Short-term dietary reduction of branched-chain amino acids reduces meal-induced insulin secretion and modifies microbiome composition in type 2 diabetes: a randomized controlled crossover trial
ABSTRACT Background Epidemiological studies have shown that increased circulating branched-chain amino acids (BCAAs) are associated with insulin resistance and type 2 diabetes (T2D). This may result from altered energy metabolism or dietary habits. Objective We hypothesized that a lower intake of BC...
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| Published in: | The American journal of clinical nutrition Vol. 110; no. 5; pp. 1098 - 1107 |
|---|---|
| Main Authors: | , , , , , , , , , , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
United States
Oxford University Press
01.11.2019
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| Subjects: | |
| ISSN: | 0002-9165, 1938-3207, 1938-3207 |
| Online Access: | Get full text |
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| Abstract | ABSTRACT
Background
Epidemiological studies have shown that increased circulating branched-chain amino acids (BCAAs) are associated with insulin resistance and type 2 diabetes (T2D). This may result from altered energy metabolism or dietary habits.
Objective
We hypothesized that a lower intake of BCAAs improves tissue-specific insulin sensitivity.
Methods
This randomized, placebo-controlled, double-blinded, crossover trial examined well-controlled T2D patients receiving isocaloric diets (protein: 1 g/kg body weight) for 4 wk. Protein requirements were covered by commercially available food supplemented ≤60% by an AA mixture either containing all AAs or lacking BCAAs. The dietary intervention ensured sufficient BCAA supply above the recommended minimum daily intake. The patients underwent the mixed meal tolerance test (MMT), hyperinsulinemic-euglycemic clamps (HECs), and skeletal muscle and white adipose tissue biopsies to assess insulin signaling.
Results
After the BCAA− diet, BCAAs were reduced by 17% during fasting (P < 0.001), by 13% during HEC (P < 0.01), and by 62% during the MMT (P < 0.001). Under clamp conditions, whole-body and hepatic insulin sensitivity did not differ between diets. After the BCAA− diet, however, the oral glucose sensitivity index was 24% (P < 0.01) and circulating fibroblast-growth factor 21 was 21% higher (P < 0.05), whereas meal-derived insulin secretion was 28% lower (P < 0.05). Adipose tissue expression of the mechanistic target of rapamycin was 13% lower, whereas the mitochondrial respiratory control ratio was 1.7-fold higher (both P < 0.05). The fecal microbiome was enriched in Bacteroidetes but depleted of Firmicutes.
Conclusions
Short-term dietary reduction of BCAAs decreases postprandial insulin secretion and improves white adipose tissue metabolism and gut microbiome composition. Longer-term studies will be needed to evaluate the safety and metabolic efficacy in diabetes patients.
This trial was registered at clinicaltrials.gov as NCT03261362. |
|---|---|
| AbstractList | ABSTRACT
Background
Epidemiological studies have shown that increased circulating branched-chain amino acids (BCAAs) are associated with insulin resistance and type 2 diabetes (T2D). This may result from altered energy metabolism or dietary habits.
Objective
We hypothesized that a lower intake of BCAAs improves tissue-specific insulin sensitivity.
Methods
This randomized, placebo-controlled, double-blinded, crossover trial examined well-controlled T2D patients receiving isocaloric diets (protein: 1 g/kg body weight) for 4 wk. Protein requirements were covered by commercially available food supplemented ≤60% by an AA mixture either containing all AAs or lacking BCAAs. The dietary intervention ensured sufficient BCAA supply above the recommended minimum daily intake. The patients underwent the mixed meal tolerance test (MMT), hyperinsulinemic-euglycemic clamps (HECs), and skeletal muscle and white adipose tissue biopsies to assess insulin signaling.
