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This article belongs to the Special Issue Nutrition, Diet and Public Health: Assessment in Different Individuals and Groups., Excess weight (EW) in children has become a severe public health problem. The present study aimed to describe the main lifestyle characteristics and their possible association with nutritional status in a group of schoolchildren enrolled in the GENYAL study, where 221 children in the first or second grade of primary education (6–9 years old) were included. Anthropometric (BMI and bioimpedance), dietary intake (twice-repeated 24 h food record), and physical activity (twice-repeated 24 h physical activity questionnaire) data were collected. Logistic and linear regressions, with p-values adjusted for multiple tests by Bonferroni’s method and with sex and age as covariates, were applied. The prevalence of EW was 19%, 25.4%, and 32.2%, according to Orbegozo Foundation, IOFT, and WHO criteria, respectively. The results showed a significant association between schoolchildren’s nutritional status and energy balance, defined as the ratio of estimated energy intake to estimated energy expenditure (%), (β = −1.49 (−1.9–1.07), p < 0.01) and KIDMED Mediterranean Diet Quality Index score (β = −0.19 (95% IC −0.38–0), p = 0.04), and between the availability of TV or other technological devices in their room and the child’s BMI (β = 1.15 (95% IC 0.20–2.10), p = 0.017) and their fat mass (β = 3.28 (95% IC 0.69–5.87), p = 0.013). The number of dairy servings/day had a protective effect against EW (OR = 0.48 (0.29–0.75), p adjusted = 0.05)). Studying lifestyle factors associated with obesity is essential for developing tools and strategies for obesity prevention in children., This research was supported by Conserjería de Educación, Universidades y Ciencia de la Comunidad de Madrid, Dirección General de Educación Infantil, Primaria y Secundaria.

Background: Diet quality patterns are associated with a lower incidence of insulin resistance (IR) in adults. The aim of this study was to investigate the association between two diet quality indices and IR in schoolchildren and to identify the best diet quality index associated with a lower risk of IR. Methods: A total of 854 schoolchildren (8–13 years) were included in a cross-sectional study, who completed a three-day dietary record to assess their diet. Fasting plasma glucose and insulin were also measured, and anthropometric data were collected. Healthy Eating Index-2015 (HEI-2015), Dietary Approaches to Stop Hypertension (DASH), and adjusted DASH (aDASH) were calculated as diet quality indices. The homeostasis model assessment of insulin resistance (HOMA-IR) was used, and IR was defined as HOMA-IR > 3.16. Results: The prevalence of IR was 5.5%, and it was higher in girls. The mean HEI-2015 and DASH scores were 59.3 and 23.4, respectively, and boys scored lower in both indices. In girls, having a HEI-2015 score above the 33rd percentile was associated with a lower risk of IR (odds ratio [95% CI]: 0.43 [0.19–0.96], p = 0.020). Conclusion: Greater adherence to a healthy dietary pattern, as assessed by a higher HEI-2015 score, was associated with a lower risk of IR in schoolchildren, especially in girls.

European Union represents a tenth of the world population, however, it has a quarter of the cancer cases in the world. Without strong action, it is estimated that by 2035 cancer cases will increase by almost 25 %, making this disease the main cause of death. Therefore, the aim of this study is to know the diet and lifestyle guidelines associated to cancer prevention. A literature review has been carried out on the diet and lifestyle guidelines related to a reduction in cancer risk. Strategies to reduce cancer risk include maintaining a healthy weight, being physically active, consuming a diet rich in whole grains, fruits, non-starchy vegetables, and legumes, limit processed and fast food, limit consumption of red meat and eat little, if any, processed meats, drink mostly water and limit the consumption of sugar sweetened drinks, finally reduce, or do not consume alcohol. Prevention is an effective tool to reduce cancer risk. Adequate diet and healthy lifestyle habits can reduce cancer risk as well as other non-communicable diseases and can even have environmental benefits.La Unión Europea representa una décima parte de la población mundial, pero tiene un cuarto de los casos de cáncer de todo el mundo. Sin una acción contundente, se estima que en 2035 los casos de cáncer aumentarán casi un 25 %, lo que convertirá a esta enfermedad en la principal causa de muerte. Por ello, el objetivo del presente estudio es conocer las pautas de alimentación y de estilo de vida que influyen en la prevención del cáncer. Para ello se ha realizado una revisión bibliográfica de las pautas de alimentación y de los principales estilos de vida que se relacionan con una reducción del riesgo de padecer cáncer. Entre las estrategias para reducir el riesgo de cáncer se encuentran el mantenimiento de un peso saludable a lo largo de toda la vida, ser físicamente activo, consumir una dieta rica en cereales integrales, frutas, verduras no almidonadas y legumbres, limitar el consumo de alimentos procesados y de comida rápida, limitar el consumo de carne roja y consumir poco o nada de carnes procesadas, consumir principalmente agua y limitar el consumo de bebidas azucaradas, y por último, reducir el consumo de alcohol o no consumirlo. La prevención es una herramienta eficaz para reducir el riesgo de padecer cáncer. Una adecuada alimentación y hábitos de vida saludables reducirán el riesgo de padecer cáncer en el futuro, así como otras enfermedades no transmisibles e, incluso, beneficios medioambientales.

The gut microbiota has emerged as a key factor on one hand as a mediator of the effects of diet on health and, on the other hand, as a source of intervariability of response to a diet. Moreover, there is a strong bidirectional interaction between our health and the microbiota that inhabit us, with each determining the presence of the other. In this review are named some of the metabolic functions in which the microbiota participates and which have an impact on our health, with particular emphasis on its ability to ferment fiber and produce short-chain fatty acids (SCFA) that provide numerous benefits to our health, but which have also been linked to obesity. Finally, some examples of dietary intervention in which the microbiota has been shown to play a key role in the results obtained are mentioned.La microbiota intestinal se ha revelado como un factor clave, por un lado, como mediador de los efectos de la dieta en la salud y, por otro lado, como fuente de intervariabilidad de respuesta a una dieta. Además, existe una fuerte interacción bidireccional entre nuestra salud y la microbiota que nos habita, determinando cada uno la presencia del otro. En esta revisión se nombran algunas de las funciones metabólicas en las que participa la microbiota y que tienen un impacto en nuestra salud, con especial hincapié en su capacidad para fermentar la fibra y producir ácidos grasos de cadena corta (AGCC), que aportan numerosos beneficios a nuestra salud, pero que también se han relacionado con la obesidad. Por último, se nombran algunos ejemplos de intervención dietética en los que se ha demostrado que la microbiota cumple un papel fundamental en los resultados obtenidos.

