[Consenso del grupo de trabajo de los trastornos de la conducta alimentaria de SENPE (GTTCA-SENPE). Evaluación y tratamiento médico-nutricional en la anorexia nerviosa. Actualización 2023]. / Consenso del grupo de trabajo de los trastornos de la conducta alimentaria de SENPE (GTTCA-SENPE). Evaluación y tratamiento médico-nutricional en la anorexia nerviosa. Actualización 2023.

Anorexia nervosa (AN) is a multifactorial disorder. A possible role of the social network and the gut microbiota in pathogenesis has been added. Exogenous shocks such as the COVID19 pandemic have had a negative impact on patients with AN. The potential medical and nutritional impact of malnutrition and/or compensatory behaviors gives rise to a complex disease with a wide range of severity, the management of which requires a multidisciplinary team with a high level of subject matter expertise. Coordination between levels of care is necessary as well as understanding how to transition the patient from pediatric to adult care is essential. A proper clinical evaluation can detect possible complications, as well as establish the organic risk of the patient. This allows caregivers to tailor the medical-nutritional treatment for each patient. Reestablishing adequate nutritional behaviors is a fundamental pillar of treatment in AN. The design of a personalized nutritional treatment and education program is necessary for this purpose. Depending on the clinical severity, artificial nutrition may be necessary. Although the decision regarding the level of care necessary at diagnosis or during follow-up depends on a number of factors (awareness of the disease, medical stability, complications, suicidal risk, outpatient treatment failure, psychosocial context, etc.), outpatient treatment is the most frequent and most preferred choice. However, more intensive care (total or partial hospitalization) may be necessary in certain cases. In severely malnourished patients, the appearance of refeeding syndrome should be prevented during renourishment. The presence of AN in certain situations (pregnancy, vegetarianism, type 1 diabetes mellitus) requires specific care. Physical activity in these patients must also be addressed correctly.

[A consensus report by the Working Group on Eating Disorders of Sociedad Española de Nutrición Clínica y Metabolismo (GTTCA-SENPE). Evaluation, medical and nutritional management of anorexia nervosa. Update 2023]. / Consenso del grupo de trabajo de los trastornos de la conducta alimentaria de SENPE (GTTCA-SENPE). Evaluación y tratamiento médico-nutricional en la anorexia nerviosa. Actualización 2023.

Introduction: Anorexia nervosa (AN) is a multifactorial disorder. A possible role of the social network and the gut microbiota in pathogenesis has been added. Exogenous shocks such as the COVID19 pandemic have had a negative impact on patients with AN. The potential medical and nutritional impact of malnutrition and/or compensatory behaviors gives rise to a complex disease with a wide range of severity, the management of which requires a multidisciplinary team with a high level of subject matter expertise. Coordination between levels of care is necessary as well as understanding how to transition the patient from pediatric to adult care is essential. A proper clinical evaluation can detect possible complications, as well as establish the organic risk of the patient. This allows caregivers to tailor the medical-nutritional treatment for each patient. Reestablishing adequate nutritional behaviors is a fundamental pillar of treatment in AN. The design of a personalized nutritional treatment and education program is necessary for this purpose. Depending on the clinical severity, artificial nutrition may be necessary. Although the decision regarding the level of care necessary at diagnosis or during follow-up depends on a number of factors (awareness of the disease, medical stability, complications, suicidal risk, outpatient treatment failure, psychosocial context, etc.), outpatient treatment is the most frequent and most preferred choice. However, more intensive care (total or partial hospitalization) may be necessary in certain cases. In severely malnourished patients, the appearance of refeeding syndrome should be prevented during renourishment. The presence of AN in certain situations (pregnancy, vegetarianism, type 1 diabetes mellitus) requires specific care. Physical activity in these patients must also be addressed correctly.

Introducción: La anorexia nerviosa (AN) es una enfermedad de origen multifactorial. Recientemente se ha sumado el papel de las redes sociales y la microbiota intestinal en la patogenia. La pandemia por COVID-19 ha tenido un impacto negativo en los pacientes con AN. La potencial afectación médica y nutricional derivada de la desnutrición o las conductas compensatorias dan lugar a una compleja enfermedad de gravedad variable, cuyo manejo precisa un equipo multidisciplinar con elevado nivel de conocimientos en la materia. Es fundamental la coordinación entre niveles asistenciales y en la transición de pediatría a adultos. Una adecuada valoración clínica permite detectar eventuales complicaciones, así como establecer el riesgo orgánico del paciente y, por tanto, adecuar el tratamiento médico-nutricional de forma individualizada. El restablecimiento de un apropiado estado nutricional es un pilar fundamental del tratamiento en la AN. Para ello es necesario diseñar una intervención de renutrición individualizada que incluya un programa de educación nutricional. Según el escenario clínico puede ser necesaria la nutrición artificial. Aunque la decisión de qué nivel de atención escoger al diagnóstico o durante el seguimiento depende de numerosas variables (conciencia de enfermedad, estabilidad médica, complicaciones, riesgo autolítico, fracaso del tratamiento ambulatorio o contexto psicosocial, entre otros), el tratamiento ambulatorio es de elección en la mayoría de las ocasiones. No obstante, puede ser necesario un escenario más intensivo (hospitalización total o parcial) en casos seleccionados. En pacientes gravemente desnutridos debe prevenirse la aparición de un síndrome de alimentación cuando se inicia la renutrición. La presencia de una AN en determinadas situaciones (gestación, vegetarianismo, diabetes mellitus de tipo 1, etc.) exige un manejo particular. En estos pacientes también debe abordarse de forma correcta el ejercicio físico.

