Climate, Agroecology and Socio-Economic Determinants of Food Availability from Agriculture in

16 Pages·2017·1.37 MB·English

nutrients
Article
Comparisons of the Postprandial Inflammatory and
Endotoxaemic Responses to Mixed Meals in Young
and Older Individuals: A Randomised Trial
AmberM.Milan1,ShikhaPundir1,ChantalA.Pileggi1,JamesF.Markworth1,
PaulA.Lewandowski2andDavidCameron-Smith1,*
1 LigginsInstitute,UniversityofAuckland,PrivateBag92019,Auckland1023,NewZealand;
[email protected](A.M.M.);[email protected](S.P.);[email protected](C.A.P.);
[email protected](J.F.M.)
2 SchoolofMedicine,DeakinUniversity,75PigdonsRoad,WarunPonds,VIC3216,Australia;
[email protected]
* Correspondence:[email protected];Tel.:[phone]
Received:7March2017;Accepted:29March2017;Published:2April2017
Abstract: Postprandial inflammation and endotoxaemia are determinants of cardiovascular and
metabolicdiseaseriskwhichareamplifiedbyhighfatmeals. Weaimedtoexaminethedeterminants
ofpostprandialinflammationandendotoxaemiainolderandyoungeradultsfollowingahighfat
mixed meal. In a randomised cross-over trial, healthy participants aged 20–25 and 60–75 years
(n=15/group)consumedahigh-fatbreakfastandalow-fatbreakfast. Plasmatakenatbaselineand
post-mealfor5hwasanalysedforcirculatingendotoxin,cytokines(monocytechemotacticprotein-1
(MCP-1),interleukin(IL)-1β,IL-6,andtumournecrosisfactor-alpha(TNF-α)),lipopolysaccharide
bindingprotein(LBP),andinflammatorygeneexpressioninperipheralbloodmononuclearcells
(PBMC).OldersubjectshadlowerbaselinePBMCexpressionofglutathioneperoxidase1(GPX-1)but
greaterinsulin-likegrowthfactor-bindingprotein3(IGFBP3)andcirculatingMCP-1comparedto
youngersubjects. Aftereithermeal,therewerenoagedifferencesinplasma,chylomicronendotoxin,
orplasmaLBPconcentrations,norininflammatorycytokinegeneandproteinexpression(MCP-1,
IL-1β,andTNF-α).Unlikeyoungerparticipants,theoldergrouphaddecreasedsuperoxidedismutase
(SOD)-2expressionafterthemeals.Afterahigh-fatmeal,olderadultshavenoincreasedinflammatory
orendotoxinresponse,butanalteredoxidativestressgeneresponsecomparedwithyoungeradults.
Healthy older adults, without apparent metabolic dysfunction, have a comparable postprandial
inflammatoryandendotoxaemiaresponsetoyoungeradults.
Keywords: ageing;endotoxaemia;highfatmeals;inflammation;oxidativestress
1. Introduction
Ageing is associated with dysfunction of the maintenance of cardiovascular and metabolic
health,likelyaggravatedbythecurrentwesternlifestyleresultingindeclininghealthandincrease
chronic disease risk. Chronic low-grade inflammation is associated with ageing and contributes
tomorbidityandmortality[1]. Theimmunosenescenceassociatedwithageing[2]manifestsasan
elevated basal immune status [3] along with insufficient immune activation after a challenge [4].
Evidenceismountinginsupportofchroniclow-gradeinflammationasafactorresponsibleinthe
developmentofinsulinresistanceandtype2diabetesmellitus(T2DM)[5],alongwithotherchronic
illnessessuchascardiovasculardiseaseorcancers[6]and,overall,asdetrimentaltohealthyageing[7].
Moreover,oxidativestressandinflammationcontributedirectlytothecellularsenescencethathelps
perpetuate the condition of immune decline in ageing [8,9]. Age-related differences in monocyte
Nutrients2017,9,354;doi:10.3390/nu9040354 www.mdpi.com/journal/nutrients
Nutrients2017,9,354 2of16
expression of genes has begun to establish a characteristic senescent profile in the elderly [10,11].
Genes,suchasinsulin-likegrowthfactor-bindingprotein3(IGFBP3)[10],clusterofdifferentiation
(CD)40ligandCD40LG,andBCL2agonist/killer1(BAK1)[11],areinvolvedincellularprocesses’
regulativecellularfunction,integrity,andresponsiveness,andage-relatedchangesinexpressionmay
contributetodifferencesinimmuneresponsivenessinageing.
Acute inflammatory responses can be initiated by meals, particularly those high in fat.
The mechanisms of these postprandial inflammatory responses are highly reliant on the lipaemia
caused by increased chylomicron formation and triacylglyceride (TAG) content in circulation.
Chylomicron and TAG adherence to [12], and activation of, monocytes [13] provokes an acute
immuneresponse. Additionally,bacterialtranslocationacrossthegut,facilitatedbyfatabsorptionand
chylomicronformation,triggersanimmuneresponse,manifestingaspostprandialendotoxaemia[14].
Thecorrespondingpostprandialinflammatorystatemayfurthercontributetoasystemiclow-grade
inflammation[15],alreadytypicallyprevalentinageingpopulations[9].
