Status: Completed
Obesity is associated with several risk factors (for example, high blood sugar, poor insulin response and inflammation) that increase risk of developing cardiovascular disease and type 2 diabetes (T2DM). Obesity is also associated with abnormalities in the immune system and an increased risk of infection. Specific components of the diet such, as high dietary intake of fat and sugar, influence not only the development of obesity but also the immune system. It is unknown if the immune abnormalities associated with obesity in humans are due to: 1) excess body fat and/or 2) elevated blood sugar levels, often seen in obesity and/or 3) overall diet quality of an individual (for example high fat and/or high sugar intakes).
The overall aim of this research was to determine if diet or alterations in blood sugar levels independently affect inflammation and immune function in participants with obesity.
Objectives:
1. To determine how obesity affects inflammation and immune function.
2. To determine how alterations in blood sugar levels affect inflammation and immune function.
3. To identify specific dietary factors that affect changes in immune function that are related to obesity.
We recruited 4 groups of participants that were similar in age and gender: lean participants with normal blood sugar levels (NG); participants with obesity and with normal blood sugar levels (obesity-NG); participants with obesity living with prediabetes (as defined by having high blood sugar levels – but not high enough to be defined as having diabetes; GI); participants with obesity who have type 2 diabetes (obesity-T2D).
Participants consumed a typical North American/Canadian diet that maintained their weight for a 4-week time period (all food was provided for the participants). Immune system markers (inflammation in the blood and the response of immune cells) and cardiovascular disease markers (blood sugar and insulin) were compared among the 4 groups of participants before and at the end of the study.
By comparing these four groups, we were be able to gain an understanding of the immune complications associated with obesity alone (i.e. excess body fat) and the relationship between blood sugar levels and diet with immune complications. Thus, this study will identify dietary interventions to counteract the immune abnormalities associated with obesity, which may in turn have implications for affecting the risk of cardiovascular disease and T2D associated with obesity.
Clinical Trials registration: NCT04291391
Publications related to this study:
1. [OPEN ACCESS] Assessment of immune function in individuals without and with obesity and normoglycemia, glucose intolerance, or type 2 diabetes: primary findings of the NutrIMM study, a single-arm controlled feeding trial
To learn more about this study:
Canola oil is low in saturated fat. Therefore, utilizing canola oil in a KETO diet may improve its health benefits in people with high risk of / living with type 2 diabetes. The purpose of our study is to investigate the health beneficial effects of a healthy KETO diet supplemented with Canola oil, compared to a traditional Keto Diet and low-fat diet in adults at high risk of type 2 diabetes.
Objectives:
1. To assess the effects on CVD risk factors. Comparisons among groups at 3 and 6 months of intervention on the main risk factors for CVD including plasma cholesterol, TG, ApoB100, glucose, insulin and HbA1C will be conducted.
2. To assess the effects on systemic inflammation and immune function.
3. To document the safety of and adherence to interventions.
Participants will be randomized to one of these three diets and will receive nutrition counselling during 6 months:
1. KETO supplemented with Canola oil (KETO-Can; high in Monounsaturated fatty acids and omega-3).
2. KETO supplemented with butter, coconut and palm oil (KETO-Sat; high in saturated fatty acids).
3. LFD supplemented with whole grains and other low-fat foods (Low-fat diet).
Utilization of 3 groups in the Randomized Controlled Trial will allow us to establish whether either KETO-Can or KETO-Sat elicit better glycemic, lipid and inflammatory outcomes compared with standard recommendations (i.e. diets lower in fat) and will allow a direct comparison between fat sources in the 2 KETO diets. Moreover, by monitoring ketosis and collecting multiple dietary records, we will be able to understand participant compliance with the diets and detailed nutrition intake.
