Overnutrition, Hyperinsulinemia and Ectopic Fat: It Is Time for A Paradigm Shift in the Management of Type 2 Diabetes.

The worldwide incidence of prediabetes/type 2 has continued to rise the last 40 years. In the same period, the mean daily energy intake has increased, and the quality of food has significantly changed. The chronic exposure of pancreatic ß-cells to calorie excess (excessive energy intake) and food additives may increase pancreatic insulin secretion, decrease insulin pulses and/or reduce hepatic insulin clearance, thereby causing chronic hyperinsulinemia and peripheral insulin resistance. Chronic calorie excess and hyperinsulinemia may promote lipogenesis, inhibit lipolysis and increase lipid storage in adipocytes. In addition, calorie excess and hyperinsulinemia can induce insulin resistance and contribute to progressive and excessive ectopic fat accumulation in the liver and pancreas by the conversion of excess calories into fat. The personal fat threshold hypothesis proposes that in susceptible individuals, excessive ectopic fat accumulation may eventually lead to hepatic insulin receptor resistance, the loss of pancreatic insulin secretion, hyperglycemia and the development of frank type 2 diabetes. Thus, type 2 diabetes seems (partly) to be caused by hyperinsulinemia-induced excess ectopic fat accumulation in the liver and pancreas. Increasing evidence further shows that interventions (hypocaloric diet and/or bariatric surgery), which remove ectopic fat in the liver and pancreas by introducing a negative energy balance, can normalize insulin secretion and glucose tolerance and induce the sustained biochemical remission of type 2 diabetes. This pathophysiological insight may have major implications and may cause a paradigm shift in the management of type 2 diabetes: avoiding/reducing ectopic fat accumulation in the liver and pancreas may both be essential to prevent and cure type 2 diabetes.

Overnutrition is a risk factor for iron, but not for zinc or vitamin A deficiency in children and young people: a systematic review and meta-analysis.

INTRODUCTION: Traditionally associated with undernutrition, increasing evidence suggests micronutrient deficiencies can coexist with overnutrition. Therefore, this work aimed to systematically review the associations between iron, zinc and vitamin A (VA) status and weight status (both underweight and overweight) in children and young people. METHODS: Ovid Medline, Ovid Embase, Scopus and Cochrane databases were systematically searched for observational studies assessing micronutrient status (blood, serum or plasma levels of iron, zinc or VA biomarkers) and weight status (body mass index or other anthropometric measurement) in humans under 25 years of any ethnicity and gender. Risk of bias assessment was conducted using the American Dietetic Association Quality Criteria Checklist. Where possible, random effects restricted maximum likelihood meta-analyses were performed. RESULTS: After screening, 83 observational studies involving 190 443 participants from 44 countries were identified, with many studies having reported on more than one micronutrient and/or weight status indicator. Iron was the most investigated micronutrient, with 46, 28 and 27 studies reporting data for iron, zinc and VA status, respectively. Synthesising 16 records of OR from seven eligible studies, overnutrition (overweight and obesity) increased odds of iron deficiency (ID) (OR (95% CI): 1.51 (1.20 to 1.82), p<0.0001, I2=40.7%). Odds appeared to be higher for children living with obesity (1.88 (1.33 to 2.43), p<0.0001, I2=20.6%) in comparison to those with overweight (1.31 (0.98 to 1.64), p<0.0001, I2=40.5%), although between group differences were not significant (p=0.08). CONCLUSIONS: Overnutrition is associated with increased risk of ID, but not zinc or VA deficiencies, with an inverted U-shaped relationship observed between iron status and bodyweight. Our results highlight significant heterogeneity in the reporting of micronutrient biomarkers and how deficiencies were defined. Inflammation status was rarely adequately accounted for, and the burden of ID may well be under-recognised, particularly in children and young people living with overnutrition. PROSPERO REGISTRATION NUMBER: CRD42020221523.

Nutrition, Nutritional Status, Micronutrients Deficiency, and Disease Course of Inflammatory Bowel Disease.

