Impact of dietary Laminaria digitata with alginate lyase or carbohydrase mixture on nutrient digestibility and gut health of weaned piglets.

Laminaria digitata is a brown seaweed rich in prebiotic polysaccharides, mainly laminarin, but its alginate-rich cell wall could compromise nutrient access. Carbohydrase supplementation, such as individual alginate lyase and carbohydrases mixture (Rovabio® Excel AP), could enhance nutrient digestibility and prebiotic potential. This study aimed to evaluate the effect of these enzymes on nutrient digestibility and gut health of weaned piglets fed with 10% L. digitata. Diets did not affect growth performance (P > 0.05). The majority of the feed fractions had similar digestibility across all diets, but the supplementation of alginate lyase increased hemicellulose digestibility by 3.3% compared to the control group (P = 0.047). Additionally, we observed that algal zinc was more readily available compared to the control group, even without enzymatic supplementation (P < 0.001). However, the increased digestibility of some minerals, such as potassium, raises concerns about potential mineral imbalance. Seaweed groups had a higher abundance of beneficial bacteria in colon contents, such as Prevotella, Oscillospira and Catenisphaera. Furthermore, the addition of alginate lyase led to a lower pH in the colon (P < 0.001) and caecum (P < 0.001) of piglets, which is possibly a result of released fermentable laminarin, and is consistent with the higher proportion of butyric acid found in these intestinal compartments. L. digitata is a putative supplement to enhance piglet gut health due to its prebiotic polysaccharides. Alginate lyase supplementation further improves nutrient digestibility and prebiotic potential. These results suggest the potential use of L. digitata and these enzymatic supplements in commercial piglet-feeding practices.

Bone Remodelling, Vitamin D Status, and Lifestyle Factors in Spanish Vegans, Lacto-Ovo Vegetarians, and Omnivores.

Sustainable healthy diets are promoted, and consequently vegetarian diets are currently increasing. However, scientific information on their effects on bone health is scarce. A cross-sectional study was performed in adults (66% women) classified into three groups: omnivores (n = 93), lacto-ovo vegetarians (n = 96), and vegans (n = 112). Nutrient intake, body composition, physical activity, vitamin D status (25-hydroxycholecalciferol, 25-OHD), parathormone (PTH), and bone formation (bone alkaline phosphatase, BAP) and resorption (N-telopeptides of type I collagen, NTx) markers were determined. Lacto-ovo vegetarians and especially vegans showed lower protein, fat, calcium, phosphorous, vitamin D, retinol, iodine, and zinc intakes, and higher carbohydrate, fibre, carotenes, magnesium, and vitamin K intakes compared to omnivores. Body composition was similar in the three groups that performed vigorous physical activity regularly. Body bone mass and muscle mass were positively correlated with BAP, and time performing physical activity with 25-OHD. The prevalence of vitamin D deficiency or insufficiency (25-OHD < 75 nmol/L) was 93.7% in the studied population, and vitamin D deficiency (25-OHD < 25 nmol/L) was significantly higher in vegans. Vegetarians of both groups had increased PTH and NTx with vegans showing significantly higher PTH and NTx than omnivores. Conclusion: Adult vegetarians, especially vegans, should reduce the risk of bone loss by appropriate diet planning and vitamin D supplementation.

Spanish Society of Anesthesiology, Reanimation and Pain Therapy (SEDAR), Spanish Society of Emergency and Emergency Medicine (SEMES) and Spanish Society of Otolaryngology, Head and Neck Surgery (SEORL-CCC) Guideline for difficult airway management. Part I.

The Airway Management section of the Spanish Society of Anesthesiology, Resuscitation, and Pain Therapy (SEDAR), the Spanish Society of Emergency Medicine (SEMES), and the Spanish Society of Otorhinolaryngology and Head and Neck Surgery (SEORL-CCC) present the Guide for the comprehensive management of difficult airway in adult patients. Its principles are focused on the human factors, cognitive processes for decision-making in critical situations, and optimization in the progression of strategies application to preserve adequate alveolar oxygenation in order to enhance safety and the quality of care. The document provides evidence-based recommendations, theoretical-educational tools, and implementation tools, mainly cognitive aids, applicable to airway management in the fields of anesthesiology, critical care, emergencies, and prehospital medicine. For this purpose, an extensive literature search was conducted following PRISMA-R guidelines and was analyzed using the GRADE methodology. Recommendations were formulated according to the GRADE methodology. Recommendations for sections with low-quality evidence were based on expert opinion through consensus reached via a Delphi questionnaire.

