Comprehensive insight into the alterations in the gut microbiome and the intestinal barrier as a consequence of iron deficiency anaemia.

BACKGROUND: Iron deficiency is the top leading cause of anaemia, whose treatment has been shown to deteriorate gut health. However, a comprehensive analysis of the intestinal barrier and the gut microbiome during IDA have not been performed to date. This study aims to delve further into the analysis of these two aspects, which will mean a step forward minimising the negative impact of iron supplements on intestinal health. METHODS: IDA was experimentally induced in an animal model. Shotgun sequencing was used to analyse the gut microbiome in the colonic region, while the intestinal barrier was studied through histological analyses, mRNA sequencing (RNA-Seq), qPCR and immunofluorescence. Determinations of lipopolysaccharide (LPS) and bacteria-specific immunoglobulins were performed to assess microbial translocation. RESULTS: Microbial metabolism in the colon shifted towards an increased production of certain amino acids, short chain fatty acids and nucleotides, with Clostridium species being enriched during IDA. Structural alterations of the colonic epithelium were shown by histological analysis. RNA-Seq revealed a downregulation of extracellular matrix-associated genes and proteins and an overall underdeveloped epithelium. Increased levels of serum LPS and an increased immune response against dysbiotic bacteria support an impairment in the integrity of the gut barrier during IDA. CONCLUSIONS: IDA negatively impacts the gut microbiome and the intestinal barrier, triggering an increased microbial translocation. This study emphasizes the deterioration of gut health during IDA and the fact that it should be addressed when treating the disease.

Fermented Goat's Milk Contributes to the Recovery of Iron Deficiency Anemia via Modulation of the Gut Microbiome.

Iron deficiency anemia (IDA) is a global public health concern affecting 1.6 billion people worldwide. The administration of iron supplements during the treatment of IDA adversely affects the intestinal barrier function and the composition and functionality of the intestinal microbiome, both of which are already altered during IDA. For this reason, it is of great interest to develop nutritional strategies aimed at alleviating these gut alterations associated with IDA and its treatment. In this sense, fermented goat's milk (FGM) was studied due to its nutritional quality. Our findings showed that in anemic animals the consumption of a FGM-based diet, compared to a standard diet, had positive modulatory effects on the intestinal microbiome. FGM-based diet restored intestinal dysbiosis, the intestinal barrier functionality, and bacterial translocation, contributing to a more efficient recovery of IDA. Therefore, FGM is a useful nutritional tool to ease intestinal alterations occurring during IDA and during its treatment.

Gut microbiome-short-chain fatty acids interplay in the context of iron deficiency anaemia.

PURPOSE: Anaemia is a global health concern, with iron deficiency anaemia (IDA) causing approximately 50% of cases. Affecting mostly the elderly, pregnant and adult women and children, physiopathology of IDA in relation to the gut microbiome is poorly understood. Therefore, the objective of this study is to analyse, in an animal model, the effect of IDA on the gut microbiome along the gastrointestinal tract, as well as to relate intestinal dysbiosis to changes in microbial metabolites such as short chain fatty acids (SCFA). METHODS: IDA was experimentally induced through an iron deficient diet for a period of 40 days, with twenty weaned male Wistar rats being randomly divided into control or anaemic groups. Blood samples were collected to control haematological parameters, and so were faecal and intestinal content samples to study gut microbial communities and SCFA, using 16S rRNA sequencing and HPLC-UV respectively. RESULTS: An intestinal dysbiosis was observed as a consequence of IDA, especially towards the distal segments of the gastrointestinal tract and the colon. An increase in SCFA was also noticed during IDA, with the major difference appearing in the colon and correlating with changes in the composition of the gut microbiome. Clostridium_sensu_stricto_1 and Clostridium_sensu_stricto_4 showed the greatest correlation with variations in butyric and propionic concentrations in the colon of anaemic animals. CONCLUSIONS: Composition of intestinal microbial communities was affected by the generation of IDA. An enrichment in certain SCFA-producing genera and SCFA concentrations was found in the colon of anaemic animals, suggesting a trade-off mechanism against disease.

Fermented goat's milk modulates immune response during iron deficiency anemia recovery.

BACKGROUND: Iron deficiency and iron overload can affect the normal functioning of the innate and adaptive immune responses. Fermented milk products may enhance immune functions, but little is known about the effect of fermented milks on modulation of the immune response during iron deficiency anemia and recovery with normal or high dietary iron intake. Eighty male Wistar rats were randomly assigned to a control group fed a standard diet or to an anemic group fed a diet deficit in iron. Control and anemic groups were fed for 30 days with diets based on a fermented goat's or cow's milk product, with normal iron content or iron overload. RESULTS: In general, during anemia recovery lectin and alternative complement pathway activity and lactoferrin decreased, because it improves iron homeostasis, which is critically important in immune system functions. Fermented goat's milk diet enhanced immune function during iron deficiency recovery, suppressed oxidant-induced eotaxin and fractalkine expression due to the concurrent reduction of free radical production and pro-inflammatory cytokines, and decreased monocyte chemoattractant protein-1 and monocyte migration and adhesion. The increase in interferon-γ can confer immunological colonization of gut microbiota and downregulate inflammation. CONCLUSION: Fermented goat's milk consumption enhances immune function, modifying complement pathway activity and decreasing pro-inflammatory cytokines as well as lactoferrin concentration, due to the improvement of iron homeostasis, which is critically important in the normal function of the immune system. © 2021 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Lockdown, Emotional Intelligence, Academic Engagement and Burnout in Pharmacy Students during the Quarantine.

