Summary
Recently, Ilesanmi-Oyelere et al. [1] reported the results of a cross-sectional study that evaluated the association between four dietary patterns, nutrients and food intakes and an array of systemic inflammation biomarkers and lipid profile among 80 postmenopausal women from New Zealand. The authors used a food frequency questionnaire to collect nutrients and food intake. Four dietary patterns were identified by principal component analysis (PCA) and plasma samples collected for the measuring of inflammatory biomarkers and lipid profile. The authors found that there were negative correlations between intake of dietary fiber, soluble and insoluble non-starch polysaccharides (NSP), vitamin C and niacin and almost all the inflammatory markers for the whole group. Vegetables, tea/coffee and especially fruit intake were negatively correlated with the inflammatory biomarkers in the whole group. A high intake of Pattern 1 (potato, bread, and fruit pattern) was associated with a low risk of high interferon (IFN)-α2, IFN-λ, interleukin (IL)-6 and IL-8 levels while a high intake of Pattern 3 (fast-food pattern) was associated with a high risk of IFN-α2 levels. Multiple linear regression showed a negative correlation between Pattern 2 (soups and vegetables pattern) and levels of C-reactive protein (CRP) as well as ferritin. A positive association was observed between Pattern 3 (fast-food pattern) and CRP levels. Positive correlation was also observed between Pattern 2 and high-density lipoprotein cholesterol (HDL-C) and total cholesterol (TC) levels; however, Pattern 4 (meat and vegetables pattern) was negatively correlated with total cholesterol (TC), LDL-C and TC/HDL-C ratio. The researchers conclude that their findings reinforce the contribution and role of the diet in modifying inflammation in postmenopausal women.
Commentary
Diet, as a modifiable lifestyle factor related to dietary patterns, is associated with chronic complications and systemic inflammation. Indeed, modifying dietary patterns can be used as a practical measure of reducing inflammation [2]. Dietary patterns have recently been related to the pathogenesis of metabolic diseases related to aging. They can cause chronic low-grade systemic inflammation, an integral part of the pathogenesis development of several non-transmissible chronic diseases [3]. Postmenopausal women have unique nutritional requirements due to their physiopathological changes, including body composition and hormones. Also, they are affected by estrogen deficiency and high levels of cytokines have been related to “inflammatory” conditions linked to the metabolic disease and certain types of cancer. Estrogen exert an anti-inflammatory protection, and is continuous decrease increases chronic systemic inflammation. Estrogen blocks the generation of tumor necrosis factor (TNF), decreasing adhesion molecules in endothelial cells; also, lower estrogen levels are associated with increased C-reactive protein (CRP) levels [4].
Food elections are a natural way to take food components without supplementation, known as dietary patterns. The benefits of the Mediterranean diet are well known, helping decrease the inflammation process. Another exciting approach to food patterns is the association of regular consumption of a diet high in fruits and vegetables related to lower CRP and fibrinogen levels. B-carotene, selenium, vitamins C and E are known in specific nutrient intake as an antioxidant inflammatory status. In addition, tannic acid and flavonoids found in cocoa, tea, red wine, and certain types of fruits and vegetables are good antioxidants and have anti-inflammatory properties.
The present commented study is the first to evaluate four dietary patterns from food groups, divided into four groups using regular consumption (potatoes, bread, and fruit), (soups and vegetables), (fast-food), and (meat and vegetables). One of the main results rely on the significance of healthy patterns such as consuming fruits and vegetables in lowering the inflammatory status, especially the dietary fiber and insoluble non-starch polysaccharides. These findings agree with those of Ma et al. [5]. The consumption of vitamin C and niacin was associated with low levels of inflammatory markers; the first one is well-known to be helpful to boost the immune system.
Another interesting finding of the present study [1] is the positive correlation found between Western-style dietary pattern and CRP levels; situation which has also been reported by Eilat-Adar et al. [6]. This diet pattern is deficient in consuming fruits and vegetables, which lowers CRP levels, also reported by Muga et al. [7]. Adding vegetables and, more specifically, fruits were negatively correlated to CRP levels. It´s interesting to suggest the meaningfulness of fruit consumption to regulate inflammation levels in postmenopausal women. The pattern of soups and vegetables was inversely correlated with blood lipids values such as TC and low-density lipoprotein and TC/HDL-C ratio.
One strength of this study is the capability of evaluating the influence of certain types of food patterns and several cytokines in postmenopausal women. Possible limitations are related to the type and design of the study, and the sample size. There is a need for longitudinal and randomized studies to seek for more relevant information. The authors conclude remarking on the significance of dietary fiber, vitamin C, and regular fruit and vegetable consumption at aiding the inflammatory status in postmenopausal women.
Ludwig R. Álvarez-Córdova, MD
Diana Fonseca-Pérez, MD
Facultad de Ciencias Médicas, Carrera de Nutrición y Dietética
Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
References
- Ilesanmi-Oyelere BL, Kruger MC. Associations between dietary patterns and an array of inflammation biomarkers and plasma lipid profile in postmenopausal women. BMC Womens Health. 2023;23(1):256.
https://pubmed.ncbi.nlm.nih.gov/37173732/ - Mohajeri M, Mohajery R, Cicero AFG. Adherence to the Mediterranean Diet Association with Serum Inflammatory Factors Stress Oxidative and Appetite in COVID-19 Patients. Medicina (Kaunas). 2023;59(2):227.
https://pubmed.ncbi.nlm.nih.gov/36837428/ - Franzago M, Santurbano D, Vitacolonna E, Stuppia L. Genes and Diet in the Prevention of Chronic Diseases in Future Generations. Int J Mol Sci. 2020;21(7):2633.
https://pubmed.ncbi.nlm.nih.gov/32290086/ - Koh KK, Ahn JY, Jin DK, et al. Effects of continuous combined hormone replacement therapy on inflammation in hypertensive and/or overweight postmenopausal women. Arterioscler Thromb Vasc Biol. 2002;22(9):1459-1464.
https://pubmed.ncbi.nlm.nih.gov/12231566/ - Ma Y, Hébert JR, Li W, et al. Association between dietary fiber and markers of systemic inflammation in the Women’s Health Initiative Observational Study. Nutrition. 2008;24(10):941-949.
https://pubmed.ncbi.nlm.nih.gov/18562168/ - Eilat-Adar S, Mete M, Nobmann ED, et al. Dietary patterns are linked to cardiovascular risk factors but not to inflammatory markers in Alaska Eskimos. J Nutr. 2009;139(12):2322-2328.
https://pubmed.ncbi.nlm.nih.gov/19828690/ - Muga MA, Owili PO, Hsu CY, Rau HH, Chao JC. Association between Dietary Patterns and Cardiovascular Risk Factors among Middle-Aged and Elderly Adults in Taiwan: A Population-Based Study from 2003 to 2012. PLoS One. 2016;11(7):e0157745.
https://pubmed.ncbi.nlm.nih.gov/27366909/
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