Resting energy metabolism and sweet taste preference during the menstrual cycle in healthy women.

Differences in blood concentration of sex hormones in the follicular (FP) and luteal (LP) phases may influence energy metabolism in women. We compared fasting energy metabolism and sweet taste preference on a representative day of the FP and LP in twenty healthy women (25·3 (sd 5·1) years, BMI: 22·2 (sd 2·2) kg/m2) with regular self-reported menses and without the use of hormonal contraceptives. From the self-reported duration of the three prior menstrual cycles, the predicted FP and LP visits were scheduled for days 5-12 and 20-25 after menses, respectively. The order of the FP and LP visits was randomly assigned. On each visit, RMR and RQ by indirect calorimetry, sweet taste preference by the Monell two-series forced-choice tracking procedure, serum fibroblast growth factor 21 by a commercial ELISA (FGF21, a liver-derived protein with action in energy balance, fuel oxidation and sugar preference) and dietary food intake by a 24-h dietary recall were determined. Serum progesterone and oestradiol concentrations displayed the expected differences between phases. RMR was lower in the FP v. LP (5042 (sd 460) v. 5197 (sd 490) kJ/d, respectively; P = 0·04; Cohen effect size, d rm = 0·33), while RQ showed borderline significant higher values (0·84 (sd 0·05) v. 0·81 (sd 0·05), respectively; P = 0·07; d rm = 0·62). Also, in the FP v. LP, sweet taste preference was lower (12 (sd 8) v. 16 (sd 9) %; P = 0·04; d rm = 0·47) concomitant with higher serum FGF21 concentration (294 (sd 164) v. 197 (sd 104) pg/ml; P < 0·01; d rm = 0·66). The menstrual cycle is associated with changes in energy expenditure, sweet taste preference and oxidative fuel partitioning.

Effects of human mobility on the spread of Dengue in the region of Caldas, Colombia.

According to the World Health Organization (WHO), dengue is the most common acute arthropod-borne viral infection in the world. The spread of dengue and other infectious diseases is closely related to human activity and mobility. In this paper we analyze the effect of introducing mobility restrictions as a public health policy on the total number of dengue cases within a population. To perform the analysis, we use a complex metapopulation in which we implement a compartmental propagation model coupled with the mobility of individuals between the patches. This model is used to investigate the spread of dengue in the municipalities of Caldas (CO). Two scenarios corresponding to different types of mobility restrictions are applied. In the first scenario, the effect of restricting mobility is analyzed in three different ways: a) limiting the access to the endemic node but allowing the movement of its inhabitants, b) restricting the diaspora of the inhabitants of the endemic node but allowing the access of outsiders, and c) a total isolation of the inhabitants of the endemic node. In this scenario, the best simulation results are obtained when specific endemic nodes are isolated during a dengue outbreak, obtaining a reduction of up to 2.5% of dengue cases. Finally, the second scenario simulates a total isolation of the network, i.e., mobility between nodes is completely limited. We have found that this control measure increases the number of total dengue cases in the network by 2.36%.

Situación Nutricional de embarazadas y lactantes haitianos atendidos en el CESFAM "Los Castaños" de la comuna de La Florida, Región Metropolitana, Chile

En Chile, al 31 de diciembre del 2020 un 12,5% de los extranjeros eran de nacionalidad haitiana. Se desconoce el estado nutricional (EN) en embarazadas y lactantes; así como también la prevalencia de lactancia materna exclusiva (LME) de la población haitiana en Chile. Los objetivos de este trabajo fueron comparar: (i) el EN de embarazadas haitianas y chilenas, (ii) el EN de lactantes y (iii) la duración de la LME en hijos de madres haitianas y chilenas. Para esto se analizó la base de datos de la población haitiana y chilena atendidos entre los años 2016-2019 en el Centro de Salud Familiar (CESFAM) "Los Castaños" ubicado en la comuna de La Florida. En la etapa pre-gestacional, las embarazadas haitianas presentaron mayor prevalencia de bajo peso en comparación a embarazadas chilenas (p= 0,0003), mientras que al término del embarazo presentaron una mayor prevalencia de estado nutricional normal (p= 0,0001) y menor prevalencia de obesidad (p= 0,0001). Respecto al estado nutricional de los lactantes, sólo se observaron diferencias en el primer mes de vida, donde un 82% de los lactantes haitianos tenían un EN normopeso en comparación al 24% en los lactantes chilenos (p= 0,0001). No se observaron diferencias significativas en la prevalencia de LME hasta los 6 meses entre lactantes haitianos y chilenos (35,3% vs 30%, respectivamente). Es importante mencionar que ninguno de los dos grupos de lactantes cumplió con la meta establecida por la Organización Mundial de la Salud (OMS) que propone LME en los primeros seis meses de vida hasta al menos 50%. En conclusión, se evidencian diferencias en el EN de las embarazadas y lactantes de ambos países, mientras que la prevalencia de LME en ambos grupos fue similar.

