A diet high in sugar-sweetened beverage and low in fruits and vegetables is associated with adiposity and a pro-inflammatory adipokine profile

Abstract

Diet, obesity and adipokines play important roles in diabetes and CVD; yet, limited studies have assessed the relationship between diet and multiple adipokines. This cross-sectional study assessed associations between diet, adiposity and adipokines in Mexican Americans. The cohort included 1128 participants (age 34·7±8·2 years, BMI 29·5±5·9 kg/m2, 73·2 % female). Dietary intake was assessed by 12-month food frequency questionnaire. Adiposity was measured by BMI, total percentage body fat and percentage trunk fat using dual-energy X-ray absorptiometry. Adiponectin, apelin, C-reactive protein (CRP), dipeptidyl peptidase-4 (DPP-IV), IL-1β, IL-1ra, IL-6, IL-18, leptin, lipocalin, monocyte chemo-attractant protein-1 (MCP-1), resistin, secreted frizzled protein 4 (SFRP-4), SFRP-5, TNF-α and visfatin were assayed with multiplex kits or ELISA. Joint multivariate associations between diet, adiposity and adipokines were analysed using canonical correlations adjusted for age, sex, energy intake and kinship. The median (interquartile range) energy intake was 9514 (7314, 11912) kJ/d. Overall, 55 % of total intake was accounted for by carbohydrates (24 % from sugar). A total of 66 % of the shared variation between diet and adiposity, and 34 % of diet and adipokines were explained by the top canonical correlation. The diet component was most represented by sugar-sweetened beverages (SSB), fruit and vegetables. Participants consuming a diet high in SSB and low in fruits and vegetables had higher adiposity, CRP, leptin, and MCP-1, but lower SFRP-5 than participants with high fruit and vegetable and low SSB intake. In Mexican Americans, diets high in SSB but low in fruits and vegetables contribute to adiposity and a pro-inflammatory adipokine profile.

Keywords: CCA canonical correlation analysis; CRP C-reactive protein; DPP-IV dipeptidyl peptidase-4; GDM gestational diabetes mellitus; HighSSB/LowFV high in sugar-sweetened beverages and low in fruit and vegetables; LowSSB/HighFV low in sugar-sweetened beverages and high in fruit and vegetables; MCP-1 monocyte chemo-attractant protein-1; SFRP secreted frizzled protein; SSB sugar-sweetened beverages; Adipokines; Adiposity; Fruit; Sugar-sweetened beverages; Vegetables.

Figure 1.

Canonical-correlation heliograph demonstrating the joint multivariate association between food consumption and adiposity (A, explained variation 66%, p<0.001) as well as food consumption and adipokines (B, explained variation 33%, p=0.017) after adjusting for sex, age, energy intake and kinship: dark bar=positive association, white bar=negative association; bar length=strength of association ranging from 1 (outer circle) to -1 (inner circle). SSB=sugar sweetened beverages

Figure 2:

Standardized residuals after adjusting for sex, age and energy intake of selected adipokines of participants consuming a diet which was high in sugar-sweetened beverages and low in fruit, fruit juices and vegetables (HighSSB/LowFV, n = 147) compared to participants consuming a diet which was low in sugar-sweetened beverages and high in fruit, fruit juices and vegetables (LowSSB/HighFV), n=147). Adipokines shown exhibited loadings ≥0.30 in CCA. The standardization was to remove measurement units to better picture the impact of dietary group on different adipokines relative to each other. P values comparing HighSSB/LowFV and LowSSB/HighFV are provided from linear mixed-effect kinship models.