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1.
Biomolecules ; 10(5)2020 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-32403394

RESUMO

Despite the fact that circulating levels of proprotein convertase subtilisin/kexin type 9 (PCSK9) remain unchanged after fat load in healthy lean individuals, PCSK9 has been suggested to have a role in postprandial lipemia regulation in obese individuals. On the other hand, intestinal permeability and endotoxemia have been observed to increase more in obese individuals than in non-obese individuals after a lipid load. This study aimed to analyze the relationship between PCSK9, intestinal permeability, and endotoxemia after a high fat load in obese individuals. We included 39 individuals with morbid obesity. Serum PCSK9 levels, intestinal permeability marker (zonulin), endotoxemia markers (LPS and LBP), and lipid parameters were measured before and after 3 h of fat load. A significant rise in triglycerides, apolipoprotein A1, zonulin, LPS, and LBP, and a significant decline in PCSK9, were observed after a lipid load. Linear regression analysis showed that low-density lipoprotein cholesterol (LDL-C) was independently related to PCSK9 at baseline, whereas both zonulin and LDL-C were independently related to PCSK9 levels after fat load. A relationship between zonulin and PCSK9 levels after fat load in individuals with morbid obesity may exist.

2.
Nutrients ; 12(4)2020 Apr 07.
Artigo em Inglês | MEDLINE | ID: mdl-32272653

RESUMO

Healthy lifestyle factors, such as physical activity (PA) and Mediterranean diet (MD), decrease the likelihood of developing metabolic syndrome (MetS). The aim of this study was to report main lifestyle components and related factors according to the MetS severity. Cross-sectional analysis was done of baseline lifestyle factors from 5739 participants with overweight/obesity and MetS features (aged 55-75 years) included in the PREDIMED-PLUS primary cardiovascular prevention randomized trial. Participants were categorized in tertiles according to a validated MetS severity score (MetSSS). Anthropometrics, visceral adiposity index, dietary nutrient intake, biochemical marker levels, as well as a Dietary Inflammatory Index and depression symptoms (Beck Depression Inventory-II) were measured. Diet quality was assessed using a 17-item energy-restricted MD questionnaire. Duration and intensity of PA was self-reported using the Minnesota-REGICOR Short Physical Activity Questionnaire. Sedentary behaviours were measured using the Spanish version of the Nurses' Health Study questionnaire. The 30 s chair stand test was also assessed. Participants with highest MetSSS showed higher values of cardiovascular risk factors (except for total cholesterol and LDL cholesterol), depression risk, sedentary and TV viewing time, and lower moderate and vigorous leisure-time physical activity (LTPA). Highest MetSSS participants tended to a pro-inflammatory dietary pattern and tended to lower MD adherence. In addition, they showed lower carbohydrate and nut intake and higher intake of protein, saturated and trans fatty acids, cholesterol, iodine, sodium, red and processed meat products, other oils different from olive oil and spirit alcoholic drinks. The highest MetS severity score was associated with lower moderate and vigorous LTPA and higher sedentary time and depression risk, as they tended to a pro-inflammatory dietary pattern and lower MD adherence.

3.
Sci Rep ; 10(1): 5305, 2020 Mar 24.
Artigo em Inglês | MEDLINE | ID: mdl-32210340

RESUMO

The aim of this study was to compare the effects of an aerobic training program with a strength training program on body composition and energy expenditure in overweight or obese (29.06 ± 3.49 kg/m2) young adults (21.96 ± 1.90 years). Subjects (N = 109) were randomly assigned to one of three groups: a control group (CG), an aerobic training (AT) group and a strength training (ST) group. Training took place over twelve weeks comprising three sessions per week with each session lasting 60 to 90 minutes. Before and after the program, weight, height, body mass index, lean mass percentage and fat mass percentage were evaluated. In addition, The International Physical Activity Questionnaire-Short Form (IPAQ-SF) was used to estimate energy expenditure. The results of both aerobic training and strength training produced statistically significant improvements in weight (AT-CG = -2.892 kg; ST-CG = -2.986 kg); BMI (AT-CG = -1.075 kg/m2; ST-CG = -1.118 kg/m2); total body fat (AT-CG = -1529.172 g; ST-CG = -763.815); and total body fat percentage (AT-CG = -1.421%; AT-ST = -0.855%). These two exercise prescription models were therefore useful in reducing overweight and obesity, which could have an impact on improving the health and quality of life of individuals with these characteristics.