Results
After the BCAA− diet, BCAAs were reduced by 17% during fasting (P < 0.001), by 13% during HEC (P < 0.01), and by 62% during the MMT (P < 0.001). Under clamp conditions, whole-body and hepatic insulin sensitivity did not differ between diets. After the BCAA− diet, however, the oral glucose sensitivity index was 24% (P < 0.01) and circulating fibroblast-growth factor 21 was 21% higher (P < 0.05), whereas meal-derived insulin secretion was 28% lower (P < 0.05). Adipose tissue expression of the mechanistic target of rapamycin was 13% lower, whereas the mitochondrial respiratory control ratio was 1.7-fold higher (both P < 0.05). The fecal microbiome was enriched in Bacteroidetes but depleted of Firmicutes.
Conclusions
Short-term dietary reduction of BCAAs decreases postprandial insulin secretion and improves white adipose tissue metabolism and gut microbiome composition. Longer-term studies will be needed to evaluate the safety and metabolic efficacy in diabetes patients.
This trial was registered at clinicaltrials.gov as NCT03261362. Epidemiological studies have shown that increased circulating branched-chain amino acids (BCAAs) are associated with insulin resistance and type 2 diabetes (T2D). This may result from altered energy metabolism or dietary habits. We hypothesized that a lower intake of BCAAs improves tissue-specific insulin sensitivity. This randomized, placebo-controlled, double-blinded, crossover trial examined well-controlled T2D patients receiving isocaloric diets (protein: 1 g/kg body weight) for 4 wk. Protein requirements were covered by commercially available food supplemented ≤60% by an AA mixture either containing all AAs or lacking BCAAs. The dietary intervention ensured sufficient BCAA supply above the recommended minimum daily intake. The patients underwent the mixed meal tolerance test (MMT), hyperinsulinemic-euglycemic clamps (HECs), and skeletal muscle and white adipose tissue biopsies to assess insulin signaling. After the BCAA- diet, BCAAs were reduced by 17% during fasting (P < 0.001), by 13% during HEC (P < 0.01), and by 62% during the MMT (P < 0.001). Under clamp conditions, whole-body and hepatic insulin sensitivity did not differ between diets. After the BCAA- diet, however, the oral glucose sensitivity index was 24% (P < 0.01) and circulating fibroblast-growth factor 21 was 21% higher (P < 0.05), whereas meal-derived insulin secretion was 28% lower (P < 0.05). Adipose tissue expression of the mechanistic target of rapamycin was 13% lower, whereas the mitochondrial respiratory control ratio was 1.7-fold higher (both P < 0.05). The fecal microbiome was enriched in Bacteroidetes but depleted of Firmicutes. Short-term dietary reduction of BCAAs decreases postprandial insulin secretion and improves white adipose tissue metabolism and gut microbiome composition. Longer-term studies will be needed to evaluate the safety and metabolic efficacy in diabetes patients.This trial was registered at clinicaltrials.gov as NCT03261362. Epidemiological studies have shown that increased circulating branched-chain amino acids (BCAAs) are associated with insulin resistance and type 2 diabetes (T2D). This may result from altered energy metabolism or dietary habits.BACKGROUNDEpidemiological studies have shown that increased circulating branched-chain amino acids (BCAAs) are associated with insulin resistance and type 2 diabetes (T2D). This may result from altered energy metabolism or dietary habits.We hypothesized that a lower intake of BCAAs improves tissue-specific insulin sensitivity.OBJECTIVEWe hypothesized that a lower intake of BCAAs improves tissue-specific insulin sensitivity.This randomized, placebo-controlled, double-blinded, crossover trial examined well-controlled T2D patients receiving isocaloric diets (protein: 1 g/kg body weight) for 4 wk. Protein requirements were covered by commercially available food supplemented ≤60% by an AA mixture either containing all AAs or lacking BCAAs. The dietary intervention ensured sufficient BCAA supply above the recommended minimum daily intake. The patients underwent the mixed meal tolerance test (MMT), hyperinsulinemic-euglycemic clamps (HECs), and skeletal muscle