Introduction: Celiac disease (CeD) is an autoimmune disease affecting the small intestine due to gluten consumption. The treatment involves adherence to a gluten-free diet (GFD); however, up to 30% of patients show symptoms after one year on a GFD, presenting non-responsive CeD (NR-CeD). Evidence suggests that the microbiome plays a role in CeD progression and symptoms manifestations. Here we study the association of microbiome profiles with the persistence of symptoms in NR-CeD. Methods: We performed shotgun metagenomics to stool samples of NR-CeD patients (n=40). We integrate the results with public data from healthy controls (n=37) and patients with CeD undergoing GFD (n=52). We performed an analysis combining the datasets, calculated diversity indexes, and performed a Linear discriminant analysis integrated with effect size (LEfSe) to find microbial biomarkers of each condition. Results: We found that the microbiome of NR-CeD was less diverse than healthy controls and R-CeD (Table). After LEfSe analysis (Figure) we found that the microbiome from healthy controls was dominated by bacteria from the phylum Firmicutes and Actinobacteria (i.e: f_Ruminocacceae, g_Bifidobacterium,). The R-CeD microbiome was characterised by bacteria from the phylum Proteobacteria, Verrucomicrobia, and Firmicutes (c_Clostridia, c_Negativicutes). NR-CeD microbiome was enriched in bacteria from the phylum Bacteroidetes (o_Bacteroidales), and Firmicutes (c_Clostridia). Conclusion: CeD patients under prolonged treatment shift their microbiome differently than healthy controls and NR-CeD, suggesting specific microbial changes associated with symptoms prevalence. Moreover, we found microbial biomarkers associated with NR-CeD, mainly genus related to active CeD in the literature (Bacteroides spp.)

Vitamin D is a key nutrient for health. Recent research has shown that it is not only necessary for the maintenance of bone health, but also for the prevention of cardiovascular diseases, insulin resistance, respiratory diseases, infections, and cancer, among others. Solar synthesis of vitamin D is usually insufficient, so it is necessary to provide enough vitamin D through the diet in order to maintain an adequate nutritional status. Studies carried out in Spain and other countries have shown that serum levels of the vitamin were usually insufficient and that average dietary intakes were well below those marked as recommended, while the main food sources of vitamin D were fatty fish, breakfast cereals, eggs, and dairy. Food sources of vitamin D are scarce, and it is naturally located in the fatty part of foods of animal origin, and in the liver and viscera. Fortifying foods that are not natural food sources of vitamin D but are regularly consumed by a significant percentage of the population, is a strategy that could help to increase vitamin D intake. In this regard, dairy products and breakfast cereals are two of the most widely used food matrices for vitamin D fortification, and their incorporation into the usual diet has proven to be an effective strategy to improve the nutritional situation of the population in vitamin D.La vitamina D es clave en la salud y sus funciones se relacionan con el mantenimiento de la salud ósea, cardiovascular, la resistencia a la insulina, enfermedades respiratorias, infecciones y cáncer, entre otras. La síntesis solar de la vitamina D es con frecuencia insuficiente, por lo que para mantener un estatus adecuado de la vitamina es necesario que se aporten cantidades suficientes con la dieta. Los estudios realizados en España y en otros países muestran que los niveles séricos de la vitamina son con frecuencia insuficientes y que las ingestas dietéticas medias se encuentran muy por debajo de las marcadas como recomendadas. Las principales fuentes alimentarias de la vitamina D son los pescados grasos, los cereales de desayuno, los huevos y los lácteos. Las fuentes alimentarias de vitamina D son escasas y se encuentra especialmente en la parte grasa de alimentos de origen animal, en hígados y en vísceras. El enriquecimiento de alimentos que de forma natural no tienen un elevado contenido en vitamina D, pero que son consumidos habitualmente por un porcentaje significativo de la población, es una estrategia que ayuda a aumentar su ingesta. En este sentido, los lácteos y los cereales de desayuno son dos de las matrices alimentarias más utilizadas y su incorporación en la dieta habitual ha demostrado ser una estrategia eficaz para mejorar la situación nutricional de la población respecto a la vitamina D.

The consumption of high nutritional quality foods is a key for proper growth and development during childhood. This work aimed to review and analyse the current recommended egg intake in children by different national organisations. Likewise, it intended to standardise a procedure to propose new recommendations for this food. A search of available national online guidelines or recommendations was performed. The Healthy Eating Guide of the Spanish Society of Community Nutrition (SENC), 2018 and the energy requirements of the European Food Safety Authority (2017) for children and adolescents were contemplated, considering a contribution of 15 % of energy as proteins to propose the new recommended egg intake. Two scenarios according to the level of physical activity and three age groups were considered. Based on the current data and evidence, we believe that egg intake recommendations should be reassessed, proposing broader recommendations, especially for children over 13 years old with average energy requirements as well as children over seven years old who perform high physical activity or are in a brief period of growth. It will contribute to breaking down old myths associated with egg consumption and promote the development of coordinated and updated recommendations.Durante la edad infantil, el consumo de alimentos de alta calidad nutricional es clave para un adecuado crecimiento y desarrollo. Este trabajo se desarrolló con el objetivo de revisar y de analizar la frecuencia y la cantidad de consumo de huevo actualmente aconsejado por diferentes organismos en el ámbito nacional. Asimismo, se buscó estandarizar un procedimiento para proponer unas nuevas recomendaciones de consumo de este alimento. Para ello, se realizó una búsqueda digital de las guías o recomendaciones nacionales disponibles. Para proponer la nueva recomendación se trabajó con las frecuencias y con las raciones de los alimentos clasificados por grupos de la Guía de la alimentación saludable de la Sociedad Española de Nutrición Comunitaria (SENC), 2018, y con los requerimientos de energía para niños y niñas y adolescentes propuestos por la European Food Safety Authority de 2017, considerando un aporte del 15 % de la energía en forma de proteínas. Se contemplaron dos escenarios de acuerdo al nivel de actividad física y se hizo una clasificación en tres grupos de edad. Con base en los datos y en la evidencia actual, consideramos que las recomendaciones de consumo de huevo deben ser reevaluadas para proponer unas recomendaciones más amplias, especialmente para niños mayores de 13 años con requerimientos medios de energía y niños mayores de 7 años que realicen una actividad física elevada o que se encuentren en un periodo de rápido empuje puberal. Esto contribuirá a derribar viejos mitos asociados a este alimento con tanto potencial para la población infantil y adolescente y al desarrollo de unas recomendaciones más coordinadas y revisadas.

In recent decades, there has been an increasing interest in vegetarian diets. It is therefore interesting to analyse the benefits and risks of these diets. To this end, a review has been done on the benefits and risks of vegetarian diets. Vegetarian diets have been associated with different health benefits. On the contrary, nutritional deficiencies has been observed in those people who follow this type of diet, mainly in those risk groups such as pregnant and lactating women, children, adolescents, and elderly. Vegetarian diets may have some health benefits, however further studies are required.En las últimas décadas se ha observado un incremento en el interés por el seguimiento de las dietas vegetarianas en la población, por lo que es interesante analizar sus beneficios y sus riesgos. Con este fin se ha realizado una revisión sobre los beneficios y los riesgos de las dietas vegetarianas. Las dietas vegetarianas se han asociado a diferentes beneficios para la salud. De forma contraria, se observan deficiencias nutricionales en aquellas personas que siguen este tipo de dietas, principalmente en grupos de riesgo como mujeres embarazadas y lactantes, niños, adolescentes y ancianos. Las dietas vegetarianas podrían tener algunos beneficios en relación con la salud, sin embargo, es necesario continuar realizando estudios.