The recent appearance and rapid spread of the new SARS-CoV-2 coronavirus meant taking unprecedented measures to control the pandemic, which in Spain forced a state of alarm and a very strict confinement, leading the university system to become virtual online teaching. Taking into account the emotional deficiencies originated during the pandemic, among the most powerful tools to achieve engagement along with the identification, control and management of emotions is emotional intelligence (EI). The present study aims to establish the effect of the current confinement on the teaching-learning process and academic performance and the impact of the application of EI on university students. In total, 47 volunteers of the second course of the Degree in Pharmacy of the University of Granada (Spain) took part in this experience. Two temporary periods were established: at the beginning of the confinement period and after teaching several concepts of emotional intelligence online for two months. The Maslach Burnout Inventory-Student Survey Inventory (MBI-SS) and the Spanish version of Utrech Work Engagement Scale-Students (UWES-S) were used to evaluate the intervention. In total, 63.5% of the students presented academic burnout during the confinement before the intervention. After the EI workshops and seminars, only 31.1% presented academic burnout. Before the intervention with the emotional intelligence workshops, 44.6% experienced exhaustion, 41.7% cynicism and 60.3% felt it was ineffective in their academic performance. After the emotional intelligence workshops and seminars, 29.1% experienced exhaustion, 30.1% cynicism and 28.8% felt it was ineffective. The scores achieved after the study of EI in physiology classes led to better levels in all the variables studied. Students managed their adaptive processes more adequately and regulated their emotions better, as they felt less academic burnout and more engaged in their academic activities at the end of the study of EI through physiology.

Estatus férrico, cambios ponderales y composición corporal durante la recuperación de la anemia en un modelo experimental: efecto de la leche fermentada de cabra o vaca / Iron status, weight changes and body composition during anemia recovery in an experimental model: the effect of fermented goat or cow milk

INTRODUCCIÓN: la anemia constituye un problema de salud pública a nivel mundial y, aunque la dieta sigue siendo el principal determinante del estatus férrico del organismo, la adiposidad y la composición corporal también podrían ser determinantes adicionales del estado del hierro. La dieta juega un papel clave en la composición corporal, además de afectar al balance energético; sin embargo, todavía hay información limitada sobre la influencia de determinados alimentos y nutrientes específicos, como los productos lácteos fermentados. OBJETIVO: determinar la relación entre el estatus férrico, cambios ponderales, ingesta, índice hepatosomático y composición corporal durante la recuperación de la anemia ferropénica con dietas basadas en leche fermentada de cabra o vaca. MATERIAL Y MÉTODOS: sesenta ratas macho Wistar albinas se han distribuido en dos grupos experimentales (control y anémico) y se han alimentado durante 40 días con dieta AIN-93G con contenido de hierro normal (45 mg/kg de dieta) o bajo (5 mg/kg de dieta). Posteriormente, ambos grupos experimentales se alimentaron durante 30 días con dietas basadas en leche fermentada de cabra o vaca. Se han determinado los parámetros hematológicos y bioquímicos relacionados con el estatus de hierro, así como los cambios ponderales y la ingesta de alimento, la relación hepatosomática y la composición corporal. RESULTADOS: el índice hepatosomático fue mayor en el grupo anémico (p < 0,05). En ambos grupos de animales alimentados con dieta de leche fermentada de cabra, el índice hepatosomático fue mayor (p < 0,001) debido a un menor peso corporal (p < 0,01) y a un mayor peso del hígado (p < 0,001). La ingesta de alimento, la ganancia de peso y la grasa corporal fueron menores en el grupo anémico (p < 0,05, p < 0,001, p < 0,001, respectivamente), mientras que la masa magra, el agua libre y el agua total fueron mayores (masa magra: p < 0,01; agua libre y total: p < 0,001). En ambos grupos de animales alimentados con dieta basada en leche fermentada de cabra, el peso y la grasa corporal fueron menores (p < 0,001), mientras que los porcentajes de masa magra, agua libre y agua total fueron mayores (masa magra: p < 0,01; agua libre y total: p < 0,001). CONCLUSIÓN: la ferrodeficiencia disminuyó la ganancia de peso, la masa magra y la grasa corporal, indicando menores almacenes de energía. La dieta basada en leche fermentada de cabra recupera más eficientemente el nivel de hierro durante la recuperación de la ferrodeficiencia, disminuye la adiposidad y aumenta el gasto energético

