Stages of change in the purchase of ultra-processed snacks among university students after the implementation of the chilean food law; a multi-center study

The Objective is to determine the stages of change in the behavior of university students regarding the purchase of ultra-processed snacks consumed. Multi-center study (14 Chilean universities). The participants (4,807 students)evaluated were applied a survey to determine the stage of change of behavior regarding the purchase of foods with warning signs. The students were evaluated and classified as (a) Nutrition Students, (b) Healthcare-related Students and (c) Other degree Students. More than 90% of the students were aware of the food regulation and knew the warning signs. More than 60% of Healthcare-related and Other degree students are in the stage of pre-contemplation or contemplation regarding purchase intent of sugary drinks, juices, cookies, sweet snacks and potato chips; this value is twice the percentage of Nutrition students in this stages ( Chi2, p<0.001). In conclusion there is a high proportion of pre-contemplation and contemplation with respect to purchase intent among the students(AU)

Determinar las etapas de cambio en el comportamiento de los estudiantes universitarios con respecto a la compra de colaciones ultraprocesadas. Estudio Multicéntrico (14 universidades chilenas). A los participantes (4.807 estudiantes) se les aplicó una encuesta para determinar el cambio en el comportamiento con respecto a la compra de alimentos con sellos de advertencia. Los estudiantes se clasificaron como (a) estudiantes de nutrición, (b) estudiantes del área de la salud y (c) estudiantes de otras carreras. Se evaluaron. Más del 90% de los estudiantes conocían la regulación alimentaria y conocían las señales de advertencia. Más del 60% de los estudiantes de la salud y de otras carreras se encuentran en la etapa de pre-contemplación o contemplación con respecto a la intención de compra de bebidas azucaradas, jugos, galletas, bocadillos dulces y papas fritas; Este valor es el doble del porcentaje de estudiantes de nutrición en estas etapas ( Chi2, p <0,001). Se concluye que existe una alta proporción de pre-contemplación y contemplación con respecto a la intención de compra entre los estudiantes universitarios(AU)

A Multicenter Study Evaluating the Stages of Change in Food Consumption with Warning Labels among Chilean University Students.

OBJECTIVE: To analyze the stage of change in food consumption with warning labels among Chilean university students. MATERIALS AND METHODS: Cross-sectional study which applied surveys in universities from all over the country. Study included 4807 participants of 18 to 40 years of both sexes who were asked about the level of knowledge of the new food law and food consumption with warning signals, including questions regarding their willingness to behavior change according to Prochaska's transtheoretical model. To compare continuous variables, Student's t-test was used in the statistical package SPSS 22.0, and p <0.05 was considered a significant difference. RESULTS: Of the total number of respondents, 99.3% of the students indicated that they know about the food law, classifying foods with signals in the precontemplation stage. Compared by sex, we observed that women give greater importance to behavior change in all of foods (p <0.001). Underweight students give less importance to change in unhealthy foods, while obesity students give more importance but do not show more confidence in behavior change (p <0.05). CONCLUSION: The university students show a low importance and confidence to make behavior change, aspects associated with sex and nutritional status. It is necessary to strengthen nutritional food education and not just talk about structural measures.

Almidón resistente: Características tecnológicas e intereses fisiológicos / Resistant starch: Technological characteristics and physiological interests

RESUMEN El almidón resistente es una fracción del almidón que es capaz de resistir a la digestión y se mantiene íntegro a lo largo del tracto gastrointestinal. Una de las ventajas de este almidón es que permite ser utilizado como un ingrediente que refuerza las características tecnológicas de los alimentos, además de otorgar beneficios fisiológicos asociados a la salud. De manera natural el almidón resistente podemos encontrarlo en granos de cereales, semillas, legumbres y tubérculos y en la industria alimentaria en una amplitud de productos asociados a la panificación, pastelería, galletería y cereales extruídos. Las ventajas tecnológicas de este almidón están explicadas por su microestructura, que permite obtener productos con una mejor textura, sin afectar las características de sabor, olor y color del alimento. Desde el punto vista fisiológico, el almidón resistente es capaz de modular la cinética de digestibilidad de los nutrientes, lo que posibilita su incorporación en el diseño de productos con menor índice glicémico y menor poder energético. La modulación del metabolismo de la glucosa y los lípidos, así como las posibles asociaciones con la salud de la microbiota, indican que el almidón resistente podría ser un ingrediente con un gran potencial en el tratamiento de enfermedades crónicas.