Background: Breakfast has traditionally been considered one of the most important meals of the day; however, there is little evidence for the influence of breakfast quality and insulin resistance (IR). This study aimed to assess the quality of breakfast in a group of schoolchildren, and its association with IR. Methods: A cross-sectional study with 852 children (8–13 years) was carried out. Fasting plasma glucose, insulin and anthropometric parameters were measured. A three-day dietary record was used to assess their diet and to calculate the Breakfast Quality Index (BQI). The sample was divided into tertiles according to the BQI (tertile 3: better breakfast quality). The homeostatic model was used to assess insulin resistance (HOMA-IR), and IR was defined as HOMA-IR > 3.16. Results: The prevalence of IR was 5.2%. The mean BQI score was 4.50 ± 1.25, and boys had lower scores than girls. Children in the BQI tertile 3 had a better global diet quality. In boys, being in the BQI tertile 3 was associated with a lower risk of IR (OR [95% CI]: 0.10 [0.01–0.77], p < 0.05). Conclusions: A higher-quality breakfast was associated with better overall diet quality and a lower risk of IR, especially in boys.

Background: Dysbiosis of the microbiome has been related to the Celiac disease (CeD) progress, an autoimmune disease characterised by gluten intolerance developed in genetically susceptible individuals under certain environmental factors. The microbiome contributes to CeD pathophysiology modulating the immune response by the action of short-chain fatty acids (SCFA), affecting gut barrier integrity allowing the entrance of gluten derived proteins, and degrading immunogenic peptides of gluten through endoprolyl peptidase enzymes. Results: We reviewed state of the art in taxonomic composition for CeD and compiled the larger dataset of 16S prokaryotic ribosomal RNA (rRNA) gene high-throughput sequencing for consensus profiling. We present for the first time an integrative analysis of metataxonomic data from CeD patients, including samples from different body sites (saliva, pharynx, duodenum, and stool). We found the presence of coordinated changes through the gastrointestinal tract characterised by an increase in Actinobacteria species in the upper tract (pharynx and duodenum), and an increase in Proteobacteria in the lower tract (duodenum and stool), as well as site-specific changes evidencing a dysbiosis in CeD patients' microbiota. Moreover, we described the effect of adherence to a gluten-free diet (GFD) evidenced by an increase in beneficial bacteria and a decrease in some Betaproteobacteriales but not fully restoring CeD-related dysbiosis. Conclusions: We illustrate that the gut microbiota acts as an enhancer of immune response in CeD through the production of lipopolysaccharides and other bacterial components that activate the immune response and by decrease SCFA producers bacteria. Furthermore, microbial changes observed through the gastrointestinal tract of CeD patients may help manage the disease and follow-up GFD treatment.

The scarcity of the results obtained for the treatment of obesity leads us to consider new strategies, contemplating all the factors involved in the development of the disease. One of the key molecules for controlling body weight and energy homeostasis is the brain-derived neurotrophic factor (BDNF). This work summarizes the mechanisms in which BDNF gene regulates this multifactorial disease. In addition, we discuss the role of other BDNF polymorphisms as genetic determinants of obesity. In this context, a total of 14 SNPs near or inside BDNF/BDNF-AS related to BMI were identified in various GWASs. Finally, we assess gene-diet interaction as a novel tool to prevent obesity and formulate solid and personalized nutritional management. Our research group has performed the first study on the association of BDNF-AS rs925946 polymorphism and calcium intake as potential modulators of the nutritional status. Although these results should be confirmed in future studies, they open the path for new prevention opportunities.

BackgroundDysbiosis of the microbiome has been related to the Celiac disease (CeD) progress, an autoimmune disease characterised by gluten intolerance developed in genetically susceptible individuals under certain environmental factors. The microbiome contributes to CeD pathophysiology modulating the immune response by the action of short-chain fatty acids (SCFA), affecting gut barrier integrity allowing the entrance of gluten derived proteins, and degrading immunogenic peptides of gluten through endoprolyl peptidase enzymes. We reviewed state of the art in taxonomic composition for CeD and compiled the larger dataset of 16S prokaryotic ribosomal RNA (rRNA) gene high-throughput sequencing for consensus profiling. We present for the first time an integrative analysis of metataxonomic data from CeD patients, including samples from different body sites (saliva, pharynx, duodenum, and stool). We found the presence of coordinated changes through the gastrointestinal tract characterised by an increase in Actinobacteria species in the upper tract (pharynx and duodenum), and an increase in Proteobacteria in the lower tract (duodenum and stool), as well as site- specific changes evidencing a dysbiosis in CeD patients’ microbiota. Moreover, we described the effect of adherence to a gluten-free diet (GFD) evidenced by an increase in beneficial bacteria and a decrease in some Betaproteobacteriales but not fully restoring CeD-related dysbiosis. We illustrate that the gut microbiota acts as an enhancer of immune response in CeD through the production of lipopolysaccharides and other bacterial components that activate the immune response and by decrease SCFA producers bacteria. Furthermore, microbial changes observed through the gastrointestinal tract of CeD patients may help manage the disease and follow-up GFD treatment.

Childhood obesity is an important public health problem, also in Spain. The ALADINO study, in the context of the COSI strategy of the WHO European office, monitors the weight status of Spanish schoolchildren aged 6 to 9 years, and analyzes the associated factors. Data from the 2019 wave indicate that 23.3 % of schoolchildren are overweight, and 17.3 % are obese. A high percentage of schoolchildren eat breakfast regularly, although breakfast quality can be improved. The frequency of consumption of fruits and vegetables is low, even lower than that of other countries participating in the COSI strategy. In terms of lifestyle, more than 70 % of schoolchildren are active, although this percentage is lower than the European average. Screen exposure time is also shorter than in other countries, but this habit may be improved in a high percentage of schoolchildren. There is a lower percentage of schoolchildren with obesity who have breakfast or are active compared to those of normal weight, while they are more sedentary, spend fewer hours sleeping, and are more likely to have a TV or electronic devices in their room. It is a priority to promote access to healthier diets and the promotion of more active and less sedentary lifestyles, both in the family and at school, from an early age.La obesidad infantil es un problema de salud pública importante, también en España. El estudio ALADINO, en el contexto de la estrategia COSI de la Oficina Europea de la OMS, monitoriza la situación ponderal de los escolares españoles de 6 a 9 años y analiza los factores asociados al padecimiento de sobrepeso y obesidad. Los datos de la oleada de 2019 indican que un 23,3 % de los escolares tienen sobrepeso y un 17,3 % tienen obesidad. Un porcentaje elevado de escolares desayuna habitualmente, aunque la calidad de esta comida es muy mejorable. Se constata que la frecuencia de consumo de frutas y verduras es baja e inferior a la de otros países participantes en la estrategia COSI. En cuanto al estilo de vida, más del 70 % de los escolares son activos, aunque este porcentaje es inferior a la media europea. También es menor el tiempo de exposición a pantallas que en otros países, aunque mejorable en un porcentaje elevado de escolares. Hay un menor porcentaje de escolares con obesidad que desayunan o son activos en comparación con los que tiene peso normal, mientras que son más sedentarios, dedican menos horas a dormir, y disponen con mayor probabilidad de TV o dispositivos electrónicos en su habitación. Es prioritario favorecer el acceso a dietas más saludables y la promoción de estilos de vida más activos y menos sedentarios, tanto en el entorno familiar como en el escolar, desde edades tempranas.

