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This article belongs to the Special Issue Selected Papers from NUTRIMAD 2018. Diet-related risk factors and physical inactivity are among the leading risk factors for disability and are responsible for a large proportion of the burden of chronic non-communicable diseases. Food-based dietary guidelines (FBDGs) are useful tools for nutrition policies and public health strategies to promote healthier eating and physical activity. In this paper, we discuss the process followed in developing the dietary guidelines for the Spanish population by the Spanish Society of Community Nutrition (SENC) and further explain the collaboration with primary healthcare practitioners as presented in the context of the NUTRIMAD 2018 international congress of SENC. From a health in all policies approach, SENC convened a group of experts in nutrition and public health to review the evidence on diet-health, nutrient intake and food consumption in the Spanish population, as well as food preparation, determinants and impact of diet on environmental sustainability. The collaborative group drafted the document and designed the graphic icon, which was then subject to a consultation process, discussion, and qualitative evaluation. Next, a collaborative group was established to plan a dissemination strategy, involving delegates from all the primary healthcare scientific societies in Spain. A product of this collaboration was the release of an attractive, easy-to-understand publication.

OBJECTIVE Common circadian-related gene variants associate with increased risk for metabolic alterations including type 2 diabetes. However, little is known about whether diet and sleep could modify associations between circadian-related variants (CLOCK-rs1801260, CRY2-rs11605924, MTNR1B-rs1387153, MTNR1B-rs10830963, NR1D1-rs2314339) and cardiometabolic traits (fasting glucose [FG], HOMA-insulin resistance, BMI, waist circumference, and HDL-cholesterol) to facilitate personalized recommendations. RESEARCH DESIGN AND METHODS We conducted inverse-variance weighted, fixed-effect meta-analyses of results of adjusted associations and interactions between dietary intake/sleep duration and selected variants on cardiometabolic traits from 15 cohort studies including up to 28,190 participants of European descent from the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium. RESULTS We observed significant associations between relative macronutrient intakes and glycemic traits and short sleep duration ( CONCLUSIONS Our results suggest that lower carbohydrate intake and normal sleep duration may ameliorate cardiometabolic abnormalities conferred by common circadian-related genetic variants. Until further mechanistic examination of the nominally significant interactions is conducted, recommendations applicable to the general population regarding diet—specifically higher carbohydrate and lower fat composition—and normal sleep duration should continue to be emphasized among individuals with the investigated circadian-related gene variants.

This chapter addresses development of technical approaches for assessment of circadian rhythm, meal patterns, physical activity and sleep patterns in outpatient settings. The daily patterns of feeding, energy utilization, and energy storage across the 24-hour cycle are based on a neuro-endocrinological system. Physical activity interferes with circadian rhythm parameters. Circadian misalignment of sleep results in particular metabolic disturbances, including dysregulation in the hypothalamic–pituitary–adrenal (HPA) axis, increased cortisol secretion, higher fasting insulin concentrations, and a higher homeostasis model assessment of insulin resistance (HOMA-IR) index. In order to increase the reliability of circadian monitoring, integrated variables obtained from processing individual variables have been recently proposed. Measurement of circadianity is based on the responsiveness of the circadian pacemaker to light of the pineal melatonin rhythm. Synchronously with the onset of melatonin secretion, a fall in body temperature via cutaneous vasodilatation occurs in evening, and opposite occurs in morning. The rhythm of skin peripheral temperature has been proposed to measuring central temperature.

Cardiotrophin (CT)-1 is a regulator of glucose and lipid homeostasis. In the present study, we analyzed whether CT-1 also acts to peripherally regulate metabolic rhythms and adipose tissue core clock genes in mice. Moreover, the circadian pattern of plasma CT-1 levels was evaluated in normal-weight and overweight subjects. The circadian rhythmicity of oxygen consumption rate (Vo2) was disrupted in aged obese CT-1-deficient (CT-1-/-) mice (12 mo). Although circadian rhythms of Vo2 were conserved in young lean CT-1-/- mice (2 mo), CT-1 deficiency caused a phase shift of the acrophase. Most of the clock genes studied (Clock, Bmal1, and Per2) displayed a circadian rhythm in adipose tissue of both wild-type (WT) and CT-1-/- mice. However, the pattern was altered in CT-1-/- mice toward a lower percentage of the rhythm or lower amplitude, especially for Bmal1 and Clock. Moreover, CT-1 mRNA levels in adipose tissue showed significant circadian fluctuations in young WT mice. In humans, CT-1 plasma profile exhibited a 24-h circadian rhythm in normal-weight but not in overweight subjects. The 24-h pattern of CT-1 was characterized by a pronounced increase during the night (from 02:00 to 08:00). These observations suggest a potential role for CT-1 in the regulation of metabolic circadian rhythms.-López-Yoldi, M., Stanhope, K. L., Garaulet, M., Chen, X. G., Marcos-Gómez, B., Carrasco-Benso, M. P., Santa Maria, E. M., Escoté, X., Lee, V., Nunez, M. V., Medici, V., Martínez-Ansó, E., Sáinz, N., Huerta, A. E., Laiglesia, L. M., Prieto, J., Martínez, J. A., Bustos, M., Havel, P. J., Moreno-Aliaga, M. J. Role of cardiotrophin-1 in the regulation of metabolic circadian rhythms and adipose core clock genes in mice and characterization of 24-h circulating CT-1 profiles in normal-weight and overweight/obese subjects.

