Elizabeth Garrett Anderson y Sophia Jex-Blake: Las médicas testarudas / Elizabeth Garrett Anderson and Sophia Jex-Blake: The stubborn doctors

A lo largo de la Historia son muchas las mujeres que han querido formarse en diferentes materias, pero la mentalidad y las convenciones sociales de sus respectivas épocas se lo impidieron. No obstante, algunas no se conformaron y decidieron luchar por conseguirlo. A pesar de las múltiples trabas que se encontraron consiguieron sus objetivos dando muestra de una tenacidad y de una valentía encomiables. En este artículo hemos querido homenajear a esas valientes haciendo hincapié en la labor realizada por dos de ellas, Elizabeth Garrett Anderson y Sophia Jex-Blake, que se aplicaron con fervor en poder conseguir su sueño: estudiar medicina.(AU)

Throughout History, many women have wanted to train in different subjects, but the mentality and social conventions of their respective times prevented it. However, some did not conform and decided to fight to get it. Despite the many obstacles they encountered, they achieved their objectives by showing commendable tenacity and courage. In this article we wanted to pay tribute to these brave women by emphasizing the work done by two of them, Elizabeth Garrett Anderson and Sophia Jex-Blake, who applied themselves with fervor to achieve their dream: to study medicine.(AU)

Coagulation, Thrombogenesis, and Insulin Resistance Markers in Increased-Cardiovascular-Risk Subjects Consuming Improved-Fat Meat Products.

OBJECTIVES: Cardiovascular disease (CVD) risk is prevalent in high-meat-product consumers. The effect of consuming lipid-improved pâtés/frankfurters on plasma low-density lipoprotein (LDL)-cholesterol, thromboxane A2 (as TXB2), prostacyclin I2 (as 6-keto-PGF1α), activated partial thromboplastin time, fibrinogen, antithrombin, and insulin-resistance/sensitivity markers in volunteers at high CVD risk was studied. SUBJECTS/METHODS: Eighteen male volunteers enrolled in a blind crossover-controlled study consumed improved products during three 4-week periods: reduced fat (RF), n-3-enriched-RF (n-3RF), and normal fat (NF), separated by 4-week washouts. RESULTS: Fibrinogen and 6-keto-PG1α decreased (p < 0.05) following the RF period; LDL-cholesterol, TXB2, and 6-keto-PGF1α decreased (p < 0.05) after the n-3RF-period, while LDL-cholesterol, fibrinogen, TXB2, insulin, and Homostatic Model Assessment-insulin resistance (HOMA-IR) increased (at least p < 0.05) and QUICKI (Quantitative Insulin Sensitivity Check Index) decreased (p < 0.05) during the NF period. The rates of changes of fibrinogen, TXB2, 6-keto-PGF1α, and HOMA-IR differ between groups (repeated-measures test p < 0.05). Fibrinogen, insulin, and HOMA-IR differed significantly (p < 0.05) between RF and n-3RF period versus NF period, while that of TXB2 and 6-keto-PGF1α differed between n-3RF and NF periods (p < 0.05). CONCLUSIONS: The consumption of n-3RF meat products, followed by RF ones, partially reduced thrombogenesis, coagulation, and insulin-resistance markers. Thus, the inclusion of lipid-improved pâtés/frankfurters might be recommended into dietary strategies in at-CVD-risk volunteers.

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.

To eat or not to eat meat. That is the question

Meat is a well accepted food with appreciable appealing. Due to its high nutritional value it plays a central role in human development. Meat/meat derivates are important sources of proteins, minerals and vitamins. Their nutritional importance is paralleled to their economic impact. Paying attention to the social alarm originated by a recent publication of WHO about the relationship between red and/or processed meat consumption and cancer, this paper reviews the following aspects: a) the present consumption of meat/meat products in Spain; b) the contribution of their macro/micronutrients to the recommended dietary allowances; c) the obliged use of additives (e.g. nitrites and nitrates) to warrant the food safety, and their daily intake. In addition health risks derived from a high consumption, as well as the most appropriate culinary uses in order to reduce the formation of toxic products (e.g. N-nitrosocompounds) are commented. Due to the huge variety of available meat products, this paper concludes that any generalization should be avoided. We also emphasize about the advantages of consuming meat/meat products in the frame of a Mediterranean diet, rich in vegetables, fruits, and bioactive compounds.

