[Vitamin D and polymorphisms of VDR and GC genes in the severity and mortality from COVID-19. A systematic review]. / Vitamina D y polimorfismos de los genes VDR y GC en la severidad y mortalidad por COVID-19. Una revisión sistemática.

Introduction: Previous studies have pointed to a possible relationship between vitamin D deficiency and the severity of the disease promoted by SARS-CoV-2, reducing respiratory and cardiovascular complications caused by a hyperreaction of the immune system known as "cytokine storm". This vitamin exerts multiple functions that depend on the presence and levels of different proteins, such as the vitamin D receptor (VDR) and the vitamin D binding protein (DBP), and the existence of single nucleotide polymorphisms (SNPs) of the genes that encode these proteins. The objective of this review is to assess whether some VDR and GC SNPs are risk factors for the most severe forms of COVID-19 disease and whether they condition the response to vitamin D supplementation. A search was performed in PubMed, Google Scholar and Scielo, finding that genotypes in patients affected by COVID-19, were rarely performed, although some studies find a relationship between different alleles and the severity of the disease. The ApaI polymorphism of the VDR gene stands out, as the minor allele "a" increases the risk of mortality from COVID-19 (OR = 11.828, CI: 2,493-56,104, p = 0.002). Results divergency in the efficacy of vitamin D supplementation suggest the need for a larger number of studies. In conclusion, the study of VDR and GC polymorphisms seems essential to effectively treat vitamin D deficiency and particularly to protect against COVID-19. Well-designed studies are needed to elucidate whether plasma vitamin D levels play a role of casuality or causality.

Introducción: Estudios previos han señalado una posible relación entre la deficiencia de la vitamina D y la severidad de la enfermedad promovida por el SARS-CoV-2, reduciendo las complicaciones respiratorias y cardiovasculares causadas por una respuesta exacerbada del sistema inmune. Esta vitamina ejerce múltiples funciones que dependen de la presencia y niveles de diferentes proteínas, como el receptor de la vitamina D (VDR) y la proteína de unión de la vitamina D (DBP), y de la existencia de polimorfismos de un solo nucleótido (SNP) de los genes que codifican a estas proteínas. El objetivo de esta revisión es evaluar si algunos SNP de VDR y GC son factores de riesgo de las formas más severas de la enfermedad COVID-19 y si condicionan la respuesta a la suplementación con vitamina D. Se realizó una búsqueda en PubMed, Google Scholar y Scielo, encontrándose que son escasos los genotipados en pacientes afectados por COVID-19, aunque algunos trabajos hallan una relación entre diferentes alelos y la severidad de la enfermedad. Destaca el polimorfismo ApaI del gen VDR, el cual alelo menor "a" aumenta el riesgo de mortalidad por COVID-19 (OR = 11,828, CI: 2.493-56.104, p = 0,002). La divergencia de resultados en la eficacia de la suplementación de vitamina D sugiere la necesidad de un mayor número de estudios. En conclusión, el estudio de polimorfismos VDR y GC resulta fundamental para tratar eficazmente la deficiencia de vitamina D y en particular en la protección frente a COVID-19. Se necesitan estudios bien diseñados para dilucidar si los niveles plasmáticos de vitamina D juegan un papel de casualidad o causalidad.

Diabesity negatively affects transferrin saturation and iron status. The DICARIVA study.

AIMS: The relationship between iron status, obesity and type 2 diabetes mellitus (T2DM) has scarcely been tested. This study hypothesizes that patients with obesity and T2DM have altered iron metabolism. METHODS: 537 T2DM patients were selected from the cross-sectional DICARIVA study excluding patients with high-sensitivity-C-reactive-protein (hs-CRP) ≥  10 mg/L. Three groups according to body mass index (BMI) and waist perimeter (WP) were analysed: a) BMI < 30 kg/m2, non-high WP (n = 105); b) BMI < 30 kg/m2, high WP (n = 202); and c) diabesity, BMI ≥  30 kg/m2, high WP (n = 230). Group differences on cardiometabolic and iron status markers were tested. RESULTS: Women had significantly lower iron, ferritin, and transferrin saturation (TSAT) but higher transferrin and total iron binding capacity than men. Triglycerides/HDL-c ratio, as insulin-resistance (IR) marker, was higher in men while hs-CRP in women. TSAT was inversely related to BMI and hs-CRP. The diabesity group showed the highest hs-CRP (p < 0.001) and IR (p < 0.001) with the lowest TSAT (p = 0.003). CONCLUSIONS: Low TSAT was highly prevalent in diabesity, mainly in women, suggesting that IR, inflammation, and abdominal adiposity alter iron transport and accumulation. The convenience of iron supplementation in diabesity patients with low TSAT should be urgently assessed, due the pro-oxidant effects of excess iron.

Palm Oil on the Edge.