BACKGROUND: anemia is a public health problem worldwide and although diet is still the main determinant of iron status in the body, recent studies suggest that adiposity and body composition could be additional determinants of iron status. Diet plays a key role in body composition, but in addition to affecting the body's energy balance, there is still limited information on the influence of specific foods and nutrients, and in this sense dairy products are an important group of foods and an important source of nutrients in the diet. OBJECTIVE: to provide detailed information on iron status, body changes, food intake, hepatosomatic index, and body composition during recovery from severe iron deficiency anemia with fermented cow or goat milk. MATERIAL AND METHODS: sixty male Wistar albino rats were divided into two experimental groups (control and anemic) and fed ad libitum an AIN-93G diet for 40 days, receiving a normal Fe diet (45 mg/kg of diet) or a low-Fe diet (5 mg/kg of diet), respectively. After induction of anemia, both the control and anemic groups were additionally fed for 30 days either a fermented cow milk-based or fermented goat milk-based diet with normal Fe content. Hematological and iron-related biochemical parameters, weight changes, food intake, hepatosomatic index, and body composition were assessed. RESULTS: the hepatosomatic index was higher in the anemic group versus the control group (p < 0.05). In both groups fed a fermented goat milk-based diet the hepatosomatic index was higher (p < 0.001) due to lower body weight (p < 0.01) and a higher liver weight (P < 0.001). Food intake, weight gain, and total body fat were lower (p < 0.05, p < 0.001, p < 0.001, respectively), whereas lean mass and free and total water were higher (lean mass: p < 0.01; free and total water: p < 0.001) in the anemic group as compared to the control group. In both animal groups fed a fermented goat milk-based diet body weight and body fat were lower (p < 0.001) and the percentages of lean mass and free water and total water were higher (lean mass: p < 0.01; free and total water: p < 0.001). CONCLUSION: iron deficiency decreased weight gain, lean mass, and body fat, indicating lower energy stores. Fermented goat milk-based diet recovers more efficiently iron status, decreased adiposity, and increased energy expenditure

Role of Fermented Goat Milk on Liver Gene and Protein Profiles Related to Iron Metabolism during Anemia Recovery.

Despite the crucial role of the liver as the central regulator of iron homeostasis, no studies have directly tested the modulation of liver gene and protein expression patterns during iron deficiency instauration and recovery with fermented milks. Fermented goat milk consumption improves the key proteins of intestinal iron metabolism during iron deficiency recovery, enhancing the digestive and metabolic utilization of iron. The aim of this study was to assess the influence of fermented goat or cow milk consumption on liver iron homeostasis during iron-deficiency anemia recovery with normal or iron-overload diets. Analysis included iron status biomarkers, gene and protein expression in hepatocytes. In general, fermented goat milk consumption either with normal or high iron content up-regulated liver DMT1, FPN1 and FTL1 gene expression and DMT1 and FPN1 protein expression. However, HAMP mRNA expression was lower in all groups of animals fed fermented goat milk. Additionally, hepcidin protein expression decreased in control and anemic animals fed fermented goat milk with normal iron content. In conclusion, fermented goat milk potentiates the up-regulation of key genes coding for proteins involved in iron metabolism, such as DMT1, and FPN1, FTL1 and down-regulation of HAMP, playing a key role in enhanced iron repletion during anemia recovery, inducing a physiological adaptation of the liver key genes and proteins coordinated with the fluctuation of the cellular iron levels, favoring whole-body iron homeostasis.

Efecto de la leche fermentada de cabra sobre la composición corporal, el metabolismo basal y el control de la ingesta en ratas / Effect of fermented goat milk on body composition, basal metabolism, and food intake control in rats

Introducción: es conocido que la dieta juega un papel clave en la composición corporal y afecta al balance energético; sin embargo, la información es limitada acerca de la influencia de alimentos y nutrientes específicos como es el caso de los productos lácteos, un grupo básico de alimentos y una importante fuente de nutrientes en la dieta. Objetivos: evaluar la influencia del consumo de leche fermentada de cabra o vaca sobre la composición corporal y la regulación del apetito en animales adultos. Material y métodos: se han utilizado 20 ratas Wistar macho adultas, alimentadas durante 30 días con dietas basadas en leche fermentada de vaca o de cabra. Se analizaron la evolución de la composición corporal y las concentraciones plasmáticas de adipoquinas (leptina y adiponectina), hormonas reguladoras del metabolismo intermediario (grelina, insulina, hormona estimulante de la glándula tiroides, triyodotironina y tiroxina) y ácidos grasos no esterificados (AGNE). Resultados: el peso y el porcentaje de grasa corporal fueron menores (p < 0,001) y la masa magra fue mayor (p < 0,01) en los animales alimentados con la dieta basada en leche fermentada de cabra. No se registraron diferencias entre dietas para las concentraciones plasmáticas de hormonas tiroideas y de insulina. Las concentraciones plasmáticas de grelina y adiponectina disminuyeron (p < 0,001), y las de leptina y AGNE aumentaron (p < 0,001) con la dieta basada en leche fermentada de cabra. Conclusión: el consumo habitual de leche fermentada de cabra disminuye la adiposidad y el peso corporal en las ratas adultas al incrementar el gasto energético, la lipólisis y la sensación de saciedad

