CLOCK 3111T/C genetic variant influences the daily rhythm of autonomic nervous function: relevance to body weight control.

BACKGROUND/OBJECTIVES: Humans carrying the genetic risk variant C at the circadian CLOCK (Circadian Locomotor Output Cycles Kaput) 3111T/C have been shown to have more difficulties to achieve desired weight loss than TT carriers. We tested the hypothesis that the daily rhythm of autonomic nervous function differs in CLOCK 3111C carriers, leading to reduced effectiveness in weight control. SUBJECTS/METHODS: We recruited 40 overweight/obese Caucasian women (body mass index>25), 20 carrying CLOCK 3111C (CC and TC) and 20 non-carriers with matched age and body mass index who participated in a dietary obesity treatment program of up to 30 weeks. Following the treatment, ambulatory electrocardiography was continuously monitored for up to 3.5 days when subjects underwent their normal daily activities. To assess autonomic function, heart rate variability analysis (HRV) was performed hourly to obtain mean inter-beat interval between two consecutive R waves (mean RR) and s.d. of normal-to-normal heartbeat intervals (SDNN), and two parasympathetic measures, namely, proportion of differences between adjacent NN intervals that are >50 ms (pNN50), and high-frequency (HF: 0.15-0.4 Hz) power. RESULTS: In the TT carriers, all tested HRV indices showed significant daily rhythms (all P-values <0.0001) with lower mean RR, SDNN, pNN50, and HF during the daytime as compared with the nighttime. The amplitudes of these rhythms except for SDNN were reduced significantly in the C carriers (mean RR: ~19.7%, P=0.001; pNN50: 58.1%, P=0.001; and HF: 41.1%, P=0.001). In addition, subjects with less weight loss during the treatment program had smaller amplitudes in the rhythms of mean RR (P<0.0001), pNN50 (P=0.007) and HF (P=0.003). Furthermore, the rhythmicity-weight loss associations were much stronger in the C carriers as compared to the TT carriers (mean RR: P=0.028, pNN50: P=0.0002; HF: P=0.015). CONCLUSIONS: The daily rhythm of parasympathetic modulation may play a role in the influence of the CLOCK variation on body weight control.

Heritability of siesta and night-time sleep as continuously assessed by a circadian-related integrated measure.

Siesta is a relevant aspect of sleep due to its posited relationship with health or cognitive function. However, unlike night-time sleep, studies about daytime-sleep determinants and characteristics are scarce, and the genetic/environmental structure of siesta is still unknown. Our aim was to explore the relative contribution of genetic and environmental factors to variation in sleep-wake rhythm, measured by a continuous assessment of temperature-activity-position (TAP), which allows for diurnal sleep analysis. The sample comprised 53 pairs of female twins (28 MZ and 25 DZ), selected from the Murcia Twin Register. Mean age of participants was 52 (SD: 6.03). Zygosity was determined by DNA. We conducted separate univariate analyses to study the sources of variance of daytime and night-time sleep parameters. About 60% of the sample reported to take siesta at least once a week. Heritability of taking siesta and daytime sleep duration was 65 and 61% respectively. Other sleep parameters obtained by TAP showed heritability estimates between 36 and 69%, suggesting a relevant impact of genetic factors on sleep rhythm. This is the first study to investigate the relative contribution of genetic factors to siesta. By using TAP, we introduce a novel approach to the study of diurnal sleep characteristics.

XVII Congreso SEINAP. Ritmos circadianos y crononutrición / XVII Congreso SEINAP. Circadian rhythms and chrononutrition

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Evening chronotype associates with obesity in severely obese subjects: interaction with CLOCK 3111T/C.