Evidence has grown supporting the role for short sleep duration as an independent risk factor for weight gain and obesity. The purpose of the present study was to examine the relationship between sleep duration and dietary quality in European adolescents. The sample consisted of 1522 adolescents (aged 12·5–17·5 years) participating in the European multi-centre cross-sectional ‘Healthy Lifestyle in Europe by Nutrition in Adolescence’ study. Sleep duration was estimated by a self-reported questionnaire. Dietary intake was assessed by two 24 h recalls. The Diet Quality Index for Adolescents with Meal index (DQI-AM) was used to calculate overall dietary quality, considering the components dietary equilibrium, dietary diversity, dietary quality and a meal index. An average sleep duration of ≥ 9 h was classified as optimal, between 8 and 9 h as borderline insufficient and r 0·130, Psd 14·18)) and borderline insufficient sleep (64·25 (sd 12·87)) scored lower on the DQI-AM than adolescents with an optimal sleep duration (64·57 (sd 12·39)) (PP= 0·018). The present study demonstrated in European adolescents that short sleep duration was associated with a lower dietary quality. This supports the hypothesis that the health consequences of insufficient sleep may be mediated by the relationship of insufficient sleep to poor dietary quality.

Introducción: Conocer la talla final de un individuo antes de finalizar el crecimiento presenta utilidad clínica para el seguimiento de la salud infantil. Objetivo: Calcular la talla diana de una población rural del sudeste de España y comparar con la talla final alcanzada. Métodos: Fueron incluidos 50 jóvenes de 18 a 22 años (44% hombres) y 100 progenitores. La selección de los jóvenes se realizó en 2 fases: 1. Estudio retrospectivo a partir de historias clínicas. 2. Estudio prospectivo: reclutamiento y determinaciones antropométricas. Se calculó talla diana y el desvío de talla. Resultados: La talla final de los chicos fue de 4,44 cm superior a la talla diana (p0,05). La edad de mayor correlación con la talla final fue a los 10 años en los chicos (r=0,819) y a los 14 años en las chicas (r=0,959). La obesidad final (IMC) de los chicos se correlacionó con la del padre (r=0,575; p

Introducción: Conocer la talla final de un individuo antes de finalizar el crecimiento presenta utilidad clínica para el seguimiento de la salud infantil. Objetivo: Calcular la talla diana de una población rural del sudeste de España y comparar con la talla final alcanzada. Métodos: Fueron incluidos 50 jóvenes de 18 a 22 años (44% hombres) y 100 progenitores. La selección de los jóvenes se realizó en 2 fases: 1. Estudio retrospectivo a partir de historias clínicas. 2. Estudio prospectivo: reclutamiento y determinaciones antropométricas. Se calculó talla diana y el desvío de talla. Resultados: La talla final de los chicos fue de 4,44 cm superior a la talla diana (p0,05). La edad de mayor correlación con la talla final fue a los 10 años en los chicos (r=0,819) y a los 14 años en las chicas (r=0,959). La obesidad final (IMC) de los chicos se correlacionó con la del padre (r=0,575; p