In Chile, until December 31st, 2020, 12.5% of foreign residents were from Haiti. The nutritional status (NS) in pregnant women and infants is unknown; as well as the prevalence of exclusive breastfeeding (EBF) of the Haitian population residing in Chile. This study aimed to compare: (i) the NS of Haitian and Chilean pregnant women, (ii) the NS of infants, and (iii) the duration of EBF in children of Haitian and Chilean mothers. We analyzed the database of the Haitian and Chilean population attended between the years 2016-2019 at the Primary Care Health Center (CESFAM) "Los Castaños" located in the commune of La Florida. During the pregestational stage, the Haitian pregnant women had a higher prevalence of low weight compared to the Chilean pregnant women (p= 0,0003), whereas, at the end of the pregnancy, they had a higher prevalence of normal nutritional status (p= 0,0001) and a lower prevalence of obesity and a tendency at the end of pregnancy. Whereas at the end of the pregnancy, Chilean women had a higher prevalence of obesity. Regarding the nutritional status of the infants, differences were only observed in the first month of life, where 82% of Haitian infants had a normal weight compared to 24% of Chilean infants (p= 0.0001). No significant differences were observed in the prevalence of EBF up to 6 months between Haitian and Chilean infants (35.3% vs. 30%, respectively). It is important to mention that neither of the two groups of infants met the goal established by the World Health Organization (WHO) that proposes EBF for the first six months of life up to at least 50%. In conclusion, there are differences in the NE of pregnant and lactating women in both countries, while the prevalence of EBF in both groups was similar.

Prevalence of non-alcoholic fatty liver disease and its association with lifestyle habits in adults in Chile: a cross-sectional study from the National Health Survey 2016-2017.

Non-alcoholic fatty liver disease (NAFLD) represents an excessive fat accumulation within the liver, usually associated with excess body weight. A liver biopsy is the gold standard for diagnosis, but it is inapplicable in population-based studies. In large populations, non-invasive methods could be used, which may also serve to identify potential protective factors. We aimed to (a) estimate NAFLD prevalence in the adult population in Chile by using non-invasive methods and (b) determine the association between the presence of NAFLD and lifestyle habits. The National Health Survey of Chile 2016­2017 was analysed. We included individuals aged 21­75 years, without infectious diseases nor risky alcohol consumption. NAFLD was detected by either fatty liver index (FLI; considers circulating TAG, circulating γ-glutamyl-transferase, BMI and waist circumference), lipid accumulation product (LAP; considers sex, circulating TAG and waist circumference) or their combination. Lifestyle habits were determined by questionnaires. We included 2774 participants, representative of 10 599 094 (9 831 644, 11 366 544) adults in Chile. NAFLD prevalence (95 % CI) was 39·4 % (36·2, 42·8) by FLI, 27·2 % (24·2, 30·4) by LAP and 23·5 % (20·7, 26·5) by their combination. The prevalence progressively increased with increasing BMI. Of note, less smoking and more moderate-vigorous physical activity and whole-grain consumption were associated with lower odds of having NAFLD, independently of BMI. At least one out of four adults in Chile is afflicted with NAFLD. Health promotion strategies focused on controlling excess body weight and promoting specific lifestyle habits are urgently required.

Educación alimentaria nutricional: Estrategias para mejorar la adherencia al plan dietoterapéutico

RESUMEN La educación alimentaria nutricional es la combinación de estrategias educativas, acompañadas de apoyos ambientales, diseñadas para facilitar la adopción voluntaria de elecciones alimentarias que conducen a un estado óptimo de salud y bienestar. La educación alimentaria nutricional tiene tres componentes: 1) motivación, 2) acción y 3) ambiente. Para elegir la técnica de educación adecuada para cada persona, se deben considerar las características psicoemocionales individuales, especialmente las motivaciones para el cambio y el tipo de personalidad, ya que ambos han mostrado ser buenos predictores de la conducta alimentaria. Dentro de los recursos educativos posibles de utilizar para realizar la educación en alimentación nutricional se encuentran indicaciones verbales, material escrito, uso de internet, dispositivos portátiles, aplicaciones de teléfonos inteligentes, e incluso la clase de cocina. La evidencia demuestra que la educación alimentaria nutricional impacta favorablemente la adherencia a las intervenciones nutricionales, lo cual a la vez se ve reflejado en efectos positivos en la salud.

