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Objectives: We tested the effects of a weight-loss intervention encouraging energy-reduced MedDiet and physical activity (PA) in comparison to ad libitum MedDiet on COVID-19 incidence in older adults., Design: Secondary analysis of PREDIMED-Plus, a prospective, ongoing, multicentre randomized controlled trial., Setting: Community-dwelling, free-living participants in PREDIMED-Plus trial., Participants: 6,874 Spanish older adults (55-75 years, 49% women) with overweight/obesity and metabolic syndrome., Intervention: Participants were randomised to Intervention (IG) or Control (CG) Group. IG received intensive behavioural intervention for weight loss with an energy-reduced MedDiet intervention and PA promotion. CG was encouraged to consume ad libitum MedDiet without PA recommendations., Measurements: COVID-19 was ascertained by an independent Event Committee until December 31, 2021. COX regression models compared the effect of PREDIMED-Plus interventions on COVID-19 risk., Results: Overall, 653 COVID-19 incident cases were documented (IG:317; CG:336) over a median (IQR) follow-up of 5.8 (1.3) years (inclusive of 4.0 (1.2) years before community transmission of COVID-19) in both groups. A significantly lowered risk of COVID-19 incidence was not evident in IG, compared to CG (fully-adjusted HR (95% CI): 0.96 (0.81,1.12))., Conclusions: There was no evidence to show that an intensive weight-loss intervention encouraging energy-reduced MedDiet and PA significantly lowered COVID-19 risk in older adults with overweight/obesity and metabolic syndrome in comparison to ad libitum MedDiet. Recommendations to improve adherence to MedDiet provided with or without lifestyle modification suggestions for weight loss may have similar effects in protecting against COVID-19 risk in older adults with high cardiovascular risks., Competing Interests: Fernandez-Aranda acknowledges consulting fees from Novo Nordisk and Wiley as EIC for the European Eat Dis Rev. He has also received honoraria for lectures and support for travel/meetings from Novo Nordisk. He discloses his honorary participation in the Data Safety Monitoring Board or Advisory Board of Sustain-Consortium-Germany. Emilio Ros has received honoraria for presentations and support for attending meetings/travel from the California Walnut Commission, Alexion and the Spanish Atherosclerosis Society. He has also received consulting fees from Alexion. He participates in the Data Safety Monitoring Board or Advisory Board of the PREDIMED-Plus Clinical Trial. Ramon Estruch has received research grants from Instituto de Salud Carlos III, Madrid, Spain. He has received honoraria for presentations from Fundacion Cerveza y Salud, Spain; Instituto Cervantes, Albuquerque, USA; Instituto Cervantes, Milan, Italy; Instituto Cervantes, Tokyo, Japan; Fundacion Bosch i Gimpera, Spain; Wine and Culinary International Forum; Pernaud Richart; Mexico; Fundacion Dieta Mediterranea, Barcelona, Spain. He has received support for travel or meetings or conference organization from ERAB, Belgium, Brewers of Europe, Belgium, and Sociedad Española de Nutrición (SEN). He has served on the Advisory Board of Cerveza y Salud, Spain. Jordi Salas-Salvadó reported receiving consulting fees from Eroski Foundation. He has also received grants and support for attending meetings/travel from Nut and Dried Fruit Foundation. He is an honorary Member of the International Advisory Board of the Project “Effect of cashew nut supplementation on glycemic status and lipid profile in type 2 diabetes subjects”, Member of the Scientific Advisory Committee of the European PEGASO project (Personalized Guidance Services for Optimizing lifestyle management in teenagers through awareness, motivation and engagement) and Member of the Scientific Committee of Danone Institute International. He received personal fees for serving as a Member of the Institute Danone Advisory Board. Sangeetha Shyam has received consulting fees from Abbott Sdn Bhd. Stephanie K. Nishi is a volunteer member of Plant-Based Canada, a non-profit organization. Other authors (Jesús Francisco García-Gavilán, Indira Paz-Graniel, José J Gaforio4 Miguel Ángel Martínez-González, Dolores Corella, J. Alfredo Martínez, Ángel M. Alonso-Gómez, Julia Wärnberg, Jesús Vioque, Dora Romaguera, José López-Miranda, Francisco J Tinahones, José Lapetra, J. Luís Serra-Majem, Aurora Bueno-Cavanillas, Josep A. Tur, Vicente Martín Sánchez, Xavier Pintó, Pilar Matía-Martín, Josep Vidal, María del Mar Alcarria, Lidia Daimiel, Óscar García Regata, Rafael Perez Araluce, Eva M Asensio, Olga Castañer, Antonio Garcia-Rios, Alejandro Oncina-Cánovas, Cristina Bouzas, M. Angeles Zulet, Elena Rayó, Rosa Casas1,16,17, Sandra Martin-Pelaez, Lucas Tojal-Sierra, Bernal-López MR, Silvia Carlos, Jose V.Sorlí, Albert Goday, Patricia J. Peña-Orihuela, Ana Pastor-Morel, Sonia Eguaras, María Dolors Zomeño, Miguel Delgado-Rodríguez, Nancy Babio, and Montserrat Fitó) declared no potential conflict of interest.