Thesepostprandiallipaemicandinflammatoryresponsesarealreadydocumentedaselevated
inmetabolically-compromisedadults,suchasthosedisplayinginsulinresistanceorT2DM[16–19],
conditions found more prevalently in older adults [20,21]. Postprandial endotoxaemia is reliant
ontheformationoftriacylglyceride-richlipoproteins(TRL)[22–24],isevidentlyelevatedinT2DM
subjects [25], and is associated with increased intestinal permeability [26]. Ageing has sometimes
beenassociatedwithdigestivedifferences[27,28],changestothegutmicrobiota[29],orgutbarrier
function[30]whichcould,therefore,contributetoelevatedpostprandialendotoxaemiaafterahigh
fat meal [31,32]. Furthermore, the exaggerated lipaemic response to high fat meals seen in older
adults [33–39], including prolonged appearance [37,39] and overproduction of TRL, would likely
contributetogreaterpostprandialendotoxaemiaandinflammationinthispopulation. Despitethis
evidence,studiesexaminingthepostprandialinflammatoryresponsesofhealthyolderadultshaveyet
tobeconducted. Therefore,theaimofthisstudywastoinvestigatethepostprandialinflammatory
response to a high fat mixed meal in older adults compared to younger adults. To achieve this,
postprandialbacterialtranslocationwasevaluatedthroughmeasuresofcirculatingendotoxin,acute
phaseproteinresponses, andmonocytegeneexpressionofpyrogenspecificreceptors. Additional
pathways of postprandial inflammatory activation were assessed through monocyte lipoprotein
receptorgeneexpression. Theresultantregulationandproductionofcytokinesandantioxidantswere
examined,alongwiththesenescentprofileofmonocytes. Itwashypothesisedthatolderadultswould
havegreaterpostprandialendotoxaemiaandinflammation,characterisedbygreaterTRLtransportof
endotoxinandanexaggeratedimmuneandoxidativestressresponse.
2. MaterialsandMethods
2.1. SubjectSelection
Thirty healthy, community-dwelling subjects (n = 7 young females, n = 8 young males, n = 9
olderfemales,n=6oldermales)fromtheAucklandregionwererecruitedthroughlocalnewspaper
advertising to participate between October 2012 and July 2013. Eligible subjects were required to
haveabodymassindex(BMI)between18and30kg/m2andbebetweentheagesof20–25yearsand
60–75years. Theoriginalprotocoltorecruitolderadults70–75wasamendedduringrecruitmentdue
todifficultyidentifyingsubjectsmeetingtheeligibilityrequirements. Individualswithahistoryof
cardiovascularormetabolicdisease/conditions,orwhousedmedicationsthatmayinterferewithstudy
endpoints(i.e.,anti-inflammatorydrugs,statindrugs)werenoteligibleforparticipation. Participant
screening,enrolment,andrandomisationaredepictedinFigure1.
ThisstudywasconductedaccordingtotheguidelineslaiddownbytheDeclarationofHelsinki
andallproceduresinvolvinghumansubjectswereapprovedbytheUniversityofAucklandHuman
Participants and Ethics Committee (Ref #8026). Written informed consent was obtained from all
Nutrients2017,9,354 3of16
subjects. This study was registered with the Australian New Zealand Clinical Trials Registry
(ID:ACTRN12612000515897).
Nutrients 2017, 9, 354  3 of 15

Figure 1. Participant eligibility, enrolment, and randomisation. HF, the high‐fat meal; LF, the low fat 
Figure1. Participanteligibility,enrolment,andrandomisation. HF,thehigh-fatmeal; LF,thelow
fmateaml.e al.
2.2. Study Design and Treatments 
2.2. StudyDesignandTreatments
In a randomised cross‐over design, subjects received two test meals in a random sequence and 
Inarandomisedcross-overdesign,subjectsreceivedtwotestmealsinarandomsequenceand
served as his/her own control. Sequences were randomly generated using www.random.org [40] 
served as his/her own control. Sequences were randomly generated using www.random.org [40]
stratified by age group and allocated by concealed envelopes prior to the first visit. The primary 
stratified by age group and allocated by concealed envelopes prior to the first visit. The primary
outcome  of elevated  postprandial  lipaemia in  the  elderly  has  been  presented  elsewhere  [41]. 
outcome of elevated postprandial lipaemia in the elderly has been presented elsewhere [41].
Inflammatory cytokine gene expression, circulating endotoxin, cytokines, and markers of oxidative 
Inflammatorycytokinegeneexpression,circulatingendotoxin,cytokines,andmarkersofoxidative
stress were assessed as secondary outcomes. 
stresswereassessedassecondaryoutcomes.
The high‐fat meal (HF) was chosen as a standard test meal with a high‐fat and protein load used 
Thehigh-fatmeal(HF)waschosenasastandardtestmealwithahigh-fatandproteinloadused
previously  to  induce  a  postprandial  inflammatory  response  [42]  and  was  purchased  from 
previouslytoinduceapostprandialinflammatoryresponse[42]andwaspurchasedfromMcDonald’s
McDonald’s Restaurants in Auckland. The low fat meal (LF) was protein‐ and carbohydrate‐matched 
RestaurantsinAuckland. Thelowfatmeal(LF)wasprotein-andcarbohydrate-matchedtotheHF
to the HF meal based on standardly available nutritional information (Table 1) and was designed to 
mealbasedonstandardlyavailablenutritionalinformation(Table1)andwasdesignedtofollowthe
follow the Australian Guide to Healthy Eating, while maintaining a low‐fat load. Subjects were not 
AustralianGuidetoHealthyEating,whilemaintainingalow-fatload. Subjectswerenotblindedto
blinded to meal identities. 
mealidentities.