Internationally recognized Spanish experts in the food industry, nutrition, toxicology, sustainability, and veterinary science met in Madrid on July 2018 to develop a consensus about palm oil (PO) as a food ingredient. Their aim was to provide a useful, evidence-based point of reference about PO. Scientific evidence about the role of PO in food safety, nutrition and sustainability was analyzed. Main conclusions were: (1) RSPO foundation responded to the environmental impact of palm crops. The Amsterdam Declaration pursues the use of 100% sustainable PO in Europe by 2020. Awareness about choosing sustainable products will help to maintain local economies and environments in the producing countries; (2) evidence shows that a moderate intake of PO within a healthy diet presents no risks for health. No evidence justifies any change fat intake recommendations; (3) food industry is interested in assuring safe, sustainable and high-quality products. The use of certified sustainable PO is increasing; and (4) there is no evidence associating PO consumption and higher cancer risk, incidence or mortality in humans. Tolerable daily intake (TDI) for toxic contaminants (2-and 3-monochloropropanediols (MCPDs), glycidyl esters (GEs)) have been established by JECFA and EFSA. Consequently, the European Commission has modified the Contaminants Regulation for GEs and it is still working on 3-MCPDs'.

Glucomannan or Glucomannan Plus Spirulina-Enriched Squid-Surimi Diets Reduce Histological Damage to Liver and Heart in Zucker fa/fa Rats Fed a Cholesterol-Enriched and Non-Cholesterol-Enriched Atherogenic Diet.

Glucomannan-enriched squid surimi improves cholesterolemia and liver antioxidant status. The effect of squid surimi enriched with glucomannan or glucomannan plus spirulina on liver and heart structures and cell damage markers was tested in fa/fa rats fed highly saturated-hyper-energetic diets. Animals were fed 70% AIN-93M rodent diet plus six versions of 30% squid surimi for 7 weeks: control (C), glucomannan (G), and glucomannan plus spirulina (GS). The cholesterol-control (HC), cholesterol-glucomannan (HG), and cholesterol-glucomannan plus spirulina (HGS) groups were given similar diets that were enriched with 2% cholesterol and 0.4% cholic acid. G and GS diets versus C diet significantly inhibited weight gain and lowered plasma alanine aminotransferase and aspartate aminotransferase, liver steatosis, lipogranulomas, and total inflammation and alteration scores. The hypercholesterolemic agent significantly increased the harmful effects of the C diet. Liver weight, the hepatosomatic index, all damage markers, and total histological scoring rose for HC versus C (at least P < .05). The addition of glucomannan (HG vs. HC) improved these biomarkers, and non-additional effects from spirulina were observed except for the total liver alteration score. In conclusion, glucomannan and glucomannan plus spirulina blocked the highly saturated-hyper-energetic diet negative effects both with and without added cholesterol. Results suggest the usefulness of including these functional ingredients in fish products.

Silicon Alleviates Nonalcoholic Steatohepatitis by Reducing Apoptosis in Aged Wistar Rats Fed a High-Saturated Fat, High-Cholesterol Diet.

Background: Lipoapoptosis has been identified as a key event in the progression of nonalcoholic fatty liver disease (NAFLD), and hence, antiapoptotic agents have been recommended as a possible effective treatment for nonalcoholic steatohepatitis (NASH). Silicon, included in meat as a functional ingredient, improves lipoprotein profiles and liver antioxidant defenses in aged rats fed a high-saturated fat, high-cholesterol diet (HSHCD). However, to our knowledge, the antiapoptotic effect of this potential functional meat on the liver has never been tested.Objective: This study was designed to evaluate the effect of silicon on NASH development and the potential antiapoptotic properties of silicon in aged rats.Methods: One-year-old male Wistar rats weighing ∼500 g were fed 3 experimental diets containing restructured pork (RP) for 8 wk: 1) a high-saturated fat diet, as an NAFLD control, with 16.9% total fat, 0.14 g cholesterol/kg diet, and 46.8 mg SiO2/kg (control); 2) the HSHCD as a model of NASH, with 16.6% total fat, 16.3 g cholesterol/kg diet, and 46.8 mg SiO2/kg [high-cholesterol diet (Chol-C)]; and 3) the HSHCD with silicon-supplemented RP with amounts of fat and cholesterol identical to those in the Chol-C diet, but with 750 mg SiO2/kg (Chol-Si). Detailed histopathological assessments were performed, and the NAFLD activity score (NAS) was calculated. Liver apoptosis and damage markers were evaluated by Western blotting and immunohistochemical staining.Results: Chol-C rats had a higher mean NAS (7.4) than did control rats (1.9; P < 0.001). The score in Chol-Si rats (5.4) was intermediate and different from that in both other groups (P < 0.05). Several liver apoptosis markers-including hepatocyte terminal deoxynucleotidyl transferase 2'-deoxyuridine 5'-triphosphate (dUTP) nick end labeling, cytosolic cytochrome c, apoptosis-inducing factor, caspases 9 and 3, and the mitochondrial Bcl-2-associated X protein (BAX)-to-B-cell lymphoma 2 (BCL2) ratio-were 9-45% lower in Chol-Si than in Chol-C rats (P < 0.05) and did not differ from values in the control group.Conclusions: Supplemental silicon substantially affects NASH development in aged male Wistar rats fed an HSHCD by partially blocking apoptosis. These results suggest that silicon-enriched RP could be used as an effective nutritional strategy in preventing NASH.

