Do Herbal Supplements and Probiotics Complement Antibiotics and Diet in the Management of SIBO? A Randomized Clinical Trial.

Small intestinal bacterial overgrowth (SIBO) arises from dysbiosis in the small intestine, manifesting with abdominal symptoms. This study aims to assess the efficacy of combined antibiotic therapy, herbal supplements, probiotics, and dietary modifications in SIBO management. A total of 179 SIBO-diagnosed patients underwent clinical evaluation and breath testing. Patients were categorized into hydrogen (H2-SIBO) and methane (CH4-SIBO) groups. The control group received standard antibiotic therapy and a low-FODMAP diet, while the intervention group received additional herbal antibiotics, probiotics, and prebiotics. After treatment, both groups exhibited reduced gas levels, particularly in CH4-SIBO. Clinical remission rates were higher in the intervention group, especially in CH4-SIBO cases. Logistic regression analysis showed gas concentrations at diagnosis as significant predictors of treatment success. In conclusion, adjunctive herbal supplements and probiotics did not significantly impact gas levels, but showed potential for clinical improvement, especially in CH4-SIBO.

Medical supervised duodenal-enteral feeding for the treatment of overweight and obesity: MESUDEFT / Nutrición duodenoenteral médicamente supervisada para el tratamiento del sobrepeso y la obesidad: MESUDEFT

Background: the development of specialised nutritional support techniques allows the maintenance of an adequate supply of nutrients in those patients in whom oral feeding is not possible or is insufficient in relation to their requirements, trying to improve the quality of life, especially in those with chronic diseases. Methods: single-center clinical study carried out in a clinical-nutritional center consisting of a medically supervised nasogastric-duodenal tube feeding treatment for overweight, obesity and increased body fat percentage in patients requiring it by means of duodeno-enteral feeding, expecting losses of more than 10 %. Results: twenty-nine patients completed the protocol (20.4 % male and 79.6 % female) with a mean age of 38 years (SD: 12.4); 87.2 kg (SD: 18.5) mean weight; 37.9 kg (SD: 4.8) mean iFat%; 32.4 (SD: 5.4) iMean body mass index (BMI); 100 cm (SD: 16.0) iMean waist; 113.6 cm (SD: 10.4) iMean hip; 33.8 cm (SD: 3.9) iMean upper arm circumference; 65.5 cm (SD: 7.5) iMean thigh circumference; 9.7 (SD: 4.8) iVisceral fat index; and 22.9 days (SD: 13.9) mean treatment. A mean of 22.9 (SD: 13.9) days of MESUDEFT influences weight loss, fat loss, visceral fat loss and decreased arm, hip and thigh circumferences (p < 0.05) (i: initial). Conclusions: MESUDEFT is shown to be an effective alternative as a sole treatment or as an adjunct prior to bariatric surgery for obesity or overweight treatment with a minimum of 10 % loss of BMI and fat mass at completion and 3-6 months follow-up.(AU)

Antecedentes: el desarrollo de técnicas especializadas de soporte nutricional permite mantener un aporte adecuado de nutrientes en aquellos pacientes en los que la alimentación oral no es posible o es insuficiente en relación a sus requerimientos, intentando mejorar la calidad de vida, especialmente de aquellos con enfermedades crónicas. Métodos: estudio clínico unicéntrico prospectivo realizado en un centro clínico-nutricional consistente en un tratamiento con alimentación por sonda nasogástrica-duodenal médicamente supervisado para el sobrepeso, la obesidad y el aumento del porcentaje de grasa corporal en pacientes que lo requieran mediante alimentación duodenoenteral, durante un mes aproximado, con previsión de pérdidas superiores al 10 % y con control posterior entre los tres y los seis meses siguientes. Resultados: veintinueve pacientes completaron el protocolo (20,4 % varones y 79,6 % mujeres) con una edad media de 38 años (DE: 12,4); 87,2 kg (DE: 18,5) iPeso medio; 37,9 kg (DE: 4,8) iGrasa% media; 32,4 (DE: 5,4) iIMC medio; 100 cm (DE: 16,0) iCintura media; 113,6 cm (DE: 10,4) iCadera media; 33,8 cm (DE: 3,9) iCircunferencia braquial media; 65,5 cm (DE: 7,5) circunferencia muslo media; 9,7 (DE: 4,8) iíndice de grasa visceral; y 22,9 días (DE: 13,9) de tratamiento medio. Una media de 22,9 (DE: 13,9) días de MESUDEFT influye en la pérdida de peso, la pérdida de grasa, la pérdida de grasa visceral y la disminución de las circunferencias del brazo, la cadera y el muslo (p < 0,05) (i: inicial). Conclusiones: MESUDEFT se muestra como una alternativa eficaz como tratamiento único o como coadyuvante previo a la cirugía bariátrica de la obesidad o tratamiento del sobrepeso con una pérdida mínima del 10 % del índice de masa corporal (IMC) y de la masa grasa al finalizar y con control durante los siguientes 3-6 meses.(AU)

Medical supervised duodenal-enteral feeding for the treatment of overweight and obesity: MESUDEFT.

