Interplay of Postprandial Triglyceride-Rich Lipoprotein Composition and Adipokines in Obese Adolescents.

In the context of the alarming rise of infant obesity and its health implications, the present research aims to uncover disruptions in postprandial lipid metabolism and the composition of triglyceride-rich lipoproteins in obese adolescents. A double-blind, controlled clinical trial in the postprandial phase on 23 adolescents aged 12 to 16 years was carried out. Twelve participants were categorized as obese (BMI > 30 kg/m2 and percentile > 95) and 11 as normal-weight (BMI = 20-25 kg/m2, percentile 5-85). Blood samples were collected after a 12-h overnight fast and postprandially after consumption of a standardized breakfast containing olive oil, tomato, bread, orange juice, and skimmed milk. Obese adolescents exhibited elevated triglyceride concentrations in both fasting and postprandial states and higher TG/apo-B48 ratios, indicating larger postprandial triglyceride-rich lipoprotein (TRL) particle size, which suggests impaired clearance. Obese subjects also exhibited higher n-6 PUFA concentrations, potentially linked to increased TRL hydrolysis and the release of pro-inflammatory adipokines. In contrast, TRL from normal-weight individuals showed higher concentrations of oleic acid and DHA (n-3 PUFA), with possible anti-inflammatory effects. The results indicate an interplay involving postprandial TRL metabolism and adipokines within the context of adolescent obesity, pointing to potential cardiovascular implications in the future.

Low intakes of vitamins C and A are associated with obesity in early adulthood.

To evaluate the relationships between the intake of individual antioxidants as well as the dietary antioxidant quality score and obesity-related measures. A cross-sectional study was conducted on 562 young adults. Fat mass, fat-mass percentage, and fat-free mass were measured using a body composition analyzer. The intake of antioxidant nutrients including vitamins C, E, and A, selenium, zinc, and magnesium were calculated based on a 72-hour diet recall interview. We observed significant differences in the vitamin C (88.6 ± 72.6 mg/day vs. 70.7 ± 60.6 mg/day, p = 0.010), vitamin A (635.8 ± 519.8 µg/day vs. 492.6 ± 318.9 µg/day, p = 0.014), and selenium (135.3 ± 88.7 µg/day vs. 139.3 ± 79.3 µg/day, p = 0.034) intake between normal-weight and overweight or obese young adults. When the Dietary Antioxidant Quality Score (DAQS) was analyzed, there were no significant differences between normal-weight versus overweight or obese young adults after adjusting for confounders. Logistic regression analysis revealed that vitamin C intake (odds ratio (OR) 0.995, 95% CI 0.992-0.999, p = 0.013) and vitamin A intake (OR 0.999, 95% CI 0.999-1.000, p = 0.016) were independent predictors of overweight/obesity after adjusting for age, sex and energy intake. In contrast, a higher selenium intake was associated with an increased risk of overweight/obesity (OR 1.003, 95% CI 1.000-1.006, p = 0.034). Future longitudinal investigations of dietary antioxidant intake in relation to the development of obesity would be of interest to better understand the effect of dietary antioxidants on obesity.

Concordance among diagnostic criteria for metabolic syndrome is inconsistent in Spanish adolescents.

BACKGROUND: The metabolic syndrome (MetS), although more frequent in adults, is a growing health problem in adolescent population. There are different criteria for the diagnosis, however without a consensus of which is the best to be used in this population. The heterogeneity of the different diagnostic criteria makes it necessary to carry out more studies that analyse the degree of agreement among these criteria. The present study was aimed to evaluate the agreement between different criteria for diagnosis of MetS in adolescents. MATERIALS AND METHODS: A cross-sectional study was performed on 981 adolescents (13.2 ± 1.2 years) randomly recruited from 18 schools in south-east Spain. MetS was diagnosed by eight different criteria. RESULTS: The criteria proposed by the IDF showed the highest mean values for WC and systolic blood pressure in boys and girls with MetS, and the lowest for glucose and triglycerides in boys. Depending on the diagnostic criteria used, the prevalence of MetS cases in boys ranged from 5.5% to 14.9%, while in girls varied from 3.4% to 32.6%. Both in boys and girls, the criteria proposed by the IDF was the less concordant with the other suggested criteria, while those proposed by Duncan et al, Rodriguez-Moran et al and Cruz and Goran, were very concordant among each other. However, in girls, concordance values were not as high as those found for boys. CONCLUSION: The variability observed in the agreement among the existing criteria suggests the need to validate uniform criteria for the diagnosis of MetS in adolescents.