Spanish Society of Anesthesiology, Reanimation and Pain Therapy (SEDAR), Spanish Society of Emergency and Emergency Medicine (SEMES) and Spanish Society of Otolaryngology, Head and Neck Surgery (SEORL-CCC) Guideline for difficult airway management. Part II.

The Airway Management section of the Spanish Society of Anesthesiology, Resuscitation, and Pain Therapy (SEDAR), the Spanish Society of Emergency Medicine (SEMES), and the Spanish Society of Otorhinolaryngology and Head and Neck Surgery (SEORL-CCC) present the Guide for the comprehensive management of difficult airway in adult patients. Its principles are focused on the human factors, cognitive processes for decision-making in critical situations, and optimization in the progression of strategies application to preserve adequate alveolar oxygenation in order to enhance safety and the quality of care. The document provides evidence-based recommendations, theoretical-educational tools, and implementation tools, mainly cognitive aids, applicable to airway management in the fields of anesthesiology, critical care, emergencies, and prehospital medicine. For this purpose, an extensive literature search was conducted following PRISMA-R guidelines and was analyzed using the GRADE methodology. Recommendations were formulated according to the GRADE methodology. Recommendations for sections with low-quality evidence were based on expert opinion through consensus reached via a Delphi questionnaire.

A microalgae docosahexaenoic acid supplement does not modify the influence of sex and diet on iron status in Spanish vegetarians or omnivores: A randomized placebo-controlled crossover study.

OBJECTIVE: Plant-based diets are accepted as healthy, provided that are well-planned and include supplements. In this context, iron deficiency is a threat, and data from Spanish vegetarians are scarce. The aim of this study was to determine if a microalgae ω-3 supplement rich in docosahexaenoic acid (DHA) affected iron status in this population. METHODS: Iron biomarkers and nutrient intake (72-h dietary records) were analyzed in 204 usual consumers of lacto-ovo vegetarian (LOV), vegan (VEG), or omnivorous (OMN) diets. A randomized double-blind, placebo-controlled crossover trial was performed in a subgroup (n = 98) to test if a microalgae DHA supplement (250 mg/d for 5 wk) changed iron status. RESULTS: Iron intake was higher in vegetarians than omnivores (P= 0.002), fiber intake was highest in vegans followed by lacto-ovo vegetarians and omnivores, whereas calcium intake was lower in vegans than both lacto-ovo vegetarians and omnivores (all P < 0.001). Women, regardless of diet type, showed lower iron status than men. Erythrocytes, hemoglobin, hematocrit, and serum ferritin were lower in lacto-ovo vegetarians and vegans than omnivores. The prevalence of iron deficiency anemia was low (<10%), but iron depletion (ferritin <15 ng/mL) was higher in lacto-ovo vegetarians than omnivores (P = 0.003). Iron biomarkers were similar in lacto-ovo vegetarians and vegans. The DHA supplementation did not change iron status compared with placebo. CONCLUSIONS: Spanish vegetarians had lower iron status than omnivores. Consumption of eggs and dairy products increased the risk for iron deficiency, but a microalgae DHA supplement had no effect. Dietary strategies to increase iron bioavailability in vegetarians, particularly in lacto-ovo vegetarians and women, are recommended.

Metabolic and nutritional biomarkers in adults consuming lacto-ovo vegetarian, vegan and omnivorous diets in Spain. A cross-sectional study.

