Impact of triple transmembrane regulator therapy on glucose metabolism in cystic fibrosis related diabetes during clinical practice.

AIMS: To evaluate the impact of elexacaftor/tezacaftor/ivacaftor (ETI) therapy on Cystic Fibrosis Related Diabetes (CFRD) glycemic control and insulin treatment in patients with CFRD during clinical practice. METHODS: We carried out a retrospective observational study of 23 adult patients with CFRD who started treatment with ETI. They had, at least, one F508del mutation. Data were collected before ETI initiation and 3, 6, and 12 months after. RESULTS: Glycemic control measured by HbA1c significantly improved by 0.3 % (0.1-0.5) after 3 months of ETI therapy (p = 0.004) and kept this improvement during follow-up (p < 0.001). The proportion of patients needing multiple daily injections of insulin was reduced by 16 % (p = 0.023). Total daily insulin dose dropped by 0.12 (0.05-0.18) UI/kg/day (p < 0.001). Data derived from Flash Continuous Glucose Monitoring (CGM) for patients treated with insulin stayed unchanged after insulin reduction, except for a significant 8 % (0.3-15.6) increase in the Time In Tight Range (TITR) between 70 and 140 mg/dL (p = 0.043). CONCLUSION: ETI therapy impacted CFRD in clinical practice reducing insulin needs and improving glycemic control measured by HbA1c and CGM. The improvements can be observed from the first 3 months of treatment.

The Role of Omega-3 Fatty Acids in Diets.

The article is a summary of Dra. Carmen Gómez Candela's presentation at the Science in Nutrition 3rd International Congress in Milan, March 2014. The article covers omega-3 fatty acids use in different medical areas and several institutions' opinions in relation to the topic. Omega-3 acids are essential fatty acids. A certain amount of omega-3 is needed in our daily diet; however, the usual consumption is generally less than the recommended amount. Changes in dietary patterns in the course of history have led to deficit levels of omega-3 in the human body. Currently, there is increasing evidence of the benefits of omega-3 in different medical specialities. There are still some gaps regarding its role in illnesses such as dementia, psychiatric disorders, and inflammatory diseases. Nevertheless, stronger evidence is being proved in cardiovascular diseases and cancer. This article provides a reflection on possible ways to increase omega-3 daily consumption and the constraints associated with food with high contents of heavy metals, which, in turn, are also rich in omega-3s.

Impact of cooked functional meat enriched with omega-3 fatty acids and rosemary extract on inflammatory and oxidative status; a randomised, double-blind, crossover study.

BACKGROUND & AIM: n-3 fatty acid intake has been associated with inflammatory benefits in cardiovascular disease (CVD). Functionalising meat may be of great interest. The aim of the present study was to assess the effect of functional meat containing n-3 and rosemary extract on inflammatory and oxidative status markers in subjects with risk for CVD. METHODS AND RESULTS: A randomised, double-blind, cross-over study was undertaken to compare the effects on the above markers of consuming functional or control meat products. 43 volunteers with at least two lipid profile variables showing risk for CVD were randomly assigned to receive functional meat (FM) or control meat (CM) over 12-weeks with a 4-week wash-out interval before crossover. Functional effects were assessed by examining lipid profile, CRP, PAI-1, TNF-alpha, IL-6, fibrinogen (inflammatory markers), and TBARS, FRAP and 8-iso-PGF2 (oxidative status markers). 33 subjects (24 women) aged 50.7±8.8 years completed the study. In FM treatment, PAI-1, fibrinogen and 8-iso-PGF2 decreased significantly after 12 weeks, while FRAP significantly increased. In contrast, in CM treatment, a significant increase was seen in PAI-1, while FRAP significantly declined. Significant differences were also seen between the FM and CM treatments after 12 weeks in terms of the change observed in PAI-1, FRAP and 8-iso-PGF2 values. No significant differences were seen in anthropometric variables nor were adverse effects reported. CONCLUSION: The consumption of FM containing n-3 and rosemary extract improved oxidative and inflammatory status of people with at least two lipid profile variables showing risk for CVD. The inclusion of such functional meat in a balanced diet might be a healthy lifestyle option.

