Alimentación funcional para corregir desórdenes gastrointestinales asociados a trastornos del espectro autista: una revisión sistemática / Functional feeding to correct gastrointestinal disorders associated with autism spectrum disorders: a systematic review

Antecedentes: los trastornos gastrointestinales (TGI) son comorbilidades comunes en los pacientes con trastornos del espectro autista (TEA); los tratamientos con dietas libres de gluten y caseína (LGLC) o suplementos de prebióticos/probióticos podrían reducir la severidad de los TGI. Objetivo: integrar y discutir la evidencia sobre la efectividad de las terapias con dietas LGLC y suplementos de prebióticos/probióticos sobre los TGI en pacientes con TEA. Metodología: se utilizaron las guías para la publicación de revisiones sistemáticas y metaanálisis (PRISMA). Se analizaron las características de los participantes, las intervenciones dietéticas, la administración de suplementos de prebióticos/prebióticos, los efectos de las intervenciones sobre los TGI, el riesgo de sesgo de los estudios y la seguridad de los tratamientos. Resultados: se analizaron quince investigaciones; la prevalencia de los TGI entre los pacientes con TEA fue alta (58 %; rango, 27-83 %). En más del 20 % de los pacientes intervenidos con dietas LGLC o suplementos disminuyó la severidad de los TGI (principalmente estreñimiento, diarrea y dolor abdominal). Se reportaron aumentos en los conteos de bacterias benéficas y una disminución de la proporción de bacterias patógenas tras el uso de los suplementos. Sin embargo, todas estas investigaciones presentaron sesgos metodológicos importantes. Conclusiones: aunque se han encontrado reducciones en la frecuencia y severidad de algunos TGI, la efectividad de estos tratamientos aún no se ha comprobado. Dadas las diferencias metodológicas de las investigaciones, se justifica el diseño de estudios rigurosos para evaluar los efectos terapéuticos de estos tratamientos sobre la salud gastrointestinal en pacientes con TEA (AU)

Background: gastrointestinal disorders (GIDs) are common comorbidities in patients with autism spectrum disorders (ASD); treatments with gluten- and casein-free (LGLC) diets or prebiotic/probiotic supplements may reduce the severity of GIDs. Objective: to integrate and discuss the evidence on the effectiveness of LGLC diet therapies and prebiotic/probiotic supplements on GIDs in patients with ASD. Methodology: the guidelines for the publication of systematic reviews and meta-analyses (PRISMA) were used. Participant characteristics, dietary interventions, prebiotic/prebiotic supplementation, effects of interventions on GIDs, risk of bias, and safety of treatments were analyzed. Results: fifteen investigations were analyzed; the prevalence of GIDs among patients with ASD was high (58 %; range, 27-83 %). In more than 20 % of the patients managed with LGLC diets or supplements GID severity decreased (mainly constipation, diarrhea, and abdominal pain). Increases in the counts of beneficial bacteria and a decrease in the proportion of pathogenic bacteria were reported after supplement use. However, all these investigations had significant methodological biases. Conclusions: although reductions in the frequency and severity of some GIDs have been found, the effectiveness of these treatments has not been proven yet. Given the methodological differences in the investigations, the design of rigorous studies to evaluate the therapeutic effects of these treatments on gastrointestinal health in patients with ASD is warranted (AU)

Potencia muscular y cinética de lactato en sangre entre genotipos de ACTN3 / Muscle Power and Blood Lactate Kinetics Among ACTN3