Introduction and objective: it is known that diet plays a key role in body composition and affects energy balance. However, scarce information is available in the scientific literature about the influence of food and specific nutrients such us dairy products, a basic food group and an important source of nutrients in the diet. The objective of this work was to evaluate the influence of fermented dairy products (goat or cow milk) on body composition and appetite regulation in adult animals. Material and methods: twenty adult male Wistar albino rats were fed fermented goat or cow milk-based diets for 30 days. The evolution of body composition and plasma concentrations of adipokines (leptine and adiponectine), intermediary metabolism regulating hormones (ghrelin, insulin, thyroid stimulating hormone, triyodotironine, thyroxine), and non-esterified fatty acid (NEFA) were analyzed. Results: body weight and body fat percentage were lower (p < 0.001) in rats fed fermented goat milk versus those fed fermented cow milk, whereas lean mass percentage was higher (p < 0.01). Plasma thyroid hormone and insulin concentrations did not show significant differences between diets. The fermented goat milk-based diet decreased ghrelin and adiponectin levels (p < 0.001), and increased leptine and NEFA concentrations (p < 0.001). Conclusion: fermented goat milk consumption decreases adiposity and body weight in adult rats by increasing energy expenditure, lipolysis, and satiety sensation

Fermented Goat Milk Consumption Enhances Brain Molecular Functions during Iron Deficiency Anemia Recovery.

Iron deficiency anemia (IDA) is one of the most prevalent nutritional deficiencies worldwide. Iron plays critical roles in nervous system development and cognition. Despite the known detrimental consequences of IDA on cognition, available studies do not provide molecular mechanisms elucidating the role of iron in brain functions during iron deficiency and recovery with dairy components. In this study, 100 male Wistar rats were placed on a pre-experimental period of 40 days and randomly divided in two groups: a control group receiving a normal-Fe diet, (45 mg/kg), and an Fe-deficient group receiving a low-Fe diet (5 mg/kg). At day 40, 10 rats per group were sacrificed to anemia control, and 80 rats were divided into eight experimental groups fed with fermented goat or cow milk-based diets, with normal Fe content or Fe overload (450 mg/kg) for 30 days. IDA decreased most of the parameters related to brain molecular functions, namely dopamine, irisin, MAO-A, oxytocin, ß-endorphin, and α-MSH, while it increased synaptophysin. These alterations result in an impairment of brain molecular functions. In general, during anemia recovery, fermented goat milk diet consumption increased dopamine, oxytocin, serotonin, synaptophysin, and α-MSH, and decreased MAO-A and MAO-B, suggesting a potential neuroprotective effect in brain functions, which could enhance brain molecular functions.

Multifactorial Etiology of Anemia in Celiac Disease and Effect of Gluten-Free Diet: A Comprehensive Review.

Celiac disease (CD) is a multisystemic disorder with different clinical expressions, from malabsorption with diarrhea, anemia, and nutritional compromise to extraintestinal manifestations. Anemia might be the only clinical expression of the disease, and iron deficiency anemia is considered one of the most frequent extraintestinal clinical manifestations of CD. Therefore, CD should be suspected in the presence of anemia without a known etiology. Assessment of tissue anti-transglutaminase and anti-endomysial antibodies are indicated in these cases and, if positive, digestive endoscopy and intestinal biopsy should be performed. Anemia in CD has a multifactorial pathogenesis and, although it is frequently a consequence of iron deficiency, it can be caused by deficiencies of folate or vitamin B12, or by blood loss or by its association with inflammatory bowel disease (IBD) or other associated diseases. The association between CD and IBD should be considered during anemia treatment in patients with IBD, because the similarity of symptoms could delay the diagnosis. Vitamin B12 deficiency is common in CD and may be responsible for anemia and peripheral myeloneuropathy. Folate deficiency is a well-known cause of anemia in adults, but there is little information in children with CD; it is still unknown if anemia is a symptom of the most typical CD in adult patients either by predisposition due to the fact of age or because biochemical and clinical manifestations take longer to appear.

Publisher Correction: Protective effects of fermented goat milk on genomic stability, oxidative stress and inflammatory signalling in testis during anaemia recovery.

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Iron Deficiency and Neuroendocrine Regulators of Basal Metabolism, Body Composition and Energy Expenditure in Rats.

Although dietary iron is a determinant of iron status in animals, body fat mass has been reported to have an inverse association with iron status in human studies. The goal of this study was to determine the relationship between Fe homeostasis, body composition, energy expenditure and neuroendocrine regulators for severe Fe-deficiency anaemia. Forty male Wistar albino rats recently weaned were divided at random into two groups: the control group was fed the basal diet, AIN-93G diet (normal-Fe) and the anaemic group received a low-Fe diet for 40 days. Neuroendocrine parameters that regulate basal metabolism and appetite (thyroid hormones, ghrelin, glucose-dependent insulinotropic polypeptide (GIP), glucagon, insulin, adrenocorticotropic hormone and corticosterone), body composition, respiratory volumes, energy expenditure, haematological and biochemical were assessed. Total body fat was lower, whereas lean mass, free and total water were higher in the anemic group. O2 consumption, CO2 production, energy expenditure (EE) and respiratory quotient (RQ) were lower in the Fe-deficient animals. Triiodothyronine and thyroxine hormones decreased, while thyroid-stimulating hormone increased in the anemic group. Circulating levels of ghrelin were lower in the anemic group, while GIP, glucagon, insulin, corticosterone and adrenocorticotropic hormone levels were higher. Fe-deficiency impairs weight gain in the rats, with marked reductions in lean mass and body fat, indicating lower energy stores.