[Nutrition in breast cancer genesis]. / El papel de la nutrición en la génesis del cáncer de mama.

Introduction: Breast cancer is the most prevalent tumor in women, ranking first in incidence and mortality in many countries. Although the causes of breast cancer are complex and multifactorial, nutritional factors and those related to nutritional status play an important role in the development of the disease. In this way, factors that increase breast cancer risk have been identified, such as weight gain, the amount of adipose tissue, waist circumference, alcohol consumption or the consumption of red meat and processed meat, while other factors have been identified that reduce the risk, such as eating fruits and vegetables. Nutritional factors or factors that depend on the state of nutrition are modifiable and preventable, so they must be considered when designing effective prevention programs.

Introducción: El cáncer de mama es el tumor más prevalente en las mujeres y ocupa el primer lugar en incidencia y en mortalidad en muchos países. Si bien las causas del cáncer de mama son complejas y multifactoriales, los factores nutricionales y aquellos relacionados con el estado nutricional juegan un papel importante en el desarrollo de la enfermedad. De esta forma, se han identificado algunos factores que aumentan su riesgo, como el aumento de peso, la cantidad de tejido adiposo, la circunferencia de cintura, el consumo de alcohol, etc., o bien, que lo reducen, como el consumo de frutas y verduras. Los factores nutricionales o que dependen del estado de nutrición son modificables y prevenibles, por lo que deben tenerse en cuenta al diseñar programas de prevención eficaces.

[Nutritional factors related to insulin resistance in children and adolescents]. / Factores nutricionales relacionados con la resistencia a la insulina en escolares y adolescentes.

Introduction: Insulin resistance is described as a defect in the binding of insulin to its receptor and is associated with several diseases, including obesity and type 2 diabetes. Insulin resistance has been linked to vitamin and mineral deficiencies, especially those involved in oxidative stress. The Mediterranean diet, a diet based on the Healthy Eating Index or the Dietary Approaches to Stop Hypertension (DASH) diet are dietary patterns that have been associated with a lower risk of developing insulin resistance in children. Therefore, a diet rich in antioxidant vitamins and minerals, fiber, calcium, and polyunsaturated fatty acids and low in free sugars, sodium and saturated fatty acids may decrease the risk of insulin resistance in this age group. In addition, other nutritional factors, such as avoiding fast food, eating dinner with the family, not eating while watching TV or eating a sufficient and healthy breakfast on a regular basis seem to be associated with a lower risk of insulin resistance. Therefore, it is important to establish balanced daily eating habits to prevent and treat insulin resistance in schoolchildren and adolescents.

Introducción: La resistencia a la insulina se explica como un defecto en la unión de la insulina con su receptor y está asociada con numerosas enfermedades, como la obesidad o la diabetes tipo 2, entre otras. La resistencia a la insulina se ha relacionado con la deficiencia de vitaminas y minerales, especialmente de aquellos involucrados en el estrés oxidativo. La dieta mediterránea, una dieta basada en el Healthy Eating Index o la dieta Dietary Approaches to Stop Hypertension (DASH) son patrones dietéticos que se han asociado con un menor riesgo de presentar resistencia a la insulina en edad infantil. Por tanto, una dieta rica en vitaminas y minerales antioxidantes, fibra, calcio y ácidos grasos poliinsaturados y baja en azucares libres, sodio y ácidos grasos saturados puede disminuir el riesgo de presentar resistencia a la insulina en este grupo de edad. Además, otros factores nutricionales, como evitar la comida rápida, cenar en familia, no comer mientras se ve la televisión o el consumo regular de un desayuno suficiente y saludable son hábitos que parecen estar relacionados con menor riesgo de presentar resistencia a la insulina. Por tanto, es importante establecer hábitos alimentarios diarios equilibrados para prevenir y tratar la resistencia a la insulina en escolares y adolescentes.

