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      Dietary intake and visceral adiposity in older adults: The Multiethnic Cohort Adiposity Phenotype study

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          Abstract

          Background

          There are established links between the accumulation of body fat as visceral adipose tissue (VAT) and the risk of developing obesity‐associated metabolic disease. Previous studies have suggested that levels of intake of specific foods and nutrients are associated with VAT accumulation after accounting for total energy intake.

          Objective

          This study assessed associations between a priori selected dietary factors on VAT quantified using abdominal magnetic resonance imaging.

          Methods

          The cross‐sectional Multiethnic Cohort Adiposity Phenotype Study included n = 395 White, n = 274 Black, n = 269 Native Hawaiian, n = 425 Japanese American and n = 358 Latino participants (mean age = 69 years ± 3 SD). Participants were enrolled stratified on sex, race, ethnicity and body mass index. General linear models were used to estimate the mean VAT area (cm 2) for participants categorized into quartiles based on their dietary intake of selected foods/nutrients adjusting for age, sex, racial and ethnic groups, the total percentage fat from whole‐body dual energy X‐ray absorptiometry and total energy.

          Results

          There were significant inverse associations with VAT for dietary intake of total vegetables, total fruits (including juice), cereals, whole grains, calcium, copper and dietary fiber ( p‐trend ≤0.04). Positive trends were observed for VAT for participants who reported higher intake of potatoes, total fat and saturated fatty acids (SFA) ( p‐trend ≤0.02). Foods/nutrients that met the multiple testing significance threshold were total fruits, whole grains, copper, dietary fiber and SFA intake.

          Conclusions

          These results highlight foods and nutrients including SFA, total fruit, whole grains, fiber and copper as potential candidates for future research to inform dietary guidelines for the prevention of chronic disease among older adults.

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          Most cited references26

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          Pathophysiology of human visceral obesity: an update.

          Excess intra-abdominal adipose tissue accumulation, often termed visceral obesity, is part of a phenotype including dysfunctional subcutaneous adipose tissue expansion and ectopic triglyceride storage closely related to clustering cardiometabolic risk factors. Hypertriglyceridemia; increased free fatty acid availability; adipose tissue release of proinflammatory cytokines; liver insulin resistance and inflammation; increased liver VLDL synthesis and secretion; reduced clearance of triglyceride-rich lipoproteins; presence of small, dense LDL particles; and reduced HDL cholesterol levels are among the many metabolic alterations closely related to this condition. Age, gender, genetics, and ethnicity are broad etiological factors contributing to variation in visceral adipose tissue accumulation. Specific mechanisms responsible for proportionally increased visceral fat storage when facing positive energy balance and weight gain may involve sex hormones, local cortisol production in abdominal adipose tissues, endocannabinoids, growth hormone, and dietary fructose. Physiological characteristics of abdominal adipose tissues such as adipocyte size and number, lipolytic responsiveness, lipid storage capacity, and inflammatory cytokine production are significant correlates and even possible determinants of the increased cardiometabolic risk associated with visceral obesity. Thiazolidinediones, estrogen replacement in postmenopausal women, and testosterone replacement in androgen-deficient men have been shown to favorably modulate body fat distribution and cardiometabolic risk to various degrees. However, some of these therapies must now be considered in the context of their serious side effects. Lifestyle interventions leading to weight loss generally induce preferential mobilization of visceral fat. In clinical practice, measuring waist circumference in addition to the body mass index could be helpful for the identification and management of a subgroup of overweight or obese patients at high cardiometabolic risk.
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            A multiethnic cohort in Hawaii and Los Angeles: baseline characteristics.

            The authors describe the design and implementation of a large multiethnic cohort established to study diet and cancer in the United States. They detail the source of the subjects, sample size, questionnaire development, pilot work, and approaches to future analyses. The cohort consists of 215,251 adult men and women (age 45-75 years at baseline) living in Hawaii and in California (primarily Los Angeles County) with the following ethnic distribution: African-American (16.3%), Latino (22.0%), Japanese-American (26.4%), Native Hawaiian (6.5%), White (22.9%), and other ancestry (5.8%). From 1993 to 1996, participants entered the cohort by completing a 26-page, self-administered mail questionnaire that elicited a quantitative food frequency history, along with demographic and other information. Response rates ranged from 20% in Latinos to 49% in Japanese-Americans. As expected, both within and among ethnic groups, the questionnaire data show substantial variations in dietary intakes (nutrients as well as foods) and in the distributions of non-dietary risk factors (including smoking, alcohol consumption, obesity, and physical activity). When compared with corresponding ethnic-specific cancer incidence rates, the findings provide tentative support for several current dietary hypotheses. As sufficient numbers of cancer cases are identified through surveillance of the cohort, dietary and other hypotheses will be tested in prospective analyses.
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              Dietary fiber and body weight.