2.3. StudyProceduresTable 1. Macronutrient composition of high‐ and low‐fat breakfasts. 
Subjects were asked to abstain from vigorous pMhaycrsoicnaultriaecnttisv (igty) ,1 high-fat foods, and
Item Name  Weight (g)  Energy (kcal) 
Carbohydrates Fat Protein 
anti-inflammatory medications and supplements the day prior to their visit to the Paykel Clinical
High fat breakfast 
TrialUnitattheLigginsInstitute. Subjectsarrivedfastedontwoseparateoccasionsaminimumof
Sausage and Egg Muffin Sandwich (×2)  162  25.2  21  23.4  390 
14daysapart. Anthropometricdatawerecollectedbeforeacatheterwasinsertedintoanantecubital
Hash Brown (×2)  56  13.5  10.1  1.5  150 
veinandabaselinesample(time0)wastakenfollowedbyconsumptionofthetestbreakfast. Blood
Total    77.4  62.2  49.8  1080 
sampleswerecollectedhourlyfor5hpost-mealinbloodcollectiontubes(BectonDickinson,Franklin
Low fat breakfast 
Lakes, NJ,USA)forserumandethylenediaminetetraaceticacid(EDTA)plasma, andprocessedas
Rolled Oats  37  20.8  1.9  5.0  120 
d1e%sc Criobtetdagpe rCevheioeuses ly[43].Plasmasupernata1n6t7s wereproces4s.5e dunderla1m.0 inarfl1o9w.7 usingpyro1g10e n-free
coMnixsuedm Garbaliens B.rPelaads maforchylomicronsepa4r2a tionwaskep11t.a2 t4◦Cand2.2p rocess5e.d1 within6h9a0n  dthe
reRmedauinceind gFaptl Pasemanautw Bausttceor,l lSemctoeodthi npyrogen2-f5r eemicrotub8e.s4 andstored9.4a t−20◦4C.4 . 140 
Fresh Peach  154  14.6  0.3  1.4  60 
Trim Milk  365  17.9  1.8  14.2  150 
Total    77.4  16.6  49.8  670 
1 Values presented are based on nutrient panel data obtained from the website of the fast food 
restaurant and from packaging of the low fat breakfast items.
Nutrients2017,9,354 4of16
Table1.Macronutrientcompositionofhigh-andlow-fatbreakfasts.
Macronutrients(g)1
ItemName Weight(g) Energy(kcal)
Carbohydrates Fat Protein
Highfatbreakfast
SausageandEggMuffinSandwich(×2) 162 25.2 21 23.4 390
HashBrown(×2) 56 13.5 10.1 1.5 150
Total 77.4 62.2 49.8 1080
Lowfatbreakfast
RolledOats 37 20.8 1.9 5.0 120
1%CottageCheese 167 4.5 1.0 19.7 110
MixedGrainBread 42 11.2 2.2 5.1 90
ReducedFatPeanutButter,Smooth 25 8.4 9.4 4.4 140
FreshPeach 154 14.6 0.3 1.4 60
TrimMilk 365 17.9 1.8 14.2 150
Total 77.4 16.6 49.8 670
1Valuespresentedarebasedonnutrientpaneldataobtainedfromthewebsiteofthefastfoodrestaurantandfrom
packagingofthelowfatbreakfastitems.
2.4. ChylomicronIsolation
Chylomicronseparationwasperformedusinggammairradiated4.7mLOptiSealtubes(Beckman
Coulter, Brea, CA, USA) in an Optima™ MAX-XP model ultracentrifuge using a TLA-110 rotor,
as described previously [44]. Density gradient solutions were prepared with 0.005% EDTA using
pyrogen-freewateraccordingtoNaito[45]andseparationprotocolswerebasedonthoseofKupkeand
Wörz-Zeugner[46]. Chylomicronswereseparatedbyoverlaying3.5mLplasmawith1.2mLsaline
solution(density=1.006g/mL)andcentrifugingat117,000×gfor10min. Thevisiblechylomicrontop
layerwasaspiratedintopyrogen-freemicrotubesandcorrectedtoafinalcollectionvolumeof1.4mL
usingpyrogen-freesalinesolutiontoprovideastandardiseddilutionfactor. Chylomicronfractions
werestoredat−80◦C.
2.5. PBMCIsolationandRNAExtraction
Wholeblood(2mL),collectedfromEDTAbloodcollectiontubes(BectonDickinson,Franklin
Lakes, NJ, USA) at 0, 2, and 4 h, was layered over 2 mL of Histopaque solution (Sigma-Aldrich,
St.Louis,MO,USA)andcentrifugedfor30minat400×gatroomtemperature. PBMCswereremoved
from the interface, washed twice with phosphate buffered saline (PBS), and RNA was extracted
(PurelinkRNAMiniKit,LifeTechnologies,Waltham,MA,USA).DNAcontaminationwaseliminated
byDNasedigestionfromthecelllysatepriortoRNAisolation. RNAconcentrationwasmeasured
usingaNanoDrop(ND-1000Spectrophotometer,ThermoScientific,Waltham,MA,USA).RNAwas
reversetranscribedusingaHighCapacityRNA-to-cDNAKit(LifeTechnologies,Waltham,MA,USA)
asperthemanufacturer’sinstructions.
2.6. QuantitativeReal-TimeReverse-TranscriptasePolymeraseChainReaction(qPCR)Analysis
qPCR was performed using a LightCycler 480 (Roche Applied Science, Penzberg, Germany)
usingSYBR™GreenIDNA-bindingdye. Thegeometricmeanofhumanβ-Actin,glyceraldehyde
3-phosphate dehydrogenase (GAPDH), and RNA18S genes was used as the endogenous control.
Primers(TableS1)wereobtainedfromInvitrogen(LifeTechnologies,Waltham,MA,USA).Samples
wereruninduplicate10µLreactionvolumeswith1.25ngcDNAperreaction. Resultsareexpressed
asabsolutegeneexpressionusingthe2−∆Cpmethod[47].
2.7. BiochemicalAnalysis
Biochemicalmeasuresofbaselineplasmatotalcholesterol,lowdensitylipoproteins(LDL)and
highdensitylipoproteins(HDL),andpostprandialtriacylglycerides,glucose,andserumC-reactive
Nutrients2017,9,354 5of16
protein (CRP) were carried out using a Hitachi 902 autoanalyser (Hitachi High Technologies
Corporation, Tokyo, Japan) by enzymatic colorimetric assay (Roche, Mannheim, Germany).
