Changes in objectively measured sleep after a multidisciplinary lifestyle intervention in children with abdominal obesity: A randomized trial.

BACKGROUND/OBJECTIVE: childhood obesity and sleep disorders have a well-established cross-sectional association, but lifestyle interventions' effects on sleep quality remain under-researched. This study aimed to evaluate the sleep quality of 122 participants (7-16 years) with abdominal obesity after a 2-year necessary lifestyle intervention. PATIENTS/METHODS: participants were assigned to either the intervention group (moderate hypocaloric Mediterranean Diet) or the usual care group (standard recommendations on a healthy diet). Sleep was objectively assessed using triaxial accelerometry, and sleep parameters analyzed included latency, efficiency, wake after sleep onset, total time in bed, total sleep time, number of awakenings, and awakening duration. RESULTS AND CONCLUSIONS: the results showed that the intervention group significantly improved sleep latency at 12 and 24 months and improved sleep efficiency at 2 and 12 months, compared to the usual care group. Wake after sleep onset and the number of awakenings were significantly reduced at 24 months in the intervention group. Wake after sleep onset and leptin levels were positively associated in all participants. Total time in bed was inversely associated with triglycerides and metabolic score, and total sleep time was inversely associated with leptin, triglycerides, and metabolic score after the 2-month intervention. Triglyceride levels were inversely associated with total time in bed and total sleep time at one year, while the metabolic score was directly associated with wake after sleep onset and the number of awakenings and inversely associated with efficiency. In conclusion, the multidisciplinary intervention in children and adolescents with abdominal obesity reduced anthropometric parameters and improved sleep habits.

[Ultra-processed food consumption and obesity-a systematic review]. / Consumo de alimentos ultraprocesados y obesidad: una revisión sistemática.

INTRODUCTION: A number of studies suggest a relationship between the intake of ultra-processed foods and the prevalence of obesity. Specifically, this type of food provides large amounts of free sugars and saturated fats, which contribute to a high energy intake. In the last few decades the consumption of these products has increased to the point of representing an important amount of calories in the daily diet of several populations. As a result, foods that are usually consumed in healthy eating patterns, containing fiber, complex carbohydrates, and good fats, have been displaced. This systematic review aims to compile the information available in the literature, and to examine the scientific evidence about the relationship between ultra-processed food and obesity. Nevertheless, there are a number of limitations due to the heterogeneity of the methodologies or food classification systems used in the different studies, which makes it difficult to draw definitive conclusions on the relationship between consumption of ultra-processed food and development of obesity.

INTRODUCCIÓN: Cada vez son más numerosos los estudios que relacionan el consumo de alimentos ultraprocesados con la prevalencia de la obesidad. Esta clase de alimentos se caracteriza porque aportan gran cantidad de azúcares libres y grasas saturadas, lo que contribuye a aumentar la ingesta energética. En las últimas décadas, el consumo de estos alimentos está aumentado hasta el punto de convertirse en una importante fuente de energía diaria en algunas poblaciones. De esta manera, resultan desplazados alimentos ricos en fibra, hidratos de carbono complejos y grasas beneficiosas para la salud que pertenecen a patrones de alimentación saludables. Esta revisión sistemática se propone recopilar la información existente en la literatura sobre la relación entre alimentos ultraprocesados y obesidad. Sin embargo, hay que reconocer que existen limitaciones con respecto a la heterogeneidad de las metodologías empleadas en los diversos estudios o la utilización de distintos sistemas de clasificación de alimentos en función del grado de procesamiento, lo que dificulta el establecimiento, de manera definitiva, de una asociación entre el consumo de ultraprocesados y el desarrollo de obesidad.

Omega-3 fatty acids and cognitive decline: a systematic review.