¿Es el consumo de carne y derivados peligroso para la salud? Relación con el riesgo de cáncer colorrectal y otras enfermedades degenerativas / Are meat and meat product consumptions harmful? Their relationship with the risk of colorectal cancer and other degenerative diseases

El consumo excesivo de carne y derivados ha sido relacionado con una incidencia incrementada de morbi-mortalidad por enfermedades degenerativas, particularmente con las enfermedades cardiovasculares y diferentes tipos de cáncer. Muy recientemente la OMS ha emitido un informe preliminar asociando consumo de carne y cáncer de colon, atribuyendo dicha relación a la presencia de diferentes tipos de compuestos (p.e. aminas aromáticas, nitritos, nitratos) presentes en este grupo de alimentos, especialmente en los cárnicos modificados y que pueden originarse por la manipulación culinaria. No obstante, y aunque la alarma y el riesgo existen, muchos aspectos señalados en ese informe tienen a nuestro entender limitaciones que pretendemos señalar y revisar, particularmente aquellas derivadas de estudios observacionales, donde la relación causa-efecto encontrada no cumple los criterios demandados por Hill para estudios epidemiológicos. Por ello la revisión analiza en el contexto de carne y productos cárnicos los siguientes apartados: 1) definición; 2) consumo en España; 3) importancia nutricional; 4) riesgos para la salud; 5) compuestos potencialmente tóxicos en carne y derivados, el informe de la OMS; 6) otros componentes de la dieta y su papel paliativo en la relación carne- patología; 7) el poder y la importancia de los medios en la comunicación de noticias; 8) conclusiones, pautas y actuaciones futuras

The excessive intake of meat and meat products has been related with increased morbi- mortality incidence of chronic diseases, particularly with cardiovascular diseases and various types of cancer. Very recently the WHO has published a preliminary inform associating meat products consumption with colorectal cancer, suggesting that this association is based in the presence of different compounds (e.g. nitrites, nitrates) that are normally present in in those foods, especially in modified meat products that are suggested to culinary procedures. Nonetheless, although risk and alarm exist, several items pointed out in this inform has, to the best of our knowledge, limitations that we will try to indicate and review, particularly those of derived from observational studies where the cause- effect relationship found did not fit the criteria demanded By Hill for Epidemiological studies. Thus, present review discuses in the frame of the meat and meat products the following items: 1) definition; 2) consumption in Spain; 3) nutritional importance; 4) consumption health risks; 5) potential toxic products in meat products, the WHO inform; 6) other dietary compounds and their palliative role in the meat- pathology relationship; 7; the role and importance of the media in the news; 8) conclusions and future remarks

To eat or not to eat meat. That is the question / Comer o no comer carne. ¿Es esa la incógnita?

Meat is a well accepted food with appreciable appealing. Due to its high nutritional value it plays a central role in human development. Meat/meat derivates are important sources of proteins, minerals and vitamins. Their nutritional importance is paralleled to their economic impact. Paying attention to the social alarm originated by a recent publication of WHO about the relationship between red and/or processed meat consumption and cancer, this paper reviews the following aspects: a) the present consumption of meat/meat products in Spain; b) the contribution of their macro/micronutrients to the recommended dietary allowances; c) the obliged use of additives (e.g. nitrites and nitrates) to warrant the food safety, and their daily intake. In addition health risks derived from a high consumption, as well as the most appropriate culinary uses in order to reduce the formation of toxic products (e.g. N-nitrosocompounds) are commented. Due to the huge variety of available meat products, this paper concludes that any generalization should be avoided. We also emphasize about the advantages of consuming meat/meat products in the frame of a Mediterranean diet, rich in vegetables, fruits, and bioactive compounds (AU)