En este trabajo se estudiaron las diferencias en la potencia muscular y la cinética de las concentraciones de lactato en sangre ([LA-]b) entre genotipos de ACTN3 durante la prueba anaeróbica de Wingate, (PAnW). Participaron 35 voluntarios (18-35 años) masculinos, sanos y físicamente activos. Se analizaron la potencia muscular, las concentraciones de [LA-]b y la actividad de la Lactato Deshidrogenasa (LDH). El gen ACTN3 se determinó a partir de ADN de glóbulos blancos en sangre periférica. Independientemente del peso y masa muscular de los participantes, los portadores del genotipo RR vs. RX y XX desarrollaron mayor potencia muscular durante la PAnW (p<0.05), lo cual sugiere una mayor capacidad en este genotipo para utilizar el sistema ATP-PC durante un ejercicio supramáximo. La cinética en la potencia muscular y en las concentraciones de [LA-]b fueron semejantes entre genotipos. La PAnW no fue suficiente para causar daño muscular observado por la concentración de LDH. (AU)

In this work, the differences in the muscle power and the kinetics of blood lactate concentrations ([LA-]b) between ACTN3 genotypes were studied during the Wingate anaerobic test (PAnW). Thirty-five healthy and physically active male volunteers (18-35 years old) participated. Muscle power, [LA-] b concentrations, and Lactate Dehydrogenase (LDH) activity were analyzed. The ACTN3 gene was determined from the DNA of white blood cells in peripheral blood. Regardless of the participants' weight and muscle mass, carriers of the RR genotype vs. RX and XX developed greater muscle power during PAnW (p <0.05), suggesting a greater capacity in this genotype to use the ATP-PC system during supramaximal exercise. The kinetics in muscle power and in [LA-]b concentrations were similar between genotypes. PAnW was not enough to cause muscle damage seen by LDH concentration. (AU)

Respuesta de creatina quinasa a un ejercicio anaerobio supramáximo en genotipos de ACTN3 / Response of Creatine Kinase to an Anaerobic Supramaximal Exercise in ACTN3 Genotypes

El objetivo del presente estudio fue investigar las diferencias en la actividad de la enzima Creatina Quinasa (CK) en pre y post ejercicio anaerobio supramáximo (EASM) en portadores de los genotipos del gen de la alfa-actinina-3 (ACTN3). Se reclutaron 39 hombres sanos físicamente activos (18-35 años) y se sometieron a un EASM de 30 s (Wingate). El gen ACTN3 se determinó a partir del ADN de glóbulos blancos en sangre periférica y se evaluó la actividad de la CK en muestras sanguíneas en condiciones basales, a las 24 y 48 h post EASM. Los portadores del genotipo XX vs RR presentaron 1,4 veces menor actividad de CK en condiciones basales (p < 0,05) y una mayor actividad de CK a las 24 h post ejercicio (p < 0,05). Una serie de EASM fue capaz de causar un incremento significativo de la actividad de CK a las 24 h en los portadores del genotipo XX

The aim of the present study was to investigate the differences in the activity of the enzyme Creatine Kinase (CK) in pre and post anaerobic supramaximal exercise (ASME) on carriers of the genotypes of the alpha-actinin-3 gene (ACTN3). 39 healthy physically active men (18-35 years) were enrolled and underwent an ASME of 30 s (Wingate). The ACTN3 gene was determined from the DNA of white blood cells in peripheral blood and the CK activity was evaluated in blood samples in basal conditions, at 24 and 48 h after of ASME. The carriers of genotype XX vs RR had 1.4 times lower CK activity in basal conditions (p < 0.05) and higher CK activity at 24 h after exercise (p < 0.05). A series of ASME was capable of causing a significant increase in CK activity at 24 h in the XX genotype carriers

Efecto del ejercicio agudo sobre la filtración glomerular de adultos mayores / Acute Exercise Effect on Glomerular Filtration in the Elderly