BACKGROUND: Chronotype has been related to obesity and metabolic disturbances. However, little is known about the relationship between circadian preferences and genetic background in CLOCK genes with obesity and weight loss among severely obese patients after bariatric surgery. OBJECTIVES: The research goals were (1) to examine whether evening chronotype is related to obesity and weight loss evolution in severely obese followed during 6 years after bariatric surgery and (2) to examine potential interactions between circadian preferences and CLOCK 3111T/C for obesity in this population. SUBJECTS/METHODS: Participants (n=252, 79% female; age (mean±s.d.): 52±11 years; body mass index (BMI): 46.4±6.0 kg m-2) were grouped into evening and morning types. Obesity and weight loss parameters, energy and macronutrients intake, energy expenditure, chronotype, meal timing, sleep duration and CLOCK genotype were studied. RESULTS: Evening-type subjects showed significantly higher initial body weight (P=0.015) and BMI (P=0.014) than morning types. Moreover, evening-type, when compared with morning types, lost less weight (percentage of excess weight loss) after bariatric surgery (P=0.015). Weight-loss progression between the two chronotype groups differed significantly from the fourth year after the bariatric surgery toward a higher weight regain among evening types (P<0.05). We also detected a significant interaction between CLOCK 3111T/C SNP and chronotype for body weight at baseline (P<0.001). Specifically, among carriers of the risk allele C, evening types showed higher body weight than morning types (P=0.012). In addition, CLOCK 3111T/C SNP significantly associated with obesity and sleep duration in the older subjects. CONCLUSIONS: Evening chronotype is associated with higher obesity in severely obese subjects and with lower weight loss effectiveness after bariatric surgery. In addition, circadian preferences interact with CLOCK 3111T/C for obesity. The circadian and genetic assessment could provide tailored weight loss recommendations in subjects who underwent bariatric surgery.

Circadian rhythms, food timing and obesity.

It is known that our physiology changes throughout the day and that several physiological hormones display circadian rhythmicity. The alteration of this normal pattern is called chronodisruption (CD). In recent years, it has been demonstrated that CD is related to obesity. Although several factors may be causing CD, one important aspect to consider is the failure in our internal clock. Indeed, studies performed in mutant animals have demonstrated that mutations in clock genes are related to obesity. In human subjects, mutations are rare (<1 % of the population). Nevertheless, it is rather common to have genetic variations in one SNP, which underlie differences in our vulnerability to disease. Several SNP in clock genes are related to obesity and weight loss. Taking into account that genetics is behind CD, as has already been demonstrated in twins' models, the question is: Are we predestinated? We will see along these lines that nutrigenetics and epigenetics answer: 'No, we are not predestinated'. Through nutrigenetics we know that our behaviours may interact with our genes and may decrease the deleterious effect of one specific risk variant. From epigenetics the message is even more positive: it is demonstrated that by changing our behaviours we can change our genome. Herein, we propose modifying 'what, how, and when we eat' as an effective tool to decrease our genetic risk, and as a consequence to diminish CD and decrease obesity. This is a novel and very promising area in obesity prevention and treatment.

Timing of food intake is associated with weight loss evolution in severe obese patients after bariatric surgery.

BACKGROUND: Recent research has demonstrated a relationship between the timing of food intake and weight loss in humans. However, whether the meal timing can be associated with weight loss in patients treated with bariatric surgery is unknown. OBJECTIVE: To evaluate the role of food-timing in the evolution of weight loss in a sample of 270 patients that underwent bariatric surgery with a follow-up of 6 years. METHODS: Participants (79% women; age [mean ± SD]: 52 ± 11 years; BMI: 46.5 ± 6.0 kg/m2) were classified according their weight loss response patterns after bariatric surgery: good weight-loss-responders (67.8%), primarily poor weight-loss-responders (10.8%) or secondarily poor weight-loss-responders (21.4%). Then, they were grouped in early-eaters and late-eaters, according to the timing of the main meal (before or after 15:00 h). Obesity and biochemical parameters, energy and macronutrients intake, energy expenditure, sleep duration, and chronotype were studied. RESULTS: The percentage of late eaters (after 15:00 h) was significantly higher in the primarily poor weight-loss-responders (∼70%) than in both secondarily poor weight-loss-responders (∼42%) and good weight-loss-responders (∼37%) (p = 0.011). Consistently, primarily poor weight-loss-responders had lunch later as compared to good and secondarily poor weight-loss-responders (p = 0.034). Age, gender and type of surgery were not determining. Surprisingly, obesity-related variables, biochemical parameters, pre-surgical total energy expenditure, sleep duration, chronotype, calorie intake and macronutrients distribution, were similar among groups. CONCLUSIONS: Weight loss effectiveness after bariatric surgery is related to the timing of the main meal. Our preliminary results suggest that the timing of food intake is important for weight regulation and that eating at the right time may be a relevant factor to consider in weight loss therapy even after bariatric surgery.

Application of multiparametric procedures for assessing the heritability of circadian health.