Knowledge on the characteristics of consumers who choose plant-based diets and the relationship with nutritional status and disease risk is needed. In the present study, 207 Spanish adults participated in a cross-sectional study, and were classified in three groups: lacto-ovo vegetarian (LOV), vegan (VEG), and omnivore (OMN). Dietary intake, anthropometry, body composition, haematology, and metabolic markers were evaluated. Body composition and body weight did not vary among groups. The majority of these adults performed moderate-vigorous physical activity, and LOV performed more moderate activity than OMN. Total energy intake (En) was similar in the three groups. However, cholesterol and fat intakes (%En) were higher in the order OMN, LOV, VEG, fibre and carbohydrate intakes showed the opposite trend, and protein intake (%En) was higher in OMN than both LOV and VEG (all p < 0.001). Systolic blood pressure (p = 0.04), erythrocytes (p < 0.001), and haematocrit (p < 0.001) were lower in LOV and VEG than OMN, and lymphocyte count was lower in LOV than OMN (p < 0.01). There were marked differences between groups in serum total-cholesterol and LDL-cholesterol that were lower in LOV and VEG than OMN (both p < 0.001). However, glucose, insulin and insulin resistance did not show group differences. Leptin and adiponectin were related with gender and body fat but not with diet. The inflammation marker interleukin-1ß was lower in LOV than OMN but TNF-α did not show differences. All levels were within normal ranges. Conclusion: consumption of plant-based diets compared to omnivorous diets in combination with moderate-high physical activity appears to protect similarly from cardiometabolic diseases in Spanish adults.

Changes in fatty acid levels after consumption of a novel docosahexaenoic supplement from algae: a crossover randomized controlled trial in omnivorous, lacto-ovo vegetarians and vegans.

PURPOSE: To determine serum fatty acids of lacto-ovo vegetarian (LOV), vegan (VEG) and omnivorous (OMN) adults, and to analyse the effects of consuming a docosahexaenoic acid (DHA) supplement of vegetable origin on fatty acid profile. METHODS: A randomized, double-blind, placebo-controlled crossover design was conducted in healthy adults. Volunteers (n = 116) were randomly assigned to a DHA-supplement (dose 250 mg/day), made from the microalgae Schizochytrium sp., or a placebo during 5-week periods separated by a 5-week washout interim period. Compliance and dietary intake were estimated and serum fatty acids were determined by gas chromatography. Results were analysed by mixed linear models. RESULTS: Percentage of linoleic acid (C18:2n6) in serum was the highest among the fatty acids in the three diet groups, followed by oleic (C18:1n9) and palmitic (C16:0) acids. Linoleic (C18:2n6) and alpha-linolenic (C18:3n3) acids were higher in VEG compared to OMN (p < 0.001), while in LOV, their levels were intermediate between the other groups. Women presented higher DHA (C22:6n3) than men (p < 0.001). The DHA-supplement increased serum DHA compared to placebo in the three diet groups (p < 0.001), and a higher increase was observed in VEG followed by LOV (p < 0.001). The ratio serum n-6/n-3 improved by the supplementation but remained higher in LOV and VEG than in OMN. In contrast, the DHA-supplement decreased docosapentaenoic (C22:5n3) and docosatetraenoic (C22:4n6) acids in all diet groups (p < 0.001) and increased the eicosapentaenoic to alpha-linolenic fatty acids ratio (p = 0.016). CONCLUSION: The DHA-supplement at dose of 250 mg/day was effective in increasing serum DHA either in omnivorous, lacto-ovo vegetarian and vegan adults. CLINICAL TRIAL REGISTRATION: Registered at Clinicaltrials.gov ( www. CLINICALTRIALS: gov ), NCT04278482.

The integrin beta1 modulator Tirofiban prevents adipogenesis and obesity by the overexpression of integrin-linked kinase: a pre-clinical approach in vitro and in vivo.