INTRODUCCIÓN: Existe una disminución de la Filtración Glomerular (FG) en adultos mayores y la práctica del ejercicio puede causar cambios en la función renal. OBJETIVO: Evaluar el efecto de diferentes intensidades de ejercicio agudo sobre la filtración glomerular en adultos mayores. MÉTODO: 20 adultos mayores aparentemente sanos de 69,8 ± 4 años realizaron 3 pruebas de ejercicio físico: máxima y 2 sub-máximas (80% y 60%). Se colectaron muestras de sangre venosa para estimar la filtración glomerular por creatinina, antes y después del ejercicio. RESULTADOS: Se observó una disminución significativa post-ejercicio en la filtración glomerular, estimada a partir de creatinina sérica en las pruebas máxima y sub-máxima a 80% (p < 0,05). CONCLUSIÓN: El ejercicio físico agudo máximo y sub-máximo al 80% de intensidad en adultos mayores aparentemente sanos, provoca una disminución de la filtración glomerular

INTRODUCTION: There is a decrease in Glomerular Filtration Rate (GFR) in older adults and the exercise practice may lead to changes in renal function. Purpose: To evaluate the effect of different intensities of acute exercise on elderly population GFR. METHODS: 20 apparently healthy older adults (69,8 ± 4 years) performed 3 exercise tests a week apart: one maximal and 2 submaximal (80% and 60%). Blood samples were collected to determine serum creatinine and to estimate GFR, before and after each exercise test. RESULTS: A significant post-exercise decline in GFR, estimated from serum creatinine values, was observed in the maximal and submaximal 80% tests (p <0,05). CONCLUSION: Maximum and sub-maximum acute physical exercise at 80% intensity causes a decrease in glomerular filtration in apparently healthy older adults

Acute physiological response to indoor cycling with and without hydration; case and self-control study.

INTRODUCTION: Oral rehydration drinks help maintain physical capacity and hydration during exercise. OBJECTIVE: Evaluate, in a case and self-control study, the effectiveness of three hydration and exercise protocols on work capacity and physical and psychosomatic stress during indoor cycling (InC). METHODS: 14 middle-aged eutrophic men participated in three controlled randomly and not sequentially hydration (~278 mL 6/c 15 min) and exercise (InC/90 min) protocols: No liquids, plain water, or sports drinks (SD). The response variables were: Body temperature (BT), heart rate (HR), and mean blood pressure (MBP). The covariables: Distance traveled (DT), ergometer resistance (R), body fat (BF), difference in body weight between tests (rBW), and age of the participants. The differences between protocols were evaluated using GLM Repeated Measures, the independence of associations by multiple linear regression. RESULTS: In non-liquids, the subjects showed higher BT, HR, and MBP than when they drank plain water or SD (p < 0.01). Work capacity was the same in the three hydration protocols. BT was the most sensitive variable detected by the hydration status of the subjects. 34%, 99%, and 21% of the associated variance to HR, MBP, and BT was explained by DT + BT, BT + BF, and ΔBW + age + R + DT + BF, respectively. CONCLUSIONS: Liquid intake with or without electrolytes does not affect work capacity, and they are equally effective as hydration sources during =?90 min of InC at strong and very strong intensities. Body temperature is the most sensitive variable detected by the subject's hydration status during exercise.

Introducción: Las bebidas de re-hidratación oral ayudan a mantener la capacidad física y el nivel de hidratación durante el ejercicio. Objetivo: Evaluar en un estudio de casos y autocontroles la efectividad de tres protocolos de hidratación y ejercicio sobre la capacidad de trabajo, estrés físico y psicosomático durante el ciclismo de sala (CiS). Métodos: 14 varones eutróficos de mediana edad participaron de manera aleatoria y no consecutiva en tres protocolos de hidratación controlada (~278 mL 6/c 15 min) y ejercicio (CiS/90 min): No líquidos, agua corriente o bebida deportiva (BD). Las variables respuesta fueron: Temperatura corporal (TC), frecuencia cardiaca (FC) y presión sanguínea media (PSM). Las covariables: distancia recorrida (DR), resistencia del ergómetro (R) grasa corporal (GC), pérdida de peso al final del ejercicio ( PC) y edad de los participantes. Las diferencias entre los protocolos fueron evaluadas por GLM de Medidas Repetidas, la independencia de las asociaciones por regresión lineal múltiple. Resultados: En no líquidos, los sujetos presentaron mayor TC, FC y PSM que cuando ingirieron agua corriente o BD (p < 0,01). La capacidad de trabajo fue igual en los tres protocolos de hidratación. La TC fue la variable más sensible que detectó el estado de hidratación de los sujetos. El 34%, 99% y 21% de la varianza asociada a FC, PSM y TC lo explicaron DR + TC, TC + GC, y ?PC + edad + R + DR + GC respectivamente. Conclusiones: La ingesta de líquidos con o sin electrolitos no afecta la capacidad de trabajo y son igualmente efectivos como medios de hidratación durante =?90 min de Cis a intensidades pesadas y muy pesadas. La TC es la variable más sensible que detecta el estado de hidratación de los sujetos durante el ejercicio.