Background and Aims: Fermented dairy products have been associated with a better diet quality and cardio-metabolic profile. However, in Mediterranean populations, these associations have not been well characterized. The aim of this study was to assess the diet quality and the associations between the consumption of total fermented dairy products and their subtypes and the prevalence of Metabolic Syndrome (MetS) components in a Mediterranean population at high cardiovascular risk., Methods and Results: Baseline cross-sectional analyses were conducted on 6,572 men and women (mean age: 65 years) with overweight or obesity and MetS recruited into the PREDIMED-Plus cohort. A 143-item Food Frequency Questionnaire (FFQ) was used, and anthropometrical, biochemical, and blood pressure measurements were recorded. Multivariate-adjusted Cox regressions were fitted to analyze the association between quartiles of consumption of fermented dairy products and their subtypes and MetS components to estimate the relative risk (RR) and 95% confidence intervals (95% CIs). Participants who were high consumers of fermented dairy products reported a higher consumption of fruit, vegetables, fish, nuts, and whole bread and a lower consumption of white bread, alcohol, and cookies. Participants in the higher quartile showed a lower prevalence of the low HDL-cholesterol component of the MetS (RR=0.88; 95% CI: 0.78-0.98) than those in the lowest quartile of cheese consumption. Cheese consumption was inversely associated with the prevalence of hypertriglyceridemia. Total fermented dairy products, yogurt, and its types were not associated with any of the MetS components., Conclusions: Compared to nonconsumers, participants consuming fermented dairy products reported a better diet quality and, particularly, cheese consumers presented a lower prevalence of hypertriglyceridemia and low HDL-cholesterol plasma levels, which are MetS components., (Copyright © 2018 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)

Background: Both fasting and postprandial hypertriglyceridaemia are considered independent risk factors for atherosclerosis. Treatment of hypertriglyceridaemia is based on fibrates, which activate the peroxisome proliferator-activated receptor alpha (PPARα). However, the metabolic pathways that activate or inhibit fibrates, and how the postprandial triglyceride levels are modified, have not yet been fully described. Accordingly, the aim of this study was to determine the feasibility of peripheral blood mononuclear cells (PBMC) to study the effects of fenofibrate in patients with the metabolic syndrome., Materials and Methods: A fat overload was given to 50 patients before and after treatment with fenofibrate for 3 months. Anthropometric and biochemical variables as well as gene expression in PBMC were analysed., Results: After treatment with fenofibrate, we observed a decrease in both baseline and postprandial (3 h after the fat overload) levels of serum triglycerides, cholesterol and uric acid and an increase in HDL cholesterol and apolipoprotein AI levels. After treatment, there was also a rise in PPARα and RXRα expression and changes in genes regulated by PPARα, both baseline and postprandial. Furthermore, in vitro experiments showed that a PPARα agonist changed the expression of genes related with lipid metabolism., Conclusion: Treatment with fenofibrate reduced fasting and postprandial serum triglyceride levels, possibly through a mechanism related with an increase in the expression of RXRα and PPARα, by activating the pathways involved in the uptake and degradation of triglycerides and increasing the synthesis of apolipoprotein. These results suggest that PBMC may be useful for the easy study of fenofibrate actions., (© 2017 John Wiley & Sons Ltd.)

Background: The impact of a lifestyle intervention (LSI) program for the long-term management of subjects with metabolic syndrome in a primary care setting is not known., Methods: This 3-year prospective controlled trial randomized adult subjects with metabolic syndrome to receive intensive LSI or to usual care in a community health centre in Malaga, Spain. LSI subjects received instruction on Mediterranean diet and a regular aerobic exercise program by their primary care professionals. Primary outcome included changes from baseline on different components of metabolic syndrome (abdominal circumference, blood pressure, HDL-cholesterol, fasting plasma glucose and triglycerides)., Results: Among the 2,492 subjects screened, 601 subjects with metabolic syndrome (24.1%) were randomized to LSI (n = 298) or to usual care (n = 303); of them, a 77% and a 58%, respectively, completed the study. At the end of the study period, LSI resulted in significant differences vs. usual care in abdominal circumference (-0.4 ± 6 cm vs. + 2.1 ± 6.7 cm, p < 0.001), systolic blood pressure (-5.5 ± 15 mmHg vs. -0.6 ± 19 mmHg, p = 0.004), diastolic blood pressure (-4.6 ± 10 mmHg vs. -0.2 ± 13 mmHg, p < 0.001) and HDL-cholesterol (+4 ± 12 mg/dL vs. + 2 ± 12 mg/dL, p = 0.05); however, there were no differences in fasting plasma glucose and triglyceride concentration (-4 ± 35 mg/dl vs. -1 ± 32 mg/dl, p = 0.43 and -0.4 ± 83 mg/dl vs. +6 ± 113 mg/dl, p = 0.28)., Conclusion: Intensive LSI counseling provided by primary care professionals resulted in significant improvements in abdominal circumference, blood pressure and HDL-cholesterol but had limited effects on glucose and triglyceride levels in patients with metabolic syndrome., (Copyright © 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.)