The immune system is a complex and integrated system whose main function is to protect the body from external aggression by microorganisms, allergens, or toxic agents. Different studies show that maintaining optimal amounts of different nutrients in the body is essential to ensure the synthesis of different factors related to the immune system. Most interesting nutrients and bioactive compounds include: vitamins A, B6, B12, C, D, E, folic acid (B9) and biotin (B7); minerals such as zinc, iron, selenium, magnesium and copper; proteins (lactoferrin) and bioactive peptides; omega-3 fatty acids; and other nutrients and bioactive compounds such as fiber, polyphenols, carotenoids, probiotics, etc. Following a varied and balanced diet, including the servings recommended by food guides for each food group, is essential to achieve nutrient requirements. Food groups to which special attention should be paid are: fruits and vegetables (because of their high content in micronutrients and antioxidant compounds), fatty fish (because it contains omega-3 fatty acids), and dairy products (because this group contains a large number of nutrients). In particular, milk-especially enriched milk-contains many of the nutrients mentioned above. Moreover, their daily consumption, within a balanced diet, can help significantly cover their nutrient reference values. Finally, it is important to consider kind of milks as a good dietary alternative to increase the intake of some important nutrients for the proper functioning of the immune system, most especially some of them such as vitamin D, since a large percentage of the population have nutritional deficiencies.El sistema inmunitario es un sistema complejo e integrado cuya función principal es proteger al organismo de agresiones externas provocadas por microorganismos, alergenos o agentes tóxicos. Diferentes estudios ponen de manifiesto que el mantenimiento de las cantidades óptimas de diferentes nutrientes es esencial para garantizar la síntesis de diferentes factores y mediadores de este sistema. Entre los nutrientes y compuestos bioactivos con mayor interés destacan: las vitaminas A, B6, B12, C, D, E, ácido fólico (B9) y biotina (B7); minerales como el zinc, hierro, selenio, magnesio y cobre; proteínas (lactoferrina) y péptidos bioactivos; ácidos grasos omega-3, y otros nutrientes y compuestos bioactivos como fibra, polifenoles, carotenoides, probióticos, etc. El seguimiento de una dieta variada y equilibrada que incluya las raciones recomendadas por las guías alimentarias para cada grupo de alimentos es fundamental para alcanzar los requerimientos de estos nutrientes. Y entre los grupos de alimentos a los que se debe prestar especial atención están: las frutas y verduras (por su alto contenido en micronutrientes y compuestos antioxidantes), los pescados azules (por contener omega-3) y los lácteos (por ser alimentos con gran cantidad de nutrientes). En concreto, la leche, especialmente enriquecida, contiene muchos de los nutrientes anteriormente mencionados y su consumo diario, dentro de una dieta equilibrada, puede contribuir a cubrir cantidades importantes de sus valores de referencia. Por último, es importante considerar las leches enriquecidas como una buena alternativa dietética para aumentar la ingesta de muchos nutrientes importantes para el buen funcionamiento del sistema inmune y, en especial, de algunos de ellos, como la vitamina D, en los que un gran porcentaje de la población presenta deficiencias nutricionales.

espanolLa educacion nutricional (EN), dentro del tratamiento de los trastornos de la conducta alimentaria (TCA), juega un papel fundamental ya que contribuye a que el paciente modifique sus actitudes y rutinas en relacion con la comida, pierda miedos y restablezca un patron de alimentacion saludable, favoreciendo de este modo su recuperacion nutricional. Sin embargo, existe falta de consenso y estandarizacion acerca de los procedimientos para llevarla a cabo. El objetivo de este trabajo es elaborar un protocolo consensuado de EN en el contexto del tratamiento de los TCA que permita ayudar a la toma de decisiones sobre: los pacientes candidatos a recibirla, los agentes (familia, comunidad escolar) y profesionales implicados, los ambitos de implementacion de la intervencion, la informacion sobre los pacientes que es necesario conocer, los temas, objetivos y contenidos a trabajar, y la necesidad de evaluacion de la progresion del paciente y los programas desarrollados. EnglishNutrition education (NE), as part of the treatment of eating disorders (EDs), plays a crucial role in helping patients to change their food attitudes and routines, lose fears, and recover a healthy eating pattern. All these changes may contribute to improving their nutritional status. However, there is a lack of consensus and standardization concerning the procedures to teach it. This work’s objective was to elaborate a consensual protocol for NE implementation in the treatment of EDs to help in decision-making regarding which patients are appropriate candidates to receive NE, the agents (family, school community) and professionals involved, and the areas in the healthcare system that are best suited for implementation. Moreover, it would help in selecting the the topics to be imparted, and in following up treatment progression.

Fasting exerts beneficial effects in mice and humans, including protection from chemotherapy toxicity. To explore the involved mechanisms, we collect blood from humans and mice before and after 36 or 24 hours of fasting, respectively, and measure lipid composition of erythrocyte membranes, circulating micro RNAs (miRNAs), and RNA expression at peripheral blood mononuclear cells (PBMCs). Fasting coordinately affects the proportion of polyunsaturated versus saturated and monounsaturated fatty acids at the erythrocyte membrane; and reduces the expression of insulin signaling-related genes in PBMCs. When fasted for 24 hours before and 24 hours after administration of oxaliplatin or doxorubicin, mice show a strong protection from toxicity in several tissues. Erythrocyte membrane lipids and PBMC gene expression define two separate groups of individuals that accurately predict a differential protection from chemotherapy toxicity, with important clinical implications. Our results reveal a mechanism of fasting associated with lipid homeostasis, and provide biomarkers of fasting to predict fasting-mediated protection from chemotherapy toxicity. General: We thank Prof. Jose Maria. Ordovas for his kind suggestions; nutritionists Helena Marcos-Pasero, Elena Aguilar-Aguilar and Isabel Espinosa-Salinas for their help with volunteers management; Rosa Serrano for her help with animal experiments; Susana Molina for her advice with PBMC isolation; Luisa Mariscal, Domingo Fernandez, Lola Martinez, Diego Megias, Patricia Gonzalez, Fernando Pelaez, Anabel Sanz, Carolina Pola, Celia de la Calle, Ana Ortega, Ana Sagrera, Jose Miguel Frade, Elena Lopez-Guadamillas, Maribel Munoz, Susana Llanos, Andres Fernandez, Aranzazu Sierra, Andres Lopez, Noemi Haro and Ildefonso Rodriguez for their excellent technical and scientific support. Work at the laboratory of P.J.F.M. is funded by the Ramon Areces Foundation, (CIVP18A3891), Asociacion Espanola contra el Cancer-AECC (SIRTBIO-LABAE18008FERN), a Ramon y Cajal Award from the Spanish Ministry of Science, Innovation and Universities (MICINN) (RYC-2017-22335), RETOS projects Program of MICINN (SAF2017-85766-R) and the Portuguese Foundation for Science and Technology (FCT-MCTES, SFRH/BD/124022/2016). Work at the laboratory of ARM was funded by the MICINN (PID2019-110183RB-C21), Regional Government of Community of Madrid (P2018/BAA-4343-ALIBIRD2020-CM) and the Ramon Areces Foundation. Work at the laboratory of A.D.R. Funded by the Comunidad de Madrid-Talento Grant 2018-T1/BMD-11966 and the MICINN PID-2019-106893RA-100. Work at the laboratory of L.D. is funded by projects from the Health Research Fund (ISCIII FIS PI14/01374 and FISPI17/00508) and from a Manuel de Oya research fellowship from the Beer and Health Foundation. Work at the laboratory of A.E. is funded by a Ramon y Cajal Award from MICINN (RYC-2013-13546) and RETOS projects Program of the MICINN, co-funded by the European Regional Development Fund (ERDF) (SAF2015-67538-R). Work in the laboratory of M.S. was funded by the IRB and by grants from the Spanish Ministry of Economy co-funded by the European Regional Development Fund (ERDF) (SAF2013-48256-R), the European Research Council (ERC-2014-AdG/669622), and the "laCaixa" Foundation. Sí