BACKGROUND: the development of specialised nutritional support techniques allows the maintenance of an adequate supply of nutrients in those patients in whom oral feeding is not possible or is insufficient in relation to their requirements, trying to improve the quality of life, especially in those with chronic diseases. METHODS: single-center clinical study carried out in a clinical-nutritional center consisting of a medically supervised nasogastric-duodenal tube feeding treatment for overweight, obesity and increased body fat percentage in patients requiring it by means of duodeno-enteral feeding, expecting losses of more than 10 %. RESULTS: twenty-nine patients completed the protocol (20.4 % male and 79.6 % female) with a mean age of 38 years (SD: 12.4); 87.2 kg (SD: 18.5) mean weight; 37.9 kg (SD: 4.8) mean iFat%; 32.4 (SD: 5.4) iMean body mass index (BMI); 100 cm (SD: 16.0) iMean waist; 113.6 cm (SD: 10.4) iMean hip; 33.8 cm (SD: 3.9) iMean upper arm circumference; 65.5 cm (SD: 7.5) iMean thigh circumference; 9.7 (SD: 4.8) iVisceral fat index; and 22.9 days (SD: 13.9) mean treatment. A mean of 22.9 (SD: 13.9) days of MESUDEFT influences weight loss, fat loss, visceral fat loss and decreased arm, hip and thigh circumferences (p < 0.05) (i: initial). CONCLUSIONS: MESUDEFT is shown to be an effective alternative as a sole treatment or as an adjunct prior to bariatric surgery for obesity or overweight treatment with a minimum of 10 % loss of BMI and fat mass at completion and 3-6 months follow-up.

Effect of an Immune-Boosting, Antioxidant and Anti-Inflammatory Food Supplement in Hospitalized COVID-19 Patients: A Prospective Randomized Pilot Study.

BACKGROUND: COVID-19 disease is a serious global health problem. Few treatments have been shown to reduce mortality and accelerate time to recovery. The aim of this study was to evaluate the potential effect of a food supplement (probiotics, prebiotics, vitamin D, zinc and selenium) in patients admitted with COVID-19. METHODS: A prospective randomized non-blinded clinical trial was conducted in a sample of 162 hospitalized patients diagnosed with COVID-19 recruited over eight months. All patients received standard treatment, but the intervention group (n = 67) was given one food supplement stick daily during their admission. After collecting the study variables, a statistical analysis was performed comparing the intervention and control groups and a multivariate analysis controlling for variables that could act as confounding factors. RESULTS: ROC curve analysis with an area under the curve (AUC) value of 0.840 (p < 0.001; 95%CI: 0.741-0.939) of the food supplement administration vs. recovery indicated good predictive ability. Moreover, the intervention group had a shorter duration of digestive symptoms compared with the control group: 2.6 ± 1.3 vs. 4.3 ± 2.2 days (p = 0.001); patients with non-severe disease on chest X-ray had shorter hospital stays: 8.1 ± 3.9 vs. 11.6 ± 7.4 days (p = 0.007). CONCLUSIONS: In this trial, the administration of a food supplement (Gasteel Plus®) was shown to be a protective factor in the group of patients with severe COVID-19 and allowed early recovery from digestive symptoms and a shorter hospital stay in patients with a normal-mild-moderate chest X-ray at admission (ClinicalTrials.gov number, NCT04666116).

Influence of Strict Lockdown on Vitamin D Deficiency in Pregnant Women: A Word of Caution.

The main source of vitamin D results from skin sunlight exposure. Vitamin D deficiency (VDD) is linked to several adverse events during pregnancy. While performing a cross-sectional study with 886 pregnant women in Elda (Spain) from September 2019 to July 2020 to determine the association of VDD with gestational diabetes mellitus in relation to body mass index, a strict lockdown (SL) due to the COVID-19 pandemic was declared from 15 March 2020 to 15 May 2020. To determine if VDD prevalence in the local population of pregnant women was influenced by SL, a retrospective cross-sectional study was conducted to estimate the prevalence odds ratio (POR) for the association of VDD and SL. A crude logistic regression model was calculated, and then further adjusted by the biweekly measured vitamin D-specific UVB dose in our geographical area. The POR during SL was 4.0 (95%CI = 2.7-5.7), with a VDD prevalence of 77.8% in the quarantine period. Our results revealed that VDD prevalence in pregnant women was influenced by SL. This valuable information could guide us in future if public officials order the population to stay indoors for any given reason.

