TY  - JOUR
A1  - Schulze, Matthias Bernd
T1  - Metabolic health in normal-weight and obese individuals
JF  - Diabetologia : journal of the European Association for the Study of Diabetes (EASD)
N2  - Cardiovascular complications are commonly associated with obesity. However, a subgroup of obese individuals may not be at an increased risk for cardiovascular complications; these individuals are said to have metabolically healthy obesity (MHO). In contrast, metabolically unhealthy individuals are at high risk of cardiovascular disease (CVD), irrespective of BMI; thus, this group can include individuals within the normal weight category (BMI 18.5-24.9kg/m(2)). This review provides a summary of prospective studies on MHO and metabolically unhealthy normal-weight (MUHNW) phenotypes. Notably, there is ongoing dispute surrounding the concept of MHO, including the lack of a uniform definition and the potentially transient nature of metabolic health status. This review highlights the relevance of alternative measures of body fatness, specifically measures of fat distribution, for determining MHO and MUHNW. It also highlights alternative approaches of risk stratification, which account for the continuum of risk in relation to CVD, which is observable for most risk factors. Moreover, studies evaluating the transition from metabolically healthy to unhealthy phenotypes and potential determinants for such conversions are discussed. Finally, the review proposes several strategies for the use of epidemiological research to further inform the current debate on metabolic health and its determination across different stages of body fatness.
KW  - Cardiovascular diseases
KW  - Cohort studies
KW  - Metabolically benign
KW  - Obesity
KW  - Review
Y1  - 0208
U6  - https://doi.org/10.1007/s00125-018-4787-8
SN  - 0012-186X
SN  - 1432-0428
VL  - 62
IS  - 4
SP  - 558
EP  - 566
PB  - Springer
CY  - New York
ER  - 
TY  - JOUR
A1  - Laeger, Thomas
A1  - Castano-Martinez, Teresa
A1  - Werno, Martin W.
A1  - Japtok, Lukasz
A1  - Baumeier, Christian
A1  - Jonas, Wenke
A1  - Kleuser, Burkhard
A1  - Schürmann, Annette
T1  - Dietary carbohydrates impair the protective effect of protein restriction against diabetes in NZO mice used as a model of type 2 diabetes
JF  - Diabetologia : journal of the European Association for the Study of Diabetes (EASD)
N2  - Aims/hypothesis Low-protein diets are well known to improve glucose tolerance and increase energy expenditure. Increases in circulating fibroblast growth factor 21 (FGF21) have been implicated as a potential underlying mechanism. Methods We aimed to test whether low-protein diets in the context of a high-carbohydrate or high-fat regimen would also protect against type 2 diabetes in New Zealand Obese (NZO) mice used as a model of polygenetic obesity and type 2 diabetes. Mice were placed on high-fat diets that provided protein at control (16 kJ%; CON) or low (4 kJ%; low-protein/high-carbohydrate [LP/HC] or low-protein/high-fat [LP/HF]) levels. Results Protein restriction prevented the onset of hyperglycaemia and beta cell loss despite increased food intake and fat mass. The effect was seen only under conditions of a lower carbohydrate/fat ratio (LP/HF). When the carbohydrate/fat ratio was high (LP/HC), mice developed type 2 diabetes despite the robustly elevated hepatic FGF21 secretion and increased energy expenditure. Conclusion/interpretation Prevention of type 2 diabetes through protein restriction, without lowering food intake and body fat mass, is compromised by high dietary carbohydrates. Increased FGF21 levels and elevated energy expenditure do not protect against hyperglycaemia and type 2 diabetes per se.
KW  - Energy expenditure
KW  - FGF21
KW  - Hyperglycaemia
KW  - Insulin resistance
KW  - NZO
KW  - Obesity
KW  - Protein restriction
Y1  - 2018
U6  - https://doi.org/10.1007/s00125-018-4595-1
SN  - 0012-186X
SN  - 1432-0428
VL  - 61
IS  - 6
SP  - 1459
EP  - 1469
PB  - Springer
CY  - New York
ER  -