TY - JOUR
T1 - Characterization of metabolic responses to healthy diets and association with blood pressure
T2 - Application to the Optimal Macronutrient Intake Trial for Heart Health (OmniHeart), a randomized controlled study
AU - Loo, Ruey Leng
AU - Zou, Xin
AU - Appel, Lawrence J.
AU - Nicholson, Jeremy K.
AU - Holmes, Elaine
N1 - Funding Information:
We thank T. Yap for her contribution to the sample preparation for NMR analyses. This manuscript was prepared using OmniHeart research materials obtained from the National Heart, Lung, and Blood Institute (NHLBI) Biologic Specimen and Data Repository Information Coordinating Center and does not necessarily reflect the opinions or views of the NHLBI. The OmniHeart study description together with the study protocol and associated metadata are available from the Biologic Specimen and Data Repository Information Coordinating Center (BioLINCC) at https://biolincc.nhlbi.nih.gov/static/studies/omniheart/MOP.pdf?link_time= 2017-07-02_01:45:33.646682. We thank the Imperial-National Institute for Health Research (NIHR) Clinical Phenome Centre, which is supported by the NIHR Imperial Biomedical Research Centre based at Imperial College Healthcare National Health Service (NHS) Trust and Imperial College London. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, or the Department of Health.
Funding Information:
Supported by the Medical Research Council, New Investigator Grant Award (G1002151). XZ is also supported by the Natural Science Foundation of Shanghai (16ZR1417900) and Shanghai Pujiang Talent Fund (16PJ1405200). EH and JKN also acknowledge support from the Biotechnology and Biological Sciences Research Council (PS8813) and National Institute for Health Research (PSA809).
Publisher Copyright:
© 2018 American Society for Nutrition.
PY - 2018/3/1
Y1 - 2018/3/1
N2 - Background Interindividual variation in the response to diet is common, but the underlying mechanism for such variation is unclear. Objective The objective of this study was to use a metabolic profiling approach to identify a panel of urinary metabolites representing individuals demonstrating typical (homogeneous) metabolic responses to healthy diets, and subsequently to define the association of these metabolites with improvement of risk factors for cardiovascular diseases (CVDs). Design 24-h urine samples from 158 participants with pre-hypertension and stage 1 hypertension, collected at baseline and following the consumption of a carbohydrate-rich, a protein-rich, and a monounsaturated fat-rich healthy diet (6 wk/diet) in a randomized, crossover study, were analyzed by proton (1 H) nuclear magnetic resonance (NMR) spectroscopy. Urinary metabolite profiles were interrogated to identify typical and variable responses to each diet. We quantified the differences in absolute excretion of metabolites, distinguishing between dietary comparisons within the typical response groups, and established their associations with CVD risk factors using linear regression. Results Globally all 3 diets induced a similar pattern of change in the urinary metabolic profiles for the majority of participants (60.1%). Diet-dependent metabolic variation was not significantly associated with total cholesterol or low-density lipoprotein (LDL) cholesterol concentration. However, blood pressure (BP) was found to be significantly associated with 6 urinary metabolites reflecting dietary intake [proline-betaine (inverse), carnitine (direct)], gut microbial co-metabolites [hippurate (direct), 4-cresyl sulfate (inverse), phenylacetylglutamine (inverse)], and tryptophan metabolism [N-methyl-2-pyridone-5-carboxamide (inverse)]. A dampened clinical response was observed in some individuals with variable metabolic responses, which could be attributed to nonadherence to diet (≤25.3%), variation in gut microbiome activity (7.6%), or a combination of both (7.0%). Conclusions These data indicate interindividual variations in BP in response to dietary change and highlight the potential influence of the gut microbiome in mediating this relation. This approach provides a framework for stratification of individuals undergoing dietary management. The original OmniHeart intervention study and the metabolomics study were registered at www.clinicaltrials.gov as NCT00051350 and NCT03369535, respectively.
AB - Background Interindividual variation in the response to diet is common, but the underlying mechanism for such variation is unclear. Objective The objective of this study was to use a metabolic profiling approach to identify a panel of urinary metabolites representing individuals demonstrating typical (homogeneous) metabolic responses to healthy diets, and subsequently to define the association of these metabolites with improvement of risk factors for cardiovascular diseases (CVDs). Design 24-h urine samples from 158 participants with pre-hypertension and stage 1 hypertension, collected at baseline and following the consumption of a carbohydrate-rich, a protein-rich, and a monounsaturated fat-rich healthy diet (6 wk/diet) in a randomized, crossover study, were analyzed by proton (1 H) nuclear magnetic resonance (NMR) spectroscopy. Urinary metabolite profiles were interrogated to identify typical and variable responses to each diet. We quantified the differences in absolute excretion of metabolites, distinguishing between dietary comparisons within the typical response groups, and established their associations with CVD risk factors using linear regression. Results Globally all 3 diets induced a similar pattern of change in the urinary metabolic profiles for the majority of participants (60.1%). Diet-dependent metabolic variation was not significantly associated with total cholesterol or low-density lipoprotein (LDL) cholesterol concentration. However, blood pressure (BP) was found to be significantly associated with 6 urinary metabolites reflecting dietary intake [proline-betaine (inverse), carnitine (direct)], gut microbial co-metabolites [hippurate (direct), 4-cresyl sulfate (inverse), phenylacetylglutamine (inverse)], and tryptophan metabolism [N-methyl-2-pyridone-5-carboxamide (inverse)]. A dampened clinical response was observed in some individuals with variable metabolic responses, which could be attributed to nonadherence to diet (≤25.3%), variation in gut microbiome activity (7.6%), or a combination of both (7.0%). Conclusions These data indicate interindividual variations in BP in response to dietary change and highlight the potential influence of the gut microbiome in mediating this relation. This approach provides a framework for stratification of individuals undergoing dietary management. The original OmniHeart intervention study and the metabolomics study were registered at www.clinicaltrials.gov as NCT00051350 and NCT03369535, respectively.
KW - diets
KW - gut microbiome
KW - hypertension
KW - metabolic profiling
KW - metabolomic
KW - metabonomic
KW - personalized health care
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U2 - 10.1093/ajcn/nqx072
DO - 10.1093/ajcn/nqx072
M3 - Article
C2 - 29506183
AN - SCOPUS:85044240950
SN - 0002-9165
VL - 107
SP - 323
EP - 334
JO - American Journal of Clinical Nutrition
JF - American Journal of Clinical Nutrition
IS - 3
ER -