Effects of Gluten on Gut Microbiota in Patients with Gastrointestinal Disorders, Migraine, and Dermatitis.

As gluten may trigger gastrointestinal disorders (GIDs), its presence or absence in the diet can change the diversity and proportion of gut microbiota. The effects of gluten after six weeks of a double-blind, placebo-controlled intervention with a gluten-free diet (GFD) were studied in participants with GIDs suffering from migraines and atopic dermatitis (n = 46). Clinical biomarkers, digestive symptoms, stool, the Migraine Disability Assessment questionnaire, and zonulin levels were analyzed. Next-generation sequencing was used to amplify the 16S rRNA gene of bacteria and the internal transcribed spacer (ITS) regions of fungi. The GFD increased Chao1 fungal diversity after the intervention, while the fungal composition showed no changes. Bacterial diversity and composition remained stable, but a positive association between bacterial and fungal Chao1 diversity and a negative association between Dothideomycetes and Akkermansia were observed. GIDs decreased in both groups and migraines improved in the placebo group. Our findings may aid the development of GID treatment strategies.

Effect of MetioNac® in patients with metabolic syndrome who are at risk of metabolic dysfunction associated fatty liver disease: a randomized controlled trial / Efecto de MetioNac® en pacientes con síndrome metabólico que están en riesgo de padecer enfermedad de hígado graso asociado a disfunción metabólica: un estudio controlado aleatorizado

Introduction: metabolic syndrome comprises a combination of diabetes, high blood pressure, and obesity, and metabolic associated fatty liver disease (MAFLD) is associated with it. Objective: to evaluate the effect of supplementation with S-adenosyl-L-methionine + N-acetylcysteine + thioctic acid + vitamin B6 (MetioNac®) for 3 months on lipidic and biochemical parameters in subjects with metabolic syndrome and at risk of MAFLD. The reduction in body weight and the oxidative stress markers malondialdehyde (MDA) and superoxide dismutase (SOD) were also evaluated. Methods: patients with metabolic syndrome, at risk of MAFLD (FIB-4 < 1.30), and with an indication for weight reduction were recruited (n = 15). Control group followed a semipersonalized Mediterranean diet (MD) for weight reduction, according to the recommendations of the Spanish Society for the Study of Obesity (SEEDO). Experimental group, in addition to the MD, took three capsules of MetioNac® supplement per day. Results: compared with the control group, subjects taking MetioNac® showed significant (p < 0.05) reductions in the levels of TG and VLDL-c, as well as in total cholesterol, LDL-c, and glucose levels. They also showed increased levels of HDL-c. Levels of AST and ALT decreased after the intervention with MetioNac®, but this decrease did not reach statistical significance. Weight loss was observed in both groups. Conclusion: supplementation with MetioNac® may be protective against hyperlipidemia, insulin resistance, and overweight among metabolic syndrome patients. Further studies on this issue are needed in a larger population.(AU)

Introducción: el síndrome metabólico se define como una combinación de diabetes, hipertensión arterial y obesidad, que se asocia con laenfermedad del hígado graso asociada a disfunción metabólica.Objetivo: evaluar el efecto de la suplementación con S-adenosil-L-metionina + N-acetilcisteína + ácido tióctico + vitamina B6 (MetioNac®)durante 3 meses sobre parámetros lipídicos y bioquímicos en sujetos con síndrome metabólico y en riesgo de enfermedad del hígado grasoasociada a disfunción metabólica. También se evaluaron la reducción del peso corporal y los marcadores de estrés oxidativo malondialdehído(MDA) y superóxido dismutasa (SOD).Métodos: se reclutaron pacientes con síndrome metabólico, riesgo de enfermedad del hígado graso asociada a disfunción metabólica (FIB-4 < 1,30) y con indicación de reducción de peso (n = 15). El grupo control siguió una dieta mediterránea (DM) semipersonalizada para la reducciónde peso, de acuerdo con las recomendaciones de la Sociedad Española para el Estudio de la Obesidad (SEEDO). El grupo intervención, ademásde la DM, tomó tres cápsulas diarias de MetioNac®.Resultados: en comparación con el grupo de control, los sujetos que tomaron MetioNac® mostraron reducciones significativas (p < 0.05) en losniveles de TG y VLDL-c, así como en los niveles de colesterol total, LDL-c y glucosa. También mostraron niveles elevados de HDL-c. Los nivelesde AST y ALT disminuyeron después de la intervención con MetioNac®, pero esta disminución no fue estadísticamente significativa. También seobservó una pérdida de peso en ambos grupos.Conclusión: la suplementación con MetioNac® puede proteger contra la hiperlipidemia, la insulinorresistencia y el sobrepeso en pacientes consíndrome metabólico. Sin embargo, es necesario realizar más estudios y seleccionar un mayor número de participantes.(AU)

Effect of MetioNac® in patients with metabolic syndrome who are at risk of metabolic dysfunction associated fatty liver disease: a randomized controlled trial.