4.
Obesity (Silver Spring) ; 28(3): 537-543, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32090511

RESUMO

OBJECTIVE: The hypertriglyceridemic waist (HTGW) phenotype is characterized by abdominal obesity and high levels of triglycerides. In a cross-sectional assessment of PREDIMED-Plus trial participants at baseline, HTGW phenotype prevalence was evaluated, associated risk factors were analyzed, and the lifestyle of individuals with metabolic syndrome and HTGW was examined. METHODS: A total of 6,874 individuals aged 55 to 75 with BMI ≥ 27 and < 40 kg/m2 were included and classified by presence (HTGW+ ) or absence (HTGW- ) of HTGW (waist circumference: men ≥ 102 cm, women ≥ 88 cm; fasting plasma triglycerides ≥ 150 mg/dL). Analytical parameters and lifestyle (energy intake and expenditure) were analyzed. RESULTS: A total of 38.2% of the sample met HTGW+ criteria. HTGW+ individuals tended to be younger, have a greater degree of obesity, be sedentary, and be tobacco users. They had higher peripheral glucose, total cholesterol, and low-density lipoprotein cholesterol levels; had lower high-density lipoprotein cholesterol levels; and had increased prevalence of type 2 diabetes mellitus. Mediterranean diet (MedDiet) adherence and physical activity were greater in HTGW- patients. Age, BMI, tobacco use, total energy expenditure, hypertension, type 2 diabetes mellitus, and MedDiet adherence were associated with HTGW+ . CONCLUSIONS: HTGW is a highly prevalent phenotype in this population associated with younger age, higher BMI, tobacco use, and decreased MedDiet adherence. HTGW- individuals were more physically active with greater total physical activity, and fewer had hypertension.

5.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31926931

RESUMO

INTRODUCTION: Thyroid nodule (TN) is a common reason for consultation in daily practice. The purpose of this study was to evaluate the diagnosis and treatment of TNs in our environment and to assess the current status regarding the existence and structure of high-resolution TN clinics. MATERIAL AND METHODS: Members of the Spanish Society of Endocrinology and Nutrition were invited in 2018 to participate in an online survey on the diagnostic and therapeutic processes of TN. RESULTS: A total of 211 valid surveys were received. Of all respondents, 30.8% stated that there were high-resolution TN clinics in their environment, with the endocrinologist being the main person responsible for performing ultrasonography (87.7%) and fine needle aspiration (FNA) (69.2%). For ultrasound classification of TNs, 32.7% used the ATA criteria, 32.2% the TI-RADS criteria, and 22.7% no classification. In situ verification of sample suitability was performed in 35.5% of the cases, and molecular analysis in 8.1%. With regard to clinical discharge, 65.4% would consider it after 5 years of follow-up and with a benign FNA. In the event of a Bethesda III result, 50.2% of respondents would repeat FNA and 35.5% would opt for surgery; if a Bethesda IV result was found, 95.8% would opt for surgery. CONCLUSIONS: High-resolution TN clinics are structures increasingly implemented in our environment where the endocrinologist is the main person responsible for performing ultrasonography and FNA. The standard clinical practice in our specialty is consistent with most recommendations concerning clinical practice guidelines for TNs.

6.
Endocrinol. diabetes nutr. (Ed. impr.) ; 67(1): 36-42, ene. 2020. tab
Artigo em Inglês | IBECS | ID: ibc-186145

RESUMO

Introduction: There is no agreement on the procedures to be used for diagnosis and treatment of gestational thyroid dysfunction. Controversy still exists on the normal range of thyroid-stimulating hormone (TSH) levels and use of gestational hypothyroidism (GH) screening. The aim of this study was to assess diagnosis and treatment of thyroid dysfunction during pregnancy in a group of Spanish hospitals. Study design: This was a retrospective, multicenter study in pregnant females with GH attending Spanish healthcare centers from March 2013 to July 2014. Variables analyzed included diagnosis criteria for GH (availability of universal screening for gestational thyroid disorders and TSH reference values (RVs) by trimester of pregnancy): risk factors for GH, iodine intake from food or supplementation, gestational age (at diagnosis/treatment) and l-thyroxine treatment. Results: Fourteen centers participated in the study. Universal screening was performed in only half of the centers, and only 14% had their own TSH RVs. Overall, 257 pregnant women were enrolled, 53.7% with hypothyroidism (HT) diagnosed before pregnancy (pre-GH) and 46.3% with HT diagnosed during pregnancy (intra-GH). A comparison of intra-GH and pre-GH women showed that intra-GH women made their first visit later (59.7% vs. 75.4% respectively before week 12, p = 0.007) and had more frequently high TSH levels (>2.5 μIU/ml) during the first trimester (94.4% vs. 67.0% respectively, p < 0.001). Conclusions: Our results suggest that GH may be underdiagnosed or inadequately diagnosed in most healthcare centers. These findings suggest the need of improving the current practice in Spain