La carne es un alimento muy bien aceptado por sus propiedades organolépticas. Es fundamental en el desarrollo del ser humano por su alto valor nutritivo. Fuente importante de minerales, vitaminas y proteínas de elevada calidad. Su importancia nutricional está en consonancia con su repercusión económica. En este artículo, y a la luz del comunicado recientemente emitido por la OMS sobre el peligro para la salud, particularmente de cáncer, del consumo elevado de carne roja y/o procesada y dada la alarma social ocasionada, pretendemos matizar algunos aspectos. Se revisan a) el consumo actual de carnes y derivados en España; b) su contribución en macro/micronutrientes a las ingestas recomendadas; c) el aporte obligado de aditivos (p.ej. nitratos y nitritos) para garantizar la seguridad alimentaria y su ingesta diaria. Se comentan los riesgos del consumo elevado de los productos cárnicos así como los usos culinarios más adecuados para reducir la formación de compuestos tóxicos (p.ej. N-nitrosocompuestos). Dada la enorme variedad de productos cárnicos ofertados, se concluye que cualquier generalización sobre el consumo de carne y derivados sería totalmente inadecuada y se resaltan las ventajas de consumirlos en el marco de una dieta tipo mediterránea, rica en verduras, frutas y compuestos bioactivos (AU)

IMPACT OF IMPROVED FAT-MEAT PRODUCTS CONSUMPTION ON ANTHROPOMETRIC MARKERS AND NUTRIENT INTAKES OF MALE VOLUNTEERS AT INCREASED CARDIOVASCULAR RISK.

INTRODUCTION: meat products have been recognized to be adequate matrix for incorporating functional ingredients. The impact of meat products formulated by replacing animal fat with a combination of olive, linseed and fish oils on energy and nutrient intakes and anthropometric measurements were tested in a non-randomized-controlled- sequential study. METHODS: eighteen male volunteers at high-CVD risk consumed weekly 200 g frankfurters and 250 g pâtés during three 4-wk periods (reduced fat (RF); n3-enriched- RF (n-3RF), and normal fat (NF)), separated by 4-wk washout. Energy and nutrient intakes, healthy eating index (HEI), and anthropometric changes were evaluated. RESULTS: body fat mass rate-of-change and the waist/ hip ratio significantly differs (p = 0.018 and p = 0.031, respectively) between periods, decreasing body fat mass, waist circumference and waist/hip ratio in RF period and increasing body fat mass in NF one (all p = 0.05). Significant inverse correlations were observed between rate- of-change of BMI and ideal body weight with dietary carbohydrate/SFA ratio in n-3RF period (p = 0.003 and p = 0.006, respectively). Initial diets presented low HEIs (means < 60). Carbohydrate, fat and protein energy contribution was 40%, 41%, and 16%, respectively. More than 33% of volunteers did not initially cover 70% of several minerals and vitamins RDAs. Product consumption improved dietary Zn, Ca, retinol equivalent, folate and vitamin B12 contents in all periods, and ameliorated n-3 PUFA contents and n-6/n-3 PUFA ratio over the n-3RF period. CONCLUSION: improved-fat meat products appear as functional foods for overweight/obeses since their consumption improved selected body-fat markers, without affecting HEI, macronutrient and energy but their n-3 PUFA and n6/n3 ratio intakes.