Introduction: Introduction: metabolic syndrome comprises a combination of diabetes, high blood pressure, and obesity, and metabolic associated fatty liver disease (MAFLD) is associated with it. Objective: to evaluate the effect of supplementation with S-adenosyl-L-methionine + N-acetylcysteine + thioctic acid + vitamin B6 (MetioNac®) for 3 months on lipidic and biochemical parameters in subjects with metabolic syndrome and at risk of MAFLD. The reduction in body weight and the oxidative stress markers malondialdehyde (MDA) and superoxide dismutase (SOD) were also evaluated. Methods: patients with metabolic syndrome, at risk of MAFLD (FIB-4 < 1.30), and with an indication for weight reduction were recruited (n = 15). Control group followed a semipersonalized Mediterranean diet (MD) for weight reduction, according to the recommendations of the Spanish Society for the Study of Obesity (SEEDO). Experimental group, in addition to the MD, took three capsules of MetioNac® supplement per day. Results: compared with the control group, subjects taking MetioNac® showed significant (p < 0.05) reductions in the levels of TG and VLDL-c, as well as in total cholesterol, LDL-c, and glucose levels. They also showed increased levels of HDL-c. Levels of AST and ALT decreased after the intervention with MetioNac®, but this decrease did not reach statistical significance. Weight loss was observed in both groups. Conclusion: supplementation with MetioNac® may be protective against hyperlipidemia, insulin resistance, and overweight among metabolic syndrome patients. Further studies on this issue are needed in a larger population.

Introducción: Introducción: el síndrome metabólico se define como una combinación de diabetes, hipertensión arterial y obesidad, que se asocia con la enfermedad del hígado graso asociada a disfunción metabólica. Objetivo: evaluar el efecto de la suplementación con S-adenosil-L-metionina + N-acetilcisteína + ácido tióctico + vitamina B6 (MetioNac®) durante 3 meses sobre parámetros lipídicos y bioquímicos en sujetos con síndrome metabólico y en riesgo de enfermedad del hígado graso asociada a disfunción metabólica. También se evaluaron la reducción del peso corporal y los marcadores de estrés oxidativo malondialdehído (MDA) y superóxido dismutasa (SOD). Métodos: se reclutaron pacientes con síndrome metabólico, riesgo de enfermedad del hígado graso asociada a disfunción metabólica (FIB-4 < 1,30) y con indicación de reducción de peso (n = 15). El grupo control siguió una dieta mediterránea (DM) semipersonalizada para la reducción de peso, de acuerdo con las recomendaciones de la Sociedad Española para el Estudio de la Obesidad (SEEDO). El grupo intervención, además de la DM, tomó tres cápsulas diarias de MetioNac®. Resultados: en comparación con el grupo de control, los sujetos que tomaron MetioNac® mostraron reducciones significativas (p < 0.05) en los niveles de TG y VLDL-c, así como en los niveles de colesterol total, LDL-c y glucosa. También mostraron niveles elevados de HDL-c. Los niveles de AST y ALT disminuyeron después de la intervención con MetioNac®, pero esta disminución no fue estadísticamente significativa. También se observó una pérdida de peso en ambos grupos. Conclusión: la suplementación con MetioNac® puede proteger contra la hiperlipidemia, la insulinorresistencia y el sobrepeso en pacientes con síndrome metabólico. Sin embargo, es necesario realizar más estudios y seleccionar un mayor número de participantes.

Existing differences between available lists of FODMAP-containing foods.

BACKGROUND AND AIM: reduced intake of fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) is useful to treat functional gastrointestinal disorders. However, there is no consensus on which foods should be included in the FODMAP list as FODMAP profile characterization is lacking for many different foods. This study aimed to emphasize the need for a unified FODMAP list to prevent patient confusion. We hypothesized that FODMAP lists do not include all products that may contain high levels of FODMAPs. METHODS: PubMed, ScienceDirect, Scielo, and Cochrane were searched to identify food composition tables, reviews, food analysis publications, laboratory analyses, and clinical trials containing FODMAP lists. RESULTS: of 1,308 articles identified, 10 were selected; 22.6 % of the 204 foods listed were classified differently among studies. This included almonds, avocados, banana, broccoli, soft cheese, eggplant, and walnuts. Nutritional guidance may be taken from existing FODMAP-related literature, but the information given is not always consistent. CONCLUSION: Unvarying lists of low FODMAP foods should be compiled to provide patients with accurate information on FODMAP dieting.

