Effects of dietary whole grain, fruit, and vegetables on weight and inflammatory biomarkers in overweight and obese women

Abstract

Purpose

The separate effects of whole grain (WG) and fruit and vegetable (F&V) diets on inflammatory biomarkers have not been assessed. Therefore, we evaluated these two high-fiber diets in relation to inflammation indices in obese and overweight women.

Study design

Parallel randomized clinical trial.

Methods

In the present study, 75 women were recruited and randomly assigned to three diet groups: a whole grain diet (WG-D) group, F&V group, and a combined whole grain and F&V diet group (WGFV-D) for 10 weeks. As a “feeding trial” all participants were asked to visit the clinic daily and eat prescribed foods in the presence of a nutritionist. Anthropometric indices and biochemical biomarkers were measured at baseline and after 10 weeks of the trial.

Results

Each of the three diet groups showed significant changes in serum biomarkers (CRP, TNF-α, IL-6, D-dimer, and serum fibrinogen) after following the diet for 10 weeks (P = 0.01). In adjusted models, significant changes were observed for CRP, TNF-α, IL-6, D-dimer, and serum fibrinogen (P = 0.01). In a model adjusted for malondialdehyde (MDA) level, a trend toward significance was observed (P = 0.05). Consumption of all three different diets for 10 weeks showed statistically significant change for all biomarkers (P < 0.05) the most notable changes in inflammatory indices were observed among participants following the WG diet.

Conclusions

Study results indicate that consumption of high-fiber diets, especially the WG diet, can help lower inflammatory levels and prevent subsequent adverse health consequences.

Level of Evidence

Level I, randomized controlled trial.

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References

  1. 1.

    WHO Fact Sheet (2018) Obesity and overweight. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight. Accessed 8 Feb 2019

  2. 2.

    Barak F et al (2015) Adherence to the Dietary Approaches to Stop Hypertension (DASH) diet in relation to obesity among Iranian female nurses. Public Health Nutr 18(4):705–712. https://doi.org/10.1017/S1368980014000822

    Article  PubMed  Google Scholar 

  3. 3.

    Janghorbani M et al (2007) First nationwide survey of prevalence of overweight, underweight, and abdominal obesity in Iranian adults. Obesity (Silver Spring) 15(11):2797–2808. https://doi.org/10.1038/oby.2007.332

    Article  Google Scholar 

  4. 4.

    Seidell JC et al (1996) Overweight, underweight, and mortality. A prospective study of 48,287 men and women. Arch Intern Med 156(9):958–963. https://doi.org/10.1001/archinte.1996.00440090054006

    CAS  Article  PubMed  Google Scholar 

  5. 5.

    Goossens GH (2008) The role of adipose tissue dysfunction in the pathogenesis of obesity-related insulin resistance. Physiol Behav 94(2):206–218. https://doi.org/10.1016/j.physbeh.2007.10.010

    CAS  Article  PubMed  Google Scholar 

  6. 6.

    Hauner H (2005) Secretory factors from human adipose tissue and their functional role. Proc Nutr S oc 64(2):163–169. https://doi.org/10.1079/PNS2005428

    CAS  Article  Google Scholar 

  7. 7.

    Fain JN (2006) Release of interleukins and other inflammatory cytokines by human adipose tissue is enhanced in obesity and primarily due to the nonfat cells. Vitam Horm 74:443–477. https://doi.org/10.1016/S0083-6729(06)74018-3

    CAS  Article  PubMed  Google Scholar 

  8. 8.

    Hotamisligil GS (2003) Inflammatory pathways and insulin action. Int J Obes Relat Metab Disord 27(Suppl 3):S53–S55. https://doi.org/10.1038/sj.ijo.0802502

    CAS  Article  PubMed  Google Scholar 

  9. 9.

    de Alvaro C et al (2004) Tumor necrosis factor alpha produces insulin resistance in skeletal muscle by activation of inhibitor kappaB kinase in a p38 MAPK-dependent manner. J Biol Chem 279(17):17070–17078. https://doi.org/10.1074/jbc.M312021200

    CAS  Article  PubMed  Google Scholar 

  10. 10.