[Cardiometabolic effects of intermittent fasting in women]. / Efectos cardiometabólicos del ayuno intermitente en la mujer.

Introduction: Intermittent fasting is a dietary pattern characterized by alternating periods of total or partial fasting and ad libitum food consumption. During prolonged fasting, the body uses the ketone bodies formed from lipolysis of body fat, which also leads to some metabolic modifications with positive effects on health. In this sense, nocturnal intermittent fasting could contribute to properly synchronize the circadian system making the physiological, hormonal, energetic and metabolic processes work correctly and keeping to the individual in homeostasis. Thus, according to the results of different studies, intermittent fasting, in the short-medium term, seems to improve body composition, as well as the values of several cardiometabolic parameters such as insulin and HOMA-IR index, among others. These effects have been observed in both pre- and postmenopausal women (no differences have been found between both states) and are similar to those found in interventions with caloric restriction diets.

Introducción: El ayuno intermitente es un patrón dietético caracterizado por la alternancia de periodos de ayuno, totales o parciales, y de consumo de alimentos ad libitum. Durante el ayuno prolongado, el organismo utiliza los cuerpos cetónicos que se forman a partir de la lipolisis de la grasa del organismo, lo que también da lugar a algunas modificaciones metabólicas con efectos positivos para la salud. En este sentido, el ayuno intermitente nocturno podría contribuir a sincronizar adecuadamente el sistema circadiano, haciendo que los procesos fisiológicos, hormonales, energéticos y metabólicos funcionen correctamente y mantengan al individuo en homeostasis. Así, de acuerdo con los resultados de diferentes estudios, el ayuno intermitente, a corto-medio plazo, parece mejorar la composición corporal, así como los valores de diversos parámetros cardiometabólicos como la insulina y el índice HOMA-IR, entre otros. Estos efectos se han observado tanto en mujeres premenopáusicas como postmenopáusicas, sin hallar diferencias entre ambos estados y son similares a los encontrados con intervenciones con dietas con restricción calórica.

[Anorexia nervosa, microbiota and brain]. / Anorexia nerviosa, microbiota y cerebro.

Introduction: Anorexia nervosa (AN) is a psychiatric disease with a high prevalence and comorbidities, characterized by a low response rate to treatment. It is considered as a multifactorial disease. In recent years, the focus has been placed on the presence of intestinal dysbiosis and its possible involvement as a causal factor as well as an alternative treatment. The objective of this work has been to review the current state of knowledge of alterations in the intestinal microbiota identified in patients with AN and the possibility of using probiotics as a therapeutic alternative. Significant changes in the diversity of species associated with weight loss have been described that could favor the perpetuation of the disorder, and that would explain many of the nutritional, gastrointestinal, psychological, and cognitive alterations present in these patients. The use of probiotics, still little studied in patients with AN, sheds some light on this matter to improve the treatment response, always hand in hand with conventional treatments.

Introducción: La anorexia nerviosa (AN) es una enfermedad psiquiátrica, con elevada prevalencia y comorbilidades, caracterizada por una baja tasa de respuesta al tratamiento. Se considera una enfermedad multifactorial. En los últimos años se ha puesto el foco en la presencia de disbiosis intestinal y su posible implicación como factor causal, así como alternativa de tratamiento. El objetivo de este trabajo ha sido revisar el estado actual del conocimiento de las alteraciones en la microbiota intestinal identificadas en pacientes con AN y la posibilidad del uso de probióticos como alternativa terapéutica. Se han descrito importantes cambios en la diversidad de las especies asociadas a la pérdida de peso que podrían contribuir a perpetuar el trastorno y que explicarían muchas de las alteraciones nutricionales, gastrointestinales, psicológicas y cognitivas presentes en estos pacientes. El uso de probióticos, poco estudiado aún en pacientes con AN, abre una nueva ventana para mejorar la respuesta, siempre de la mano de los tratamientos convencionales.

Dietary and Physical Activity Habits as Conditioning Factors of Nutritional Status among Children of GENYAL Study.

