Effects of exercise in addition to a family-based lifestyle intervention program on hepatic fat in children with overweight

ClinicalTrials.gov ID: NCT02258126Background: Paediatric hepatic steatosis is highly prevalent and closely related to type 2 diabetes. Aims: To determine whether the addition of supervised exercise to a family-based lifestyle- and psycho-educational intervention results in greater reduction of percentage hepatic fat (HF), adiposity, and cardiometabolic risk factors in children with overweight/obesity. Methods: The study subjects of this non-randomized, two-arm, parallel design, clinical trial were 116 overweight/obese children (10.6±1.1 years, 53.4% girls) living in Vitoria-Gasteiz (Spain). For 22 weeks they followed either a lifestyle- and psycho-education program (control intervention [CI], N=57), consisting of two family-based education sessions/month, or the same plus supervised exercise (intensive intervention [II], N=59) focused mainly on high-intensity aerobic workouts (3 sessions/week, 90 min/session). The primary outcome was the change in percentage HF (as measured by MRI) between baseline and the end of the intervention period. Secondary outcomes included changes in body mass index (BMI), fat mass index (FMI), abdominal fat (measured by dual-X-ray-absorptiometry), blood pressure, triglycerides, high density lipoprotein, low density lipoprotein, gamma-glutammyl-transferase, glucose and insulin concentrations. Results: A total of 102 children completed the trial (N=53 and N=49 in the CI and II groups, respectively). Percentage HF decreased only in the II group (-1.20±0.31% vs. 0.04±0.30%, II and CI, respectively), regardless of baseline value and any change in adiposity (P<0.01). BMI, FMI, abdominal fat (P≤0.001) and insulin (P<0.05) were reduced in both groups. Conclusions: Multicomponent intervention programs that include exercise training may help reduce, adiposity, insulin resistance and hepatic steatosis in overweight/obese children.Spanish Ministry of Health "Fondos de Investigation Sanitaria del Institute de Salud Carlos III" PI13/01335Spanish Ministry of Industry and Competitiveness DEP2016-78377-REU Fondos Estructurales de la Union Europea (FEDER) funds ("Una manera de hacer Europa")Spanish Ministry of Education, Culture and Sports FPU14/03329Education Department of the Government of the Basque Country PRE_2016_1_0057 PRE_2017_2_0224 PRE_2018_2_0057University of Granada Plan Propio de Investigacion 2016-Excellence actions: Unit of Excellence on Exercise and Health (UCEES)Junta de Andalucia, Consejeria de Conocimiento, Investigacion y Universidades (FEDER) SOMM17/6107/UG

Survival of frail elderly with delirium

This study aims to determine when frailty increases the risks of delirium mortality. Hospital patients falling into the elderly frail or pre-frail category were recruited, some without delirium, some with delirium at admission, and some who developed delirium during admission. We screened for frailty, cognitive status, and co-morbidities whenever possible and extracted drug information and mortality data from electronic health records. Kaplan–Meier estimates of survival probability functions were computed at four times, comparing delirium versus non delirium patients. Differences in survival were assessed by a log-rank test. Independent Cox’s regression was carried out to identify significant hazard risks (HR) at 1 month, 6 months, 1 year, and 2 years. Delirium predicted mortality (log-rank test, p < 0.0001) at all four censoring points. Variables with significant HRs were frailty indicators, comorbidities, polypharmacy, and the use of specific drugs. For the delirium cohort, variables with the most significant 2-year hazard risks (HR(95%CI)) were: male gender (0.43 20 (0.26,0.69)), weight loss (0.45 (0.26,0.74)), sit and stand up test (0.67 (0.49,0.92)), readmission within 30 days of discharge (0.50 (0.30,0.80)), cerebrovascular disease (0.45 (0.27,0.76)), head trauma (0.54 22 (0.29,0.98)), number of prescribed drugs (1.10 (1.03,1.18)), and the use of diuretics (0.57 (0.34,0.96)). These results suggest that polypharmacy and the use of diuretics increase mortality in frail elderly patients with delirium.The work in this paper was partially supported by FEDER funds for the MINECO project TIN2017-85827-P, and 2016111138 of the health funding program of the Basque Government. This project received funding from the European Union's Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie grant agreement no. 777720

Circulating miRNAs as Biomarkers of Obesity and Obesity-Associated Comorbidities in Children and Adolescents: A Systematic Review