    Yudkin JS (2003) Adipose tissue, insulin action and vascular disease: inflammatory signals. Int J Obes Relat Metab Disord 27(Suppl 3):S25–S28. https://doi.org/10.1038/sj.ijo.0802496

    CAS  Article  PubMed  Google Scholar 

  11. 11.

    Yudkin JS et al (2000) Inflammation, obesity, stress and coronary heart disease: is interleukin-6 the link? Atherosclerosis 148(2):209–214. https://doi.org/10.1016/S0021-9150(99)00463-3

    CAS  Article  PubMed  Google Scholar 

  12. 12.

    Yudkin JS et al (1999) C-reactive protein in healthy subjects: associations with obesity, insulin resistance, and endothelial dysfunction: a potential role for cytokines originating from adipose tissue? Arterioscler Thromb Vasc Biol 19(4):972–978

    CAS  PubMed  Google Scholar 

  13. 13.

    Dixon JB (2010) The effect of obesity on health outcomes. Mol Cell Endocrinol 316(2):104–108. https://doi.org/10.1016/j.mce.2009.07.008

    CAS  Article  PubMed  Google Scholar 

  14. 14.

    Kaul L, Nidiry J (1993) High-fiber diet in the treatment of obesity and hypercholesterolemia. J Natl Med Assoc 85(3):231–232

    CAS  PubMed  PubMed Central  Google Scholar 

  15. 15.

    Sackner-Bernstein J, Kanter D, Kaul S (2015) Dietary intervention for overweight and obese adults: comparison of low-carbohydrate and low-fat diets. A meta-analysis. PLoS One 10(10):e0139817. https://doi.org/10.1371/journal.pone.0139817

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  16. 16.

    Sayon-Orea C et al (2015) Adherence to Mediterranean dietary pattern and menopausal symptoms in relation to overweight/obesity in Spanish perimenopausal and postmenopausal women. Menopause 22(7):750–757. https://doi.org/10.1097/GME.0000000000000378

    Article  PubMed  Google Scholar 

  17. 17.

    Hajihashemi P et al (2014) Whole-grain intake favorably affects markers of systemic inflammation in obese children: a randomized controlled crossover clinical trial. Mol Nutr Food Res 58(6):1301–1308. https://doi.org/10.1002/mnfr.201300582

    CAS  Article  PubMed  Google Scholar 

  18. 18.

    Holt EM et al (2009) Fruit and vegetable consumption and its relation to markers of inflammation and oxidative stress in adolescents. J Am Diet Assoc 109(3):414–421. https://doi.org/10.1016/j.jada.2008.11.036

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  19. 19.

    Macready AL et al (2014) Flavonoid-rich fruit and vegetables improve microvascular reactivity and inflammatory status in men at risk of cardiovascular disease–FLAVURS: a randomized controlled trial. Am J Clin Nutr 99(3):479–489. https://doi.org/10.3945/ajcn.113.074237

    CAS  Article  PubMed  Google Scholar 

  20. 20.

    Oliveira A, Rodriguez-Artalejo F, Lopes C (2009) The association of fruits, vegetables, antioxidant vitamins and fibre intake with high-sensitivity C-reactive protein: sex and body mass index interactions. Eur J Clin Nutr 63(11):1345–1352. https://doi.org/10.1038/ejcn.2009.61

    CAS  Article  PubMed  Google Scholar 

  21. 21.

    Sahyoun NR et al (2006) Whole-grain intake is inversely associated with the metabolic syndrome and mortality in older adults. Am J Clin Nutr 83(1):124–131. https://doi.org/10.1093/ajcn/83.1.124

    CAS  Article  PubMed  Google Scholar 

  22. 22.