Chronobiology is a word derived from three Greek stems: kronos for time, bios for life and logos for study. From microarrays studies, now it is accepted that 10-30% of the human genome is under the control of circadian molecular clocks. This implies that most behavioral, physiological and biochemical variables display circadian rhythms in their expression. In its simplest form, circadian clocks are composed of a set of proteins that generate self-sustained circadian oscillations. The molecular clock comprises two transcription factors, CLOCK and BMAL1, whereas PERs and CRYs are responsible for the negative limb. One of the most important questions related to the circadian system and obesity, was to elucidate if adipose tissue displayed circadian rhythmicity or whether it had an internal peripheral clock. Our group of research has provided an overall view of the internal temporal order of circadian rhythms in human adipose tissue. A new concept related to illness is Chronodisruption (CD). It is defined as a relevant disturbance of the internal temporal order of physiological and behavioral circadian rhythms. In our modern society, CD may be common in several conditions such as jet lag, shift work, light at night, or social jet lag. In addition clock gene polymorphisms and aging may have also chronodisruptive effects. Our group has also demonstrated that Obesity and CD are also highly interconnected. With the help of chronobiology we can reach a new view of obesity considering not only "what" are the factors involved in obesity, but also "when" these factors are produced. Cronobiología es una palabra de origen griego: kronos significa tiempo, bios, vida y logos, estudio. A partir de los estudios de microarrays, se acepta en la actualidad que del 10 al 30% del genoma humano queda bajo el control de relojes moleculares circadianos. Este implica que la expresión de la mayor parte de las variables de la conducta, psicológicas y bioquímicas muestran ritmos circadianos. En su forma más sencilla, los relojes circadianos están compuestos por un conjunto de proteínas que generan oscilaciones circadianas automantenidas. El reloj molecular comprende dos factores de trascripción, CLOCK y BMAL1, mientras que los PERs y los CRYs son responsables de la fracción negativa. Una de las preguntas más importantes relacionadas con el sistema circadiano y la obesidad fue dilucidar si el tejido adiposo mostraba un ritmo circadiano o si poseía un reloj periférico interno. Nuestro grupo de investigación proporcionó una visión de conjunto del orden temporal interno de los ritmos circadianos del tejido adiposo humano. Un nuevo concepto relacionado con la enfermedad es el de cronodisrupción (CD). Se define como una alteración relevante del orden temporal interno de los ritmos circadianos fisiológicos y conductuales. En nuestra sociedad moderna, la CD podría ser frecuente en diversos trastornos como el jet lag, el trabajo a turnos, la luz nocturna o el jet lag social. Además, los polimorfismos de los genes horarios y el envejecimiento también podrían tener efectos de cronodisrupción. Nuestro grupo también ha demostrado que la obesidad y la CD están muy interconectadas. Con la ayuda de la cronobiología podemos llegar a un nuevo enfoque de la obesidad, considerando no solamente "cuáles" son los factores implicados en la obesidad, sino también "cuándo" se producen estos factores.

Introducción: El método de pérdida de peso (dieta mediterránea, terapia de comportamiento y educación nutricional) ha mostrado ser efectivo en el tratamiento de la obesidad. Objetivo: El objetivo del presente trabajo es evaluar y comparar la calidad de las dietas ingeridas antes y durante el tratamiento mediante el Índice de Alimentación Saludable (IAS) y su relación con diferentes variables. Materiales y métodos: La muestra fue de 392 pacientes (330 mujeres, 62 hombres), edad 39,3 ± 11,5 años y IMC de 31,2 ± 5,3 kg/m². A partir del recuerdo-24 h previo al tratamiento y del registro dietético 7 días se estimó el IAS de "antes" y "durante" tratamiento. El IAS consta de 10 variables que representan el cumplimiento de objetivos nutricionales para la población española (SENC, 2004). Resultados: Dieta previa, presentó un IAS "necesita mejorar" (68,6 ± 11,6) con lípidos (%) (43,9 ± 8,4) y AGS (% lípidos) (67,4 ± 20,1) elevados, además el contenido en AGM (% lípidos) (27,8 ± 15,1) fue insuficiente. El IAS varió en función del IMC siendo el de obesos inferior al de personas con sobrepeso (65,1 ± 11,6 vs 69, 2 ± 13,9; P < 0,05). La dieta ingerida durante el tratamiento mejoró notablemente IAS (91,4 ± 9,7). El IAS de las mujeres fue superior (92,3 ± 9,1) al de los hombres (84,4 ± 12,0) (P < 0,05). Aquellos que alcanzaron la meta de pérdida de peso adquirieron mejores valores de IAS durante el tratamiento que los que no la alcanzaron (92,1 ± 9,2 vs 87,9 ± 11,7) (P < 0,05). Conclusiones: Según el IAS, la calidad de la dieta estudiada durante el tratamiento de pérdida de peso mejoró significativamente en relación a la dieta habitual del paciente. El IAS de la dieta durante el tratamiento se asocia con el sexo, el estado ponderal (sobrepeso y obesidad) y con el éxito del tratamiento (> 5% de pérdida del peso inicial). Introduction: The "Garaulet" Method (Mediterranean Diet, therapy of behavior and nutritional education), has shown to be effective in the treatment of the obesity. Objectives: To evaluate and to compare the quality of the diets ingested before and during the treatment by means of Index-of-Feeding-Healthful (IAS) and its relationship with others variables. Materials and methods: The sample was of 450 patients (383 women, 67 men), age 39.3 + 11.5 years and 31.2 + 5.3 of IMC. IAS of "before" and "during" treatment was calculated with a 24 h-recall previous to the treatment and a Seven-days-dietary-record questionnaire during treatment. The IAS consists of 10 variables that include cereal consumption, fruits, vegetables, dairy products and meats and other variables related to the nutritional guidelines for the Spanish population (SENC, 2004). Results: Habitual dietary habits of the patients were acceptable with an IAS of 67 9 ± 13. However, lipids (43.9 ± 8.4%) and saturated fats (67.4 ± 20.1%) intakes were higher than recommended, while monounsaturated fats were lower (27.8 ± 15.1%). The IAS varied with the BMI and was significantly lower among obese subjects (65.1 ± 11.6) as compared to overweight (69.2 ± 13.9) (P < 0.05). Diet during the treatment, significantly improved with an IAS of 91.4 ± 9.8). IAS of the women studied was better (92.3 ± 9.0) than the one of men (86.4 ± 11.8) (P < 0.05). Patients who reached the goal in weight loss acquired better values of IAS (92.1 ± 9.2) during the treatment that those that did not reach it (87.9 ± 11.7) (P < 0.05). Conclusion: In this Spanish population, the diet studied, is useful to promote weight loss through the introduction of changes in dietary habits towards the reincorporation of the Mediterranean cultural tradition.