Effects of improved fat meat products consumption on emergent cardiovascular disease markers of male volunteers at cardiovascular risk

High meat-product consumption has been related to cardiovascular disease (CVD). However, previous results suggest the benefits of consuming improved fat meat products on lipoprotein-cholesterol and anthropometric measurements. Present study aims to assess the effect of consuming different Pâté and Frankfurter formulations on emergent CVD biomarkers in male volunteers at increased CVD risk. Eighteen male volunteers with at least two CVD risk factors were enrolled in a sequentially controlled study where different pork-products were tested: reduced-fat (RF), omega-3-enriched-RF (n-3RF), and normal-fat (NF). Pork-products were consumed during 4-week periods separated by 4-week washout. The cardiometabolic index (CI), oxidized low density lipoproteins (oxLDL), apolipoproteins (Apo) A1 and B, homocysteine (tHcys), arylesterase (AE), C-reactive Protein (CRP), tumor necrotic factor-alpha (TNFα), and lipoprotein (a) (Lp(a)) were tested and some other related ratios calculated. AE, oxLDL and Lp(a), AE/HDLc, LDLc/Apo B, and AE/oxLDL rate of change were differently affected (P<0.01) by pork-products consumption. RF increased (P < 0.05) AE, AE/HDLc and AE/oxLDL ratios and decreased TNFα, tHcys; n-3RF increased (P < 0.001) AE, AE/HDLc and AE/oxLDL ratios and decreased (P < 0.05) Lp(a); while NF increased (P<0.05) oxLDL and Lp(a) levels. In conclusion, RF and n-3RF products affected positively the level of some emergent CVD markers. The high regular consumption of NF-products should be limited as significantly increased Lp(a) and oxLDL values. The high variability in response observed for some markers suggests the need to perform more studies to identify targets for RF- and n-3RF-products (AU)

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Effects of improved fat meat products consumption on emergent cardiovascular disease markers of male volunteers at cardiovascular risk.

High meat-product consumption has been related to cardiovascular disease (CVD). However, previous results suggest the benefits of consuming improved fat meat products on lipoprotein-cholesterol and anthropometric measurements. Present study aims to assess the effect of consuming different Pâté and Frankfurter formulations on emergent CVD biomarkers in male volunteers at increased CVD risk. Eighteen male volunteers with at least two CVD risk factors were enrolled in a sequentially controlled study where different pork-products were tested: reduced-fat (RF), omega-3-enriched-RF (n-3RF), and normal-fat (NF). Pork-products were consumed during 4-week periods separated by 4-week washout. The cardiometabolic index (CI), oxidized low density lipoproteins (oxLDL), apolipoproteins (Apo) A1 and B, homocysteine (tHcys), arylesterase (AE), C-reactive Protein (CRP), tumor necrotic factor-alpha (TNFα), and lipoprotein (a) (Lp(a)) were tested and some other related ratios calculated. AE, oxLDL and Lp(a), AE/HDLc, LDLc/Apo B, and AE/oxLDL rate of change were differently affected (P<0.01) by pork-products consumption. RF increased (P < 0.05) AE, AE/HDLc and AE/oxLDL ratios and decreased TNFα, tHcys; n-3RF increased (P < 0.001) AE, AE/HDLc and AE/oxLDL ratios and decreased (P < 0.05) Lp(a); while NF increased (P<0.05) oxLDL and Lp(a) levels. In conclusion, RF and n-3RF products affected positively the level of some emergent CVD markers. The high regular consumption of NF-products should be limited as significantly increased Lp(a) and oxLDL values. The high variability in response observed for some markers suggests the need to perform more studies to identify targets for RF- and n-3RF-products. Graphical Abstract Emergent CVD markers.

Effects of Silicon vs. Hydroxytyrosol-Enriched Restructured Pork on Liver Oxidation Status of Aged Rats Fed High-Saturated/High-Cholesterol Diets.

BACKGROUND: Pork is an essential component of the diet that has been linked with major degenerative diseases and development of non-alcoholic steatohepatitis (NASH). Previous studies have. Previous studies have demonstrated the in vitro antioxidant activity of silicon (Si). Furthermore, when Si is added to restructured pork (RP) strongly counterbalances the negative effect of high-cholesterol-ingestion, acting as an active hypocholesterolemic and hypolipemic dietary ingredient in aged rats. OBJECTIVE: This study was designed to evaluate the effects of Si vs hydroxytyrosol (HxT) RP on liver antioxidant defense in aged rats fed cholesterol-enriched high saturated/high cholesterol diets as a NASH model. METHODS: Four diets were prepared: Control RP diet (C) with non-added cholesterol; Cholesterol-enriched high-saturated/high-cholesterol control RP diet (CHOL-C) with added cholesterol and cholic acid; Si- or HxT-RP cholesterol-enriched high-saturated/high-cholesterol diets (CHOL-Si and CHOL-HxT). Groups of six male Wistar rats (1-yr old) were fed these modified diets for eight weeks. Total cholesterol, hepatosomatic index, liver Nrf2 and antioxidant (CAT, SOD, GSH, GSSG, GR, GPx) markers were determined. RESULTS: Both CHOL-Si and CHOL-HxT diets enhanced the liver antioxidant status, reduced hepatosomatic index and increased SOD actvity. Hydrogen peroxide removal seemed to be involved, explaining that the value of redox index was even lower than C without changing the CAT activity. CHOL-Si results were quite better than CHOL-HxT in most measured parameters. CONCLUSIONS: Our study suggests that Si incorporated into RP matrix was able to counterbalance, more efficiently than HxT, the deleterious effect of consuming a high-saturated/high-cholesterol diet, by improving the liver antioxidant defenses in the context of NASH.