ABSTRACT Food and nutrition education is the combination of educational strategies, accompanied by environmental supports designed to facilitate voluntary adoption of food choices conducive of health and well-being. It has a motivational phase, an action phase, and an environmental component. To choose the right educational technique for each patient, their individual psychoemotional characteristics must be considered; especially what their motivations for change are, as well as their personality type, because both are good predictors of food behavior. Among the resources that can be used to perform nutrition education are verbal indications, written material, the internet, mobile devices, smartphone applications, and even the kitchen as a place for education. Evidence shows that nutrition education has a favorable impact on diet adherence in different conditions that have an important nutritional component, such as celiac disease, inflammatory bowel disease, diabetes and obesity, which at the same time produces positive health outcomes.

Profesionalismo en el nutricionista: ¿Qué es y cómo incorporarlo en la formación de pregrado?

RESUMEN El profesionalismo es un pilar fundamental en la formación y ejercicio profesional de un nutricionista que implícitamente se ha incluido y desarrollado en los estándares de práctica. Recientemente se ha intentado establecer una terminología común para su definición, esta se basa en cuatro aspectos centrales: a) atributos personales como empatía, autoconciencia e inteligencia emocional, b) comunicación interpersonal, tanto con pares, otros profesionales de la salud y usuarios, c) actuar centrado en la práctica, que considera el entorno laboral en cuanto a las leyes y normativas que rigen el actuar profesional y 4) compromiso con el aprendizaje permanente, como el proceso de reflexión y autoevaluación del propio trabajo. Para garantizar un actuar profesional, la enseñanza del profesionalismo debe ser considerada de manera formal en el plan curricular, implementando distintas técnicas educativas y evaluaciones correspondientes que permitan la adquisición de conocimientos y habilidades necesarias. En el proceso formativo cobra especial relevancia el contexto y ambiente en el que se desempeñan los estudiantes para un óptimo uso de recursos.

ABSTRACT Professionalism is a fundamental aspect in the training and professional practice of a dietitian that has been implicitly included and developed in standards of practice. However, recently, an attempt to establish a common terminology for its definition has been made. The concept of professionalism is based on four central aspects: a) personal attributes such as empathy, self-awareness and emotional intelligence, b) interpersonal communication, both with peers, other health professionals and users, c) approach to practice, which considers the laws and regulations that govern professional actions, and 4) commitment to lifelong learning, such as the process of reflection and self-evaluation. To guarantee professionalism in dietitians, the teaching of professionalism must be considered formally in the plan of study, implementing different educational techniques and corresponding evaluations that guarantee the acquisition of necessary knowledge and skills. In the training process, the context and environment in which students work is especially relevant for an optimal use of resources.

[The role of intestinal microbiota in the development of non-alcoholic fatty liver disease]. / Rol de la microbiota intestinal en el desarrollo del hígado graso no alcohólico.

Non-alcoholic fatty liver disease (NAFLD) encompasses a wide spectrum of hepatic pathologies ranging from simple steatosis (SS) to hepatocellular carcinoma. Intestinal microbiota (IM) is composed of trillions of microorganisms existing in the gut. It has 150 times more genes than the host. Changes in the composition and function of the IM are associated with different diseases, including NAFLD. In this condition, IM could have a pathogenic role through different mechanisms such as energy salvaging from food, an inflammatory stimulus, a modulation of the innate immune system, regulation of bile acid turnover, alteration of choline metabolism and increasing endogenous ethanol levels. This review is an update on the role of the intestinal microbiota in NAFLD and the possible mechanisms involved.

Nikolai Gogol's account of sleep paralysis in the tale "The Portrait".