Introducción: Los procedimientos a seguir para el diagnóstico y tratamiento de la disfunción tiroidea en la gestación no están del todo consensuados. Aún se discute el rango de normalidad de los valores de la hormona estimulante del tiroides (TSH) y el uso de screening para detectar hipotiroidismo gestacional (HG). El objetivo de este estudio es evaluar la forma de diagnóstico y tratamiento de la disfunción tiroidea durante la gestación en un grupo de hospitales de España. Diseño del estudio: Estudio retrospectivo, multicéntrico en mujeres embarazadas con HG atendidas en instituciones sanitarias españolas entre marzo de 2013 y julio de 2014. Las variables analizadas incluyeron criterios diagnósticos de HG (disponibilidad de screening universal para trastornos tiroideos gestacionales y valores de referencia de TSH según el trimestre gestacional); factores de riesgo de HG, ingesta de yodo mediante alimentos o suplementos, edad gestacional (al diagnóstico/tratamiento) y tratamiento con L-tiroxina. Resultados: Participaron un total de 14 centros. Únicamente la mitad de los centros empleaba el screening universal, y solo el 14% tenía valores de referencia de TSH propios. Se incluyeron un total de 257 embarazadas, 53,7% con diagnóstico de hipotiroidismo previo al embarazo (pre-HG) y 46,3% con hipotiroidismo diagnosticado durante el embarazo (intra-HG). Comparando los casos de pre-HG e intra-HG, las mujeres con intra-HG realizaban la primera visita más tarde (antes de la semana 12; 59,7% vs. 75,4% respectivamente, p = 0,007) y tenían más frecuentemente valores elevados de TSH (> 2,5 μUI/ml) durante el primer trimestre (94,4% vs. 67,0% respectivamente, p < 0,001). Conclusiones: Nuestros resultados sugieren que el HG puede estar infradiagnosticado o diagnosticado indebidamente en la mayoría de los centros sanitarios. Estos hallazgos sugieren la necesidad de mejorar la práctica actual en España


Assuntos
Humanos , Feminino , Gravidez , Hipotireoidismo/diagnóstico , Hipotireoidismo/terapia , Complicações na Gravidez/terapia , Fatores de Risco , Hipotireoidismo/complicações , Estudos Retrospectivos , Iodo/uso terapêutico , Suplementos Nutricionais , Idade Gestacional , Tiroxina/uso terapêutico
7.
Artigo em Inglês | MEDLINE | ID: mdl-31991632

RESUMO

Background: Decision-making in soccer has repercussions and depends on the environment of training or competition. The demands on the players can reveal if the decision-making is similar or different from that required during competition. Objectives: The aim of this study was to assess the physical and physiological responses of players in training matches (TM) and official competition matches (CM) according to the playing position (external defenders, internal defenders, midfielders, and forwards/extremes). Methods: Twenty semi-professional male soccer players and 10 CM (n = 40) and 10 TM (n = 40) were studied using global positioning system technology, and paired and one-way ANOVA tests were carried out to compare physical (distances and number of sprints) and physiological (heart rates) responses with the factors a) match environments (TM and CM) and b) the playing position, respectively. Results: The results revealed that during CM, players covered higher total distance, partial distances, and sprints at different speeds (0-21 km/h) and produced higher physiological responses. Midfielders covered the greatest total distance in both TM (7227.6 m) and CM (11,225.9 m), in comparison to the other playing positions. However, forwards and extremes spent more time (56.8% of the CM [d = 0.78]) at 76% to 84% of their maximal heart rates. Conclusions: First, the physical and physiological responses in TM were significantly lower than in CM. Second, these responses were different according to the playing position, so this study was able to verify the exact amount of variation between the load produced in TM and CM. These results will help the coach and technical staff to design training tasks to complement the responses found in TM.