Excess weight (EW) in children has become a severe public health problem. The present study aimed to describe the main lifestyle characteristics and their possible association with nutritional status in a group of schoolchildren enrolled in the GENYAL study, where 221 children in the first or second grade of primary education (6-9 years old) were included. Anthropometric (BMI and bioimpedance), dietary intake (twice-repeated 24 h food record), and physical activity (twice-repeated 24 h physical activity questionnaire) data were collected. Logistic and linear regressions, with p-values adjusted for multiple tests by Bonferroni's method and with sex and age as covariates, were applied. The prevalence of EW was 19%, 25.4%, and 32.2%, according to Orbegozo Foundation, IOFT, and WHO criteria, respectively. The results showed a significant association between schoolchildren's nutritional status and energy balance, defined as the ratio of estimated energy intake to estimated energy expenditure (%), (ß = -1.49 (-1.9-1.07), p < 0.01) and KIDMED Mediterranean Diet Quality Index score (ß = -0.19 (95% IC -0.38-0), p = 0.04), and between the availability of TV or other technological devices in their room and the child's BMI (ß = 1.15 (95% IC 0.20-2.10), p = 0.017) and their fat mass (ß = 3.28 (95% IC 0.69-5.87), p = 0.013). The number of dairy servings/day had a protective effect against EW (OR = 0.48 (0.29-0.75), p adjusted = 0.05)). Studying lifestyle factors associated with obesity is essential for developing tools and strategies for obesity prevention in children.

[Results of the survey on care units and caring for eating disorders in Spain. SENPE Working Group on Eating Disorders]. / Resultados de la encuesta sobre unidades asistenciales y atención a trastornos de la conducta alimentaria en España. Grupo de Trabajo sobre Trastornos de la Conducta Alimentaria de SENPE.

Introduction: Introduction: eating disorders (EDs) entail a therapeutic challenge. Objective: to describe ED care from the perspective of Nutrition Units (NU) in relation to human and care resources, the activities carried out, and satisfaction with care in Spain; to collect demands from professionals to improve assistance. Methods: a cross-sectional, observational study based on a questionnaire sent online to members of the Spanish Society of Clinical Nutrition and Metabolism (SENPE) and to the Nutrition Area of the Spanish Society of Endocrinology and Nutrition (SEEN). The data were analyzed according to number of beds of the hospitals surveyed (< 500/≥ 500). Results: 23 responses from 8 autonomous communities. In 87 % of NUs care was given to eating disorders; 65.2 % had a specific process; 91.3 % collaborated with Psychiatry; 34.8 % had their own hospitalization area; 56.5 % had a day hospital, but 21.7 % participated in it; 39.1 % had a monographic consultation office; nutritional education was carried out in 87 %, especially by nursing; individualized diets and oral supplements were frequently prescribed in 39.1 % and 56.5 %, respectively; only the largest hospitals participated in research on EDs (62.5 %), and 21.7 % collaborated with patient associations. Hospitals with ≥ 500 beds had more resources and were more satisfied. Professionals demanded resources and processes agreed with Psychiatry. Conclusions: resources and care practices are uneven in the NUs surveyed, as well as multidisciplinary collaboration. The collected evidence allows us to design improvement strategies in this area.

Introducción: Introducción: los trastornos de la conducta alimentaria (TCA) suponen un reto terapéutico. Objetivo: describir la asistencia a los TCA desde la perspectiva de las unidades de nutrición clínica y dietética (UNCyD) en relación con los recursos humanos y asistenciales, las actividades realizadas y la satisfacción con la atención en España; recoger demandas de los profesionales para mejorar la asistencia. Métodos: estudio transversal y observacional a partir de un cuestionario remitido online a socios de la Sociedad Española de Nutrición Clínica y Metabolismo (SENPE) y al Área de Nutrición de la Sociedad Española de Endocrinología y Nutrición (SEEN). Los datos se analizaron según las camas de los hospitales encuestados (< 500/≥ 500). Resultados: 23 respuestas de 8 comunidades autónomas. En el 87 % de las UNCyD se prestaba atención a los TCA; el 65,2 % contaban con un proceso específico; el 91,3 % colaboraban con Psiquiatría; el 34,8 % tenían área propia de hospitalización; el 56,5 % disponían de hospital de día pero participaban en él el 21,7 %; el 39,1 % tenían consulta monográfica; se realizaba educación nutricional en el 87 %, sobre todo por enfermería; se prescribían frecuentemente dietas individualizadas y suplementos orales en el 39,1 y el 56,5 %, respectivamente; solo los hospitales más grandes participaban en investigación sobre TCA (62,5 %); y el 21,7 % colaboraban con asociaciones de pacientes. Los hospitales con ≥ 500 camas disponían de más recursos y estaban más satisfechos. Los profesionales demandaban recursos y procesos consensuados con psiquiatría. Conclusiones: los recursos y las prácticas asistenciales son dispares en las UNCyD encuestadas, así como la colaboración multidisciplinar. La evidencia recogida permite diseñar estrategias de mejora en este ámbito.

Breakfast Quality and Insulin Resistance in Spanish Schoolchildren: A Cross-Sectional Study.