Protective effects of fermented goat milk on genomic stability, oxidative stress and inflammatory signalling in testis during anaemia recovery.

Oxidative stress is a harmful factor for male reproductive function, and a major cause of infertility. On the other hand, fermented goat milk has positive effects on anemia recovery and mineral metabolism. This study evaluated the effect of feeding rats with fermented milks during anaemia recovery on molecular mechanisms linked to oxidative stress and inflammatory signalling in rats reproductive system. Forty male Wistar rats were placed on a pre-experimental period of 40 days (control group, receiving normal-Fe diet and Fe-deficient group, receiving low-Fe diet). Lately, rats were fed with fermented goat or cow milk-based diets during 30 days. After feeding the fermented milks, Total antioxidant status (TAS) and non-esterified fatty acids (NEFA) increased and 8-hydroxy-2'-deoxyguanosine (8-OHdG), 15-F2t-isoprostanes and thiobarbituric acid reactive substances (TBARS) decreased in testis. DNA oxidative damage in testis germ cells was lower with fermented goat milk. Fermented goat milk reduced IL-6 and TNF-α in control animals, increasing INF-γ in control and anaemic rats. NRF2 and PGC-1α protein levels increased in testis after fermented goat milk consumption in control and anaemic rats. Fermented goat milk also increased TAS and decreased oxidative damage, protecting the main testis cell bioconstituents (lipids, proteins, DNA, prostaglandins) from oxidative damage and reduced inflammatory activity, preventing injuries to testis germinal epithelium. Fermented goat milk enhanced lipolysis, fatty acids degradation and immune response, attenuating inflammatory signalling, representing a positive growth advantage for testicular cells.

Fermented goat milk consumption improves cardiovascular health during anemia recovery.

BACKGROUND: Iron (Fe) plays a crucial role in several fundamental processes, including erythropoiesis, cellular metabolism, and in cardiovascular disease. The aim of this work was to contribute to a better understanding of the physiology of and recovery from Fe deficiency by studying how fermented milk consumption affects vascular biomarkers during Fe repletion. RESULTS: The deleterious cardiovascular biomarkers cytokine-induced neutrophil chemoattractant 1, connective tissue growth factor (CTGF), interleukin-6, monocyte chemoattractant protein-1 (MCP-1), inhibitor of tissue plasminogen activator 1 total, metallopeptidase inhibitor 1 (TIMP-1), tumor necrosis factor alpha, vascular endothelial growth factor (VEGF), sE-selectin, and soluble intercellular adhesion molecule 1 (sICAM-1) decreased after fermented goat milk consumption in groups of fed animals either with normal Fe or Fe overload with respect to rats fed with fermented cow milk. The beneficial cardiovascular biomarkers caveolin-1 and adiponectin were higher in both control and anemic rats fed fermented goat milk either with normal Fe or Fe overload with respect to fermented cow milk. Anemia decreased TIMP-1 in rats fed fermented goat milk with Fe overload, whereas there was increased CTGF and MCP-1 in animals fed fermented cow milk with either normal or Fe overload. In addition, Fe overload increased VEGF. CONCLUSION: Fermented goat milk consumption improves hematological status and promotes beneficial metabolic responses, which may attenuate cardiovascular risk factors during anemia recovery and iron overload to lessen the inflammatory response, macrophages activation and atherosclerosis development. © 2018 Society of Chemical Industry.

Análisis predictivo que evalúa la pérdida de masa magra en pacientes oncológicos expuestos a tratamiento de radioterapia / Predictive analytics assessing the lean mass loss in oncologic patients exposed to radiotherapy treatment

ANTECEDENTES: la pérdida de masa magra en el paciente oncológico produce graves consecuencias, tales como: la disminución de la calidad de vida, la peor tolerancia a los tratamientos y el aumento de los costos de la asistencia social. OBJETIVO: El objetivo del presente estudio fue establecer y desarrollar un análisis predictivo que evalúe la pérdida de masa magra experimentada en pacientes oncológicos en tratamiento de radioterapia. MÉTODOS: Se realizó un análisis prospectivo, tomando una muestra de 231 pacientes oncológicos que han sido expuestos a radioterapia. Las mediciones antropométricas se han registrado a través del instrumento TANITA TBF-300. El método hacia atrás se ha utilizado para determinar la ecuación que se desarrolla a partir de un modelo de regresión completo que incluye varias variables independientes. RESULTADOS: solo se estudiaron 197 pacientes que conformaron la muestra. La variable más representativa que contribuyó a la pérdida de masa magra se ha tomado como una variable de referencia. Esta es el tratamiento de quimioterapia (p = 0.02, IC = 95%), y a través del análisis estadístico, se ha obtenido la siguiente ecuación: % de pérdida de masa magra = -0.453 + 0.167% de contenido de agua inicial - 0.065% de masa magra + 0.246% de peso pérdida (R2 = 0.264, F = 5.375, p <0.01). CONCLUSIÓN: La ecuación obtenida para predecir el% de pérdida de masa magra, en cualquier punto o etapa durante el curso del tratamiento, es efectiva y confiable