At present, the measurement of circadian system status under free-living conditions by the use of sensors is a relatively new technique. The data obtained using these methods are influenced by strong environmental masking factors and artifacts that can affect its recording. Therefore, the use of integrative variables such as TAP, a measure that includes temperature, activity and position that reduces these drawbacks and the number of parameters obtained is necessary. However, the relative genetic contribution to this circadian marker is unknown. The aim of our study was to ascertain the relative importance of genetic influences in TAP, and for each of its components using classical twin models. The study was performed in 53 pairs of female twins [28 monozygotic (MZ) and 25 dizygotic (DZ)] with mean age 52 ± 6 years. Circadian patterns were studied by analyzing temperature, body position and activity for 1 week every 1 min with "Circadianware®.". Genetic influences affecting the variability of each of the measurements were estimated by comparing the observed data in twin pairs. MZ twins showed higher intrapair correlations than DZ twins for most of the parameters. Genetic factors (broad sense heritability) were responsible for about 40-72% of TAP variance in parameters such as mesor, acrophase, amplitude, Rayleigh test, percentage of rhythmicity and circadian function index. We found more homogeneous heritability estimates of the circadian system when using an integrative technique such as TAP than with individual variables alone, suggesting that this measurement can be more reliable and less subject to environmental artifacts.

Toward a chronobiological characterization of obesity and metabolic syndrome in clinical practice.

BACKGROUND & AIMS: To test several circadian rhythm variables in a female population to identify the best tool to assess chronodisruption in obesity and metabolic syndrome (MetS) to define a score to be used for chronodisruption characterization in clinical practice. METHODS: Anthropometric measurements and markers of circadian rhythms, such as sleep and feeding diary, Horne-Ostberg questionnaire, melatonin and cortisol measurements, and wrist temperature measurements, were determined. MetS variables were also analyzed. Study was conducted in 70 women. Data were subjected to factor analysis. Receiver operating characteristic curves were used as predictors of chronodisruption risk, and a score was calculated to classify the subjects of risk. RESULTS: Factor analysis showed that the first-factor grouped variables were related to the skin temperature measurement. Second factor consisted of variables related to salivary cortisol levels and obesity-related measurements. Third factor included variables related to sleep-wake cycle. Fourth factor referred to peripheral temperature variables and included the classification of subjects according to the Horne-Ostberg questionnaire. To obtain a final punctuation we performed the weighted mean of the first four factors. The final range was from 27 to 57, mean value of 42. Punctuation was defined as the "chronodisruption score." Women displaying higher chronodisruption scores had higher MetS risk. CONCLUSION: The study demonstrates that wrist temperature recordings, together with two questions of sleep onset and offset, and one morning salivary cortisol determination could be enough to characterize the chronobiology of obesity and MetS, a new chronodisruption score was developed.

Meal timing affects glucose tolerance, substrate oxidation and circadian-related variables: A randomized, crossover trial.

BACKGROUND/OBJECTIVES: Timing of food intake associates with body weight regulation, insulin sensitivity and glucose tolerance. However, the mechanism is unknown. The aim of this study was to investigate the effects of changes in meal timing on energy-expenditure, glucose-tolerance and circadian-related variables. SUBJECTS/METHODS: Thirty-two women (aged 24±4 years and body mass index 22.9±2.6 kg m(-2)) completed two randomized, crossover protocols: one protocol (P1) including assessment of resting-energy expenditure (indirect-calorimetry) and glucose tolerance (mixed-meal test) (n=10), the other (P2) including circadian-related measurements based on profiles in salivary cortisol and wrist temperature (Twrist) (n=22). In each protocol, participants were provided with standardized meals (breakfast, lunch and dinner) during the two meal intervention weeks and were studied under two lunch-eating conditions: Early Eating (EE; lunch at 13:00) and Late Eating (LE; lunch 16:30). RESULTS: LE, as compared with EE, resulted in decreased pre-meal resting-energy expenditure (P=0.048), a lower pre-meal protein-corrected respiratory quotient (CRQ) and a changed post-meal profile of CRQ (P=0.019). These changes reflected a significantly lower pre-meal utilization of carbohydrates in LE versus EE (P=0.006). LE also increased glucose area under curve above baseline by 46%, demonstrating decreased glucose tolerance (P=0.002). Changes in the daily profile of cortisol and Twrist were also found with LE blunting the cortisol profile, with lower morning and afternoon values, and suppressing the postprandial Twrist peak (P<0.05). CONCLUSIONS: Eating late is associated with decreased resting-energy expenditure, decreased fasting carbohydrate oxidation, decreased glucose tolerance, blunted daily profile in free cortisol concentrations and decreased thermal effect of food on Twrist. These results may be implicated in the differential effects of meal timing on metabolic health.

