. Knowing this opens the door to improved therapies for cardiometabolic disease,” said Scott D. Solomon, M.D., a professor of medicine at Harvard Medical School and a senior physician at Brigham and Women’s Hospital in Boston, who led the research. He explained that the study is the first to fully evaluate the link between mutations in the gene mainly responsible for absorbing glucose in the gut — SGLT-1, or sodium glucose co-transporter-1 — and cardiometabolic disease.

People who have the natural gene mutation appear to have an advantage when it comes to diet, Solomon noted. Those who eat a high-carbohydrate diet and have this mutation will absorb less glucose than those without the mutation. A high-carbohydrate diet includes such foods as pasta, breads, cookies, and sugar-sweetened beverages.

In the study, the researchers analyzed the relationship between SGLT-1 mutations and cardiometabolic disease using genetic data obtained from 8,478 participants in the Atherosclerosis Risk In Communities (ARIC) study. The study was a 25-year-long observational trial of atherosclerosis and cardiovascular risk factors in people living in four U.S. communities.

The researchers found that about 6 percent of the subjects carried a mutation in SGLT-1 that causes limited impairment of glucose absorption. Individuals with this mutation had a lower incidence of type 2 diabetes, were less obese, had a lower incidence of heart failure, and had a lower mortality rate when compared to those without the mutation, even after adjusting for dietary intake (including total calories, sodium, and sugars).

Based on these findings, the scientists suggest that selectively blocking the SGLT-1 receptor could provide a way to slow down glucose uptake to prevent or treat cardiometabolic disease and its consequences. They caution that development of such targeted drugs could take years and that clinical trials are still needed to determine if the drugs reduce the incidence of diabetes and heart failure and improve lifespan.

The ARIC study is performed as a collaborative study supported by NHLBI contracts ((HHSN268201100005C, HHSN268201100006C, HHSN268201100007C, HHSN268201100008C, HHSN26820110000 9C, HHSN268201100010C, HHSN268201100011C, and HHSN26820 1100012C). NHLBI funding support also includes the following grants: (2T32HL094301-06, R01HL131532, and R01HL134168).  In addition to NIH funding from NHLBI, this study was also funded by the National Institute of Diabetes and Digestive and Kidney Diseases: (K24DK106414 and R01DK089174). The study was also supported by additional institutions outside of NIH.

Part of the National Institutes of Health, the National Heart, Lung, and Blood Institute (NHLBI) plans, conducts, and supports research related to the causes, prevention, diagnosis, and treatment of heart, blood vessel, lung, and blood diseases; and sleep disorders. The Institute also administers national health education campaigns on women and heart disease, healthy weight for children, and other topics.

Obese people more likely to smoke, says new gene research: WHO

New research indicates that people who are genetically prone to being overweight have a higher risk of taking up smoking – and they are likely to smoke more than average — UN scientists said on Wednesday.

 

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World Bank Photo: World Bank

According to Dr. Paul Brennan from IARC, the International Agency for Research on Cancer, around 70 genes have been identified for the first time that could explain this behaviour. IARC is a World Health Organization (WHO) agency, mandated to conduct research on the causes of cancer, and its prevention.

 

The study, which is being published on Thursday in the British Medical Journal, and funded by Cancer Research UK, found that increased body mass index (BMI), body fat percentage and even waist circumference, were associated with “a higher risk of being a smoker, and with greater smoking intensity, measured by the number of cigarettes smoked per day”.

“Based on genetic markers of obesity, the study allows us to better understand the complex relationship between obesity and important smoking habits,” said Dr. Brennan, a genetic epidemiology expert with IARC, and one of the authors of the study.

He added that the study showing the relationship between body mass and smoking, also suggested that there was possibly a “common biological basis for addictive behaviours, such as nicotine addiction and higher energy intake”.

Dr. Brennan also noted that in understanding the link better, it could also be useful as a tool in helping people to stop smoking — a habit that kills more than 7 million people each year, according to WHO.

It is well established that smokers have a lower body weight on average than non-smokers, possibly due to reduced appetite, but that many gain weight after they stop smoking.

“However, among smokers, those who smoke more intensively, tend to weigh more,” said IARC.

IARC Director, Dr. Christopher Wild, said that “prevention of smoking is key to reducing the global burden of cancer and other chronic diseases, such as cardiovascular disease and diabetes”.

He added that obesity was among the most important preventable causes of those chronic illnesses. “These new results provide intriguing insights into the potential benefits of jointly addressing these risk factors.”

Obesity during pregnancy may lead directly to fetal overgrowth, NIH study suggests

Obesity during pregnancy — independent of its health consequences such as diabetes — may account for the higher risk of giving birth to an atypically large infant, according to researchers at the National Institutes of Health. Their study appears in JAMA Pediatrics.

Obesity

“Our results underscore the importance of attaining a healthy body weight before pregnancy,” said the study’s lead author, Cuilin Zhang, M.D., Ph.D., a researcher in the Division of Intramural Population Health Research at NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development. “They also suggest that clinicians should carefully monitor the pregnancies of all obese women, regardless of whether or not they have obesity-related health conditions.”

Macrosomia — large body size at birth — is common among children born to obese women, particularly those who have gestational diabetes (high blood sugar during pregnancy). Macrosomia increases the risk that an infant will experience bone fracture during delivery. It also increases the likelihood that the infant will need to be delivered by cesarean section. Having a large infant also increases a mother’s risk for postpartum hemorrhage, or excessive bleeding at birth.