BACKGROUND: The loss of lean mass in the oncological patient produces serious consequences such as: the decrease in the quality of life, in tolerance to treatments and increase in social healthcare costs. OBJECTIVE: The aim of the present study was to establish and develop a predictive analytics which assesses for the lean mass loss experienced in oncologic patients under radiotherapy treatment. METHODS: A prospective analysis has been undertaken, taking a sample of 231 oncologic patients which have been exposed to radiotherapy treatment. Anthropometric measurements have been recorded via TANITA TBF-300 instrument. Backward method has been used to determine the equation which develops from a complete regression model including several independent variables. RESULTS: Only 197 patients that conformed the sample were studied. The most representative variable that contributed to the lean mass loss has been taken as a reference variable. This is the chemotherapy treatment (p = 0.02, IC = 95%), and through statistical analysis, the following equation has been obtained:% lean mass loss = -0.453 + 0.167 % initial water content - 0.065 % lean mass + 0.246 % weight loss (R2 = 0.264, F = 5.375, p < 0.01). CONCLUSION: The equation obtained to predict the % lean mass loss, at any point or stage during the treatment course, is effective and reliable

[Analysis of three methods of nutritional screening in oncologic patients]. / Cribado nutricional en pacientes oncológicos: análisis de tres métodos.

BACKGROUND: malnutrition is one of the complications that appears most frequently in oncological patients and causes serious consequences such as loss of lean mass. OBJECTIVE: to know which nutritional screening method is most useful in predicting the loss of lean mass in cancer patients. METHODS: a descriptive study was carried out evaluating three methods of nutritional screening, Malnutrition Screening Tool (MST), Malnutrition Universal Screening (MUST) and Nutritional Risk Screening (NRS-2002), in oncological patients undergoing radiotherapy treatment. Each method was analyzed by ROC curves with AUC calculation. RESULTS: loss of lean mass is present in 48.73% of the patients. Of them, 29.44% present a loss of lean mass between 0-2%; 10.66% of patients, between 2-5%; and 8.13% of patients present a loss of lean mass > 5%. The results show that when taking a loss of lean mass > 5% as a cut-off point, the MST method has a higher AUC than the one presented by the MUST and the NRS-2002 (0.596, CI: 0.444-0.747), with significant statistics (p = 0.041). In addition, it presents high sensitivity and positive and negative predictive value. CONCLUSIONS: MST is a more valid nutritional screening method than MUST and NRS-2002 to predict the loss of lean mass > 5% in oncological patients undergoing radiotherapy treatment. Its routine use is recommended in patients under radiotherapy treatment.

INTRODUCCIÓN: la desnutrición es una de las complicaciones que aparecen con mayor frecuencia en el paciente oncológico y provoca graves consecuencias como la pérdida de masa magra. OBJETIVO: conocer qué método de cribado nutricional es más útil en la predicción de la pérdida de masa magra en pacientes oncológicos. MÉTODOS: se ha realizado un estudio descriptivo prospectivo en el que se evalúan el método de cribado nutricional Malnutrition Screening Tool (MST), el Malnutrition Universal Screening (MUST) y el Nutritional Risk Screening (NRS-2002) en pacientes oncológicos sometidos a tratamiento de radioterapia. Se analizó cada método mediante curvas ROC con cálculo AUC. RESULTADOS: el 48,73% de los pacientes presentan pérdida de masa magra. De ellos, el 29,44% presenta una pérdida de masa magra entre 0-2%; el 10,66%, entre el 2-5%; y el 8,13% presenta una pérdida de masa magra > 5%. Los resultados muestran que cuando se toma como punto de corte la pérdida de masa magra > 5%, el método MST presenta un AUC superior al presentado por el MUST y el NRS-2002 (0,596; IC: 0,444-0,747) y con significación estadística (p = 0,041). Además, presenta una alta sensibilidad y valor predictivo positivo y negativo. CONCLUSIONES: el MST es un método de cribado nutricional más válido que el MUST y el NRS-2002 para predecir la pérdida de masa magra > 5% en pacientes oncológicos sometidos a tratamiento radioterápico. Se recomienda su uso rutinario en todos los pacientes que acuden a tratamiento de radioterapia.