BACKGROUND: Obesity is caused by the enlargement of the white adipose tissue (WAT) depots, characterized by the hypertrophic enlargement of malfunctioning adipocytes within WAT which increases the storage of triglycerides (TG) in the lipid droplets (LD). Adipogenesis pathways as well as the expression and activity of some extracellular matrix receptors integrins are upregulated. Integrinß1 (INTB1) is the main isoform involved in WAT remodeling during obesity and insulin resistance-related diseases. We recently described Integrin Linked Kinase (ILK), a scaffold protein recruited by INTB1, as an important mediator of WAT remodeling and insulin resistance. As the few approved drugs to fight obesity have brought long-term cardiovascular side effects and given that the consideration of INTB1 and/or ILK modulation as anti-obesogenic strategies remains unexplored, we aimed to evaluate the anti-obesogenic capacity of the clinically approved anticoagulant Tirofiban (TF), stated in preclinical studies as a cardiovascular protector. METHODS: Fully differentiated adipocytes originating from C3H10T1/2 were exposed to TF and were co-treated with specific INTB1 blockers or with siRNA-based knockdown ILK expression. Lipid-specific dyes were used to determine the TG content in LD. The genetic expression pattern of ILK, pro-inflammatory cytokines (MCP1, IL6), adipogenesis (PPARγ, Leptin), thermogenesis (UCP1), proliferation (PCNA), lipid metabolism (FASN, HSL, ATGL), and metabolite transporters (FABP4, FAT, AQP7) were detected using quantitative PCR. Cytoskeletal actin polymerization was detected by confocal microscopy. Immunoblotting was performed to detect INTB1 phosphorylation at Thr788/9 and ILK activity as phosphorylation levels of protein kinase B (AKT) in Ser473 and glycogen synthase kinase 3ß (GSK3ß) at Ser9. TF was intraperitoneally administered once per day to wildtype and ILK knockdown mice (cKDILK) challenged with a high-fat diet (HFD) or control diet (STD) for 2 weeks. Body and WAT weight gains were compared. The expression of ILK and other markers was determined in the visceral epididymal (epi) and inguinal subcutaneous (sc) WAT. RESULTS: TF reduced TG content and the expression of adipogenesis markers and transporters in adipocytes, while UCP-1 expression was increased and the expression of lipases, cytokines or PCNA was not affected. Mechanistically, TF rapidly increased and faded the intracellular phosphorylation of INTB1 but not AKT or GSK3ß. F-actin levels were rapidly decreased, and INTB1 blockade avoided the TF effect. After 24 h, ILK expression and phosphorylation rates of AKT and GSK3ß were upregulated, while ILK silencing increased TG content. INTB1 blockade and ILK silencing avoided TF effects on the TG content and the transcriptional expression of PPARγ and UCP1. In HFD-challenged mice, the systemic administration of TF for several days reduced the weight gain on WAT depots. TF reduced adipogenesis and pro-inflammatory biomarkers and increased lipolysis markers HSL and FAT in epiWAT from HFD, while increased UCP1 in scWAT. In both WATs, TF upregulated ILK expression and activity, while no changes were observed in other tissues. In HFD-fed cKDILK, the blunted ILK in epiWAT worsened weight gain and avoided the anti-obesogenic effect of in vivo TF administration. CONCLUSIONS: ILK downregulation in WAT can be considered a biomarker of obesity establishment. Via an INTB1-ILK axis, TF restores malfunctioning hypertrophied WAT by changing the expression of adipocyte-related genes, increasing ILK expression and activity, and reducing TG storage. TF prevents obesity, a property to be added to its anticoagulant and cardiovascular protective advantages.

Benefica chirurgia. A global surgery project focusing on hernia surgery.

BACKGROUND: The aim of international health cooperation projects is to alleviate the deficiencies in the area of health in low resource settings. Hernia surgery is a procedure that is well suited to these missions, due to its low morbidity, the fact that it can be performed on an outpatient basis, and the improvement in quality of life that it provides. OBJECTIVE: To describe the results of Benefica Chirurgia (BC), a Spanish non-profit humanitarian association in hernia pathology. METHODS: Five one-week surgical campaigns were carried out in Ecuador between 2015 and 2019, involving anesthetists, general and pediatric surgeons. Surgical and medical equipment was provided and transported by BC. ASA I/II patients underwent surgery. RESULTS: Surgery was performed on 240 patients with hernia pathology on 27 days. Sixty-three per cent of patients were male and the mean age was 48.2 years (range: 1-83). Hernia location was inguinal in 113 patients, umbilical in 101, and other in 26. The anesthetic technique used was spinal in 185 patients (77.1%), local plus intravenous sedation in 31 (12.9%), and general in 24 (10%). The surgical technique used was hernioplasty in 191 patients, herniorrhaphy in 31, incisional hernia repair in 15 and herniotomy in three. Surgery was performed on an outpatient basis in 98.4% of cases. Morbidity was 2%. Long-term postoperative evaluation is very complex. CONCLUSION: These campaigns make a significant contribution to health in low resource settings and provide great personal satisfaction for those involved. Standards achieved in the immediate postoperative period were similar to those obtained at the surgeons' centers in Europe. However, it is difficult to establish the rates of recurrence and chronic pain.