During the disease course, most Inflammatory Bowel Disease patients present a condition of malnutrition, undernutrition, or even overnutrition. These conditions are mainly due to suboptimal nutritional intake, alterations in nutrient requirements and metabolism, malabsorption, and excessive gastrointestinal losses. A suboptimal nutritional status and low micronutrient serum levels can have a negative impact on both induction and maintenance of remission and on the quality of life of Inflammatory Bowel Disease patients. We performed a systematic review including all the studies evaluating the connection between nutrition, nutrition status (including undernutrition and overnutrition), micronutrient deficiency, and both disease course and therapeutic response in Inflammatory Bowel Disease patients. This systematic review was performed using PubMed/MEDLINE and Scopus. Four main clinical settings concerning the effect of nutrition on disease course in adult Inflammatory Bowel Disease patients were analyzed (induction of remission, maintenance of remission, risk of surgery, post-operative recurrence, and surgery-related complications). Four authors independently reviewed abstracts and manuscripts for eligibility. 6077 articles were found; 762 duplicated studies were removed. Out of 412 full texts analyzed, 227 were included in the review. The evidence summarized in this review showed that many nutritional aspects could be potential targets to induce a better control of symptoms, a deeper remission, and overall improve the quality of life of Inflammatory Bowel Disease patients.

Etiquetado frontal de advertencia nutricional de alimentos y bebidas pre-envasados. Postura intersectorial de expertos en Centro América y República Dominicana / Front-of-package warning labelling system for pre-packaged foods and beverages: an intersectoral position of expertsin Central American and Dominican Republic

La región latinoamericana ha sido pionera en la implementación del etiquetado frontal de advertencia nutricional (EFAN), mismo que ha demostrado su eficacia y efectividad para identificar correctamente cuando un producto contiene cantidades excesivas de nutrientes asociados a Enfermedades no transmisibles (ENT). Sin embargo, ningún país del Sistema de la Integración Centroamericana (SICA); que incluye a Belice, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, Panamá y República Dominicana, lo ha adoptado. Por esta razón, el Instituto de Nutrición de Centro América y Panamá, convocó a un grupo de expertos de la academia y la sociedad civil con el objetivo de establecer una postura técnica, basada en la mejor evidencia científica, en relación al etiquetado frontal para los nutrientes críticos de alimentos y bebidas pre- envasados en la región centroamericana. Se presenta evidencia específica de la región del SICA que demuestran la superioridad del EFAN frente a otros etiquetados como las Guías Diarias de Alimentación (GDA), el semáforo y el Nutriscore para seleccionar opciones más saludables. Dentro del marco de los derechos de la niñez y de los consumidores, se brindan argumentos y se hace un llamado a los gobiernos para la pronta adopción del EFAN como una política costo-efectiva para la prevención de ENT. Además, se proveen recomendaciones para su monitoreo y evaluación, así como recomendaciones de otras políticas costo-efectivas como la regulación de la publicidad de alimentos no saludables dirigido a la niñez y adolescencia, entre otros, para la prevención de las ENT y la creación de ambientes y sistemas alimentarios más saludables y sostenibles(AU)

The Latin American region has been a pioneer in the implementation of a front- of-pack warning labeling system (FOPWL), which has demonstrated its efficacy and effectiveness in correctly identifying when a product contains excessive amounts of nutrients associated with Non-Communicable Diseases (NCDs). However, countries of the Central American Integration System (SICA); which includes Belize, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, Panama and the Dominican Republic, have no adopted it. For this reason, the Institute of Nutrition of Central America and Panama convened a group of experts from academia and civil society with the aim of establishing an evidence-based technical position, in relation to front-of-pack labelling for critical nutrients of pre-packaged foods and beverages in the Central American region. Specific evidence from the SICA region demonstrating the superiority of FOPWL over other labels such as the Guideline Daily Amount (GDA), the traffic light and Nutriscore to select healthier choices is presented. Within the framework of children's and consumer rights, arguments are provided, and a call is made to governments for the prompt adoption of FOPWL as a cost-effective policy for the prevention of NCDs. In addition, recommendations for its monitoring and evaluation are provided, as well as recommendations for other cost-effective policies such as the regulation of unhealthy food advertising aimed at children and adolescents, among others, for the prevention of NCDs and the creation ofhealthier and more sustainable environments and food systems(AU)

Chinese Dietary Indices and Glioma: New Insights of a Case-Control Study in the Chinese Population.