ABSTRACT Resistant starch is a fraction of starch able to resist digestion and remains intact in the gastrointestinal tract. One of the benefits of this starch is that it can be used as an ingredient that reinforces the technological characteristics of foods, in addition to providing physiological benefits related to health. Resistant starch are found naturally in cereal grains, seeds, legumes and tubers and, in the food industry, it is in products associated with baking, pastries, cookies and extruded cereals. The technological benefits provided by resistant starch are due to its microstructure, which makes possible the generation of products with a better texture, without affecting flavor, smell or coloring characteristics of the food. From a health point of view, resistant starch is able to modulate nutrient digestibility kinetics, allowing its incorporation in the design of products with lower glycemic index and lower caloric value energy. Modulation of glucose and lipid metabolism, as well as possible associations with intestinal microbiota health, indicate that resistant starch could be an ingredient with great potential in the treatment of chronic diseases.

Efecto de la activación del receptor sensor de calcio sobre la expresión de genes lipogénicos en células HepG2 / Effect of calcium sensing receptor activation on lipogenic gene expression in HepG2 cells

Introduction: The Calcium Sensing Receptor (CaSR) is expressed in human fat cells, and its stimulation may be associated with adipose tissue dysfunction. The multisystemic character of obesity and the search of deepening the scope of the activation of CaSR in this disorder allows us to study the response of this protein in tissues that differ from adipose. Objective: To evaluate the effect of CaSR activation on the expression of lipogenic genes in a model of excess glucose and fatty acids in HepG2 human liver cells. Materials and methods: The effect of the calcimimetic cinacalcet (allosteric agonist of CaSR) on the content of triglycerides (fluorimetry) in a model of glucose supply and on the expression of lipogenic genes (qPCR) in hyperglycemia and hyperlipidemia conditions in the Liver cell line HepG2. Results: Cinacalcet, glucose (25 mM) and oleic acid (0.6 mM) did not affect cell viability. Activation of CaSR in the presence of glucose failed to increase the intracellular triglyceride content at 72 hours. Under these conditions, no response was observed for the factors coding for lipogenic genes (SREBP1c and FAS) at 24 hours of stimulation with cinacalcet in the liver cells. In the case of the over supply of fatty acids, the HepG2 cells did not show a variation in the gene expression of the DGAT enzymes after exposure to cinacalcet. Conclusion:Under conditions of glucose exposure, cinacalcet did not show a response in the triglyceride content, nor in the expression of genes related to hepatic lipogenesis. Therefore, stimulation of CaSR would not be associated with hepatic steatosis in HepG2 cells exposed to glucose.

Calcium sensing receptor effects in adipocytes and liver cells: Implications for an adipose-hepatic crosstalk.

The calcium sensing receptor (CaSR) is expressed in human adipose cells, and its activation may associate with adipose tissue (AT) dysfunction. We evaluated whether CaSR stimulation influences adipocyte triglyceride (TG) and fatty acid binding protein 4 (aP2) content, and hepatocyte TGs and proinflammatory cytokine expression. The effect of the calcimimetic cinacalcet on TGs (fluorimetry), lipogenic genes (qPCR) and aP2 (immunoblot) was evaluated in LS14 adipocytes or AT. In the human HepG2 hepatic cell line, we assessed CaSR expression and cinacalcet effect on TGs and lipogenic and proinflammatory genes. CaSR activation decreased adipocyte TG content by 20% and the expression of GPD and LPL by 34% and 20%, respectively. Cinacalcet increased aP2 protein expression by 60%. CaSR expression was shown in HepG2 cells and human liver samples. Cinacalcet-treated HepG2 cells in the presence of oleic acid exhibited a19% increased TG content. No changes were observed in the expression of lipogenic genes in HepG2 cells, however there was a 50%-300% elevation in the expression of proinflammatory cytokines. CaSR activation in adipocytes may associate with decreased TG storage ability and increased aP2. Hepatic CaSR stimulation may elevate steatosis and proinflammatory factors. We propose that CaSR may contribute to obesity-associated hepatic metabolic consequences.

Preadipocyte proliferation is elevated by calcium sensing receptor activation.