PostprandialplasmainsulinwasmeasuredusinganAbbottAxSYMsystem(AbbottLaboratories,
Abbott Park, IL, USA) by microparticle enzyme immunoassay. The acute phase protein, plasma
lipopolysaccharidebindingprotein(LBP),wasassessedusingacommerciallyavailableELISAkit
for quantification of human LBP (Abnova, Jhongli, Taiwan) at 0, 1, 2, and 3 h only, based on the
postprandial responses reported by others [42]. Plasma inflammatory markers (n = 7 younger,
n=6older),includingtumournecrosisfactor-alpha(TNF-α),monocytechemotacticprotein-1(MCP-1),
interleukin-1β(IL-β),andinterleukin-6(IL-6),wereanalysedusingaflowcytometricmultiplexarray
(MilliplexMAPKitHumanCytokineMagneticBeadPanelAssay,Millipore,Billerica,MA,USA)after
theHFbreakfastonly,at0,2,and4htimepointsonlymatchingwithpostprandialRNAanalysistime
points. Similarly,totalsuperoxidedismutase(SOD)activityandtotalantioxidantstatus(TAS)were
measuredaftertheHFbreakfastonly,at0,2,and4htimepointsonly,matchingwithpostprandialRNA
analysistimepoints,usingcommercialassaykitsasperthemanufacturer’sinstructions(Sapphire
Bioscience,Melbourne,Australia).
2.8. EndotoxinAnalysis
Plasmaandchylomicronendotoxinconcentrationsweredetermined(n=12/group)usingthe
Kinetic-QCL chromogenic Limulus Amebocyte Lysate (LAL) assay (Lonza, Cleveland, TN, USA)
asperthemanufacturer’sinstructions. Chylomicronsampleswerediluted1:100withLALreagent
water(LRW)andheatinactivatedat70◦Cfor10min. Plasmasampleswereacidtreatedtoremove
inhibitoryplasmaproteinsasdescribedbyKetchumandNovitsky[48]inreagentspreparedinLRW.
Inbrief,samplesweretreatedwith1.32Nnitricacid,heattreatedat37◦Cfor5minandcentrifugedat
1500×gfor5min. Thesupernatantwasremovedandneutralisedwith0.55NNaOHbeforedilution
to1:100withLRW.Theendotoxinconcentrationwasexpressedasendotoxinunits(EU)/mL.
2.9. StatisticalAnalyses
Thehomeostaticmodelassessmentofinsulinresistance(HOMA-IR)wascalculatedfromfasting
glucoseandinsulinconcentrationsusingtheequationfromMatthewsetal.[49]. Maximumpeaktimes
(T )wereidentifiedasthenominalsamplingtimecorrespondingwithpeakconcentration. Sample
max
sizecalculationshavebeendescribedelsewhereforaprimaryoutcomeofpostprandiallipaemia[41];
these were estimated to detect with 80% power a between-subject TAG incremental AUC (iAUC)
differenceof4.77mmol/Lperh[35]withasignificancelevelofp≤0.05. Statisticalanalyseswere
conductedwithSPSS(IBM,Armonk,NY,USA,version21). Dataarepresentedasmeans±standard
errorofthemean(SEM),exceptT whichispresentedasmedianandinterquartilerange(IQR).
max
Baseline concentrations were compared using two-way analysis of variance (ANOVA, treatment
comparedwithin-subjectandagecomparedbetweensubject). T wascomparedusingageneralised
max
estimationequation(GEE)withSPSS.Thelinkidentitywascumulativeprobitandanunstructured
covariance matrix (UN); for binary variables (meal and age) a probit model was used. Protein
expressionofCRP,cytokines,andantioxidantswerecomparedusingtwo-factorrepeated-measures
ANOVA (time compared within-subject and age compared between subject), while three-factor
repeated-measures ANOVA was used for all other analyses (treatment and time each compared
within-subjectandagecomparedbetweensubject). Sidakposthoctestswereusedforallmultiple
comparisonsbetweengroups. WhereMauchly’ssphericitytestfailed,theHuynh-Feldtcorrectionwas
applied. Alphawassetatp<0.05. FiguresweregeneratedwithGraphPadPrism(GraphPadSoftware
Inc.,LaJolla,CA,USA,version6.01).
Nutrients2017,9,354 6of16
3. Results
3.1. SubjectCharacteristics
There were no age differences for fasting measurements of BMI, plasma glucose, insulin,
triglycerides,orHOMA-IR.Oldersubjectshadhigherfastingtotalcholesterol,LDLandHDL(p<0.001,
p = 0.008, and p < 0.001, respectively; Table 2). Differences in postprandial lipaemia are reported
elsewhere[41]. Inbrief,olderparticipantsshowedexaggeratedandprolongedpostprandialelevations
ofTAG.TherewerenodifferencesinTAGiAUCbetweenolderandyoungersubjectsaftereithermeal,
butiAUCwasloweraftertheLFmealinbothgroups(treatmenteffectp<0.05). However,thetimeto
maximumTAGconcentration(T )wasgreaterforolderadultscomparedtoyoungeradultsafter
max
boththeHFandLFmeals(T HF3(IQR3–4)vs. 2(IQR1.5–3)handT LF4(IQR3–5)vs. 3(IQR
max max
2–3)hforoldervs. youngersubjects,respectively;ageeffectp<0.05).
Table2.Baselinesubjectcharacteristics.
