Annatto-Enriched Egg Improves the Perception of Satiety in Healthy Adults-Randomized Clinical Trial: EGGANT Study.

Diet is one of the factors that prevents the development and death from cardiovascular diseases (CVD). It has been proposed that diets high in protein, which increase satiety, and with a high content of antioxidants, help reduce cardiovascular risk factors. The egg is one of the foods that produces greater satiety and provides antioxidants. In addition, due to its lipophilic matrix, it could improve the bioavailability of other dietary antioxidants such as Annatto. OBJECTIVE: This study evaluated the effects of egg and annatto-enriched egg consumption on satiety markers and CVD risk factors in healthy adults from Colombia. METHODS: A parallel randomized clinical trial was conducted, where one hundred and five (n = 105) men and women, divided into three groups, consumed daily for 8 weeks: (a) two eggs (egg group), or (b) two eggs with annatto (egg + annatto group), or (c) two egg whites (placebo group). RESULTS: The three groups were similar in gender distribution. No significant changes were found over time (before vs. after) in any of the groups nor between the groups in anthropometric variables, physical activity, eating profile, and ghrelin as an objective marker of satiety. In the egg + annatto group, subjective satiety increased (effect size 0.431; p < 0.05) after consumption. CONCLUSIONS: In healthy adults, the intake of two eggs, or two eggs with annatto daily for 8 weeks, did not result in significant changes in ghrelin; but eggs with annatto tend to increase the perception of satiety.

Correlation of body mass index and waist to height ratio with cardiovascular risk factors in Colombian preschool and school children.

Objective: To analyze the agreement between body mass index (BMI) and waist-to-height Ratio (WHtR) to identify preschool and school children with cardiovascular risk factors (CRFs). Methods: Three-hundred-twenty-one kids were divided into preschool (3-5 years) and school children (6-10 years). BMI was used to classify children as overweight or obese. Abdominal obesity was defined with a WHtR ≥0.50. Fasting blood lipids, glucose and insulin were measured, and the homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. The presence of CRFs and multiple non-waist circumference (non-WC) metabolic syndrome factors (MetS-Factors) [high HOMA-IR, high triglycerides and low high-density lipoprotein cholesterol (HDL-C)] were analyzed. Results: One-hundred-twelve preschool and 209 school children were evaluated. WHtR ≥0.50 classified abdominal obesity in more than half of the preschool children, exceeding those classified with overweight+obesity by BMI (59.5% vs. 9.8%; p<0.001). There was no agreement between WHtR and BMI to identify preschool kids with CRFs and multiple non-WC MetS-Factors (kappa: 0.0 to 0.23, p>0.05). There were similar proportions of school children classified with abdominal obesity by the WHtR and overweight+obesity by the BMI (18.7% vs. 24.9%; p>0.05). There was substantial agreement between WHtR and BMI to identify school children with high total cholesterol values, low-density lipoprotein cholesterol (LDL-C), triglycerides, non-HDL-C, insulin, HOMA-IR, low HDL-C values, and the presence of multiple non-WC MetS-Factors (kappa: 0.616 to 0.857, p<0.001). Conclusion: In preschool children WHtR ≥0.5 disagree with BMI results, but in school kids, it has good agreement with the BMI to classify the children´s nutritional status and to identify those with CRFs.

Objetivo: Analizar el grado de acuerdo entre el índice de masa corporal (IMC) y la relación/cintura estatura (rCE) para identificar niños con factores de riesgo cardiovascular (FRC). Métodos: Estudio transversal analítico con 112 niños preescolares (3-5 años) y 209 escolares (6-10 años). El sobrepeso y la obesidad se clasificaron con el IMC y la obesidad abdominal con la rCE ≥0.50. Se tomaron muestras sanguíneas en ayuno para análisis de glucosa, insulina, lípidos y cálculo del índice HOMA-IR. Se analizó la presencia de FRC y de múltiples factores del síndrome metabólico (Factores-SinMet) diferentes a la cintura [HOMA-IR elevado, triglicéridos elevados y colesterol de alta densidad (HDL-C) bajo]. Resultados: rCE ≥0.50 clasificó con obesidad abdominal a más de la mitad de los niños preescolares, excediendo el número de niños clasificados con sobrepeso+obesidad por IMC (59.5% vs 9.8%; p<0.001). No hubo acuerdo entre el IMC y la rCE para identificar niños preescolares con FRC o múltiples Factores-SinMet diferentes a la cintura (kappa: 0.0 a 0.23, p>0.05). Fueron similares las proporciones de niños escolares clasificados con obesidad abdominal por la rCE o con sobrepeso+obesidad por el IMC (18.7% vs. 24.9%; p>0.05). Hubo acuerdo sustancial entre la rCE y el IMC para identificar niños escolares con valores elevados de colesterol total, colesterol de baja densidad, triglicéridos, colesterol no-HDL, insulina, HOMA-IR, valores bajos de HDL-C y la presencia de múltiples Factores-SinMet diferentes a la cintura (kappa: 0.616 a 0.857, p<0.001). Conclusión: En niños preescolares la aplicación de rCE ≥0.5 no presenta acuerdo con el IMC, pero en escolares presenta un acuerdo sustancial con el IMC en la clasificación del estado nutricional y en la identificación de niños con FRC.

