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Association of daily carbohydrate intake with intermuscular adipose tissue in Korean individuals with obesity: a cross-sectional study

  • Ha-Neul Choi (Department of Food and Nutrition, Changwon National University) ;
  • Young-Seol Kim (Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine) ;
  • Jung-Eun Yim (Department of Food and Nutrition, Changwon National University)
  • Received : 2023.05.24
  • Accepted : 2023.11.16
  • Published : 2024.02.01

Abstract

BACKGROUND/OBJECTIVES: The prevalence of obesity, a worldwide pandemic, has been increasing steadily in Korea. Reports have shown that increased intermuscular adipose tissue (IMAT) is associated with an increased risk of cardiovascular disease, independent of body mass index. However, the relationship between dietary intake and IMAT accumulation in the Korean population remains undetermined. The objective of this study was to evaluate regional fat compartments using advanced magnetic resonance imaging (MRI) techniques. We also aimed to investigate the association between IMAT amounts and dietary intake, including carbohydrate intake, among Korean individuals with obesity. SUBJECTS/METHODS: This cross-sectional study, performed at a medical center in South Korea, recruited 35 individuals with obesity (15 men and 20 women) and classified them into 2 groups according to sex. Anthropometry was performed, and body fat distribution was measured using MRI. Blood parameters, including glucose and lipid profiles, were analyzed using commercial kits. Linear regression analysis was used to test whether the IMAT was associated with daily carbohydrate intake. RESULTS: Carbohydrate intake was positively associated with IMAT in all individuals, with adjustments for age, sex, height, and weight. No significant differences in blood indicators were found between the sexes. CONCLUSIONS: Regardless of sex and age, higher carbohydrate intake was strongly correlated with greater IMAT accumulation. This suggests the need to better understand sex differences and high carbohydrate diet patterns in relation to the association between obesity and metabolic risk, which may help reduce obesity prevalence.

Keywords

Acknowledgement

We are grateful to all the patients who participated in this study.