Background: Breakfast has traditionally been considered one of the most important meals of the day; however, there is little evidence for the influence of breakfast quality and insulin resistance (IR). This study aimed to assess the quality of breakfast in a group of schoolchildren, and its association with IR. Methods: A cross-sectional study with 852 children (8−13 years) was carried out. Fasting plasma glucose, insulin and anthropometric parameters were measured. A three-day dietary record was used to assess their diet and to calculate the Breakfast Quality Index (BQI). The sample was divided into tertiles according to the BQI (tertile 3: better breakfast quality). The homeostatic model was used to assess insulin resistance (HOMA-IR), and IR was defined as HOMA-IR > 3.16. Results: The prevalence of IR was 5.2%. The mean BQI score was 4.50 ± 1.25, and boys had lower scores than girls. Children in the BQI tertile 3 had a better global diet quality. In boys, being in the BQI tertile 3 was associated with a lower risk of IR (OR [95% CI]: 0.10 [0.01−0.77], p < 0.05). Conclusions: A higher-quality breakfast was associated with better overall diet quality and a lower risk of IR, especially in boys.

Folliculin-interacting protein FNIP2 impacts on overweight and obesity through a polymorphism in a conserved 3' untranslated region.

BACKGROUND: Overweight and obesity are defined by an anomalous or excessive fat accumulation that may compromise health. To find single-nucleotide polymorphisms (SNPs) influencing metabolic phenotypes associated with the obesity state, we analyze multiple anthropometric and clinical parameters in a cohort of 790 healthy volunteers and study potential associations with 48 manually curated SNPs, in metabolic genes functionally associated with the mechanistic target of rapamycin (mTOR) pathway. RESULTS: We identify and validate rs2291007 within a conserved region in the 3'UTR of folliculin-interacting protein FNIP2 that correlates with multiple leanness parameters. The T-to-C variant represents the major allele in Europeans and disrupts an ancestral target sequence of the miRNA miR-181b-5p, thus resulting in increased FNIP2 mRNA levels in cancer cell lines and in peripheral blood from carriers of the C allele. Because the miRNA binding site is conserved across vertebrates, we engineered the T-to-C substitution in the endogenous Fnip2 allele in mice. Primary cells derived from Fnip2 C/C mice show increased mRNA stability, and more importantly, Fnip2 C/C mice replicate the decreased adiposity and increased leanness observed in human volunteers. Finally, expression levels of FNIP2 in both human samples and mice negatively associate with leanness parameters, and moreover, are the most important contributor in a multifactorial model of body mass index prediction. CONCLUSIONS: We propose that rs2291007 influences human leanness through an evolutionarily conserved modulation of FNIP2 mRNA levels.

Association of Healthy Eating Index-2015 and Dietary Approaches to Stop Hypertension Patterns with Insulin Resistance in Schoolchildren.

Background: Diet quality patterns are associated with a lower incidence of insulin resistance (IR) in adults. The aim of this study was to investigate the association between two diet quality indices and IR in schoolchildren and to identify the best diet quality index associated with a lower risk of IR. Methods: A total of 854 schoolchildren (8−13 years) were included in a cross-sectional study, who completed a three-day dietary record to assess their diet. Fasting plasma glucose and insulin were also measured, and anthropometric data were collected. Healthy Eating Index-2015 (HEI-2015), Dietary Approaches to Stop Hypertension (DASH), and adjusted DASH (aDASH) were calculated as diet quality indices. The homeostasis model assessment of insulin resistance (HOMA-IR) was used, and IR was defined as HOMA-IR > 3.16. Results: The prevalence of IR was 5.5%, and it was higher in girls. The mean HEI-2015 and DASH scores were 59.3 and 23.4, respectively, and boys scored lower in both indices. In girls, having a HEI-2015 score above the 33rd percentile was associated with a lower risk of IR (odds ratio [95% CI]: 0.43 [0.19−0.96], p = 0.020). Conclusion: Greater adherence to a healthy dietary pattern, as assessed by a higher HEI-2015 score, was associated with a lower risk of IR in schoolchildren, especially in girls.

A comprehensive map of microbial biomarkers along the gastrointestinal tract for celiac disease patients.

Dysbiosis of the microbiome has been related to Celiac disease (CeD) progress, an autoimmune disease characterized by gluten intolerance developed in genetically susceptible individuals under certain environmental factors. The microbiome contributes to CeD pathophysiology, modulating the immune response by the action of short-chain fatty acids (SCFA), affecting gut barrier integrity allowing the entrance of gluten-derived proteins, and degrading immunogenic peptides of gluten through endoprolyl peptidase enzymes. Despite the evidence suggesting the implication of gut microbiome over CeD pathogenesis, there is no consensus about the specific microbial changes observed in this pathology. Here, we compiled the largest dataset of 16S prokaryotic ribosomal RNA gene high-throughput sequencing for consensus profiling. We present for the first time an integrative analysis of metataxonomic data from patients with CeD, including samples from different body sites (saliva, pharynx, duodenum, and stool). We found the presence of coordinated changes through the gastrointestinal tract (GIT) characterized by an increase in Actinobacteria species in the upper GIT (pharynx and duodenum) and an increase in Proteobacteria in the lower GIT (duodenum and stool), as well as site-specific changes evidencing a dysbiosis in patients with CeD' microbiota. Moreover, we described the effect of adherence to a gluten-free diet (GFD) evidenced by an increase in beneficial bacteria and a decrease in some Betaproteobacteriales but not fully restoring CeD-related dysbiosis. Finally, we built a Random Forest model to classify patients based on the lower GIT composition achieving good performance.