Serum leptin as a mediator of the influence of insulin resistance on hepatic steatosis in youths with excess adiposity.

BACKGROUND AND AIMS: The relationship between insulin resistance (IR) and hepatic steatosis (fatty liver) is well known; however, the extent to which the satiety hormone leptin acts as a confounder or mediator in this relationship is uncertain. We examined whether the association between IR and hepatic steatosis is mediated by leptin in Colombian adolescents with excess adiposity. METHODS AND RESULTS: A total of 122 adolescents (mean age: 13.4 years; 68% girls) participated in the study. We assessed body composition, hepatic steatosis (as defined by the controlled attenuation parameter [CAP]), cardiometabolic risk factors (body mass index, waist circumference, body composition), biochemical variables (leptin, insulin, glucose, lipid profile, cardiometabolic Z-score, transaminases, etc.), and physical fitness (cardiorespiratory fitness and grip strength). Partial correlation, regression, and mediation analyses were conducted using the Barron and Kenny framework. RESULTS: Ninety-two youths (75.4%) had IR. Mediation analysis revealed a positive relationship between Homeostasis Model Assessment-IR (HOMA-IR) and CAP (ßdir = 3.414, 95% confidence interval [CI]: 1.012 to 5.816, p < 0.001), which was attenuated when leptin was included in the model, thus indicating that leptin mediates this relationship (ßind = 1.074, 95% CI: 0.349 to 2.686, p < 0.001). The percentage of the total effect mediated by leptin was 21%. Regarding sex, the mediation effect of leptin remains significant among boys (ßind = 0.962, 95% CI: 0.009 to 2.615, p < 0.001), but not in girls (ßind = 0.991, 95% CI: 1.263 to 5.483, p = 0.477). CONCLUSIONS: The findings are clinically relevant to consider leptin levels as a surrogate marker of insulin sensitivity when assessing youths with excess adiposity and/or suspected Nonalcoholic hepatic steatosis or nonalcoholic fatty liver disease (NAFLD).

Dietary Inflammatory Index Scores Are Associated with Pressure Pain Hypersensitivity in Women with Fibromyalgia.

OBJECTIVE: Pain hypersensitivity has been described as one of the most disabling symptoms of fibromyalgia syndrome (FMS). Here we analyzed the relationship between an anti-inflammatory diet profile and the pressure pain thresholds (PPTs) of tender point sites and other fibromyalgia-related symptoms in patients with FMS. METHODS: This cross-sectional study included 95 women diagnosed with FMS and 98 menopause-status matched controls. The Dietary Inflammatory Index (DII) was calculated by conducting a 24-hour diet recall interview. The PPTs of tender point sites and self-reported global pain levels were evaluated by algometry and the visual analog scale, respectively. Disease severity, fatigue, sleep anxiety, and central sensitization were also evaluated. RESULTS: Linear regression analysis revealed that the PPTs of tender point sites including the occiput (ß = 0.234, 95% confidence interval [CI] = 0.016-0.452, P = 0.036), trapezius (ß = 0.299, 95% CI = 0.083-0.515, P = 0.007), zygapophyseal joint (ß = 0.291, 95% CI = 0.022-0.559, P = 0.035), second rib (ß = 0.204, 95% CI = 0.060-0.348, P = 0.006), gluteus (ß = 0.591, 95% CI = 0.110-1.072, P = 0.017), greater trochanter (ß = 0.379, 95% CI = 0.016-0.742, P = 0.041), and knee (ß = 0.482, 95% CI = 0.117-0.850, P = 0.011) were associated with DII score after adjustments for the age, menopausal status, and global energy levels reported by the patients with FMS. No significant differences were found for the cases or controls between the DII score and the remaining clinical symptoms. Analyses of covariance showed that the PPTs of the aforementioned tender point sites were also significantly associated (P < 0.05) with the DII score quartiles in patients with FMS, but no significant differences were found between these quartiles and the other clinical symptoms. CONCLUSIONS: A pro-inflammatory diet was associated with pain hypersensitivity in patients with FMS.