              This review provides an update of recent studies of dietary fiber and weight and includes a discussion of potential mechanisms of how dietary fiber can aid weight loss and weight maintenance. Human studies published on dietary fiber and body weight were reviewed and summarized. Dietary fiber content of popular low-carbohydrate diets were calculated and are presented. Epidemiologic support that dietary fiber intake prevents obesity is strong. Fiber intake is inversely associated with body weight and body fat. In addition, fiber intake is inversely associated with body mass index at all levels of fat intake after adjusting for confounding factors. Results from intervention studies are more mixed, although the addition of dietary fiber generally decreases food intake and, hence, body weight. Many mechanisms have been suggested for how dietary fiber aids in weight management, including promoting satiation, decreasing absorption of macronutrients, and altering secretion of gut hormones. The average fiber intake of adults in the United States is less than half recommended levels and is lower still among those who follow currently popular low-carbohydrate diets, such as Atkins and South Beach. Increasing consumption of dietary fiber with fruits, vegetables, whole grains, and legumes across the life cycle is a critical step in stemming the epidemic of obesity found in developed countries. The addition of functional fiber to weight-loss diets should also be considered as a tool to improve success.
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                Author and article information

                Contributors
                melissa.merritt@sydney.edu.au
                Journal
                Obes Sci Pract
                Obes Sci Pract
                10.1002/(ISSN)2055-2238
                OSP4
                Obesity Science & Practice
                John Wiley and Sons Inc. (Hoboken )
                2055-2238
                22 January 2024
                February 2024
                : 10
                : 1 ( doiID: 10.1002/osp4.v10.1 )
                : e734
                Affiliations
                [ 1 ] The Daffodil Centre The University of Sydney, a Joint Venture with Cancer Council NSW Sydney New South Wales Australia
                [ 2 ] Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia
                [ 3 ] Cancer Epidemiology Program University of Hawaii Cancer Center University of Hawaii Honolulu Hawaii USA
                [ 4 ] Division of Public Health Sciences Fred Hutchinson Cancer Research Center Seattle Washington USA
                [ 5 ] Division of Pediatric Gastroenterology, Hepatology, and Nutrition Department of Pediatrics Seattle Children's Hospital Seattle Washington USA
                [ 6 ] Department of Diagnostic Radiology and Nuclear Medicine University of Maryland Baltimore Maryland USA
                Author notes
                [*] [* ] Correspondence

                Melissa A. Merritt, The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, The University of Sydney, Building A27 ‐ Edward Ford Building, Sydney, NSW 2006, Australia.

                Email: melissa.merritt@ 123456sydney.edu.au

                Author information
                https://orcid.org/0000-0002-5067-6119
                Article
                OSP4734
                10.1002/osp4.734
                10802887
                38259353
                59abc2bf-bb07-468e-9693-1adfefc2f736
                © 2024 The Authors. Obesity Science & Practice published by World Obesity and The Obesity Society and John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 01 December 2023
                : 06 August 2023
                : 29 December 2023
                Page count
                Figures: 0, Tables: 2, Pages: 9, Words: 5960
                Funding
                Funded by: National Institutes of Health , doi 10.13039/100000002;
                Award ID: P01 CA168530
                Award ID: U01 CA164973
                Award ID: UL1 TR000130
                Funded by: National Cancer Institute , doi 10.13039/100000054;
                Categories
                Original Article
                Original Article
                Custom metadata
                2.0
                February 2024
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.3.6 mode:remove_FC converted:22.01.2024

                adiposity,diet,ethnic minorities,visceral fat
                adiposity, diet, ethnic minorities, visceral fat

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