Influence of Picual olive ripening on virgin olive oil alteration and stability during potato frying.

Ripening modifies oil attributes and composition. However, the influence of olive ripening on virgin olive oil (VOO) thermal oxidative stability on food-frying has not been studied yet. Oils from Picual olives of low (VOO1), medium (VOO2), and high (VOO3) ripeness were obtained, and their thermal oxidative stability during 40 potato-fryings was tested. Unused VOO1 showed higher antioxidant content and oxidative stability than VOO2 and VOO3. Polar compounds (PC), oligomers, and altered fatty acid methyl esters (polar-FAME) increased, whereas linoleic acid, polyphenols, and tocopherols decreased in the three VOOs through frying. The alteration was lower in VOO1, followed by VOO2 (0.105, 0.117, and 0.042 g/100 g oil less of PC, oligomers and polar-FAME per frying, respectively, in VOO1 than in VOO3). In conclusion, VOO obtained from low-ripeness Picual olives should be preferred when frying fresh-potatoes due to its higher thermal and oxidative stability, permitting a higher number of potato-frying uses.

Organic silicon protects human neuroblastoma SH-SY5Y cells against hydrogen peroxide effects.

BACKGROUND: Hydrogen peroxide (H2O2) is a toxic agent that induces oxidative stress and cell death. Silicon (Si) is a biological element involved in limiting aluminium (Al) absorption with possible preventive effects in Alzheimer's disease. However, Si has not yet been associated with other neuroprotective mechanisms. METHODS: The present experiments evaluated in the SH-SY5Y human neuroblastoma cell line the possible role of different Si G5 (50-1000 ng/mL) concentrations in preventing cellular death induced by H2O2 (400 µM, 24 hours). RESULTS: Our findings showed that H2O2 promoted cell death in the human SH-SY5Y cell cultures and this could be prevented by Si treatment. The loss in cell viability mediated by H2O2 was due to an apoptotic and necrotic process. Apoptotic death was incurred by regulating caspase-8 activity in the extrinsic pathway. The apoptotic and necrotic cell death induced by H2O2 was almost totally reversed by Si (50-500 ng/mL), indicating that it down-regulates both processes in H2O2 treated cells. CONCLUSIONS: According to our data, Si is able to increase SH-SY5Y cell survival throughout partially blocking cellular damage related to oxidative stress through a mechanism that would affect H2O2/ROS elimination.

Effects of Undaria pinnatifida, Himanthalia elongata and Porphyra umbilicalis extracts on in vitro alpha-glucosidase activity and glucose diffusion / Efectos de extractos de undaria pinnatifida, himantalia elongata y porfira umbilicalis sobre la actividad alpha-glucosidasa y la difusion de la glucosa in vitro

Background: Seaweeds are good sources of dietary fibre, which can influence glucose uptake and glycemic control. Objective: To investigate and compare the in vitro inhibitory activity of different extracts from Undaria pinnatifida (Wakame), Himanthalia elongata (Sea spaghetti) and Porphyra umbilicalis (Nori) on α-glucosidase activity and glucose diffusion. Methods: The in vitro effects chloroform-, ethanol- and water-soluble extracts of the three algae were assayed on α- glucosidase activity and glucose diffusion through membrane. Principal Components Analysis (PCA) was applied to identify patterns in the data and to discriminate which extract will show the most proper effect. Results: Only water extracts of Sea spaghetti possessed significant in vitro inhibitory effects on α-glucosidase activity (26.2% less mmol/L glucose production than control, p < 0.05) at 75 min. PCA distinguished Sea spaghetti effects, supporting that soluble fibre and polyphenols were involved. After 6 h, Ethanol-Sea spaghetti and water-Wakame extracts exerted the highest inhibitory effects on glucose diffusion (65.0% and 60.2% vs control, respectively). This extracts displayed the lowest slopes for glucose diffusion-time lineal adjustments (68.2% and 62.8% vs control, respectively). Conclusions: The seaweed hypoglycemic effects appear multi-faceted and not necessarily concatenated. According to present results, ethanol and water extracts of Sea spaghetti, and water extracts of Wakame could be useful for the development of functional foods with specific hypoglycemic properties (AU)