Acute physiological response to indoor cycling with and without hydration; case and self-control study / Respuesta fisiológica aguda al ciclismo de sala con y sin hidratación; estudio de casos y autocontroles

Introduction: Oral rehydration drinks help maintain physical capacity and hydration during exercise. Objective: Evaluate, in a case and self-control study, the effectiveness of three hydration and exercise protocols on work capacity and physical and psychosomatic stress during indoor cycling (InC). Methods: 14 middle-aged eutrophic men participated in three controlled randomly and not sequentially hydration (~278 mL 6/c 15 min) and exercise (InC/90 min) protocols: No liquids, plain water, or sports drinks (SD). The response variables were: Body temperature (BT), heart rate (HR), and mean blood pressure (MBP). The covariables: Distance traveled (DT), ergometer resistance (R), body fat (BF), difference in body weight between tests (rBW), and age of the participants. The differences between protocols were evaluated using GLM Repeated Measures, the independence of associations by multiple linear regression. Results: In non-liquids, the subjects showed higher BT, HR, and MBP than when they drank plain water or SD (p < 0.01). Work capacity was the same in the three hydration protocols. BT was the most sensitive variable detected by the hydration status of the subjects. 34%, 99%, and 21% of the associated variance to HR, MBP, and BT was explained by DT + BT, BT + BF, and ABW + age + R + DT + BF, respectively. Conclusions: Liquid intake with or without electrolytes does not affect work capacity, and they are equally effective as hydration sources during ≤ 90 min of InC at strong and very strong intensities. Body temperature is the most sensitive variable detected by the subject's hydration status during exercise (AU)

Introducción: Las bebidas de rehidratación oral ayudan a mantener la capacidad física y el nivel de hidratación durante el ejercicio. Objetivo: Evaluar en un estudio de casos y autocontroles la efectividad de tres protocolos de hidratación y ejercicio sobre la capacidad de trabajo, estrés físico y psicosomático durante el ciclismo de sala (CiS). Métodos: 14 varones eutróficos de mediana edad participaron de manera aleatoria y no consecutiva en tres protocolos de hidratación controlada (~278 mL 6/c 15 min) y ejercicio (CiS/90 min): No líquidos, agua corriente o bebida deportiva (BD). Las variables respuesta fueron: Temperatura corporal (TC), frecuencia cardiaca (FC) y presión sanguínea media (PSM). Las covariables: distancia recorrida (DR), resistencia del ergómetro (R) grasa corporal (GC), pérdida de peso al final del ejercicio (PC) y edad de los participantes. Las diferencias entre los protocolos fueron evaluadas por GLM de Medidas Repetidas, la independencia de las asociaciones por regresión lineal múltiple. Resultados: En no líquidos, los sujetos presentaron mayor TC, FC y PSM que cuando ingirieron agua corriente o BD (p < 0,01). La capacidad de trabajo fue igual en los tres protocolos de hidratación. La TC fue la variable más sensible que detectó el estado de hidratación de los sujetos. El 34%, 99% y 21% de la varianza asociada a FC, PSM y TC lo explicaron DR + TC, TC + GC, y APC + edad + R + DR + GC respectivamente. Conclusiones: La ingesta de líquidos con o sin electrolitos no afecta la capacidad de trabajo y son igualmente efectivos como medios de hidratación durante ≤ 90 min de Cis a intensidades pesadas y muy pesadas. La TC es la variable más sensible que detecta el estado de hidratación de los sujetos durante el ejercicio (AU)