Measure1 Unit YoungerSubjects(n=15)2 OlderSubjects(n=15)2,3
Age years 22.7±0.4 67.3±1.5***
BMI kg/m2 23.7±0.8 24.4±1.0
Glucose mmol/L 5.1±0.1 5.2±0.1
HOMA-IR 2.1±0.2 1.9±0.2
Cholesterol mmol/L 4.0±0.1 5.0±0.1***
LDL mmol/L 2.5±0.1 3.0±0.1**
HDL mmol/L 1.3±0.0 1.8±0.1***
TAG mmol/L 0.8±0.0 0.9±0.0
Insulin µU/mL 9.2±0.8 8.7±1.2
1 BMI: body mass index; HOMA-IR: homeostatic model assessment of insulin resistance; LDL: low density
lipoproteins;HDL:highdensitylipoproteins;TAG:triacylglyceride;2Valuespresentedasmeans±standarderrorof
themean(SEM)overbothtreatments;3Maineffectsandinteractionswereanalysedbytwo-factorrepeated-measures
analysisofvariance(ANOVA;treatmentandage).Therewerenodifferencesbetweengroupbaselinevaluesbetween
treatmentdays;***p<0.001,**p<0.01comparedwithyoungersubjects.
3.2. PostprandialEndotoxaemia
Plasmaendotoxinconcentrationdidnotdifferinthepostprandialperiod(Figure2a).Postprandial
endotoxaemia tended to be greater after the HF breakfast (p = 0.156), with no evident impact of
age (p = 0.84). Although endotoxaemia did not differ with age, older subjects tended to have
prolongedendotoxaemiaafter3h(p=0.059)whiletheyoungergroupdidnot. Chylomicronendotoxin
concentration tended to differ between breakfast treatments (p = 0.061) and treatment differences
tendedtodependontime(p=0.097;Figure2b). ChylomicronendotoxaemiaaftertheHFbreakfast
varied more greatly between subjects, and post hoc analysis revealed a tendency towards greater
differencesatbaselinebetweenstudyvisits,andat1and4hafterthemeal(p=0.064,p=0.052,and
p=0.133,respectively). ChangesinLBPconcentrationdifferedbetweentreatmentsandagegroups
(p=0.013,Figure2c). OldersubjectshadgreaterLBPconcentrationsatbaselineand1hduringthe
LF challenge than during the HF breakfast (p = 0.008 and 0.036, respectively). This corresponded
withhigherLBPconcentrationsintheolderparticipantsatbaselineand1hduringtheLFchallenge
(p=0.017andp=0.024respectively). Withthehigherbaselineconcentrationinolderparticipants
beforetheLFmeal,theoldergroupexperiencedasignificantdecreaseinLBPconcentrationby2h
post-meal(baselinevs. 2h;p=0.016). TheyoungergrouphadhigherconcentrationsofLBPat3h
aftertheLFthanaftertheHFbreakfast.
Nutrients 2017, 9, 354  6 of 15
adults after both the HF and LF meals (T  HF 3 (IQR 3–4) vs. 2 (IQR 1.5–3) h and T  LF 4 (IQR 3–
max max
5) vs. 3 (IQR 2–3) h for older vs. younger subjects, respectively; age effect p < 0.05). 
Table 2. Baseline subject characteristics. 
Measure 1  Unit  Younger Subjects (n= 15) 2 Older Subjects (n = 15) 2,3 
Age  years  22.7 ± 0.4  67.3 ± 1.5 *** 
BMI  kg/m2  23.7 ± 0.8  24.4 ± 1.0 
Glucose  mmol/L  5.1 ± 0.1  5.2 ± 0.1 
HOMA‐IR    2.1 ± 0.2  1.9 ± 0.2 
Cholesterol  mmol/L  4.0 ± 0.1  5.0 ± 0.1 *** 
LDL  mmol/L  2.5 ± 0.1  3.0 ± 0.1 ** 
HDL  mmol/L  1.3 ± 0.0  1.8 ± 0.1 *** 
TAG  mmol/L  0.8 ± 0.0  0.9 ± 0.0 
Insulin  μU/mL  9.2 ± 0.8  8.7 ± 1.2 
1 BMI: body mass index; HOMA‐IR: homeostatic model assessment of insulin resistance; LDL: low 
density lipoproteins; HDL: high density lipoproteins; TAG: triacylglyceride; 2 Values presented as 
means ± standard error of the mean (SEM) over both treatments; 3 Main effects and interactions were 
analysed by two‐factor repeated‐measures analysis of variance (ANOVA; treatment and age). There 
were no differences between group baseline values between treatment days; *** p < 0.001, ** p < 0.01 
compared with younger subjects. 
3.2. Postprandial Endotoxaemia 
Plasma  endotoxin  concentration  did  not  differ  in  the  postprandial  period  (Figure  2a). 
Postprandial endotoxaemia tended to be greater after the HF breakfast (p = 0.156), with no evident 
impact of age (p = 0.84). Although endotoxaemia did not differ with age, older subjects tended to have 
prolonged endotoxaemia after 3 h (p = 0.059) while the younger group did not. Chylomicron 
endotoxin concentration tended to differ between breakfast treatments (p = 0.061) and treatment 
differences tended to depend on time (p = 0.097; Figure 2b). Chylomicron endotoxaemia after the HF 
breakfast varied more greatly between subjects, and post hoc analysis revealed a tendency towards 
greater differences at baseline between study visits, and at 1 and 4 h after the meal (p = 0.064, p = 
0.052, and p = 0.133, respectively). Changes in LBP concentration differed between treatments and 
age groups (p = 0.013, Figure 2c). Older subjects had greater LBP concentrations at baseline and 1 h 
during the LF challenge than during the HF breakfast (p = 0.008 and 0.036, respectively). This 
corresponded with higher LBP concentrations in the older participants at baseline and 1 h during the 
LF challenge (p = 0.017 and p = 0.024 respectively). With the higher baseline concentration in older 
participants  before  the  LF  meal,  the  older  group  experienced  a  significant  decrease  in  LBP 
concentration  by  2  h  post‐meal  (baseline  vs.  2  h;  p  =  0.016).  The  younger  group  had  higher 
concentrations of LBP at 3 h after the LF than after the HF breakfast. 