In the current study, researchers analyzed ultrasound scans taken throughout pregnancy of more than 2,800 pregnant women: 443 obese women with no accompanying health conditions, such as diabetes, and more than 2300 non-obese women. The researchers categorized the women’s weight according to their body mass index (BMI) score. Women with a BMI ranging from 30 to 44.9 were classified as obese, while those with a BMI of 29.9 were considered non-obese.

Beginning in the 21st week of pregnancy, ultrasound scans revealed that for fetuses of obese women, the femur (thigh bone) and humerus (upper arm bone) were longer than those of the fetuses of non-obese women. The differences between fetuses of obese and non-obese women continued through the 38th week of pregnancy. For fetuses in the obese group, the average femur length was 0.8 millimeters longer (about 0.03 inches), compared to the non-obese group, and humerus length was about 1.1 millimeters longer (about 0.04 inches), compared to the non-obese group. Average birth weight was about 100 grams (about 0.2 pounds) heavier in the obese group. Moreover, infants born to obese women were more likely to be classified as large for gestational age (birth weight above the 90th percentile), compared to infants born to non-obese women.

The study could not determine exactly why the fetuses of obese women were larger and heavier than fetuses in the non-obese group. The researchers theorize that because obese women are more likely to have insulin resistance (difficulty using insulin to lower blood sugar), higher blood sugar levels could have promoted overgrowth in their fetuses.

The authors pointed out that earlier studies have indicated that the higher risk of overgrowth seen in newborns of obese women may predispose these infants to obesity and cardiovascular disease later in life. They called for additional studies to follow the children born to obese women to determine what health issues they may face.

About the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD): NICHD conducts and supports research in the United States and throughout the world on fetal, infant and child development; maternal, child and family health; reproductive biology and population issues; and medical rehabilitation. For more information, visit NICHD’s website.

About the National Institutes of Health (NIH): NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

Targeting ‘lipid chaperones’ may hold promise for lifelong preservation of metabolic health

Researchers have found that, in a mouse model, it may be possible to achieve lifelong metabolic health. The Harvard T.H. Chan School of Public Health scientists found that mice that lack fatty acid-binding proteins (FABPs) exhibit substantial protection against obesity, inflammation, insulin resistance, type 2 diabetes, and fatty liver disease as they age compared with mice that have FABPs. However, this remarkable extension of metabolic health was not found to lengthen lifespan.

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Genetic deletion of adipose tissue lipid binding proteins (Fabp-/-) reduces inflammation in fat tissue of mice, a tissue damage associated with aging (wild-type).

“From a public health perspective, extending the number of years that people are healthy would be a huge achievement,” said Gökhan S. Hotamisligil, J.S. Simmons Professor of Genetics and Metabolism and chair of the Department of Genetics and Complex Diseases and Sabri Ülker Center at Harvard Chan School. “Our findings show that this may be possible through a mechanism that can be translated into human populations through pharmacological and nutritional interventions.”

The study appeared online October 10, 2017 in Cell Reports.

FABPs are escort proteins or “lipid chaperones” that latch onto fat molecules, transport them within cells, and dictate their biological effects. Previous work from Hotamisligil’s lab found that when FABP-deficient mice were fed high-fat or high-cholesterol-containing diets, they did not develop type 2 diabetes, fatty liver, or heart disease.

Metabolic health typically deteriorates with age, and researchers believe that this contributes to age-associated chronic diseases and mortality. Studies have shown that high-calorie diets impair metabolism and accelerate aging; conversely, calorie restriction has been shown to prevent age-related metabolic diseases and extend lifespan.

In the new study, Hotamisligil, co-first authors Khanichi Charles, Min-Dian Li, and colleagues examined metabolic function in multiple cohorts of FABP-deficient mice throughout their life. They found that FABP deficiency markedly reduced age-related weight gain, inflammation, deterioration of glucose tolerance, insulin sensitivity, and other metabolic malfunctions. This effect was more strongly observed in female than male mice. Surprisingly however, they did not find any improvement to lifespan or preservation of muscular, cognitive, or cardiac functions with age.

The researchers saw striking similarities between the alterations in tissue gene expression and metabolite signatures in the genetic model of FABP-deficiency developed for this study and the alterations that occur due to calorie restriction. The findings suggest that it may be possible to mimic part of the metabolic benefits of calorie restriction by targeting FABPs. In addition, by examining the molecular differences between these models, it may also be possible to identify other pathways that contribute to longer life span or alternative strategies to prevent metabolic diseases.

“These simple proteins carry many fascinating mysteries that could unlock some of the greatest challenges to human health,” said Hotamisligil.

Other Harvard Chan School authors included Feyza EnginAna Paula Arruda, and Karen Inouye.

Work on FABPs in Hotamisligil’s lab is supported in part by the grant from the National Institutes of Health (AI116901). Charles was supported by training grants 5T32ES016645 and 5T32CA009078.

“Uncoupling of Metabolic Health from Longevity through Genetic Alteration of Adipose Tissue Lipid-Binding Proteins,” Khanichi N. Charles, Min-Dian Li, Feyza Engin, Ana Paula Arruda, Karen Inouye, Gökhan S. Hotamisligil, Cell Reports, online October 10, 2017, doi: 10.1016/j.celrep.2017.09.051