    Vitaglione P et al (2015) Whole-grain wheat consumption reduces inflammation in a randomized controlled trial on overweight and obese subjects with unhealthy dietary and lifestyle behaviors: role of polyphenols bound to cereal dietary fiber. Am J Clin Nutr 101(2):251–261. https://doi.org/10.3945/ajcn.114.088120

    CAS  Article  PubMed  Google Scholar 

  23. 23.

    Yeon JY, Kim HS, Sung MK (2012) Diets rich in fruits and vegetables suppress blood biomarkers of metabolic stress in overweight women. Prev Med 54(Suppl):S109–S115. https://doi.org/10.1016/j.ypmed.2011.12.026

    CAS  Article  PubMed  Google Scholar 

  24. 24.

    Katcher HI et al (2008) The effects of a whole grain-enriched hypocaloric diet on cardiovascular disease risk factors in men and women with metabolic syndrome. Am J Clin Nutr 87(1):79–90. https://doi.org/10.1093/ajcn/87.1.79

    CAS  Article  PubMed  Google Scholar 

  25. 25.

    Kim Y, Je Y (2014) Dietary fiber intake and total mortality: a meta-analysis of prospective cohort studies. Am J Epidemiol 180(6):565–573. https://doi.org/10.1093/aje/kwu174

    Article  PubMed  Google Scholar 

  26. 26.

    Esmaillzadeh A, Azadbakht L (2012) Legume consumption is inversely associated with serum concentrations of adhesion molecules and inflammatory biomarkers among Iranian women. J Nutr 142(2):334–339. https://doi.org/10.3945/jn.111.146167

    CAS  Article  PubMed  Google Scholar 

  27. 27.

    Wong SH et al (1987) Lipoperoxides in plasma as measured by liquid-chromatographic separation of malondialdehyde-thiobarbituric acid adduct. Clin Chem 33(2 Pt 1):214–220

    CAS  PubMed  Google Scholar 

  28. 28.

    de Punder K, Pruimboom L (2013) The dietary intake of wheat and other cereal grains and their role in inflammation. Nutrients 5(3):771–787. https://doi.org/10.3390/nu5030771

    Article  PubMed  PubMed Central  Google Scholar 

  29. 29.

    Esposito K et al (2004) Effect of a mediterranean-style diet on endothelial dysfunction and markers of vascular inflammation in the metabolic syndrome: a randomized trial. JAMA 292(12):1440–1446. https://doi.org/10.1001/jama.292.12.1440

    CAS  Article  PubMed  Google Scholar 

  30. 30.

    Lutsey PL et al (2007) Whole grain intake and its cross-sectional association with obesity, insulin resistance, inflammation, diabetes and subclinical CVD: the MESA Study. Br J Nutr 98(2):397–405. https://doi.org/10.1017/S0007114507700715

    CAS  Article  PubMed  Google Scholar 

  31. 31.

    Qi L et al (2006) Whole-grain, bran, and cereal fiber intakes and markers of systemic inflammation in diabetic women. Diabetes Care 29(2):207–211. https://doi.org/10.2337/diacare.29.02.06.dc05-1903

    CAS  Article  PubMed  Google Scholar 

  32. 32.

    Root MM et al (2012) Combined fruit and vegetable intake is correlated with improved inflammatory and oxidant status from a cross-sectional study in a community setting. Nutrients 4(1):29–41. https://doi.org/10.3390/nu4010029

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  33. 33.

    Ghalandari H et al (2018) Comparison of two calorie-reduced diets of different carbohydrate and fiber contents and a simple dietary advice aimed to modify carbohydrate intake on glycemic control and inflammatory markers in type 2 diabetes: a randomized trial. Int J Endocrinol Metab 16(1):e12089. https://doi.org/10.5812/ijem.12089

    Article  PubMed  Google Scholar 

  34. 34.

    Kuo SM (2013) The interplay between fiber and the intestinal microbiome in the inflammatory response. Adv Nutr 4(1):16–28. https://doi.org/10.3945/an.112.003046

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  35. 35.