Antecedentes: Las algas son importante fuente alimentaria de fibra dietética y puede influir sobre la absorción de glucosa y el control glucémico. Objetivo: Evaluar y comparar in vitro los efectos de diferentes extractos de las algas Undaria pinnatifida (Wakame), Himanthalia elongata (Espagueti de mar) y Porphyra umbilicalis (Nori) sobre la actividad enzimática α-glucosidasa y la difusión de glucosa. Métodos: Se estudiaron los efectos de los extractos clorofórmicos, etánólicos y acuosos de las tres algas sobre la actividad α-glucosidasa y la difusión de glucosa a través de una membrana de diálisis. Se aplicó a los resultados un análisis de los componentes principales (PCA) para identificar posibles patrones de composición y seleccionar el extracto que mejores propiedades posea. Resultados: El extracto acuoso de Espagueti de mar inhibió de forma significativa la actividad α-glucosidasa (26,2% menos liberación de glucosa, p < 0,05). El PCA sugiere que la fibra soluble y los polifenoles son los responsables de tal efecto. Respecto a la difusión de glucosa, el extracto etanólico de Espagueti de mar y el acuoso de Wakame mostraron un mayor efecto inhibidor después de 6 horas (65% y 60,2% vs control, respectivamente) y las menores pendientes en los ajustes lineales difusión de glucosa-tiempo (68,2% y 62,8% vs control respectivamente). Conclusiones: Los resultados de los diferentes extractos sugieren que los efectos hipogluceminates de las algas son variados y no están necesariamente concatenados. Los extractos acuosos y etanólicos de Espagueti de mar y los acuosos de Wakame parecen los más adecuados para el desarrollo de alimentos funcionales con propiedades hipoglucemiantes (AU)

Effects of Undaria pinnatifida, Himanthalia elongata and Porphyra umbilicalis extracts on in vitro α-glucosidase activity and glucose diffusion.

BACKGROUND: Seaweeds are good sources of dietary fibre, which can influence glucose uptake and glycemic control. OBJECTIVE: To investigate and compare the in vitro inhibitory activity of different extracts from Undaria pinnatifida (Wakame), Himanthalia elongata (Sea spaghetti) and Porphyra umbilicalis (Nori) on α-glucosidase activity and glucose diffusion. METHODS: The in vitro effects Chloroform-, ethanol- and water-soluble extracts of the three algae were assayed on α- glucosidase activity and glucose diffusion through membrane. Principal Components Analysis (PCA) was applied to identify patterns in the data and to discriminate which extract will show the most proper effect. RESULTS: Only water extracts of Sea spaghetti possessed significant in vitro inhibitory effects on α-glucosidase activity (26.2% less mmol/L glucose production than control, p < 0.05) at 75 min. PCA distinguished Sea spaghetti effects, supporting that soluble fibre and polyphenols were involved. After 6 h, Ethanol-Sea spaghetti and water-Wakame extracts exerted the highest inhibitory effects on glucose diffusion (65.0% and 60.2% vs control, respectively). This extracts displayed the lowest slopes for glucose diffusion-time lineal adjustments (68.2% and 62.8% vs control, respectively). CONCLUSIONS: The seaweed hypoglycemic effects appear multi-faceted and not necessarily concatenated. According to present results, ethanol and water extracts of Sea spaghetti, and water extracts of Wakame could be useful for the development of functional foods with specific hypoglycemic properties.

Antecedentes: Las algas son importante fuente alimentaria de fibra dietética y puede influir sobre la absorción de glucosa y el control glucémico. Objetivo: Evaluar y comparar in vitro los efectos de diferentes extractos de las algas Undaria pinnatifida (Wakame), Himanthalia elongata (Espagueti de mar) y Porphyra umbilicalis (Nori) sobre la actividad enzimática -glucosidasa y la difusión de glucosa. Métodos: Se estudiaron los efectos de los extractos clorofórmicos, etánólicos y acuosos de las tres algas sobre la actividad -glucosidasa y la difusión de glucosa a través de una membrana de diálisis. Se aplicó a los resultados un análisis de los componentes principales (PCA) para identificar posibles patrones de composición y seleccionar el extracto que mejores propiedades posea. Resultados: El extracto acuoso de Espagueti de mar inhibió de forma significativa la actividad -glucosidasa (26,2% menos liberación de glucosa, p < 0,05). El PCA sugiere que la fibra soluble y los polifenoles son los responsables de tal efecto. Respecto a la difusión de glucosa, el extracto etanólico de Espagueti de mar y el acuoso de Wakame mostraron un mayor efecto inhibidor después de 6 horas (65% y 60,2% vs control, respectivamente) y las menores pendientes en los ajustes lineales difusión de glucosa- tiempo (68,2% y 62,8% vs control respectivamente). Conclusiones: Los resultados de los diferentes extractos sugieren que los efectos hipogluceminates de las algas son variados y no están necesariamente concatenados. Los extractos acuosos y etanólicos de Espagueti de mar y los acuosos de Wakame parecen los más adecuados para el desarrollo de alimentos funcionales con propiedades hipoglucemiantes.

A clinical approach to the nutritional care process in protein-energy wasting hemodialysis patients.