Identifying modifiable factors in primary prevention strategies is a typical goal of glioma epidemiology. Among many glioma risk factors, diet was always considered as one. Most of the relevant studies thus far were concentrated on the West. It was crucial to investigate the connection between the Chinese diet and gliomas given the stark variations between western and eastern diets. A food frequency questionnaire including 114 items was used to investigate the food intake of the study subjects. The Chinese Dietary Quality Index (CDQI), the Chinese Dietary Balance Index (CDBI), the Dietary Antioxidant Index (DAI), the Dietary Inflammation Index (DII), and the Chinese Healthy Eating Index (CHEI) were calculated based on the data provided by the food frequency questionnaire to evaluate dietary quality, dietary balance, dietary antioxidants, dietary inflammation and adherence to the Chinese dietary guidelines in 506 glioma patients and 506 controls, respectively. After adjusting covariates, CHEI (OR = 0.90, 95% CI: 0.88-0.93) and DAI (OR = 0.61, 95% CI: 0.54-0.70) were correlated to a reduced glioma risk, and CDBI-based undernutrition (OR = 1.08, 95% CI: 1.06-1.12) and overnutrition (OR = 1.14, 95% CI: 1.09-1.20) and DII (OR = 2.20, 95% CI: 1.81-2.68) were correlated to an elevated glioma risk. Moreover, restrictive cubic spline analysis showed that there were significant nonlinear dose-response relationships between CHEI, CDBI, DAI, DII, and glioma. Therefore, adhering to the Chinese dietary guidelines was connected with a lower glioma risk, and undernutrition and overnutrition in the Chinese diet were associated with an increased risk of glioma.

Fasting: From Physiology to Pathology.

Overnutrition is a risk factor for various human diseases, including neurodegenerative diseases, metabolic disorders, and cancers. Therefore, targeting overnutrition represents a simple but attractive strategy for the treatment of these increasing public health threats. Fasting as a dietary intervention for combating overnutrition has been extensively studied. Fasting has been practiced for millennia, but only recently have its roles in the molecular clock, gut microbiome, and tissue homeostasis and function emerged. Fasting can slow aging in most species and protect against various human diseases, including neurodegenerative diseases, metabolic disorders, and cancers. These centuried and unfading adventures and explorations suggest that fasting has the potential to delay aging and help prevent and treat diseases while minimizing side effects caused by chronic dietary interventions. In this review, recent animal and human studies concerning the role and underlying mechanism of fasting in physiology and pathology are summarized, the therapeutic potential of fasting is highlighted, and the combination of pharmacological intervention and fasting is discussed as a new treatment regimen for human diseases.

Neonatal overnutrition, but not neonatal undernutrition, disrupts CCK-induced hypophagia and neuron activation of the nucleus of the solitary tract and paraventricular nucleus of hypothalamus of male Wistar rats.

Metabolic programming may be induced by reduction or enhancement of litter size, which lead to neonatal over or undernutrition, respectively. Changes in neonatal nutrition can challenge some regulatory processes in adulthood, such as the hypophagic effect of cholecystokinin (CCK). In order to investigate the effects of nutritional programming on the anorexigenic function of CCK in adulthood, pups were raised in small (SL, 3 pups per dam), normal (NL, 10 pups per dam), or large litters (LL, 16 pups per dam), and on postnatal day 60, male rats were treated with vehicle or CCK (10 µg/Kg) for the evaluation of food intake and c-Fos expression in the area postrema (AP), nucleus of solitary tract (NTS), and paraventricular (PVN), arcuate (ARC), ventromedial (VMH), and dorsomedial (DMH) nuclei of the hypothalamus. Overnourished rats showed increased body weight gain that was inversely correlated with neuronal activation of PaPo, VMH, and DMH neurons, whereas undernourished rats had lower body weight gain, inversely correlated with increased neuronal activation of PaPo only. SL rats showed no anorexigenic response and lower neuron activation in the NTS and PVN induced by CCK. LL exhibited preserved hypophagia and neuron activation in the AP, NTS, and PVN in response to CCK. CCK showed no effect in c-Fos immunoreactivity in the ARC, VMH, and DMH in any litter. These results indicate that anorexigenic actions, associated with neuron activation in the NTS and PVN, induced by CCK were impaired by neonatal overnutrition. However, these responses were not disrupted by neonatal undernutrition. Thus, data suggest that an excess or poor supply of nutrients during lactation display divergent effects on programming CCK satiation signaling in male adult rats.

Adrenomedullin2 stimulates progression of thyroid cancer in mice and humans under nutrient excess conditions.

