A Combination of Metabolites Predicts Adherence to the Mediterranean Diet Pattern and Its Associations with Insulin Sensitivity and Lipid Homeostasis in the General Population: The Fenland Study, United Kingdom.
Tong, Tammy YN
Griffin, Julian L
Oxford University Press (OUP)
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Tong, T. Y., Koulman, A., Griffin, J. L., Wareham, N., Forouhi, N., & Imamura, F. (2020). A Combination of Metabolites Predicts Adherence to the Mediterranean Diet Pattern and Its Associations with Insulin Sensitivity and Lipid Homeostasis in the General Population: The Fenland Study, United Kingdom.. J Nutr, 150 (3), 568-578. https://doi.org/10.1093/jn/nxz263
BACKGROUND: Cardiometabolic benefits of the Mediterranean diet have been recognized, but underlying mechanisms are not fully understood. OBJECTIVES: We aimed to investigate how the Mediterranean diet could influence circulating metabolites and how the metabolites could mediate the associations of the diet with cardiometabolic risk factors. METHODS: Among 10,806 participants (58.9% women, mean age = 48.4 y) in the Fenland Study (2004-2015) in the United Kingdom, we assessed dietary consumption with FFQs and conducted a targeted metabolomics assay for 175 plasma metabolites (acylcarnitines, amines, sphingolipids, and phospholipids). We examined cross-sectional associations of the Mediterranean diet score (MDS) and its major components with each metabolite, modeling multivariable-adjusted linear regression. We used the regression estimates to summarize metabolites associated with the MDS into a metabolite score as a marker of the diet. Subsequently, we assessed how much metabolite subclasses and the metabolite score would mediate the associations of the MDS with circulating lipids, homeostasis model assessment of insulin resistance (HOMA-IR), and other metabolic factors by comparing regression estimates upon adjustment for the metabolites. RESULTS: Sixty-six metabolites were significantly associated with the MDS (P ≤ 0.003, corrected for false discovery rate) (Spearman correlations, r: -0.28 to +0.28). The metabolite score was moderately correlated with the MDS (r = 0.43). Of MDS components, consumption of nuts, cereals, and meats contributed to variations in acylcarnitines; fruits, to amino acids and amines; and fish, to phospholipids. The metabolite score was estimated to explain 37.2% of the inverse association of the MDS with HOMA-IR (P for mediation < 0.05). The associations of the MDS with cardiometabolic factors were estimated to be mediated by acylcarnitines, sphingolipids, and phospholipids. CONCLUSIONS: Multiple metabolites relate to the Mediterranean diet in a healthy general British population and highlight the potential to identify a set of biomarkers for an overall diet. The associations may involve pathways of phospholipid metabolism, carnitine metabolism, and development of insulin resistance and dyslipidemia.
Humans, Insulin Resistance, Patient Compliance, Diet, Mediterranean, Homeostasis, Adult, Middle Aged, Female, Male, Lipid Metabolism, Biomarkers, United Kingdom
The Fenland Study was funded by the Medical Research Council. Metabolomics analyses were funded by the Medical Research Council grant on Omic approaches (MC_PC_13046). TYNT, NJW, FI, NGF, received support from Medical Research Council Epidemiology Unit (MC_UU_12015/5; MC_UU_12015/1); NGF, AK, NJW acknowledge National Institute for Health Research (NIHR) Biomedical Research Centre grant (IS-BRC-1215-20014); NJW is an NIHR senior investigator; and AK, JLG acknowledge Medical Research Council Elsie Widdowson Laboratory (MC_UD99999906).
Medical Research Council (MC_UU_12015/5)
Cambridge University Hospitals NHS Foundation Trust (CUH) (146281)
Medical Research Council (MC_UU_12015/1)
Department of Health (via National Institute for Health Research (NIHR)) (NF-SI-0617-10149)
Medical Research Council (MR/P011705/1)
Medical Research Council (MR/P01836X/1)
Medical Research Council (MC_PC_13030)
Biotechnology and Biological Sciences Research Council (BB/M027252/2)
Biotechnology and Biological Sciences Research Council (BB/P028195/1)
Biotechnology and Biological Sciences Research Council (BB/M027252/1)
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External DOI: https://doi.org/10.1093/jn/nxz263
This record's URL: https://www.repository.cam.ac.uk/handle/1810/297343
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