8.
Endocrinol Diabetes Nutr ; 67(1): 36-42, 2020 Jan.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31109823

RESUMO

INTRODUCTION: There is no agreement on the procedures to be used for diagnosis and treatment of gestational thyroid dysfunction. Controversy still exists on the normal range of thyroid-stimulating hormone (TSH) levels and use of gestational hypothyroidism (GH) screening. The aim of this study was to assess diagnosis and treatment of thyroid dysfunction during pregnancy in a group of Spanish hospitals. STUDY DESIGN: This was a retrospective, multicenter study in pregnant females with GH attending Spanish healthcare centers from March 2013 to July 2014. Variables analyzed included diagnosis criteria for GH (availability of universal screening for gestational thyroid disorders and TSH reference values (RVs) by trimester of pregnancy): risk factors for GH, iodine intake from food or supplementation, gestational age (at diagnosis/treatment) and l-thyroxine treatment. RESULTS: Fourteen centers participated in the study. Universal screening was performed in only half of the centers, and only 14% had their own TSH RVs. Overall, 257 pregnant women were enrolled, 53.7% with hypothyroidism (HT) diagnosed before pregnancy (pre-GH) and 46.3% with HT diagnosed during pregnancy (intra-GH). A comparison of intra-GH and pre-GH women showed that intra-GH women made their first visit later (59.7% vs. 75.4% respectively before week 12, p=0.007) and had more frequently high TSH levels (>2.5µIU/ml) during the first trimester (94.4% vs. 67.0% respectively, p<0.001). CONCLUSIONS: Our results suggest that GH may be underdiagnosed or inadequately diagnosed in most healthcare centers. These findings suggest the need of improving the current practice in Spain.

9.
Int J Behav Nutr Phys Act ; 16(1): 137, 2019 12 23.
Artigo em Inglês | MEDLINE | ID: mdl-31870449

RESUMO

BACKGROUND: This study explored the association between inactive time and measures of adiposity, clinical parameters, obesity, type 2 diabetes and metabolic syndrome components. It further examined the impact of reallocating inactive time to time in bed, light physical activity (LPA) or moderate-to-vigorous physical activity (MVPA) on cardio-metabolic risk factors, including measures of adiposity and body composition, biochemical parameters and blood pressure in older adults. METHODS: This is a cross-sectional analysis of baseline data from 2189 Caucasian men and women (age 55-75 years, BMI 27-40 Kg/m2) from the PREDIMED-Plus study (http://www.predimedplus.com/). All participants had ≥3 components of the metabolic syndrome. Inactive time, physical activity and time in bed were objectively determined using triaxial accelerometers GENEActiv during 7 days (ActivInsights Ltd., Kimbolton, United Kingdom). Multiple adjusted linear and logistic regression models were used. Isotemporal substitution regression modelling was performed to assess the relationship of replacing the amount of time spent in one activity for another, on each outcome, including measures of adiposity and body composition, biochemical parameters and blood pressure in older adults. RESULTS: Inactive time was associated with indicators of obesity and the metabolic syndrome. Reallocating 30 min per day of inactive time to 30 min per day of time in bed was associated with lower BMI, waist circumference and glycated hemoglobin (HbA1c) (all p-values < 0.05). Reallocating 30 min per day of inactive time with 30 min per day of LPA or MVPA was associated with lower BMI, waist circumference, total fat, visceral adipose tissue, HbA1c, glucose, triglycerides, and higher body muscle mass and HDL cholesterol (all p-values < 0.05). CONCLUSIONS: Inactive time was associated with a poor cardio-metabolic profile. Isotemporal substitution of inactive time with MVPA and LPA or time in bed could have beneficial impact on cardio-metabolic health. TRIAL REGISTRATION: The trial was registered at the International Standard Randomized Controlled Trial (ISRCTN: http://www.isrctn.com/ISRCTN89898870) with number 89898870 and registration date of 24 July 2014, retrospectively registered.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Exercício Físico/fisiologia , Síndrome Metabólica/epidemiologia , Obesidade/epidemiologia , Comportamento Sedentário , Sono/fisiologia , Acelerometria , Adiposidade/fisiologia , Idoso , HDL-Colesterol/sangue , Estudos Transversais , Diabetes Mellitus Tipo 2/sangue , Feminino , Humanos , Masculino , Síndrome Metabólica/sangue , Pessoa de Meia-Idade , Obesidade/sangue , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Triglicerídeos/sangue , Reino Unido , Circunferência da Cintura
10.
PLoS One ; 14(11): e0224326, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31714921