Association between antibiotic pressure and the risk of colonization/infection by multidrug-resistant Acinetobacter baumannii complex: a time series analysis.

OBJECTIVE: To analyze the association between antibiotic pressure and the risk of colonization/infection by Acinetobacter baumannii complex (AB), evaluating both the individual and general prescriptions of antibiotics. METHODS: This is an analytical, observational, case-control study on patients admitted to an Intensive Care Unit (ICU) during an AB outbreak (14 months). A five-year time series was constructed with the monthly incidence of cases of infection/colonization with strains of AB resistant to each antibiotic administered and with the monthly consumption of these antibiotics in the ICU. RESULTS: We identified 40 patients either infected (23) or colonized (17) by AB and 73 controls. We found an epidemic multidrug-resistant clone of AB in 75% of cases. Risk factors associated with the development of AB infection/colonization were: greater use of medical instruments, the presence of a tracheostomy, cutaneous ulcers, surgical lesions and prior antibiotic therapies. The regression analysis of individual use of antibiotics showed that prior treatment with ceftazidime, ceftriaxone, amoxicillin/clavulanate, imipenem, levofloxacin, linezolid, and vancomycin was a risk factor for acquiring AB. ARIMA models showed that the relationship were greatest and statistically significant when the treatment occurred between 6 months (ceftazidime) and 9 months (imipenem and levofloxacin) prior. CONCLUSIONS: The dynamic and aggregate relationship between the incidence of infection/colonization by multidrug-resistant strains of AB and prior antibiotic treatment was statistically significant for intervals of 6 to 9 months.

Ratio de sexo en la descendencia de futbolistas profesionales: estudio preliminar / Sex ratio in the offspring of professional soccer players: preliminary study / Proporção sexual em filhos de jogadores profissionais de futebol: estudo preliminar

OBJETIVO: Analizar si el entrenamiento de alta carga de los deportistas masculinos de élite puede influir en la proporción de sexo de sus descendientes. MÉTODO: Diseño observacional, descriptivo y transversal. Participaron 15 futbolistas, siendo condición necesaria que en el momento del estudio se encontrasen deportivamente activos, sin problemas de fertilidad y con descendencia. Las variables de estudio fueron el sexo de la descendencia, el número de hijos y el orden de nacimiento, y cargas de volumen e intensidad. El análisis estadístico consistió en relacionar las variables de carga, volumen e intensidad de ejercicio físico, con el sexo de los hijos, a través de la prueba de Ji cuadrado, teniendo en cuenta un nivel de significación p < 0.05. RESULTADOS: La descendencia fue de 28 hijos (13 niños, 15 niñas). El análisis de volumen e intensidad no reflejó diferencias significativas en la proporción niño/niña (p = 0.935; p = 0.296 respectivamente). En cambio, dentro de la población de niñas nacidas se observaron más nacimientos como consecuencia del entrenamiento de alta intensidad (p = 0.037). CONCLUSIONES: Este es el primer artículo hasta la fecha que evalúa la influencia del ejercicio físico de alta carga sobre el sexo de la descendencia de varones deportistas. Pese a que el número de niñas no ha sido significativamente mayor al de niños, se observa mayor número de niñas nacidas cuando el entrenamiento es de alta intensidad

OBJECTIVE: To analyze whether the high load training of elite male athletes can influence the sex ratio of their offspring. METHOD: Observational, descriptive cross-sectional study. Fifteen male soccer players participated from the study according to the following criteria at the time of the study: being engaged in sports practice and competition, no fertility issues and live offspring. The study variables were the sex of the offspring, the number of children and the order of birth, and volume and intensity loads. The statistical analysis consisted in relating the variables of volume and intensity load with frequency tables by means of the Chi square test, with margin of error p <0.05. RESULTS: The offspring was 28 children (13 boys, 15 girls). Volume and intensity analysis did not show significant differences in the boy/girl ratio (p = 0.935, p = 0.296 respectively). In contrast, within the population of girls, more births were observed as a consequence of high intensity training (p = 0.037). CONCLUSIONS: This is the first article to date that assesses the influence of high-load physical exercise on the sex of the offspring of male athletes. Although the number of girls has not been significantly greater than that of boys, there is a greater number of girls born when the training is of high intensity