Objetivos: La ingesta de omega-3 se ha asociado con efectos antinflamatorios relacionados con la prevención de la enfermedad cardiovascular (ECV). Desarrollar productos cárnicos funcionales podría ser de gran interés para la población. El objetivo del presente estudio fue evaluar el efecto de una carne funcional con omega-3 y extracto de romero sobre marcadores de inflamación y oxidación en personas con riesgo cardiovascular. Pacientes y métodos: Se diseñó un ensayo clínico cruzado y doble-ciego para estudiar el efecto del consumo de un producto cárnico funcional sobre marcadores de inflamación y oxidación. Se incluyeron 43 voluntarios con al menos 2 parámetros del perfil lipídico alterado, indicando riesgo de ECV. Fueron asignados aleatoriamente en 2 grupos que consumieron en cruzado carne funcional (CF) o carne control (CC) durante 12 semanas con un periodo de lavado de 4 semanas entre ellos. Al finalizar el estudio se evaluó: perfil lipídico, marcadores de inflamación (PCR, PAI-1, TNF-alpha, IL-6, fibrinógeno) y marcadores de oxidación (TBARS, FRAP, 8-iso-PGF2). Resultados: Completaron el estudio 33 personas (24 mujeres) con edad media de 50.7±8.8 años. Tras consumir CF durante 12 semanas se observó una disminución significativa del PAI-1, fibrinógeno y 8-iso-PGF2, mientras que el FRAP incrementó significativamente. Sin embargo, con CC incrementó PAI-1 y disminuyó FRAP significativamente. Además se observaron diferencias significativas entre los cambios producidos tras consumir uno u otro producto de los marcadores PAI-1, FRAP y 8-iso-PGF2. Al final de cada intervención no se observaron cambios en variables antropométricas ni efectos adversos. Conclusiones: El consumo de CF con omega-3 y extracto de romero mejora el estado inflamatorio y oxidativo de personas con al menos 2 parámetros del perfil lipídico alterado. La inclusión de estas CF en una dieta equilibrada podría ser una opción más para mantener un estilo de vida saludable. ClinicalTrials.gov NCT0199088.

[Food sources and average intake of calcium in a representative sample of Spanish schoolchildren]. / Ingesta y fuentes de calcio en una muestra representativa de escolares españoles.

INTRODUCTION: There is controversy about the adequacy of calcium intake to that recommended in Spanish schoolchildren. Some studies indicate that the intake is inadequate in a variable percentage of children, while others insist on the danger of an excessive intake in a huge percentage of this population. AIM: To assess calcium intake and food sources of this nutrient in a representative sample of Spanish children and to judge the adequacy of its contribution to the coverage of recommended intakes. METHODS: 903 schoolchildren (7 to 11 years) from 10 Spanish provinces (Tarragona, Caceres, Burgos, Guadalajara, Valencia, Salamanca, Cordoba, Vizcaya, Lugo and Madrid) were studied. They constituted a representative sample of the Spanish schoolchildren population. The energy and nutrient intake was determined using a "Food record questionnaire" for 3 days, including a Sunday. Calcium intake was compared with the recommended intakes (RI) for the mineral. Weight and height were recorded and body mass index (BMI) calculated. RESULTS: In the studied group (55.3% girls and 44.7% of children), 30.7% had an excess body weight (23.3% overweight and 7.4% obesity). Calcium intake was 859.9 ± 249.2 mg / day (79.5% of the recommendations). 76.7% of children had intakes below 100% of those recommended and 40.1% below of 67% of RI. The ratios calcium/phosphorus (0.74 ± 0.21) and calcium/protein (10.1 ± 2.8) and the index of nutritional quality for calcium (0.78 ± 0.29) were lower than recommended in 91.6%, 99.8% and 81.1% of children, respectively. Dietary calcium came from dairy products (64.7%), dietetic products and infant formulae (7.6%), cereals (7.3%), vegetables (3.5%), fruits (3.4%), pre-cooked meals (3.3%), meats (2.8%), fishes (2.8%) and pulses (2.2%), with no differences by gender. CONCLUSION: Calcium intake was lower than recommended in 76.7% of the children and 40.1% had insufficient intake (< 67% of RI). Having in mind that the main calcium source was dairy products (64.7%), increase consumption of this food group is recommended, especially in the 37.1% of children who did not reach the 2 recommended servings per day.

[Overweight and obesity among Spanish adults]. / Prevalencia de sobrepeso y obesidad en adultos españoles.

AIM: to assess the prevalence of overweight and obesity in Spanish adults and to know the current situation and its evolution in the last years. MATERIAL AND METHODS: The study involved 418 subjects (196 men and 222 women) from 18 to 60 years, who were selected to constitute a representative sample of the Spanish population as a whole. Sanitary, socioeconomic and anthropometric (weight, height, waist circumference and percentage body fat by bioimpedance) data was collected. Body Mass Index and waist-height were ratio calculated. RESULTS: The prevalence of overweight was 34.2%, 43.9% in men and 25.7% in women, and the prevalence of obesity was 13.6% (it was similar in men and women). 47.8% of the population had excess of body weight and 70.2% excess of body fat, these parameters were higher in men than in women and they increased with age. 22.2% of the population had central obesity (taking waist circumference as reference) and 54.7% central obesity and high cardiovascular risk (because waist/height was > 0.5), both parameters were higher in men than in women. CONCLUSION: Overweight and obesity prevalence among the Spanish population is very high and more than the half of the population is in risk of suffering from cardiovascular disease. Furthermore, the situation is worse than a few years ago, so it is necessary to continue working to decrease the prevalence of overweight and obesity among the Spanish population.

Changes in folate status in overweight/obese women following two different weight control programmes based on an increased consumption of vegetables or fortified breakfast cereals.

The modification of folate status was analysed in a group of sixty-seven overweight/obese women of childbearing age (20-35 years). Subjects were randomly assigned to one of two slightly hypocaloric diets: diet V (increased consumption of vegetables) or diet C (increased consumption of breakfast cereals). Dietetic, anthropometric and biochemical data were collected at the start of the study and again at 2 and 6 weeks. At 6 weeks a weight loss of 2.0 (sd 1.3) kg was achieved in V subjects and of 2.8 (sd 1.4) kg in C subjects (P < 0.05). At the start of the study, 64.2 % of all subjects had a folate intake of < 67 % of the recommended intake; this fell to just 3 % (7.14 % of V subjects and 0 % of C subjects) by week 6. Significant increases were only seen in C subjects in serum folate concentrations (both at 2 and 6 weeks), accompanied by a significant reduction in serum homocysteine (at week 6). Some 62.1 % of all subjects had serum folate concentrations of > or = 13.6 nmol/l (associated with a very low risk of neural tube defects) at the start of the study, while 87.0 % (85.2 % of V subjects and 88.9 % of C subjects) had concentrations of > or = 13.6 nmol/l at 6 weeks (P < 0.01). Increasing the relative consumption of vegetables/cereals in the context of a slightly hypocaloric diet may therefore be a good way to lose body weight. Breakfast cereals may be of special help with respect to folate status and serum homocysteine levels in overweight/obese young women following energy restriction diets.

[Response to a weight control program based on approximating the diet to its theoretical ideal]. / Respuesta ante un programa de control de peso basado en la aproximación de la dieta al ideal teórico.

UNLABELLED: Obesity is a risk factor for a number of degenerative diseases common in industrial societies and the number of overweight/obese people continues to grow. The control of body weight is therefore a priority public health objective. OBJECTIVE: To analyze the response to a weight loss program based on approximating the diet to the theoretical ideal (by increasing the consumption of recommended foods under-represented in the diet: cereals and vegetables). SUBJECTS: The study involved 67 women aged between 20 and 35 years with a body mass index (BMI) of between 24 and 35 kg/m2. These women were randomly assigned to two groups with the aim of improving weight control and of approximating the diet to the theoretical ideal. INTERVENTIONS: Both groups were advised to follow a slightly hypocaloric diet, but with one group increasing the intake of greens and vegetables (H) and the other increasing the intake of cereals (especially breakfast cereals) (C). Dietary data were obtained via the keeping of a daily food record over three days, including a Sunday. Anthropometric data were obtained at the start of the study and again 2 and 6 weeks later. RESULTS: Both treatments approximated the energy profile of the diets to the theoretical ideal. The amount of energy gained from lipids fell and that gained from carbohydrates increased (both at 2 and 6 weeks), significantly more so for group C. Fifty seven women completed the study and showed a mean reduction in body weight of 2.4 +/-1.4 kg. The weight lost by group C was significantly greater than that lost by group H (2.8 +/- 1.4 kg compared to 2.0 +/- 1.3 kg; p < 0.05). The women who followed diet C showed a greater number of skin folds of significantly reduced size, both at 2 and 6 weeks. More group C women completed the study (93.5% compared to 77.8% of group H women). CONCLUSION: In overweight or slightly obese women, approximating the diet to the theoretical ideal (by increasing the intake of vegetables of cereals) can help to control body weight and improve the quality of the diet (both in terms of the number and size of food rations, and the overall energy profile). The present results show that increasing the consumption of breakfast cereals may be of particular use owing to their high fiber, vitamin and iron contents.