Existing differences between available lists of FODMAP-containing foods

Background and aim: reduced intake of fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) is useful to treat functional gastrointestinal disorders. However, there is no consensus on which foods should be included in the FODMAP list as FODMAP profile characterization is lacking for many different foods. This study aimed to emphasize the need for a unified FODMAP list to prevent patient confusion. We hypothesized that FODMAP lists do not include all products that may contain high levels of FODMAPs. Methods: PubMed, ScienceDirect, Scielo, and Cochrane were searched to identify food composition tables, reviews, food analysis publications, laboratory analyses, and clinical trials containing FODMAP lists. Results: of 1,308 articles identified, 10 were selected; 22.6 % of the 204 foods listed were classified differently among studies. This included almonds, avocados, banana, broccoli, soft cheese, eggplant, and walnuts. Nutritional guidance may be taken from existing FODMAP-related literature, but the information given is not always consistent. Conclusion: Unvarying lists of low FODMAP foods should be compiled to provide patients with accurate information on FODMAP dieting (AU)

Knowledge and attitudes towards baby-led-weaning by health professionals and parents: A cross-sectional study.

OBJECTIVE: Baby-led-weaning (BLW) is a novel model of complementary feeding. Although there is little scientific evidence to support the suitability or superiority of this complementary feeding model, BLW is followed by many families today. The aim was to evaluate the knowledge and attitudes of a group of parents and health professionals regarding BLW in Spain. METHODS: This research was designed as a cross-sectional study in a sample of 502 parents and 364 health professionals. Two questionnaires generated and disseminated through Google forms were used. The differences between groups of professionals were analyzed using the Chi-Square test. RESULTS: 92.3% of professionals and 93.4% of parents knew about BLW. They recommend BLW "always" in 39.8% and 69.3% of the cases, and "sometimes" in 49.7% and 24.9%, respectively. Of the health professionals, 80.5% recommended starting complementary feeding as of six months, 36% of them using BLW, 24% followed traditional weaning, 3.3% bottle feeding and the remaining 36% did not indicate. Eighty-three percent recommended chewing as soon as the child showed interest. CONCLUSION: Both health professionals and parents recommend BLW and consider it helps promote the developmental milestones of the baby. Providing nurses with an adequate number of resources to guide parents on complementary feeding will continue to improve childcare.

Bioavailability of magnesium food supplements: A systematic review.

OBJECTIVES: The market for food supplements is booming thanks to their increased consumption. European regulations include different ways in which vitamins and minerals are administered, without making it clear to the consumer whether one formulation has advantages over the other. The aim of this review was to compare the bioavailability of different forms of magnesium and analyze the differences between them. METHODS: Based on a PICO (population, intervention, comparison, outcome) research question, a search strategy was established for magnesium bioavailability studies comparing different forms in the PubMed, Cochrane, Web of Science, and Scopus databases. We found 433 studies, out of which 14 were finally selected. RESULTS: Inorganic formulations appear to be less bioavailable than organic ones, and the percentage of absorption is dose dependent. CONCLUSIONS: All magnesium dietary supplements can maintain physiological levels in healthy people without prior deficit, although this cannot be assured in older people or those with illnesses or previous subphysiological levels.

Knowledge and attitudes towards baby-led-weaning by health professionals and parents: A cross-sectional study.

OBJECTIVE: Baby-led-weaning (BLW) is a novel model of complementary feeding. Although there is little scientific evidence to support the suitability or superiority of this complementary feeding model, BLW is followed by many families today. The aim was to evaluate the knowledge and attitudes of a group of parents and health professionals regarding BLW in Spain. METHODS: This research was designed as a cross-sectional study in a sample of 502 parents and 364 health professionals. Two questionnaires generated and disseminated through Google forms were used. The differences between groups of professionals were analyzed using the Chi-Square test. RESULTS: 92.3% of professionals and 93.4% of parents knew about BLW. They recommend BLW "always" in 39.8% and 69.3% of the cases, and "sometimes" in 49.7% and 24.9%, respectively. Of the health professionals, 80.5% recommended starting complementary feeding as of six months, 36% of them using BLW, 24% followed traditional weaning, 3.3% bottle feeding and the remaining 36% did not indicate. Eighty-three percent recommended chewing as soon as the child showed interest. CONCLUSION: Both health professionals and parents recommend BLW and consider it helps promote the developmental milestones of the baby. Providing nurses with an adequate number of resources to guide parents on complementary feeding will continue to improve childcare.

