Current metabolic perspective on malnutrition in obesity: towards more subgroup-based nutritional approaches?

Ellen E. Blaak*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

14 Citations (Web of Science)

Abstract

Lifestyle intervention may be effective in reducing type 2 diabetes mellitus incidence and cardiometabolic risk. A more personalised nutritional approach based on an individual or subgroup-based metabolic profile may optimise intervention outcome. Whole body insulin resistance (IR) reflects defective insulin action in tissues such as muscle, liver, adipose tissue, gut and brain, which may precede the development of cardiometabolic diseases. IR may develop in different organs but the severity may vary between organs. Individuals with more pronounced hepatic IR have a distinct plasma metabolome and lipidome profile as compared with individuals with more pronounced muscle IR. Additionally, genes related to extracellular modelling were upregulated in abdominal subcutaneous adipose tissue in individuals with more pronounced hepatic IR, whilst genes related to inflammation as well as systemic low-grade inflammation were upregulated in individuals with primarily muscle IR. There are indications that these distinct IR phenotypes may also respond differentially to dietary macronutrient composition. Besides metabolic phenotype, microbial phenotype may be of importance in personalising the response to diet. In particular fibres or fibre mixtures, leading to a high distal acetate and SCFA production may have more pronounced effects on metabolic health. Notably, individuals with prediabetes may have a reduced response to diet-induced microbiota modulation with respect to host insulin sensitivity and metabolic health outcomes. Overall, we need more research to relate metabolic subphenotypes to intervention outcomes to define more optimal diets for individuals with or predisposed to chronic metabolic diseases.

Original languageEnglish
Article number0029665120000117
Pages (from-to)331-337
Number of pages7
JournalProceedings of the Nutrition Society
Volume79
Issue number3
DOIs
Publication statusPublished - Aug 2020
Event13th European Nutrition Conference on Malnutrition in an Obese World - European Perspectives of Federation-of-European-Nutrition-Societies (FENS) - The Convention Centre Dublin, Dublin, Ireland
Duration: 15 Oct 201918 Oct 2019

Keywords

  • Tissue-specific insulin resistance
  • Metabolomics
  • Lipidomics
  • Transcriptomics
  • Dietary intervention
  • Personalised approaches
  • DIETARY-FAT MODIFICATION
  • LIFE-STYLE INTERVENTION
  • WEIGHT-LOSS
  • INSULIN SENSITIVITY
  • RISK-FACTORS
  • MUSCLE
  • ACIDS
  • DETERMINANTS
  • MARKERS
  • INDEX

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