Several classical writers had an impressive power of observation and often depicted medical conditions in their works long before medical literature did. Sleep paralysis is a common and frightening experience, in particular when occurring for the first time. Therefore, it is not surprising that it has been frequently described in the classical literature, eg by Dostoevsky, Kafka, Dickens, and Maupassant. In Nikolai Gogol's tale "The portrait" (1833) we could recognize an excellent description of a sleep paralysis, in which several components of this condition were depicted including motor paralysis, visual and auditory hallucinations, and autonomic manifestations. To the best of our knowledge, this account is the earliest description of a sleep paralysis in non-medical literature.

Crossing a critical threshold: Accelerated and widespread land use changes drive recent carbon and nitrogen dynamics in Vichuquén Lake (35°S) in central Chile.

Global afforestation/deforestation processes (e.g., Amazon deforestation and Europe afforestation) create new anthropogenic controls on carbon cycling and nutrient supply that have not been fully assessed. Here, we use a watershed-lake dynamics approach to investigate how human-induced land cover changes have altered nutrient transference during the last 700 years in a mediterranean coastal area (Vichuquén Lake). We compare our multiproxy reconstruction with historical documentation and use satellite images to reconstruct land use/cover changes for the last 45 years. Historical landscape changes, including those during the indigenous settlements, Spanish conquest, and the Chilean Republic up to mid-20th century did not significantly alter sediment and nutrient fluxes to the lake. In contrast, the largest changes in the lake-watershed system occurred in the mid-20th century and particularly after the 1980s-90s and were characterized by a large increase in total nitrogen and organic carbon fluxes as well as negative shifts in sediment δ15N and δ13C values. This shift was coeval with the largest land cover transformation in the Vichuquén watershed, as native forests nearly disappeared while anthropogenic tree plantations expanded up to 60% of the surface area.

Rol de la microbiota intestinal en el desarrollo del hígado graso no alcohólico / The role of intestinal microbiota in the development of non-alcoholic fatty liver disease

Non-alcoholic fatty liver disease (NAFLD) encompasses a wide spectrum of hepatic pathologies ranging from simple steatosis (SS) to hepatocellular carcinoma. Intestinal microbiota (IM) is composed of trillions of microorganisms existing in the gut. It has 150 times more genes than the host. Changes in the composition and function of the IM are associated with different diseases, including NAFLD. In this condition, IM could have a pathogenic role through different mechanisms such as energy salvaging from food, an inflammatory stimulus, a modulation of the innate immune system, regulation of bile acid turnover, alteration of choline metabolism and increasing endogenous ethanol levels. This review is an update on the role of the intestinal microbiota in NAFLD and the possible mechanisms involved.

Characterization of Cross-Linked Enzyme Aggregates of the Y509E Mutant of a Glycoside Hydrolase Family 52 ß-xylosidase from G. stearothermophilus.

Cross-linked enzyme aggregates (CLEAs) of the Y509E mutant of glycoside hydrolase family 52 ß-xylosidase from Geobacillus stearothermophilus with dual activity of ß-xylosidase and xylanase (XynB2Y509E) were prepared. Ammonium sulfate was used as the precipitant agent, and glutaraldehyde as cross-linking agent. The optimum conditions were found to be 90% ammonium sulfate, 12.5 mM glutaraldehyde, 3 h of cross-linking reaction at 25 °C, and pH 8.5. Under these (most effective) conditions, XynB2Y509E-CLEAs retained 92.3% of their original ß-xylosidase activity. Biochemical characterization of both crude and immobilized enzymes demonstrated that the maximum pH and temperature after immobilization remained unchanged (pH 6.5 and 65 °C). Moreover, an improvement in pH stability and thermostability was also found after immobilization. Analysis of kinetic parameters shows that the K m value of XynB2Y509E-CLEAs obtained was slightly higher than that of free XynB2Y509E (1.2 versus 0.9 mM). Interestingly, the xylanase activity developed by the mutation was also conserved after the immobilization process.

Anthropometric and bioimpedance equations for fat and fat-free mass in Chilean children 7-9 years of age.