Thyroid cancer is associated with genetic alterations, e.g. BRAFV600E , which may cause carcinomatous changes in hormone-secreting epithelial cells. Epidemiological studies have shown that overnutrition is related to the development and progression of cancer. In this study, we attempted to identify the cell nonautonomous factor responsible for the progression of BRAFV600E thyroid cancer under overnutrition conditions. We developed a mouse model for inducible thyrocyte-specific activation of BRAFV600E , which showed features similar to those of human papillary thyroid cancer. LSL-BrafV600E ;TgCreERT2 showed thyroid tumour development in the entire thyroid, and the tumour showed more abnormal cellular features with mitochondrial abnormalities in mice fed a high-fat diet (HFD). Transcriptomics revealed that adrenomedullin2 (Adm2) was increased in LSL-BrafV600E ;TgCreERT2 mice fed HFD. ADM2 was upregulated on the addition of a mitochondrial complex I inhibitor or palmitic acid with integrated stress response (ISR) in cancer cells. ADM2 stimulated protein kinase A and extracellular signal-regulated kinase in vitro. The knockdown of ADM2 suppressed the proliferation and migration of thyroid cancer cells. We searched The Cancer Genome Atlas and Genotype-Tissue Expression databases and found that increased ADM2 expression was associated with ISR and poor overall survival. Consistently, upregulated ADM2 expression in tumour cells and circulating ADM2 molecules were associated with aggressive clinicopathological parameters, including body mass index, in thyroid cancer patients. Collectively, we identified that ADM2 is released from cancer cells under mitochondrial stress resulting from overnutrition and acts as a secretory factor determining the progressive properties of thyroid cancer. © 2022 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.

PACAP attenuates hepatic lipid accumulation through the FAIM/AMPK/IRß axis during overnutrition.

OBJECTIVE: Pituitary adenylate cyclase-activating polypeptide (PACAP) was reported to attenuate hepatic lipid accumulation in overnutrition-related metabolic disorder, mediated by up-regulation of fas apoptosis inhibitory molecule (FAIM). However, how PACAP regulates FAIM in metabolic tissues remains to be addressed. Here we investigated the underlying mechanism on the role of PACAP in ameliorating metabolic disorder and examined the potential therapeutic effects of PACAP in preventing the progression of metabolic associated fatty liver disease (MAFLD). METHODS: Mouse models with MAFLD induced by high-fat diet were employed. Different doses of PACAP were intraperitoneally administrated. Western blot, luciferase assay, lentiviral-mediated gene manipulations and animal metabolic phenotyping analysis were performed to explore the signaling pathway involved in PACAP function. RESULTS: PACAP ameliorated the excessive hepatic lipid accumulation and inhibited lipogenesis in HFD-fed C57BL/6J mice. Mechanistically, PACAP activated the FAIM-AMPK-IRß axis to inhibit the expression of lipid synthesis genes, and FAIM mediated the effects of PACAP. FAIM suppression via lentiviral-mediated shRNA inhibited the activation of AMPK, whereas FAIM overexpression promoted AMPK activation. PACAP increased the promoter activity of FAIM gene through activating PKA-CREB signaling pathway. CONCLUSION: Our work demonstrated that the administration of PACAP represented a feasible approach for treating hepatic lipid accumulation in MAFLD. The findings reveal the molecular mechanism that PACAP increase FAIM expression and activates the FAIM/AMPK/IRß signaling axis, thus inhibits lipogenesis to mediate its beneficial effects.

Non-alcoholic fatty liver disease: a multi-system disease influenced by ageing and sex, and affected by adipose tissue and intestinal function.

In recent years, a wealth of factors are associated with increased risk of developing non-alcoholic fatty liver disease (NAFLD) and NAFLD is now thought to increase the risk of multiple extra-hepatic diseases. The aim of this review is first to focus on the role of ageing and sex as key, poorly understood risk factors in the development and progression of NAFLD. Secondly, we aim to discuss the roles of white adipose tissue (WAT) and intestinal dysfunction, as producers of extra-hepatic factors known to further contribute to the pathogenesis of NAFLD. Finally, we aim to summarise the role of NAFLD as a multi-system disease affecting other organ systems beyond the liver. Both increased age and male sex increase the risk of NAFLD and this may be partly driven by alterations in the distribution and function of WAT. Similarly, changes in gut microbiota composition and intestinal function with ageing and chronic overnutrition are likely to contribute to the development of NAFLD both directly (i.e. by affecting hepatic function) and indirectly via exacerbating WAT dysfunction. Consequently, the presence of NAFLD significantly increases the risk of various extra-hepatic diseases including CVD, type 2 diabetes mellitus, chronic kidney disease and certain extra-hepatic cancers. Thus changes in WAT and intestinal function with ageing and chronic overnutrition contribute to the development of NAFLD - a multi-system disease that subsequently contributes to the development of other chronic cardiometabolic diseases.

Maternal soybean diet on prevention of obesity-related breast cancer through early-life gut microbiome and epigenetic regulation.