RESUMO

Stress control as well as other psychological characteristics influence sports performance (SP) and could be relevant according to the playing position in team sports, such as the futsal where players have different specific functions within the team. The aim of this study was to analyze the psychological characteristics and profile related to SP of top-level young futsal players, according to the offensive or defensive role. A total of one hundred sixty-seven young promises futsal players participated in this study (84 U16 and 83 U19) and have been chosen to play Championship of Spain Selections. The Psychological Characteristics related to SP for soccer players Questionnaire was used, and one-way ANOVA test was performed based on the playing position (goalkeeper, defender and defender-wing, wing and wing-defender, pivot and wing-pivot, and universal). Results showed that goalkeepers had the best psychological profile and characteristics related to SP. Pivots and wing-pivots had less self-confidence, and universals players, less stress control in relation to the rest of the playing positions (p < 0.05). The main findings revealed that the psychological characteristics and profile related to SP in young promises futsal players are different according to the playing position, and this study suggest the inclusion of psychological-training programs in order to improve the psychological abilities of players, especially for players with offensive role who seek to score goals.

11.
Antioxidants (Basel) ; 8(11)2019 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-31717390

RESUMO

Overweight and obesity are important risk factors for type 2 diabetes (T2D). Moving towards healthier diets, namely, diets rich in bioactive compounds, could decrease the odds of suffering T2D. However, those individuals with high body mass index (BMI) may have altered absorption or metabolism of some nutrients and dietary components, including polyphenols. Therefore, we aimed to assess whether high intakes of some classes of polyphenols are associated with T2D in a population with metabolic syndrome and how these associations depend on BMI and sex. This baseline cross-sectional analysis includes 6633 participants from the PREDIMED-Plus trial. Polyphenol intakes were calculated from food frequency questionnaires (FFQ). Cox regression models with constant time at risk and robust variance estimators were used to estimate the prevalence ratios (PRs) for polyphenol intake and T2D prevalence using the lowest quartile as the reference group. Analyses were stratified by sex and BMI groups (overweight and obese) to evaluate potential effect modification. Catechins, proanthocyanidins, hydroxybenzoic acids, and lignans were inversely associated with T2D. Hydroxycinnamic acids were directly related in men. These associations were different depending on sex and BMI, that is, women and overweight obtained stronger inverse associations.

13.
Nutr. hosp ; 36(5): 1055-1060, sept.-oct. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-184626

RESUMO

Introducción: el sobrepeso y la obesidad alcanzan una alta prevalencia desde la infancia en España. Objetivo: describir el efecto del sobrepeso y la obesidad en niños escolares de once años de edad, en pruebas que valoran la fuerza, tanto de las extremidades inferiores como de las superiores, así como la velocidad. Método: participaron en el estudio 423 escolares de once años de edad. Se obtuvieron características básicas antropométricas y desarrollaron diversos test de la batería EUROFIT. Resultados: los niños y niñas que se encuentran en normopeso poseen mejores puntuaciones en las pruebas de condición física en general. De este modo, los saltos verticales y horizontales, suspensión en barra y abdominales son superiores en los participantes con normopeso (p < 0,05). Además, recorren en menos tiempo un circuito de velocidad en ambos sexos (p < 0,001); sin embargo, en la fuerza isométrica manual, en el grupo de niñas poseen mejores resultados aquellas que se encuentran en sobrepeso u obesidad (p < 0,01). Conclusiones: los niños de once años con sobrepeso y obesidad muestran una menor prestación muscular, salvo en el caso de la fuerza isométrica manual. También se han determinado diversas ecuaciones de predicción de resultados de las pruebas físicas llevadas a cabo, como saltos, dinamometría y velocidad, a través del sexo e índice de masa corporal (IMC)


Introduction: overweight and obesity reach a high prevalence since childhood in Spain. Objective: to describe the effect of overweight and obesity, in schoolchildren of eleven years of age, in tests that assess the strength of both the lower and upper extremities, as well as speed. Method: four hundred and twenty-three schoolchildren of eleven years of age participated in the study. Basic anthropometric characteristics were obtained and several tests of the EUROFIT battery were developed. Results: normal-weight boys and girls had better scores in physical condition tests in general. Therefore, the vertical and horizontal jumps, bar suspension and abdominals were higher in the participants with normal-weight (p < 0.05). In addition, they performed in less time a speed circuit in both sexes (p < 0.001); however, in relation to the manual isometric strength, in the group of girls those who are overweight or obese have better results (p < 0.01). Conclusions: overweight and obese children of eleven year-olds showed a lower muscular performance, except in the case of manual isometric strength. Several equations haven been also determined for predicting the results of physical tests carried out such as jumps, dynamometry and speed, through sex and body mass index (BMI)