This is not just any FODMAP diet: Hispanic adaptation of the FODMAP diet and a reintroduction guide / Esta no es una dieta FODMAP cualquiera: adaptación hispana de la dieta FODMAP y una guía de reintroducción

Short-chain carbohydrates and sugar alcohols are poorly absorbed in the small intestine and rapidly fermented by bacteria. Fermentable oligo-, di-, monosaccharides and polyols (FODMAP) content of a wide range of foods has been measured. However, the list of foods allowed, as well as the quantities of FODMAP each food differ between studies, making the management of the low FODMAP diet difficult.The aim of this research was to propose a FODMAP diet guide culturally adapted to different Hispanic countries for dietitians-nutritionists and nutrition experts, to facilitate the management of patients who benefit from this diet.A consortium of FODMAP diet experts was created among Spanish-speaking countries. Dieticians from 11 Latin American countries (Argentina, Colombia, Ecuador, El Salvador, Guatemala, Honduras, Mexico, Panama, Peru, Uruguay and Venezuela) and Spain elaborated a low FODMAP diet adjusted each to the gastronomic culture of their own country. They also created a list of foods to be reintroduced in phase 2 (or reintroduction phase) of the FODMAP diet, along with typical recipes from the country.Twelve low FODMAP diets with their corresponding reintroduction phase were designed, each adapted to the commonly consumed foods and recipes of each country. The adaptation of the diet to local gastronomy is pertinent, as it may increase the likelihood of durable adherence and better response to symptomatology.There are limitations in developing tables of FODMAP-rich and FODMAP-poor foods. The cut-off levels of FODMAP content are not clearly defined. More studies are needed to reach a unified consensus, as inconsistency in the data provided between studies has been found in relation to the FODMAP diet.(AU)

Los carbohidratos de cadena corta y los alcoholes de azúcar se absorben mal en el intestino delgado y las bacterias los fermentan rápidamente. Se ha medido el contenido de oligo, di, monosacáridos y polioles fermentables (FODMAP) de una amplia gama de alimentos. Sin embargo, la lista de alimentos permitidos, así como las cantidades de FODMAP de cada alimento, difieren entre estudios, lo que dificulta el manejo de la dieta baja en FODMAP.El objetivo de esta investigación fue proponer una guía dietética FODMAP adaptada culturalmente a diferentes países hispanos para facilitar a dietistas-nutricionistas y expertos en nutrición el manejo de los pacientes que se benefician de la dieta baja en FODMAP.Se creó un consorcio de expertos en dieta FODMAP entre países de habla hispana. Dietistas de 11 países latinoamericanos (Argentina, Colombia, Ecuador, El Salvador, Guatemala, Honduras, México, Panamá, Perú, Uruguay y Venezuela) y España elaboraron una dieta baja en FODMAP ajustada cada una a la cultura gastronómica del país. También crearon una lista de alimentos para ser reintroducidos en la fase 2 (o fase de reintroducción) de la dieta FODMAP, junto con recetas típicas del país.Se diseñaron doce dietas bajas en FODMAP con su correspondiente fase de reintroducción, cada una adaptada a los alimentos y recetas de consumo común de cada país. La adaptación de la dieta a la gastronomía local fue pertinente, ya que puede aumentar la adherencia a la dieta y una mejor respuesta a la sintomatología.Existen limitaciones en el desarrollo de tablas de alimentos ricos y pobres en FODMAP. Los niveles de corte del contenido de FODMAP no están claramente definidos. Se necesitan más estudios para alcanzar un consenso unificado, ya que se ha encontrado inconsistencia en los datos proporcionados en estudios relacionados con la dieta FODMAP.(AU)

Lifestyle factors, diet and attention-deficit/hyperactivity disorder in Spanish children - an observational study.