The scarcity of the results obtained for the treatment of obesity leads us to consider new strategies, contemplating all the factors involved in the development of the disease. One of the key molecules for controlling body weight and energy homeostasis is the brain-derived neurotrophic factor (BDNF). This work summarizes the mechanisms in which BDNF gene regulates this multifactorial disease. In addition, we discuss the role of other BDNF polymorphisms as genetic determinants of obesity. In this context, a total of 14 SNPs near or inside BDNF/BDNF-AS related to BMI were identified in various GWASs. Finally, we assess gene-diet interaction as a novel tool to prevent obesity and formulate solid and personalized nutritional management. Our research group has performed the first study on the association of BDNF-AS rs925946 polymorphism and calcium intake as potential modulators of the nutritional status. Although these results should be confirmed in future studies, they open the path for new prevention opportunities.

Fibromyalgia (FM), chronic fatigue syndrome (CFS) and multiple chemical sensitivity (MCS) are some of the central sensitization syndromes (CSSs). The complexity of their diagnosis, the high interindividual heterogeneity and the existence of multi-syndromic patients requires a multifaceted treatment. The scientific literature is contradictory regarding the role of food in CSS, and evidence on the role of nutrition in MCS is particularly scarce. This review consists in gathering information about the current status of dietary recommendations (i.e., special dietary interventions, the role of additives, presence of micronutrient deficiencies, nutritional supplements and elimination of other nutrients and substances) and discussing the scientific evidence in depth to shed light on appropriate nutritional treatment managements for CSS patients. Current indications show that dietary modifications may vastly improve the patients’ quality of life at a low cost. We suggest personalized treatment, taking into consideration the severity of the disease symptoms, quality of life, coexistence with other diseases, pharmacological treatment, changing clinical characteristics, nutritional status, energy requirements and food tolerances, among others, as the best ways to tailor specific dietary interventions. These approaches will partially overcome the lack of scientific and clinical research on MSC. Patients should also be advised on the serious consequences of following dietary guidelines without a dietitian’s and clinician’s supervision.

Chronobiological aspects controlled by CLOCK genes may influence obesity incidence. Although there are studies that show an association between the expression of these genes and energy intake, waist circumference or abdominal obesity phenotypes, interactions with appetite have been insufficiently investigated in relation to chrononutrition. The objective was to identify interactions between CLOCK genetic variants involved in appetite status. A total of 442 subjects (329 women, 113 men, aged 18 to 65 years) were recruited. Anthropometric, dietary and lifestyle data were collected by trained nutritionists. Participants were classified according to their appetite feelings with a Likert scale. Multiple linear regression models were used to examine associations of the type genotype x appetite status on adiposity-related variables. p values were corrected by the Bonferroni method. A significant influence was found concerning the effects of appetite on waist circumference with respect to rs3749474 CLOCK polymorphism (p &lt, 0.001). An additive model analysis (adjusted by age, gender, exercise and energy intake) showed that risk allele carriers, increased the waist circumference around 14 cm (&beta, = 14.1, CI = 6.3&ndash, 22.0) by each increment in the level of appetite. The effects of appetite on waist circumference may be partly modulated by the rs3749474 CLOCK polymorphism.

The aim of this study was to evaluate the distribution of energy intake and macronutrients consumption throughout the day, and how its effect on nutritional status can be modulated by the presence of the rs3749474 polymorphism of the CLOCK gene in the Cantoblanco Platform for Nutritional Genomics (&ldquo, GENYAL Platform&rdquo, ). This cross-sectional study was carried out on 898 volunteers between 18 and 69 years old (65.5% women). Anthropometric measurements, social issues and health, dietary, biochemical, genetic, and physical activity data were collected. Subsequently, 21 statistical interaction models were designed to predict the body mass index (BMI) considering seven dietary variables analyzed by three genetic models (adjusted by age, sex, and physical activity). The average BMI was 26.9 &plusmn, 4.65 kg/m2, 62.14% presented an excess weight (BMI &gt, 25 kg/m2). A significant interaction was observed between the presence of the rs3749474 polymorphism and the evening carbohydrate intake (% of the total daily energy intake [%TEI]) (adjusted p = 0.046), when predicting the BMI. Participants carrying TT/CT genotype showed a positive association between the evening carbohydrate intake (%TEI) and BMI (&beta, = 0.3379, 95% CI = (0.1689,0.5080)) and (&beta, = 0.1529, 95% CI = (&minus, 0.0164,0.3227)), respectively, whereas the wild type allele (CC) showed a negative association (&beta, = &minus, 0.0321, 95% CI = (&minus, 0.1505,0.0862)). No significant interaction with the remaining model variables was identified. New dietary strategies may be implemented to schedule the circadian distribution of macronutrients according to the genotype. Clinical Trial number: NCT04067921.

Background and objective Multiple chemical sensitivity (MCS) is a complex, acquired, chronic syndrome of multifactorial etiology with multiple symptoms. The aim of the study was to assess the nutritional habits, dietary characteristics and physical activity, as well as their determinants, of a population diagnosed with MCS, which may allow for a more precise approach to nutritional improvement. Patients and method A descriptive, cross-sectional study in patients diagnosed with MCS. Information was collected using adapted questionnaires. Data included presence of comorbidities, nutritional (use of supplements, types of diet) and food purchasing habits. Dietary intake, food intolerances, and physical activity were also recorded. Results The study included of 52 patients (48 female) aged 50.9 ± 10.3 years. Diagnosis of MCS was commonly associated to chronic fatigue syndrome (70.1%), fibromyalgia (65.4%), or electrosensitivity (51.9%). The most common comorbidities were irritable bowel, gastroesophageal reflux, and depression/anxiety-depressive disorder. Exclusion diets were followed by 57.7%, 52.1% commonly used supplements (6.4 ± 5.2 per person), and 16.0% took more than 10 daily. A high proportion of volunteers did not take the recommended amounts of dairy products (84.3%), fruit (82.3%), and cereals (64.7%), the foods to which intolerance was greatest. As regards physical activity, active subjects only represented 12.5%. Conclusions The data collected support the need to improve food pattern and to perform physical activity according to individual characteristics. Nutritional education and diet personalization could prevent incomplete, monotonous, and unbalanced diets which impair quality of life and physiological status.