Emotional impact on children during home confinement in Spain.

Introduction: The COVID-19 pandemic has brought about important changes. On March 14, 2020, a strict home confinement was decreed in Spain. Children did not attend school and were not allowed to leave their homes. The aim of this study was to determine the emotional state of these children, as well as associated factors. Material and methods: A cross-sectional descriptive study was conducted using an online questionnaire sent by cell phone. This survey includes sociodemographic items and questions concerning the emotional impact of the lockdown. With the questions on emotions, two categories of emotional state were established with the variables fear, irritability, sadness and somatization: those who were less or more emotionally affected. A multivariate logistic model was used to estimate the associations between the variables. Results: A total of 3,890 responses were obtained. The mean age of the children was 6.78 years (range 0 to 16). A score indicating poor emotional state was reported by 40.12%. The multivariate logistic model for poor emotional state was directly associated with having less appetite, sleep disturbances, and with parents' beliefs that their child will have difficulties returning to normal life after lockdown. A better emotional state was associated with being an only child, access to outdoor spaces at home, having pets, and parents informing their children about the pandemic using creative explanations. Conclusions: During strict home confinement, a considerable emotional impact was observed in children as described by their parents. Specific elements were associated with a better or poorer emotional state.

Genito Pelvic Pain/Penetration Disorder (GPPPD) in Spanish Women-Clinical Approach in Primary Health Care: Review and Meta-Analysis.

Sexuality is a component of great relevance in humans. Sexual disorders are a major public health problem representing a high prevalence in the general population. DSM-5 genito-pelvic pain/penetration disorder (GPPPD) includes dyspareunia and vaginismus (DSM-IV-TR). To assess the importance of research on these disorders in Spain, we evaluated the Spanish scientific publications of primary and community care. The objective was to quantify the magnitude of the publications of GPPPD in Spanish women in primary and community care. For this, we used the method of conducting a systematic review and meta-analysis of studies evaluating GPPPD. As main results, of the 551 items found, we selected 11 studies that met the inclusion criteria. In primary care in Spain, one in nine women has these disorders; the percentage of women with GPPPD in this study (raw data) was 11.23% (95% CI: 0-29%) (vaginismus 5%; penetration pain 8.33%; dyspareunia 16.45%). These percentages can differ of those from other countries, and they are at the top of the data of the European countries (9-11.9%). There is much variability in the studies found in the world with respect to the prevalence of these health problems.

Barriers and Solutions to Improve Therapeutic Adherence from the Perspective of Primary Care and Hospital-Based Physicians.

Purpose: To identify the barriers affecting treatment adherence in patients with chronic disease and to determine solutions through the physician's opinion of primary care and hospital settings. Methods: An observational study using the nominal group technique was performed to reach a consensus from experts. A structured face-to-face group discussion was carried out with physicians with more than 10 years of experience in the subject of treatment adherence/compliance in either the primary care setting or the hospital setting. The experts individually rated a list of questions using the Likert scale and prioritized the top 10 questions to identify barriers and seek solutions afterward. The top 10 questions that obtained the maximum score for both groups of experts were prioritized. During the final discussion group, participating experts analyzed the prioritized items and debated on each problem to reach consensual solutions for improvement. Results: A total of 17 professionals experts participated in the study, nine of them were from a primary care setting. In the expert group from the primary care setting, the proposed solution for the barrier identified as the highest priority was to simplify treatments, measure adherence and review medication. In the expert group from the hospital setting, the proposed solution for the barrier identified as the highest priority was training on motivational clinical interviews for healthcare workers undergraduate and postgraduate education. Finally, the expert participants proposed implementing an improvement plan with eight key ideas. Conclusion: A consensual improvement plan to facilitate the control of therapeutic adherence in patients with chronic disease was developed, taking into account expert physicians' opinions from primary care and hospital settings about barriers and solutions to address therapeutic adherence in patients with chronic disease.

Degree of Accuracy of the BMI Z-Score to Determine Excess Fat Mass Using DXA in Children and Adolescents.

Obesity is caused by fat accumulation. BMI Z-score is used to classify the different degrees of weight status in children and adolescents. However, this parameter does not always express the true percentage of body fat. Our objective was to determine the degree of agreement between the fat mass percentage measured by DXA and the stratification of weight according to BMI Z-score in the pediatric age group. We designed a descriptive cross-sectional study. The patients were classified as underweight/normal weight with Z-scores between -2 and +0.99, overweight from 1 to 1.99, obese from 2 to 2.99, and very obese ≥3. We included 551 patients (47% girls), with a mean age of 11.5 ± 2.8 years (3.7-18 years). Higher BMI Z-scores were associated with a higher percentage of total fat (p < 0.001). However, there were important overlaps between both parameters, such that the BMI Z-score classified patients with the same percentage of total fat mass as having a different nutritional status classification. In conclusion, the stratification of weight status according to BMI Z-score revealed that 46.7% of patients had a fat percentage that did not correspond to their classification. For a more accurate weight assessment in clinical practice, we recommend combining anthropometric indices with diagnostic tools that better correlate with DXA, such as electrical bioimpedance.