OBJETIVO: Analisar se o treinamento de alta carga de atletas de elite do sexo masculino pode influenciar na proporção sexual de seus descendentes. MÉTODO: Estudo observacional, transversal e descritivo. Quinze jogadores de futebol do sexo masculino participaram do estudo de acordo com os seguintes critérios na época do estudo: estar envolvido na prática de esportes e competição, sem problemas de fertilidade e prole viva. As variáveis de estudo foram o sexo da prole, o número de filhos e a ordem de nascimento e as cargas de volume e intensidade. A análise estatística consistiu em relacionar as variáveis de volume e intensidade da carga com tabelas de frequência por meio do teste Qui-quadrado, com margem de erro p <0,05. RESULTADOS: A prole foi de 28 crianças (13 meninos e 15 meninas). A análise de volume e intensidade não mostrou diferenças significativas na relação menino / menina (p = 0,935, p = 0,296 respectivamente). Por outro lado, na população de meninas, mais nascimentos foram observados como consequência do treinamento de alta intensidade (p = 0,037). CONCLUSÕES: Este é o primeiro artigo até o momento que avalia a influência do exercício físico de alta carga sobre o sexo de filhos de atletas do sexo masculino. Embora o número de meninas não tenha sido significativamente maior que o de meninos, há um maior número de meninas nascidas quando o treinamento é de alta intensidade

Foods for Plant-Based Diets: Challenges and Innovations.

Plant-based diets have become popular as a means of reducing the environmental footprint of the diet and promoting human health and animal welfare. Although the percentages of vegetarians and vegans are low compared to omnivores, their numbers have increased significantly in the last years. The use of non-animal food products other than meat alternatives is also increasing and this tendency constitutes an opportunity for the food industry. In this review, we present that plant-based meat and milk alternatives are consolidated but that there is a niche for egg, seafood alternatives, and new products which may not resemble any traditional animal food. However, not all animal food substitutes are sustainable and some of them are even ultra-processed. In addition, there are concerns on safety and labeling, and consumers demand clear information and regulation. The challenges in this field are connected with food design and technology, sensory science, nutrition, and dietetics. Moreover, adequate selection and combination of foods is important in order to achieve consumer acceptance while preventing nutritional deficiencies in those who choose this type of diet.

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.

Acute supplementation with grapes in obese subjects did not affect postprandial metabolism: a randomized, double-blind, crossover clinical trial.

PURPOSE: The aim of this study was to determine whether grape polyphenols have a "second-meal effect", modulating glucose and lipid elevations in the postprandial period after two successive meals in subjects with obesity. METHODS: A randomized, double-blind, placebo-controlled, acute clinical trial was conducted. Twenty-five obese subjects (BMI = ≥ 30 and < 40 kg/m2) were randomly divided into two groups. At an initial visit, blood was collected in a fasting state and the subjects received breakfast and 46 g of either grape powder (equivalent to 252 g fresh grapes) or placebo, both solved in water. Lunch was provided 5 h later and then blood was collected after 0, 30, 60, 120, 180, 240, 300, 330, 360, and 420 min since arrival. Two weeks later, at a second visit, the subjects received the other powder. The following were determined: glucose, insulin, triglycerides, uric acid, blood count, hemoglobin, viscosity, antioxidant capacity, and satiety perception. RESULTS: Postprandial increases were observed as expected in, for example, glucose and triglycerides after breakfast and lunch. The grape powder supplementation did not cause any significant modification compared to placebo, in these parameters; nor did it significantly modify plasma antioxidant capacity in the 6 h postprandial period. DISCUSSION: Single grape powder supplementation did not modify postprandial responses in obese subjects, probably because the polyphenol dose was insufficient to induce such an effect. The result of a combination of grape with other polyphenol-rich products or chronic supplementation with grape powder on postprandial responses remains to be elucidated. TRIAL REGISTRATION NUMBER: www.clinicaltrials.gov , NCT03741218.

Individual participant data (IPD)-level meta-analysis of randomised controlled trials with vitamin D-fortified foods to estimate Dietary Reference Values for vitamin D.