[ES]: [Antecedentes y objetivo] La sensibilidad química múltiple (SQM) es un síndrome complejo, adquirido, crónico y multifactorial, con amplia sintomatología. El objetivo del presente estudio fue conocer los hábitos alimentarios, las características dietéticas y la actividad física, así como sus condicionantes en un colectivo afectado de SQM, lo que permitirá un abordaje más preciso para la mejora de su estado nutricional. [Pacientes y método] Estudio descriptivo y transversal en pacientes con SQM. Se recogió información mediante cuestionarios adaptados sobre presencia de comorbilidades, hábitos dietéticos (consumo de complementos/suplementos, tipos de dietas) y de compra, así como registro de ingesta dietética, intolerancias alimentarias y actividad física. [Resultados] Se incluyó a 52 pacientes (48 mujeres) de 50,9 ± 10,3 años de edad media. Fue habitual el diagnóstico conjunto de SQM con síndrome de fatiga crónica (70,1%), fibromialgia (65,4%) o electrosensibilidad (51,9%). Las comorbilidades más frecuentes fueron colon irritable, reflujo gastroesofágico y depresión/trastorno ansioso-depresivo. El 57,7% seguía regímenes de exclusión. El 52,1% consumía complementos/suplementos habitualmente (6,4 ± 5,2 por persona) y el 16,0% tomaba más de 10 diarios. Fue elevado el porcentaje de voluntarios que no alcanzó las raciones aconsejadas de lácteos (84,3%), frutas (82,3%) y cereales (64,7%), coincidiendo con los alimentos con mayor intolerancia. Con respecto a la actividad física, los sujetos activos solo representaban el 12,5%. [Conclusiones] Los datos obtenidos confirman la necesidad de mejora del patrón alimentario y realización de actividad física según características individuales. La educación nutricional y personalización de las pautas podrían evitar dietas incompletas, monótonas y desequilibradas que empeoren la calidad de vida y situación fisiológica., [EN]: [Background and objective] Multiple chemical sensitivity (MCS) is a complex, acquired, chronic syndrome of multifactorial etiology with multiple symptoms. The aim of the study was to assess the nutritional habits, dietary characteristics and physical activity, as well as their determinants, of a population diagnosed with MCS, which may allow for a more precise approach to nutritional improvement. [Patients and method] A descriptive, cross-sectional study in patients diagnosed with MCS. Information was collected using adapted questionnaires. Data included presence of comorbidities, nutritional (use of supplements, types of diet) and food purchasing habits. Dietary intake, food intolerances, and physical activity were also recorded. [Results] The study included of 52 patients (48 female) aged 50.9±10.3 years. Diagnosis of MCS was commonly associated to chronic fatigue syndrome (70.1%), fibromyalgia (65.4%), or electrosensitivity (51.9%). The most common comorbidities were irritable bowel, gastroesophageal reflux, and depression/anxiety-depressive disorder. Exclusion diets were followed by 57.7%, 52.1% commonly used supplements (6.4±5.2 per person), and 16.0% took more than 10 daily. A high proportion of volunteers did not take the recommended amounts of dairy products (84.3%), fruit (82.3%), and cereals (64.7%), the foods to which intolerance was greatest. As regards physical activity, active subjects only represented 12.5%. [Conclusions] The data collected support the need to improve food pattern and to perform physical activity according to individual characteristics. Nutritional education and diet personalization could prevent incomplete, monotonous, and unbalanced diets which impair quality of life and physiological status.

Understanding individuals' response to dietary bioactives is crucial for personalized nutrition. We report here for the first time in a Caucasian cohort (5-90 years, n = 839) that aging is the main factor that determines the gut microbiota involved in the ellagic acid-ellagitannin metabolism (urolithin metabotypes), with potential consequences for human health.

Resumen Antecedentes y objetivos La sensibilidad quimica multiple (SQM) es un sindrome multisistemico y cronico, de etiologia desconocida. El objetivo de este estudio fue describir el estado nutricional y la calidad de vida, asi como identificar posibles polimorfismos asociados al sindrome o a su patogenia. Pacientes y metodos Estudio epidemiologico, descriptivo y transversal en pacientes con diagnostico de SQM. Se recogieron datos antropometricos, composicion corporal, fuerza muscular y calidad de vida. La seleccion de single nucleotide polymorphisms (SNP, «polimorfismos de un solo nucleotido») se centro en genes asociados previamente a la SQM y genes que participan en rutas de estres oxidativo e inflamacion. Resultados Se incluyeron 52 pacientes (93,2% del sexo femenino), con una edad media de 50,9 (10,3) anos. Respecto a su estado nutricional (IMC), un 48% estaba fuera de rangos de normalidad (17% desnutricion y 32% sobrepeso y obesidad). Un 30% presento masa muscular por debajo de la referencia para la edad, un 84% una fuerza muscular inferior al percentil 10 y un 51,8% un porcentaje de masa grasa elevado. Respecto a la calidad de vida, las puntuaciones medias estuvieron por debajo de las de otras enfermedades en todas las subescalas evaluadas. Se observaron diferencias significativas en las frecuencias encontradas entre casos y controles para los SNP rs1801133 (MTHFR), rs174546 (FADS1) y rs1801282 (PPARγ). Conclusion Un elevado porcentaje de pacientes presento un estado nutricional anormal con masa y fuerza muscular disminuidas, lo que reduce la calidad de vida de estos pacientes, ya mermada por la sintomatologia. No se identificaron polimorfismos geneticos especificos asociados al sindrome o a su patogenia.

Background and objectives Multiple chemical sensitivity (MCS) is a chronic, multisystem syndrome of unknown etiology. The aim of the present study was to describe the nutritional status and quality of life of patients suffering from MCS, as well as to identify potential polymorphisms associated with this illness. Patients and methods A cross-sectional, descriptive study was performed on patients with a diagnosis of MCS. Data on anthropometric and body composition variables, hand muscle strength and quality of life were collected. The selection of single nucleotide polymorphisms (SNPs) was based on genes previously associated with MCS and genes involved in inflammatory and oxidative stress pathways. Results A total of 52 patients (93.2% female), with a mean age of 50.9 (10.3) years were included in the study. Among them, based on their BMI, 48% had an inadequate nutritional status (17% were underweight and 32% were overweight or obese). Thirty percent of patients had a low muscle mass for their age, 84% had muscle strength below the tenth percentile, and 51.8% had a high fat mass percentage. Regarding quality of life, all median scores were lower than those of other illnesses assessed for every subscale assessed. Statistically significant differences between patient cases and controls were found with respect to rs1801133 (MTHFR), rs174546 (FADS1) and rs1801282 (PPARγ) polymorphisms. Conclusion A high percentage of patients had a poor nutritional status, low muscle strength and decreased muscle mass. These facts exacerbate the already-lower quality of life of these patients. Specific genetic polymorphisms associated with the syndrome or its pathogenesis was not identified.

The increased prevalence of childhood obesity is expected to translate in the near future into a concomitant soaring of multiple cardio-metabolic diseases. Obesity has a complex, multifactorial etiology, that includes multiple and multidomain potential risk factors: genetics, dietary and physical activity habits, socio-economic environment, lifestyle, etc. In addition, all these factors are expected to exert their influence through a specific and especially convoluted way during childhood, given the fast growth along this period. Machine Learning methods are the appropriate tools to model this complexity, given their ability to cope with high-dimensional, non-linear data. Here, we have analyzed by Machine Learning a sample of 221 children (6–9 years) from Madrid, Spain. Both Random Forest and Gradient Boosting Machine models have been derived to predict the body mass index from a wide set of 190 multidomain variables (including age, sex, genetic polymorphisms, lifestyle, socio-economic, diet, exercise, and gestation ones). A consensus relative importance of the predictors has been estimated through variable importance measures, implemented robustly through an iterative process that included permutation and multiple imputation. We expect this analysis will help to shed light on the most important variables associated to childhood obesity, in order to choose better treatments for its prevention.

