Obesity has reached epidemic proportions worldwide and, especially when accompanied by group of disorders known as metabolic syndrome, is the common factor of reduced lifespan. Diagnosis of metabolic syndrome allows the identification of people at two-fold increased risk of cardiovascular disease and five-fold increased risk of type 2 diabetes.
According to the International Diabetes Federation, for a person to be defined as having the metabolic syndrome they must have: central obesity (waist circumference: men> 94 cm, women> 80 cm, or BMI>30kg/m²) plus two of the following four factors: raised triglycerides (>1.7 mmol/L), reduced HDL-cholesterol (<1.03 mmol/L in males and <1.29 mmol/L in females), raised blood pressure (systolic BP ≥ 130 or diastolic BP ≥ 85 mm Hg), raised fasting plasma glucose (≥ 5.6 mmol/L).
Approximately one fourth of the adult European population is estimated to have metabolic syndrome. Diet is an integral part of treating metabolic syndrome. Dietary treatment aims to prevent diabetes and cardiovascular diseases by reducing individual risk factors. Thus, the goals are not only to reduce body weight but also to combat insulin resistance, to improve the lipids metabolism and to normalise blood pressure.
Healthy dietary and nutrition habits can help treat the metabolic syndrome by reducing body weight and improve the lipids metabolism, but general dietary recommendations do not work for everyone.
General dietary recommendations for metabolic syndrome patients focus on adjusting the caloric content of the diet to achieve the desired body weight as well as on reducing fat intake, especially saturated fatty acids and trans isomers, minimising the consumption of added simple sugars and products with a high glycemic index. It is also recommended to limit salt and alcohol intake. Moreover, this diet should contain an increased amount of vegetables and fruits (rich in fiber), fish, low-fat dairy products, nuts, fresh herbs and spices.
However, following these general dietary recommendations do not always result in the desired reduction in risk factors. This is because of differences in the response of people to dietary components. Those conditions that affect the individual response to the diet are determined by nutrigenetics. We are all different, not only in genetics, but also due to epigenetic influences especially from the prenatal period and childhood.
The development of new omics technologies used in molecular medicine in recent years has shown a picture of a complex network of many factors that affect the overall state of our health. In addition to the classic biomarkers of the metabolic syndrome, the importance of additional factors has emerged, e.g. chronic inflammation, oxidative stress and gut microbiota dysbiosis.
Thanks to the omics technologies we can identify what happens inside our body at a biochemical level and provide patients with metabolic syndrome a personalised dietary plan based on their individual needs.
At the same time, certain foods are known to contain anti-inflammatory ingredients (e.g. garlic, fish oil), antioxidants (e.g. green tea, grapes), probiotics (e.g. yogurt, sauerkraut) thus have the potential to restore the balance in disturbed processes. It is currently assumed that examining all these processes at the biochemical level along with genetic context allows to tailor an individual diet to the patient and gives a better chance to treat the metabolic syndrome.
Such personalised nutrition planning tools that comprehensively utilize the novel technologies will soon be tested in pilot studies in United Kingdom, Poland, Spain and Denmark within the PREVENTOMICS project.
A bi-center study on the potential benefits of a personalized diet as well as personalized overall diet and behaviour change plan, conducted in the UK and Poland, will include adult subjects with abdominal obesity. As abdominal obesity is a fundamental component of the metabolic syndrome, the effects of nutritional and behavioural interventions not only on weight loss, waist circumference but also on other components of the metabolic syndrome will be investigated. Study in Denmark will focus on the influence of personalized meals delivered for 10 weeks to overweight or obese participants, on the cardiovascular risk. Study with non-obese, healthy adults in Spain will investigate the importance of personal recommendations for healthy food choices using Preventomics retailer website, for maintaining health and reducing the risk of developing metabolic syndrome and other diet-related diseases in the community.
All the consumer centred interventions will assess classic components of metabolic syndrome, such as blood lipids, glucose and blood pressure, as well as novel molecular, biochemical and genetic markers of metabolic disorders, gut microbiota dysbiosis, oxidative stress and chronic inflammation. This new approach may help reduce the prevalence of the metabolic syndrome.
About the authors
Joanna Góralska is currently assistant professor at the Chair of Clinical Biochemistry of the Jagiellonian University Medical College in Krakow, Poland. Master of Biology (2001), PhD in the Faculty of Medicine (2006), Jagiellonian University in Krakow. She is currently head of Department of Genetic Diagnostics and Nutrigenomics. She teaches at the Faculty of Medicine and at the School of Medicine in English on the Jagiellonian University in Krakow. She is a member of the European and Polish Associations for Studies on Obesity and Polish Lipid Association. Her research focuses on the role of nutrients, such as vitamins and n-3 PUFA, in obesity and its metabolic and inflammatory complications. Author of 33 original papers. She took part in different research projects for experimental and clinical intervention studies, funded by European Commission, Minister of Science and University. Her current interests are related to hormones responded to diet and involved in the organ cross-talk, being especially focused on the role of incretin hormones in energetic homeostasis and obesity.
Urszula Raźny is assistant professor at the Department of Clinical Biochemistry at Jagiellonian University Medical College. Education: 2012 – PhD of medical sciences (Jagiellonian University, Medical College), 2003 – Master of Science (The Faculty of Biotechnology, Jagiellonian University). Membership of scientific societies and institutions: Polish Society of Obesity, Polish Society of Lipidology. Main research projects: 2010-2015- FP7: 244995: 7th Framework Programme:” BIOmarkers of Robustness of Metabolic Homeostasis for Nutrigenomics-derived Health CLAIMS Made on Food”, 2004-2010 -FP6-2002-FOOD 506360 “European Nutrigenomics Organisation – Linking genomics, nutrition and health research”. She took part at different research projects for investigating the role of high fat diet on complications of obesity in different mice models in studies funded by the Minister of Health and University. Since her graduation she has been devoted to the investigation of pathological angiogenesis mechanisms accompanying obesity and prediabetes through the study of neovascularisation process in mice presenting different obesity complications. Her current interests are: the role of nutrition on the occurrence of obesity complications; impact of dietary habits on the osteogenesis and bone mineralization in metabolic disturbances of obesity, genetic factors predisposing to defects in bone formation. She is author of 28 papers published in peer-reviewed International Journals.
Małgorzata Malczewska-Malec, PhD, MD is professor and head of the Department of Clinical Biochemistry at Jagiellonian University Medical College in Krakow, Poland. She also works as a doctor in a specialist clinic for patients with metabolic diseases.
Education: She is a graduate of the Faculty of Medicine at the Jagiellonian University (1979).
Specialty: Internal medicine
Dr Malgorzata Malczewska-Malec directs a research laboratory that focuses on the basic mechanism of metabolic diseases. Together with her colleagues, she conducts research on the pathophysiology of obesity, diabetes and lipid disorders.