Clinical trials registration: NCT05681468
To learn more about this study or find out if you are eligible: https://sites.google.com/ualberta.ca/ketoim-study
Status: Ongoing
Obesity is associated with an increased risk of infection due to an impaired immune system. Dairy is highly unique due to its nutrient density and provides many essential macro- and micronutrients, including choline. Although dairy products are high in choline in general, buttermilk, the co-product of butter making, is one of the richest sources of milk fat globule membrane (MFGM)-derived polar lipids comprised of lipid soluble forms of choline i.e. phosphatidylcholine and sphingomyelin. In contrast, evidence now suggests that dairy products are either neutral or beneficial for many risk factors including inflammation. Moreover, our group has recently demonstrated that the forms of choline derived from buttermilk have a beneficial effect on the immune system during both the lactation and early developmental periods (see past studies below). Despite this, no studies have specifically examined how buttermilk-derived polar lipids can improve obesity-related immune dysfunction.
The main objective of this research project is to test the hypothesis that lipid-soluble forms of choline from buttermilk can precisely counteract the immune dysfunction observed in obesity. This project will focus on the importance of consuming buttermilk as a whole and its derived polar lipids on inflammation and the immune system. Outcomes from this study will provide essential mechanistic evidence of buttermilk and dairy fat's nutritional and health benefits to improve the immune system. Finally, this research project has the potential to support dietary guidelines to recommend regular dairy consumption to meet the daily requirement of choline intake to prevent obesity-related immune dysfunction.
Status: Completed
Phosphatidylcholine (PC) is a lipid-soluble form of choline that is present in both animal (egg yolks, dairy, beef) and plant (soy) sources. PC is an integral phospholipid in cell membranes, and also plays a role in maintaining the mucosal layer of the gastrointestinal tract. Thus, dietary PC may support immune function by supporting immune cell membrane composition and the intestinal barrier.
Using an animal model, we explored the following 3 objectives:
1. To investigate the effect of feeding a diet containing 100% egg-PC on the development of obesity-related T cell dysfunction.
2. To determine the dose response of feeding egg-PC on T cell function in obesity.
3. To compare the efficacy of feeding soy-PC vs. egg-PC on T cell function in obesity.
This study has implications for the general public by providing evidence of the health benefits of PC containing foods such as eggs and soy. Further, this study has implications for research as most rodent research diets provide choline solely in the form of water-soluble free choline and thus may not confer optimal effects on immune function.
Status: Completed
Choline is an essential nutrient that can be found in the diet as water- (i.e., free choline (FC)) and lipid-soluble (i.e., phosphatidylcholine (PC) and sphingomyelin (SM)) forms. Previous studies have demonstrated that choline is needed for optimal maternal immune function and the immune system development in offspring with the most benefits being observed when choline was provided as PC in rodents. Yet, this is not representative of the choline forms distribution in a human diet. Despite evidence suggesting a greater impact of PC on immune responses when compared to FC, little is known about the role of SM, another important dietary form of choline, on the immune system. In rodents, feeding dietary PC has been shown to enhance T cell function by increasing the production of Th1 cytokines (i.e. IFN-γ and TNF-α) and IL-2 (a proliferation marker) upon stimulation.
A series of experiments were conducted to determine the impact of feeding diets high in SM and/or PC using buttermilk on immune responses of lactating dams and local and peripheral immune systems development in their offspring. We observed that the forms of choline in the maternal diet were able to modulate the proportion of choline forms in breastmilk during the lactation period. Feeding lactating dams a diet high in SM and PC (34-36% each) improved T cell response by increasing the ex vivo production of IL-2, TNF-α, and IFN-γ by splenocytes. In addition, when dams were fed diets containing a high proportion of lipid-soluble forms (at least 50%) T cell responses were enhanced in both suckled and weaned pups where a higher production of IL-2 TNF-α, and IFN-γ by splenocytes was observed. Similarly, in mesenteric lymph nodes (MLN) of weaned pups, the lipid-soluble forms of choline positively modulated T cell responses in the gut by increasing IL-2, TNF-α, and IFN-γ production. Moreover, upon dietary antigen stimulation, there was a lower production of IL-2, TNF-α, and IL-6 and a higher production of IL-10 by immune cells from both the spleen and MLN in weaned pups, suggesting that the lipid-soluble forms of choline could potentially favor the development of oral tolerance (i.e. lower the risk of allergies).