Circadian rhythmicity as a predictor of weight-loss effectiveness.

OBJECTIVES: Some of the major challenges associated with successful dietary weight management include the identification of individuals not responsive to specific interventions. The aim was to investigate the potential relationship between weight loss and circadian rhythmicity, using wrist temperature and actimetry measurements, in women undergoing a weight-loss program, in order to assess whether circadian rhythmicity could be a marker of weight-loss effectiveness. METHODS: Participants were 85 overweight and obese women (body mass index, BMI: 30.24±4.95 kg m(-2)) subjected to a weight-reduction program. Efficacy of the treatment was defined as total weight loss, percentage of initial weight and weekly weight loss rates. Circadian rhythmicity in wrist temperature motor activity and position were analyzed using different sensors. RESULTS: Lower weight loss was related with a more flattened pattern measured as amplitude from cosinor (r=0.235, P=0.032), a higher fragmentation of rhythms determined by higher intradaily variability (IV) (r=-0.339, P=0.002), and an impaired wrist temperature circadian rhythm determined by the means of Circadian Function Index (r=0.228, P=0.038). Further analyses showed that low responders displayed lower amplitude (0.71±0.36 versus 1.24±0.62, P=0.036) and higher fragmentation of the circadian rhythm (0.24±0.11 versus 0.15±0.07, P=0.043) than high responders. Whereas we did not find significant differences in total activity rates between high responders and low responders, we found significant differences for the mean values of body position for high responders (39.12±3.79°) as compared with low responder women (35.31±2.53°, P=0.01). CONCLUSIONS: Circadian rhythms at the beginning of the treatment are good predictors of future weight loss. Further treatment should consider chronobiological aspects to diagnose obesity and effectiveness of treatments.

Timing of food intake predicts weight loss effectiveness.

BACKGROUND: There is emerging literature demonstrating a relationship between the timing of feeding and weight regulation in animals. However, whether the timing of food intake influences the success of a weight-loss diet in humans is unknown. OBJECTIVE: To evaluate the role of food timing in weight-loss effectiveness in a sample of 420 individuals who followed a 20-week weight-loss treatment. METHODS: Participants (49.5% female subjects; age (mean ± s.d.): 42 ± 11 years; BMI: 31.4 ± 5.4 kg m(-2)) were grouped in early eaters and late eaters, according to the timing of the main meal (lunch in this Mediterranean population). 51% of the subjects were early eaters and 49% were late eaters (lunch time before and after 1500 hours, respectively), energy intake and expenditure, appetite hormones, CLOCK genotype, sleep duration and chronotype were studied. RESULTS: Late lunch eaters lost less weight and displayed a slower weight-loss rate during the 20 weeks of treatment than early eaters (P=0.002). Surprisingly, energy intake, dietary composition, estimated energy expenditure, appetite hormones and sleep duration was similar between both groups. Nevertheless, late eaters were more evening types, had less energetic breakfasts and skipped breakfast more frequently that early eaters (all; P<0.05). CLOCK rs4580704 single nucleotide polymorphism (SNP) associated with the timing of the main meal (P=0.015) with a higher frequency of minor allele (C) carriers among the late eaters (P=0.041). Neither sleep duration, nor CLOCK SNPs or morning/evening chronotype was independently associated with weight loss (all; P>0.05). CONCLUSIONS: Eating late may influence the success of weight-loss therapy. Novel therapeutic strategies should incorporate not only the caloric intake and macronutrient distribution - as is classically done - but also the timing of food.

Differences in circadian rhythmicity in CLOCK 3111T/C genetic variants in moderate obese women as assessed by thermometry, actimetry and body position.