Sexuality, Quality of Life, Anxiety, Depression, and Anger in Patients with Anal Fissure. A Case-Control Study.

Anal fissures (AFs) are lesions located in the lower anal canal. They can be primary (chronic or acute) or secondary to a basic disease. There is high comorbidity of depression and anxiety in patients with chronic AF, with poorer quality of life (QoL) and sexual function. This is a case-control study carried out in the San Juan Hospital (Alicante, Spain). Sixty-seven participants were included in the study, including 35 cases and 32 controls: 36 males and 31 females. This study aims to investigate the association of presenting AFs with sexuality, quality of life, anxiety, depression, and anger. The instruments used were the Spanish validated versions of the validated original selected questionnaires. These instruments were used to assess health-related quality of life, anxiety, anger, depression, and sexual function. Results show higher values in cases than in controls with statistical significance in anxiety state and trait; anxiety and depression; bodily pain, general health, and vitality; and 10 of the 12 anger factors. Higher values in controls than in cases with statistical significance in sexuality and many of the QoL factors were found. Addressing these issues in AF surgical patients would be beneficial for their clinical assessment and intervention.

Evaluation of changes in intestinal microbiota in Crohn's disease patients after anti-TNF alpha treatment.

Intestinal dysbiosis is key in the onset and development of Crohn's disease (CD). We evaluated the microbiota changes in CD patients before and after a six-month anti-TNF treatment, comparing these changes with the microbiota of healthy subjects. This prospective multicenter observational study involved 27 CD patients initiating anti-TNF treatment and 16 healthy individuals. Inflammatory activity was determined at baseline, 3 and 6 months, classifying patients into responders and non-responders. Fecal microbiota was analyzed by massive genomic sequencing thought 16S rRNA amplicon sequencing before and after six months of anti-TNF treatment. The CD cohort showed a decrease in genera of the class Clostridia, short-chain fatty acid producers, and an increase in the phylum Proteobacteria (p < 0.01) versus the healthy cohort. After anti-TNF treatment, the phylum Proteobacteria also increased in non-responders versus responders (13/27) (p < 0.005), with the class Clostridia increasing. In addition, alpha diversity increased in responders versus non-responders (p < 0.01), tending towards eubiosis. An association was found (p < 0.001) in the F.prausnitzii/E.coli ratio between responders and non-responders. The F/E ratio was the most accurate biomarker of anti-TNF response (area under the curve 0.87). Thus, anti-TNF treatment allows partial restoration of intestinal microbiota in responders and the F.prausnitzii/E.coli ratio can provide a reliable indicator of response to anti-TNF in CD.

Factors Associated with Non-Adherence to Drugs in Patients with Chronic Diseases Who Go to Pharmacies in Spain.

BACKGROUND: Pharmacological non-adherence in chronic diseases is 40-65%. No predictive profile of non-adherence exists in patients with multiple chronic diseases. Our study aimed to quantify the prevalence of non-adherence to pharmacological treatment and its associated factors in patients who visit pharmacies in Spain. METHODS: This observational cross-sectional study included patients with one or more chronic diseases. The variables analyzed were demographics, diseases involved, self-medication, information about disease, and lifestyle. The main variable was adherence using the Morisky-Green test. A total of 132 pharmacies collaborated, providing 6327 patients representing all Spain regions (April-December 2016). Bivariate and multivariate analyses were performed and the area under the receiver operating characteristic (ROC) curve was calculated. RESULTS: Non-adherence was 48.4% (95% confidence interval (CI): 47.2-49.7%). The variables that reached significance in the multivariate model were: difficulty in taking medication, self-medication, desire for more information, smoking, lower physical activity, younger age and number of chronic treatments. Discrimination was satisfactory (area under the ROC curve = 70%). Our study found that 50% patients was non-adherent and we obtained a profile of variables associated with therapeutic non-adherence. CONCLUSIONS: It is cause for concern that in patients with multiple diseases and taking multiple medications, there is an association between non-adherence, self-medication and worse lifestyle.

Insulin Resistance as a Diagnostic Criterion for Metabolically Healthy Obesity in Children.