Consumption of Eggs Alone or Enriched with Annatto (Bixa orellana L.) Does Not Increase Cardiovascular Risk in Healthy Adults-A Randomized Clinical Trial, the Eggant Study.

Most atherosclerotic cardiovascular diseases can be prevented by modifying lifestyles, including unhealthy diets. Eggs contain important carotenoids that may impact cardiovascular risk. The lipid nature of eggs can improve the bioavailability of other carotenoids, such as Annatto (Bixa orellana L.), with reported antioxidant properties. Although numerous studies have shown that there is no association between egg consumption and cardiovascular risk, there is still controversy. In addition, there is limited information about Annatto's effects on human health. This study evaluated the association between egg consumption and its enrichment with Annatto in lipid biomarkers of cardiovascular disease. In a parallel clinical trial, one hundred and five (n = 105) men and women were randomized by age, sex, and body mass index (BMI), and distributed into three groups. Subjects consumed daily, for 8 weeks, either two eggs, two eggs with Annatto, or two egg whites. Plasma lipids were measured by enzymatic colorimetric methods, plasma apolipoproteins and lipoprotein subfractions and size by nuclear magnetic resonance. There were no differences between groups in age, sex, and BMI. No significant changes were found over time or between groups in plasma triglycerides, LDL cholesterol, HDL cholesterol, apolipoprotein (apo) A1, apo B, or lipoprotein subfraction concentrations. In healthy adults, the intake of two eggs a day, or two eggs with Annatto for eight weeks, did not generate adverse changes in cardiovascular risk markers.

Comparative Evaluation of the Effects of Consumption of Colombian Agraz (Vaccinium meridionale Swartz) on Insulin Resistance, Antioxidant Capacity, and Markers of Oxidation and Inflammation, Between Men and Women with Metabolic Syndrome.

The metabolic syndrome (MS) is a constellation of related factors that increases the risk of developing cardiovascular diseases. Vaccinium meridionale Swartz contains polyphenols that could modulate some components of MS. Epidemiological and intervention studies have shown differences between men and women in MS components and antioxidant capacity. The objective of this study is to compare between men and women with MS the effects of agraz consumption on insulin resistance, antioxidant capacity, and markers of oxidation and inflammation. Men and women diagnosed with MS according to the Adult Treatment Panel III criteria were recruited in a double-blind, crossover study of 12 weeks. Participants were assigned to consume agraz nectar or placebo over 4 weeks. After 4 weeks of washout, they were switched to the alternative treatment. At the end of each period, the components of the MS, insulin resistance, antioxidant capacity, and some oxidative (oxidized low-density lipoprotein [oxLDL]; thiobarbituric acid reactive substances) and inflammatory (high-sensitive C-reactive protein [hs-CRP]) markers were evaluated. After consuming agraz, there was a tendency to increase the levels of antioxidants and to reduce the levels of hs-CRP in both genders. In addition, women who increased their serum phenols after consuming agraz had a significant reduction in insulin resistance, which was different from the results in men. Regarding men, those who increased their serum antioxidant capacity after consuming agraz had a better effect on the reduction of oxLDL levels that was significant compared to women. There are important differences between genders in the effects of agraz consumption in adults with MS.