Fatty acids homeostasis during fasting predicts protection from chemotherapy toxicity.

Fasting exerts beneficial effects in mice and humans, including protection from chemotherapy toxicity. To explore the involved mechanisms, we collect blood from humans and mice before and after 36 or 24 hours of fasting, respectively, and measure lipid composition of erythrocyte membranes, circulating micro RNAs (miRNAs), and RNA expression at peripheral blood mononuclear cells (PBMCs). Fasting coordinately affects the proportion of polyunsaturated versus saturated and monounsaturated fatty acids at the erythrocyte membrane; and reduces the expression of insulin signaling-related genes in PBMCs. When fasted for 24 hours before and 24 hours after administration of oxaliplatin or doxorubicin, mice show a strong protection from toxicity in several tissues. Erythrocyte membrane lipids and PBMC gene expression define two separate groups of individuals that accurately predict a differential protection from chemotherapy toxicity, with important clinical implications. Our results reveal a mechanism of fasting associated with lipid homeostasis, and provide biomarkers of fasting to predict fasting-mediated protection from chemotherapy toxicity.

[Recommended egg intake in children: past, present, and future]. / Recomendaciones de consumo de huevo en población infantil: pasado, presente y futuro.

Introduction: The consumption of high nutritional quality foods is a key for proper growth and development during childhood. This work aimed to review and analyse the current recommended egg intake in children by different national organisations. Likewise, it intended to standardise a procedure to propose new recommendations for this food. A search of available national online guidelines or recommendations was performed. The Healthy Eating Guide of the Spanish Society of Community Nutrition (SENC), 2018 and the energy requirements of the European Food Safety Authority (2017) for children and adolescents were contemplated, considering a contribution of 15 % of energy as proteins to propose the new recommended egg intake. Two scenarios according to the level of physical activity and three age groups were considered. Based on the current data and evidence, we believe that egg intake recommendations should be reassessed, proposing broader recommendations, especially for children over 13 years old with average energy requirements as well as children over seven years old who perform high physical activity or are in a brief period of growth. It will contribute to breaking down old myths associated with egg consumption and promote the development of coordinated and updated recommendations.

Introducción: Durante la edad infantil, el consumo de alimentos de alta calidad nutricional es clave para un adecuado crecimiento y desarrollo. Este trabajo se desarrolló con el objetivo de revisar y de analizar la frecuencia y la cantidad de consumo de huevo actualmente aconsejado por diferentes organismos en el ámbito nacional. Asimismo, se buscó estandarizar un procedimiento para proponer unas nuevas recomendaciones de consumo de este alimento. Para ello, se realizó una búsqueda digital de las guías o recomendaciones nacionales disponibles. Para proponer la nueva recomendación se trabajó con las frecuencias y con las raciones de los alimentos clasificados por grupos de la Guía de la alimentación saludable de la Sociedad Española de Nutrición Comunitaria (SENC), 2018, y con los requerimientos de energía para niños y niñas y adolescentes propuestos por la European Food Safety Authority de 2017, considerando un aporte del 15 % de la energía en forma de proteínas. Se contemplaron dos escenarios de acuerdo al nivel de actividad física y se hizo una clasificación en tres grupos de edad. Con base en los datos y en la evidencia actual, consideramos que las recomendaciones de consumo de huevo deben ser reevaluadas para proponer unas recomendaciones más amplias, especialmente para niños mayores de 13 años con requerimientos medios de energía y niños mayores de 7 años que realicen una actividad física elevada o que se encuentren en un periodo de rápido empuje puberal. Esto contribuirá a derribar viejos mitos asociados a este alimento con tanto potencial para la población infantil y adolescente y al desarrollo de unas recomendaciones más coordinadas y revisadas.

[Microbiota-diet interactions: towards personalized nutrition]. / Interacciones microbiota-dieta: hacia la personalización de la nutrición.