OBJECTIVES: In recent years, a subgroup of individuals with obesity has been described as having a lower risk of metabolic and cardiovascular complications. These individuals have what is referred to as metabolically healthy obesity (MHO), which has a favorable metabolic profile and a lower probability of long-term complications. The definition of this subtype in children is not clear. The aim of the present study was to determine whether Homeostasis Model Assessment (HOMA) above a set threshold could be the marker of metabolically unhealthy obesity (MUO) in children, or a parameter that can be used in the overall assessment. It is intended to compare the International Diabetes Federation (IDF) criteria against HOMA in the diagnosis of MUO. METHODS: This observational, retrospective, cohort study included children with obesity and analyzed their metabolic state by means of blood testing and dual-energy X-ray absorptiometry. RESULTS: A total of 96 patients were included, 44.8% boys and 55.2% girls, ages 6-17 years. The patients with MHO according to the HOMA criterion were younger (P = 0.001), had a lower body mass index (BMI) z score (P = 0.006), waist-height index (P = 0.009), hip-height index (P = 0.010), blood glucose (P = 0.003), insulin (P < 0.001), and lower percentages of total fat (P = 0.002), trunk fat (P = 0.001), and android fat (P = 0.009) than those with MUO. The logistic regression analysis according to IDF criteria detected an area under the receiver operating characteristic (ROC) curve of 0.659 (95% CI 0.546-0.771; P = 0.009) versus the area under the ROC curve of 0.854 (95% CI 0.777-0.931; P < 0.001) for the HOMA definition. Therefore, the determination of the metabolic state according to HOMA has greater sensitivity and specificity than the IDF criteria. The multivariate analysis in children classified according to HOMA revealed that the percentage of total fat and gynoid fat distributions and triglyceride level could be markers of a healthy or unhealthy metabolic state in children with obesity (P < 0.001). CONCLUSIONS: The use of HOMA as a single criterion was demonstrated to be an effective and simple detector of adiposity, which predicts the metabolically healthy obesity in children.

Vitamin D Deficiency and Gestational Diabetes Mellitus in Relation to Body Mass Index.

A relationship between vitamin D deficiency (VDD) and gestational diabetes mellitus (GDM) has been described. Considering that GDM prevalence depends on body mass index (BMI), our main objective was to determine if VDD is associated with GDM, independent of BMI. A cross-sectional study with 886 pregnant women was conducted in Elda (Spain) from September 2019 to June 2020. To assess the association, Poisson regression models with robust variance were used to estimate the prevalence ratio (PR). The observed GDM prevalence was 10.5%, while the VDD prevalence was 55.5%. In the crude model, both VDD and obesity were associated with GDM, but in the adjusted model, only VDD was statistically significant (PR = 1.635, p = 0.038). A secondary event analysis did not detect differences in VDD, but BMI yielded a higher frequency of births by cesarean section and newborns with a >90 percentile weight in the obesity group. In conclusion, VDD is associated with GDM, independent of BMI. Future longitudinal studies could provide information on causality.

Evaluation of Changes in Gut Microbiota in Patients with Crohn's Disease after Anti-Tnfα Treatment: Prospective Multicenter Observational Study.

Background: Crohn's disease is believed to result from the interaction between genetic susceptibility, environmental factors and gut microbiota, leading to an aberrant immune response. The objectives of this study are to evaluate the qualitative and quantitative changes in the microbiota of patients with Crohn's disease after six months of anti-tumor-necrosis factor (anti-TNFα) (infliximab or adalimumab) treatment and to determine whether these changes lead to the recovery of normal microbiota when compared to a control group of healthy subjects. In addition, we will evaluate the potential role of the Faecalibacterium prausnitzii/Escherichia coli and Faecalibacterium prausnitzii/Clostridium coccoides ratios as indicators of therapeutic response to anti-TNFα drugs. Methods/Design: This prospective multicenter observational study will comprise a total of 88 subjects: 44 patients with Crohn's disease scheduled to start anti-TNFα treatment as described in the drug specifications to control the disease and 44 healthy individuals who share the same lifestyle and eating habits. The presence of inflammatory activity will be determined by the Harvey-Bradshaw index, analytical parameters in blood, including C-reactive protein, and fecal calprotectin levels at commencement of the study, at three months and at six months, allowing the classification of patients into responders and non-responders. Microbiota composition and the quantitative relationship between Faecalibacterium prausnitzii and Escherichia coli and between Faecalibacterium prausnitzii and Clostridium coccoidesgroup as indicators of dysbiosis will be studied at inclusion and six months after initiation of treatment using ultra sequencing with Illumina technology and comparative bioinformatics analysis for the former relationship, and digital droplet PCR using stool samples for the latter. Upon inclusion, patients will complete a survey of dietary intake for the three days prior to stool collection, which will be repeated six months later in a second collection to minimize dietary bias. Discussion: In this study, massive sequencing, a reliable new tool, will be applied to identify early biomarkers of response to anti-TNF treatment in patients with Crohn's disease to improve clinical management of these patients, reduce morbidity rates and improve efficiency.

Validation of self-reported adherence in chronic patients visiting pharmacies and factors associated with the overestimation and underestimation of good adherence.

