Lausanne, Switzerland 7th June 2018. Weight loss in obese individuals aims to reduce the risk of type 2 diabetes by improving glycemic control (the ability to maintain blood glucose levels within their normal range). Yet outcomes vary significantly between individuals, and successful glycemic control is difficult to predict. A team of scientists from the Nestlé Institute of Health Sciences set out to develop a model that would accurately predict how an individual’s insulin sensitivity would react following a low-caloric diet.
The research was based on the pan-European DiOGenes study (for the quantification of multiple plasma lipids and metabolites respectively) for more than 400 overweight/obese non-diabetic subjects in an attempt to predict improvements in Matsuda index (an established measure of insulin sensitivity) six months after an eight-week low-caloric diet. The researchers tested different approaches and different types of data to identify which subjects would benefit from weight loss intervention to improve their glycemic control.
The most accurate results were achieved using an omics model based on 27 variables, which was subsequently drastically simplified while maintaining the same performance through the use of just three variables: baseline Matsuda index, proline (an amino-acid) and phosphatidylcholine (PC O-34:1 – a lipid), all of which are accessible from blood samples. This model showed that non-responders generally have good insulin sensitivity at baseline (logically, they have less room for improvement after dietary intervention), lower plasma PC O-34:1 levels and higher proline levels than responders.
“To the best of our knowledge, there is currently no established model to predict glycemic outcomes, so our solution offers a first standard that could serve as a benchmark for future models”, NIHS researcher Armand Valsesia explains. “This model opens up new potential for clinical practice and may help the medical community to better understand the wide variability in dietary interventions, and so manage patient expectations in terms of setting realistic objectives for glycemic improvements prior to intervention.
“This work builds on our existing research to predict the impact of diet on glycemic control. Our latest findings, published today in the American Journal of Clinical Nutrition, have the potential to be used to identify patients at severe risk of developing diabetes who are likely to benefit from weight loss intervention. Conversely, doctors will be better able to tailor interventions for patients at risk, but for whom only moderate glycemic improvement is predicted.
“Meal-replacement interventions are becoming more popular in primary care for subjects at risk of developing type 2 diabetes. Our findings will allow much better targeting of patients most likely to benefit from such intervention whilst maintaining low costs, as the model is based solely on easily-accessible blood sampling methods.
“Our approach also has the potential to guide additional biomarker studies that aim to predict clinical outcomes upon intervention.”
Meyer A, Montastier E, Hager J, Saris WHM, Astrup A, Viguerie N and Valsesia A (2018). Plasma metabolites and lipids predict insulin sensitivity improvement in obese, non-diabetic individuals after a 2-phase dietary intervention. Am J Clin Nutr.
Armenise C, Lefebvre G, Carayol J, Bonnel S, Bolton J, Di Cara A, Gheldof N, Descombes P, Langin D, Saris WHM, Astrup A, Hager J, Viguerie N and Valsesia A (2017). Transcriptome profiling from adipose tissue during low-caloric diet reveals predictors of weight and glycemic outcomes in obese, non-diabetic subjects. Am J Clin Nutr, 106:736–46. See news release here.
Valsesia A, Saris WHM, Astrup A, Hager J and Masoodi M (2016). Distinct lipid profiles predict improved glycemic control in obese, non-diabetic patients following low-caloric diet intervention: the DiOGenes randomized trial. Am J Clin Nutr, Aug 10, 104:1–10. See news release here.
NIHS is a biomedical research institute, part of Nestlé’s global R&D network, dedicated to fundamental research aimed at understanding health and disease and developing science-based, targeted nutritional solutions for the maintenance of health. To achieve its aim, NIHS employs state-of-the-art technologies and biological models to characterize health and disease with a holistic and integrated approach. The ultimate goal of the Institute is to develop knowledge that can empower people to better maintain their health through nutritional approaches, especially in relation to their molecular profile and lifestyle status.
Diogenes is a pan-European Program of the EU Sixth Framework for Research and Technological Development (2005-2009). Diogenes targets the obesity problem from a dietary perspective, seeking new insights and new routes to treatment and prevention. The name Diogenes is an acronym that stands for "Diet, Obesity and Genes”. Diogenes was supported by 14.5 million Euros of EU funding, with a total project budget of 20.1 million Euros. The five-year program involved a consortium of 29 partners across Europe. It was made up of world-class centers in diet and health studies, epidemiology, dietary genomics and food technology. It also included 3 major food industrials and 5 small and medium-sized enterprises. Based on the new knowledge generated, the project has demonstrated prototypes of innovative products or advice regimes which help susceptible individuals to avoid weight gain and re-gain.
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Laura Camurri, Communications, NIHS