Download Biomarkers of dietary fatty acids and metabolism and body mass index

Biomarkers of dietary fatty acids and
metabolism and body mass index: the
EPIC-PANACEA Study
Véronique Chajès
Nutrition and Metabolism
International Agency for Research on Cancer
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Fatty acids and obesity -Epidemiology
Obesity: a serious health problem worldwide
 Increase in obesity thought to be due largely to lifestyle factors, such as
diet and physical inactivity, along with a genetic component.
(de Ferranti and Mozaffarian. Clin Chem 2008;54:945-55)
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Fatty acids and obesity - Rationale
Obesity: a serious health problem worldwide
 Increase in obesity thought to be due largely to lifestyle factors, such as
diet and physical inactivity, along with a genetic component.
Fatty acids, overweight and obesity
 The role of dietary fatty acids in weight gain and obesity remains highly
controversial
(Melanson et al. Ann Nutr Metab 2009; 55:229-43)
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Fatty acids and obesity - Rationale
Obesity: a serious health problem worldwide
 Increase in obesity thought to be due largely to lifestyle factors, such as
diet and physical inactivity, along with a genetic component.
Fatty acids, overweight and obesity
 The role of dietary fatty acids in weight gain and obesity remains highly
controversial
Total fatty acids
possible positive association
Saturated fatty acids
(Melanson et al. Ann Nutr Metab 2009; 55:229-43)
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Fatty acids and obesity - Rationale
Obesity: a serious health problem worldwide
 Increase in obesity thought to be due largely to lifestyle factors, such as
diet and physical inactivity, along with a genetic component.
Fatty acids, overweight and obesity
 The role of dietary fatty acids in weight gain and obesity remains highly
controversial
Total fatty acids
possible positive association
Saturated fatty acids
-
Monounsaturated fatty acids
PUFA
Trans fatty acids
evidence less clear
(Melanson et al. Ann Nutr Metab 2009; 55:229-43;
Jakobsen et al. Obes Facts 2011;4:312-18)
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Methodological issues
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BMI as indicator of adiposity
Dietary measurement error (FFQ vs other reporting instrument)
Conversion of food items into their fatty acid content complex
Homogeneous populations with a narrow range of fat intakes
Limited data on biomarkers of lipid exposure and metabolism
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What biomarkers of fatty acids may offer
Long-term biomarker
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Adipose tissue (gluteal, breast, etc.)
• Triglycerides
2 years
Erythrocytes or platelets
• Membrane phospholipids
3 months
Lipid
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fractions in serum or plasma
Phospholipids
Cholesterol esters
Triglycerides
Total serum
weeks to months
weeks
hours
?
Short-term biomarker
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Design
EPIC - European Prospective
Investigation into Cancer and
Nutrition (1992-ongoing):
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Cohort involving 23 centres in 10 European
countries (N=520,000)
Country-specific dietary questionnaires
validated locally
Anthropometric data and blood samples
were collected at baseline
The EPIC Study
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Design
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Cross-sectional analyses on 3,003 subjects who
are part of the EPIC sub-calibration study.
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Plasma phospholipid fatty acids measured by gas
chromatography at the IARC-WHO laboratory.
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Associations between plasma phospholipid fatty
acids (% of total fatty acids) and BMI [<25; 2530; >30kg/m2], as indicator of overall obesity.
All measurements were adjusted for region, age,
menopausal status, alcohol intake, physical
activity, smoking status, educational level, and
energy intake.