Bioactive supplements display relevant therapeutic properties when properly applied according to validated molecular effects. Our previous research efforts established the basis to develop a dietary supplement based on a Rosmarinus officinalis supercritical extract. This was enriched in phenolic diterpenes (RE) with proven properties against signaling pathways involved in colon tumorigenesis, and shark liver oil rich in alkylglycerols (AKG) as a bioactive lipid vehicle to improve RE bioavailability and synergize with the potential therapeutic action of the extract. Herein, we have investigated the tolerability and safety of the supplement and the biological and molecular effects from an immuno-nutritional perspective. Sixty healthy volunteers participated in a six week, double-blind, randomized parallel pilot study with two study arms: RE-AKG capsules (CR) and control capsules (CC). Mean age (&plusmn, SD) of volunteers was 28.32 (&plusmn, 11.39) and 27.5 (&plusmn, 9.04) for the control and the study groups, respectively. Safety of the CR product consumption was confirmed by analyzing liver profile, vital constants, and oxidation markers (LDLox in blood and isoprostanes and thromboxanes in urine). The following were monitored: (1) the phenotyping of plasmatic leukocytes and the ex vivo response of lipopolysaccharide (LPS)-stimulated peripheral blood mononuclear cells (PBMCs), (2) expression of genes associated with immune-modulation, inflammation, oxidative stress, lipid metabolism, and tumorigenesis, and (3) the correlation of selected genetic variants (SNPs) with the differential responses among individuals. The lack of adverse effects on liver profile and oxidation markers, together with adequate tolerability and safe immunological adaptations, provide high-quality information for the potential use of CR as co-adjuvant of therapeutic strategies against colorectal cancer.

[Background & aims]: Calcium and dairy products have multiple health benefits. The objective of this work was to evaluate the association between calcium/dairy intake, blood pressure, the BDNF-AS rs925946 polymorphism and nutritional status in a group of schoolchildren., [Methods]: As part of the GENYAL study to childhood obesity prevention, 221 children belonging to different areas of the Community of Madrid were enrolled. Anthropometric and dietary data were collected, and children were genotyped according to the rs925946 polymorphism. Adjusted logistic and linear models were used to describe the data., [Results]: A significantly lower consumption of calcium in overweight versus normal weight children was observed (811.0 ± 174.1; 859.0 ± 195.9; 954.0 ± 223.1 mg; for obesity, overweight and normal weight, respectively, p = 0.010). Moreover, an inverse association between blood pressures and calcium intake was detected (β = −0.006 (−0.011, −3e−4)), p = 0.040. The number of dairy servings/day showed a protective effect against overweight (OR = 0.48 (0.29, 0.75), p = 0.001). Finally, common homozygous children (GG) showed an inverse association between the calcium intake and the BMI (β = −0.003 (−0.006, −0.001), p = 0.004), which was not observed in children carrying the T allele (β = −1.3e−4 (−0.0022, 0.0024), p = 0.93)., [Conclusion]: Calcium and dairy were strongly associated with the nutritional status and blood pressure. The identification of differential effects of calcium/dairy consumption on the nutritional status according to genetics may contribute to the personalization of future nutritional advice.

Exercise performance is influenced by genetics. However, there is a lack of knowledge about the role played by genetic variability in the frequency of physical exercise practice. The objective was to identify genetic variants that modulate the commitment of people to perform physical exercise and to detect those subjects with a lower frequency practice. A total of 451 subjects were genotyped for 64 genetic variants related to inflammation, circadian rhythms, vascular function as well as energy, lipid and carbohydrate metabolism. Physical exercise frequency question and a Minnesota Leisure Time Physical Activity Questionnaire (MLTPAQ) were used to qualitatively and quantitatively measure the average amount of physical exercise. Dietary intake and energy expenditure due to physical activity were also studied. Differences between genotypes were analyzed using linear and logistic models adjusted for Bonferroni. A significant association between GCKR rs780094 and the times the individuals performed physical exercise was observed (p = 0.004). The carriers of the minor allele showed a greater frequency of physical exercise in comparison to the major homozygous genotype carriers (OR: 1.86, 95% CI: 1.36–2.56). The analysis of the GCKR rs780094 variant suggests a possible association with the subjects that present lower frequency of physical exercise. Nevertheless, future studies are needed to confirm these findings., This work was supported by IMDEA Food Institute.

Scope The gut microbiota ellagitannin-metabolizing phenotypes (i.e., urolithin metabotypes [UMs]) are proposed as potential cardiovascular disease (CVD) risk biomarkers because the host blood lipid profile is reported to be associated with specific UMs. However, the link for this association remains unknown so far. Methods and results The gut microbiome of 249 healthy individuals is analyzed using 16S rDNA sequencing analysis. Individuals are also stratified by UMs (UM-A, UM-B, and UM-0) and enterotypes (Bacteroides, Prevotella, and Ruminococcus). Associations of UMs discriminating bacteria with CVD risk markers are investigated. Distribution and gut microbiota composition of UMs and enterotypes are not coincident. Almost half of the discriminating genera between UM-A and UM-B belongs to the Coriobacteriaceae family. UM-B individuals present higher blood cholesterol levels and higher alpha-diversity, including Coriobacteriaceae family, than those of UM-A. Coriobacteriaceae, whose abundance is the highest in UM-B, is positively correlated with total cholesterol, LDL cholesterol, and body mass index. Conclusions Results herein suggest that the family Coriobacteriaceae could be a link between individuals' UMs and their blood cholesterol levels. Further research is needed to explore the mechanisms of the host metabolic phenotype, including cholesterol excretion products, to modulate this bacterial family.

Eating disorders (ED) are characterized by persistent changes in eating habits that negatively affect a person's health and psychosocial abilities. They are considered psychiatric disorders, highly variable in their presentation and severity, with a huge impact on nutrition, which conditions various therapeutic approaches within a key multidisciplinary context. A group of experts in nutrition, we decided to set up a task force adscribed to the "Sociedad Española de Nutrición Parenteral y Enteral" (SENPE), which has stated as one of its goals the development of a consensus document to generate a protocol based on the best scientific evidence and professional experience available in order to improve health care in this field.