Objectives: Apolipoprotein C-III (APOC3) is a component of triglyceride rich lipoproteins, and SstI polymorphism has been associated with hypertriglyceridemia. Apolipoprotein A-I (APOA1) is the major component of HDL and MspI polymorphism has been associated with APOA1 and HDL-C levels. Thus, we study the influence of these polymorphisms in the postprandial response in metabolic syndrome (MS)., Design and Methods: 73 MS patients and 21 healthy subjects underwent a fat overload, with measurements of their fasting and postprandial lipid profile. The APOC3 SstI and the APOA1MspI polymorphisms were genotyped., Results: No significant differences were found in the lipid profile with respect to the MspI genotype. Patients with the S2S2 APOC3 genotype had significantly higher fasting and postprandial triglyceride levels and postprandial APOC3 and chylomicron-triglyceride levels compared with the other SstI APOC3 genotypes., Conclusions: Homozygosity for the minor allele of the APOC3 SstI polymorphism was associated to a worse postprandial response in MS patients., (Copyright © 2010 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.)

Background: Patients with the metabolic syndrome have greater levels of oxidative stress. However, as the response of markers of this stress to a fat overload is unknown, we evaluated certain markers of oxidative stress in these patients., Material and Methods: The study population comprised 93 subjects (70 men and 23 women): 13 healthy people (controls) with a mean age of 48.81 +/- 9.01 years and 80 patients with the metabolic syndrome (mean age, 43.25 +/- 11.55 years), according to the Adult Treatment Panel III criteria. All the participants were given a 60 g fat overload (Supracal). Three hours later the following biomarkers of oxidative stress were measured: lipid peroxidation products, protein carbonyl groups, reduced glutathione, glutathione peroxidase (GSH-Px), catalase, superoxide dismutase, glutathione reductase (GSH-Road) and glutathione S-transferase. The levels of oxidized glutathione (GSSG) were calculated., Results: Compared with the controls, the patients showed greater baseline oxidative stress, higher levels of lipid peroxidation products and oxidized glutathione, and lower levels of reduced glutathione, glutathione peroxidase activity, glutathione reductase and glutathione transferase. This stress was more intense after the subjects received a fat overload, more so in the patients who experienced a greater reduction in GSHpx and GSHrd antioxidant activity and a greater increase in the levels of carbonylated proteins and lipoperoxides than the controls., Conclusions: Patients with the metabolic syndrome have greater oxidative stress than healthy people. The variation in markers of this stress after a fat overload was even more pronounced in the patients.

Objective: We compared the levels of biomarkers of oxidative stress before and after a fat overload in three groups., Materials and Methods: 17 controls and two groups with hypertriglyceridemia: 43 without the metabolic syndrome (TG-non-MS) and 29 with the metabolic syndrome (TG-MS). All subjects underwent a 60 g fat overload. Baseline measurements included glucose, BMI (body mass index), waist circumference and HOMA IR (homeostasis model assessment insulin resistance). Cholesterol, triglycerides, HDL (high density lipoprotein) cholesterol, TNF-alpha (tumor necrosis factor) and IL-6 (interleukin-6), lipoperoxide (LPO), carbonylated proteins, reduced glutathione (GSH), oxidized glutathione (GSSG), glutathione peroxidase (GSH-PX), glutathione reductase (GSH-Rd), catalase and glutathione transferase (GST) were measured at baseline and 3 h after fat overload., Results: Compared to the controls, the two patient groups had higher plasma levels at baseline and after overload of cholesterol, triglycerides and apolipoprotein B, LPO, carbonylated proteins and GSSG, and lower levels of antioxidants at baseline and after the fat overload., Conclusion: The two patient groups had the same degree of oxidative stress.