Waist circumference and abdominal volume index are the strongest anthropometric discriminators of metabolic syndrome in Spanish adolescents.

BACKGROUND: Waist circumference has been suggested as predictor for metabolic syndrome (MetS) in adolescents but it has not been compared with newly proposed anthropometric indexes. This study aimed to disclose the capacity of ten classic and novel anthropometric indexes to discriminate by the presence of MetS in this young population. MATERIALS AND METHODS: A cross-sectional study was performed on 981 adolescents (13.2 ± 1.2 years) randomly recruited from eighteen schools in south-east Spain. Body fat percentage (BF%), abdominal volume index (AVI), body roundness index (BRI), body mass index (BMI), body adiposity index (BAI), body adiposity index for paediatrics (BAIp), conicity index (C-Index), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and body shape index (ABSI) were measured and calculated. Receiver-operator curves (ROC) were created to determine the discriminatory capacity of these anthropometric parameters for MetS. RESULTS: The prevalence of MetS was 7.0% for boys and 6.1% in girls. Participants with MetS had significantly higher levels of blood pressure and plasma levels of lipids, glucose and insulin. All anthropometric indexes were elevated in MetS individuals compared to the non-MetS group. AVI and WC showed the highest AUC values (0.83 for boys and 0.86 for girls). In contrast, according to ROC analyses, no anthropometric index was capable of discriminating the components of MetS (hypertension, hypertriglyceridemia, hyperglycaemia and low-HDL levels), except for abdominal obesity. CONCLUSION: We suggest the use of WC and AVI, with the cut-off points presented herein, for the discrimination between adolescents with or without MetS.

Muscle mass to visceral fat ratio is an important predictor of the metabolic syndrome in college students.

This study aimed to evaluate the associations between the muscle mass to visceral fat (MVF) ratio and cardiometabolic risk factors in a large population of college students in Colombia and to propose cut-off points of this index for the metabolic syndrome (MetS). A total of 1464 young adults recruited from the FUPRECOL (Asociación de la Fuerza Prensil con Manifestaciones Tempranas de Riesgo Cardiovascular en Jóvenes y Adultos Colombianos) study were categorised into four groups based on their MVF ratio. Muscle mass and visceral fat level of the participants were measured using a bioelectrical impedance analysis. Cardiometabolic risk factors including lifestyle characteristics, anthropometry, blood pressure and biochemical parameters were assessed. The prevalence of moderate to severe obesity, hypertension and the MetS was higher in subjects in quartile (Q)1 (lower MVF ratio) (P <0·001). ANCOVA revealed that the subjects in Q1 had higher cardiometabolic disturbances, including altered anthropometry, blood pressure, muscle strength and biochemical parameters after adjusting for age and sex compared with young adults in higher MVF ratio quartiles (P <0·001). Muscular mass and physical activity levels were significantly lower in subjects with a lower MVF ratio (P <0·001). The receiver operating characteristic curve analyses indicated that in men the best MVF ratio cut-off point for detecting the MetS was 18·0 (AUC 0·83, sensitivity 78 % and specificity 77 %) and for women, the MVF ratio cut-off point was 13·7 (AUC 0·85, sensitivity 76 % and specificity 87 %). A lower MVF ratio is associated with a higher risk cardiometabolic profile in early adulthood, supporting that the MVF ratio could be used as a complementary screening tool that may help clinicians identify young adults at high cardiometabolic risk.