Overnutrition-induced obesity and metabolic dysregulation are considered major risk factors contributing to breast cancer. The origin of both obesity and breast cancer can retrospect to early development in human lifespan. Genistein (GE), a natural isoflavone enriched in soybean products, has been proposed to associate with a lower risk of breast cancer and various metabolic disorders. Our study aimed to determine the effects of maternal exposure to soybean dietary GE on prevention of overnutrition-induced breast cancer later in life and explore potential mechanisms in different mouse models. Our results showed that maternal dietary GE treatment improved offspring metabolic functions by significantly attenuating high-fat diet-induced body fat accumulation, lipid panel abnormalities and glucose intolerance in mice offspring. Importantly, maternal dietary GE exposure effectively delayed high-fat diet-simulated mammary tumor development in female offspring. Mechanistically, we found that maternal dietary GE may exert its chemopreventive effects through affecting essential regulatory gene expression in control of metabolism, inflammation and tumor development via, at least in part, regulation of offspring gut microbiome, bacterial metabolites and epigenetic profiles. Altogether, our findings indicate that maternal GE consumption is an effective intervention approach leading to early-life prevention of obesity-related metabolic disorders and breast cancer later in life through dynamically influencing the interplay between early-life gut microbiota, key microbial metabolite profiles and offspring epigenome.

Reducing ether lipids improves Drosophila overnutrition-associated pathophysiology phenotypes via a switch from lipid storage to beta-oxidation.

High-calorie diets increase the risk of developing obesity, cardiovascular disease, type-two diabetes (T2D), and other comorbidities. These "overnutrition" diets also promote the accumulation of a variety of harmful lipids in the heart and other peripheral organs, known as lipotoxicity. However, the mechanisms underlying lipotoxicity and its influence on pathophysiology remain unknown. Our study uses genetics to identify the role of ether lipids, a class of potential lipotoxins, in a Drosophila model of overnutrition. A high-sugar diet (HSD) increases ether lipids and produces T2D-like pathophysiology phenotypes, including obesity, insulin resistance, and cardiac failure. Therefore, we targeted ether lipid biosynthesis through the enzyme dihydroxyacetonephosphate acyltransferase (encoded by the gene DHAPAT). We found that reducing DHAPAT in the fat body improved TAG and glucose homeostasis, cardiac function, respiration, and insulin signaling in flies fed a HSD. The reduction of DHAPAT may cause a switch in molecular signaling from lipogenesis to fatty acid oxidation via activation of a PPARα-like receptor, as bezafibrate produced similar improvements in HS-fed flies. Taken together, our findings suggest that ether lipids may be lipotoxins that reduce fitness during overnutrition.

Myeloid FoxO1 depletion attenuates hepatic inflammation and prevents nonalcoholic steatohepatitis.

Hepatic inflammation is culpable for the evolution of asymptomatic steatosis to nonalcoholic steatohepatitis (NASH). Hepatic inflammation results from abnormal macrophage activation. We found that FoxO1 links overnutrition to hepatic inflammation by regulating macrophage polarization and activation. FoxO1 was upregulated in hepatic macrophages, correlating with hepatic inflammation, steatosis, and fibrosis in mice and patients with NASH. Myeloid cell conditional FoxO1 knockout skewed macrophage polarization from proinflammatory M1 to the antiinflammatory M2 phenotype, accompanied by a reduction in macrophage infiltration in liver. These effects mitigated overnutrition-induced hepatic inflammation and insulin resistance, contributing to improved hepatic metabolism and increased energy expenditure in myeloid cell FoxO1-knockout mice on a high-fat diet. When fed a NASH-inducing diet, myeloid cell FoxO1-knockout mice were protected from developing NASH, culminating in a reduction in hepatic inflammation, steatosis, and fibrosis. Mechanistically, FoxO1 counteracts Stat6 to skew macrophage polarization from M2 toward the M1 signature to perpetuate hepatic inflammation in NASH. FoxO1 appears to be a pivotal mediator of macrophage activation in response to overnutrition and a therapeutic target for ameliorating hepatic inflammation to stem the disease progression from benign steatosis to NASH.

Prevalencia de malnutrición por exceso en niños, niñas y adolescentes en pandemia, en centro médico de la Escuela de Medicina de la Universidad de Tarapaca / Prevalence of malnutrition due to excess in children, girls and adolescents during pandemic, in a medical center of the School of Medicine of the University of Tarapacá