Background: The aetiology of Attention Deficit Hyperactivity Disorder (ADHD) continues to be debated, although several contributing factors have been acknowledged.Objective: Assess the association between weight, birth attributes, exercise and sleep habits, dietary intake and adherence to a Mediterranean diet, and impulsive behaviour on Spanish ADHD children. Establish whether specific food groups (not just adherence to the Mediterranean diet) associate with impulsive behaviour.Methods: This observational cross-sectional study included 57 ADHD children from Madrid (Spain). Demographic, clinical data, sleep, exercise and technology-use habits were obtained. Anthropometric measurements included height and weight. Adherence to the Mediterranean diet was assessed using the KIDMED test. Barratt Impulsivity Scale version-11c was used to assess impulsivity. Subjects were divided into three groups for analysis, according to their age (6-10 years, children; 11-13 years, pre-adolescents; 14-16 years, adolescents).Results: There were clear associations between those who had higher BIS scores and who slept less at weekends (49.4 ± 10.16 vs. 43.8 ± 12.51), who adhered poorly to the Mediterranean diet (49.9 ± 11.72 vs. 41.6 ± 16.52), who used internet and technological devices for >3 h/day (45.5 ± 13.6 vs. 44.7 ± 12.11), who were born with >2.5 kg (46.1 ± 11.61 vs. 42.9 ± 15.29), who were delivered by caesarean (45.1 ± 12.78 vs. 44.7 ± 12.5) and who were not breastfed (45.0 ± 13.38 vs. 44.8 ± 12.39). Subjects exercising more than 3 days a week also scored slightly higher (45.4±14.02 vs. 44.6±11.85) in the BIS.Conclusion: There is a need to follow up the link between ADHD and sleep onset difficulties, dietary patterns, technological habits, perinatal factors, breastfeeding and birth delivery mode.

Effectiveness of an intermittent fasting diet versus continuous energy restriction on anthropometric measurements, body composition and lipid profile in overweight and obese adults: a meta-analysis.

The effects of an intermittent fasting (IF) diet in the overweight or obese adult population are still controversial. This study aimed to evaluate the effectiveness of an IF diet to reduce anthropometric parameters (body mass index, body weight, and waist circumference), change body composition (fat mass, lean body mass and muscle mass) and lipid profile (total cholesterol, HDL-c, LDL-c and triglycerides), and to adhere to the diet in comparison to continuous energy restriction (CER) in overweight or obese adults. A research question PICO (patients, intervention, comparison, outcome) was established. PubMed, Scopus, Web of Science, Cochrane, and Scielo databases were searched to identify randomized clinical trials that compared an IF diet with a CER diet or a regular diet. DeCS and MeSH descriptors and Boolean operators (AND and OR) were used. From 859 studies identified through the literature search, 18 articles were finally selected. Overall, IF diets were associated with higher weight loss in four studies and similar reduction in waist circumference in one study, compared with a CER regimen. Fat mass tended to decrease more in the IF groups in five studies. However, the lean and muscle mass loss was similar in both groups. Only three studies observed significant differences in lipid profile variables, mostly in the IF groups. Adherence to the diet was inconclusive. An IF diet may provide a benefit by improving anthropometry, body composition, and lipid profile in overweight or obese adult population, likewise a CER diet.

Is the inclusion of Randomized Controlled Trials data in clinical guides enough for the best evidence-practices? NO / ¿Es la inclusión de datos de Ensayos Controlados Aleatorizados en las guías clínicas suficiente para la mejor práctica basada en la evidencia?

No disponible

Disparity in general nutrition knowledge among students of Food and Nutritional Sciences, graduates and experienced dieticians / Disparidad en el conocimiento general de nutrición entre estudiantes de Ciencias de la Alimentación y Nutrición, graduados y dietistas experimentados

BACKGROUND: Applying nutrition knowledge and skills to all aspects of health care are extremely important. The quantity and quality of formalized nutrition education is shrinking in curricula of health professions. OBJECTIVE: To describe the level of general nutrition knowledge in students enrolled in the B.Sc. degree in Human Nutrition and Dietetics in Spain and already graduated dieticians, and compare knowledge status across different occupations. The secondary aim was to investigate the variation in knowledge among the cohort according to academic year, years of experience and area of expertise. METHODS: Food and Nutritional Sciences students, dieticians and other health professionals in Spain were invited to participate in an online survey in 2018. The questionnaire comprised 7 relevant socio-demographic questions and 16 items related to personal beliefs and dietary aspects, eating recommendations, degrees of evidence and studies funding. Subjects were divided into different groups for analysis, according to discipline, academic year, years of experience and area of expertise. RESULTS: 364 subjects participated in the study. Overall, dieticians suggested there is no ideal distribution of macronutrients along the day, Harvard plate is the guide with the greatest scientific support for the Spanish population and agreed on meta-analysis of randomized clinical trials to be the study type with the greatest degree of evidence. 44.5% of dieticians asserted that studies financed by the industry have no credibility or reliability and he most experienced ones (>20 years' experience) agreed that pharmaceutical industry and food industry with high conflict of interest were the source of funding of high impact studies. On the other hand, students believed university contributes an outdated knowledge in the majority of the content. Freshmen and sophomore students supported eating 4-5 times/day, while juniors and seniors would personalize the recommendation depending on the patient. CONCLUSION: The general nutrition knowledge level appeared to be disparate between students and practicing dieticians. Overall knowledge was influenced by discipline, academic year and area of expertise. Strategies to fill the gaps in nutrition education are needed