INTRODUCTION: Genetics is behind our circadian machinery. CLOCK (Circadian Locomotor Output Cycles Kaput) 3111T/C single-nucleotide polymorphism (SNP) has been previously related to obesity and weight loss. However, phenotypic association and functionality of CLOCK 3111 locus is still unknown. The aim of this study was to determine, in free-living conditions, if the presence of CLOCK 3111C in overweight women could be related to (a) circadian disorders, and (b) changes in sleep quality, to improve understanding of the previously demonstrated associations with obesity and reduced weight loss of the C carriers. METHODS: Wrist temperature, actimetry and position (TAP) and TAP variables were measured as markers of circadian functionality during 8 consecutive days. A rest-activity and food diary was also completed, whereas sleep quality was determined by domiciliary polysomnography. We recruited 85 women who were overweight with body mass index (BMI) of 28.59±4.30 kg m(-2) and age 43±12 years. From this sample, we found that 43 women were carrying the minor allele (C) for CLOCK 3111T/C SNP and 42 women were TT carriers (major allele carriers). Both groups of patients were matched for number, age, obesity parameters and energy intake. RESULTS: Compared with TT subjects, who showed more robust circadian rhythm profiles, patients with the C allele displayed significant circadian abnormalities: lower amplitude and greater fragmentation of the rhythm, a less stable circadian pattern and a significantly weakened circadian function, as assessed by the circadian function index (CFI). C subjects were also less active, started their activities later in the morning and were sleepier during the day, showing a delayed acrophase that characterizes 'evening-type' subjects. CONCLUSION: C genetic variants in CLOCK 3111T/C display a less robust circadian rhythm than TT and a delayed acrophase that characterizes 'evening-type' subjects. We support the notion that identifying CLOCK genotypes in patients may assist the therapist in characterization of the roots of the metabolic problem.

Desarrollo de una versión actualizada de una aplicación informática para investigación y práctica en nutrición humana (GRUNUMUR 2.0) / Development of a current version of a software application for research and practice in human nutrition (GRUNUMUR 2.0)

El objetivo de este trabajo es la descripción de una nueva versión de la aplicación informática GRUNUMUR, herramienta de utilidad en estudios de nutrición humana diseñada por el Grupo de investigación en Nutrición de la Universidad de Murcia. De forma similar a la primera, esta versión ofrece la posibilidad de abordar diferentes tipos de estudios: dietéticos, nutricionales y de hábitos alimentarios, epidemiológicos, así como antropométricos y clínicos. La nueva versión, denominada GRUNUMUR 2.0, compatible con la primera, dispone de un sistema de ayuda en línea para todas las funciones de la aplicación, facilitando las tareas al usuario; permite el almacenamiento seguro de un número prácticamente ilimitado de resultados, de forma ordenada y organizada, que se pueden recuperar en el momento que se precise, gracias a un sistema de copias de seguridad y mantenimiento programado y desatendido (tareas realizadas por un servidor); otra ventaja es su total accesibilidad, tanto desde la intranet universitaria (www.um.es) como desde el internet, por su funcionamiento vía navegador Web (http://senver.inf.um.es/esen); y por último, permite la exportación de los datos a Excel para su posterior tratamiento con otras aplicaciones, así como la edición de informes en PDF, para entregar a los participantes del estudio en caso necesario. La nueva versión ha sido validada por comparación de los resultados extraídos con los obtenidos de otros programas informáticos, no encontrándose diferencias significativas entre ellos para ninguna de las variables analizadas. La aplicación GRUNUMUR 2.0 es una herramienta mejorada, útil y fiable para abordar estudios de nutrición humana (AU)

The aim of this paper is the description of a new version of the software application GRUNUMUR, a useful tool for human nutrition studies designed by the Nutrition Research Group from the Murcia University. Similar to the first, this second version offers the possibility to address different types of study: dietary habits (24 h recall, 7-days dietary record and Food Frequency Questionnaire), epidemiological, anthropometrical and clinical studies. The new version, called GRUNUMUR 2.0, compatible with the first one, has an online help system for all functions of the application, providing the user tasks, allows safe storage of a virtually unlimited number of results, in an orderly and organized way, you can retrieve it when required, through a system of backups and scheduled maintenance and unattended (tasks performed by a server), another advantage is its total accessibility, both from the university intranet (www.um.es) and from the internet, it works via Web Browser (http://senver.inf.um.es/esen), and finally, allows data to be exported to Excel for further processing with other applications as well as publishing reports in PDF, to deliver study participants if necessary. The new version has been validated by comparing the extracted results with those obtained from the other software with no significant differences for any of the variables analyzed. The application GRUNUMUR 2.0 is a tool improved, useful and reliable for addressing human nutrition studies (AU)

Validation of a questionnaire on emotional eating for use in cases of obesity: the Emotional Eater Questionnaire (EEQ).

