Wanders, L, Gijbels, A, Hul, GB, Feskens, EJM, Afman, LA, Blaak, EE, Hopman, MTE, Goossens, GH and Thijssen, DHJ (2025) Impact of a 12-week personalized dietary intervention on vascular function and cardiovascular risk factors. Diabetes, Obesity and Metabolism: A Journal of Pharmacology and Therapeutics. ISSN 1462-8902

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Abstract

AIMS: Individuals with liver insulin-resistant (LIR) or muscle insulin-resistant (MIR) phenotypes may respond differently to dietary interventions. Given the interaction between insulin resistance and cardiovascular risk, this sub-analysis of the PERSON study examined whether a personalized diet according to MIR or LIR phenotypes improves vascular function and cardiovascular disease risk factors. MATERIALS AND METHODS: We randomized 119 participants to a 12-week low-fat, high-protein, high-fibre diet (LFHP; may be optimal for LIR) or Mediterranean diet (high in monounsaturated fat, HMUFA; may be optimal for MIR). Randomization linked the insulin-resistant (IR) phenotype to the proposed optimal diet, leading to PhenoDiet A (MIR-HMUFA and LIR-LFHP) and PhenoDiet B (MIR-LFHP and LIR-HMUFA). Before and after the intervention, vascular function (carotid artery reactivity) and cardiovascular risk factors (blood pressure, total cholesterol, HDL-cholesterol and Framingham risk score) were examined. A 7-point oral glucose tolerance test was performed to determine insulin resistance (Matsuda index and HOMA-IR) and disposition index. RESULTS: Following drop-out (n = 18), 101 participants finished the intervention (54 women, 61 ± 7 years, 27.6 [26.4;30.0] kg/m2), with n = 80 available for the primary outcome of vascular function. Overall, the dietary interventions significantly decreased blood pressure, total cholesterol, HDL-cholesterol and the Framingham risk score (all p < 0.05), while vascular function was not affected (p = 0.485). Insulin resistance (p ≤ 0.001), but not disposition index (p = 0.362), was significantly improved after intervention. The Matsuda index (p = 0.078) tended to increase more and total cholesterol (p = 0.052) tended to decrease more in PhenoDiet group B than A, but other changes in outcome parameters were not significantly different between PhenoDiet groups. The LFHP diet resulted in more pronounced improvements in cholesterol, diastolic blood pressure (DBP) and insulin resistance compared with the HMUFA diet (all p < 0.05). CONCLUSION: A 12-week diet improves metabolic and cardiovascular outcomes, but not vascular function in insulin-resistant adults with overweight or obesity. Whilst the LFHP diet resulted in greater improvements in cardiometabolic risk markers than the HMUFA diet, we found no significant differences between the PhenoDiet groups.

Item Type:	Article
Uncontrolled Keywords:	cardiovascular; diet; insulin resistance; nutrition; 32 Biomedical and Clinical Sciences; 3210 Nutrition and Dietetics; Clinical Research; Heart Disease; Nutrition; Obesity; Diabetes; Cardiovascular; Prevention; 2.1 Biological and endogenous factors; Cardiovascular; Metabolic and endocrine; 3 Good Health and Well Being; 1103 Clinical Sciences; Endocrinology & Metabolism; 3202 Clinical sciences
Subjects:	T Technology > TX Home economics > TX341 Nutrition. Foods and food supply R Medicine > RC Internal medicine > RC1200 Sports Medicine
Divisions:	Sport and Exercise Sciences
Publisher:	Wiley
SWORD Depositor:	A Symplectic
Date Deposited:	06 Mar 2025 15:53
Last Modified:	06 Mar 2025 16:00
DOI or ID number:	10.1111/dom.16261
URI:	https://researchonline.ljmu.ac.uk/id/eprint/25809

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