References

  1. Yang YS, Han BD, Han K, Jung JH, Son JW; Taskforce Team of the Obesity Fact Sheet of the Korean Society for the Study of Obesity. Obesity fact sheet in Korea, 2021: trends in obesity prevalence and obesityrelated comorbidity incidence stratified by age from 2009 to 2019. J Obes Metab Syndr 2022;31:169-77. 
  2. World Health Organization. The Asia-Pacific Perspective: Redefining Obesity and Its Treatment. Sydney: Health Communications Australia; 2000.
  3. Ansari S, Haboubi H, Haboubi N. Adult obesity complications: challenges and clinical impact. Ther Adv Endocrinol Metab 2020;11:2042018820934955.
  4. Kotchen TA, Grim CE, Kotchen JM, Krishnaswami S, Yang H, Hoffmann RG, McGinley EL. Altered relationship of blood pressure to adiposity in hypertension. Am J Hypertens 2008;21:284-9. 
  5. Flegal KM, Kit BK, Orpana H, Graubard BI. Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis. JAMA 2013;309:71-82.
  6. Britton KA, Fox CS. Ectopic fat depots and cardiovascular disease. Circulation 2011;124:e837-41. 
  7. Kahn D, Macias E, Zarini S, Garfield A, Zemski Berry K, Gerszten R, Schoen J, Cree-Green M, Bergman BC. Quantifying the inflammatory secretome of human intermuscular adipose tissue. Physiol Rep 2022;10:e15424.
  8. Yim JE, Heshka S, Albu J, Heymsfield S, Kuznia P, Harris T, Gallagher D. Intermuscular adipose tissue rivals visceral adipose tissue in independent associations with cardiovascular risk. Int J Obes 2007;31:1400-5.
  9. Miljkovic I, Vella CA, Allison M. Computed tomography-derived myosteatosis and metabolic disorders. Diabetes Metab J 2021;45:482-91.
  10. Kahn DE, Bergman BC. Keeping it local in metabolic disease: adipose tissue paracrine signaling and insulin resistance. Diabetes 2022;71:599-609.
  11. van Dam RM, Seidell JC. Carbohydrate intake and obesity. Eur J Clin Nutr 2007;61 Suppl 1:S75-99. 
  12. Goss AM, Chandler-Laney PC, Ovalle F, Goree LL, Azziz R, Desmond RA, Wright Bates G, Gower BA. Effects of a eucaloric reduced-carbohydrate diet on body composition and fat distribution in women with PCOS. Metabolism 2014;63:1257-64.
  13. Goss AM, Gower B, Soleymani T, Stewart M, Pendergrass M, Lockhart M, Krantz O, Dowla S, Bush N, Garr Barry V, et al. Effects of weight loss during a very low carbohydrate diet on specific adipose tissue depots and insulin sensitivity in older adults with obesity: a randomized clinical trial. Nutr Metab (Lond) 2020;17:64.
  14. Gower BA, Goss AM. A lower-carbohydrate, higher-fat diet reduces abdominal and intermuscular fat and increases insulin sensitivity in adults at risk of type 2 diabetes. J Nutr 2015;145:177S-83S.
  15. Ha K, Song Y. Low-carbohydrate diets in Korea: why does it matter, and what is next? J Obes Metab Syndr 2021;30:222-32.
  16. Choi HN, Lim H, Kim YS, Rhee SY, Yim JE. Differences of regional fat distribution measured by magnetic resonance imaging according to obese phenotype in Koreans. Metab Syndr Relat Disord 2022;20:551-7. 
  17. Gallagher D, Kelley DE, Yim JE, Spence N, Albu J, Boxt L, Pi-Sunyer FX, Heshka S; MRI Ancillary Study Group of the Look AHEAD Research Group. Adipose tissue distribution is different in type 2 diabetes. Am J Clin Nutr 2009;89:807-14.
  18. Seo MH, Lee WY, Kim SS, Kang JH, Kang JH, Kim KK, Kim BY, Kim YH, Kim WJ, Kim EM, et al. 2018 Korean society for the study of obesity guideline for the management of obesity in Korea. J Obes Metab Syndr 2019;28:40-5.
  19. Despres JP. Body fat distribution and risk of cardiovascular disease: an update. Circulation 2012;126:1301-13. 
  20. Albu JB, Kovera AJ, Allen L, Wainwright M, Berk E, Raja-Khan N, Janumala I, Burkey B, Heshka S, Gallagher D. Independent association of insulin resistance with larger amounts of intermuscular adipose tissue and a greater acute insulin response to glucose in African American than in white nondiabetic women. Am J Clin Nutr 2005;82:1210-7.
  21. Boettcher M, Machann J, Stefan N, Thamer C, Haring HU, Claussen CD, Fritsche A, Schick F. Intermuscular adipose tissue (IMAT): association with other adipose tissue compartments and insulin sensitivity. J Magn Reson Imaging 2009;29:1340-5.
  22. Goodpaster BH, Krishnaswami S, Resnick H, Kelley DE, Haggerty C, Harris TB, Schwartz AV, Kritchevsky S, Newman AB. Association between regional adipose tissue distribution and both type 2 diabetes and impaired glucose tolerance in elderly men and women. Diabetes Care 2003;26:372-9.
  23. Miljkovic-Gacic I, Gordon CL, Goodpaster BH, Bunker CH, Patrick AL, Kuller LH, Wheeler VW, Evans RW, Zmuda JM. Adipose tissue infiltration in skeletal muscle: age patterns and association with diabetes among men of African ancestry. Am J Clin Nutr 2008;87:1590-5.
  24. Kim JE, Dunville K, Li J, Cheng JX, Conley TB, Couture CS, Campbell WW. Intermuscular adipose tissue content and intramyocellular lipid fatty acid saturation are associated with glucose homeostasis in middle-aged and older adults. Endocrinol Metab 2017;32:257-64.
  25. Tuttle LJ, Sinacore DR, Mueller MJ. Intermuscular adipose tissue is muscle specific and associated with poor functional performance. J Aging Res 2012;2012:172957.
  26. Goodpaster BH, Bergman BC, Brennan AM, Sparks LM. Intermuscular adipose tissue in metabolic disease. Nat Rev Endocrinol 2023;19:285-98.
  27. Janmahasatian S, Duffull SB, Ash S, Ward LC, Byrne NM, Green B. Quantification of lean bodyweight. Clin Pharmacokinet 2005;44:1051-65.
  28. Cho SM, Lee H, Lee HH, Baek J, Heo JE, Joo HJ, Hong SJ, Kim HC; Korean Society of Lipid and Atherosclerosis (KSoLA) Public Relations Committee. Dyslipidemia fact sheets in Korea 2020: an analysis of nationwide population-based data. J Lipid Atheroscler 2021;10:202-9.
  29. Cho YA, Choi JH. Association between carbohydrate intake and the prevalence of metabolic syndrome in Korean women. Nutrients 2021;13:3098.
  30. Schulze MB, Hu FB. Dietary approaches to prevent the metabolic syndrome: quality versus quantity of carbohydrates. Diabetes Care 2004;27:613-4.
  31. Song S, Lee JE, Song WO, Paik HY, Song Y. Carbohydrate intake and refined-grain consumption are associated with metabolic syndrome in the Korean adult population. J Acad Nutr Diet 2014;114:54-62. 
  32. Ha K, Kim K, Chun OK, Joung H, Song Y. Differential association of dietary carbohydrate intake with metabolic syndrome in the US and Korean adults: data from the 2007-2012 NHANES and KNHANES. Eur J Clin Nutr 2018;72:848-60.
  33. Shankar K, Harrell A, Kang P, Singhal R, Ronis MJ, Badger TM. Carbohydrate-responsive gene expression in the adipose tissue of rats. Endocrinology 2010;151:153-64.
  34. Ortega-Prieto P, Postic C. Carbohydrate sensing through the transcription factor ChREBP. Front Genet 2019;10:472.
  35. Linden AG, Li S, Choi HY, Fang F, Fukasawa M, Uyeda K, Hammer RE, Horton JD, Engelking LJ, Liang G. Interplay between ChREBP and SREBP-1c coordinates postprandial glycolysis and lipogenesis in livers of mice. J Lipid Res 2018;59:475-87.
  36. Sjoholm K, Gripeteg L, Larsson I. Macronutrient and alcohol intake is associated with intermuscular adipose tissue in a randomly selected group of younger and older men and women. Clin Nutr ESPEN 2016;13:e46-51.