BACKGROUND: Studies validating indirect methods to identify nonadherence in chronic patients who visit pharmacies are lacking. The aim of this study was to validate self-reported adherence and assess the variables associated with both overestimation and underestimation of good adherence when using this method. MATERIALS AND METHODS: An observational, cross-sectional study was undertaken to validate self-reported adherence in 132 community pharmacies throughout Spain in 6237 chronic patients. The Morisky-Green test was used as the validation method and through a 2 × 2 table, the validity indicators, predictive values, and likelihood ratios were calculated. To assess the variables associated with both overestimation and underestimation of good adherence, multivariate logistic regression analysis and calculation of the area under the ROC curve were used to evaluate discriminatory capacity. RESULTS: Sensitivity was 27.8% (95% CI: 26.2-29.4) and specificity was 93.9% (95% CI: 93.1-94.7). Discrepancy analysis obtained a significant overestimation of good adherence (p < 0.001). The factors associated with overestimating good adherence were performing a mnemonic trick (p < 0.001), not self-medicating (p < 0.001), a high level of physical activity (p < 0.001), and an older age (p = 0.014). Factors associated with underestimation were self-medication (p < 0.001), desiring more information (p < 0.001), smoking (p = 0.014), not engaging in physical activity in the low (p = 0.006) or high (p < 0.001) categories, having a younger mean age (p = 0.007), and taking two to three (p = 0.029) or four or more (p < 0.001) chronic treatments. CONCLUSION: Self-reported adherence has good specificity but poor sensitivity. The associated profiles of the discrepancies were obtained to identify both good and poor adherence.

Macronutrients and micronutrients in Spanish adult vegans (Mediterranean population) / Macronutrientes y micronutrientes en adultos veganos españoles (población mediterránea)

OBJECTIVE: studies have been published in Europe comparing the mean macronutrient and micronutrient intake values of the general population with those of the vegan population, but none has been conducted in a country that mainly follows the Mediterranean diet. Therefore, the aim of this study was to carry out this comparison in Spain. METHODS: a cross-sectional study of a sample of Spanish vegans was designed in 2015. To compare the distribution of nutrients with those of the general population, we used data from the Spanish Agency for Food Safety and Nutrition, which was considered to be normally distributed as it was a large population with biological parameters. All participants were asked about their dietary intake for the previous day (24 hour reminder) and the nutrients were calculated using specialized software. The distributions were compared using the Kolmogorov-Smirnov test. RESULTS: the sample comprised 102 vegans, 67 of whom were women. The vegan population consumed more carbohydrates and fiber, less total fat (women only), fewer saturated fatty acids, and more polyunsaturated fatty acids. They had much lower cholesterol intake, lower calcium and iodine intake, higher iron and folic acid intake, and much lower intake of vitamins B12 and D. CONCLUSIONS: Spanish vegans had nutritional deficiencies compared to the general population and should therefore ensure their diet includes the necessary supplements

ANTECEDENTES: se han publicado en Europa estudios que comparan los valores medios de ingesta de macronutrientes y micronutrientes de la población general con los de la población vegana, pero ninguno se ha llevado a cabo en un país que sigue principalmente la dieta mediterránea. Por lo tanto, el objetivo de este estudio fue llevar a cabo esta comparación en España. MÉTODOS: se diseñó un estudio transversal de una muestra de veganos españoles en 2015. Para comparar la distribución de nutrientes con los de la población general, utilizamos datos de la Agencia Española de Seguridad Alimentaria y Nutrición, considerando dichos datos como una distribución normal de parámetros biológicos al constituir una gran muestra. A todos los participantes se les preguntó sobre su ingesta dietética en el día anterior y los nutrientes se calcularon utilizando un software especializado. Las distribuciones se compararon mediante la prueba de Kolmogorov-Smirnov. RESULTADOS: la muestra comprendió 102 veganos, 67 de los cuales eran mujeres. La población vegana consumió más carbohidratos y fibra, menos grasa total (solo mujeres), menos ácidos grasos saturados y más ácidos grasos poliinsaturados. Tenían una ingesta mucho más baja de colesterol, una ingesta más baja de calcio y yodo, una mayor ingesta de hierro y ácido fólico, y una ingesta mucho más baja de vitaminas B12 y D. CONCLUSIÓN: los veganos españoles tenían deficiencias nutricionales en comparación con la población general y, por lo tanto, deben asegurarse de que su dieta incluya los suplementos necesarios

Macronutrients and micronutrients in Spanish adult vegans (Mediterranean population).