INTRODUCTION: Malnutrition/wasting/cachexia are complex-disease conditions that frequently remain undiagnosed and/or untreated in up to 75% of prevalent hemodialysis (HD) patients. The nutrition care process (NCP) based on assessment, diagnosis, intervention and monitoring of nutritional status is a systematic method that nutrition professionals use to make decisions in clinical practice. OBJECTIVE: This review examines from a clinical-nutritional practice point of view: a) nutritional status as a mortality causative factor; b) phenotypic characteristics of malnutrition/wasting/cachexia, and c) current trends of NCP with special emphasis on nutritional support and novel nutrient and pharmacologic adjunctive therapies in HD patients. METHOD: A literature review was conducted using the Pubmed, Science Direct, Scielo, Scopus, and Medline electronic scientific basis. Studies which assessing nutritional status and nutritional support published from 1990 to 2013 in HD patients were included and discussed. RESULTS: From all the epidemiological data analyzed, NCP was the suggested method for identifying malnutrition/ wasting or cachexia in clinical practice. Nutrition support as an unimodal therapy was not completely able to reverse wasting in HD patients. Novel experimental therapeutic strategies including the use of appetite stimulants, ghrelin agonist, MC4-R antagonists, anabolic steroids, anti-inflammatory drugs, cholecalciferol, and other components are still under clinical evaluation. CONCLUSION: Nutritional status is a strong predictor of morbidity and mortality in HD patients. The terms called malnutrition, wasting and cachexia have different nutritional therapeutics implications. The NCP is a necessary tool for assessing and monitoring nutritional status in the current clinical practice. Novel pharmacological therapies or specific nutrient supplementation interventions studies are required.

Introducción: Malnutrición/desgaste proteico-energético (DPE)/caquexia son situaciones patológicas complejas frecuentemente infradiagnosticadas o no tratadas hasta en un 75% de los pacientes prevalentes en hemodiálisis (HD). El proceso de atención nutricional (PAN) basado en la evaluación, diagnóstico, intervención y monitorización del estado nutricional es un método que los profesionales de la nutrición utilizan para tomar decisiones en la práctica clínica. Objetivo: Esta revisión examina desde la perspectiva de la práctica clínica nutricional: a) el estado nutricional como factor causante de morbi-mortalidad; b) las características fenotípicas de malnutrición, DPE y caquexia y, c) el PAN con especial énfasis en el soporte nutricional y las nuevas terapias nutricionales y farmacológicas en pacientes en HD. Métodos: Revisión sistemática de la literatura usando las bases científicas electrónicas Pubmed, Science Direct, Scielo, Scopus y Medline. Se incluyeron estudios publicados desde 1990 hasta 2013 que valoraban el estado nutricional y/o el soporte nutricional en pacientes en HD. Resultados: De todos los datos epidemiológicos analizados, el PAN fue el método sugerido para identificar malnutrición/ DPE/caquexia. El soporte nutricional como tratamiento aislado no era capaz de revertir totalmente la malnutrición o el DPE. Nuevas estrategias terapéuticas experimentales incluyendo el uso de estimulantes del apetito, agonistas de grelina, antagonistas MC4-R, esteroides anabólicos, antiinflamatorios y colecalciferol entre otros componentes, están siendo aún evaluados clínicamente. Conclusiones: El estado nutricional es un predictor de morbilidad y mortalidad en pacientes en HD. Malnutrición, DPE y caquexia son términos con implicaciones terapéuticas diferentes. El PAN es una herramienta necesaria para la evaluación y la monitorización nutricional en la práctica clínica habitual. Estudios con nuevas terapias farmacológicas o intervenciones con suplementación de nutrientes específicos son requeridos.

Protective effects of sea spaghetti-enriched restructured pork against dietary cholesterol: effects on arylesterase and lipoprotein profile and composition of growing rats.

There is a general assumption that seaweeds are hypocholesterolemics and antioxidants. However, controversial results suggest specific properties for each individual alga. This study aims to assess the effect of including Sea Spaghetti alga (S) in a restructured-pork (RP) diet, both enriched and not enriched with dietary cholesterol, on arylesterase (AE) activity and lipoprotein concentration and composition of Wistar rats. Four groups of 10 growing male Wistar rats were each fed a mix of 85% AIN-93M diet and 15% freeze-dried RP for 5 weeks. The control group (C) consumed control RP-C; the S group consumed RP-S with 5% seaweeds; the Chol-C group consumed the C diet but enriched with cholesterol (2.43%) and cholic acid (0.49%); the Chol-S group consumed the S diet but enriched with cholesterol and cholic acid. AE activity was five times higher (P<.01) in S compared with C rats, but three times lower in Chol-S compared with Chol-C rats (P<.01). The Chol-C diet induced hypercholesterolemia but reduced triglycerides (TG), giving rise to the presence of very low-density lipoprotein (VLDL) that was enriched in cholesterol. The Chol-S diet partially blocked (P<.001) the hypercholesterolemic induction of the Chol-C diet, and reduced TG levels (P<.05) with respect to S rats. The cholesterol supplementation increased total cholesterol, VLDL-cholesterol, and intermediate-density lipoprotein+LDL-cholesterol (IDL+LDL)-cholesterol (P<.001) in Chol-C rats, but the effect was lower in the Chol-S diet. In conclusion, RP-S increases the antioxidant capacity within a noncholesterol enriched diet while improving the lipoprotein profile within a cholesterol-enriched diet.

Effects of improved fat content of frankfurters and pâtés on lipid and lipoprotein profile of volunteers at increased cardiovascular risk: a placebo-controlled study.