and white adipose tissue biopsies to assess insulin signaling.METHODSThis randomized, placebo-controlled, double-blinded, crossover trial examined well-controlled T2D patients receiving isocaloric diets (protein: 1 g/kg body weight) for 4 wk. Protein requirements were covered by commercially available food supplemented ≤60% by an AA mixture either containing all AAs or lacking BCAAs. The dietary intervention ensured sufficient BCAA supply above the recommended minimum daily intake. The patients underwent the mixed meal tolerance test (MMT), hyperinsulinemic-euglycemic clamps (HECs), and skeletal muscle and white adipose tissue biopsies to assess insulin signaling.After the BCAA- diet, BCAAs were reduced by 17% during fasting (P < 0.001), by 13% during HEC (P < 0.01), and by 62% during the MMT (P < 0.001). Under clamp conditions, whole-body and hepatic insulin sensitivity did not differ between diets. After the BCAA- diet, however, the oral glucose sensitivity index was 24% (P < 0.01) and circulating fibroblast-growth factor 21 was 21% higher (P < 0.05), whereas meal-derived insulin secretion was 28% lower (P < 0.05). Adipose tissue expression of the mechanistic target of rapamycin was 13% lower, whereas the mitochondrial respiratory control ratio was 1.7-fold higher (both P < 0.05). The fecal microbiome was enriched in Bacteroidetes but depleted of Firmicutes.RESULTSAfter the BCAA- diet, BCAAs were reduced by 17% during fasting (P < 0.001), by 13% during HEC (P < 0.01), and by 62% during the MMT (P < 0.001). Under clamp conditions, whole-body and hepatic insulin sensitivity did not differ between diets. After the BCAA- diet, however, the oral glucose sensitivity index was 24% (P < 0.01) and circulating fibroblast-growth factor 21 was 21% higher (P < 0.05), whereas meal-derived insulin secretion was 28% lower (P < 0.05). Adipose tissue expression of the mechanistic target of rapamycin was 13% lower, whereas the mitochondrial respiratory control ratio was 1.7-fold higher (both P < 0.05). The fecal microbiome was enriched in Bacteroidetes but depleted of Firmicutes.Short-term dietary reduction of BCAAs decreases postprandial insulin secretion and improves white adipose tissue metabolism and gut microbiome composition. Longer-term studies will be needed to evaluate the safety and metabolic efficacy in diabetes patients.This trial was registered at clinicaltrials.gov as NCT03261362.CONCLUSIONSShort-term dietary reduction of BCAAs decreases postprandial insulin secretion and improves white adipose tissue metabolism and gut microbiome composition. Longer-term studies will be needed to evaluate the safety and metabolic efficacy in diabetes patients.This trial was registered at clinicaltrials.gov as NCT03261362. |
| Author | Burkart, Volker Roden, Michael Szendroedi, Julia Pesta, Dominik Koessler, Theresa Simon, Marie-Christine Schmoll, Dieter Zaharia, Oana-Patricia Jelenik, Tomas Tura, Andrea Karusheva, Yanislava Mastrototaro, Lucia Markgraf, Daniel Bódis, Kálmán Wolkersdorfer, Martin Pacini, Giovanni Müssig, Karsten Bärenz, Felix Strassburger, Klaus |
| Author_xml | – sequence: 1 givenname: Yanislava surname: Karusheva fullname: Karusheva, Yanislava organization: Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany – sequence: 2 givenname: Theresa orcidid: 0000-0001-5121-3549 surname: Koessler fullname: Koessler, Theresa organization: Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany – sequence: 3 givenname: Klaus orcidid: 0000-0002-6636-1373 surname: Strassburger fullname: Strassburger, Klaus organization: German Center for Diabetes Research, München-Neuherberg, Germany – sequence: 4 givenname: Daniel orcidid: 0000-0002-2252-8442 surname: Markgraf fullname: Markgraf, Daniel organization: Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany – sequence: 5 givenname: Lucia surname: Mastrototaro fullname: Mastrototaro, Lucia organization: Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany – sequence: 6 givenname: Tomas orcidid: 0000-0002-2061-1162 surname: Jelenik fullname: Jelenik, Tomas organization: Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany – sequence: 7 givenname: Marie-Christine orcidid: 