Anorexia nervosa is the most common psychiatric disease among young women and it is assumed to be of multifactorial origin. Diagnostic criteria have recently been modified; therefore amenorrhea has ceased to be a part of them. This disease shows a large variability in its presentation and severity which conditions different therapeutic approaches and the need to individualize the treatment, thus it is indispensable a multidisciplinary approach. The goals are to restore nutritional status (through an individualized diet plan based on a healthy consumption pattern), treat complications and comorbidities, nutritional education (based on healthy eating and nutritional patterns), correction of compensatory behaviors and relapse prevention. The treatment will vary according to the patient's clinical situation, and it may be performed in outpatient clinics (when there is clinical stability), in a day hospital or ambulatory clinic (intermediate mode between traditional outpatient treatment and hospitalization) or hospitalization (when there is outpatient management failure or presence of serious medical or psychiatric complications). Artificial nutrition using oral nutritional supplements, enteral nutrition and exceptionally parenteral nutrition may be necessary in certain clinical settings. In severely malnourished patients the refeeding syndrome should be avoided. Anorexia nervosa is associated with numerous medical complications which determines health status, life quality, and is closely related to mortality. There is little clinical evidence to assess the results of different treatments in anorexia nervosa, when most of the recommendations are being based on expert consensus.

Objective The association of dairy food consumption with the risk for developing cardiovascular disease (CVD) has been investigated in many studies, but results often have been contradictory. The aim of the present study was to determine whether genetic polymorphisms are associated with interindividual variation in the response of CVD risk biomarker values after milk consumption. Methods Fourteen single nucleotide polymorphisms (SNPs) in nine genes related to lipid metabolism were examined in 161 volunteers randomly allocated to consume either 500 mL/d of skimmed (S) or semi-skimmed (SS) milk for 1 year in addition to their usual diets. Total cholesterol/high-density lipoprotein cholesterol (TC/HDL-C) and low-density lipoprotein/HDL-C ratios were used as biomarkers of CVD risk. Three-way repeated-measures analysis of variance was used to examine the effect of time, treatment (S or SS), and genotype on these biomarkers. Results A TT genotype for the proliferator-activated receptor alpha polymorphism (PPARA rs135549 SNP) was significantly associated with a reduction in the TC/HDL and LDL/HDL ratios after 12 mo of S milk intake (mean reduction −0.29, 95% confidence interval [CI], −0.63 to 0.05; P = 0.0015 and −0.31, 95% CI, −0.58 to −0.03; P = 0.0005, respectively). However, no differences were observed after consuming either S or SS milk in the C allele carriers. Conclusions Saturated fatty acid consumption has long been linked to an increased risk for CVD; indeed, the consumption of saturated fat-free products is recommended as a means of reducing this risk. However, the present results suggest that many individuals might not benefit from such general recommendations. Genetic analysis of PPARA rs135549 might help identify those individuals who are more likely to benefit from reducing the saturated fatty acid content of their diet.

Over the past two decades, there has been a steady flow of publications about the health effects related to mushrooms consumption. They represent a valuable source of protein, present high levels of fiber, some vitamins and minerals, and they also have reduced amount of fat and sodium. In addition, their complex carbohydrates profile can strengthen considerably the immune system.Edible mushrooms have been related to significant functional properties due to their bioactive compounds, such as eritadenine, phenolic compounds, sterols (as ergosterol), chitosan, etc., These substances are considered as important agents in the prevention and treatment of different health conditions like obesity, diabetes, or cardiovascular disease. However, it is important to remember that most of scientific studies are made in animal models and, therefore, some evidences regarding mushroom consumption have yet to be confirmed in clinical trials.Despite of the growing appeal for humans by their medicinal effects and nutritional value, mushrooms are also very appreciated for their texture, flavor, and versatility in culinary. They can be easily incorporated into any kind of dish, improving the dietary diversity without adding many calories.The information presented in this review point out that the positive effect of mushrooms on health is beyond basic nutrition. Therefore, it is very valuable expanding our knowledge about mushrooms, in order to identify all their active principles and the mechanisms involved in each health benefit, getting aware about the doses required to achieve that, in a safe range for humans.

Inflammation markers (IM) have been associated with the development of chronic diseases. This study compares the effects on IM of three exercise programs combined with a hypocaloric diet.119 overweight participants (73 women, 46 men) aged 18-50 years were randomised into four treatment groups: strength training (S; n = 30), endurance training (E; n = 30), combined S + E (SE; n = 30), and a diet and physical activity recommendations group (D; n = 29). Energy intake, anthropometric variables (AV), training variables (VO2peak, strength index, dynamometric strength index [DSI]) and plasma IM were recorded at baseline and after 22 weeks of treatment.84 participants completed the study. At 22 weeks, all groups showed a significantly reduced energy intake (P0.001) and improved AV (P0.001). VO2peak significantly increased in all groups (P0.01). DSI increased in the exercise groups only (P0.05). Plasma leptin fell significantly (P0.001) in the S and E groups, but not significantly in the SE group (P = 0.029) (no significant differences between these groups). Tumour necrosis factor-α (TNF-α), and C-reactive protein (CRP) concentrations decreased in all groups when examined together, but not when examined separately. No significant differences were seen in interleukin-6 (IL-6).Combining strength or endurance training with a hypocaloric diet improved AV and reduced plasma leptin concentrations. No differences were seen between groups in terms of TNF-α, IL-6 or CRP reduction. This trial was registered at clinical trials.gov as NCT01116856. http://clinicaltrials.gov/.

et al., Metabolic syndrome (MetS) is established as the combination of central obesity and different metabolic disturbances, such as insulin resistance, hypertension and dyslipidemia. This cluster of factors affects approximately 10%-50% of adults worldwide and the prevalence has been increasing in epidemic proportions over the last years. Thus, dietary strategies to treat this heterogenic disease are under continuous study. In this sense, diets based on negative-energy-balance, the Mediterranean dietary pattern, n-3 fatty acids, total antioxidant capacity and meal frequency have been suggested as effective approaches to treat MetS. Furthermore, the type and percentage of carbohydrates, the glycemic index or glycemic load, and dietary fiber content are some of the most relevant aspects related to insulin resistance and impaired glucose tolerance, which are important co-morbidities of MetS. Finally, new studies focused on the molecular action of specific nutritional bioactive compounds with positive effects on the MetS are currently an objective of scientific research worldwide. The present review summarizes some of the most relevant dietary approaches and bioactive compounds employed in the treatment of the MetS to date.

Multiple chemical sensitivity (MCS) is a chronic, multisystem syndrome of unknown etiology. The aim of the present study was to describe the nutritional status and quality of life of patients suffering from MCS, as well as to identify potential polymorphisms associated with this illness.A cross-sectional, descriptive study was performed on patients with a diagnosis of MCS. Data on anthropometric and body composition variables, hand muscle strength and quality of life were collected. The selection of single nucleotide polymorphisms (SNPs) was based on genes previously associated with MCS and genes involved in inflammatory and oxidative stress pathways.A total of 52 patients (93.2% female), with a mean age of 50.9 (10.3) years were included in the study. Among them, based on their BMI, 48% had an inadequate nutritional status (17% were underweight and 32% were overweight or obese). Thirty percent of patients had a low muscle mass for their age, 84% had muscle strength below the tenth percentile, and 51.8% had a high fat mass percentage. Regarding quality of life, all median scores were lower than those of other illnesses assessed for every subscale assessed. Statistically significant differences between patient cases and controls were found with respect to rs1801133 (MTHFR), rs174546 (FADS1) and rs1801282 (PPARγ) polymorphisms.A high percentage of patients had a poor nutritional status, low muscle strength and decreased muscle mass. These facts exacerbate the already-lower quality of life of these patients. Specific genetic polymorphisms associated with the syndrome or its pathogenesis were not identified.