PURPOSE: To study the effect of modified frankfurters and pâtés: (a) reduced-fat products (RF) (15.3 and 15.2 % fat, respectively); (b) n-3-enriched reduced-fat products (n-3 RF) (15.1 and 15.5 % fat, respectively); and (c) normal-fat products (NF) (18 and 30.8 % fat, respectively) on lipids, lipoproteins, atherogenic ratios, oxidized LDL, and blood pressure of volunteers at high CVD risk. METHODS: Twenty-two volunteers were enrolled in a sequential study of 3 consecutive 4-week periods separated by 4-week washout periods. RESULTS: LDL-cholesterol (p < 0.01), oxidized LDL, LDL-cholesterol/HDL-cholesterol (both p < 0.05) were significantly affected by the overall intervention. Compared to baseline, LDL-cholesterol decreased significantly (p = 0.012) during the RF period; the LDL-cholesterol/HDL-cholesterol ratio (p = 0.08) and the diastolic blood pressure (p = 0.06) also decreased, although non-significantly, after RF consumption. LDL-cholesterol (p = 0.040) and oxidized LDL (p = 0.016) increased significantly after NF product consumption; systolic blood pressure did not show significant variations after this period. No significant differences, in absolute or relative changes, were observed between RF and n-3 RF consumption for any parameter tested. However, LDL-cholesterol, oxidized LDL, and the LDL-cholesterol/HDL-cholesterol ratio were lower (12, 15 and 10 %, respectively) after n-3 RF versus NF product consumption. Oxidized LDL was approximately 15 % lower after RF versus NF product consumption. CONCLUSIONS: The regular consumption of RF meat products, enriched in n-3 fatty acids or not, positively affects the lipoprotein profile of volunteers, decreasing LDL-cholesterol and oxidized LDL levels and, thus, future risk of cardiovascular accident. On comparison with the effects of NF product intake, the responses to n-3 RF and RF products differ, and while n-3 RF intake induces a reduction in LDL-cholesterol, oxidized LDL-cholesterol, and LDL-cholesterol/HDL-cholesterol ratio, the intake of RF products modifies only the oxidized LDL level.

Nori- and Sea spaghetti- but not Wakame-restructured pork decrease the hypercholesterolemic and liver proapototic short-term effects of high-dietary cholesterol consumption / El consumo de carne de cerdo reestructurada conteniendo Nori o, Espaguetti de Mar, pero no el de Wakame, reduce los efectos hipercolesterolemiantes y proapoptóticos hepáticos inducidos por altas cantidades de colesterol en la dieta

Restructured pork (RP) enriched in Seaweeds are potential functional foods. The ant apoptotic and hypocholesterolemic effects of consuming cholesterol enriched diets containing Wakame-RP (CW), Nori-RP (CN) and Sea Spaghetti (CS) were tested in a 1-wk study. Groups of six rats per group were fed a mix of 85% AIN-93Mrodent-diet containing cholesterol and cholic acid as a cholesterol rising agent plus 15% RP containing alga. These diets were compared to control-RP diets enriched or not in cholesterol (CC and C, respectively). After 1-wk,cholesterol feeding significantly increased liver apoptosis markers which were significantly reduced by CS (cellularcycle DNA, caspase-3, and cytochrome c), CN (caspase-3and cytochrome c) and CW (caspase-3) diets. CN and CSdiets significantly blocked the cholesterolaemic rising effect observed in the CC group but no protective effect was observed in the CW group. Differences in seaweed composition added to RP appear responsible for blocking or not the proapoptotic and hypercholesterolemia effects of high cholesterol-RP consumption; thus, any generalization on seaweed effects or food containing seaweeds must be avoided. Although present results are worthy, future studies are demanded to ascertain the utility of consuming algal-RP as part of usual diets (AU)

La incorporación de algas, ricas en fibra y compuestos asociados, a reestructurados de carne de cerdo (R) resulta en derivados cárnicos potencialmente funcionales. Eneste trabajo se estudian los efectos antiapoptóticos e hipocolesterolemia antes de dietas en las que se incluyen agentes hipercolesterolemiantes y R enriquecidos en diferentes algas, Wakame (RW), Nori-R (RN) y Espagueti de Mar(RE). Durante una semana grupos de seis ratas cada uno recibieron una mezcla constituida por 85% de dieta AIN-93M para roedores suplementada con colesterol y ácido cólico, como agente hipercolesterolemia te, y 15% deRW, RN o RE. Estas dietas fueron comparadas con otrasa las que se incorporó R control y a las que se añadió o no el agente hipercolesterolemiante. Después de 1 semana de tratamiento el incremento de marcadores de apoptosishepática observado en el lote control con colesterol seredujo por el consumo de las dietas RE (DNA ciclo celular,caspasa-3, y citocromo c), RN (caspasa-3, y citocromoc) and RW (caspasa-3). Sólo las dietas con RN and RE bloquearon significativamente la inducción hipercolesterolemiantede la dieta control enriquecida en colesterol. Teniendo en cuenta las diferencias observadas entre los lotes respecto a sus efectos hipocolesterolémicos y antiapoptóticos, debe evitarse cualquier generalización sobre el consumo de algas y en particular de carnes conteniendo algas. Aunque los resultados son relevantes, deben realizarse estudios futuros para determinar la utilidad del consumo de estos R enriquecidos en algas dentro de dietas habituales (AU)

Effects of hydroxytyrosol-enriched sunflower oil consumption on CVD risk factors.

