A dietary biomarker approach captures compliance and cardiometabolic effects of a healthy nordic diet in individuals with metabolic syndrome

M Marklund, O K Magnusdottir, F Rosqvist, L Cloetens, R Landberg, Marjukka Kolehmainen, L Brader, K Hermansen, Kaisa Poutanen, K-H Herzig, J Hukkanen, M J Savolainen, L O Dragsted, U Schwab, J Paananen, M Uusitupa, B Åkesson, I Thorsdottir, U Riserus

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Abstract

Assessment of compliance with dietary interventions is necessary to understand the observed magnitude of the health effects of the diet per se. To avoid reporting bias, different dietary biomarkers (DBs) could be used instead of self-reported data. However, few studies investigated a combination of DBs to assess compliance and its influence on cardiometabolic risk factors. The objectives of this study were to use acombination of DBs toassesscompliance andto investigatehowahealthyNordic diet(ND) influencescardiometabolic risk factors in participantswith high apparent compliance comparedwith the whole study population. From a recently conducted isocaloric randomized trial, SYSDIET (Systems Biology in Controlled Dietary Interventions and Cohort Studies), in 166 individuals withmetabolic syndrome, several DBs were assessed to reflect different key components of the ND: canola oil (serumphospholipid a-linolenic acid), fatty fish [eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)], vegetables (plasma b-carotene), and whole grains (plasma alkylresorcinols). High-fat dairy intake (expectedly low in the ND) was reflected by serum pentadecanoic acid. All participants with biomarker data (n = 154) were included in the analyses. Biomarkers were combined by using a biomarker rank score (DB score) and principal component analysis (PCA). The DB score was then used to assess compliance. During the intervention, median concentrations of alkylresorcinols, a-linolenic acid,EPA, and DHA were>25%higher in the ND individuals than in the controls (P>0.05),where as median concentrations of pentadecanoic acid were14%higher in controls (P>0.05). MedianDBscorewas57%higher in the ND than in controls (P > 0.001) during the intervention, and participants were ranked similarly by DB score and PCA score. Overall, estimates of group difference in cardiometabolic effects generally appeared to be greater among compliant participants than in the whole study population (e.g., estimates of treatment effects on blood pressure and lipoproteinswere;1.5- to 2-fold greater in the most compliant participants), suggesting that poor compliance attenuated the dietary effects. With adequate consideration of their limitations, DB combinations (e.g., DB score) could be useful for assessing compliance in intervention studies investigating cardiometabolic effects of healthy dietary patterns. The study was registered at clinicaltrials.gov as NCT00992641
Original languageEnglish
Pages (from-to)1642-1649
JournalJournal of Nutrition
Volume144
Issue number10
DOIs
Publication statusPublished - 2014
MoE publication typeA1 Journal article-refereed

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Compliance
Biomarkers
alpha-Linolenic Acid
Eicosapentaenoic Acid
Docosahexaenoic Acids
Principal Component Analysis
Healthy Diet
Diet
Systems Biology
Carotenoids
Vegetables
Population
Fishes
Cohort Studies
Fats
Blood Pressure
Health

