@article{WillmannHeniLinderetal.2019,
  author    = {Willmann, Caroline and Heni, Martin and Linder, Katarzyna and Wagner, Robert and Stefan, Norbert and Machann, J{\"u}rgen and Schulze, Matthias Bernd and Joost, Hans-Georg and Haring, Hans-Ulrich and Fritsche, Andreas},
  title     = {Potential effects of reduced red meat compared with increased fiber intake on glucose metabolism and liver fat content},
  series = {The American journal of clinical nutrition : a publication of the American Society for Nutrition, Inc.},
  volume    = {109},
  journal   = {The American journal of clinical nutrition : a publication of the American Society for Nutrition, Inc.},
  number    = {2},
  publisher = {Oxford Univ. Press},
  address   = {Oxford},
  issn      = {0002-9165},
  doi       = {10.1093/ajcn/nqy307},
  pages     = {288 -- 296},
  year      = {2019},
  abstract  = {Background: Epidemiological studies suggest that an increased red meat intake is associated with a higher risk of type 2 diabetes, whereas an increased fiber intake is associated with a lower risk. Objectives: We conducted an intervention study to investigate the effects of these nutritional factors on glucose and lipid metabolism, body-fat distribution, and liver fat content in subjects at increased risk of type 2 diabetes. Methods: This prospective, randomized, and controlled dietary intervention study was performed over 6 mo. All groups decreased their daily caloric intake by 400 kcal. The "control" group (N = 40) only had this requirement. The "no red meat" group (N = 48) in addition aimed to avoid the intake of red meat, and the "fiber" group (N = 44) increased intake of fibers to 40 g/d. Anthropometric parameters and frequently sampled oral glucose tolerance tests were performed before and after intervention. Body-fat mass and distribution, liver fat, and liver iron content were assessed by MRI and single voxel proton magnetic resonance spectroscopy. Results: Participants in all groups lost weight (mean 3.3 +/- 0.5 kg, P < 0.0001). Glucose tolerance and insulin sensitivity improved (P < 0.001), and body and visceral fat mass decreased in all groups (P < 0.001). These changes did not differ between groups. Liver fat content decreased significantly (P < 0.001) with no differences between the groups. The decrease in liver fat correlated with the decrease in ferritin during intervention (r(2) = 0.08, P = 0.0021). This association was confirmed in an independent lifestyle intervention study (Tuebingen Lifestyle Intervention Program, N = 229, P = 0.0084). Conclusions: Our data indicate that caloric restriction leads to a marked improvement in glucose metabolism and body-fat composition, including liver-fat content. The marked reduction in liver fat might be mediated via changes in ferritin levels. In the context of caloric restriction, there seems to be no additional beneficial impact of reduced red meat intake and increased fiber intake on the improvement in cardiometabolic risk parameters. This trial was registered at clinicaltrials.gov as NCT03231839.},
  language  = {en}
}
@article{LehnStefanPeterMachannetal.2022,
  author    = {Lehn-Stefan, Angela and Peter, Andreas and Machann, J{\"u}rgen and Schick, Fritz and Randrianarisoa, Elko and Heni, Martin and Wagner, Robert and Birkenfeld, Andreas L. and Fritsche, Andreas and Schulze, Matthias Bernd and Stefan, Norbert and Kantartzis, Konstantinos},
  title     = {Impaired metabolic health and low cardiorespiratory fitness independently associate with subclinical atherosclerosis in obesity},
  series = {The journal of clinical endocrinology \& metabolism},
  volume    = {107},
  journal   = {The journal of clinical endocrinology \& metabolism},
  number    = {6},
  publisher = {Endocrine Society},
  address   = {Washington},
  issn      = {0021-972X},
  doi       = {10.1210/clinem/dgac091},
  pages     = {E2417 -- E2424},
  year      = {2022},
  abstract  = {Context For a given body mass index (BMI), both impaired metabolic health (MH) and reduced cardiorespiratory fitness (CRF) associate with increased risk of cardiovascular disease (CVD). Objective It remains unknown whether both risk phenotypes relate to CVD independently of each other, and whether these relationships differ in normal weight, overweight, and obese subjects. Methods Data from 421 participants from the Tubingen Diabetes Family Study, who had measurements of anthropometrics, metabolic parameters, CRF (maximal aerobic capacity [VO2max]) and carotid intima-media thickness (cIMT), an early marker of atherosclerosis, were analyzed. Subjects were divided by BMI and MH status into 6 phenotypes. Results In univariate analyses, older age, increased BMI, and a metabolic risk profile correlated positively, while insulin sensitivity and VO2max negatively with cIMT. In multivariable analyses in obese subjects, older age, male sex, lower VO2max (std. ss -0.21, P = 0.002) and impaired MH (std. ss 0.13, P = 0.02) were independent determinants of increased cIMT. After adjustment for age and sex, subjects with metabolically healthy obesity (MHO) had higher cIMT than subjects with metabolically healthy normal weight (MHNW; 0.59 +/- 0.009 vs 0.52 +/- 0.01 mm; P < 0.05). When VO2max was additionally included in this model, the difference in cIMT between MHO and MHNW groups became statistically nonsignificant (0.58 +/- 0.009 vs 0.56 +/- 0.02 mm; P > 0.05). Conclusion These data suggest that impaired MH and low CRF independently determine increased cIMT in obese subjects and that low CRF may explain part of the increased CVD risk observed in MHO compared with MHNW.},
  language  = {en}
}