Traditional Atlantic Diet and Its Effect on Health and the Environment: A Secondary Analysis of the GALIAT Cluster Randomized Clinical Trial.

Importance: The universal call to action for healthier and more sustainable dietary choices is the framework of the United Nations's Sustainable Development Goals. The Atlantic diet, originating from the northwest of the Iberian Peninsula, represents an example of a traditional diet that aligns with these principles. Objective: To explore a 6-month intervention based on the Atlantic diet's effects on metabolic and environmental health, assessing metabolic syndrome (MetS) incidence and the carbon footprint. Design, Setting, and Participants: The Galician Atlantic Diet study was a 6-month randomized clinical trial designed to assess the effects of this regional traditional diet on families' eating habits. The study was conducted from March 3, 2014, to May 29, 2015, at a local primary health care center in the rural town of A Estrada in northwestern Spain and involved a multisectoral collaboration. Families were randomly selected from National Health System records and randomized 1:1 to an intervention or control group. This secondary analysis of the trial findings was performed between March 24, 2021, and November 7, 2023. Interventions: Over 6 months, families in the intervention group received educational sessions, cooking classes, written supporting material, and foods characteristic of the Atlantic diet, whereas those randomized to the control group continued with their habitual lifestyle. Main Outcomes and Measures: The main outcomes were MetS incidence, defined per National Cholesterol Education Program Adult Treatment Panel III guidelines, and carbon footprint emissions as an environmental metric using life cycle assessment with daily dietary intake as the functional unit. Results: Initially, 250 families were randomized (574 participants; mean [SD] age, 46.8 [15.7] years; 231 males [40.2%] and 343 females [59.8%]). The intervention group included 126 families (287 participants) and the control group, 124 families (287 participants). Ultimately, 231 families completed the trial. The intervention significantly reduced the risk of incident cases of MetS (rate ratio, 0.32; 95% CI, 0.13-0.79) and had fewer MetS components (proportional odds ratio, 0.58; 95% CI, 0.42-0.82) compared with the control condition. The intervention group did not have a significantly reduced environmental impact in terms of carbon footprint emissions compared with the control group (-0.17 [95% CI, -0.46 to 0.12] kg CO2 equivalents/person/d). Conclusions and Relevance: These findings provide important evidence that a family-focused dietary intervention based on a traditional diet can reduce the risk of incident MetS. Further research is needed to understand the underlying mechanisms and determine the generalizability to other populations, taking into account regional cultural and dietary variations. Trial Registration: ClinicalTrials.gov Identifier: NCT02391701.

Puzzling interference in the Siemens tacrolimus assay in a renal transplant patient: A case report.

BACKGROUND: Therapeutic drug monitoring is a key tool for optimizing tacrolimus therapy in transplant recipients. The modified ACMIA assay from Siemens Healthcare Diagnostics is an immunoassay commonly used for tacrolimus monitoring, but it is not known whether this assay is resistant to interference from endogenous substances in real-world use. OBJECTIVE: To describe a case of unexpected interference in tacrolimus monitoring using the modified ACMIA method in a kidney transplant recipient, and to highlight the importance of careful interpretation of laboratory results and effective communication with clinicians in optimizing patient care. CASE DESCRIPTION: This case report describes a significant interference in the monitoring of tacrolimus in a kidney transplant recipient using the new ACMIA method. In this case, when aberrant results for tacrolimus were found using the new ACMIA method, they were re-analyzed using the CMIA method from Abbott. The presence of positive ANCA-MPO autoantibodies was found to be the most likely cause of the interference after an extensive workup. CONCLUSIONS: This is the first report of major interference with the modified ACMIA tacrolimus method and emphasizes the importance of proper interpretation of laboratory results and effective communication with clinicians in optimizing patient care.

Changes in Dietary Patterns through a Nutritional Intervention with a Traditional Atlantic Diet: The Galiat Randomized Controlled Trial.