INTRODUCTION: Objective: studies have been published in Europe comparing the mean macronutrient and micronutrient intake values of the general population with those of the vegan population, but none has been conducted in a country that mainly follows the Mediterranean diet. Therefore, the aim of this study was to carry out this comparison in Spain. Methods: a cross-sectional study of a sample of Spanish vegans was designed in 2015. To compare the distribution of nutrients with those of the general population, we used data from the Spanish Agency for Food Safety and Nutrition, which was considered to be normally distributed as it was a large population with biological parameters. All participants were asked about their dietary intake for the previous day (24 hour reminder) and the nutrients were calculated using specialized software. The distributions were compared using the Kolmogorov-Smirnov test. Results: The sample comprised 102 vegans, 67 of whom were women. The vegan population consumed more carbohydrates and fiber, less total fat (women only), fewer saturated fatty acids, and more polyunsaturated fatty acids. They had much lower cholesterol intake, lower calcium and iodine intake, higher iron and folic acid intake, and much lower intake of vitamins B12 and D. Conclusions: Spanish vegans had nutritional deficiencies compared to the general population and should therefore ensure their diet includes the necessary supplements.

INTRODUCCIÓN: Antecedentes: se han publicado en Europa estudios que comparan los valores medios de ingesta de macronutrientes y micronutrientes de la población general con los de la población vegana, pero ninguno se ha llevado a cabo en un país que sigue principalmente la dieta mediterránea. Por lo tanto, el objetivo de este estudio fue llevar a cabo esta comparación en España. Métodos: se diseñó un estudio transversal de una muestra de veganos españoles en 2015. Para comparar la distribución de nutrientes con los de la población general, utilizamos datos de la Agencia Española de Seguridad Alimentaria y Nutrición, considerando dichos datos como una distribución normal de parámetros biológicos al constituir una gran muestra. A todos los participantes se les preguntó sobre su ingesta dietética en el día anterior y los nutrientes se calcularon utilizando un software especializado. Las distribuciones se compararon mediante la prueba de Kolmogorov-Smirnov. RESULTADOS: La muestra comprendió 102 veganos, 67 de los cuales eran mujeres. La población vegana consumió más carbohidratos y fibra, menos grasa total (solo mujeres), menos ácidos grasos saturados y más ácidos grasos poliinsaturados. Tenían una ingesta mucho más baja de colesterol, una ingesta más baja de calcio y yodo, una mayor ingesta de hierro y ácido fólico, y una ingesta mucho más baja de vitaminas B12 y D. Conclusión: los veganos españoles tenían deficiencias nutricionales en comparación con la población general y, por lo tanto, deben asegurarse de que su dieta incluya los suplementos necesarios.

Influence of olive polyphenols on glucose and cholesterol levels in medaka fish / Influencia de los polifenoles del olivo en los niveles de glucosa y colesterol en el pez medaka

BACKGROUND: Polyphenol-rich olive extracts are non-toxic and have anti-inflammatory, neuroprotective and antiadipogenic effects in cell and animal models. OBJECTIVE: To evaluate the potential influence of olive extracts on the mechanisms of digestion and absorption of polysaccharides and fats by quantifying amylase, glucose, phospholipase, and cholesterol in the medaka fish model. MATERIAL AND METHODS: For each assay, six adult fish were placed in a tank with an extract (0.01% concentration), performing three replicates per extract. A control group with standard feeding was used. The same procedure was followed to study glucose, adding a polysaccharide-rich diet and a corresponding overfed control. The fish were maintained under these conditions for five days. Five olive extracts were used without attempting to purify the polyphenols due to possible synergistic effects. Total concentrations were between 2-116mg/g (mainly oleuropein and hydroxytyrosol). On completion, amylase, phospholipase A2, glucose and cholesterol were quantified in each group. All assays were conducted in triplicate. Enzyme activities were also studied in juveniles. Non-parametric tests were used to determine possible differences, considering p < 0.05 to denote statistical significance. RESULTS: Polyphenol extracts were not toxic at a concentration of 0.1%, ten times higher than the concentration used. An overall decrease in glucose levels was observed in fish overfed with carbohydrates with the addition of the extracts, but without returning to the levels in the control group with standard feeding (between 15-40% decrease). There was no impact on amylase in adults or juveniles, an overall but not significant decrease in cholesterol, and an overall increase in phospholipase in the juveniles. CONCLUSION: Olive extracts rich in polyphenols lower glucose levels in overfed fish