Assessing children's growth adequately is important due to the necessary prevention of adequate body composition, especially at pre-pubertal age. Simpler measurements such as anthropometry or bioimpedance, using equations validated in Caucasian children, have been demonstrated to overestimate or underestimate fat mass percentage (FM%) or fat-free mass (FFM) in Chilean children. In a sample of 424 children (198 boys and 226 girls) of 7-9 years old, the three component (3C) model was assessed, where total body water was determined by 2H dilution and body volume by air displacement plethysmography, in order to design and validate anthropometry and bioimpedance equations. The FM (%) equation specific for Chilean children was validated as (1·743 × BMI z-score) + (0·727 × triceps skinfold) + (0·385 × biceps skinfold) + 15·985, against the 3C model (R2 0·79). The new FFM equation (kg) generated was (log FFM = (0·018 × age) + (0·047 × sex) + (0·006 × weight) + (0·027 × resistance) + 2·071), with an R2 0·93 (female = 1 and male = 2). The Bland-Altman analysis shows a mean difference of 0·27 (sd 3·5) for the FM% in the whole group as well as 0·004 (sd 0·9) kg is the mean difference for the bioelectrical impedance analysis (BIA) FFM (kg) equation. The new equations for FM (%) and FFM (kg) in Chilean children will provide a simple and valid tool for the assessment of body composition in cohort studies or to assess the impact of nutritional programmes or public policies.

Sobrepeso y obesidad en la enfermedad celiaca activa: posibles mecanismos fisiopatológicos / Overweight and obesity in active celiac disease: possible pathophysiological mechanisms

RESUMEN La enfermedad celiaca (EC) es una enteropatía crónica del intestino delgado, mediado por una respuesta inmune, gatillada por la exposición al gluten en individuos genéticamente susceptibles. La presentación clínica de la EC es variada y conduce a mala absorción. El estado nutricional en el momento del diagnóstico de la EC depende del tiempo en que la enfermedad ha estado activa, la extensión de la inflamación intestinal, grado de mala absorción e ingesta alimentaria. Sin embargo, en los últimos años se ha observado un cambio epidemiológico del estado nutricional en los pacientes celiacos al momento del diagnóstico. La presente revisión tuvo por objetivo realizar un análisis descriptivo de la presencia de obesidad en pacientes celiacos y de los posibles mecanismos fisiopatológicos que la explicarían.

ABSTRACT Celiac disease (CD) is a chronic enteropathy of the small intestinal, mediated by an immune response triggered by exposure to dietary gluten in genetically predisposed individuals. The clinical presentation of CD is varied and leads to malabsorption. Nutritional status at the time of diagnosis of CD depends on the time in which the disease has been active, the extent of intestinal inflammation, degree of malabsorption, and dietary intake. However, in recent years an epidemiological change of nutritional status has been observed in celiac patients at the time of diagnosis. The objective of this review was to perform a descriptive analysis of the presence of obesity in celiac patients and the possible physiopathological mechanisms that would explain it.

Short-term impact of sucralose consumption on the metabolic response and gut microbiome of healthy adults.

Sucralose is an artificial non-nutritive sweetener used in foods aimed to reduce sugar and energy intake. While thought to be inert, the impact of sucralose on metabolic control has shown to be the opposite. The gut microbiome has emerged as a factor shaping metabolic responses after sweetener consumption. We examined the short-term effect of sucralose consumption on glucose homeostasis and gut microbiome of healthy male volunteers. We performed a randomised, double-blind study in thirty-four subjects divided into two groups, one that was administered sucralose capsules (780 mg/d for 7 d; n 17) and a control group receiving placebo (n 17). Before and after the intervention, glycaemic and insulinaemic responses were assessed with a standard oral glucose load (75 g). Insulin resistance was determined using homeostasis model assessment of insulin resistance and Matsuda indexes. The gut microbiome was evaluated before and after the intervention by 16S rRNA sequencing. During the study, body weight remained constant in both groups. Glycaemic control and insulin resistance were not affected during the 7-d period. At the phylum level, gut microbiome was not modified in any group. We classified subjects according to their change in insulinaemia after the intervention, to compare the microbiome of responders and non-responders. Independent of consuming sucralose or placebo, individuals with a higher insulinaemic response after the intervention had lower Bacteroidetes and higher Firmicutes abundances. In conclusion, consumption of high doses of sucralose for 7 d does not alter glycaemic control, insulin resistance, or gut microbiome in healthy individuals. However, it highlights the need to address individual responses to sucralose.