Assuntos
Humanos , Masculino , Feminino , Criança , Obesidade Pediátrica/epidemiologia , Sobrepeso/epidemiologia , Força Muscular/fisiologia , Dinamômetro de Força Muscular , Obesidade Pediátrica/complicações , Sobrepeso/complicações , Índice de Massa Corporal , Análise de Classes Latentes
14.
Nutr Hosp ; 36(5): 1055-1060, 2019 Oct 17.
Artigo em Espanhol | MEDLINE | ID: mdl-31516003

RESUMO

Introduction: Introduction: overweight and obesity reach a high prevalence since childhood in Spain. Objective: to describe the effect of overweight and obesity, in schoolchildren of eleven years of age, in tests that assess the strength of both the lower and upper extremities, as well as speed. Method: four hundred and twenty-three schoolchildren of eleven years of age participated in the study. Basic anthropometric characteristics were obtained and several tests of the EUROFIT battery were developed. Results: normal-weight boys and girls had better scores in physical condition tests in general. Therefore, the vertical and horizontal jumps, bar suspension and abdominals were higher in the participants with normal-weight (p < 0.05). In addition, they performed in less time a speed circuit in both sexes (p < 0.001); however, in relation to the manual isometric strength, in the group of girls those who are overweight or obese have better results (p < 0.01). Conclusions: overweight and obese children of eleven year-olds showed a lower muscular performance, except in the case of manual isometric strength. Several equations haven been also determined for predicting the results of physical tests carried out such as jumps, dynamometry and speed, through sex and body mass index (BMI).

15.
Endocrinol. diabetes nutr. (Ed. impr.) ; 66(7): 443-458, ago.-sept. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-182864

RESUMO

Objetivo: El tratamiento de la diabetes tipo 2 (DM2) es complejo y su propósito es reducir la morbimortalidad, por lo que su manejo tiene que incluir: un control glucémico individualizado precoz (mediante una adecuada educación diabetológica, modificaciones del estilo de vida y tratamiento farmacológico), el control de los factores de riesgo cardiovascular (CV), la detección y tratamiento precoz de las complicaciones y la evaluación de las comorbilidades asociadas. El objetivo fue elaborar un documento para unificar los aspectos necesarios para el abordaje integral de las personas con DM2. Participantes: Miembros del Grupo de trabajo de Diabetes Mellitus de la Sociedad Española de Endocrinología y Nutrición. Métodos: Se realizó una revisión de la evidencia disponible relativa a cada aspecto del manejo de la diabetes: objetivos de control glucémico, dieta y ejercicio, tratamiento farmacológico, tratamiento y control de factores de riesgo, detección de complicaciones y manejo del paciente frágil con DM2. Las recomendaciones se formularon según los grados de evidencia recogidos en los Standards of Medical Care in Diabetes 2018. Tras la formulación de las recomendaciones el documento fue consensuado por los miembros del Grupo de trabajo de Diabetes Mellitus de la Sociedad Española de Endocrinología y Nutrición. Conclusiones: El objetivo de este documento es proporcionar, desde el punto de vista del endocrinólogo clínico, unas recomendaciones prácticas basadas en la evidencia acerca de todos los aspectos necesarios para el abordaje integral de la DM2


Objective: Treatment of type 2 diabetes mellitus (T2DM) is complex and is intended to decrease morbidity and mortality. Management should therefore include adequate diabetes education, lifestyle changes, drug treatment to achieve early blood glucose control and reduction of cardiovascular (CV) risk factors, early detection and treatment of complications, and assessment of associated comorbidities. The objective was to prepare a document including all aspects required for a comprehensive approach to T2DM. Participants: Members of the Diabetes Mellitus Working Group of the Spanish Society of Endocrinology. Methods: The available evidence regarding each aspect of diabetes management (blood glucose control goals, diet and exercise, drug treatment, risk factor management and control, detection of complications, and management of frail patients) was reviewed. Recommendations were formulated based on the grades of evidence stated in the 2018 Standards of Medical Care in Diabetes. Recommendations were discussed and agreed by the working group members. Conclusions: This document is intended to provide evidence-based practical recommendations for comprehensive management of T2DM by clinical endocrinologists