ANTECEDENTES: Los extractos de aceitunas ricos en polifenoles no son tóxicos y tienen efectos antiinflamatorios, neuroprotectores y antiadipogénicos en modelos celulares y animales. OBJETIVO: Evaluar la influencia potencial de los extractos de aceituna en los mecanismos de digestión y absorción de polisacáridos y grasas mediante la cuantificación de amilasa, glucosa, fosfolipasa y colesterol en el modelo de pez medaka. MATERIAL Y MÉTODOS: Para cada ensayo, se colocaron seis peces adultos en un tanque con un extracto (al 0,01%), realizando tres repeticiones por extracto. Se usó un grupo control con alimentación estándar. Se siguió el mismo procedimiento para estudiar la glucosa, agregando una dieta rica en polisacáridos y un control de sobrealimentados. Los peces se mantuvieron en estas condiciones durante cinco días. Se usaron cinco extractos del olivo sin intentar purificar los polifenoles debido a posibles efectos sinérgicos. Las concentraciones totales fueron entre 2-116 mg/g (principalmente oleuropeína e hidroxitirosol). Al finalizar, se cuantificaron amilasa, fosfolipasa A2, glucosa y colesterol en cada grupo. Todos los ensayos se realizaron por triplicado. Las actividades enzimáticas también se estudiaron en alevines. Se utilizaron pruebas no paramétricas para determinar posibles diferencias, considerando p <0.05 para significación estadística. RESULTADOS: Los extractos de polifenoles no fueron tóxicos a una concentración de 0.1%, diez veces mayor que la concentración utilizada. Se observó una disminución general en los niveles de glucosa en peces sobrealimentados con carbohidratos con la adición de extractos, pero sin volver a los niveles del grupo control con alimentación estándar (disminución entre 15-40%). No hubo impacto sobre la amilasa en adultos o juveniles, se observó una disminución general pero no significativa del colesterol y un aumento general de la fosfolipasa en los juveniles. CONCLUSIÓN: Los extractos de aceitunas ricos en polifenoles reducen los niveles de glucosa en peces sobrealimentados

¿Qué variables influyen en el cumplimiento de las recomendaciones de actividad física en preescolares? / Which variables influence compliance with physical activity recommendations in young children?

INTRODUCCIÓN: Existen recomendaciones europeas de actividad física para la infancia. El principal objetivo de estudio era determinar los factores que podrían influir en el cumplimiento de las recomendaciones europeas de actividad física en la primera infancia. MÉTODOS: Se incluyó a 136 niños (2-8 años), clasificados según su estado de peso medido con puntajes Z del IMC siguiendo los estándares de la Organización Mundial de la Salud. Se midió la actividad física durante 5 días consecutivos con acelerómetros y la ingesta diaria. RESULTADOS: Una mayor actividad física se asoció con un menor estado de peso (B = -1,55; IC 95%: --2,02 a -1,08; p < 0,001), menor edad (B = -1,33; IC 95%: -1,72 a -0,93; p < 0,001) y mayor gasto energético (B = 0,02; IC 95%: 0,02 a 0,03; p < 0,001). El total de la muestra tuvo una actividad física ligera (media = 589 cpm/día). Los niños con sobrepeso y obesidad pasaron menos tiempo en actividad física moderada-vigorosa (p = 0,005) y más tiempo en actividad física sedentaria (p = 0,005) que los del grupo normopeso. Todos los grupos pasaron entre 90 y 130 min diarios en actividades sedentarias, con una media que supone un 15,5% del tiempo de actividad (eliminando las horas de sueño). El cumplimiento de las recomendaciones europeas depende del sexo (p = 0,010) y del estado de peso (p = 0,038). CONCLUSIÓN: Los preescolares pasaron más de 100 min diarios en tiempo sedentario. Las recomendaciones europeas de actividad física moderada-vigorosa diarias se cumplieron por la mayoría de la muestra. Sin embargo, este cumplimiento dependía del sexo y del menor estado de peso

INTRODUCTION: There are established European guidelines for physical activity in childhood. The main goal of our study was to determine the factors that may influence compliance with European recommendations for physical activity in young children. METHODS: We included 136 children (aged 2-8 years) classified by weight status, calculated based on the body mass index z-score using the growth standards of the World Health Organization. We measured physical activity over 5 consecutive days with accelerometers and recorded the food intake. RESULTS: A greater level of physical activity was associated with a lower weight status category (B = -1.55; 95% CI: -2.02 to -1.08; P < .001), lower age (B = -1.33; 95% CI: -1.72 to -0.93; P < .001) and greater energy expenditure (B = 0.02; 95% CI: 0.02 to 0.03; P < .001). The overall physical activity in the sample was light (mean = 589 cpm/day). Children with overweight and obesity spent less time engaged in moderate to vigorous physical activity (P = .005) and more time engaged in sedentary activities (P = .005) compared to children with normal weight. All groups spent between 90 and 130minutes a day in sedentary activities, with a mean time spent that amounted to 15.5% of their time (excluding time spent sleeping). The adherence to European recommendations varied in association with sex (P = .010) and weight status (P = .038). CONCLUSION: Young children spent more than 100minutes a day engaged in sedentary activities. Most of the sample met the European recommendations for daily moderate to vigorous physical activity. However, the degree of adherence depended on sex and weight status