Cribado nutricional en pacientes oncológicos: análisis de tres métodos / Analysis of three methods of nutritional screening in oncologic patients

Introducción: la desnutrición es una de las complicaciones que aparecen con mayor frecuencia en el paciente oncológico y provoca graves consecuencias como la pérdida de masa magra. Objetivo: conocer qué método de cribado nutricional es más útil en la predicción de la pérdida de masa magra en pacientes oncológicos. Métodos: se ha realizado un estudio descriptivo prospectivo en el que se evalúan el método de cribado nutricional Malnutrition Screening Tool (MST), el Malnutrition Universal Screening (MUST) y el Nutritional Risk Screening (NRS-2002) en pacientes oncológicos sometidos a tratamiento de radioterapia. Se analizó cada método mediante curvas ROC con cálculo AUC. Resultados: el 48,73% de los pacientes presentan pérdida de masa magra. De ellos, el 29,44% presenta una pérdida de masa magra entre 0-2%; el 10,66%, entre el 2-5%; y el 8,13% presenta una pérdida de masa magra > 5%. Los resultados muestran que cuando se toma como punto de corte la pérdida de masa magra > 5%, el método MST presenta un AUC superior al presentado por el MUST y el NRS-2002 (0,596; IC: 0,444-0,747) y con significación estadística (p = 0,041). Además, presenta una alta sensibilidad y valor predictivo positivo y negativo. Conclusiones: el MST es un método de cribado nutricional más válido que el MUST y el NRS-2002 para predecir la pérdida de masa magra > 5% en pacientes oncológicos sometidos a tratamiento radioterápico. Se recomienda su uso rutinario en todos los pacientes que acuden a tratamiento de radioterapia

Background: malnutrition is one of the complications that appears most frequently in oncological patients and causes serious consequences such as loss of lean mass. Objective: to know which nutritional screening method is most useful in predicting the loss of lean mass in cancer patients. Methods: a descriptive study was carried out evaluating three methods of nutritional screening, Malnutrition Screening Tool (MST), Malnutrition Universal Screening (MUST) and Nutritional Risk Screening (NRS-2002), in oncological patients undergoing radiotherapy treatment. Each method was analyzed by ROC curves with AUC calculation. Results: loss of lean mass is present in 48.73% of the patients. Of them, 29.44% present a loss of lean mass between 0-2%; 10.66% of patients, between 2-5%; and 8.13% of patients present a loss of lean mass > 5%. The results show that when taking a loss of lean mass > 5% as a cut-off point, the MST method has a higher AUC than the one presented by the MUST and the NRS-2002 (0.596, CI: 0.444-0.747), with significant statistics (p = 0.041). In addition, it presents high sensitivity and positive and negative predictive value. Conclusions: MST is a more valid nutritional screening method than MUST and NRS-2002 to predict the loss of lean mass > 5% in oncological patients undergoing radiotherapy treatment. Its routine use is recommended in patients under radiotherapy treatment

Fermented goat milk consumption improves iron status and evokes inflammatory signalling during anemia recovery.

In spite of the crucial role of the inflammatory state under anemic conditions, to date, no studies have directly tested the modulation of cytokines during iron overload. The aim of this work was to contribute to a better understanding of the pathophysiology and recovery from iron deficiency, by studying how fermented goat milk consumption affects inflammatory signalling during iron repletion. Eighty male Wistar rats were used for a pre-experimental period of 40 days, by dividing them into two groups (the control group receiving a normal-Fe diet and the Fe-deficient group receiving a low-Fe diet). Later, the rats were fed with a fermented goat or cow milk-based diet, with a normal-Fe content or Fe-overload (450 mg kg-1) for 30 days. After feeding the fermented milk, the anti-inflammatory and pro-inflammatory cytokines were assessed. The anti-inflammatory cytokines (IL-13, IL-10 and IL-4) were higher in both groups of animals (control and anemic) fed fermented goat milk either with normal Fe or Fe-overload with respect to the fermented cow milk. With regard to pro-inflammatory signalling, fermented goat milk consumption decreased the pro-inflammatory cytokines (IL-2, TNF-α, IL-1ß, IL-12p70 and IP-10). The Fe overload increased the anti-inflammatory cytokines together with IL-1ß and IP-10. Fermented goat milk consumption improves the hematological status and promotes the beneficial metabolic responses related to the inflammatory signaling in nutritional ferropenic anemia recovery, which may be a dietary strategy to lessen the evoked inflammation during iron repletion. Additionally, the parameters of inflammation should therefore be incorporated as routine biomarkers of iron deficiency or overload severity.

Correlation between loss of lean mass and quality of life in cancer patients / Relación entre la pérdida de masa magra y la calidad de vida en pacientes con cánce

Introduction: Weight loss and especially the loss of lean mass, can lead into losing own self-esteem, due to body changes suffered in the event of malnutrition and the progressive dependence of relatives and/or carers, making the oncological patient to perceive their health state in a negative way. Objective: The aim of this study was to identify the relationship or association between the loss of lean mass and the quality of life in patients with cancer. Methods: A longitudinal and prospective study was performed in 231 oncologic patients undergoing radiotherapy treatment. Sociodemographic, clinical, anthropometric and life-quality variables where measured, evaluated and collected by means of the Health-Related Quaility of Life (EORTC-QLQ c30) questionnaire. Results: Of the total sample only 197 ends with the study. The results revealed that there was a positive correlation in pre- and post-treatment, although this was not significant in most cases (rho <0.63). In addition, the results were obtained through the application of Chi-square approach, did not identify the relationship between mass loss and its effect on the quality of life of the patient, in addition to the differentiation between the categories in which the problem was subdivided P <0.05). Conclusions: The loss of lean mass, without considering other health conditions or effects, did not prove to be detrimental to the quality of life of the patient. HRQoL is a multidimensional concept