CONTEXT AND PURPOSE: Individual participant data-level meta-regression (IPD) analysis is superior to meta-regression based on aggregate data in determining Dietary Reference Values (DRV) for vitamin D. Using data from randomized controlled trials (RCTs) with vitamin D3-fortified foods, we undertook an IPD analysis of the response of winter serum 25-hydroxyvitamin (25(OH)D) to total vitamin D intake among children and adults and derived DRV for vitamin D. METHODS: IPD analysis using data from 1429 participants (ages 2-89 years) in 11 RCTs with vitamin D-fortified foods identified via a systematic review and predefined eligibility criteria. Outcome measures were vitamin D DRV estimates across a range of serum 25(OH)D thresholds using unadjusted and adjusted models. RESULTS: Our IPD-derived estimates of vitamin D intakes required to maintain 97.5% of winter 25(OH)D concentrations ≥ 25 and ≥ 30 nmol/L are 6 and 12 µg/day, respectively (unadjusted model). The intake estimates to maintain 90%, 95% and 97.5% of concentrations ≥ 50 nmol/L are 33.4, 57.5 and 92.3 µg/day, respectively (unadjusted) and 17.0, 28.1 and 43.6 µg/day, respectively (adjusted for mean values for baseline serum 25(OH)D, age and BMI). CONCLUSIONS: IPD-derived vitamin D intakes required to maintain 90%, 95% and 97.5% of winter 25(OH)D concentrations ≥ 50 nmol/L are much higher than those derived from standard meta-regression based on aggregate data, due to the inability of the latter to capture between person-variability. Our IPD provides further evidence that using food-based approaches to achieve an intake of 12 µg/day could prevent vitamin D deficiency (i.e., serum 25(OH)D < 30 nmol/L) in the general population.

Signs of early cellular dysfunction in multiple system atrophy.

AIMS: Multiple system atrophy (MSA) is a fatal neurodegenerative disease that belongs to the family of α-synucleinopathies. At post mortem examination, intracellular inclusions of misfolded α-synuclein are found in neurons and oligodendrocytes and are considered to play a significant role in the pathogenesis. However, the early steps of the disease process are unknown and difficult to study in tissue derived from end-stage disease. METHODS: Induced pluripotent stem cells (iPSCs) were generated from patients' and control skin fibroblasts and differentiated into NCAM-positive neural progenitor cells (NPCs). The mitochondrial morphology and function were assessed by immunocytochemistry and high resolution respirometry. The ability to cope with exogenous oxidative stress was tested by exposure to different doses of luperox. The expression of α-synuclein was studied by immunocytochemistry. RESULTS: We identified increased tubulation of mitochondria with preserved respiration profile in MSA-derived NPCs. Exposure of these cells to exogenous oxidative stress even at low doses, triggered an excessive generation of reactive oxygen species (ROS) and cleavage of caspase-3. MSA-derived NPCs did not present changed levels of SNCA gene expression nor intracellular aggregates of α-synuclein. However, we identified disease-related translocation of α-synuclein to the nucleus. CONCLUSIONS: Our results show early cellular dysfunction in MSA-derived NPCs. We identified changes in the redox homeostasis which are functionally compensated at baseline but cause increased susceptibility to exogenous oxidative stress. In addition, nuclear translocation of α-synuclein in MSA-derived NPCs supports an early cellular stress response which may precede the neurodegenerative process in this disorder.

Birth sex ratio in the offspring of professional male soccer players: influence of exercise training load.