Factores fisiológicos y sociales asociados a la masa corporal de jóvenes mexicanos con discapacidad intelectual / Physiological and social factors associated with increments of body mass of Mexican young people with intellectual disabilities

Introducción: Estudios sobre el estado de salud y nutrición de Mexicanos con discapacidad intelectual (DI) incluyendo aquellos con Síndrome de Down (SD), son escasos. Objetivo: Analizar algunos factores fisiológicos y sociales asociados a la masa corporal de jóvenes con DI del norte de México. Métodos: A 57 jóvenes con DI (17 ± 5 años, SD = 16%) y al menos uno de sus tutores, se les midió su peso, talla, y otras variables antropométricas. Se determinó su IMC (kg/m2), somatotipo y estado nutricio mediante 3 criterios internacionales y glucosa, colesterol total y triacilglicéridos plasmáticos. Al tutor se le aplicó un cuestionario socioeconómico, de inseguridad alimentaria y conocimientos de nutrición. Resultados: Los participantes con SD eran 12 cm más pequeños y median 6 mm más de pliegue subscapular (PSECP) que aquellos con otra DI (p < 0,05). El sobrepeso-obesidad estuvo presente en 70 y 44%, respectivamente. Los parámetros bioquímicos fueron similares entre grupos, pero 25% tenía alguna dislipidemia. El IMC del participante correlacionó (p < 0,01) con varios indicadores antropométricos y de adiposidad (r = 0,40 a 0,88), plasmáticos [triacilglicéridos (r = 0,48), colesterol total (r = 0,44)] y edad del participante y tutor (r = 0,35). El gasto en alimentos correlaciono con PSECP del participante (r = -0,33, p < 0,05). La circunferencia de cadera, cintura, pantorrilla y PSECP, explicaron el 89% de la varianza del IMC. Conclusión: La masa corporal de jóvenes con DI del norte de México se relaciona fuertemente con el grado de adiposidad corporal, con dislipidemias y con factores socioeconómicos de su entorno familiar (AU)

Introduction: Studies on the state of health and nutrition of Mexicans with intellectual disability (ID) including those with Down syndrome (DS), are scarce. Objective: To analyze some physiological and social factors associated with the body mass of young people with ID from northern México. Methods: Body weight, height and other anthropometric values were measured in fifty seven young (17 ± 5 years) participants with ID (DS,16%) and at least one guardian. BMI (kg/m2), somatotype and nutritional status were established by three international standards and total blood glucose, cholesterol & triacylglycerides, were also analyzed. Guardian's socio-economic, household food insecurity and nutrition literacy status were estimated with validated questionnaires by direct interview. Results: Participants with SD were 12 cm smaller but subscapular skinfold (SECPS) was 6 mm thicker than that from other ID participants (p < 0.05). Prevalence of overweight/obesity was 70 and 44%, respectively. Blood biochemicals were similar between groups, but 25% had dyslipidemias. Participant's BMI correlated (p < 0,01) with several anthropometric & adiposity indicators (r = 0,40 a 0,88 ), blood triglycerides (r = 0,48 ) and cholesterol (r = 0,44) and guardians & participants' age (r = 0,35). The spending in food correlated (p < 0.05) with participant's SECPS (r = -0.33). The circumference of the waist, hip, calf and PSECP, 89% of the variance of the BMI explained. Conclusion: The body mass of young people with DI from northern Mexico, is strongly related to the degree of body adiposity, dyslipidemias, and some socio-economic factors of their family environment (AU)

[Physiological and social factors associated with increments of body mass of Mexican young people with intellectual disabilities]. / Factores fisiológicos y sociales asociados a la masa corporal de jóvenes Mexicanos con discapacidad intelectual.