Introducción: la carne es una matriz adecuada para la inclusión de ingredientes funcionales. En un estudio no secuencial controlado y aleatorio se evaluó el impacto del consumo de productos cárnicos, en los que se sustituyó la grasa animal por una combinación de aceite de oliva, de linaza y de pescado, sobre la ingesta de energía y nutrientes y sobre los marcadores antropométricos. Métodos: dieciocho voluntarios con elevado riesgo cardiovascular consumieron semanalmente 200 g de salchichas tipo frankfurt y 250 g de paté durante tres períodos sucesivos de 4 semanas (bajo en grasa (RF); enriquecidos en n-3 (n-3RF), y grasa normal (NF)), separados por un lavado de 4 semanas. Se evaluó la ingesta de nutrientes y energía, el índice de alimentación saludable (HEI) y los cambios antropométricos. Resultados: hubo diferencias significativas entre períodos para las tasas de cambio de la grasa corporal y de la relación cintura/cadera (p = 0,018 y p = 0,031, respectivamente), disminuyendo la masa grasa, el perímetro de la cintura y la relación cintura/cadera en el periodo RF, e incrementándose la grasa corporal en el periodo NF (todos p = 0,05). En el período n-3RF las tasas de cambio de IMC y del peso ideal correlacionaron inversa y significativamente (p = 0.003 y p = 0.006, respectivamente) con el cociente hidratos de carbono/AGS. El HEI inicial de las dietas fue muy bajo (valor medio < 60). La contribución energética de carbohidratos, grasa y proteínas fue 40%, 41% y 16%, respectivamente. Más del 33% de los voluntarios no cubrían al inicio el 70% de las RDA para minerales y vitaminas. La intervención mejoró en todos los períodos la ingesta de Zn, Ca, equivalentes de retinol, folatos y vitamina B12. En el período n-3RF incrementó los AGPn-3 y redujo el cociente n-6/n-3. Conclusión: los productos cárnicos con menos grasa o enriquecidos en AGP n-3 son alimentos funcionales para personas con sobrepeso/obesidad, ya que su consumo mejora los marcadores de grasa corporal, los niveles de AGP n-3 y el cociente n-6/n-3 sin afectar al HEI ni a la ingesta de energía y macronutrientes.

Impact of improved fat-meat products consumption on anthropometric markers and nutrient intakes of male volunteers at increased cardiovascular risk / Impacto del consumo de productos cárnicos con calidad grasa mejorada sobre marcadores antropométricos e ingesta de nutrientes en voluntarios con riesgo cardiovascular elevado

Introduction: meat products have been recognized to be adequate matrix for incorporating functional ingredients. The impact of meat products formulated by replacing animal fat with a combination of olive, linseed and fish oils on energy and nutrient intakes and anthropometric measurements were tested in a non-randomized-controlled-sequential study. Methods: eighteen male volunteers at high-CVD risk consumed weekly 200 g frankfurters and 250 g pâtés during three 4-wk periods (reduced fat (RF); n3-enriched-RF (n-3RF), and normal fat (NF)), separated by 4-wk washout. Energy and nutrient intakes, healthy eating index (HEI), and anthropometric changes were evaluated. Results: body fat mass rate-of-change and the waist/ hip ratio significantly differs (p=0.018 and p=0.031, respectively) between periods, decreasing body fat mass, waist circumference and waist/hip ratio in RF period and increasing body fat mass in NF one (all p=0.05). Significant inverse correlations were observed between rate-of-change of BMI and ideal body weight with dietary carbohydrate/SFA ratio in n-3RF period (p=0.003 and p=0.006, respectively). Initial diets presented low HEIs (means<60). Carbohydrate, fat and protein energy contribution was 40%, 41%, and 16%, respectively. More than 33% of volunteers did not initially cover 70% of several minerals and vitamins RDAs. Product consumption improved dietary Zn, Ca, retinol equivalent, folate and vitamin B12 contents in all periods, and ameliorated n-3 PUFA contents and n-6/n-3 PUFA ratio over the n-3RF period. Conclusion: improved-fat meat products appear as functional foods for overweight/obeses since their consumption improved selected body-fat markers, without affecting HEI, macronutrient and energy but their n-3 PUFA and n6/n3 ratio intakes (AU)

