Fibre-Enriched High-Carbohydrate (FEHC) Diet Modulates Inflammation Without Affecting Bone Health in Older Women With Obesity: A Randomised Clinical Trial

IF 6 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes/Metabolism Research and Reviews Pub Date : 2025-09-30 DOI:10.1002/dmrr.70089

Francesca Cannata, Viola Viola, Giulia Leanza, Alice Laudisio, Malak Faraj, Flavia Tramontana, Alessandra Piccoli, Rocky Strollo, Mauro Maccarrone, Fabrizio Russo, Gianluca Vadalà, Veronica Sansoni, Giovanni Lombardi, Giuseppe Banfi, Chiara Verdelli, Rocco Papalia, Nicola Napoli

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Abstract

Background

In older adults, obesity is associated with frailty, conditions worsened by age related decline in bone mineral density (BMD) and muscle mass.

Objective

To evaluate whether a 3-month Fibre-Enriched High Carbohydrate (FEHC) diet preserves bone health, reduces inflammation and modulates Wnt signalling in older adults with obesity.

Methods

In this clinical trial, 86 women aged 65–85 years with obesity (BMI ≥ 30 kg/m²) undergoing hip arthroplasty were assigned to a free control diet (FCD) or a FEHC diet (FEHC) group for 3 months before surgery. Clinical, systemic, and molecular assessments were performed, including gene expression analyses in bone and muscle tissues.

Results

A significant reduction in waist circumference was observed over time in the FEHC group (p = 0.037), whereas no changes were detected in body weight, BMD or bone microarchitecture. Compared to FCD, the FEHC group showed reduced circulating IL-6 (p = 0.03), IL-8 (p = 0.022) and TNFα (p = 0.04) levels, along with lower IL-6 gene expression in muscle (p = 0.035). A strong trend of increased IGF-1 gene expression in muscle tissue of the FEHC group was also observed (p = 0.058). Gene expression analyses revealed a significant increase in WNT5a expression in muscle (p = 0.049), and an upward trend in WNT10b expression in bone (p = 0.055) while serum levels of DKK-1 were significantly higher in the FEHC group compared to FCD (p < 0.0001).

Conclusion

The FEHC diet reduces systemic and local inflammation, without affecting skeletal health in older adults with obesity.

Abstract Image

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富含纤维的高碳水化合物（FEHC）饮食调节炎症而不影响老年肥胖妇女的骨骼健康：一项随机临床试验

背景：在老年人中，肥胖与虚弱有关，骨密度（BMD）和肌肉质量随年龄下降而恶化。目的：评估3个月富含纤维的高碳水化合物（FEHC）饮食是否能保持老年肥胖患者的骨骼健康，减少炎症并调节Wnt信号。方法：在本临床试验中，86名65-85岁的肥胖（BMI≥30 kg/m2）女性接受髋关节置换术，术前3个月分为自由对照饮食组（FCD）和FEHC饮食组（FEHC）。进行了临床、系统和分子评估，包括骨和肌肉组织的基因表达分析。结果：随着时间的推移，FEHC组的腰围明显减小（p = 0.037），而体重、骨密度或骨微结构没有变化。与FCD相比，FEHC组的循环IL-6 （p = 0.03）、IL-8 （p = 0.022）和TNFα (p = 0.04)水平降低，肌肉中IL-6基因表达降低（p = 0.035）。FEHC组肌肉组织中IGF-1基因表达也有明显升高的趋势（p = 0.058）。基因表达分析显示，与FCD相比，FEHC组肌肉中WNT5a表达显著增加（p = 0.049），骨骼中WNT10b表达呈上升趋势（p = 0.055），而血清中DKK-1水平显著高于FCD组(p)。结论：FEHC饮食减少了全身和局部炎症，不影响老年肥胖患者的骨骼健康。

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来源期刊

Diabetes/Metabolism Research and Reviews 医学-内分泌学与代谢

CiteScore

17.20

自引率

2.50%

发文量

审稿时长

4-8 weeks

期刊介绍： Diabetes/Metabolism Research and Reviews is a premier endocrinology and metabolism journal esteemed by clinicians and researchers alike. Encompassing a wide spectrum of topics including diabetes, endocrinology, metabolism, and obesity, the journal eagerly accepts submissions ranging from clinical studies to basic and translational research, as well as reviews exploring historical progress, controversial issues, and prominent opinions in the field. Join us in advancing knowledge and understanding in the realm of diabetes and metabolism.