Use of dietary supplements by pregnant women in Colombia.

BACKGROUND: During pregnancy, the need for certain nutrients increases. This study assessed the prevalence and socio-demographic factors associated with dietary supplement use in a representative sample of pregnant women in Colombia. METHOD: Data for this study were obtained from a cross-sectional, nationally representative survey (ENSIN, 2010). A total of 1856 pregnant women, 13-49 years of age, were recruited. The use of prenatal dietary supplements (Vitamins A, C or E) was treated as a binary outcome (used at some time or never sued during pregnancy when prescribed by a doctor) in multinomial analyses. Sociodemographic data and associated factors were assessed by computer-assisted personal interview technology. RESULTS: Of the sample, 1123 women (68.6%) reported taking prenatal dietary supplements at some stage during their pregnancy. Most users had a high socioeconomic level (79.5%), were in their third trimester of pregnancy (79.5%), were 30-49 years of age (74.0%), and lived in the central region of Colombia (73.8%). The multivariate logistic regression showed that third trimester of pregnancy (OR 6.2;95% CI 4.0 to 9.3), high educational level (OR 2.3; 95% CI 1.5 to 3.4), high socioeconomic level -SISBEN IV or more- (OR 2.0; 95% CI 1.4 to 2.8), residence in the Atlantic region (north) (OR 2.6; 95% CI 1.7 to 3.6), Eastern region (OR 2.0; 95% CI 1.3 to 3.1), central region (OR 2.6; 95% CI 1.7 to 3.9), Pacific region (west) (OR 1.5; 95% CI 1.0 to 2.3), and belonging to the mestizo (others) ethnic group (OR 1.2; 95% CI 1.0 to 2.6), were all associated with a higher probability of dietary supplement intake. CONCLUSION: The prevalence of prenatal dietary supplements in pregnant women in Colombia was found to be substantial. The variables significantly associated with their use were educational level, socioeconomic level, trimester of pregnancy, geographic level and ethnic group. These results indicate the necessity of implementing new health policies that guarantee uniform access to nutritional supplements for all population sectors, especially in countries, such as Colombia, who are currently undergoing a process of nutritional transition.

Validation of multi-frequency bioelectrical impedance analysis versus dual-energy X-ray absorptiometry to measure body fat percentage in overweight/obese Colombian adults.

OBJECTIVES: To verify the validity of multi-frequency bioelectrical impedance analysis (mBCA) for predicting body fat percentage (BF%) in overweight/obese adults using dual-energy X-ray absorptiometry (DXA) as the reference method. METHODS: Forty-eight adults participated (54% women, mean age = 41.0 ± 7.3 years old). The Pearson's correlation coefficient was used to evaluate the correlation between BIA and BF% assessed by DXA. The concordance between BF% measured by both methods was obtained with Lin's concordance correlation coefficient and Bland-Altman difference plots. RESULTS: Measures of BF% were estimated as 39.0 (SD = 6.1) and 38.3 (SD = 6.5) using DXA and mBCA, respectively. The Pearson's correlation coefficient reflected a strong correlation (r =.921, P = .001). The paired t-test showed a significant mean difference between these methods for obese men BF% of -0.6 [(SD 1.95; 95% CI = -4.0 to 3.0), P =.037]. Overall, the bias of the mBCA was -0.6 [(SD 2.2; 95% CI = -5.0 to 3.7), P =.041], which indicated that the mBCA method significantly underestimated BF% in comparison to the reference method. Finally, in both genders, Lin's concordance correlation coefficient showed a strong agreement. More specifically the DXA value was ρc = 0.943 (95% CI = 0.775 to 0.950) and the mBCA value was ρc = 0.948 (95% CI = 0.778 to 0.978). CONCLUSIONS: Our analysis showed a strong agreement between the two methods as reflected in the range of BF%. These results show that mBCA and DXA are comparable methods for measuring body composition with higher body fat percentages. However, due to broad limits of agreement, we can only recommend mBCA for groups of populations.