Assuntos
Humanos , Diabetes Mellitus Tipo 2/terapia , Diabetes Mellitus Tipo 2/complicações , Fatores de Risco , Sociedades Médicas/normas , 36448 , Índice Glicêmico , Estilo de Vida , Sociedades Médicas/organização & administração , Estratégias de eSaúde , Exercício Físico/fisiologia
16.
Eur J Nutr ; 2019 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-31385063

RESUMO

PURPOSE: To assess the association between the consumption of non-soy legumes and different subtypes of non-soy legumes and serum uric acid (SUA) or hyperuricemia in elderly individuals with overweight or obesity and metabolic syndrome. METHODS: A cross-sectional analysis was conducted in the framework of the PREDIMED-Plus study. We included 6329 participants with information on non-soy legume consumption and SUA levels. Non-soy legume consumption was estimated using a semi-quantitative food frequency questionnaire. Linear regression models and Cox regression models were used to assess the associations between tertiles of non-soy legume consumption, different subtypes of non-soy legume consumption and SUA levels or hyperuricemia prevalence, respectively. RESULTS: Individuals in the highest tertile (T3) of total non-soy legume, lentil and pea consumption, had 0.14 mg/dL, 0.19 mg/dL and 0.12 mg/dL lower SUA levels, respectively, compared to those in the lowest tertile (T1), which was considered the reference one. Chickpea and dry bean consumption showed no association. In multivariable models, participants located in the top tertile of total non-soy legumes [prevalence ratio (PR): 0.89; 95% CI 0.82-0.97; p trend = 0.01, lentils (PR: 0.89; 95% CI 0.82-0.97; p trend = 0.01), dry beans (PR: 0.91; 95% C: 0.84-0.99; p trend = 0.03) and peas (PR: 0.89; 95% CI 0.82-0.97; p trend = 0.01)] presented a lower prevalence of hyperuricemia (vs. the bottom tertile). Chickpea consumption was not associated with hyperuricemia prevalence. CONCLUSIONS: In this study of elderly subjects with metabolic syndrome, we observed that despite being a purine-rich food, non-soy legumes were inversely associated with SUA levels and hyperuricemia prevalence. TRIAL REGISTRATION: ISRCTN89898870. Registration date: 24 July 2014.

17.
Front Psychol ; 10: 1783, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31428030

RESUMO

Canoeing is one of the sport disciplines that brings great success to Spain in international competitions and Olympic Games (of the 17 medals won in Rio in 2016, four were in this sport, including three gold). However, the journey to become an elite athlete coincides in time with the challenge of pursuing an academic education, which often involves making difficult choices in the training-university dichotomy. The aim of this research was to ascertain how the Spanish under-23 calm water canoeing team perceives their athletic and academic careers. The present study was carried out with the Spanish under-23 flat water canoeing team, the step prior to competition at the highest level. The study sample comprised the whole population, namely the entire national team, made up of 21 athletes (11 women and 10 men) with a mean age of 20.57 ± 2.64 years and 10.00 ± 3.49 years of experience. These athletes are usually based at La Cartuja High Performance Center (Seville) and combine their sports activity with studying toward a university degree. A double qualitative and quantitative methodology was used. For the first of these, an interview script was elaborated based on the theoretical model by Wylleman et al. (2013). Applicable consents were requested from the Spanish Royal Canoeing Federation, coaches and paddlers. Interviews were carried out with each athlete twice: at the beginning and at the end of the season/academic year, which were recorded and subsequently tabulated and analyzed. Concerning quantitative methodology, the ESTPORT dual career questionnaire validated by Sánchez-Pato et al. (2016) was used. The results show that for all the paddlers canoeing is very important. It is typically complicated for them to attend classes, and subject planning is usually based on their training schedules. In the second/last part of the course, it is stressful for these athletes to combine both activities and some drop out of school. During the course, though, they appreciate having another activity that allows them to escape from the training routine. In addition, they miss not having an academic tutor to guide and advise them. These student-athletes are aware that their sport causes them to miss out on many moments with family and friends due to training or competing. However, at present this is offset, largely because of their high level of performance, which makes it easier for them to obtain scholarships that provide economic support.