INTRODUCCIÓN: La malnutrición por exceso afecta aproximadamente a 337 millones de niños, niñas y adolescentes en el mundo. Entre los aspectos multifactoriales asociados a la obesidad, destaca el contexto Pandemia por COVID-19, el cual ha aumentado las cifras de obesidad infantil. Por otro lado, la obesidad es considerada un factor de riesgo para desarrollar de forma grave la enfermedad por COVID-19. Este estudio busca analizar el efecto de la pandemia en los índices de malnutrición por exceso en los niños, niñas y adolescentes atendidos en el centro médico de la carrera de medicina de la Universidad de Tarapacá durante el año 2021 y compararlos con estudios previos realizados en Chile. METODOLOGÍA: La investigación tiene un enfoque analítico, transversal, retrospectivo y observacional. El estudio se basó en la revisión de fichas clínicas de 1094 pacientes entre 2 y 17 años atendidos en el Centro Médico de la Escuela de Medicina de la Universidad de Tarapacá en la ciudad de Arica. Los datos obtenidos fueron almacenados en plantilla Excel para ser ingresados en un programa estadístico. RESULTADOS: Del total de 1094 fichas analizadas, 611 pacientes (55,8%) se encontraron en un estado nutricional concordante con malnutrición por exceso, predominando en el sexo masculino (54,7%) y a mayor edad mayor malnutrición por exceso, encontrando mayor prevalencia de obesidad y obesidad severa en los(las) adolescentes. DISCUSIÓN: La malnutrición por exceso ha adquirido las características de epidemia y es un problema frecuente de los países en vías de desarrollo, convirtiéndose en un problema de salud pública. En este estudio se demuestra un aumento en los niveles de malnutrición por exceso durante el año 2021, comparando los resultados obtenidos en relación a la realidad nacional y regional en los años 2019 y 2020.

INTRODUCTION: Malnutrition due to excess affects approximately 337 million children and adolescents in the world. Among the multifactorial aspects associated with obesity, the COVID-19 Pandemic context stands out, which has warned the figures of childhood obesity. On the other hand, obesity is considered a risk factor for severely developing COVID-19 disease. This study seeks to analyze the effect of the pandemic on the rates of malnutrition due to excess in children and adolescents treated at the medical center of the University of Tarapacá during the year 2021 and compare them with previous studies carried out in Chile. METHODOLOGY: The research has an analytical, cross-sectional, retrospective and observational approach. The study was based on the review of clinical records of 1094 patients between 2 and 17 years of age treated at the Medical Center of the School of Medicine of the University of Tarapacá in the city of Arica. The data obtained was stored in an Excel template to be entered into a statistical program. RESULTS: Of the total of 1094 records analyzed, 611 patients (55.8%) were found to be in a nutritional state consistent with malnutrition due to excess, predominating in males (54.7%) and at older ages, finding a higher prevalence of obesity and severe obesity in adolescents. DISCUSSION: Malnutrition due to excess has acquired the characteristics of an epidemic and is a frequent problem in developing countries, becoming a public health problem. This study demonstrates an increase in the levels of malnutrition by excess during the year 2021, comparing the results obtained in relation to the national and regional reality in the years 2019 and 2020.

Evolución del estado nutricional en adolescentes chilenos entre el 2010 y 2019: una revisión narrativa / Evolution of nutritional status in Chilean adolescents between 2010 and 2019: a narrative review

INTRODUCCIÓN: La adolescencia es una fase crítica del crecimiento con múltiples cambios fisiológicos. Dentro de sus factores determinantes se encuentran el estado nutricional. Adicionalmente, en el año 2016 se implementó la Ley de Etiquetado Nutricional con el objetivo de asegurar una oferta saludable de alimentos. Por lo tanto, se considera relevante conocer la evolución del estado nutricional relacionado a la implementación de esta nueva ley. OBJETIVO: Describir la evolución del estado nutricional de adolescentes chilenos,durante el 2010 y 2019. MÉTODOS: Revisión narrativa, que reúne los datos utilizando bases científicas como revistas, paper e informes de Scielo, Google Académico, Scopus, Pubmed e información del Ministerio de Salud (MINSAL), publicados entre los años 2010 hasta el 2019, en inglés o español. RESULTADOS: El estado nutricional normal en los adolescentes, muestra una disminución de un 10%. El porcentaje de adolescentes con malnutrición por exceso en el 2010 fue de 37.1% y en el año 2019 de 47.6%, aumentando un 10,5% en 10 años. CONCLUSIÓN: El estado nutricional de los adolescentes chilenos, entre los años 2010 y 2019, ha mostrado una evolución hacia la malnutrición por exceso, Esto podría traer consecuencias negativas en la salud y aumentar el riesgo de enfermedades asociadas a un estilo de vida poco saludable en la adultez.