Nutrients2017,9,354 7of16

Figure2. Endotoxinandlipopolysaccharidebindingprotein(LBP)responsestohigh-fat(HF)and
low-fat(LF)breakfastsinolderandyoungersubjects.Olderhigh-fat(filledsquares),olderlow-fat(open
squares),youngerhigh-fat(filledcircles),youngerlow-fat(opencircles).Valuesrepresentmean±SEMin

EU/mLforplasmaendotoxin((a);n=12/group)andchylomicronendotoxin((b);n=12/group)and
inµg/mLforLBP((c);n=15/group).Therewerenodifferencesinplasmaorchylomicronendotoxin
responsesbetweenolderandyoungersubjects.ThereweresignificantdifferencesintheLBPresponse
overtime,dependentonageandtreatment(age×time×treatmentinteractionofp<0.05,three-factor
repeated-measuresANOVA).εp<0.05agedifferenceafterLF;§p<0.05treatmentdifferenceinolder
subjects;φp<0.05treatmentdifferenceinyoungersubjects;†p<0.05timedifferenceafterLFinolder
subjects(Sidakcorrectedposthoctests).
3.3. PBMCSenescenceRNAExpression
IGFBP3 expression was greater in the older group (p = 0.001) and tended to be higher before
theLFmeal(p=0.073)causingasignificanttime-treatmentinteraction(p=0.005;Figure3a). BAK1
expressionwasnodifferentbetweengroupsanddidnotdifferwithfeeding(Figure3b). Bothgroups
hadincreasedCD40LGexpressionat4hafterbothmeals(p=0.002;Figure3c).
3.4. PBMCRNAExpressionofEndotoxaemicActivation
YoungersubjectshaddecreasedCD14expressionat4hcomparedto2h(p=0.005;Figure3d),
whileoldersubjectsshowednochangesaftermealingestion.Toll-likereceptor(TLR)2(TLR2)response
wasnodifferentbetweengroupsaftereithermealbutwashigherat2hthan4h(p=0.002;Figure3e).
TLR9expressiontendedtobeloweroverallinolderparticipants(p=0.055;Figure3f).
3.5. PBMCRNAExpressionofActivationbyLipoproteins
NochangeinATP-bindingcassettetransporter1(ABCA-1)expressionwasobservedaftereither
mealineitheragegroup(Figure3g). ApolipoproteinB48receptor(ApoB48r)expressiontendedto
behigherinolderparticipants(p=0.111),higheraftertheLFmeal(p=0.087)andhigheratbaseline
(p=0.15;Figure3h). TheoldergrouphadlowerLDLreceptor(LDLr)expression(p=0.038;Figure3i).
Nutrients 2017, 9, 354  7 of 15
Figure 2. Endotoxin and lipopolysaccharide binding protein (LBP) responses to high‐fat (HF) and 
low‐fat (LF) breakfasts in older and younger subjects. Older high‐fat (filled squares), older low‐fat (open 
squares), younger high‐fat (filled circles), younger low‐fat (open circles). Values represent mean ± SEM 
in EU/mL for plasma endotoxin ((a); n = 12/group) and chylomicron endotoxin ((b); n = 12/group) and 
in μg/mL for LBP ((c); n = 15/group). There were no differences in plasma or chylomicron endotoxin 
responses between older and younger subjects. There were significant differences in the LBP response 
over time, dependent on age and treatment (age × time × treatment interaction of p < 0.05, three‐factor 
repeated‐measures ANOVA). ɛ p < 0.05 age difference after LF; § p < 0.05 treatment difference in older 
subjects; ϕ p < 0.05 treatment difference in younger subjects; † p < 0.05 time difference after LF in older 
subjects (Sidak corrected post hoc tests). 
3.3. PBMC Senescence RNA Expression 
IGFBP3 expression was greater in the older group (p = 0.001) and tended to be higher before the 
LF meal (p = 0.073) causing a significant time‐treatment interaction (p = 0.005; Figure 3a). BAK1 
expression was no different between groups and did not differ with feeding (Figure 3b). Both groups 
Nutrients2017,9,354 8of16
had increased CD40LG expression at 4 h after both meals (p = 0.002; Figure 3c). 

Figure 3. Relative senescence‐related, endotoxaemia‐related and lipid receptor peripheral blood 
Figure 3. Relative senescence-related, endotoxaemia-related and lipid receptor peripheral blood
mononuclear cells (PBMC) gene expression responses to high‐fat (HF) and low‐fat (LF) breakfasts in 
mononuclearcells(PBMC)geneexpressionresponsestohigh-fat(HF)andlow-fat(LF)breakfastsin
older and younger subjects. Older high‐fat (filled squares), older low‐fat (open squares), younger high‐
olderandyoungersubjects.Olderhigh-fat(filledsquares),olderlow-fat(opensquares),youngerhigh-fat
f(afitl le(dfilcleirdc lecsir)c,lyeso)u, nygoeurnlogwer- flaotw(o‐pfaetn (coirpcelnes )c.irVcalelsu)e. sVraeplureess ernetpmreesaennt± mSeEaMn (±n =SE1M5/ g(nro =u p1)5i/ngraorubpit)r airny 
aurnbiittsra(AryU u)nfiotrs I(GAFUB)P fo3r( aIG),FBBAPK31 (a(b), )B,ACDK410 (LbG), C(cD),4C0DLG14 ((cd),) C,TDL1R42 (d(e)), ,TTLLRR29 ((ef)),, TALBRC9A (f-)1, (AgB),CAAp‐o1B (4g8),r 
A(hp)o,aBn4d8rL (Dh)L, ran(id), LreDspLer c(tii)v, erelys.pTehcteirveelwy.e Trehneroed wifeferere nnoc edsififnerBeAncKe1s TinL BRA2,KT1L TRL9,RA2,B TCLAR-91,, AorBACApo‐1B,4 o8rr 

responsesbetweenolderandyoungeradults. ThereweresignificantagedifferencesinLDLrgene
expression(ageeffectofp<0.05)andchangesovertimeforCD40LGandTLR2(timeeffectofp<0.05
andp<0.01,respectively). Thereweresignificantagedifferencesandtimedifferences,dependent
ontreatmentintheIGFBP3response(time×treatmentinteractionofp<0.01,ageeffectofp<0.01,
three-factorrepeated-measuresANOVA).CD14expressionwassignificantlydifferentbetweenolder
andyoungeradultsovertime(time × ageinteractionofp<0.05). a p<0.05mainagedifference;
**p<0.01changefrombaseline;λp<0.05timedifferenceinyoungersubjects;γp<0.01timedifference
(Sidakcorrectedposthoctests).