Introduction: The gut microbiota has emerged as a key factor on one hand as a mediator of the effects of diet on health and, on the other hand, as a source of intervariability of response to a diet. Moreover, there is a strong bidirectional interaction between our health and the microbiota that inhabit us, with each determining the presence of the other. In this review are named some of the metabolic functions in which the microbiota participates and which have an impact on our health, with particular emphasis on its ability to ferment fiber and produce short-chain fatty acids (SCFA) that provide numerous benefits to our health, but which have also been linked to obesity. Finally, some examples of dietary intervention in which the microbiota has been shown to play a key role in the results obtained are mentioned.

Introducción: La microbiota intestinal se ha revelado como un factor clave, por un lado, como mediador de los efectos de la dieta en la salud y, por otro lado, como fuente de intervariabilidad de respuesta a una dieta. Además, existe una fuerte interacción bidireccional entre nuestra salud y la microbiota que nos habita, determinando cada uno la presencia del otro. En esta revisión se nombran algunas de las funciones metabólicas en las que participa la microbiota y que tienen un impacto en nuestra salud, con especial hincapié en su capacidad para fermentar la fibra y producir ácidos grasos de cadena corta (AGCC), que aportan numerosos beneficios a nuestra salud, pero que también se han relacionado con la obesidad. Por último, se nombran algunos ejemplos de intervención dietética en los que se ha demostrado que la microbiota cumple un papel fundamental en los resultados obtenidos.

[Diet and lifestyle in cancer prevention]. / Alimentación y estilo de vida en la prevención del cáncer.

Introduction: European Union represents a tenth of the world population, however, it has a quarter of the cancer cases in the world. Without strong action, it is estimated that by 2035 cancer cases will increase by almost 25 %, making this disease the main cause of death. Therefore, the aim of this study is to know the diet and lifestyle guidelines associated to cancer prevention. A literature review has been carried out on the diet and lifestyle guidelines related to a reduction in cancer risk. Strategies to reduce cancer risk include maintaining a healthy weight, being physically active, consuming a diet rich in whole grains, fruits, non-starchy vegetables, and legumes, limit processed and fast food, limit consumption of red meat and eat little, if any, processed meats, drink mostly water and limit the consumption of sugar sweetened drinks, finally reduce, or do not consume alcohol. Prevention is an effective tool to reduce cancer risk. Adequate diet and healthy lifestyle habits can reduce cancer risk as well as other non-communicable diseases and can even have environmental benefits.

Introducción: La Unión Europea representa una décima parte de la población mundial, pero tiene un cuarto de los casos de cáncer de todo el mundo. Sin una acción contundente, se estima que en 2035 los casos de cáncer aumentarán casi un 25 %, lo que convertirá a esta enfermedad en la principal causa de muerte. Por ello, el objetivo del presente estudio es conocer las pautas de alimentación y de estilo de vida que influyen en la prevención del cáncer. Para ello se ha realizado una revisión bibliográfica de las pautas de alimentación y de los principales estilos de vida que se relacionan con una reducción del riesgo de padecer cáncer. Entre las estrategias para reducir el riesgo de cáncer se encuentran el mantenimiento de un peso saludable a lo largo de toda la vida, ser físicamente activo, consumir una dieta rica en cereales integrales, frutas, verduras no almidonadas y legumbres, limitar el consumo de alimentos procesados y de comida rápida, limitar el consumo de carne roja y consumir poco o nada de carnes procesadas, consumir principalmente agua y limitar el consumo de bebidas azucaradas, y por último, reducir el consumo de alcohol o no consumirlo. La prevención es una herramienta eficaz para reducir el riesgo de padecer cáncer. Una adecuada alimentación y hábitos de vida saludables reducirán el riesgo de padecer cáncer en el futuro, así como otras enfermedades no transmisibles e, incluso, beneficios medioambientales.

[Benefits and risks of vegetarian diets]. / Beneficios y riesgos de las dietas vegetarianas.

Introduction: In recent decades, there has been an increasing interest in vegetarian diets. It is therefore interesting to analyse the benefits and risks of these diets. To this end, a review has been done on the benefits and risks of vegetarian diets. Vegetarian diets have been associated with different health benefits. On the contrary, nutritional deficiencies has been observed in those people who follow this type of diet, mainly in those risk groups such as pregnant and lactating women, children, adolescents, and elderly. Vegetarian diets may have some health benefits, however further studies are required.

Introducción: En las últimas décadas se ha observado un incremento en el interés por el seguimiento de las dietas vegetarianas en la población, por lo que es interesante analizar sus beneficios y sus riesgos. Con este fin se ha realizado una revisión sobre los beneficios y los riesgos de las dietas vegetarianas. Las dietas vegetarianas se han asociado a diferentes beneficios para la salud. De forma contraria, se observan deficiencias nutricionales en aquellas personas que siguen este tipo de dietas, principalmente en grupos de riesgo como mujeres embarazadas y lactantes, niños, adolescentes y ancianos. Las dietas vegetarianas podrían tener algunos beneficios en relación con la salud, sin embargo, es necesario continuar realizando estudios.