Correlation of body mass index and waist to height ratio with cardiovascular risk factors in Colombian preschool and school children

Objective: To analyze the agreement between body mass index (BMI) and waist-to-height Ratio (WHtR) to identify preschool and school children with cardiovascular risk factors (CRFs). Methods: Three-hundred-twenty-one kids were divided into preschool (3-5 years) and school children (6-10 years). BMI was used to classify children as overweight or obese. Abdominal obesity was defined with a WHtR ≥0.50. Fasting blood lipids, glucose and insulin were measured, and the homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. The presence of CRFs and multiple non-waist circumference (non-WC) metabolic syndrome factors (MetS-Factors) [high HOMA-IR, high triglycerides and low high-density lipoprotein cholesterol (HDL-C)] were analyzed. Results: One-hundred-twelve preschool and 209 school children were evaluated. WHtR ≥0.50 classified abdominal obesity in more than half of the preschool children, exceeding those classified with overweight+obesity by BMI (59.5% vs. 9.8%; p0.05). There were similar proportions of school children classified with abdominal obesity by the WHtR and overweight+obesity by the BMI (18.7% vs. 24.9%; p>0.05). There was substantial agreement between WHtR and BMI to identify school children with high total cholesterol values, low-density lipoprotein cholesterol (LDL-C), triglycerides, non-HDL-C, insulin, HOMA-IR, low HDL-C values, and the presence of multiple non-WC MetS-Factors (kappa: 0.616 to 0.857, p<0.001). Conclusion: In preschool children WHtR ≥0.5 disagree with BMI results, but in school kids, it has good agreement with the BMI to classify the children´s nutritional status and to identify those with CRFs.

Objetivo: Analizar el grado de acuerdo entre el índice de masa corporal (IMC) y la relación/cintura estatura (rCE) para identificar niños con factores de riesgo cardiovascular (FRC). Métodos: Estudio transversal analítico con 112 niños preescolares (3-5 años) y 209 escolares (6-10 años). El sobrepeso y la obesidad se clasificaron con el IMC y la obesidad abdominal con la rCE ≥0.50. Se tomaron muestras sanguíneas en ayuno para análisis de glucosa, insulina, lípidos y cálculo del índice HOMA-IR. Se analizó la presencia de FRC y de múltiples factores del síndrome metabólico (Factores-SinMet) diferentes a la cintura [HOMA-IR elevado, triglicéridos elevados y colesterol de alta densidad (HDL-C) bajo]. Resultados: rCE ≥0.50 clasificó con obesidad abdominal a más de la mitad de los niños preescolares, excediendo el número de niños clasificados con sobrepeso+obesidad por IMC (59.5% vs 9.8%; p0.05). Fueron similares las proporciones de niños escolares clasificados con obesidad abdominal por la rCE o con sobrepeso+obesidad por el IMC (18.7% vs. 24.9%; p>0.05). Hubo acuerdo sustancial entre la rCE y el IMC para identificar niños escolares con valores elevados de colesterol total, colesterol de baja densidad, triglicéridos, colesterol no-HDL, insulina, HOMA-IR, valores bajos de HDL-C y la presencia de múltiples Factores-SinMet diferentes a la cintura (kappa: 0.616 a 0.857, p<0.001). Conclusión: En niños preescolares la aplicación de rCE ≥0.5 no presenta acuerdo con el IMC, pero en escolares presenta un acuerdo sustancial con el IMC en la clasificación del estado nutricional y en la identificación de niños con FRC.

Evaluation of Agraz Consumption on Adipocytokines, Inflammation, and Oxidative Stress Markers in Women with Metabolic Syndrome.

Metabolic syndrome (MetS) is characterized by increased oxidative stress and a pro-inflammatory state. Vaccinium meridionale Swartz (known as "agraz") is a berry rich in polyphenolic compounds with demonstrated antioxidant activity and anti-inflammatory effects in preclinical studies. The aim of this study was to evaluate the effects of agraz consumption on inflammatory and oxidative stress markers in women with MetS. Forty women with MetS (47 ± 9 years) were randomly assigned to consume daily either 200 mL of agraz nectar or placebo over four weeks in a double-blind, cross-over design study, separated by a 4-week washout period. Metabolic and inflammatory markers in serum and antioxidant/oxidative stress markers in serum and urine were assessed at the end of each period. Serum antioxidant capacity measured by the 2,2-diphenyl-1-picrylhydrazyl (DPPH) method was significantly higher (p = 0.028), while urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG) was lower (p = 0.041) after agraz consumption, compared to placebo. In conclusion, consumption of agraz during four weeks increased serum antioxidant capacity and decreased a marker of DNA oxidative damage in women with MetS, compared to placebo. These results suggest that agraz consumption may play a protective role in patients with MetS.