Disruption of the circadian system may be causal for manifestations of the metabolic syndrome (MetS).The objective was to study the associations of 5 CLOCK polymorphisms with MetS features by analyzing fatty acid (FA) composition from dietary and red blood cell (RBC) membrane sources.Participants (n = 1100) in the Genetics of Lipid Lowering Drugs and Diet Network (GOLDN) study were included. Dietary intake was estimated with a validated questionnaire. Anthropometric and biochemical measurements and genotypes were determined. Postprandial lipids and the FA composition of RBC membranes were analyzed.CLOCK single nucleotide polymorphisms were significantly associated with obesity and individual components of MetS. For single nucleotide polymorphism rs4580704, minor allele carriers had a 46% lower risk of hypertension than did noncarriers. The monounsaturated fatty acid (MUFA) content of RBC membranes, particularly oleic acid, changed according to CLOCK genetic variants (P0.05). We identified significant gene-diet interactions associated with MetS at the CLOCK locus. By dichotomizing MUFA intake, we found different effects across rs4580704 genotypes for glucose (P = 0.020) and insulin resistance (P = 0.026). The protective effect of the minor allele on insulin sensitivity was only present when MUFA intake was13.2% of energy. We also found different effects across CLOCK 3111T--C genotypes for saturated fatty acid intake (% of energy) (P = 0.017). The deleterious effect of gene variants on waist circumference was only found with high saturated fatty acid intakes (11.8%).CLOCK polymorphisms interact with FAs to modulate MetS traits. The dietary source and membrane content of MUFAs are implicated in the relations between alterations in the circadian system and MetS.

The importance of metabolic syndrome (MetS) lies in its associated risk of cardiovascular disease and type 2 diabetes, as well as other harmful conditions such as nonalcoholic fatty liver disease. In this report, the available scientific evidence on the associations between lifestyle changes and MetS and its components is reviewed to derive recommendations for MetS prevention and management. Weight loss through an energy-restricted diet together with increased energy expenditure through physical activity contribute to the prevention and treatment of MetS. A Mediterranean-type diet, with or without energy restriction, is an effective treatment component. This dietary pattern should be built upon an increased intake of unsaturated fat, primarily from olive oil, and emphasize the consumption of legumes, cereals (whole grains), fruits, vegetables, nuts, fish, and low-fat dairy products, as well as moderate consumption of alcohol. Other dietary patterns (Dietary Approaches to Stop Hypertension, new Nordic, and vegetarian diets) have also been proposed as alternatives for preventing MetS. Quitting smoking and reducing intake of sugar-sweetened beverages and meat and meat products are mandatory. Nevertheless, there are inconsistencies and gaps in the evidence, and additional research is needed to define the most appropriate therapies for MetS. In conclusion, a healthy lifestyle is critical to prevent or delay the onset of MetS in susceptible individuals and to prevent cardiovascular disease and type 2 diabetes in those with existing MetS. The recommendations provided in this article should help patients and clinicians understand and implement the most effective approaches for lifestyle change to prevent MetS and improve cardiometabolic health.

The major function of the circadian system is the internal cycling of physiologic and metabolic events. In the last years, there has been an exponential increase in our understanding of the role of clock-related genes in Metabolic-syndrome (MetS) -related phenotypes. Nevertheless, our understanding about how the components of the circadian system interact each other to modulate the metabolism and cardiovascular system remains a major challenge. Systems biology introduces a new concept for revealing the pathogenesis of human disorders and suggests the presence of common physiologic processes and molecular networks influencing the risk of a disease. In this review, we use systems biology approaches to integrate genomic, molecular, and physiological data to decipher putative circadian rhythmic pathways suspected to play a role in the etiology of the metabolic syndrome (MetS)-associated phenotypes with a main focus in obesity and as other authors are discussing diverse related topics, we will discuss the findings of our own group. Fil: Sookoian, Silvia Cristina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Médicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina Fil: Pirola, Carlos José. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Médicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina