"We Feel Alone and Not Listened To": Parents' Perspectives on Pediatric Serious Illness Care in Somali, Hmong, and Latin American Communities.

PURPOSE: The experience of ethnically diverse parents of children with serious illness in the US health care system has not been well studied. Listening to families from these communities about their experiences could identify modifiable barriers to quality pediatric serious illness care and facilitate the development of potential improvements. Our aim was to explore parents' perspectives of their children's health care for serious illness from Somali, Hmong, and Latin-American communities in Minnesota. METHODS: We conducted a qualitative study with focus groups and individual interviews using immersion-crystallization data analysis with a community-based participatory research approach. RESULTS: Twenty-six parents of children with serious illness participated (8 Somali, 10 Hmong, and 8 Latin-American). Parents desired 2-way trusting and respectful relationships with medical staff. Three themes supported this trust, based on parents' experiences with challenging and supportive health care: (1) Informed understanding allows parents to understand and be prepared for their child's medical care; (2) Compassionate interactions with staff allow parents to feel their children are cared for; (3) Respected parental advocacy allows parents to feel their wisdom is heard. Effective communication is 1 key to improving understanding, expressing compassion, and partnering with parents, including quality medical interpretation for low-English proficient parents. CONCLUSIONS: Parents of children with serious illness from Somali, Hmong, and Latin-American communities shared a desire for improved relationships with staff and improved health care processes. Processes that enhance communication, support, and connection, including individual and system-level interventions driven by community voices, hold the potential for reducing health disparities in pediatric serious illness.

Mobile health technology for hypertension management with Hmong and Latino adults: mixed-methods community-based participatory research.

OBJECTIVE: To identify Hmong and Latino adults' perspectives about a mHealth-based care model for hypertension (HTN) management involving blood pressure (BP) self-monitoring, electronic transmission of BP readings, and responsive HTN medication adjustment by a provider team. DESIGN: We conducted a mixed-methods formative study with 25 Hmong and 25 Latino participants with HTN at an urban federally-qualified health center. We used a tool to assess HTN knowledge and conducted open-ended interviews to identify perspectives about mHealth-based care model. RESULTS: While most participants agreed that lowering high blood pressure decreased the risk of strokes, heart attacks, and kidney failure, there were gaps in medical knowledge. Three major themes emerged about the mHealth-based care model: (1) Using mHealth technology could be useful, especially if assistance was available to patients with technological challenges; (2) Knowing blood pressures could be helpful, especially to patients who agreed with doctors' medical diagnosis and prescribed treatment; (3) Transmitting blood pressures to the clinic and their responsive actions could feel empowering, and the sense of increased surveillance could feel entrapping. Some people may feel empowered since it could increase patient-provider communication without burden of clinic visits and could increase involvement in BP control for those who agree with the medical model of HTN. However, some people may feel entrapped as it could breach patient privacy, interfere with patients' lifestyle choices, and curtail patient autonomy. CONCLUSIONS: In general, Hmong and Latino adults responded positively to the empowering aspects of the mHealth-based care model, but expressed caution for those who had limited technological knowledge, who did not agree with the medical model and who may feel entrapped. In a shared decision-making approach with patients and possibly their family members, health care systems and clinicians should explore barriers and potential issues of empowerment and entrapment when offering a mHealth care model in practice.

Identifying the interplay between protective measures and settings on the SARS-CoV-2 transmission using a Bayesian network.

Contact tracing played a crucial role in minimizing the onward dissemination of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) in the recent pandemic. Previous studies had also shown the effectiveness of preventive measures such as mask-wearing, physical distancing, and exposure duration in reducing SARS-CoV-2 transmission. However, there is still a lack of understanding regarding the impact of various exposure settings on the spread of SARS-CoV-2 within the community, as well as the most effective preventive measures, considering the preventive measures adherence in different daily scenarios. We aimed to evaluate the effect of individual protective measures and exposure settings on the community transmission of SARS-CoV-2. Additionally, we aimed to investigate the interaction between different exposure settings and preventive measures in relation to such SARS-CoV-2 transmission. Routine SARS-CoV-2 contact tracing information was supplemented with additional data on individual measures and exposure settings collected from index patients and their close contacts. We used a case-control study design, where close contacts with a positive test for SARS-CoV-2 were classified as cases, and those with negative results classified as controls. We used the data collected from the case-control study to construct a Bayesian network (BN). BNs enable predictions for new scenarios when hypothetical information is introduced, making them particularly valuable in epidemiological studies. Our results showed that ventilation and time of exposure were the main factors for SARS-CoV-2 transmission. In long time exposure, ventilation was the most effective factor in reducing SARS-CoV-2, while masks and physical distance had on the other hand a minimal effect in this ventilation spaces. However, face masks and physical distance did reduce the risk in enclosed and unventilated spaces. Distance did not reduce the risk of infection when close contacts wore a mask. Home exposure presented a higher risk of SARS-CoV-2 transmission, and any preventive measures posed a similar risk across all exposure settings analyzed. Bayesian network analysis can assist decision-makers in refining public health campaigns, prioritizing resources for individuals at higher risk, and offering personalized guidance on specific protective measures tailored to different settings or environments.

Identifying risk factors of developing type 2 diabetes from an adult population with initial prediabetes using a Bayesian network.

Background: It is known that people with prediabetes increase their risk of developing type 2 diabetes (T2D), which constitutes a global public health concern, and it is associated with other diseases such as cardiovascular disease. Methods: This study aimed to determine those factors with high influence in the development of T2D once prediabetes has been diagnosed, through a Bayesian network (BN), which can help to prevent T2D. Furthermore, the set of features with the strongest influences on T2D can be determined through the Markov blanket. A BN model for T2D was built from a dataset composed of 12 relevant features of the T2D domain, determining the dependencies and conditional independencies from empirical data in a multivariate context. The structure and parameters were learned with the bnlearn package in R language introducing prior knowledge. The Markov blanket was considered to find those features (variables) which increase the risk of T2D. Results: The BN model established the different relationships among features (variables). Through inference, a high estimated probability value of T2D was obtained when the body mass index (BMI) was instantiated to obesity value, the glycosylated hemoglobin (HbA1c) to more than 6 value, the fatty liver index (FLI) to more than 60 value, physical activity (PA) to no state, and age to 48-62 state. The features increasing T2D in specific states (warning factors) were ranked. Conclusion: The feasibility of BNs in epidemiological studies is shown, in particular, when data from T2D risk factors are considered. BNs allow us to order the features which influence the most the development of T2D. The proposed BN model might be used as a general tool for prevention, that is, to improve the prognosis.

Sex and age differences in the association of fatty liver index-defined non-alcoholic fatty liver disease with cardiometabolic risk factors: a cross-sectional study.

BACKGROUND: Despite the extensive scientific evidence accumulating on the epidemiological risk factors for non-alcoholic fatty liver disease (NAFLD), evidence exploring sex- and age-related differences remains insufficient. The present cross-sectional study aims to investigate possible sex differences in the prevalence of FLI-defined NAFLD as well as in its association with common risk factors across different age groups, in a large sample of Spanish working adults. METHODS: This cross-sectional study included data from 33,216 Spanish adult workers (18-65 years) randomly selected during voluntary routine occupational medical examinations. Sociodemographic characteristics (age and social class), anthropometric (height, weight, and waist circumference) and clinical parameters (blood pressure and serum parameters) were collected. NAFLD was determined by the validated fatty liver index (FLI) with a cut-off value of ≥ 60. The presence of metabolic syndrome (MetS) was assessed according to the diagnostic criteria of the International Diabetes Federation. Cardiovascular risk was determined using the REGICOR-Framingham equation. The association between FLI-defined NAFLD and risk factors by sex and age was evaluated by multivariate logistic regression. RESULTS: The prevalence of FLI-defined NAFLD (FLI ≥ 60) was 19.1% overall, 27.9% (95% CI 23.3-28.5%) for men and 6.8% (95% CI 6.4-7.3%) for women and increasing across age intervals. As compared to women, men presented worse cardiometabolic and anthropometric profiles. The multivariate analysis model showed that hepatic steatosis assessed by FLI was strongly associated with age, HDL-cholesterol, social class, prediabetes, diabetes, prehypertension, hypertension, and smoking status for both men and women. The association between diabetes and hypertension with FLI-defined NAFLD was stronger in women than in men at both univariate and multivariate analyses. CONCLUSIONS: Men presented a higher prevalence of NAFLD than women across all age intervals, as well as a worse cardiometabolic profile and a higher cardiovascular risk. Nevertheless, the association between FLI-defined NAFLD and diabetes or hypertension was significantly stronger in women than in men, possibly indicating that the presence of a dysmetabolic state might affect women more than men with regard to liver outcomes.

Association between Body Mass Index with Sugar-Sweetened and Dairy Beverages Consumption in Children from the Mexico-USA Border.

The consumption of sugar-sweetened beverages has been associated with the onset of cardiometabolic diseases. The aim of this study was to describe consumption patterns of sugar-sweetened and dairy beverages and to evaluate their correlation with the body mass index in children residing at the Mexico−USA border. A total of 722 (370 girls, 352 boys) elementary school children aged 9 to 12 years from Tijuana, Mexico, participated in the study. Anthropometric measures were recorded, and a beverage intake questionnaire was completed by the children's parents. Significant age by sex interactions were found on body mass index Z-scores (p < 0.01). Boys showed higher sugar intake (p < 0.05) and total relative energy consumption from sugar (p < 0.05) than girls. The energy consumption from sugar-sweetened and dairy beverages was similar between sexes (p > 0.05). Sugar intake from beverages was higher than the limit recommended by the World Health Organization in boys (66%) and girls (44%). A high frequency of consumption of sugar-sweetened beverages and similar intake of dairy beverages were found in children from the Mexico−USA border. The high consumption of sugar exceeds international recommendations and should be carefully monitored.

The potential and challenges of Health 4.0 to face COVID-19 pandemic: a rapid review.

The COVID-19 pandemic has generated the need to evolve health services to reduce the risk of contagion and promote a collaborative environment even remotely. Advances in Industry 4.0, including the internet of things, mobile networks, cloud computing, and artificial intelligence make Health 4.0 possible to connect patients with healthcare professionals. Hence, the focus of this work is analyzing the potentiality, and challenges of state-of-the-art Health 4.0 applications to face the COVID-19 pandemic including augmented environments, diagnosis of the virus, forecasts, medical robotics, and remote clinical services. It is concluded that Health 4.0 can be applied in the prevention of contagion, improve diagnosis, promote virtual learning environments, and offer remote services. However, there are still ethical, technical, security, and legal challenges to be addressed. Additionally, more imaging datasets for COVID-19 detection need to be made available to the scientific community. Working in the areas of opportunity will help to address the new normal. Likewise, Health 4.0 can be applied not only in the COVID-19 pandemic, but also in future global viruses and natural disasters.

Effect of calcium-enriched high-fat diet on calcium, magnesium and zinc retention in mice.

The aim of this work was to assess the effects of a high-fat diet enriched in Ca, which accompanies lower body fat deposition, on mineral depots, as well as to assess the potential role of adaptive thermogenesis in mice. Male mice were fed ad libitum a high-fat (43 %) diet with a Ca content of 4 g/kg from calcium carbonate (control group) or 12 g/kg (42 % from milk powder and the rest from calcium carbonate) (Ca group) for 56 d. Body weight, food intake and urine were periodically collected. Tissue samples were collected when the mice were killed and the composition was determined. Expression of uncoupling proteins was determined by Western blotting. Mineral content was measured by flame atomic absorption spectrometry. Lower body weight gain and fat accretion was found in the Ca group. This could not be attributable to lower gross energy intake or to activation of adaptive thermogenesis. Although significant urine mineral loss was found in the Ca group, preservation of mineral depots in bone was observed. Our data support the fact that adding more Ca to the diet, using a combination of calcium carbonate plus milk powder containing among other things higher Zn and Mg, contributes to counteracting obesity and improving lipid metabolism.

Dietary calcium attenuation of body fat gain during high-fat feeding in mice.

Human epidemiological studies have supported the hypothesis that a dairy food-rich diet is associated with lower fat accumulation, although prospective studies and intervention trials are not so conclusive and contradictory data exist in animal models. The purpose of this study was to assess the effects on body weight and fat depots of dairy calcium (12 g/kg diet) in wild-type mice under ad libitum high-fat (43%) and normal-fat (12%) diets and to gain comprehension on the underlying mechanism of dairy calcium effects. Our results show that calcium intake decreases body weight and body fat depot gain under high-fat diet and accelerates weight loss under normal-fat diet, without differences in food intake. No differences in gene or protein expression of UCP1 in brown adipose tissue or UCP2 in white adipose tissue were found that could be related with calcium feeding, suggesting that calcium intake contributed to modulate body weight in wild-type mice by a mechanism that is not associated with activation of brown adipose tissue thermogenesis. UCP3 protein but not gene expression increased in muscle due to calcium feeding. In white adipose tissue there were effects of calcium intake decreasing the expression of proteins related to calcium signalling, in particular of stanniocalcin 2. CaSR levels could play a role in decreasing cytosolic calcium in adipocytes and, therefore, contribute to the diminution of fat accretion. Results support the anti-obesity effect of dietary calcium in male mice and indicate that, at least at the time-point studied, activation of thermogenesis is not involved.

A Bayesian Approach to Sport Injuries Likelihood: Does Player's Self-Efficacy and Environmental Factors Plays the Main Role?

The psychological factors of sports injuries constitute a growing field of study, even from the point of view of the prediction of their occurrence. Most of them, however, do not take into account the likelihood of the injuries' occurrence and the weight and role of the psychological variables on it. We conducted a study building up a Bayesian Network on a big sample of athletes, trying to assess these probabilistic links among several relevant psychological variables and the injuries' occurrence. The sample was constituted by 297 athletes (239 males, 58 females) from a wide range of sports: track and field; judo; fencing; karate; boxing; swimming; kayaking; artistic rollerskating, and team sports as football, basketball, and handball (Mean age: 25.10 ±-3.87; range: 21-38 years). Several psychological variables, such as anxiety, social support, and self-efficacy were studied. Also, we recorded the history of injuries as well the body mass index and personal epidemiological data. The overall picture of the generated graph and Bayesian Network and its analysis - including the use of hypothetical data by means of several instantiations - includes the nuclear role of the Self-Efficacy regarding the injuries' occurrence likelihood; the decreasing impact of the competitive anxiety previous to the injury; the probabilistic independence of the players' risk behaviors, and the relevance of the environmental clues such the use of coping strategies and social support in order to build up a good level of Self-Efficacy after the occurrence of an injury. All these data are relevant when designing both preventive and recovery interventions from the multidisciplinary as well as from the psychological point of view.

Calcium supplementation modulates gut microbiota in a prebiotic manner in dietary obese mice.

SCOPE: Dietary calcium has been inversely associated with body fat and energy balance. The main scope of this study has been to assess the potential contribution of gut microbiota on energy regulation mediated by calcium. METHODS AND RESULTS: Gut microbiota in C57BL/6J mice receiving calcium supplementation under a high-fat (HF) diet were analysed by PCR and their relationships with host metabolic parameters were determined. Calcium conferred a prebiotic-like effect on gut microbiota, and animals presented lower plasmatic endotoxin levels, increased expression of angiopoietin-like 4 in intestine and lower hepatic lipid content, although increased expression of stress markers in adipose tissue and of inflammation in liver was also found. To determine whether slimming effects could be transferred to obese mice, a faecal microbial transplant (FMT) was carried out, showing that host bacteria grown under a HF diet could not be superseded by those from calcium-fed animals. Therefore, FMT was not able to transfer the beneficial effects of calcium. CONCLUSION: In conclusion, calcium modulated gut microbiota in a prebiotic manner, establishing a host cross-talk and promoting a healthier metabolic profile. However, lack of effectiveness of FMT suggests the need of further appropriate dietary factors in addition to the bacteria per se.

The Latin American laws of correct nutrition: Review, unified interpretation, model and tools.

BACKGROUND: The "Laws of Correct Nutrition": the Law of Quantity, the Law of Quality, the Law of Harmony and the Law of Adequacy, provide the basis of a proper diet, i.e. one that provides the body with the energy required and nutrients it needs for daily activities and maintenance of vital functions. For several decades, these Laws have been the basis of nourishing menus designed in Latin America; however, they are stated in a colloquial language, which leads to differences in interpretation and ambiguities for non-experts and even experts in the field. METHODS: We present a review of the different interpretations of the Laws and describe a consensus. We represent concepts related to nourishing menu design employing the Unified Modeling Language (UML). We formalize the Laws using the Object Constraint Language (OCL). We design a nourishing menu for a particular user through enforcement of the Laws. RESULTS: We designed a domain model with the essential elements to plan a nourishing menu and we expressed the necessary constraints to make the model׳s behavior conform to the four Laws. We made a formal verification and validation of the model via USE (UML-based Specification Environment) and we developed a software prototype for menu design under the Laws. CONCLUSION: Diet planning is considered as an art but consideration should be given to the need for a set of strict rules to design adequate menus. Thus, we model the "Laws of Nutrition" as a formal basis and standard framework for this task.

Cognitive Interviewing to Enhance Comprehension and Accuracy of Responses to a Spanish-Language Nutrition Program Evaluation Tool.

OBJECTIVE: To cognitively test a Spanish translation of a questionnaire evaluating parent and child food and activity behaviors and assess accuracy of understanding and ease of answering. METHODS: Iterative rounds of cognitive interviewing, qualitative analysis, and revision were conducted with 19 low-income, native Spanish-speaking mothers of children aged 3-11 years, in 5 communities in New York. Key informant interviews were conducted with 2 Spanish-speaking nutrition educators experienced with the questionnaire. RESULTS: Based on responses, improvements were made to (1) ensure clear and familiar wording, (2) clarify time frames for specifying the frequency of behaviors, and (3) express constructs not amenable to direct translation or for which meanings differed by country of origin. Cognitive interviewing results also informed improvements to the English language version. CONCLUSIONS AND IMPLICATIONS: Even after translation by native speakers, in-depth cognitive interviewing is needed to ensure that questionnaires are understood as intended by low-literacy, immigrant populations and to facilitate collection of valid evaluation data.

Conjugated Linoleic Acid Supplementation under a High-Fat Diet Modulates Stomach Protein Expression and Intestinal Microbiota in Adult Mice.

The gastrointestinal tract constitutes a physiological interface integrating nutrient and microbiota-host metabolism. Conjugated linoleic acids (CLA) have been reported to contribute to decreased body weight and fat accretion. The modulation by dietary CLA of stomach proteins related to energy homeostasis or microbiota may be involved, although this has not been previously analysed. This is examined in the present study, which aims to underline the potential mechanisms of CLA which contribute to body weight regulation. Adult mice were fed either a normal fat (NF, 12% kJ content as fat) or a high-fat (HF, 43% kJ content as fat) diet. In the latter case, half of the animals received daily oral supplementation of CLA. Expression and content of stomach proteins and specific bacterial populations from caecum were analysed. CLA supplementation was associated with an increase in stomach protein expression, and exerted a prebiotic action on both Bacteroidetes/Prevotella and Akkermansia muciniphila. However, CLA supplementation was not able to override the negative effects of HF diet on Bifidobacterium spp., which was decreased in both HF and HF+CLA groups. Our data show that CLA are able to modulate stomach protein expression and exert a prebiotic effect on specific gut bacterial species.

A comparison between multiple regression models and CUN-BAE equation to predict body fat in adults.

BACKGROUND: Because the accurate measure of body fat (BF) is difficult, several prediction equations have been proposed. The aim of this study was to compare different multiple regression models to predict BF, including the recently reported CUN-BAE equation. METHODS: Multi regression models using body mass index (BMI) and body adiposity index (BAI) as predictors of BF will be compared. These models will be also compared with the CUN-BAE equation. For all the analysis a sample including all the participants and another one including only the overweight and obese subjects will be considered. The BF reference measure was made using Bioelectrical Impedance Analysis. RESULTS: The simplest models including only BMI or BAI as independent variables showed that BAI is a better predictor of BF. However, adding the variable sex to both models made BMI a better predictor than the BAI. For both the whole group of participants and the group of overweight and obese participants, using simple models (BMI, age and sex as variables) allowed obtaining similar correlations with BF as when the more complex CUN-BAE was used (ρ = 0:87 vs. ρ = 0:86 for the whole sample and ρ = 0:88 vs. ρ = 0:89 for overweight and obese subjects, being the second value the one for CUN-BAE). CONCLUSIONS: There are simpler models than CUN-BAE equation that fits BF as well as CUN-BAE does. Therefore, it could be considered that CUN-BAE overfits. Using a simple linear regression model, the BAI, as the only variable, predicts BF better than BMI. However, when the sex variable is introduced, BMI becomes the indicator of choice to predict BF.

Dietary supplementation of calcium may counteract obesity in mice mediated by changes in plasma fatty acids.

The scope of this study was to assess the impact of calcium and conjugated linoleic acid (CLA) supplementation on plasma fatty acid profiles and to evaluate potential synergistic effects of both compounds against dietary obesity. Mice separated into five experimental groups were followed: control (C), high-fat diet (HF), HF with calcium (Ca), HF plus CLA and HF with both Ca and CLA. Plasma metabolites and fatty acids were determined by commercial kits and gas chromatography, respectively. Both dietary calcium and CLA supplementation contributed to lower body fat gain under a HF diet. Maximum efficacy was seen with calcium; no additional effect was associated with the combined treatment with CLA. Plasma leptin, adiponectin and HOMA index were in accordance with an altered glucose/insulin homeostasis in the HF and HF + CLA groups, whereas control levels were attained under Ca-enriched diets. Plasma fatty acids showed minor changes associated to CLA treatment, but a high impact on PUFA was observed under Ca-enriched diets. Our results show that the mechanism underlying the anti-obesity effects of calcium supplementation is mediated mainly by changes in PUFA plasma profile. In addition, the lack of synergy on body weight reduction in combination with associated lipid profiles of calcium and CLA suggests that calcium may interfere with absorption and/or bioactivity of CLA, which can be of relevance when using CLA-fortified dairy products against human obesity.

Effects of milk supplementation with conjugated linoleic acid on weight control and body composition in healthy overweight people.

INTRODUCTION: Conjugated linoleic acids (CLAs) have shown beneficial effects in weight control therapy however this relation is not clear. OBJETIVE: The aim of the study was to examine the effects and safety of 3g of a 1:1 mix of c9-t11 and t10-c12 on weight control and body composition in healthy overweight individuals. METHODS: A prospective, placebo-controlled, randomised double-blind, parallel clinical trial lasting 24 weeks was carried out in 38 volunteers (29w, 9m) aged 30-55 years and BMI ≥27-<30 kg/m2 who consumed 200 ml/day of skimmed milk with 3g of CLAs or 3g olive oil (placebo). Anthropometric, biochemical and dual x-ray absorptiometry (DXA) tests were measured. Diet and physical activity were assessed. RESULTS: Subjects maintained their habitual dietary and exercise patterns over the study. Only CLA group showed a significant decrease in weight (74.43 ± 10.45 vs 73.54 ± 11.66 kg, p = 0.029) and waist circumference (91.45 ± 10.33 vs 90.65 ± 9.84 cm, p = 0.012) between baseline and end of the study. BMI and waist height ratio decreased (28.44 ± 1.08 vs 27.81 ± 1.43 kg/m2, p = 0.030 and 0.57 ± 0.05 vs 0.56 ± 0.04 p = 0.013 respectively) in CLA group at the end. CLA group experienced a reduction in total fat mass after 24 weeks (38.62 ± 5.02 vs 36.65 ± 5.64%, p = 0.035). No decrease was observed in Control group. HOMA index had no changes. CONCLUSIONS: The consumption of skimmed milk enriched with 3g of a 1:1 mixture of c9-t11 and t10-c12 for 24 weeks led to a decrease in body weight and total fat mass in healthy, overweight subjects who maintained habitual diets and exercise patterns. No adverse effects were observed. Registered under ClinicalTrials.gov Identifier No. NCT01503047.

INTRODUCTION: Conjugated linoleic acids (CLAs) have shown beneficial effects in weight control therapy however this relation is not clear. OBJETIVE: The aim of the study was to examine the effects and safety of 3g of a 1:1 mix of c9-t11 and t10-c12 on weight control and body composition in healthy overweight individuals. METHODS: A prospective, placebo-controlled, randomised double-blind, parallel clinical trial lasting 24 weeks was carried out in 38 volunteers (29w, 9m) aged 30-55 years and BMI ¡Ý27-

Transcriptional analysis reveals a high impact of conjugated linoleic acid on stearoyl-Coenzyme A desaturase 1 mRNA expression in mice gastrocnemius muscle.

We examined the potential implication of skeletal muscle in the fat-lowering effect observed in mice treated with moderate doses of CLA. In experiment 1, mice fed with a standard-fat diet were orally treated with sunflower oil (control) and 3 or 10 mg CLA mixture/day for 37 days. In experiment 2, mice were fed with a high-fat diet for 65 days. For the first 30 days, they received the same doses as in experiment 1 and, from that time onwards, animals received double doses. Gene expression of key proteins involved in fatty acid transport, oxidation, regulation of lipid and carbohydrate utilization, composition of muscle fiber, and thermogenesis were determined and, in most of them, no major impact of CLA was seen. Therefore, enhancement of fatty acid oxidation in muscle did not seem to contribute to the antiobesity effect of CLA as seen in other studies with higher CLA doses. However, a strong induction of classically associated lipogenic genes such as Fasn (up to twofold) and, particularly, Scd1 (up to ninefold) was found. This activation could contribute to a protective role in muscle cells, since expression of ER stress markers was decreased and inversely correlated with the induction of Scd1.

Moderate doses of conjugated linoleic acid reduce fat gain, maintain insulin sensitivity without impairing inflammatory adipose tissue status in mice fed a high-fat diet.

BACKGROUND: The enrichment of diet with nutrients with potential benefits on body composition is a strategy to combat obesity. Conjugated linoleic acid (CLA) due its beneficial effects on body composition and inflammatory processes becomes an interesting candidate, since the promotion and impairment of obesity is closely linked to a low-grade inflammation state of adipose tissue. Previously we reported the favourable effects of moderate doses of CLA mixture on body composition and inflammatory status of adipose tissue in mice fed a standard-fat diet. In the present study we assessed the potential beneficial effects of CLA mixture (cis-9, trans-11 and trans-10, cis-12, 50:50) in mice fed a high-fat diet. METHODS: Two doses were assayed: 0.15 g (CLA1) and 0.5 g CLA/kg body weight (CLA2) for the first 30 days of the study and then animals received a double amount for another 35 days. RESULTS: The lowest dose (CLA1) had minor effects on body composition, plasma parameters and gene expression. However, a clear reduction in fat accumulation was achieved by CLA2, accompanied by a reduction in leptin, adiponectin and non-esterified fatty acids (NEFA) plasma concentrations. Insulin sensitivity was maintained despite a slight increase in fasting glucose and insulin plasma concentrations. The study of gene expression both in adipocytes and in the stromal vascular fraction (SVF) suggested that CLA may reduce either the infiltration of macrophages in adipose tissue or the induction of expression of pro-inflammatory cytokines. CONCLUSION: In conclusion, the use of moderate doses of an equimolar mix of the two main CLA isomers reduces body fat content, improves plasma lipid profile, maintains insulin sensitivity (despite a moderate degree of hyperinsulinaemia) without the promotion of inflammatory markers in adipose tissue of mice fed a high-fat diet.

Expression of adipose microRNAs is sensitive to dietary conjugated linoleic acid treatment in mice.

BACKGROUND: Investigation of microRNAs (miRNAs) in obesity, their genetic targets and influence by dietary modulators is of great interest because it may potentially identify novel pathways involved in this complex metabolic disorder and influence future therapeutic approaches. This study aimed to determine whether miRNAs expression may be influenced by conjugated linoleic acid (CLA), currently used to induce fat loss. METHODOLOGY/PRINCIPAL FINDINGS: We determined retroperitoneal adipose tissue (rWAT) expression of five miRNAs related to adipocyte differentiation (miRNA-143) and lipid metabolism (miRNA-103 and -107) and altered in obesity (miRNA-221 and -222), using the TaqMan®MicroRNA Assay (Applied-Biosystems). In the first experiment, mice were fed with a standard fat diet and orally treated with sunflower oil (control group) and 3 or 10 mg CLA/day for 37 days. In the second experiment, mice were fed with a high fat diet for 65 days. For the first 30 days, mice received the same doses of CLA described above and, from that time onwards, animals received a double dose. Results showed that expression of selected miRNAs was modified in response to CLA treatment and metabolic status. Interestingly, a strong correlation was observed between miR-103 and -107 expression, as well as miR-221 and -222 in both experiments. Moreover, changes in miRNAs expression correlated with several adipocyte gene expressions: miR-103 and -107 correlated with genes involved in fatty acid metabolism whereas miR-221 and miR-222 correlated with the expression of adipocytokines. Regarding the minor changes observed in miR-143 expression, no differences in expression of adipogenic markers were observed. CONCLUSIONS/SIGNIFICANCE: Although elucidating the functional implications of miRNAs is beyond the scope of this study, these findings provide the first evidence that miRNAs expression may be influenced by dietary manipulation, reflecting or even contributing to the new metabolic state originated by CLA treatment.