INTRODUCTION: Emotions have a powerful effect on our choice of food and eating habits. It has been found that in some people there is relationship between eating, emotions and the increased energy intake. This relationship should be measurable to better understand how food is used to deal with certain mood states and how these emotions affect the effectiveness of weight loss programs. OBJECTIVE: To develop and analyze the psychometric characteristics of a questionnaire on emotional eating for obesity easy to apply in clinical practice. SUBJECTS AND METHODS: A ten-item questionnaire called Emotional-Eater-Questionnaire (EEQ) was developed and administered to a total of 354 subjects (body mass index, 31 ± 5), aged 39 ± 12, who were subjected to a weight-reduction program. The questionnaire was specifically designed for obesity. Analysis of the internal structure, internal consistency, test-retest reliability and convergent validity with Mindful-Eater-Questionnaire (MEQ) were conducted. RESULTS: After principal components analysis, the questionnaire was classified in three different dimensions that explained 60% of the total variance: Disinhibition, Type-of-food and Guilt. Internal consistency showed that Cronbach's alpha was 0.773 for the "Dishinibition" subscale, 0.656 for the "Type of food" subscale and 0.612 for the "Guilt" subscale. The test-retest stability was r = 0.70. The data showed that the percentage of agreement between the EEQ and the MEQ was around 70% with a Kappa index of 0.40; P < 0.0001. CONCLUSION: We have presented a new questionnaire, which classifies individuals as a function of the relation between food intake and emotions. Such information will permit personalized treatments to be designed by drawing up early strategies from the very beginning of treatment programmes.

Validation of a questionnaire on emotional eating for use in cases of obesity; the Emotional Eater Questionnaire (EEQ) / Validación de un cuestionario de comedores emocionales para uso en casos de obesidad; Cuestionario de Comedor Emocional (CCE)

Introduction: Emotions have a powerful effect on our choice of food and eating habits. It has been found that in some people there is relationship between eating, emotions and the increased energy intake. This relationship should be measurable to better understand how food is used to deal with certain mood states and how these emotions affect the effectiveness of weight loss programs. Objective: To develop and analyze the psychometric characteristics of a questionnaire on emotional eating for obesity easy to apply in clinical practice. Subjects and methods: A ten-item questionnaire called Emotional-Eater-Questionnaire (EEQ) was developed and administered to a total of 354 subjects (body mass index, 31 ± 5), aged 39 ± 12, who were subjected to a weight-reduction program. The questionnaire was specifically designed for obesity. Analysis of the internal structure, internal consistency, test-retest reliability and convergent validity with Mindful-Eater-Questionnaire (MEQ) were conducted. Results: After principal components analysis, the questionnaire was classified in three different dimensions that explained 60% of the total variance: Disinhibition, Type-of-food and Guilt. Internal consistency showed that Cronbach's alpha was 0.773 for the "Dishinibition" subscale, 0.656 for the "Type of food" subscale and 0.612 for the "Guilt" subscale. The test-retest stability was r = 0.70. The data showed that the percentage of agreement between the EEQ and the MEQ was around 70% with a Kappa index of 0.40; P < 0.0001. Conclusion: We have presented a new questionnaire, which classifies individuals as a function of the relation between food intake and emotions. Such information will permit personalised treatments to be designed by drawing up early strategies from the very beginning of treatment programmes (AU)

Introducción: Las emociones tienen un poderoso efecto sobre la elección de alimentos y los hábitos alimentarios. Existe una relación entre comer, emociones y el aumento del aporte calórico. Esta relación debería ser medible para comprender mejor cómo utilizamos los alimentos en determinados estados de ánimo y cómo las emociones afectan a la eficacia de los programas de pérdida de peso. Objetivo: Desarrollar y analizar las características psicométricas de un cuestionario para identificar la ingesta emocional en la obesidad de fácil aplicación en la práctica clínica. Material y métodos: Se ha desarrollado y administrado un cuestionario de diez ítems llamado Cuestionario-de-Comedor-Emocional (CCE) a un total de 354 sujetos (Índice de Masa Corporal: 31 ± 5), (Edad: 39 ± 12 años), pertenecientes a un programa de reducción de peso. Se llevó a cabo un análisis de la estructura interna del cuestionario, de la consistencia interna, la fiabilidad testretest y la validez convergente con el Mindful-Eater-Questionnaire (MEQ). Resultados: El análisis de componentes principales del cuestionario encontró tres dimensiones diferentes que explicaban el 60% de la varianza: desinhibición, tipo de alimento y culpa. La consistencia interna mostró que el alfa de Cronbach fue de 0,773 para la subescala "Desinhibición", 0,656 para "Tipo de alimentos" y 0,612 para "culpa". La estabilidad test-retest fue de r = 0,70. Los datos mostraron que el porcentaje de acuerdo entre el CCE y MEQ era del 70% con un índice Kappa de 0,40, P < 0,0001. Conclusión: Hemos presentado un nuevo cuestionario, que clasifica a los individuos en función de la relación entre la ingesta de alimentos y las emociones. Esta información permitirá el diseño de tratamientos personalizados desde el inicio para la obesidad (AU)