Obesity is a major worldwide problem, despite considerable efforts against it. While excess body fat defines obesity, adipose tissue quality and functionality are key to whether cardiovascular and metabolic comorbidities develop. Adipose tissue cellular composition can vary considerably, and excess adipocyte progenitors (preadipocytes) is associated with obesity. We have proposed that calcium sensing receptor (CaSR) activation in adipose tissue leads to dysfunction. This study evaluated whether CaSR activation elevates preadipocyte proliferation. Human LS14 preadipocytes were exposed to CaSR activators cinacalcet (2 µM), GdCl3 (5 µM) and spermine (1 µM), and cell viability was evaluated after 72h. CaSR activators elevated proliferation by 19-24%, and CaSR silencing (siRNA) abolished the effect. Cinacalcet elevated phospho-ERK1/2 content, and upstream inhibition of ERK1/2 phosphorylation reverted cinacalcet-induced proliferation. Cinacalcet also elevated expression of the proinflammatory factors IL1ß, IL6 and CCL2. The results suggest that CaSR induces preadipocyte proliferation, partly through ERK1/2 activation. Considering reported proinflammatory and adipogenic CaSR effects, excess preadipocyte proliferation further supports the dysfunctional effect of CaSR in obesity.

Calcium, obesity, and the role of the calcium-sensing receptor.

The elevated prevalence of obesity worldwide is a challenging public health problem. Dietary calcium intake is frequently below recommendations, and evidence gathered for more than a decade suggests that inadequate calcium intake may be related to increased body weight and/or body fat, although a consensus has yet to be reached. Whole-body energy balance and the cellular mechanisms involved have been proposed to explain this relationship, and increasing evidence from epidemiological, clinical, and basic research lends support to the hypothesis that calcium is linked to the regulation of body weight. This review provides a critical appraisal of evidence from studies that examined several different aspects of this issue. Different mechanisms are highlighted and, based on recent work, new perspectives are offered, which incorporate the concept of obesity-associated inflammation and the possible role of the extracellular calcium-sensing receptor.

Identification of novel 11ß-HSD1 inhibitors by combined ligand- and structure-based virtual screening.

11 beta-hydroxysteroid dehydrogenase type 1 (11ß-HSD1) converts cortisone to cortisol in a NADPH dependent manner. Overexpression of 11ß-HSD1 in key metabolic tissues is related to the development of type 2 diabetes, obesity, hypertension and metabolic syndrome. Using crystal structures of human 11ß-HSD1 in complex with inhibitors as source of structural information, a combined ligand and structure-based virtual screening approach was implemented to identify novel 11ß-HSD1 inhibitors. A selected group of compounds was identified in silico and further evaluated in cell-based assays for cytotoxicity and 11ß-HSD1 mediated cortisol production inhibitory capacity. The expression of 11ß-HSD1 and 11ß-HSD2 in human LS14 adipocytes was assessed during differentiation. Biological evaluation of 39 compounds in adipocytes and steroids quantification by HPLC-MS/MS identify 4 compounds that exhibit 11ß-HSD1 mediated cortisol production inhibitory activity with potencies in the micromolar range. Two compounds showed to be selective for the 11ß-HSD1 reductase activity and over 11ß-HSD2 isoform, and thus represent novel leads for the development of more active derivatives with higher efficacies targeting intracellular cortisol levels in type 2 diabetes and metabolic syndrome.

Adipogenic effect of calcium sensing receptor activation.

We established that human adipose cells and the human adipose cell line LS14 express the calcium-sensing receptor (CaSR) and that its activation induces inflammatory cytokine production. Also, its expression is enhanced upon exposure to obesity-associated proinflammatory cytokines. We have thus proposed that CaSR activation may be associated with adipose dysfunction. Here, we evaluated a possible effect on adipogenesis. We induced adipose differentiation of primary and LS14 human preadipocytes with or without the simultaneous activation of CaSR, by the exposure to the calcimimetic cinacalcet. Activation of the receptor for 24 h decreased by 40 % the early differentiation marker CCAAT/enhancer-binding protein ß. However, upon longer-term (10 day) exposure to the adipogenic cocktail, cinacalcet exerted the opposite effect, causing a dose-response increase in the expression of the mature adipose markers adipocyte protein 2, adiponectin, peroxisome proliferator-activated receptor γ, fatty acid synthase, and glycerol-3-phosphate dehydrogenase. To assess whether there was a time-sensitive effect of CaSR activation on adipogenesis, we evaluated the 10 day effect of cinacalcet exposure for the first 6, 24, 48 h, 6, and 10 days. Our observations suggest that regardless of the period of exposure, 10 day adipogenesis is elevated by cinacalcet. CaSR activation may interfere with the initial stages of adipocyte differentiation; however, these events do not seem to preclude adipogenesis from continuing. Even though adipogenesis (particularly in subcutaneous depots) is associated with insulin sensitivity and adequate adipose function, the implications of our findings in visceral adipocytes, especially in the context of inflamed AT and overnutrition, remain to be established.