Apolipoprotein E (apo E) is a constituent molecule of the triglyceride-rich lipoproteins and participates in their clearance. Polymorphisms in the apo E gene are associated with increased fasting and postprandial levels of triglycerides. We studied 66 patients with the metabolic syndrome, none of whom had diabetes. Details were recorded for cholesterol, triglycerides, apo AI, apo B, insulin, homeostasis model assessment of insulin resistance, homeostasis model assessment of insulin secretion, uric acid, 24-h uric acid urinary excretion, high-density lipoprotein cholesterol, waist to hip ratio, body mass index, and age. The patients were given a 60-g fat overload (Supracal), and measurements were made at 4 h of cholesterol, triglycerides, high-density lipoprotein cholesterol, apo AI, and apo B. Patients who did not have the E3/3 genotype had an odds ratio of postprandial hypertriglyceridemia of 6.2 (confidence interval, 1.41-16.08; P = 0.01) and an odds ratio of hyperuricemia compared with the E3/3-positive patients of 7.5 (confidence interval, 1.04-39.31; P = 0.02). This study shows that patients with the metabolic syndrome who do not have the E3/3 genotype have a greater risk of hyperuricemia and postprandial hypertriglyceridemia after a fat overload.

Aim:To study the prevalence of hypertriglyceridemic waist (HTGW) in an urban adult Spanish population and its association with type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD).Methods:We undertook a cross-sectional analysis in a random sample of 2270 individuals (18-80 years of age). All participants provided a clinical history and underwent a physical examination. Blood and urine analyses were conducted. HTGW was diagnosed using anthropometric criteria for the European population (waist circumference: for men, 94 cm; for women, 80 cm) and fasting plasma triglycerides (TGs) 1.71 mmol l−1 (150 mg per 100 ml).Results:The prevalence of HTGW was 14.5% (men: 18.2%, women: 10.8%) and was significantly greater in men <59 years (P<0.001). HTGW was associated with older individuals, a low educational level and, in men, with a sedentary lifestyle (P<0.001). Subjects with HTGW had higher levels of total cholesterol, low-density lipoprotein-cholesterol (LDL-c) and uric acid, lower levels of high-density lipoprotein-cholesterol, a higher blood pressure, a greater degree of obesity and a higher prevalence of T2DM (20.00 vs 6.4%, P<0.001) (odds ratio (OR) 3.61; 95% confidence interval (95% CI), 2.60-5.01) and CVD (8.5 vs 3.4%, P<0.001) (OR 2.63; 95% CI, 1.66-4.16). The association of HTGW with T2DM and CVD disappeared after adjusting for age. The degree of concordance between HTGW and the metabolic syndrome (MS) was moderate, with both the Adult Treatment Panel III Report (ATP-III) and the International Diabetes Federation criteria (κ=0.51 and κ=0.58, respectively). Subjects with isolated HTGW as compared with those with isolated MS (ATP-III) were younger, had greater levels of total cholesterol, LDL-c and TGs and a lower prevalence of obesity, high blood pressure and dysglycemia.Conclusion:HTGW is a phenotype of cardiometabolic risk prevalent in the adult population in our environment. HTGW may be an alternative to MS to detect the population at risk for T2DM and CVD, especially in young individuals who do not fulfill the criteria for MS. [ABSTRACT FROM AUTHOR]

Aim:The Wnt/β-catenin signaling network offers potential targets to diagnose and uncouple obesity from its metabolic complications. In this study, we investigate the role of the Wnt antagonist, secreted frizzled-related protein 1 (SFRP1), in promoting adipogenesis in vitro and adipose tissue expansion in vivo.Methods:We use a combination of human and murine, in vivo and in vitro models of adipogenesis, adipose tissue expansion and obesity-related metabolic syndrome to profile the involvement of SFRP1.Results:SFRP1 is expressed in both murine and human mature adipocytes. The expression of SFRP1 is induced during in vitro adipogenesis, and SFRP1 is preferentially expressed in mature adipocytes in human adipose tissue. Constitutive ectopic expression of SFRP1 is proadipogenic and inhibits the Wnt/β-catenin signaling pathway. In vivo endogenous levels of adipose SFRP1 are regulated in line with proadipogenic states. However, in longitudinal studies of high-fat-diet-fed mice, we observed a dynamic temporal but biphasic regulation of endogenous SFRP1. In agreement with this profile, we observed that SFRP1 expression in human tissues peaks in patients with mild obesity and gradually falls in morbidly obese subjects.Conclusions:Our results suggest that SFRP1 is an endogenous modulator of Wnt/β-catenin signaling and participates in the paracrine regulation of human adipogenesis. The reduced adipose expression of SFRP1 in morbid obesity and its knock-on effect to prevent further adipose tissue expansion may contribute to the development of metabolic complications in these individuals. [ABSTRACT FROM AUTHOR]