Dietary inflammatory index and cardiovascular risk factors in Spanish children and adolescents.

Dietary inflammatory potential is an established risk factor for adverse cardiovascular events. In this study we analyzed the relation between the Dietary Inflammatory Index (DII) and cardiovascular risk factors, based on anthropometric, body composition, blood pressure, and heart rate parameters in children and adolescents. We conducted a cross-sectional study of 428 Spanish schoolchildren (mean age 12.32 ± 1.84), whose DII was calculated, based on a 24-hr diet recall over 3 days. Anthropometric measurements were taken, and body composition analyzed by bioelectrical impedance analysis. Blood pressure and heart rate parameters were assessed with an automatic monitor. Pubertal stage was assessed based on Tanner criteria. We analyzed the DII both as a continuous variable and as a category variable based on quartiles. Linear regression analysis revealed that the DII was significantly associated with waist to height ratio (WHtR) (p = .026; B = 0.128, 95% CI [.001-.016]) after adjusting for age, sex, total energy intake, and Tanner stage. All macro- and micronutrient intakes were found to be higher in the DII Q1 (anti-inflammatory diet) except for caffeine. This study provides preliminary evidence of a significant association between the DII and WHtR, an index of cardiovascular risk. The results obtained indicate that the inflammatory potential of the diet may play a role in children and adolescents becoming overweight or developing obesity. Future studies in young people should be conducted to validate and further explore these relationships.

Dietary inflammatory index, bone health and body composition in a population of young adults: a cross-sectional study.

Diet quality has been postulated as a relevant factor in disorders like obesity and osteoporosis as it modulates inflammatory biomarkers. The aim of this study was to investigate whether the dietary inflammatory index (DII) is associated with bone health status and body composition parameters in a population of young adults. The study population consisted of 599 young adults (aged 20.41 ± 2.72). Linear regression analysis revealed that weight and fat-free mass (FFM) were significantly associated with the DII after adjustments for age, sex and total energy (ß = -0.91, 95% CI -1.782, -0.213, p = .013 and ß = -0.059, 95% CI -0.842, -0.107, p = .011, respectively). Our results suggest that the inflammatory potential of diet, measured using the DII, is associated with obesity-related parameters such as FFM and weight, although it may not contribute to osteoporosis in early adulthood.

Associations between body composition, nutrition, and physical activity in young adults.

OBJECTIVE: The aim of the present study is to investigate the associations between total energy, macronutrient intakes, and physical activity (PA) and body composition by assessing body fat mass, fat-free mass, and BMI in a population of young adults. METHODS: The study population consisted of 605 young Spanish adults (median age 20.38 ± 2.67). Body composition, including fat mass and fat-free mass, was calculated with body composition analyzer. Daily energy and macronutrient intakes were measured using a 72-h recall method. The International PA Questionnaire was used to assess PA and sedentary time. Linear regression analyses were performed to test the possible associations between nutrition, PA factors, and body composition. RESULTS: Linear regression analyses revealed that BMI has a significant positive association with protein intake (P = .004, B = 0.088, 95% CI 0.028-0.149) and an inverse association with carbohydrate intake (P = 0.034, B = -0.027, 95% CI -0.053 - -0.002). Protein intake also demonstrated a significant association with fat-free mass, but the size of the effect was smaller (P = .027, B = 96.965, 95% CI 11.250-182.679). There was evidence of a positive association between total PA and moderate-to-vigorous PA (P < .001, B = 15.630, 95% CI 6.989 -24.270) and fat-free mass (P < .001, B = 20.208, 95% CI 9.694 -30.723). When fat mass was used as the outcome variable, there was no evidence of any association with the PA, total energy, and macronutrient intakes variables analyzed. CONCLUSIONS: Our findings suggest that PA variables were consistently associated with body composition, specifically fat-free mass. Dietary factors also have influence over body composition; we showed that protein intake is significantly associated with fat-free mass and BMI.