Introducción: El cáncer y sus tratamientos pueden dar lugar a la desnutrición, produciendo cambios metabólicos que pueden dar lugar a una disminución de la calidad de vida. Dentro de estos cambios se encuentra la pérdida de masa magra, que puede originar aumento de las comorbilidades, dependencia y cambios corporales. Objetivo: Evaluar si la pérdida de masa magra influye en la calidad de vida en pacientes con cáncer. Métodos: Se ha realizado un estudio longitudinal y prospectivo, en una muestra de 231 pacientes que acudieron a tratamiento de radioterapia. Se recogen variables sociodemográficas, clínicas, antropométricas y de calidad de vida mediante el cuestionario Health-Related Quaility of Life (EORTCQLQ c30) antes de inciar el tratamiento y una vez finalizado el mismo. Resultados: Del total de pacientes que se seleccionaron, se analizan 197 de ellos (33 pérdidas y 1 exitus). Los resultados pre y postratamiento muestran que existe correlación positiva entre los dos momentos de corte, aunque esta no sea alta en la mayoría de las categorías (rho < 0,63). Además el resultado obtenido mediante el test Chi-cuadrado, no refleja relación existente entre la pérdida de masa magra y la disminución de la calidad de vida, así como en las diferentes categorías en las que se divide el cuestionario de manera significativamente estadística (p>0,05). Conclusiones: La relación entre la pérdida de masa magra y la calidad de vida (CVRS) es un concepto multidimensional que no solo depende de un factor. Por ello, la pérdida de masa magra de forma aislada sin efectos derivados de la misma (aumento de las UPP, disminución de la dependencia, etc.) no conduce a una disminución de la percepción de calidad de vida

Ingesta dietética y seguimiento de la Dieta Mediterránea en pacientes oncológicos / Dietary intake and follow-up of the Mediterranean Diet in cancer patients

Introducción: Las investigaciones sobre la relación de la dieta y el cáncer se han centrado en la prevención del cáncer mediante la ingesta de algún tipo de nutriente y/o la presencia de desnutrición, pero es necesario conocer la ingesta de estos pacientes y valorar si cubren sus requerimientos nutricionales. Además, esta ingesta debe adaptarse a una dieta saludable, como la dieta mediterránea (DM) Objetivo: Conocer la ingesta dietética y el cumplimiento de las ingestas recomendadas, en estos pacientes, así como la adherencia a la DM. Material y métodos: Estudio observacional prospectivo en pacientes oncológicos que van a ser sometidos a radioterapia. Se evalúa la ingesta dietética mediante registro dietético de 3 días y adherencia a la DM mediante el cuestionario utilizado por el grupo de Prevención con Dieta Mediterránea (PREDIMED). Resultados: Se estudian un total de 84 pacientes, observándose una ingesta energética, de hidratos de carbono y ácidos grasos poliinsaturados por debajo del 5% de las IR y de proteínas, grasas y ácidos grasos monoinsaturatos superior al 5%. La ingesta de colesterol es superior para ambos sexos, especialmente en mujeres, y la de fibra inferior. El 65,48% de la muestra presenta baja adherencia a la DM y el 34,52% alta adherencia. Las mujeres presentan mejor adherencia que los hombres (37,21% frente al 31,71%), pero esta diferencia no es estadísticamente significativa (p>0,05). Conclusiones: Los resultados obtenidos muestran que los pacientes no ingieren una dieta equilibrada y adaptada a su estado de salud. Además, se deben proporcionar pautas para conseguir una mejor adherencia a la DM

Introduction: Research on the relationship between diet and cancer has focused on the prevention of cancer through the ingestion of some type of nutrient and / or the presence of malnutrition, but it is necessary to know the intake of these patients and to evaluate if they cover Their nutritional requirements. In addition, this intake should be adapted to a healthy diet, such as the Mediterranean diet (DM). Objective: To know the dietary intake and the compliance of the recommended intakes, in these patients, as well as the adherence to the DM. Material and methods: Prospective observational study in oncology patients who will undergo radiotherapy. The dietary intake is evaluated through 3-day dietary registration and adherence to DM through the questionnaire used by the Mediterranean Diet Prevention Group (PREDIMED). Results: A total of 84 patients were studied, with an energy intake of carbohydrates and polyunsaturated fatty acids below 5% of IR and protein, fat and monounsaturated fatty acids higher than 5%. Cholesterol intake is higher for both sexes, especially in women, and lower fiber intake. 65.48% of the sample shows low adherence to DM and 34.52% high adherence. Women presented better adherence than men (37.21% vs. 31.71%), but this difference is not statistically significant (p> 0.05). Conclusions: The results show that patients do not eat a balanced diet and adapted to their health status. In addition, guidelines should be provided to achieve a better adherence to DM