Exceso de peso y síntomas gastrointestinales en pacientes celiacos chilenos al momento del diagnóstico / Excess weight and gastrointestinal symptoms in Chilean celiac patients at the time of diagnosis

Introducción: la enfermedad celiaca es una patología inmune que genera alteraciones histológicas en el intestino delgado y síntomas digestivos o extradigestivos. La lesión intestinal produce pobre absorción y deteriora el peso o dificulta una ganancia óptima de peso. Sin embargo, la presencia de sobrepeso y obesidad se puede encontrar en estos pacientes, a pesar de la lesión histológica. El objetivo de este estudio fue determinar la prevalencia de exceso de peso en pacientes celiacos (adultos) recién diagnosticados. Métodos: estudio observacional retrospectivo de pacientes con diagnóstico reciente de enfermedad celiaca según la clasificación estándar propuesta por Marsh. Se evaluó el estado nutricional en base al índice de masa corporal (IMC) clasificado por criterio de la Organización Mundial de la Salud (OMS). La presentación clínica se clasificó en típica y atípica. Adicionalmente, se evaluó si existían diferencias en la presencia de síntomas gastrointestinales según estado nutricional. Resultados: se revisaron 135 historias clínicas de pacientes celiacos adultos (mujeres = 123; hombres = 12). El promedio de peso e IMC fue de 61,1 kg y 23,7 kg/m2, respectivamente. La presentación clínica típica fue de 59,2% y la atípica, de 40,8%. Del total de pacientes, el 71,8% presentó IMC de bajo peso y normal y el 28,1%, IMC de sobrepeso y obesidad. No se encontraron diferencias en la presencia de síntomas gastrointestinales según estado nutricional. Conclusiones: es necesario realizar estudios que evalúen en conjunto la ingesta energética y la absorción intestinal de estos pacientes de manera que se pueda explicar la alta presencia de exceso de peso

Introduction: celiac disease is an immune condition that results in histologic changes in the small bowel and produces both digestive and extra-digestive symptoms. Intestinal damage results in malabsorption and impaired weight or impaired optimal weight gain. However, these patients may be overweight or obese in spite of histologic damage. The aim of this study was to determine the prevalence of excess weight in newly diagnosed (adult) celiac patients. Methods: this was a retrospective observational study of patients recently diagnosed with celiac disease according to the standard Marsh classification. Nutritional status was assessed based on body mass index (BMI), as categorized by the World Health Organization (WHO). Clinical presentation was classified as typical or atypical. Potential differences in gastrointestinal symptoms according to nutritional status were also assessed. Results: a total of 135 medical records of adult celiac patients (women = 123; men = 12) were reviewed. The average weight and BMI were 61.1 kg and 23.7 kg/m2, respectively. The proportion of typical clinical presentations was 59.2% and of atypical presentations 40.8%. A total of 71.8% of patients had a BMI indicating low or normal weight and 28.1% had a BMI indicative of being overweight or obese. No differences with regard to the presence of gastrointestinal symptoms were found according to nutritional status. Conclusions: further studies are needed to jointly assess energy intake and intestinal absorption in these patients, in order to explain the high rate of excess weight

Issues in Measuring and Interpreting Energy Balance and Its Contribution to Obesity.

PURPOSE OF REVIEW: Obesogenic environment challenges individuals' ability to preserve energy homeostasis, leading to weight gain. To understand how this energy imbalance proceeds, several methods and analytical procedures to determine energy intake and expenditure are currently available. However, these methods and procedures are not exempt from issues that may lead to equivocal conclusions. Our purpose herein is to discuss major issues involved in energy balance assessment. RECENT FINDINGS: Measurement of energy intake mostly relies on self-report methods that provide inaccurate data. In contrast, determination of energy expenditure is more accurate as long as methodological and analytical issues are correctly addressed. Accurate measurements of energy expenditure can be obtained with the current methods once issues in measuring and interpreting data are correctly addressed. However, development of new technologies to measure energy intake is imperative to further understand the small and chronic energy imbalance leading to obesity.

Excess weight and gastrointestinal symptoms in Chilean celiac patients at the time of diagnosis.