Effect of Agraz (Vaccinium meridionale Swartz) on High-Density Lipoprotein Function and Inflammation in Women with Metabolic Syndrome.

Metabolic syndrome (MetS) is associated with low-grade inflammation and high-density lipoprotein (HDL) dysfunction. Polyphenol-rich foods may improve these alterations. Agraz is a fruit rich in polyphenols (mainly anthocyanins); however, there is limited information about its effects on human health. We evaluated the effects of agraz consumption as compared to placebo on HDL function and inflammation in women with MetS. Forty volunteers (25⁻60 years) were included in this double-blind crossover study. Women consumed agraz or placebo over 4 weeks; separated by a 4-week washout period. HDL function (apoliprotein-A1; paraoxonase 1 (PON1) activity; cholesterol efflux capacity), oxidative stress (myeloperoxidase (MPO), advanced oxidation protein products) and inflammatory markers (serum cytokines/chemokines and peripheral blood mononuclear cell nuclear factor-kB) were measured after each period. Compared to placebo, agraz consumption did not significantly change any of the biomarkers measured. Interestingly, only after agraz period there were significant positive correlations between PON1 activities and cholesterol efflux. Additionally, there were significant inverse correlations between changes in inflammatory markers and HDL function markers and positive correlations with oxidative markers. Although polyphenol-rich foods have been shown to be beneficial for certain conditions; polyphenol-rich agraz fruit consumption did not impact inflammation and HDL function in the current study of women with MetS.

Cardiometabolic risk factors in preschool children with abdominal obesity from Medellín, Colombia.

Background Abdominal obesity (AO) is linked to inflammation and insulin resistance (IR). However, there is limited information on whether preschoolers with AO present these risk factors. We evaluated the association between AO and cardiovascular risk factors in preschoolers. Methods We enrolled 232 children (2-5 years), of whom 50% had AO. Serum total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-c), high-density lipoprotein-cholesterol (HDL-c), triglycerides (TG), apolipoprotein B (Apo-B) and apolipoprotein A-1 (Apo-A1), glucose, insulin, high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-alpha (TNF-α), interleukin (IL)-6, IL-1ß, monocyte chemoattractant protein (MCP-1/CCL2), leptin, adiponectin, vascular cell adhesion molecule (VCAM-1/CD106) and intercellular adhesion molecule (ICAM-1/CD54) were measured. The homeostatic model assessment of IR (HOMA-IR) was calculated. We analyzed these variables according to the presence of AO and other metabolic syndrome (MetS) components. Results A total of 75.8% of children with AO had one or more risk factors for MetS. Children with AO had significantly higher body mass indexes (BMIs), insulin, HOMA-IR, TG, very low-density lipoprotein-cholesterol (VLDL-c) and TC/HDL-c ratio and lower HDL-c, compared to children without AO; but there were no differences in inflammatory markers. After adjusting for BMI, sex and age, the differences between groups were not significant for any variable. Waist circumference (WC) was correlated with insulin (r=0.547; p<0.001), TG (r=0.207; p=0.001), ICAM-1 (r=0.213; p=0.039), hs-CRP (r=0.189; p=0.015) and glucose (r=0.187; p=0.004). After adjusting for BMI, age and sex, AO plus one MetS component contributed to individual variation in glucose, insulin, HOMA-IR and TG. Conclusions AO in preschool children is associated with greater IR and atherogenic lipid profiles, although these findings seem to be more related to general obesity than just central obesity. In addition, our data suggest that IR may precede the elevation of systemic cytokines in obese children, unlike findings in adults. More studies in pediatric populations are needed to elucidate these associations.

Prevalencia de dislipidemias en una institución prestadora de servicios de salud de Medellín (Colombia), 2013 / Prevalence of dyslipidemia in a health services provider institution of Medellin (Colombia), 2013