3.6. PBMCInflammatoryCytokineGeneExpression
IL-1βexpressionchangedaftermealingestion(p=0.03)andtendedtodecreasecomparedto
baseline (p = 0.107). MCP-1 expression did not change after meal ingestion and the response was
similarbetweenagegroups(Figure4a,b). TNF-αexpressionincreasedovertime(p=0.033;Figure4c),
butwasnotdifferentbetweenbreakfastsoragegroups.
Nutrients 2017, 9, 354  8 of 15
ApoB48r responses between older and younger adults. There were significant age differences in LDLr 
gene expression (age effect of p < 0.05) and changes over time for CD40LG and TLR2 (time effect of  
p < 0.05 and p < 0.01, respectively). There were significant age differences and time differences, 
dependent on treatment in the IGFBP3 response (time × treatment interaction of p < 0.01, age effect of 
p < 0.01, three‐factor repeated‐measures ANOVA). CD14 expression was significantly different 
between older and younger adults over time (time × age interaction of p < 0.05). a p < 0.05 main age 
difference; ** p < 0.01 change from baseline; λ p < 0.05 time difference in younger subjects; γ p < 0.01 
time difference (Sidak corrected post hoc tests). 
3.4. PBMC RNA Expression of Endotoxaemic Activation 
Younger subjects had decreased CD14 expression at 4 h compared to 2 h (p = 0.005; Figure 3d), 
while older subjects showed no changes after meal ingestion. Toll‐like receptor (TLR) 2 (TLR2) 
response was no different between groups after either meal but was higher at 2 h than 4 h (p = 0.002; 
Figure 3e). TLR9 expression tended to be lower overall in older participants (p = 0.055; Figure 3f). 
3.5. PBMC RNA Expression of Activation by Lipoproteins 
No change in ATP‐binding cassette transporter 1 (ABCA‐1) expression was observed after either 
meal in either age group (Figure 3g). Apolipoprotein B48 receptor (ApoB48r) expression tended to be 
higher in older participants (p = 0.111), higher after the LF meal (p = 0.087) and higher at baseline  
(p = 0.15; Figure 3h). The older group had lower LDL receptor (LDLr) expression (p = 0.038; Figure 
3i). 
3.6. PBMC Inflammatory Cytokine Gene Expression 
IL‐1β expression changed after meal ingestion (p = 0.03) and tended to decrease compared to 
baseline (p = 0.107). MCP‐1 expression did not change after meal ingestion and the response was 
similar between age groups (Figure 4a,b). TNF‐α expression increased over time (p = 0.033; Figure 
Nutrients2017,9,354 9of16
4c), but was not different between breakfasts or age groups. 

Figure 4. Relative inflammatory cytokine and oxidative stress peripheral blood mononuclear cells 
Figure4. Relativeinflammatorycytokineandoxidativestressperipheralbloodmononuclearcells
(PBMC) gene expression responses to high‐fat (HF) and low‐fat (LF) breakfasts in older and younger 
(PBMC)geneexpressionresponsestohigh-fat(HF)andlow-fat(LF)breakfastsinolderandyounger
susubbjejcetcst.s O.Oldldere rhihgihg‐hf-afta (tf(ilfilellde dsqsuqauraerse)s,) o,lodldere rlolwow‐f-afta t(o(poepne nsqsuqauraerse)s,) y,oyuounngegre rhhigihgh‐f-afta t(f(ilfillelde dcicricrlcelse)s,) a,nandd 
youngerlow-fat(opencircles). Valuesrepresentmean±SEM(n=15/group)inarbitraryunits(AU)

forIL-1β(a),MCP-1(b),TNF-α(c),GPX-1(d),andSOD-2(e),respectively.Therewerenodifferences
inIL-1β,MCP-1,orTNF-α,responsesbetweenolderandyoungersubjects. Thereweresignificant
agedifferencesinGPX-1geneexpression(ageeffectofp<0.05eachrespectively)andchangesover
timeforIL-1βandTNF-α(timeeffectofp<0.05eachrespectively).TheSOD-2responsedifferedover
time,dependentonageandtreatment(age×time×treatmentinteractionofp<0.05,three-factor
repeated-measuresANOVA).ap<0.05mainagedifference;*p<0.05changefrombaseline;εp<0.05
agedifferenceafterLF;§p<0.05treatmentdifferenceinoldersubjects;‡p<0.05timedifferenceafter
HFinoldersubjects(Sidakcorrectedposthoctests).
3.7. PBMCRNAExpressionofOxidativeStressResponse
Youngersubjectshadhigherglutathioneperoxidase1(GPX-1)expression(p=0.014;Figure4d),
however,thisdidnotchangeaftereithermeal. SOD-2expressiondecreasedat2and4haftermeal
ingestionintheoldergroup,butnottheyoungergroup(p<0.001;Figure4e). Forthisreason,older
subjectshadlowerSOD-2expressionat2and4hcomparedtoyoungersubjects(p=0.044andp=
0.004,respectively).