INTRODUCTION: celiac disease is an immune condition that results in histologic changes in the small bowel and produces both digestive and extra-digestive symptoms. Intestinal damage results in malabsorption and impaired weight or impaired optimal weight gain. However, these patients may be overweight or obese in spite of histologic damage. The aim of this study was to determine the prevalence of excess weight in newly diagnosed (adult) celiac patients. METHODS: this was a retrospective observational study of patients recently diagnosed with celiac disease according to the standard Marsh classification. Nutritional status was assessed based on body mass index (BMI), as categorized by the World Health Organization (WHO). Clinical presentation was classified as typical or atypical. Potential differences in gastrointestinal symptoms according to nutritional status were also assessed. RESULTS: a total of 135 medical records of adult celiac patients (women = 123; men = 12) were reviewed. The average weight and BMI were 61.1 kg and 23.7 kg/m2, respectively. The proportion of typical clinical presentations was 59.2% and of atypical presentations 40.8%. A total of 71.8% of patients had a BMI indicating low or normal weight and 28.1% had a BMI indicative of being overweight or obese. No differences with regard to the presence of gastrointestinal symptoms were found according to nutritional status. CONCLUSIONS: further studies are needed to jointly assess energy intake and intestinal absorption in these patients, in order to explain the high rate of excess weight.

Stress during Lactation Induces Insulin Resistance Associated with an Increase in Type 1 Cannabinoid Receptors in Liver and Adipose Tissue.

Several reports have shown that stress during lactation causes long-term metabolic and hormonal disruptions. In this study, we designed experiments to evaluate the effects of stress during lactation on the abundance of Type 1 cannabinoid/endocannabinoid receptors (CB1R) in epididymal fat and liver and development of insulin resistance in adult mice. During the whole lactation, male mice pups were daily subcutaneously injected (days 1-21) with a saline solution to produce a soft nociceptive stress (NS). Mice body weight and food intake were periodically evaluated. Adult animals were subsequently subjected to an insulin tolerance test and some days later sacrificed to evaluate the amount of epididymal fat and abundance of CB1R and adipophilin in liver and epididymal adipose tissue. Lipoprotein lipase (LPL) activity and circulating levels of leptin, adiponectin, and corticosterone were also evaluated. In this model, NS during lactation significantly increased the amount of epididymal fat and induced insulin resistance in adult mice. In addition, a significantly increased abundance of CB1R and adipophilin in epididymal fat and liver was observed, together with elevated circulating levels of leptin and corticosterone. Adult NS animals also had low plasmatic adiponectin and, although nonsignificant, had a sustained trend to a greater LPL activity associated with epididymal fat. These results indicate that increased abundance of CB1R in liver and epididymal fat alters tissue functionality likely associated with development of systemic metabolic alterations such as insulin resistance in adult mice. All these pathophysiological facts are long-term consequences of nociceptive stress during lactation.

[Overweight and obesity in celiac disease: expression of the interleukin profile Th17]. / Sobrepeso y obesidad en enfermedad celiaca: expresión del perfil de interleuquinas Th17.

INTRODUCTION: the histological alteration in the small intestine of the celiac patients produces a poor absorption that deteriorates or hinder an optimal weight gain. This can be the result of an increase expression of the Th17 gluten-specific interleukins. OBJECTIVE: the aim of this study was to compare the expression of Th17 interleukins in celiac patients with normal and overweight/obese nutritional status. METHODS: a total of 22 patients with newly diagnosed celiac disease were eligible: 15 patients with normal weight and seven overweight/obese. Small intestine biopsies were taken for the evaluation of the expression of interleukins through real-time PCR. RESULTS: expression levels of Th17 interleukins showed a tendency to be higher in intestinal biopsies of overweight/obese patients compared to normal weight celiac subjects; however, this difference was not statistical significant. CONCLUSION: body weight excess in celiac patients is not influenced by the expression levels of Th17 interleukins.

Introducción: la alteración histológica en el intestino delgado de los enfermos celiacos produce una pobre absorción que deteriora o dificulta una ganancia óptima de peso. Esto puede ser el resultado de un aumento de la expresión de las interleuquinas Th17 gluten-específicas. Objetivo: el objetivo de este estudio fue comparar la expresión de las interleuquinas Th17 en pacientes celiacos con peso normal y sobrepeso/ obesidad. Métodos: se estudiaron 22 pacientes con reciente diagnóstico de enfermedad celiaca: 15 con peso normal y siete con sobrepeso/obesidad. Se tomaron biopsias de intestino delgado para la evaluación de la expresión de las interleuquinas a través de PCR a tiempo-real.Resultados: los niveles de expresión de las interleuquinas Th17 mostraron una tendencia a ser más altos en las biopsias de intestino de pacientes con sobrepeso/obesidad en comparación a los celiacos con peso normal, sin embargo, esta diferencia no fue significativa. Conclusión: el exceso de peso en pacientes celiacos no es influenciado por los niveles de expresión de interleuquinas Th17.