Unhealthy dietary patterns (DPs) can lead to cardiovascular and other chronic diseases. We assessed the effects of a community-focused intervention with a traditional Atlantic diet on changes in DPs in families and the associations of these changes with weight loss. The Galiat study is a randomized, controlled trial conducted in 250 families (720 adults and children) and performed at a primary care setting with the cooperation of multiple society sectors. Over 6 months, families randomized to the intervention group received educational sessions, cooking classes, written supporting material, and foods that form part of the Atlantic diet, whereas those randomized to the control group followed their habitual lifestyle. At baseline, five DPs that explained 30.1% of variance were identified: "Caloric", "Frieds", "Fruits, vegetables, and dairy products", "Alcohol", and "Fish and boiled meals." Compared to the controls, the intervention group showed significant improvements in "Fruits, vegetables, and dairy products" and "Fish and boiled meals" and reductions in the "Caloric" and "Frieds". Changes in bodyweight per unit increment of "Frieds" and "Fruits, vegetables, and dairy products" scores were 0.240 kg (95% CI, 0.050-0.429) and -0.184 kg (95% CI, -0.379-0.012), respectively. We found that a culturally appropriate diet improved DPs associated with weight loss.

Effects of a Community-Based Behavioral Intervention with a Traditional Atlantic Diet on Cardiometabolic Risk Markers: A Cluster Randomized Controlled Trial ("The GALIAT Study").

The Atlantic diet, the traditional dietary pattern in northern Portugal and northwest Spain, has been related to metabolic health and low ischemic heart disease mortality. The Galiat Study is a randomized controlled trial aimed to assess the effects of the Atlantic diet on anthropometric variables, metabolic profile, and nutritional habits. The dietary intervention was conducted in 250 families (720 adults and children) and performed at a primary care center. Over six months, families randomized to the intervention group received educational sessions, cooking classes, written supporting material, and foods that form part of the Atlantic diet, whereas those randomized to the control group followed their habitual lifestyle. 213 families (92.4%) completed the trial. Adults in the intervention group lost weight as opposed to controls who gained weight (adjusted mean difference -1.1 kg, p < 0.001) and total serum cholesterol (adjusted mean difference -5.2 mg/dL, p = 0.004). Significant differences in favor of the intervention were found in other anthropometric variables and low-density lipoprotein cholesterol, but changes in triglycerides, high-density lipoprotein cholesterol, inflammation markers, blood pressure, and glucose metabolism were not observed. A family-based nutritional intervention based on the Atlantic diet showed beneficial effects on adiposity and the lipid profile.

A propósito de la adecuación de la demanda. Nefropatía diabética / Adjusting of the demand. Diabetic nephropathy

Introducción. La importancia de la determinación de albúmina en orina ha sido claramente establecida; sin embargo, existe controversia sobre las recomendaciones a seguir para su uso en el diagnóstico de la nefropatía diabética. El objetivo de este trabajo es evaluar los resultados y los costes del programa de escrutinio de la nefropatía diabética en nuestra área sanitaria. Material y métodos. Se ha realizado un estudio descriptivo retrospectivo sobre la demanda de escrutinios para detección de la nefropatía diabética en el año 2006. Para ello, se ha analizado una muestra de 1.111 escrutinios solicitados por los médicos de Atención Primaria. Los pacientes se han clasificado en los distintos estadios de la nefropatía diabética de acuerdo a la excreción urinaria de albúmina. Resultados. Solo el 39,7% de los escrutinios cumplieron con todos los criterios de prescripción especificados en el programa. La frecuencia de resultados positivos fue distinta según el sexo y el grupo de edad considerado. El coste por resultado positivo fue de 29,61€ para varones mientras que resultó de 71,17€ para mujeres, para un intervalo de edad de 12–70 años. Conclusiones. La adecuación de la demanda es necesaria para asegurar la eficiencia de la atención sanitaria (AU)