Introducción: las dislipidemias comprenden un conjunto de alteraciones en las concentraciones de los lípidos sanguíneos, como resultado de variaciones genéticas o secundarias a factores del estilo de vida. Objetivo: determinar la prevalencia de dislipidemias en individuos atendidos en un laboratorio docente asistencial e investigativo de Medellín, durante el año 2013. Métodos: estudio descriptivo transversal realizado en una población de 6 384 sujetos, utilizando información secundaria. Se realizaron medidas de resumen y frecuencia, regresión logística binaria multivariante. Los análisis se realizaron en SPSS 21.0® y Epidat 3.0. Resultados: la prevalencia global de hipertrigliceridemia fue 41,8 %, hipercolesterolemia 46,0 %, colesterol LDL elevado 67,5 %, colesterol HDL bajo 40,4 % y de dislipidemias 74,7 %. Las alteraciones lipídicas presentaron asociación estadística con el sexo y el grupo etario. Conclusión: se encontró una elevada prevalencia de dislipidemias y alteración de todos los índices aterogénicos; los adultos con edad mayor a 44 años y las mujeres son quienes presentan mayor riesgo de dislipidemia; estos son datos importantes porque precisan la población prioritaria para intervenciones posteriores.

Introduction: dyslipidemias include a set of alterations on blood lipid concentrations due to genetic variations and/or secondary to lifestyle factors. Objective: to determine the dyslipidemia prevalence in people attending an Investigative, Teaching and Healthcare Laboratory of Medellín, in 2013. Methods: a cross sectional study was performed in a population of 6,384 people using secondary information. Summary measures and frequency, and multivariate binary logistic regression were performed. All analyzes were performed using SPSS 21.0® and Epidat 3.0. Results: the total prevalence of hypertriglyceridemia was 41.8 %, hypercholesterolemia 46.0 %, high LDL Cholesterol 67.5 %, low HDL Cholesterol 40.4 % and dyslipidemia 74.7 %; lipid abnormalities showed statistical association with sex and age group. Conclusion: A high prevalence of dyslipidemia and alteration of all atherogenic ratios were found; the adults over 44 years and women had increased risk of dyslipidemia, these are important data because it determines which population needs subsequent interventions..

Síndrome metabólico en niños: problemática, componentes y criterios diagnósticos / Metabolic syndrome in children: issues, components and diagnostic criteria

RESUMEN Antecedentes el síndrome metabólico en niños aumenta el riesgo de diabetes mellitus tipo 2 y enfermedad cardiovascular en la adultez. Objetivo describir los componentes del síndrome metabólico en niños, su prevalencia y criterios diagnósticos propuestos por diferentes organizaciones y autores. Materiales y métodos se realizó una búsqueda bibliográfica en las siguientes bases de datos: Pubmed, Science Direct, Embase, Lilacs y Scielo. Resultados y discusión varias organizaciones han establecido definiciones para diagnosticar el síndrome metabólico en niños, algunas abordando criterios utilizados en adultos o adoptando puntos de corte derivados de poblaciones seleccionadas como niños obesos o sin incluir niños pre-adolescentes, aduciendo en estos últimos una baja prevalencia de alteraciones. Así, la prevalencia de este síndrome en una misma población puede variar (0,9 a 11,4%) según la definición empleada. Sin embargo, dicha prevalencia aumenta con el grado de obesidad infantil y se han demostrado prevalencias altas en pre-púberes, independiente de la clasificación empleada. Recientemente, se propuso usar puntajes continuos para mejorar la evaluación en niños. Conclusión los puntos de corte actualmente empleados ponderan de forma diferente los componentes del síndrome metabólico. Por tanto, se recomienda emplear percentiles según edad, sexo y población para cada componente y evaluar la utilidad de puntajes continuos en esta población.

ABSTRACT Background The metabolic syndrome in children increases the risk for type 2 diabetes and cardiovascular disease in adulthood. Aim To describe the components of metabolic syndrome in children, their prevalence, and diagnostic criteria proposed by different authors and organizations. Materials and methods A literature search of articles published in Pubmed, Science Direct, Embase, Lilacs and Scielo databases was conducted. Results and discussion: Several organizations have established definitions for metabolic syndrome diagnosis in children, some including criteria used for adults or adopting cutoffs derived from selected populations such as obese children or without including pre-adolescent children, arguing a low prevalence of alterations in these. Thus, the prevalence of metabolic syndrome in a particular population varies (0,9% to 11,4%) according to the definition used. However, this prevalence increases according to the obesity grade, and a high prevalence in pre-pubers has been reported, independent of the classification used. Recently, it was proposed the use of a continuous score to improve the metabolic syndrome evaluation in children. Conclusion: The cutoffs currently used give different weighting for each component of metabolic syndrome. Therefore, it is recommended the use of percentiles according to sex and age and population for each component and to evaluate the utility of continuous scores in this population.