ANTECEDENTES: La aplicación de conocimientos y habilidades nutricionales a todos los aspectos de la atención médica es extremadamente importante. La cantidad y calidad de la educación nutricional formalizada se está reduciendo en los planes de estudio de las profesiones de la salud. OBJETIVO: Describir el nivel de conocimiento general de nutrición en estudiantes matriculados en Nutrición Humana y Dietética en España y dietistas ya graduados, y comparar el estado del conocimiento en diferentes ocupaciones. El objetivo secundario fue investigar la variación en el conocimiento entre la cohorte según el año académico, años de experiencia y área de especialización. MÉTODOS: Se invitó a estudiantes de ciencias de la alimentación y nutrición, dietistas y otros profesionales de la salud en España a participar en una encuesta en línea en 2018. El cuestionario constaba de 7 preguntas sociodemográficas relevantes y 16 ítems relacionados con creencias personales y aspectos dietéticos, recomendaciones alimentarias, títulos de evidencia y financiación de estudios. Los sujetos se dividieron en diferentes grupos para su análisis, según la disciplina, el año académico, los años de experiencia y el área de especialización. RESULTADOS: 364 sujetos participaron en el estudio. En general, los dietistas sugirieron que no hay una distribución ideal de macronutrientes a lo largo del día, la placa de Harvard es la guía con el mayor respaldo científico para la población española y acordó que el metanálisis de ensayos clínicos aleatorios sea el tipo de estudio con mayor grado de evidencia. El 44.5% de los dietistas afirmaron que los estudios financiados por la industria no tienen credibilidad o confiabilidad y los más experimentados (> 20 años de experiencia) estuvieron de acuerdo en que la industria farmacéutica y la industria alimentaria con alto conflicto de intereses fueron la fuente de financiación de los estudios de alto impacto. Por otro lado, los estudiantes creían que la universidad aporta un conocimiento desactualizado en la mayoría del contenido. Los estudiantes de primer año y segundo año apoyaron comer 4-5 veces / día, mientras que los estudiantes de tercer y cuarto año personalizarían la recomendación según el paciente. CONCLUSIÓN: El nivel general de conocimiento de nutrición parecía ser disparejo entre los estudiantes y los dietistas practicantes. El conocimiento general estuvo influenciado por la disciplina, el año académico y el área de especialización. Se necesitan estrategias para llenar los vacíos en la educación nutricional

Detección de la alteración del metabolismo glucídico y resistencia a la insulina en una muestra piloto infantil: Aproximación metabolómica / Detection of impaired glucidic metabolism and insulin resistance in a pilot child sample

Resumen Introducción: La metabolómica permite estudiar la resistencia a insulina (RI), un factor de riesgo de pre-diabetes y diabetes. Quantose IR TM es el único test que mide la RI mediante la abrazadera hiperinsulinémica euglicémica. Objetivo: Se comprobó la eficacia de un test metabolómico en la detección de marcadores de RI en población infantil. Materiales ymétodos: Once niños, de edad 8,54±3,53 años y con factores de riesgo de diabetes, fueron reclutados del Hospital El Escorial. Se estableció como criterio diagnóstico para la prediabetes el estándar de la Asociación Americana de Diabetes (ADA) (HbA1C 5,7-6,4% y glucosa basal 100-125mg/dl). Se compararon las analíticas de sangre con la prueba de Quantose IR TM , estudiando el perfil del metaboloma relacionado con la RI (ácido alfa-hidroxibutírico, ácido oleico, linoleo-glicerofosfocolina e insulina). Su análisis generó una puntuación Quantose © (escala 0-100), siendo >63 RI. Resultados: Ningún sujeto cumplió el criterio de la ADA para prediabetes: HbA1C fue 5,3±0,18 % y glucosa 86,6±5,6 mg/dl. Por el contrario, 10 sujetos cumplieron criterios del test Quantose IR TM para la RI (score: 78,09 ± 9,24 (>63)). Conclusiones: El test Quantose IR TM mide el porcentaje de hemoglobina unida a glucosa dentro de los glóbulos rojos. Permite prever el riesgo de diabetes, y tomar medidas preventivas.