Timing and duration of sleep and meals in obese and normal weight women. Association with increase blood pressure.

The aim was to evaluate the efficiency and duration of sleep and meals in normal-weight and obese women and the impact of these factors on metabolic syndrome (MetS) variables. The study was conducted in 70 women, normal-weight women (n=20) and obese women (n=50). Anthropometric variables, plasma glucose, lipids and ghrelin concentrations were determined. Blood pressure measurement was performed before lunch and before dinner for a week on alternate days. Subjects were instructed to keep a sleep and feeding diary. In general, obese women displayed longer and a significantly higher number of awakenings per week than normal-weight women and a higher duration of naps. Sleep efficiency was significantly lower in obese women. The higher intake in energy in the obese women was due to snacking differences. Moreover, higher sleep efficiency was correlated with a decrease in the diastolic blood pressure evening/morning ratio. Interestingly, among normal-weight women, visceral fat increased with the number of awakenings while plasma ghrelin was inversely correlated with meal duration (P=0.027). In conclusion, obese women had lower sleep efficiency, ate more quickly and spent more time eating and sleeping during the daytime hours than normal-weight women. Of note, sleep efficiency was associated with MetS features. Further interventions in obesity could include educating patients in food timing and in healthier sleep-hygiene practices, helping them to modify bad sleep habits.

SIRT1 and CLOCK 3111T> C combined genotype is associated with evening preference and weight loss resistance in a behavioral therapy treatment for obesity.

BACKGROUND: A new negative feedback loop has been proposed, which suggests connections between the circadian clock and SIRTUIN1 (SIRT1)-dependent functions associated with cell survival, development and metabolism. OBJECTIVE: To develop a SIRT1 and circadian locomotor output cycles kaput (CLOCK) combined genotype and to assess its associations with the chronotype of subjects and their potential resistance to weight loss in a behavioral treatment for obesity based on a Mediterranean diet. DESIGN: Overweight /obese subjects (n=1465), aged 20-65 years, who attended outpatient obesity clinics, were genotyped for SIRT1 (rs1467568) and CLOCK (3111T>C, rs1801260). Anthropometric, biochemical and dietary-intake variables were analyzed. Effectiveness of the program and weight loss progression during 30 weeks of treatment was assessed. RESULTS: We found highly consistent associations between the morning/evening questionnaires across the different genotype categories. Subjects carrying minor alleles at SIRT1 and CLOCK loci (R group) displayed a higher resistance to weight loss and a lower weekly weight loss rate as compared with homozygotes for both major alleles (P group). Significant differences were found across genotypes in weight loss progression during the 30 weeks of treatment (P=0.039). Dietary habits indicated that R carriers had a lower intake of total carbohydrates and monounsaturated fats, and a higher intake of saturated fats than those carrying the intermediate (M) and the P genotype (P=0.02). Plasma ghrelin concentrations were also significantly higher in subjects carrying the R genotype. CONCLUSION: Variants of both SIRT1 and CLOCK have an additive effect on resistance to weight loss that could be related to the chronotype of the subject, higher plasma levels of ghrelin and less adherence to Mediterranean diet patterns.

Apolipoprotein A-II polymorphism: relationships to behavioural and hormonal mediators of obesity.