INTRODUCTION: Studies on the state of health and nutrition of Mexicans with intellectual disability (ID) including those with Down syndrome (DS), are scarce. OBJECTIVE: To analyze some physiological and social factors associated with the body mass of young people with ID from northern México. METHODS: Body weight, height and other anthropometric values were measured in fifty seven young (17 ± 5 years) participants with ID (DS,16%) and at least one guardian. BMI (kg/m²), somatotype and nutritional status were established by three international standards and total blood glucose, cholesterol & triacylglycerides, were also analyzed. Guardian's socio-economic, household food insecurity and nutrition literacy status were estimated with validated questionnaires by direct interview. RESULTS: Participants with SD were 12 cm smaller but subscapular skinfold (SECPS) was 6 mm thicker than that from other ID participants (p < 0.05). Prevalence of overweight/obesity was 70 and 44%, respectively. Blood biochemicals were similar between groups, but 25% had dyslipidemias. Participant's BMI correlated (p < 0,01) with several anthropometric & adiposity indicators (r = 0,40 a 0,88 ), blood triglycerides (r = 0,48 ) and cholesterol (r = 0,44) and guardians & participants' age (r = 0,35). The spending in food correlated (p < 0.05) with participant's SECPS (r = -0.33). The circumference of the waist, hip, calf and PSECP, 89% of the variance of the BMI explained. CONCLUSION: The body mass of young people with DI from northern Mexico, is strongly related to the degree of body adiposity, dyslipidemias, and some socio-economic factors of their family environment.

Effects of single sessions of low-intensity continuous and moderate-intensity intermittent exercise on blood lipids in the same endurance runners.

The factors responsible for the acute effects of exercise on blood lipids are not well known, and there have been few studies comparing different kinds of exercise in the same population. The concentration of blood lipids was evaluated in this study at the end and at post-24h of two 14km/90min single exercise sessions: continuous exercise (CE) at 44.5+/-5.6% VO(2max) and intermittent exercise (IE) at 39-72% VO(2max), in subjects with high levels of aerobic training. Fourteen male athletes (endurance runners) took part in this study and each completed a 24h dietary record. The O(2) uptake and CO(2) production were recorded, and blood lactate and blood lipids were measured. The results showed that triacylglycerols were not modified by any kind of exercise. Total cholesterol was increased at the end of both exercises: 7.04% for CE (p<0.001) and 4.23% for IE (p=0.001). High-density lipoprotein cholesterol was increased at the end of IE: 11.38% (p=0.03) and low-density lipoprotein cholesterol was increased only at the end of CE: 7.45% (p=0.006). The increase of lipids for CE was negatively correlated with aerobic fitness indicators (heart rate and %HRmax at lactate threshold), and was positively associated with energy expenditure. For IE, %HRmax and lactate were negatively correlated, and the respiratory exchange ratio was positively correlated, with the lipid increase. We conclude that in trained male athletes, a 14km run in 90min induced different changes of lipid profile if the exercise was done continuously or intermittently, and that in CE the extent of these increases was influenced by aerobic fitness.

Boutonneuse fever transmitted by conjunctival inoculation.

We report three cases (two adult males and a 12-year-old child) of boutonneuse fever produced by inoculation of the conjunctival mucosa (probably through accidental entry of R. conorii fluid into the eyes through rubbing or splashing). All three patients developed similar symptoms of disease, including high fever, headache, maculopapular exanthem, and conjunctivitis, and none had tache noire. Specific immunofluorescent antibodies appeared in these patients' serum mostly after the 2nd week; agglutinins to Proteus OX-19, OX-2 (Weil-Felix reaction) were found. Cure was obtained by oral tetracycline. Conjunctival inoculation of R. conorii producing boutonneuse fever is very rare; this report will probably be one of the first published in the medical literature.