INTRODUCTION: In a growing elderly population, mild cognitive impairment (MCI) and age related cognitive decline (ARCD) are increasing in prevalence worldwide. In the search for food compounds able to ameliorate this condition, it has been postulated that n-3 Long chain polyunsaturated fatty acids (n-3 LCPUFA), also known as omega-3, consumption could have a positive effect in the prevention or therapy of these cognitive declines. However, there are contradictory findings in the literature concerning the effects of n-3 LCPUFA on cognitive decline making it difficult to draw a conclusion on this topic. This current systematic review studies the relationship between n-3 LCPUFAs and cognitive status in aged adult and elder populations to determine whether there is or not a positive effect of n-3 LCPUFAs supplementation on cognitive decline. Additionally, we remark how duration periods, different cognitive baseline status in subjects, dosage of n-3 LCPUFAs administration and the presence of other factors might be related to different outcomes. A search of randomized controlled trials (RCTs) related with the relationship between cognitive impairment and n-3 LCPUFA (docosahexaenoic acid, eicosapentanoic acid or combined) supplementation was conducted through PubMed database from January 2010 to December 2017 following the PRISMA statement. Interventional studies which included aged adults or elder subjects with or without MCI and with no previous intake of fish oil supplements (FOS) were included. Ten out of the fourteen RCTs reviewed showed positive outcome on at least one domain of cognitive function (working memory, executive function, verbal memory, short-term memory, perceptual speed, etc.). This systematic review concludes that omega-3 supplementation might have a positive effect on cognitive function. Thus, n-3 LCPUFAs could be used as a preventive or therapeutic tool for cognitive decline in aged or elder adults.

INTRODUCCIÓN: En grupos de población de mayores en constante crecimiento, el deterioro cognitivo asociado o no a la edad incrementa en prevalencia mundialmente. Se ha postulado que el consumo de ácidos grasos de cadena larga n-3 (AGCL n-3), también conocidos como omega-3, podrían tener un efecto positivo en la prevención o tratamiento del deterioro cognitivo. Sin embargo, existen hallazgos contradictorios en la literatura respecto al efecto de los AGCL n-3 sobre la función cognitiva, lo cual hace difícil extraer una conclusión sobre su posible función. La presente revisión sistemática estudia la relación entre los AGCL n-3 y el estado cognitivo en adultos de mediana edad y mayores de 60 años para determinar si hay un efecto positivo de la suplementación con omega-3 en el deterioro cognitivo. Adicionalmente, se hace énfasis en cómo la duración de los ensayos, el estado cognitivo basal de los sujetos, la dosis de AGCL n-3 y la presencia de otros factores pudiesen estar relacionados con los diferentes resultados obtenidos. Una búsqueda de ensayos clínicos aleatorizados relacionados con la relación entre el deterioro cognitivo y la suplementación de AGCL n-3 (ácido docosahexaenoico, ácido eicosapentanoico o una combinación de los mismos) se llevó a cabo a través de la base de datos PubMed desde enero de 2010 hasta febrero de 2018 siguiendo la metodología PRISMA. Estudios de intervención que incluían sujetos adultos de mediana edad y mayores de 60 años con o sin deterioro cognitivo leve sin que hubieran recibido otros suplementos (aceite de pescado) fueron incluidos. Diez de los 14 ensayos clínicos aleatorizados mostraron una mejora en algún dominio de la función cognitiva (memoria de trabajo, función ejecutiva, memoria verbal, memoria a corto plazo, rapidez de percepción, etc.). Esta revisión sistemática concluye que la suplementación con AGCL n-3 puede tener un efecto positivo en la función cognitiva. De esta manera, podrían ser usados como una medida preventiva o como tratamiento para el deterioro cognitivo.

Diet quality index as a predictor of treatment efficacy in overweight and obese adolescents: The EVASYON study.

