Altered proteome profiles related to visceral adiposity may mediate the favorable effect of green Mediterranean diet: the DIRECT-PLUS trial

Hila Zelicha; Alon Kaplan; Anat Yaskolka Meir; Ehud Rinott; Gal Tsaban; Matthias Blüher; Nora Klöting; Uta Ceglarek; Berend Isermann; Michael Stumvoll; Yoash Chassidim; Ilan Shelef; Frank B Hu; Iris Shai

doi:10.1002/oby.24036

Altered proteome profiles related to visceral adiposity may mediate the favorable effect of green Mediterranean diet: the DIRECT-PLUS trial

Obesity (Silver Spring). 2024 May 16. doi: 10.1002/oby.24036. Online ahead of print.

Authors

Hila Zelicha¹, Alon Kaplan¹, Anat Yaskolka Meir¹, Ehud Rinott¹, Gal Tsaban¹, Matthias Blüher², Nora Klöting², Uta Ceglarek³, Berend Isermann³, Michael Stumvoll³, Yoash Chassidim⁴, Ilan Shelef⁵, Frank B Hu^{6

7

8}, Iris Shai^{1

3

8}

Affiliations

¹ The Health and Nutrition Innovative International Research Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel.
² Helmholtz Institute for Metabolic, Obesity and Vascular Research (HI-MAG) of the Helmholtz Zentrum München at the University of Leipzig and University Hospital Leipzig, Leipzig, Germany.
³ Department of Medicine, University of Leipzig, Leipzig, Germany.
⁴ Department of Engineering, Sapir Academic College, Sapir, Israel.
⁵ Soroka University Medical Center, Be'er Sheva, Israel.
⁶ Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA.
⁷ Harvard Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
⁸ Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA.

PMID: 38757229
DOI: 10.1002/oby.24036

Abstract

Objective: The objective of this study was to explore the effects of a green Mediterranean (green-MED) diet, which is high in dietary polyphenols and green plant-based protein and low in red/processed meat, on cardiovascular disease and inflammation-related circulating proteins and their associations with cardiometabolic risk parameters.

Methods: In the 18-month weight loss trial Dietary Intervention Randomized Controlled Trial Polyphenols Unprocessed Study (DIRECT-PLUS), 294 participants with abdominal obesity were randomized to basic healthy dietary guidelines, Mediterranean (MED), or green-MED diets. Both isocaloric MED diet groups consumed walnuts (28 g/day), and the green-MED diet group also consumed green tea (3-4 cups/day) and green shakes (Mankai plant shake, 500 mL/day) and avoided red/processed meat. Proteome panels were measured at three time points using Olink CVDII.

Results: At baseline, a dominant protein cluster was significantly related to higher phenotypic cardiometabolic risk parameters, with the strongest associations attributed to magnetic resonance imaging-assessed visceral adiposity (false discovery rate of 5%). Overall, after 6 months of intervention, both the MED and green-MED diets induced improvements in cardiovascular disease and proinflammatory risk proteins (p < 0.05, vs. healthy dietary guidelines), with the green-MED diet leading to more pronounced beneficial changes, largely driven by dominant proinflammatory proteins (IL-1 receptor antagonist protein, IL-16, IL-18, thrombospondin-2, leptin, prostasin, galectin-9, and fibroblast growth factor 21; adjusted for age, sex, and weight loss; p < 0.05). After 18 months, proteomics cluster changes presented the strongest correlations with visceral adiposity reduction.

Conclusions: Proteomics clusters may enhance our understanding of the favorable effect of a green-MED diet that is enriched with polyphenols and low in red/processed meat on visceral adiposity and cardiometabolic risk.

Abstract

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