STUDY QUESTION: Can the exercise training load of elite male athletes influence the sex ratio of their offspring? SUMMARY ANSWER: This is the first study assessing the influence of exercise training load on the offspring sex ratio of children from male professional athletes, observing a bias toward more females being born as a result of both high-intensity and high-volume loads, with intensity having the greatest effect. WHAT IS KNOWN ALREADY: There is a relatively constant population sex ratio of males to females among various species; however, certain events and circumstances may alter this population sex ratio favoring one sex over the other. STUDY DESIGN, SIZE, DURATION: Observational, descriptive cross-sectional study with a duration of 3 months. PARTICIPANTS/MATERIALS, SETTING, METHODS: Seventy-five male professional soccer players from First Division soccer teams. Offspring variables were sex of the offspring, number of children and order of birth. Exercise training variables were volume and intensity. MAIN RESULTS AND THE ROLE OF CHANCE: Total offspring was 122 children (52 males (42.6%), 70 females (57.4%)). Analysis revealed that increase in either the volume (P < 0.001) or intensity (P < 0.001) of training by the players shifted the birth offspring ratio more toward females. Within the sample of females born, more births (i.e. number) were observed as a consequence of training at the highest intensity (45 out of 70; P < 0.001), no such pattern occurred within males (P > 0.05). When female versus male births were compared within each intensity, only the high-intensity comparison was significant (45 (75%) females vs 15 (25%) males, P < 0.001). LIMITATIONS, REASONS FOR CAUTION: While this is the first study assessing differences in the sex ratio of the offspring of male athletes (i.e. soccer players), we acknowledge there are limitations and confounders within our approach; e.g. small sample size, ethnic background and variations in the timing of intercourse relative to ovulation as well as in sex hormone levels. As such, we propose that future research is needed to confirm or refute our findings. It is recommended that such work expand on the measurements obtained and conduct direct assessment of sperm characteristics. WIDER IMPLICATIONS OF THE FINDINGS: The findings of the study support the fact that different stressors on the body may alter the sex of the offspring. While in the present study the stressor is the excessive training load of soccer players, other events may lead to similar results. The bias in offspring sex ratio may have important implications for demography and population dynamics, as well as genetic trait inheritance. STUDY FUNDING/COMPETING INTEREST(S): There is no funding nor competing interests. TRIAL REGISTRATION NUMBER: N/A.

Innovative processing strategies and technologies to obtain hydrocolloids from macroalgae for food applications.

The macroalgal hydrocolloid industry is a rapidly growing industry with an annual growth in the global production of 2-3 %. Hydrocolloids from macroalgae are mainly in the form of polysaccharides with other nutrients, such as vitamins, minerals, and proteins. Due to its potential industrial applications, macroalgae have been used as raw materials for hydrocolloids extraction. Compared to the conventional extraction methods, emerging innovative assisted extraction technologies (e.g., Ultrasound/Microwave assisted extraction) have been developed to maximise the extraction yields, efficiency and thereby, maintaining sustainability along the process. These novel techniques are considered as clean and green strategies, with a potential for a large-scale production; thus, avoiding or reducing the use of chemicals. However, more research is required to establish their mechanism of action in order to finally implement them at industrial level. This paper reviews the most relevant strategies and technologies involved in the production of hydrocolloids from macroalgae.

Relationship between iron status markers and insulin resistance: an exploratory study in subjects with excess body weight.

BACKGROUND: Controversy exists on the relationship between iron metabolism and cardiometabolic risk. The aim of this study was to determine if there is a link between dysmetabolic iron and cardiometabolic markers in subjects with excess body weight. METHODS: Cross-sectional study with fifty participants presenting overweight or obesity and at least another metabolic syndrome factor. Determinations: anthropometry, body composition, blood pressure, lipids, glucose, insulin, leptin, areas under the curve (AUC) for glucose and insulin after an oral glucose tolerance test, hs-C reactive protein (hs-CRP), blood count, ferritin, transferrin, transferrin saturation (TSAT), soluble transferrin receptor (sTfR). Gender-adjusted linear correlations and two independent samples t tests were used. RESULTS: Ferritin was positively correlated with insulin-AUC (r = 0.547, p = 0.008) and TSAT was negatively correlated with waist-hip ratio (r =  - 0.385, p = 0.008), insulin (r =  - 0.551, p < 0.001), and insulin resistance (HOMA-IR, r =  - 0.586, p < 0.001). Subjects with TSAT ≤ 20% had higher insulin (p = 0.012) and HOMA-IR (p = 0.003) compared to those with TSAT > 20%. In conclusion, the observed results suggest that iron transport and storage are altered in subjects with overweight/obesity, at the same time that they exhibit the characteristic features of insulin resistance. Nevertheless, this occurs without iron overload or deficiency. These results should be validated in wider cohorts since they suggest that iron transport and storage should be assessed when performing the clinical evaluation of subjects with excess body weight.