The EPIC-PANACEA
Study
Physical Activity,
Nutrition, Alcohol,
Cessation of Smoking,
Eating out of Home
and Obesity Project
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Prevalence of obesity (BMI) in the EPICPANACEA Study
BMI
Umea
Athens
30
Granada
25
Murcia
Malmo
20
15
Denmark
Northern Spain
10
5
UK Health conscious
Ragusa/Naples
0
UK General population
MEN
WOMEN
Florence
Varese/Turin
The Netherlands
Potsdam
France
Heidelberg
Overweight and obesity, estimated by BMI measures, are higher in Southern
vs Northern centres
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Saturated fatty acids (diet) and BMI
Fatty acids
Tertiles
P-trend
OR* 95%CI
15:0
<.0001
1
1.00
2
0.92
0.74-1.15
3
0.64
0.51-0.81
1
1.00
2
0.71
0.57-0.89
3
0.38
0.30-0.49
17:0
<.0001
0.5
1
*adjusted for region, age, alcohol intake,
physical activity, smoking status,
educational level, and energy intake
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Saturated fatty acids (diet/metabolism) and
BMI
Fatty acids Tertiles OR*
P-trend
95%CI
16:0
0.0218
1
1.00
2
1.33
1.07-1.65
3
1.34
1.05-1.71
1
1.00
2
1.47
1.20-1.80
3
2.02
1.61-2.53
18:0
<.0001
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2
*adjusted for region, age, alcohol intake,
physical activity, smoking status,
educational level, and energy intake
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Monounsaturated fatty acids and BMI
Fatty acids Tertiles OR*
P-trend
95%CI
16:1n7/9t + 18:1n-9t
<.0001
1
1.00
2
1.25
1.00-1.58
3
1.71
1.33-2.19
1
1.00
2
1.03
0.84-1.26
3
0.81
0.65-1.02
18:1n9c
0.0809
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2
*adjusted for region, age, alcohol intake,
physical activity, smoking status,
educational level, and energy intake
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Ratios of fatty acids (desaturases) and BMI
Fatty acids
Tertiles OR* 95%CI
16:1n-7/16:0
∆-9 desaturase or SCD-1
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P-trend
<.0001
1.00
2
1.39 1.11-1.74
3
1.78 1.39-2.27
1
1.00
2
1.47 1.20-1.80
3
1.90 1.54-2.34
1
1.00
2
0.67 0.55-0.83
3
0.38 0.31-0.48
18:3n-6/18:2n-6
∆-6 desaturase
<.0001
20:4n-6/20:3n-6
∆-5 desaturase
<.0001
0.5
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2
*adjusted for region, age, alcohol intake,
physical activity, smoking status,
educational level, and energy intake
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Conclusion
A specific fatty acid profile, as a biomarker of both lipid exposure and
fatty acid metabolism, is associated to BMI
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Conclusion
A specific fatty acid profile, as a biomarker of both lipid exposure and
fatty acid metabolism, is associated to BMI
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Biomarkers of dietary exposure
High intake of saturated 15:0 and 17:0 (dairy products) may decrease risk of
obesity
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Conclusion
A specific fatty acid profile, as a biomarker of both lipid exposure and
fatty acid metabolism, is associated to BMI
Biomarkers of dietary exposure
•
High intake of saturated 15:0 and 17:0 (dairy products) may decrease risk of
obesity
•
High intake of trans fatty acids (industrial trans fatty acids) may increase risk of
obesity
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Conclusion
A specific fatty acid profile, as a biomarker of both lipid exposure and
fatty acid metabolism, is associated to BMI
Biomarkers of dietary exposure
•
High intake of saturated 15:0 and 17:0 (dairy products) may decrease risk of
obesity
•
High intake of trans fatty acids (industrial trans fatty acids) may increase risk of
obesity
Biomarkers of fatty acid metabolism
•
High intake of saturated fatty acids (16:0 and 18:0) along with increased hepatic
expression/activity of Δ-9 desaturase may increase risk of obesity
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Perspectives
A specific fatty acid profile, as a biomarker of both lipid exposure and
fatty acid metabolism, is associated to BMI
Biomarkers of dietary exposure
•
High intake of saturated 15:0 and 17:0 (dairy products) may decrease risk of
obesity
•
High intake of trans fatty acids (industrial trans fatty acids) may increase risk of
obesity
Biomarkers of fatty acid metabolism
•
High intake of saturated fatty acids (16:0 and 18:0) along with increased hepatic
expression/activity of Δ-9 desaturase may increase risk of obesity
Perspectives
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Association between biomarkers of fatty acids and BMI change
Comparison of natural trans fatty acids versus industrial trans fatty acids
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Acknowledgements
IARC, Lyon
N. Slimani (DEX)
I. Romieu (NEP)
P. Ferrari (NEP)
Imperial College, London
E. Riboli
EPIC PIs
Financial support
European Commission, LNCC,
INCA (France)
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