Interleukin-6 and lipopolysaccharide modulate hepcidin mRNA expression by HepG2 cells.

Iron homeostasis is controlled by hepcidin (Hpc) as well as other ways. Hpc expression is regulated by iron (Fe) storage and by inflammation, but the joint effect of both stimuli remains unclear. We studied the modulatory role of inflammatory agents (IL6 and LPS) over Hpc and DMT1 mRNA expression in HepG2 cells preloaded with Fe. HepG2 cells were preloaded with different Fe concentrations (holo-Tf or Fe-NTA) and then incubated with IL6 or LPS. We measured intracellular Fe levels by AAS with graphite furnace, transferrin receptor (TfR) by ELISA and mRNA relative abundance of Hpc and DMT1 by qRT-PCR. The maximum effect on Fe uptake was observed in cells incubated with 30 ng/ml IL6 (p < 0.01) and 500 ng/ml LPS (p < 0.05). In HepG2 cells preloaded with holo-Tf or Fe-NTA and challenged with IL6 and LPS, we observed a decreased: (a) Hpc mRNA relative abundance (two-way ANOVA: p < 0.05 and p < 0.001, respectively), (b) DMT1 mRNA relative abundance and TfR1 protein levels (two-way ANOVA: p < 0.001), and (c) intracellular Fe concentration (two-way ANOVA: p < 0.001 and p < 0.01, respectively) compared to control cells incubated only with Fe (holo-Tf or Fe-NTA). Our results support the idea that Fe storage and inflammation act together to regulate Fe homeostasis and suggest a negative regulation in this hepatic cellular model to prevent excessive increases in Hpc.

Type 2 diabetic patients and their offspring show altered parameters of iron status, oxidative stress and genes related to mitochondrial activity.

Type 2 diabetes (T2D) is directly related to alterations in iron status, oxidative stress and decreased mitochondrial activity, but the possible interaction of these parameters among T2D patients and their offspring is unclear. The whole study included 301 subjects: 77 T2D patients and one of their offspring and 51 control subjects with one of their offspring. The offspring were older than 20 years old. We measured parameters of iron status (serum iron, ferritin and transferrin receptor), diabetes (pre and post-prandial glucose, insulin, lipids), oxidative stress (Heme oxygenase activity, TBARS, SOD, GSH, Vitamin E), as well as the expression of genes in blood leukocytes related to mitochondrial apopotosis (mitofusin and Bcl/Bax ratios). The offspring of T2D patients had increased levels of serum ferritin (P < 0.01) and lower transferrin receptor (P < 0.008); higher insulin (P < 0.03) and total and LDL cholesterol; higher heme oxygenase and SOD activities increased TBARS and lower GSH; decreased mitofusin and Bcl/Bax expression ratios compared to offspring of normal subjects. These results suggest that the offspring of T2D patients could have an increased metabolic risk of develop a cardiovascular disease mediated by oxidative stress and iron status.

Effect of dietary protein on heme iron uptake by Caco-2 cells.

OBJECTIVE: To study heme iron bioavailability and the role of dietary protein (animal and vegetable) on iron uptake using an in vitro model (Caco-2 cell line). METHODS: Caco-2 cells were seeded in bicameral chambers with different animal (beef, chicken or fish) or vegetable (peas, lentils, and soybeans) proteins or with pure animal (collagen and casein) or vegetable (gliadin, zein, and glutein) protein extracts. The effect of each protein over heme iron absorption was assessed. RESULTS: Intact heme uptake was higher than either heme plus albumin or digested heme plus albumin, but lower than digested heme. White meal exerted the highest inhibitory effect on hemin uptake. Heme iron uptake decreased in the presence of all legume extracts, but was not significantly different among them (one-way ANOVA, NS). Pure animal (collagen and casein) and vegetable (zein and glutelin) proteins increased heme iron uptake, except for gliadin. CONCLUSION: Animal and vegetable protein in general decreased heme iron uptake. However, purified animal and vegetable protein induce an increase in heme iron uptake.