INTRODUCTION: Adolescence is a critical phase of growth with multiple physiological changes. Among its determining factors is the nutritional status. Additionally, in 2016 the Nutritional Labeling Law was implemented with the aim of ensuring a healthy food supply. Therefore, it is considered relevant to know the evolution of nutritional status related to the implementation of this new law. OBJECTIVE: To describe the evolution of the nutritional status of Chilean adolescents between 2010 and 2019. METHODS: Narrative review, which gathers data usings cientific data bases such as journals, papers and reports from Scielo, Google Scholar, Scopus, Pubmed and information from the Ministry of Health (MINSAL), published between 2010 and 2019, in English or Spanish. RESULTS: The normal nutritional status in adolescents showed a decrease of 10%. The percentage of adolescents with excess malnutrition in 2010 was 37.1% and in 2019 47.6%, increasing by 10.5% in 10 years. CONCLUSION: The nutritional status of Chilean adolescents, between 2010 and 2019, has shown an evolution towards excess malnutrition. This could have negative consequences on health and increase the risk of diseases associated with an unhealthy lifestyle in adulthood.

Disruption of Pituitary Gonadotrope Activity in Male Rats After Short- or Long-Term High-Fat Diets Is Not Associated With Pituitary Inflammation.

Overnutrition is associated with the activation of inflammatory pathways in metabolically linked organs and an early hypothalamic inflammation is now known to disrupt the central control of metabolic function. Because we demonstrated that fatty acids (FA) target the pituitary and affect gonadotropin synthesis, we asked whether overnutrition induces pituitary inflammation that may contribute to obesity-associated disorders in the control of reproduction. We analyzed pituitary inflammation and hypothalamic-pituitary-testicular axis in male rats fed a short- (4 weeks) or long-term (20 weeks) high-fat diet. The effect of diet enrichment with the ω3 polyunsaturated FA, DHA, was also analyzed. After only 4 weeks and before weight gain of rats, high-fat diet caused a significant decrease in pituitary gonadotropin and hypothalamic GnRH transcript levels despite unchanged testosterone and inhibin B levels. Contrasting with the hypothalamus, there was no concomitant increases in gene expression of pituitary inflammatory mediators and even a reduction of prototypical cytokines such as interleukin-1ß and TNF-α. No inflammation was still detected in the pituitary after 20 weeks although gonadotropin transcripts and circulating levels were still altered. Gonadotropins were the only pituitary hormones remaining affected at this stage of the regimen, underlying a differential susceptibility of pituitary lineages to metabolic disorders. DHA enrichment of the diet did not prevent alterations of gonadotrope activity due to either a long- or a short-term high-fat diet although it blocked early hypothalamic inflammation and attenuated several metabolic effects. Taken together, our findings suggest that high-fat diet-induced defects in gonadotrope activity in male rats occurred despite a lack of pituitary inflammation.

Could "cellular exercise" be the missing ingredient in a healthy life? Diets, caloric restriction, and exercise-induced hormesis.

Overnutrition is a poor dietary habit that has been correlated with increased health risks, especially in the developed world. This leads to an imbalance between energy storage and energy breakdown. Many biochemical processes involving hormones are involved in conveying the excess of energy into pathologic states, mainly atherosclerosis, hypertension, cardiovascular diseases, and diabetes. Diverse modalities of regular exercise have been shown to be beneficial, to varying extents, in overcoming the overnutrition comorbidities. Cellular exercises and hormesis are triggered by dietary protocols that could underlie the cellular mechanisms involved in modulating the deleterious effects of overnutrition through activation of specific cellular signal pathways. Of interest are the oxidative stress signaling, nuclear factor erythroid-2, insulin-like growth factor-1, AMP-activated protein kinase as well as sirtuins and nuclear factor-κB. Therefore, the value of intermittent fasting diets as well as different diet regimens inducing hormesis are evaluated in terms of their beneficial effects on health and longevity. In parallel, important effects of diets on the immune system are explored as essential components that can undermine the overall health outcome. Additionally, the subtle but relevant relation between diet and sleep is investigated for its impact on the cardiovascular system and quality of life. The aim of this review is to focus on how calorie restriction triggers multiple molecular pathways that ultimately lead to hormetic effects resulting in cell longevity and resistance to cardiovascular disease, stroke, and cancer.

Overnutrition and its associated factors among adult human immunodeficiency virus positive patients on antiretroviral therapy, Northwest, Ethiopia.