3.8. CytokineandAntioxidantProteinExpression
There were no differences between age groups in postprandial concentrations of serum CRP
(p = 0.84, Figure 5a), and plasma IL-1β (p = 0.436), IL-6, and TNF-α (Figure 5b,d; p = 0.111 and
p=0.112respectively),althoughIL-6andTNF-αtendedtobehigherinolderparticipants. Cytokine
concentrationsmeasuredforIL-1βandIL-6wereverylowwithreferencetothestandardcurve,and
IL-6(butnotIL-1β)increasedbetweenbaselineand4hinbothagegroups(p=0.007). IL-1βdidnot
changeafterthemealforolderoryoungersubjects(p=0.336timeeffect;iAUC−87.9±90.0(older
subjects)vs. −19.8±12.7(youngersubjects);p=0.504). MCP-1concentrationwashigherintheolder
Nutrients 2017, 9, 354  9 of 15
younger low‐fat (open circles). Values represent mean ± SEM (n = 15/group) in arbitrary units (AU) for 
IL‐1β (a), MCP‐1 (b), TNF‐α (c), GPX‐1 (d), and SOD‐2 (e), respectively. There were no differences in 
IL‐1β, MCP‐1, or TNF‐α, responses between older and younger subjects. There were significant age 
differences in GPX‐1 gene expression (age effect of p < 0.05 each respectively) and changes over time 
for IL‐1β and TNF‐α (time effect of p < 0.05 each respectively). The SOD‐2 response differed over time, 
dependent on age and treatment (age × time × treatment interaction of p < 0.05, three‐factor repeated‐
measures ANOVA). a p < 0.05 main age difference; * p < 0.05 change from baseline; ɛ p < 0.05 age 
difference after LF; § p < 0.05 treatment difference in older subjects; ‡ p < 0.05 time difference after HF 
in older subjects (Sidak corrected post hoc tests). 
3.7. PBMC RNA Expression of Oxidative Stress Response 
Younger subjects had higher glutathione peroxidase 1 (GPX‐1) expression (p = 0.014; Figure 4d), 
however, this did not change after either meal. SOD‐2 expression decreased at 2 and 4 h after meal 
ingestion in the older group, but not the younger group (p < 0.001; Figure 4e). For this reason, older 
subjects had lower SOD‐2 expression at 2 and 4 h compared to younger subjects (p = 0.044 and p = 
0.004, respectively). 
3.8. Cytokine and Antioxidant Protein Expression 
There were no differences between age groups in postprandial concentrations of serum CRP (p 
= 0.84, Figure 5a), and plasma IL‐1β (p = 0.436), IL‐6, and TNF‐α (Figure 5b,d; p = 0.111 and p = 0.112 
respectively),  although  IL‐6  and  TNF‐α  tended  to  be  higher  in  older  participants.  Cytokine 
concentrations measured for IL‐1β and IL‐6 were very low with reference to the standard curve, and 
IL‐6 (but not IL‐1β) increased between baseline and 4 h in both age groups (p = 0.007). IL‐1β did not 
Nutrients2017,9,354 10of16
change after the meal for older or younger subjects (p = 0.336 time effect; iAUC −87.9 ± 90.0 (older 
subjects) vs. −19.8 ± 12.7 (younger subjects); p = 0.504). MCP‐1 concentration was higher in the older 
ggrroouupp ((pp == 00..002288,, FFiigguurree 55cc)),, aanndd uunncchhaannggeedd wwiitthh mmeeaall iinnggeessttiioonn.. SSOODD aaccttiivviittyy aanndd TTAASS wweerree nnoott 
ddiiffffeerreennttb beettwweeeenna aggeeg grroouuppssn noorra afffefeccteteddb byyH HFFm meeaalli ninggeesstitoionn( F(Figiguurere5 5dd,e,e).). 

Figure5. CirculatingC-reactiveprotein,cytokineproteinconcentrations,andantioxidantstatusin
olderandyoungersubjectsafterthehigh-fatbreakfastonly. C-reactiveprotein(CRP),superoxide
dismutase activity (SOD), and total antioxidant status (TAS, n = 15/group), and cytokine protein
concentrationsinolder(filledsquares,n=7)andyoungeradults(filledcircles,n=6),respectively.Values
representmean±SEMforCRP(a)inmg/L,IL-6(b)inpg/mL,MCP-1(c)inpg/mL,TNF-α(d)in
pg/mL,SOD(e)inU/mL,andTAS(f)inmM.TherewerenodifferencesinCRP,IL-6,TNF-α,SOD,
andTASresponsesbetweenolderandyoungersubjects. Thereweresignificantagedifferencesin
MCP-1proteinconcentrations(ageeffectofp<0.05)andchangesovertimeforIL-6(timeeffectof
p<0.01,two-factorrepeated-measuresANOVA).ap<0.05mainagedifference;*p<0.05changefrom
baseline;γp<0.01timedifference(Sidakcorrectedposthoctests).
4. Discussion
Thisstudydemonstratesthatinanotherwisehealthyoldercohort,postprandialinflammation
is not exaggerated compared to younger adults. Our results indicate that baseline differences in
immunestatusmaybepresentinhealthyolderadults,butthatanysuchdifferencesarenotassociated
withdifferencesinthepostprandialimmuneresponsetoahighfatmeal. Thesimilaritiesinimmune
responsebetweenolderandyoungeradultsareinspiteofexaggeratedpostprandiallipaemiainthese
oldersubjects[41]andsuggestthattheinflammatoryresponsetoahigh-fatmealisnotexacerbatedin
olderagedespiteage-relateddifferencesinthebasalimmuneprofile.
Previous studies have shown that a high-fat meal induces postprandial inflammation;
however,themagnitudeandthespecificmeasurablemarkersofthisinflammationvariesbetween
studies [50], and are reliant on the precise meal components included [51–54], as well as