BACKGROUND & AIM: A diet quality index (DQI) is a tool that provides an overall score of an individual's dietary intake when assessing compliance with food-based dietary guidelines. A number of DQIs have emerged, albeit their associations with health-related outcomes are debated. The aim of the present study was to assess whether adherence to dietary intervention, and the overall quality of the diet, can predict body composition changes. METHODS: To this purpose, overweight/obese adolescents (n = 117, aged: 13-16 years; 51 males, 66 females) were recruited into a multi-component (diet, physical activity and psychological support) family-based group treatment programme. We measured the adolescents' compliance and body composition at baseline and after 2 months (intensive phase) and 13 months (extensive phase) of follow-up. Also, at baseline, after 6 months, and at the end of follow-up we calculated the DQI. RESULTS: Global compliance with the dietary intervention was 37.4% during the intensive phase, and 14.3% during the extensive phase. Physical activity compliance was 94.1% at 2-months and 34.7% at 13months and psychological support compliance were growing over the intervention period (10.3% intensive phase and 45.3% during extensive phase). Adolescents complying with the meal frequency criteria at the end of the extensive phase had greater reductions in FMI z-scores than those did not complying (Cohen's d = 0.53). A statistically significant association was observed with the diet quality index. DQI-A variation explained 98.1% of BMI z-score changes and 95.1% of FMI changes. CONCLUSIONS: We conclude that assessment of changes in diet quality could be a useful tool in predicting body composition changes in obese adolescents involved in a diet and physical activity intervention programme backed-up by psychological and family support.

Anthropometric indices to assess body-fat changes during a multidisciplinary obesity treatment in adolescents: EVASYON Study.

BACKGROUND & AIMS: The main objectives of weight loss interventions in children and adolescents are to decrease fat mass while maintaining fat-free mass. Several methods are available to assess childhood and adolescence obesity, such as weight and height, bioelectrical impedance, skin-fold thickness measurements and other laboratory methods. The aim was to assess simple anthropometric indices as predictors of body-fat changes, using dual-energy X-ray absorptiometry measurements as reference method. METHODS: Multi-intervention approach (diet, physical activity and psychological support in a family-group-based treatment) was implemented with a one-year follow-up in 13-to-16-year-old overweight or obese Spanish adolescents. A total of 83 adolescents were recruited from Granada and Zaragoza, males (n = 43) (31.6 kg/m(2)) and females (n = 40) (32.0 kg/m(2)). We measured body composition with anthropometry and dual-energy X-ray absorptiometry. All measurements were made at baseline, and after 2 and 13 months. Random coefficient regression model was used to calculate the proportion of body composition changes during follow-up that would be explained by simple body composition indices based on anthropometric measures. RESULTS: After controlling for age and Tanner stage, body mass index explained 76.5% of body composition changes in males and 90.1% in females, while fat mass index (assessed by skin-folds) explained 78.9% of body composition changes in males and 84.0% of body composition changes in females. CONCLUSIONS: In conclusion, we found that BMI was a good indicator of body fat composition changes in children and adolescents, although FMI assessed by anthropometry was also a good indicator.

Effects of the FTO gene on lifestyle intervention studies in children.

The effects of FTO on body weight, body composition, and the risk of developing overweight and obesity in children, adolescents, and adults are analyzed in this review. Most trails have been conducted on the rs9939609 SNP of the FTO gene. The minor A-allele frequency ranged from 0.38 to 0.49 in different European populations. Briefly, it has been reported that overweight-obesity risk per A-allele ranged from 1.76 to 1.35, whereas z-score for BMI has a wider variation from 0.05 to 0.5 kg/m(2) in European children and adolescents. As for other adiposity indexes, a waist circumference increase from 0.60 to 0.95 cm per A-allele was found together with an increase in fat mass from 0.68 to 1.78 kg in European children and adoles-cents. In regard to food intake, AA carrier subjects were reported to have reduced satiety responsiveness scores and a higher total energy and fat intake. However, it is not clear whether energy expenditure did modify the role of the rs9939609 FTO gene variant in adiposity. Furthermore, few reports examined the influence of FTO gene variants using intervention studies. Overall, it seems that the A-allele (rs9939609 FTO) is associated with higher body weight gain. However, further studies into FTO gene variants in children and adults are needed.