Abstract Introduction: Metabolomics enables the study of insulin resistance (IR), a risk factor for pre-diabetes and diabetes. Quantose IRTM is the only test that measures IR using the euglycemic hyperinsulinemic clamp. Objective: The effectiveness of a metabolomic test for the detection of RI markers in a child population was verified. Materials and methods: Eleven children aged 8.54 ± 3.53 years with diabetes risk factors were recruited from the El Escorial Hospital. The American Diabetes Association (ADA) Standards (5,7-6,4% HbA1C and 100-125 mg/dl basal glucose) were established as diagnostic criteria for prediabetes. Blood tests were compared to the Quantose IRTM assay studying the metabolomic profile related to IR (alpha-hydroxybutyric acid, oleic acid, linoleo-glycerophosphocoline and insulin). This analysis generated a Quantose © score of IR > 63. Results: None of the subjects met the ADA criteria for prediabetes: HbA1C=5,3±0,18 and glucose=86,6± 5,6 mg/dl. On the contrary, 10 subjects met the Quantose IRTM test criterion for IR (score: 78,09 ± 9,24 (>63)). Conclusions: The Quantose IRTM test measures the percentage of glucose bound hemoglobin within red blood cells. This assay makes it possible to predict diabetes risk and take preventive measures.

Gene Influence in the Effectiveness of Plant Sterols Treatment in Children: Pilot Interventional Study.

Cardiovascular disease is linked to high serum low density lipoprotein (LDL)-cholesterol levels. Cardiovascular risk may be indirectly influenced by genetic load. Serum LDL-cholesterol levels may be reduced by the consumption of food enriched with plant sterols (PS). The aim was to test a plant sterol treatment on cholesterol levels according to different genetic polymorphisms. A pilot interventional trial was performed in 26 children (n = 16 girls, n = 10 boys). Seven hundred milliliters/day of commercial skimmed milk with added plant sterols delivering 2.2 g plant sterols were ingested for three weeks. Blood draws were performed at the baseline and end of the study. Significant modifications of non-high density lipoprotein (HDL)-cholesterol (p = 0.010; p = 0.013) and LDL-cholesterol (p = 0.004; p = 0.013) levels appeared in the genes LIPC C-514T and PPAR-α L162V carriers. No statistically significant differences were observed for other genes. LIPC C-514T and PPAR-alpha L162V carriers could benefit from a plant sterol supplement to ameliorate hypercholesterolemia.

Hydration Status: Influence of Exercise and Diet Quality.

Physical activity, adherence to a healthy diet, and healthy beverage pattern are considered essential components of a healthy lifestyle. We aimed to evaluate the associations between physical exercise, diet quality, and total fluid intake, along with fluid recommendations compliance in a sample of adults. Data on fluid intake from different types of beverages were collected in a cross-sectional study, in 1161 men and women between 18 and 65 years of age, using a fluid-specific diary. Exercise was evaluated with a self-reported questionnaire, and quality of diet was assessed using the Healthy Eating Index-2010 (HEI). Mean volume of water consumed was 1497.5 mL for men, 1309.5 mL for women. A total of 37.4% did not follow the recommendations of the European Food Safety Agency for total water intake. There was a statistically significant difference (P = .002) between total water intake and follow-up of recommendations, as well as for sex (P < .001). Mean HEI-2010 score was 65.21. There were no statistically significant differences (P = .301) in HEI index among better or worse hydration. Sport variables had influence on milliliters of water consumed (P < .001). Participants who engaged in more physical exercise exhibit a healthier pattern of fluid intake. Healthy individuals with the highest scores for HEI-2010 did not present the healthiest beverage patterns.

Modulation of plasma triglycerides concentration by sterol-based treatment in children carrying different genes.