Background: Anti-retroviral therapy was introduced to treat human immunodeficiency virus patients; comorbidities affecting individuals with human immunodeficiency virus-positive have changed dramatically, with increasing the prevalence of overnutrition. Overnutrition has increased from time to time in people living with the human immunodeficiency virus. However, there is scarce adequate documented evidence regarding nutrition on human immunodeficiency virus. Objective: The study aimed to assess the magnitude of over nutrition and its associated factors among human immunodeficiency virus receiving antiretroviral therapy. Methods: We used a cross-sectional study design to collect data from 422 participants from Debre Markos hospital. We used a systematic sampling technique to select the total number of participants. The outcomes of Data were entered, and coded using Epi-data version 4.1 and analysed using STATA Version 14.1. We performed a multivariable logistic regression model to identify determinants of over-nutrition at a p-value of less than 0.05. Results: The magnitude of overnutrition was 19.7% (95%CI: 14.6-25.4). Age group > 45 years (AOR: 3.18:95%CI: 1.09, 9.22), being farmer (AOR: 0.068, 95%CI (0.007, 0.611), family size greater than or equal to 4 (AOR: 3.18:95%CI (1.09-9.22), viral load less than 1000 copies/ml (AOR: 4.45 95%CI (1.69-11.76), and use of prophylaxis therapy (AOR: 2.67:95%CI (1.138-6.291) were significantly associated with over nutrition. Conclusions: In this study one-fifth of Human Immunodeficiency Virus/Acquired Immunodeficiency Virus patients had over nutrition. In this study, the magnitude of overnutrition is high associated with a viral load of fewer than 1000 copies/cell, age greater than 45, and having taken prophylaxis therapy. Therefore, education about lifestyle change, regular monitoring of weight, regular nutritional assessment, and intervention of the existed problems like doing regular exercise is highly recommended.

Relación del estado nutricional de las madres y la alteración de los factores de riesgo cardiovascular de sus hijos / Relationship between mothers' nutritional status and alterations in cardiovascular risk factors of their offsprings

RESUMEN: ANTECEDENTES: La obesidad infantil es uno de los principales problemas de salud pública, y es el mejor predictor de obesidad adulta, que conlleva a futuras consecuencias, como enfermedades cardiovasculares. OBJETIVO: Este estudio pretende relacionar el estado nutricional de las madres con los factores de riesgo cardiovascular (FRCV) de sus hijos con malnutrición por exceso (MNPE). MÉTODOS: Estudio descriptivo de corte transversal y muestreo de tipo no probabilístico por conveniencia, se efectuó en 100 diadas madres/hijos con MNPE. En cada diada se efectuaron mediciones antropométricas, peso, talla, estado nutricional según índice de masa corporal (IMC) y perímetro cintura (PC). En escolares se determinó presión arterial (PA), glicemia y consumo alimentario. El análisis estadístico incluyó Riesgo relativo (RR) y regresión logística. Su usó el software Stata 14. RESULTADOS: Los promedios encontrados en los hijos fueron: edad 8.8 años, IMC/edad 21.1 kg/mt2. En las madres, la edad promedio fue 36,9 años y el IMC 29,0 kg/mt2. En relación con los FRCV, los escolares presentaron glicemias y presión arterial alteradas y obesidad abdominal. La malnutrición por exceso y la alteración de la percepción de las madres sobre el estado nutricional de sus hijos aumentó el RR de presentar alteración de la glicemia en 1,31 veces. La obesidad según IMC/edad presentó un RR de 1,5 y una relación positiva OR de 5,73. CONCLUCIONES: Existe una asociación positiva entre la MNPE de las madres y la obesidad de sus hijos. Se observó un aumento en los factores de riesgo cardiovascular de los escolares, quienes presentaban obesidad abdominal y presión arterial y glicemia alteradas.

ABSTRACT: BACKGROUP: Childhood obesity is one of the main public health problems. It is the best predictor of adult obesity, leading to adverse consequences, especially in relation to cardiovascular diseases. OBJETIVE: This study aims to relate the nutritional status of mothers to the cardiovascular risk factors (CVRF) of their offsprings with excess MNPE. Methods: A descriptive, cross-sectional study with non-probabilistic convenience sampling included 100 mother/child dyads with MNPE. Anthropometric measurements and determination of weight, height, nutritional status (body mass index (BMI) and waist circumference (WC)), as well as blood pressure (BP), glycemia and food consumption were evaluated in schoolchildren. The statistical analysis included Relative Risk (RR) and logistic regression, using the Stata 14 software. RESULTS: Average results in children included: age 8.8 years, BMI/age 21.1 kg/mt2. In mothers, mean age was 36.9 years and BMI 29.0 kg/mt2. In relation to CVRF, schoolchildren presented altered glycemia, higher blood pressure and abdominal obesity. The MNPE and the alteration of mothers' perception of the nutritional status of their children increased the RR of altered glycemia 1.31 fold. Obesity according to BMI/age presented a RR of 1.5 and a positive OR 5.73. CONCLUSIONS: There was a positive association between the mothers' MNPE and elevated cardiovascular risk factors in school children including abdominal obesity, higher blood pressure and altered glycemia.