[Impact of vitamin D on health. Difficulties and strategies to reach the recommended intakes]. / Impacto de la vitamina D en la salud. Dificultades y estrategias para alcanzar las ingestas recomendadas.

Introduction: Vitamin D is a key nutrient for health. Recent research has shown that it is not only necessary for the maintenance of bone health, but also for the prevention of cardiovascular diseases, insulin resistance, respiratory diseases, infections, and cancer, among others. Solar synthesis of vitamin D is usually insufficient, so it is necessary to provide enough vitamin D through the diet in order to maintain an adequate nutritional status. Studies carried out in Spain and other countries have shown that serum levels of the vitamin were usually insufficient and that average dietary intakes were well below those marked as recommended, while the main food sources of vitamin D were fatty fish, breakfast cereals, eggs, and dairy. Food sources of vitamin D are scarce, and it is naturally located in the fatty part of foods of animal origin, and in the liver and viscera. Fortifying foods that are not natural food sources of vitamin D but are regularly consumed by a significant percentage of the population, is a strategy that could help to increase vitamin D intake. In this regard, dairy products and breakfast cereals are two of the most widely used food matrices for vitamin D fortification, and their incorporation into the usual diet has proven to be an effective strategy to improve the nutritional situation of the population in vitamin D.

Introducción: La vitamina D es clave en la salud y sus funciones se relacionan con el mantenimiento de la salud ósea, cardiovascular, la resistencia a la insulina, enfermedades respiratorias, infecciones y cáncer, entre otras. La síntesis solar de la vitamina D es con frecuencia insuficiente, por lo que para mantener un estatus adecuado de la vitamina es necesario que se aporten cantidades suficientes con la dieta. Los estudios realizados en España y en otros países muestran que los niveles séricos de la vitamina son con frecuencia insuficientes y que las ingestas dietéticas medias se encuentran muy por debajo de las marcadas como recomendadas. Las principales fuentes alimentarias de la vitamina D son los pescados grasos, los cereales de desayuno, los huevos y los lácteos. Las fuentes alimentarias de vitamina D son escasas y se encuentra especialmente en la parte grasa de alimentos de origen animal, en hígados y en vísceras. El enriquecimiento de alimentos que de forma natural no tienen un elevado contenido en vitamina D, pero que son consumidos habitualmente por un porcentaje significativo de la población, es una estrategia que ayuda a aumentar su ingesta. En este sentido, los lácteos y los cereales de desayuno son dos de las matrices alimentarias más utilizadas y su incorporación en la dieta habitual ha demostrado ser una estrategia eficaz para mejorar la situación nutricional de la población respecto a la vitamina D.

"GENYAL" Study to Childhood Obesity Prevention: Methodology and Preliminary Results.

Objective: This article describes the methodology and summarizes some preliminary results of the GENYAL study aiming to design and validate a predictive model, considering both environmental and genetic factors, that identifies children who would benefit most from actions aimed at reducing the risk of obesity and its complications. Design: The study is a cluster randomized clinical trial with 5-year follow-up. The initial evaluation was carried out in 2017. The schools were randomly split into intervention (nutritional education) and control schools. Anthropometric measurements, social and health as well as dietary and physical activity data of schoolchildren and their families are annually collected. A total of 26 single nucleotide polymorphisms (SNPs) were assessed. Machine Learning models are being designed to predict obesity phenotypes after the 5-year follow-up. Settings: Six schools in Madrid. Participants: A total of 221 schoolchildren (6-8 years old). Results: Collected results show that the prevalence of excess weight was 19.0, 25.4, and 32.2% (according to World Health Organization, International Obesity Task Force and Orbegozo Foundation criteria, respectively). Associations between the nutritional state of children with mother BMI [ß = 0.21 (0.13-0.3), p (adjusted) <0.001], geographical location of the school [OR = 2.74 (1.24-6.22), p (adjusted) = 0.06], dairy servings per day [OR = 0.48 (0.29-0.75), p (adjusted) = 0.05] and 8 SNPs [rs1260326, rs780094, rs10913469, rs328, rs7647305, rs3101336, rs2568958, rs925946; p (not adjusted) <0.05] were found. Conclusions: These baseline data support the evidence that environmental and genetic factors play a role in the development of childhood obesity. After 5-year follow-up, the GENYAL study pretends to validate the predictive model as a new strategy to fight against obesity. Clinical Trial Registration: This study has been registered in ClinicalTrials.gov with the identifier NCT03419520, https://clinicaltrials.gov/ct2/show/NCT03419520.