Inclusion of biophenols in traditional foods transforms them into functional foods that may help to decrease CVD risk. The aim of the present study was to determine whether the consumption of hydroxytyrosol-enriched sunflower oil (HSO) improves certain CVD biomarker values. A total of twenty-two healthy volunteers participated in a cross-over study involving two 3-week periods, separated by a 2-week washout period, in which volunteers consumed 800-1275 µg/d [corrected] of either HSO (45-50 mg/d of hydroxytyrosol) or non-enriched (control) sunflower oil. Total cholesterol, LDL-cholesterol, HDL-cholesterol, arylesterase activity, oxidised LDL and soluble vascular cell adhesion molecule (sVCAM-1) levels were measured in the plasma obtained at the beginning and at the end of each treatment period. The HSO group displayed a significantly higher level (P < 0·01) of arylesterase activity and significantly lower levels of oxidised LDL and sVCAM-1 (both P < 0·05) than the control group. These results suggest that HSO may help prevent CVD.

Wakame and Nori in restructured meats included in cholesterol-enriched diets affect the antioxidant enzyme gene expressions and activities in Wistar rats.

The effects of diets including restructured meats (RM) containing Wakame or Nori on total liver glutathione status, and several antioxidant enzyme gene expressions and activities were tested. Six groups of ten male growing Wistar rats each were fed a mix of 85% AIN-93 M diet and 15% freeze-dried RM for 35 days. The control group (C) consumed control RM, the Wakame (W) and the Nori (N) groups, RM with 5% Wakame and 5% Nori, respectively. Animals on added cholesterol diets (CC, CW, and CN) consumed their corresponding basal diets added with cholesterol (2%) and cholic acid (0.4%). Alga and dietary cholesterol significantly interact (P < 0.002) influencing all enzyme expressions but not activities. The cholesterol supplement decreased most enzyme expression and activity. W-RM vs. C-RM increased (P < 0.05) expression of GPx, GR, Mn-SOD, and Cu,Zn-SOD and decreased that of catalase. N-RM vs. C-RM increased (P < 0.05) expression of catalase and Mn-SOD. GR activity increased in W-RM rats while SOD activity increased, but that of Se-GPx decreased in N animals. W-RM increased total and reduced glutathione and decreased the redox index. CN diet induced significantly lower plasma cholesterol levels (P < 0.001) than the CW diet. In conclusion, Nori-RM is a hypocholesterolemic food while Wakame-RM is an antioxidant food. This should be taken into account when including this kind of RM as potential functional foods in human.

Fasting status and thermally oxidized sunflower oil ingestion affect the intestinal antioxidant enzyme activity and gene expression of male Wistar rats.

The effect of thermally oxidized sunflower oil ingestion on antioxidant levels, enzyme activities and expressions in the small intestine of fed and fasted rats was studied. For three consecutive days, 12 male Wistar rats received 0.5 g of unused sunflower oil/100 g of body weight (controls, C) while another 12 were given 0.5 g of thermally oxidized sunflower oil/100 g of body weight (test group, T). On the night of day 3, 6 rats from each group were fasted (FC and FT, respectively) while the other 6 animals from each group were given free access to food (NFC and NFT, respectively). On day 4, FC and NFC rats received 1 g of unused oil/100 g of body weight, while FT and NFT rats were given 1 g of altered oil/100 g of body weight. Small intestines were extracted after 4 h exposure to the oils. Fasting and oil alteration significantly interacted modifying total, Se-GPx (both, P < 0.001) and non-Se-GPx (P < 0.05) activity, and GPx and Cu,Zn-SOD expressions (both P < 0.001). FT rats showed a significant increase in TBARS (P < 0.05) and catalase activity (P < 0.001) and a decrease in SOD, Se- and non-Se-dependent GPx activities (at least, P < 0.05) with respect to FC and NFT animals. SOD and GPx expressions decreased (p<0.001) but that of TNFalpha increased significantly (P < 0.001) in FT rats with respect to FC and NFT animals. Lengthy fasting and consumption of food containing oxidized fat should both be avoided to prevent intestinal oxidative stress.

Characteristics and nutritional and cardiovascular-health properties of seaweeds.

While marine algae have traditionally formed part of the Oriental diet, their major use in Western countries has been in the phytocolloid industry. Only a few coastal communities outside Asia have customarily used seaweeds as components of special dishes. Of late, however, seaweeds have gained importance as foodstuffs in Western countries and most recently as components of functional foods because of their high dietary fiber, mineral, vitamin, and phytochemical content, low energy levels, and high concentrations of certain polyunsaturated fatty acids. The present paper reviews the available data for some of the components of the major edible algae and studies several factors that can affect their physiochemical properties (e.g., hydration, water and oil-holding capacity, fermentability, binding capacity, etc.) and, in turn, their nutritional importance. The effects of marine alga consumption on growth and body weight, mineral availability, lipid metabolism, blood pressure, and antioxidant properties are reviewed, together with preliminary data on the effects of some functional foods containing seaweeds on lipid metabolism and gene expression of enzymes engaged in antioxidant protection. This review concludes with some remarks regarding the danger of the improper use of seaweeds in herbal medications. In addition, as the properties of algae are highly dependent on their individual composition, any generalization regarding these properties may be considered misleading and scientifically inappropriate.