BACKGROUND: The interaction between apolipoprotein A-II (APOA2) m265 genotype and saturated fat for obesity traits has been more extensively demonstrated than for any other locus, but behavioural and hormonal mechanisms underlying this relationship are unexplored. In this study, we evaluated relationships between APOA2 and obesity risk with particular focus on patterns of eating and ghrelin, a hormonal regulator of food intake. DESIGN: Cross-sectional study. SUBJECTS: Overweight and obese subjects (n=1225) were evaluated at baseline in five weight loss clinics in southeastern Spain. METHODS: Behavioural data were assessed using a checklist of weight loss obstacles. Logistic regression models were fitted to estimate the risk of a specific behaviour associated with APOA2 genotype. Relationships between APOA2 genotype and saturated fat intakes for anthropometric traits and plasma ghrelin were evaluated by analysis of variance. To construct categorical variables to evaluate interactions, saturated fat intake was dichotomized into high and low according to the population median intake or as tertiles. RESULTS: Homozygous minor (CC) subjects were more likely to exhibit behaviours that impede weight loss ('Do you skip meals', odds ratio (OR)=2.09, P=0.008) and less likely to exhibit the protective behaviour of 'Do you plan meals in advance' (OR=0.64, P=0.034). Plasma ghrelin for CC subjects consuming low saturated fat was lower compared with (1) CC subjects consuming high saturated fat, (2) TT+TC carriers consuming low saturated fat and (3) TT+TC carriers consuming high saturated fat (all P<0.05). CONCLUSIONS: APOA2 m265 genotype may be associated with eating behaviours and dietary modulation of plasma ghrelin. Expansion of knowledge of APOA2 and obesity to include modulation of specific behaviours and hormonal mediators not only broadens understanding of gene-diet interactions, but also facilitates the pragmatic, future goal of developing dietary guidelines based on genotype.

[Development of a current version of a software application for research and practice in human nutrition (GRUNUMUR 2.0)]. / Desarrollo de una versión actualizada de una aplicación informática para investigación y práctica en nutrición humana (GRUNUMUR 2.0).

The aim of this paper is the description of a new version of the software application GRUNUMUR, a useful tool for human nutrition studies designed by the Nutrition Research Group from the Murcia University. Similar to the first, this second version offers the possibility to address different types of study: dietary habits (24 h recall, 7-days dietary record and Food Frequency Questionnaire), epidemiological, anthropometrical and clinical studies. The new version, called GRUNUMUR 2.0, compatible with the first one, has an online help system for all functions of the application, providing the user tasks, allows safe storage of a virtually unlimited number of results, in an orderly and organized way, you can retrieve it when required, through a system of backups and scheduled maintenance and unattended (tasks performed by a server), another advantage is its total accessibility, both from the university intranet (www.um.es) and from the internet, it works via Web Browser (http://senver.inf.um.es/esen), and finally, allows data to be exported to Excel for further processing with other applications as well as publishing reports in PDF, to deliver study participants if necessary. The new version has been validated by comparing the extracted results with those obtained from the other software with no significant differences for any of the variables analyzed. The application GRUNUMUR 2.0 is a tool improved, useful and reliable for addressing human nutrition studies.

Sexual dimorphism in clock genes expression in human adipose tissue.

BACKGROUND: This study was carried out to investigate whether sex-related differences exist in the adipocyte expression of clock genes from subcutaneous abdominal and visceral fat depots in severely obese patients. METHODS: We investigated 16 morbidly obese patients, eight men and eight women (mean age 45 ± 20 years; mean BMI 46 ± 6 kg/m(2)), undergoing laparoscopic gastric bypass surgery. Biopsies were taken as paired samples [subcutaneous and visceral adipose tissue (AT)] at the beginning of the surgical process at 11:00 h in the morning. Metabolic syndrome features such as waist circumference, plasma glucose, triglycerides, total cholesterol, high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were also studied. The expression of clock genes (PER2, BMAL1, and CRY1) was measured by quantitative real-time PCR, Western blot, and immunohistochemical analysis. RESULTS: Gene expression was significantly higher in women than in men for the three genes studied in both ATs (P < 0.05). In visceral fat, these differences were more marked. (P < 0.001). Western blot analysis partially confirmed these results since statistical differences were observed for PER2 in both ATs and for CRY1 in subcutaneous adipose tissue. There were no differences in BMAL1 protein expression. Interestingly, clock gene expression level was correlated with LDL-C and HDL-C (P < 0.05). Moreover, we found significant associations with body fat mass in women and with age in men. CONCLUSIONS: Clock genes expression is sex dependent in human adipose tissue from morbidly obese subjects and correlates to a decreased in metabolic syndrome-related traits. These preliminary results make necessary to go deep into the knowledge of the molecular basis of the sexual dimorphism in chronobiology.