Introduction. The importance of measuring albumin in urine is well established; however, there is still controversy regarding the recommendations to be used for detecting early renal impairment in diabetic patients. The objective of this work is to evaluate the results and the costs of the screening program for diabetic nephropathy in our health area. Material and methods. A retrospective descriptive study was carried out on the requests for screening for diabetic nephropathy in 2006. We performed 1111 diabetic nephropathy screening tests requested by general practitioners. Patients were classified into different clinical nephropathy stages according to their albumin excretion rate. Results. Only 39.7% of the requests for diabetic nephropathy screening fulfilled all the prescription criteria specified in the program. The frequency of positive results was different in relation to sex and age groups. The cost per positive result was 29.61€ for men, whereas it was 71.17€ for women, in the 12–70 years age group. Conclusions. The adjustment of the demand is necessary to ensure the efficiency of health care (AU)

Etiología y resistencia bacteriana de las infecciones urinarias extrahospitalarias del norte de Tenerife / Etiology and antibacterial resistances of urinary infection of outpatients in north of Tenerife

Objectivo. Conocer los microorganismos causantes de las infecciones urinarias extrahospitalarias y sus resistencias antimicrobianas en nuestra área para facilitar el tratamiento antibiótico de forma empírica. Diseño. Se describen las infecciones del tracto urinario (ITU) identificadas a partir de la revisión sistemática de los resultados de urianálisis y urocultivo realizados en nuestro laboratorio. Pacientes y métodos. Urocultivos solicitados y remitidos a nuestro laboratorio entre los meses de abril a noviembre de 2003. Se identificó el tipo de germen y la sensibilidad antibiótica. Se analizaron un total de 4.874 urocultivos, de los cuales 1.310 (27 por ciento) fueron positivos. El germen más prevalente fue E. coli (48 por ciento) con mayor sensibilidad a fosfomicina, nitrofurantoína y amoxicilinaclavulánico, seguido de E. faecalis (14 por ciento), P. mirabilis (4 por ciento) y K. pneumoniae (3 por ciento). Conclusiones. E. coli fue el germen más frecuentemente aislado. Considerando una tasa de resistencia inferior al 20 por ciento para el empleo empírico de antibióticos en las ITU no complicadas, no se recomienda el uso de ampicilina, cotrimoxazol y quinolonas. En nuestro medio, los antibióticos de elección para el tratamiento de ITU serían amoxicilina-clavulánico y cefalosporinas de primera generación (AU)

Estimación de la prevalencia de hipotiroidismo clínico y de hipertiroidismo clínico en el Área Norte de la isla de Tenerife / Estimation of prevalence the hypothyroidism and hyperthyroidism in the Area North of the Tenerife island

Fundamento. La determinación analítica de tirotropina puede proporcionar un diagnóstico correcto en la mayoría de pacientes con trastornos de la glándula tiroidea, pero si se emplea de forma inapropiada puede resultar ineficiente. El objetivo de este trabajo es estimar la prevalencia de hipotiroidismo clínico y de hipertiroidismo clínico en la población en general mediante el escrutinio de los trastornos de la glándula tiroidea realizado por los médicos de Atención Primaria. Métodos. Se ha realizado un estudio retrospectivo sobre el escrutinio para la detección de trastornos de la glándula tiroidea, desarrollado en el Área Norte de la isla de Tenerife y durante los años de 2000 a 2002. Para ello se ha analizado una muestra de 24.424 escrutinios. Resultados. La prevalencia de hipotiroidismo clínico en la población en general se ha estimado en el 1,22 por ciento. La prevalencia de hipertiroidismo clínico ha quedado establecida en el 0,50 por ciento. El porcentaje de pacientes con tiroxicosis por triidotironina frente aquellos con hipertiroidismo clínico fue del 8,73 por ciento. Los casos de hipotiroidismo clínico e hipertiroidismo clínico relacionados con enfermedades hipotalámicas-hipofisarias fueron muy infrecuentes. Conclusiones. La evidencia mediante estudios comunitarios es que el escrutinio sistemático de la población sólo detecta pocos pacientes con trastornos de la glándula tiroidea y, por tanto, están injustificados. En nuestro caso, se recomienda aplicar el escrutinio a los grupos de alto riesgo, como en mujeres con edades superiores a los 45 años y en varones con edades superiores a los 75 años (AU)