Normative data for quantitative calcaneal ultrasound in young males and females.

OBJECTIVE: The quantitative ultrasound (QUS) method has been recognized as an optimal screening tool for assessing bone mass status. The aim of this study was to provide standardized values for bone health status measured by the QUS technique based on age, sex, and body mass index (BMI). METHODS: The study population consisted of 1322 healthy individuals (822 females and 500 males) aged 14-25 years. Bone mass in both calcaneus was estimated with QUS to obtain Broadband ultrasound attenuation (BUA) (dB/MHz). RESULTS: The linear models revealed statistically significant differences between bone mass status of the calcaneus and age, sex, and BMI (P < .001). Bone mass increased at a rate of approximately 0.015 units per year after the age of 14 and these values increased in approximately 0.1 units in males in comparison to females. There was an increase of approximately 0.17 units for each increase in categories of BMI. CONCLUSION: It is crucial to provide standardized values for the QUS parameter in young males and females to allow reliable comparisons and evaluate trends in preventive programs that may enable the identification of individuals at risk for osteoporosis.

Using LMS tables to determine waist circumference and waist-to-height ratios in Colombian children and adolescents: the FUPRECOL study.

BACKGROUND: Waist circumference (WC) and waist-to-height ratio (WHtR) are often used as indices predictive of central obesity. The aims of this study were: 1) to obtain smoothed centile charts and LMS tables for WC and WHtR among Colombian children and adolescents; 2) to evaluate the utility of these parameters as predictors of overweight and obesity. METHOD: A cross-sectional study was conducted of a sample population of 7954 healthy Colombian schoolchildren [3460 boys and 4494 girls, mean age 12.8 (±2.3) years]. Weight, height, body mass index (BMI), WC and WHtR were measured, and percentiles were calculated using the LMS method (Box-Cox, median and coefficient of variation). Appropriate cut-off points of WC and WHtR for overweight and obesity, according to International Obesity Task Force definitions, were selected using receiver operating characteristic (ROC) analysis. The discriminating power of WC and WHtR is expressed as area under the curve (AUC). RESULTS: Reference values for WC and WHtR are presented. Mean WC increased and WHtR decreased with age for both genders. A moderate positive correlation was observed between WC and BMI (r = 0.756, P < 0.01) and between WHtR and BMI (r = 0.604, P < 0.01). ROC analysis revealed strong discrimination power in the identification of overweight and obesity for both measures in our sample population. Overall, WHtR was a slightly better predictor of overweight/obesity (AUC 95% CI 0.868-0.916) than WC (AUC 95% CI 0.862-0.904). CONCLUSION: This paper presents the first sex and age-specific WC and WHtR percentiles for Colombian children and adolescents aged 9.0-17.9 years. The LMS tables obtained, based on Colombian reference data, can be used as quantitative tools for the study of obesity and its comorbidities.

Need of improvement of diet and life habits among university student regardless of religion professed.

At present, few studies have assessed the possible influence of culture and religion on healthy eating habits among the university population. The aim of this study was to identify differences in healthy and eating habits among university students of different religions. A cross-sectional study was performed with a sample population of 257 students (22.4 ± 4.76 y) at the campus of the University of Granada in Melilla (Spain). The quality of diet was assessed by the Healthy Eating Index (HEI) and the adherence to the Mediterranean diet by a validated score (MDS). There were a higher prevalence of overweight in Christian boys and girls compared to Muslims. Muslim students omit breakfast and dinner more often than Christians. Significant differences in sodium intake (p < 0.001) were observed among boys of Christian and Muslim faith, with significantly higher intakes in Christians. In contrast, a higher cholesterol intake (p = 0.038) was observed in Muslim girls compared to Christians. Regarding alcohol intake, its consumption being much higher among students of Christian faith. Likewise, there were no significant differences in the quality of the diet as assessed by HEI, this being of poor, together with a low adherence to the Mediterranean diet in both groups. Muslim university students have a lower risk of drinking alcohol (OR = 7.88, 95% CI = 4.27, 14.54). Few differences were found between girls and boys in both religions although the Mediterranean Diet Score was lower for girls. In conclusion, Melilla university students eat low quality foods and have little adherence to the Mediterranean diet regardless of the religion professed or gender, although Christians tend to drink more alcohol and to smoke more cigarettes and Muslims skip some meals.