Cite this

Marklund, M., Magnusdottir, O. K., Rosqvist, F., Cloetens, L., Landberg, R., Kolehmainen, M., ... Riserus, U. (2014). A dietary biomarker approach captures compliance and cardiometabolic effects of a healthy nordic diet in individuals with metabolic syndrome. Journal of Nutrition, 144(10), 1642-1649. https://doi.org/10.3945/jn.114.193771
Marklund, M ; Magnusdottir, O K ; Rosqvist, F ; Cloetens, L ; Landberg, R ; Kolehmainen, Marjukka ; Brader, L ; Hermansen, K ; Poutanen, Kaisa ; Herzig, K-H ; Hukkanen, J ; Savolainen, M J ; Dragsted, L O ; Schwab, U ; Paananen, J ; Uusitupa, M ; Åkesson, B ; Thorsdottir, I ; Riserus, U. / A dietary biomarker approach captures compliance and cardiometabolic effects of a healthy nordic diet in individuals with metabolic syndrome. In: Journal of Nutrition. 2014 ; Vol. 144, No. 10. pp. 1642-1649.
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abstract = "Assessment of compliance with dietary interventions is necessary to understand the observed magnitude of the health effects of the diet per se. To avoid reporting bias, different dietary biomarkers (DBs) could be used instead of self-reported data. However, few studies investigated a combination of DBs to assess compliance and its influence on cardiometabolic risk factors. The objectives of this study were to use acombination of DBs toassesscompliance andto investigatehowahealthyNordic diet(ND) influencescardiometabolic risk factors in participantswith high apparent compliance comparedwith the whole study population. From a recently conducted isocaloric randomized trial, SYSDIET (Systems Biology in Controlled Dietary Interventions and Cohort Studies), in 166 individuals withmetabolic syndrome, several DBs were assessed to reflect different key components of the ND: canola oil (serumphospholipid a-linolenic acid), fatty fish [eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)], vegetables (plasma b-carotene), and whole grains (plasma alkylresorcinols). High-fat dairy intake (expectedly low in the ND) was reflected by serum pentadecanoic acid. All participants with biomarker data (n = 154) were included in the analyses. Biomarkers were combined by using a biomarker rank score (DB score) and principal component analysis (PCA). The DB score was then used to assess compliance. During the intervention, median concentrations of alkylresorcinols, a-linolenic acid,EPA, and DHA were>25{\%}higher in the ND individuals than in the controls (P>0.05),where as median concentrations of pentadecanoic acid were14{\%}higher in controls (P>0.05). MedianDBscorewas57{\%}higher in the ND than in controls (P > 0.001) during the intervention, and participants were ranked similarly by DB score and PCA score. Overall, estimates of group difference in cardiometabolic effects generally appeared to be greater among compliant participants than in the whole study population (e.g., estimates of treatment effects on blood pressure and lipoproteinswere;1.5- to 2-fold greater in the most compliant participants), suggesting that poor compliance attenuated the dietary effects. With adequate consideration of their limitations, DB combinations (e.g., DB score) could be useful for assessing compliance in intervention studies investigating cardiometabolic effects of healthy dietary patterns. The study was registered at clinicaltrials.gov as NCT00992641",
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Marklund, M, Magnusdottir, OK, Rosqvist, F, Cloetens, L, Landberg, R, Kolehmainen, M, Brader, L, Hermansen, K, Poutanen, K, Herzig, K-H, Hukkanen, J, Savolainen, MJ, Dragsted, LO, Schwab, U, Paananen, J, Uusitupa, M, Åkesson, B, Thorsdottir, I & Riserus, U 2014, 'A dietary biomarker approach captures compliance and cardiometabolic effects of a healthy nordic diet in individuals with metabolic syndrome', Journal of Nutrition, vol. 144, no. 10, pp. 1642-1649. https://doi.org/10.3945/jn.114.193771

A dietary biomarker approach captures compliance and cardiometabolic effects of a healthy nordic diet in individuals with metabolic syndrome. / Marklund, M; Magnusdottir, O K; Rosqvist, F; Cloetens, L; Landberg, R; Kolehmainen, Marjukka; Brader, L; Hermansen, K; Poutanen, Kaisa; Herzig, K-H; Hukkanen, J; Savolainen, M J; Dragsted, L O; Schwab, U; Paananen, J; Uusitupa, M; Åkesson, B; Thorsdottir, I; Riserus, U.

In: Journal of Nutrition, Vol. 144, No. 10, 2014, p. 1642-1649.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - A dietary biomarker approach captures compliance and cardiometabolic effects of a healthy nordic diet in individuals with metabolic syndrome