    Le Leu RK et al (2010) Synbiotic intervention of Bifidobacterium lactis and resistant starch protects against colorectal cancer development in rats. Carcinogenesis 31(2):246–251. https://doi.org/10.1093/carcin/bgp197

    CAS  Article  PubMed  Google Scholar 

  36. 36.

    Samuel BS et al (2008) Effects of the gut microbiota on host adiposity are modulated by the short-chain fatty-acid binding G protein-coupled receptor, Gpr41. Proc Natl Acad Sci USA 105(43):16767–16772. https://doi.org/10.1073/pnas.0808567105

    Article  PubMed  Google Scholar 

  37. 37.

    Martinez I et al (2013) Gut microbiome composition is linked to whole grain-induced immunological improvements. ISME J 7(2):269–280. https://doi.org/10.1038/ismej.2012.104

    CAS  Article  PubMed  Google Scholar 

  38. 38.

    Tighe P et al (2010) Effect of increased consumption of whole-grain foods on blood pressure and other cardiovascular risk markers in healthy middle-aged persons: a randomized controlled trial. Am J Clin Nutr 92(4):733–740. https://doi.org/10.3945/ajcn.2010.29417

    CAS  Article  PubMed  Google Scholar 

  39. 39.

    Andersson A et al (2007) Whole-grain foods do not affect insulin sensitivity or markers of lipid peroxidation and inflammation in healthy, moderately overweight subjects. J Nutr 137(6):1401–1407. https://doi.org/10.1093/jn/137.6.1401

    CAS  Article  PubMed  Google Scholar 

  40. 40.

    Esmaillzadeh A et al (2006) Fruit and vegetable intakes, C-reactive protein, and the metabolic syndrome. Am J Clin Nutr 84(6):1489–1497. https://doi.org/10.1093/ajcn/84.6.1489

    CAS  Article  PubMed  Google Scholar 

  41. 41.

    Nadeem N et al (2014) Serum amyloid A-related inflammation is lowered by increased fruit and vegetable intake, while high-sensitive C-reactive protein, IL-6 and E-selectin remain unresponsive. Br J Nutr 112(7):1129–1136. https://doi.org/10.1017/S0007114514001639

    CAS  Article  PubMed  Google Scholar 

  42. 42.

    Lock K et al (2005) The global burden of disease attributable to low consumption of fruit and vegetables: implications for the global strategy on diet. Bull World Health Organ 83(2):100–108

    PubMed  PubMed Central  Google Scholar 

  43. 43.

    Organization, W.H. (2002) The world health report 2002: reducing risks, promoting healthy life. World Health Organization, Geneva

    Google Scholar 

  44. 44.

    Gaskins AJ et al (2010) Whole grains are associated with serum concentrations of high sensitivity C-reactive protein among premenopausal women. J Nutr 140(9):1669–1676. https://doi.org/10.3945/jn.110.124164

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  45. 45.

    Masters RC et al (2010) Whole and refined grain intakes are related to inflammatory protein concentrations in human plasma. J Nutr 140(3):587–594. https://doi.org/10.3945/jn.109.116640

    CAS  Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

The authors are grateful to all individuals who participated in this study.

Funding

This study was supported by Isfahan University of Medical Sciences.

Author information

Affiliations

Authors

Contributions

NA and SF prepared the manuscript. ED and PM conducted the study. ED and LA checked and edited the article. LA supervised all aspects of the study.

Corresponding author

Correspondence to Leila Azadbakht.

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Conflict of interest

The authors report no conflict of interest.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of Isfahan University of Medical Sciences.

Informed consent

Informed consent was obtained from all study participants.

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Cite this article

Arabzadegan, N., Daneshzad, E., Fatahi, S. et al. Effects of dietary whole grain, fruit, and vegetables on weight and inflammatory biomarkers in overweight and obese women. Eat Weight Disord 25, 1243–1251 (2020). https://doi.org/10.1007/s40519-019-00757-x

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Keywords

  • Inflammatory factors
  • Weight reduction
  • Diet
  • Whole grain
  • Randomized clinical trial