Sexual orientation and its impact on sexual behaviour of young people aged 15-29: a cross-sectional study.

AIMS: The aim of this study was to determine whether there was a direct relation between sexual orientation and sexual practices involving penetration; to analyse whether condom use in the first sexual relation was conditioned by sexual orientation; to verify whether consistent condom use in sexual relations was determined by sexual orientation. BACKGROUND: Recent research suggests that sexual orientation (i.e. heterosexuality, homosexuality or bisexuality) is a determining factor in high-risk sexual behaviour. DESIGN: A cross-sectional study with purposive sampling. METHODS: Data were collected between March 2013-April 2014 from 900 participants (524 males and 376 females). All participants were 15-29 years of age. Their mean age was 20·93 years. The participants were given a socio-demographic survey as well as a psychometric test on high-risk sexual behaviour, which had been used in previous studies. RESULTS: There were no statistically significant differences in relation to sexual orientation and sexual practices involving penetration either in the general model for both sexes or in the models for men and women. It was also found that sexual orientation did not significantly affect condom use in the first sexual relation. Furthermore, consistent condom use had a protector effect in the general model for homosexuals and bisexuals. In the model for men, this was also true for homosexuals and in the model for women, this was the case for bisexuals. CONCLUSION: Condom use in the first sexual relation was similar in all sexual orientations. However, the sexual orientation of the subject was found to be a determining factor in consistent condom use.

A Cross-Sectional Study of the Association of VDR Gene, Calcium Intake, and Heel Ultrasound Measures in Early Adulthood.

The acquisition of a high adult peak bone mass (PBM) is considered an important determinant of osteoporotic risk later in life. Genetic and environmental factors determine optimal PBM acquisition in early adulthood. The aim of this study was to test the association of vitamin D receptor (VDR) gene polymorphisms and dietary calcium intake with the bone mass of young adults. The study population comprised a total of 305 individuals (mean age 20.41; SD 2.36) whose bone mass was assessed through heel ultrasound [quantitative ultrasound measurements (QUS)] measurements (BUA, dB/MHz). The FokI G/A, rs9729 G/T, and TaqI G/A polymorphisms were selected as genetic markers of VDR. A significant difference in BUA values was observed according to gender (females 82.96; SD 15.89 vs. males 97.72; SD 16.50; p < 0.00001). The mean dietary calcium intake of the study group (827.84 mg/day; SD 347.04) was lower than the dietary reference intake for young adults (1000 mg/day) and had no association with BUA. None of the three VDR polymorphisms tested showed an association with BUA. Similarly, the analysis of VDR 3' haplotypes, estimated using rs9729 and Taq1 as tag SNPs, did not reveal any significant association with QUS traits. Our results confirm the existence of different heel QUS for women and men, as well as a tendency towards low calcium consumption by young adults, and they also suggest that the VDR gene does not play a major role in the genetic determination of QUS parameter in early adulthood.

A randomized controlled trial of the effect of a photographic display with and without music on pre-operative anxiety.