AU - Marklund, M

AU - Magnusdottir, O K

AU - Rosqvist, F

AU - Cloetens, L

AU - Landberg, R

AU - Kolehmainen, Marjukka

AU - Brader, L

AU - Hermansen, K

AU - Poutanen, Kaisa

AU - Herzig, K-H

AU - Hukkanen, J

AU - Savolainen, M J

AU - Dragsted, L O

AU - Schwab, U

AU - Paananen, J

AU - Uusitupa, M

AU - Åkesson, B

AU - Thorsdottir, I

AU - Riserus, U

PY - 2014

Y1 - 2014

N2 - Assessment of compliance with dietary interventions is necessary to understand the observed magnitude of the health effects of the diet per se. To avoid reporting bias, different dietary biomarkers (DBs) could be used instead of self-reported data. However, few studies investigated a combination of DBs to assess compliance and its influence on cardiometabolic risk factors. The objectives of this study were to use acombination of DBs toassesscompliance andto investigatehowahealthyNordic diet(ND) influencescardiometabolic risk factors in participantswith high apparent compliance comparedwith the whole study population. From a recently conducted isocaloric randomized trial, SYSDIET (Systems Biology in Controlled Dietary Interventions and Cohort Studies), in 166 individuals withmetabolic syndrome, several DBs were assessed to reflect different key components of the ND: canola oil (serumphospholipid a-linolenic acid), fatty fish [eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)], vegetables (plasma b-carotene), and whole grains (plasma alkylresorcinols). High-fat dairy intake (expectedly low in the ND) was reflected by serum pentadecanoic acid. All participants with biomarker data (n = 154) were included in the analyses. Biomarkers were combined by using a biomarker rank score (DB score) and principal component analysis (PCA). The DB score was then used to assess compliance. During the intervention, median concentrations of alkylresorcinols, a-linolenic acid,EPA, and DHA were>25%higher in the ND individuals than in the controls (P>0.05),where as median concentrations of pentadecanoic acid were14%higher in controls (P>0.05). MedianDBscorewas57%higher in the ND than in controls (P > 0.001) during the intervention, and participants were ranked similarly by DB score and PCA score. Overall, estimates of group difference in cardiometabolic effects generally appeared to be greater among compliant participants than in the whole study population (e.g., estimates of treatment effects on blood pressure and lipoproteinswere;1.5- to 2-fold greater in the most compliant participants), suggesting that poor compliance attenuated the dietary effects. With adequate consideration of their limitations, DB combinations (e.g., DB score) could be useful for assessing compliance in intervention studies investigating cardiometabolic effects of healthy dietary patterns. The study was registered at clinicaltrials.gov as NCT00992641

AB - Assessment of compliance with dietary interventions is necessary to understand the observed magnitude of the health effects of the diet per se. To avoid reporting bias, different dietary biomarkers (DBs) could be used instead of self-reported data. However, few studies investigated a combination of DBs to assess compliance and its influence on cardiometabolic risk factors. The objectives of this study were to use acombination of DBs toassesscompliance andto investigatehowahealthyNordic diet(ND) influencescardiometabolic risk factors in participantswith high apparent compliance comparedwith the whole study population. From a recently conducted isocaloric randomized trial, SYSDIET (Systems Biology in Controlled Dietary Interventions and Cohort Studies), in 166 individuals withmetabolic syndrome, several DBs were assessed to reflect different key components of the ND: canola oil (serumphospholipid a-linolenic acid), fatty fish [eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)], vegetables (plasma b-carotene), and whole grains (plasma alkylresorcinols). High-fat dairy intake (expectedly low in the ND) was reflected by serum pentadecanoic acid. All participants with biomarker data (n = 154) were included in the analyses. Biomarkers were combined by using a biomarker rank score (DB score) and principal component analysis (PCA). The DB score was then used to assess compliance. During the intervention, median concentrations of alkylresorcinols, a-linolenic acid,EPA, and DHA were>25%higher in the ND individuals than in the controls (P>0.05),where as median concentrations of pentadecanoic acid were14%higher in controls (P>0.05). MedianDBscorewas57%higher in the ND than in controls (P > 0.001) during the intervention, and participants were ranked similarly by DB score and PCA score. Overall, estimates of group difference in cardiometabolic effects generally appeared to be greater among compliant participants than in the whole study population (e.g., estimates of treatment effects on blood pressure and lipoproteinswere;1.5- to 2-fold greater in the most compliant participants), suggesting that poor compliance attenuated the dietary effects. With adequate consideration of their limitations, DB combinations (e.g., DB score) could be useful for assessing compliance in intervention studies investigating cardiometabolic effects of healthy dietary patterns. The study was registered at clinicaltrials.gov as NCT00992641

U2 - 10.3945/jn.114.193771

DO - 10.3945/jn.114.193771

M3 - Article

VL - 144

SP - 1642

EP - 1649

JO - Journal of Nutrition

JF - Journal of Nutrition

SN - 0022-3166

IS - 10

ER -