18.
Endocrinol Diabetes Nutr ; 66(7): 443-458, 2019.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30827909

RESUMO

OBJECTIVE: Treatment of type 2 diabetes mellitus (T2DM) is complex and is intended to decrease morbidity and mortality. Management should therefore include adequate diabetes education, lifestyle changes, drug treatment to achieve early blood glucose control and reduction of cardiovascular (CV) risk factors, early detection and treatment of complications, and assessment of associated comorbidities. The objective was to prepare a document including all aspects required for a comprehensive approach to T2DM. PARTICIPANTS: Members of the Diabetes Mellitus Working Group of the Spanish Society of Endocrinology. METHODS: The available evidence regarding each aspect of diabetes management (blood glucose control goals, diet and exercise, drug treatment, risk factor management and control, detection of complications, and management of frail patients) was reviewed. Recommendations were formulated based on the grades of evidence stated in the 2018 Standards of Medical Care in Diabetes. Recommendations were discussed and agreed by the working group members. CONCLUSIONS: This document is intended to provide evidence-based practical recommendations for comprehensive management of T2DM by clinical endocrinologists.

19.
PLoS One ; 14(2): e0212640, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30785933

RESUMO

Self-concept influences identity and the way that people behave, and it fluctuates over time. The main purpose of this study was to analyze fluctuations in the dimensions of self-concept as a function of gender, educational level, grade, age, physical activity, and weight. In total, 712 Spanish adolescents who were in the 5th and 8th grades (354 boys and 358 girls) and 10 to 14 years old (M = 11.9; SD = 1.3) participated in this study. The Self-Concept Questionnaire, Form 5 was used to analyze several dimensions of self-concept (academic, social, emotional, family, and physical), using the average scores in each dimension. The data showed strong differences in the dimensions of self-concept during the school transition. Middle-school students, compared to elementary-school students, showed significantly lower levels in almost all dimensions (academic, social, family, and physical). Furthermore, student age was a negative predictor of the social and academic dimensions, explaining 33% and 37% of the variance, respectively. Educational level and grade were smaller factors influencing the academic dimension (explaining 29% and 25% of the variance, respectively). The main findings revealed that the school transition and, specifically, increased age were associated with a lower self-concept. These results help us understand the need to strengthen psychological and educational self-concept at school.


Assuntos
Autoimagem , Logro , Adolescente , Desenvolvimento do Adolescente , Peso Corporal , Criança , Desenvolvimento Infantil , Emoções , Exercício Físico , Família , Feminino , Humanos , Masculino , Instituições Acadêmicas , Estudantes , Inquéritos e Questionários
20.
Diabetes Care ; 41(11): 2385-2395, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30224347

RESUMO

OBJECTIVE: Type 1 diabetes is associated with compositional differences in gut microbiota. To date, no microbiome studies have been performed in maturity-onset diabetes of the young 2 (MODY2), a monogenic cause of diabetes. Gut microbiota of type 1 diabetes, MODY2, and healthy control subjects was compared. RESEARCH DESIGN AND METHODS: This was a case-control study in 15 children with type 1 diabetes, 15 children with MODY2, and 13 healthy children. Metabolic control and potential factors modifying gut microbiota were controlled. Microbiome composition was determined by 16S rRNA pyrosequencing. RESULTS: Compared with healthy control subjects, type 1 diabetes was associated with a significantly lower microbiota diversity, a significantly higher relative abundance of Bacteroides, Ruminococcus, Veillonella, Blautia, and Streptococcus genera, and a lower relative abundance of Bifidobacterium, Roseburia, Faecalibacterium, and Lachnospira. Children with MODY2 showed a significantly higher Prevotella abundance and a lower Ruminococcus and Bacteroides abundance. Proinflammatory cytokines and lipopolysaccharides were increased in type 1 diabetes, and gut permeability (determined by zonulin levels) was significantly increased in type 1 diabetes and MODY2. The PICRUSt analysis found an increment of genes related to lipid and amino acid metabolism, ABC transport, lipopolysaccharide biosynthesis, arachidonic acid metabolism, antigen processing and presentation, and chemokine signaling pathways in type 1 diabetes. CONCLUSIONS: Gut microbiota in type 1 diabetes differs at taxonomic and functional levels not only in comparison with healthy subjects but fundamentally with regard to a model of nonautoimmune diabetes. Future longitudinal studies should be aimed at evaluating if the modulation of gut microbiota in patients with a high risk of type 1 diabetes could modify the natural history of this autoimmune disease.


Assuntos
Diabetes Mellitus Tipo 1/microbiologia , Diabetes Mellitus Tipo 2/microbiologia , Microbioma Gastrointestinal/fisiologia , Adolescente , Técnicas de Tipagem Bacteriana , Estudos de Casos e Controles , Criança , Fezes/microbiologia , Feminino , Microbioma Gastrointestinal/genética , Voluntários Saudáveis , Humanos , Masculino , RNA Ribossômico 16S/análise
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