AIMS: To determine the effectiveness of photographic display at reducing pre-operative anxiety in an ear, nose and throat surgery unit; alone and in combination with music. BACKGROUND: The waiting time prior to the surgery is often unpleasant and a time of anxiety for patients. Anxiety can affect physical recovery and psychological well-being; lengthening convalescence and hospital stay after the surgery. Improving pre-operative anxiety is a challenge with potential impacts on improving patients' satisfaction and well-being and decreasing the cost of care. DESIGN: A clinical trial was conducted with two intervention groups and one control group. METHODS: The sample consisted of 180 subjects from the otolaryngology major ambulatory surgery unit in a tertiary hospital in the province of Granada, with 60 subjects per group. The outcome variables measured were state anxiety, heart and respiratory rate and blood pressure. The data were collected from May-December 2013. RESULTS: After the intervention, in the comparison between control group and photographic display group, all variables had lower means in the intervention group, although a significant P value was only obtained for respiratory rate using one-way anova test. When comparing control group and photographic display combined with music group, using one-way anova test, all mean values were lower in the intervention group and a significant P value were observed for all variables except diastolic blood pressure. CONCLUSION: Photographic display in combination with music is more effective at reducing pre-operative anxiety than the standard intervention and photographic display alone.

Effects of supervised exercise on cancer-related fatigue in breast cancer survivors: a systematic review and meta-analysis.

BACKGROUND: Cancer-related fatigue (CRF) is the most common and distressing symptom in breast cancer survivors. Approximately 40% to 80% of cancer patients undergoing active treatment suffer from CRF. Exercise improves overall quality of life and CRF; however, the specific effects of the training modalities are not well understood. METHODS: This study aimed to determine the pooled effects of supervised exercise interventions on CRF in breast cancer survivors. We searched PubMed/MEDLINE, EMBASE, Scopus, CENTRAL and CINAHL databases between December 2013 and January 2014 without language restrictions. Risk of bias and methodological quality were evaluated using the PEDro score. Pooled effects were calculated with a random-effects model according to the DerSimonian and Laird method. Heterogeneity was evaluated with the I (2) test. RESULTS: Nine high-quality studies (n = 1156) were finally included. Supervised aerobic exercise was statistically more effective than conventional care in improving CRF among breast cancer survivors (SMD = -0.51, 95%CI -0.81 to -0.21), with high statistical heterogeneity (P = 0.001; I (2) = 75%). Similar effects were found for resistance training on CRF (SMD = -0.41, 95%CI -0.76 to -0.05; P = 0.02; I(2) = 64%). Meta-regression analysis revealed that exercise volume parameters are closely related with the effect estimates on CRF. Egger's test suggested moderate evidence of publication bias (P = 0.04). CONCLUSIONS: Supervised exercise reduces CRF and must be implemented in breast cancer rehabilitation settings. High-volume exercises are safe and effective in improving CRF and overall quality of life in women with breast cancer. Further research is encouraged. TRIAL REGISTRATION: CRD42014007223.

Metabolic syndrome in Spanish adolescents and its association with birth weight, breastfeeding duration, maternal smoking, and maternal obesity: a cross-sectional study.

PURPOSE: The metabolic syndrome (MetS) in adolescents is a growing problem. The objectives were to verify the association among early predictors such as birth weight, breastfeeding, maternal weight status, smoking during pregnancy, and the development of MetS. METHODS: A cross-sectional study was performed of 976 children and adolescents, 10-15 years of age, at schools in the provinces of Granada and Almeria (Spain). For this purpose, we analyzed the physical characteristics as well as the biochemical markers of the participants with a view to ascertaining the prevalence of the MetS. Relevant data were also extracted from the clinical histories of their mothers. RESULTS: It was found that 3.85% of the female subjects and 5.38% of the male subjects in the sample population suffered from MetS. In both sexes, there was an association between birth weight and positive MetS diagnosis (OR 1.27). For both males and females, there was an inverse association between the length of time that they had been breastfed and positive MetS diagnosis (OR1-3 months 3.16; OR4-6 months 1.70; OR(>6 months) 0.13). There was also a significant association between maternal weight (OR(overweight )30.79; OR(obesity) 49.36) and cigarette consumption during pregnancy (OR 1.47) and the subsequent development of MetS in the children of these mothers. CONCLUSIONS: Those subjects born with a higher than average birth weight had a greater risk of developing MetS in childhood and adolescence. Breastfeeding children for longer than 6 months protected them from MetS in their early years as well as in their teens. Other risk factors for MetS were maternal smoking during pregnancy as well as maternal overweight and obesity.