0000-0001-6625-1265 surname: Simon fullname: Simon, Marie-Christine organization: Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany – sequence: 8 givenname: Dominik surname: Pesta fullname: Pesta, Dominik organization: Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany – sequence: 9 givenname: Oana-Patricia orcidid: 0000-0002-5738-9585 surname: Zaharia fullname: Zaharia, Oana-Patricia organization: Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany – sequence: 10 givenname: Kálmán surname: Bódis fullname: Bódis, Kálmán organization: Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany – sequence: 11 givenname: Felix surname: Bärenz fullname: Bärenz, Felix organization: Sanofi-Aventis Deutschland GmbH, Frankfurt, Germany – sequence: 12 givenname: Dieter surname: Schmoll fullname: Schmoll, Dieter organization: Sanofi-Aventis Deutschland GmbH, Frankfurt, Germany – sequence: 13 givenname: Martin surname: Wolkersdorfer fullname: Wolkersdorfer, Martin organization: Landesapotheke Salzburg, Salzburg, Austria – sequence: 14 givenname: Andrea orcidid: 0000-0003-3466-5900 surname: Tura fullname: Tura, Andrea organization: Metabolic Unit, Institute of Biomedical Engineering, National Research Council, Padova, Italy – sequence: 15 givenname: Giovanni surname: Pacini fullname: Pacini, Giovanni organization: Metabolic Unit, Institute of Biomedical Engineering, National Research Council, Padova, Italy – sequence: 16 givenname: Volker surname: Burkart fullname: Burkart, Volker organization: Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany – sequence: 17 givenname: Karsten orcidid: 0000-0003-0107-1196 surname: Müssig fullname: Müssig, Karsten organization: Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany – sequence: 18 givenname: Julia orcidid: 0000-0002-5185-8168 surname: Szendroedi fullname: Szendroedi, Julia email: julia.szendroedi@ddz.de organization: Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany – sequence: 19 givenname: Michael surname: Roden fullname: Roden, Michael organization: Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany |
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| ContentType | Journal Article |
| Copyright | Copyright © American Society for Nutrition 2019. 2019 Copyright © American Society for Nutrition 2019. |
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| Keywords | insulin sensitivity mitochondrial function gut microbiome patients with type 2 diabetes diet insulin secretion branched-chain amino acids |
| Language | English |
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| PublicationDate | 2019-11-01 |
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| PublicationDate_xml | – month: 11 year: 2019 text: 2019-11-01 day: 01 |
| PublicationDecade | 2010 |
| PublicationPlace | United States |
| PublicationPlace_xml | – name: United States |
| PublicationTitle | The American journal of clinical nutrition |
| PublicationTitleAlternate | Am J Clin Nutr |
| PublicationYear | 2019 |
| Publisher | Oxford University Press |
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| Snippet | ABSTRACT
Background
Epidemiological studies have shown that increased circulating branched-chain amino acids (BCAAs) are associated with insulin resistance and... Epidemiological studies have shown that increased circulating branched-chain amino acids (BCAAs) are associated with insulin resistance and type 2 diabetes... |
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| StartPage | 1098 |
| SubjectTerms | Adipose Tissue, White - metabolism Amino Acids, Branched-Chain - administration & dosage Cross-Over Studies Diabetes Mellitus, Type 2 - microbiology Double-Blind Method Female Gastrointestinal Microbiome Humans Insulin Secretion Male Meals Middle Aged Mitochondria - physiology Muscle, Skeletal - metabolism |
| Title | Short-term dietary reduction of branched-chain amino acids reduces meal-induced insulin secretion and modifies microbiome composition in type 2 diabetes: a randomized controlled crossover trial |
| URI | https://www.ncbi.nlm.nih.gov/pubmed/31667519 https://www.proquest.com/docview/2310711487 |
| Volume | 110 |
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