BACKGROUND: Dyslipidemias have increased during the last decades in children. AIM: The objective of this study was to analyze the influence of different polymorphisms in plasma triglyceride levels of children following a dietary treatment with plant sterols. DESIGN: A randomized, double-blind, crossover, controlled clinical trial was carried out in 26 children (16 women). MATERIALS AND METHODS: Commercial milk, with 2.24 g sterols, was ingested daily during 3 weeks , and the same amount of kimmed milk without sterols, during the 3 week placebo phase. Both phases were separated by a washout period of 2 weeks. At the beginning and end of each phase, blood draws were performed. RESULTS: Apolipoprotein A5 Ser19Trp (P = 0.002), peroxisome proliferator-activated receptor-alpha L162V (P = 0.003), APOE APOE2/3/4 (P = 0.012), and APOE APOE2,3,4 (P = 0.025) show statistically significant differences between their haplotypes in plasma triglyceride levels. Other genes did not show statistically significant differences. CONCLUSIONS: Further studies are needed to establish which genotype combinations would be the most protective against hypertriglyceridemia.

Successful Implementation of a Mediterranean Weight Loss Program to Prevent Overweight and Obesity in the Workplace.

OBJECTIVE: Reducing obesity is a priority for employers seeking to lower the incidence and severity of chronic illness and associated health services. The aim was to identify if a workplace-based dietary intervention monitored by health professionals is effective at reducing obesity, as part of an obesity-control-program at work. METHODS: A 12-week dietary intervention was designed for 102 overweight/obese Spanish employees in Madrid. Dietary and anthropometric (height, weight, body mass index [BMI], fat mass, and waist circumference) assessment was conducted at baseline, follow-up, and final. Six 20-minute counseling sessions were undertaken by participants. RESULTS: Significant post-intervention reductions were observed in all anthropometric measures. 77.5% of the participants were considered respondents to the intervention, while 22.5% remaining were not. A higher proportion of women responded positively to the treatment compared with men. However, higher decrease in anthropometric measures were observed in men. CONCLUSION: The workplace is deemed to be effective for providing guided dietary intervention and behavioral support based on the proximity of health professionals to the employee.

Genomic Influence in the Prevention of Cardiovascular Diseases with a Sterol-Based Treatment.

Raised serum cholesterol concentration is a well-established risk factor in cardiovascular disease. In addition, genetic load may have an indirect influence on cardiovascular risk. Plant-based sterol-supplemented foods are recommended to help reduce the serum low-density lipoprotein cholesterol level. The objective was to analyse the influence of different polymorphisms in hypercholesterolemia patients following a dietary treatment with plant sterols. A randomised double-blind cross-over controlled clinical trial was carried out in 45 people (25 women). Commercial milk, containing 2.24 g of sterols, was ingested daily during a 3-week period, and then the same amount of skim milk, without sterols, was consumed daily during the 3-week placebo phase. Both phases were separated by a washout period of 2 weeks. At the beginning and end of each phase, blood draws were performed. Genes LIPC C-514T and APOA5 C56G are Ser19Trp carriers and greatly benefit from sterol intake in the diet. LIPC C-514T TT homozygous carriers had lower low-density lipoprotein cholesterol (LDL-c) levels than CC homozygote and CT heterozygote carriers after the ingestion of plant sterols (p = 0.001). These two genes also showed statistically significant changes in total cholesterol levels (p = 0.025; p = 0.005), and no significant changes in high-density lipoprotein (HDL) cholesterol levels (p = 0.032; p = 0.003), respectively. No statistically significant differences were observed for other genes. Further studies are needed to establish which genotype combinations would be the most protective against hypercholesterolemia.

Nutritional and environmental factors in attention-deficit hyperactivity disorder (ADHD): A cross-sectional study.

OBJECTIVES: Attention-deficit hyperactivity disorder (ADHD) has been related to nutrient deficiencies and 'unhealthy' diets, and to date there is only one study that examined the relationship between the Mediterranean diet and ADHD. The aim was to determine the association between those environmental, nutritional, and body composition factors that may affect the pathogenesis and symptomatology of patients with ADHD in Spain. METHODS: A total of 89 children and adolescents (41 with diagnosed ADHD and 48 controls) were studied in an observation case-control study. Anthropometry, nutritional status, adherence to a Mediterranean diet, sedentary behaviour, and sleep were measured. RESULTS: Lower adherence to a Mediterranean diet was associated with ADHD diagnosis. Individuals with ADHD more often missed having a second serving of vegetables daily and showed reduced intakes of fish, pulses, and pasta or rice almost every day when compared with controls. Statistically significant differences (P < 0.05) were found for fish, cereal, no breakfast and commercially baked goods consumption. There were also statistically significant differences between ADHD individuals and controls when analysing sedentary behaviours and BMI (P < 0.05). CONCLUSION: Low adherence to a Mediterranean diet might play a role in ADHD development. Not only specific nutrients but also the whole diet should be considered in ADHD. No clear association was found for anthropometry and sedentary behaviours.