A Carbohydrate Beverage Reduces Monocytes Expressing TLR4 in Children with Overweight or Obesity

J Nutr. 2020 Mar 1;150(3):616-622. doi: 10.1093/jn/nxz294.

Abstract

Background: Childhood obesity is increasing, with about one-third of children overweight or obese. Obesity is characterized by a state of chronic low-grade inflammation that is related to cardiometabolic comorbidities. Inflammatory monocytes, which are classified into 3 different groups-classical, intermediate, and nonclassical monocytes, with Toll-like receptor 4 (TLR4+) expression indicating a proinflammatory state-underlie several obesity-associated morbidities.

Objectives: This study aimed to assess the responses of monocyte populations to beverages of differing macronutrient composition in children with healthy weight (HW) or overweight/obesity (OW/OB).

Methods: Ten HW children (5th to 84.9th percentile; mean age 12.29 ± 2.5 y) and 7 children with OW/OB (85th to 99.99th percentile; mean age 11.96 ± 3.8 y) completed the study. Adiposity was determined via DXA. Using a double-blinded, randomized, crossover design, participants consumed either a high-carbohydrate (CHO; 210 kcal; 0 g fat/56 g carbohydrates/0 g protein) or a whole-egg-based high-protein/fat (EGG; 210 kcal; 15 g fat/0 g carbohydrates/18 g protein) beverage. Venous blood was collected at baseline and 2 h postprandially for evaluation of metabolic and inflammatory responses. Repeated measures ANOVA and Pearson correlations were conducted.

Results: Consuming the CHO beverage significantly reduced the primary outcome: TLR4+ expression on classical monocytes in children with OW/OB only (25.60% decrease from baseline in OW/OB compared with 1.61% increase in HW). Children with OW/OB had significantly less percentages of TLR4+ nonclassical monocytes than HW (47.66% lower after CHO). Insulin and glucose (secondary outcomes), were significantly higher after the CHO condition compared with baseline (230.61% and 9.93% increase, respectively). Changes in glucose were significantly and negatively related to changes in monocyte populations in the CHO condition.

Conclusions: These data suggest that high-carbohydrate beverages alter monocyte populations in the blood in children with OW/OB, which is related to glucose metabolism. These findings have implications for nutritional recommendations in children with overweight/obesity. National Clinical Trial registry trial number: NCT03597542.

Keywords: adolescents; diet; inflammation; inflammatory cytokines; innate immune system.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Beverages*
  • Blood Glucose / metabolism
  • Child
  • Cross-Over Studies
  • Cytokines / metabolism
  • Dietary Carbohydrates / administration & dosage*
  • Double-Blind Method
  • Female
  • Humans
  • Inflammation Mediators / metabolism
  • Insulin / blood
  • Male
  • Monocytes / immunology*
  • Monocytes / metabolism
  • Obesity / immunology*
  • Overweight / immunology*
  • Toll-Like Receptor 4 / metabolism*

Substances

  • Blood Glucose
  • Cytokines
  • Dietary Carbohydrates
  • Inflammation Mediators
  • Insulin
  • TLR4 protein, human
  • Toll-Like Receptor 4

Associated data

  • ClinicalTrials.gov/NCT03597542