Introducción: la carne es una matriz adecuada para la inclusión de ingredientes funcionales. En un estudio no secuencial controlado y aleatorio se evaluó el impacto del consumo de productos cárnicos, en los que se sustituyó la grasa animal por una combinación de aceite de oliva, de linaza y de pescado, sobre la ingesta de energía y nutrientes y sobre los marcadores antropométricos. Métodos: dieciocho voluntarios con elevado riesgo cardiovascular consumieron semanalmente 200 g de salchichas tipo frankfurt y 250 g de paté durante tres períodos sucesivos de 4 semanas (bajo en grasa (RF); enriquecidos en n-3 (n-3RF), y grasa normal (NF)), separados por un lavado de 4 semanas. Se evaluó la ingesta de nutrientes y energía, el índice de alimentación saludable (HEI) y los cambios antropométricos. Resultados: hubo diferencias significativas entre períodos para las tasas de cambio de la grasa corporal y de la relación cintura/cadera (p=0,018 y p=0,031, respectivamente), disminuyendo la masa grasa, el perímetro de la cintura y la relación cintura/cadera en el periodo RF, e incrementándose la grasa corporal en el periodo NF (todos p=0,05). En el período n-3RF las tasas de cambio de IMC y del peso ideal correlacionaron inversa y significativamente (p=0.003 y p=0.006, respectivamente) con el cociente hidratos de carbono/AGS. El HEI inicial de las dietas fue muy bajo (valor medio <60). La contribución energética de carbohidratos, grasa y proteínas fue 40%, 41% y 16%, respectivamente. Más del 33% de los voluntarios no cubrían al inicio el 70% de las RDA para minerales y vitaminas. La intervención mejoró en todos los períodos la ingesta de Zn, Ca, equivalentes de retinol, folatos y vitamina B12. En el período n-3RF incrementó los AGPn-3 y redujo el cociente n-6/n-3. Conclusión: los productos cárnicos con menos grasa o enriquecidos en AGP n-3 son alimentos funcionales para personas con sobrepeso/obesidad, ya que su consumo mejora los marcadores de grasa corporal, los niveles de AGP n-3 y el cociente n-6/n-3 sin afectar al HEI ni a la ingesta de energía y macronutrientes (AU)

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.

Beneficial effects of the RESMENA dietary pattern on oxidative stress in patients suffering from metabolic syndrome with hyperglycemia are associated to dietary TAC and fruit consumption.

Hyperglycemia and oxidative stress are conditions directly related to the metabolic syndrome (MetS), whose prevalence is increasing worldwide. This study aimed to evaluate the effectiveness of a new weight-loss dietary pattern on improving the oxidative stress status on patients suffering MetS with hyperglycemia. Seventy-nine volunteers were randomly assigned to two low-calorie diets (-30% Energy): the control diet based on the American Health Association criteria and the RESMENA diet based on a different macronutrient distribution (30% proteins, 30% lipids, 40% carbohydrates), which was characterized by an increase of the meal frequency (seven-times/day), low glycemic load, high antioxidant capacity (TAC) and high n-3 fatty acids content. Dietary records, anthropometrical measurements, biochemical parameters and oxidative stress biomarkers were analyzed before and after the six-month-long study. The RESMENA (Metabolic Syndrome Reduction in Navarra) diet specifically reduced the android fat mass and demonstrated more effectiveness on improving general oxidative stress through a greater decrease of oxidized LDL (oxLDL) values and protection against arylesterase depletion. Interestingly, oxLDL values were associated with dietary TAC and fruit consumption and with changes on body mass index (BMI), waist circumference, fat mass and triacilglyceride (TG) levels. In conclusion, the antioxidant properties of the RESMENA diet provide further benefits to those attributable to weight loss on patients suffering Mets with hyperglycemia.