Early detection of obesity and its associated comorbidities in children needs priority for the development of effective therapeutic intervention. Circulating miRNAs (microRNAs) have been proposed as biomarkers for obesity and its comorbidities; therefore, we conducted a systematic review to summarize results of studies that have quantified the profile of miRNAs in children and adolescents with obesity and/or associated disorders. Nine studies aiming to examine differences in miRNA expression levels between children with normal weight and obesity or between obese children with or without cardiometabolic diseases were included in this review. We identified four miRNAs overexpressed in obesity (miR-222, miR-142–3, miR-140-5p, and miR-143) and two miRNAs (miR-122 and miR-34a) overexpressed in children with obesity and nonalcoholic fatty liver disease (NAFLD) and/or insulin resistance. In conclusion, circulating miRNAs are promising diagnostic biomarkers of obesity-associated diseases such as NAFLD and type 2 diabetes already in childhood. However, more studies in children, using massive search technology and with larger sample sizes, are required to draw any firm conclusions.This research was funded by the Spanish Ministry of Industry and Competitiveness (DEP2016-78377-R) and by the European Regional Development Fund (ERDF), M.O. is supported by a grant from the Spanish Ministry of Economy and Competitiveness, grant number; BES-2017-080770 and the APC was funded by additional support from the University of Granada, UGR Research and Knowledge Transfer Fund (PPIT) 2016, Excellence Actions Programme, and Excellence Actions Programe. C.M.A. and I.L.G. are part of the “URG Plan propio de Investigación 2016” and the “Excellence actions: Unit of Excellence on Exercise and Health (UCEES), University of Granada

Impact of cow's milk intake on exercise performance and recovery of muscle function: a systematic review

Dairy products are thought to improve recovery after both resistance and endurance exercises due to their nutritional proprieties. We systematically reviewed the effects of dairy product intake on exercise performance and recovery of muscle function in humans. A literature search was conducted in the MEDLINE (via PubMed) and Web of Science databases from their inception to 15th April 2018. The initial search retrieved 7708 articles, and a total of 11 studies were finally included after applying inclusion and exclusion criteria. All the selected studies were conducted with cow's milk. Whereas some studies found significant positive effect of cow's milk on exercise performance and recovery of muscle function, others did not find any effect. These controversies could be due to the heterogeneity of cow's milk ingestion (e.g., amount of cow's milk, timing of consuming the cow's milk), to the type of intervention, and to the large heterogeneity of outcomes measured. Limited studies exist examining the effects of cow's milk consumption and its influence on exercise performance and recovery of muscle function, therefore further studies are needed to draw more definitive conclusions.The study was supported by the Spanish Ministry of Education (FPU 13/04365 and 15/04059), by the Redes temáticas de investigación cooperativa RETIC (Red SAMID RD16/0022), and by the University of Granada Plan Propio de Investigacion 2016 -Excellence actions: Unit of Excellence on Exercise and Health (UCEES) - and Plan Propio de Investigación 2018 - Programa Contratos-Puente, and the Junta de Andalucía, Consejería de Conocimiento, Investigación y Universidades (ERDF: ref. SOMM17/6107/UGR), and by the Interprofessional Dairy Organization (INLAC) of Spain

Reproducibility of the energy metabolism response to an oral glucose tolerance test: influence of a postcalorimetric correction procedure

Purpose Metabolic fexibility (MetF), which is a surrogate of metabolic health, can be assessed by the change in the respiratory exchange ratio (RER) in response to an oral glucose tolerance test (OGTT). We aimed to determine the day-to-day reproducibility of the energy expenditure (EE) and RER response to an OGTT, and whether a simulation-based postcalorimetric correction of metabolic cart readouts improves day-to-day reproducibility. Methods The EE was assessed (12 young adults, 6 women, 27±2 years old) using an Omnical metabolic cart (Maastricht Instruments, Maastricht, The Netherlands) after an overnight fast (12 h) and after a 75-g oral glucose dose on 2 separate days (48 h). On both days, we assessed EE in 7 periods (one 30-min baseline and six 15-min postprandial). The ICcE was performed immediately after each recording period, and capillary glucose concentration (using a digital glucometer) was determined. Results We observed a high day-to-day reproducibility for the assessed RER (coefcients of variation [CV]<4%) and EE (CVs<9%) in the 7 diferent periods. In contrast, the RER and EE areas under the curve showed a low day-to-day reproducibility (CV=22% and 56%, respectively). Contrary to our expectations, the postcalorimetric correction procedure did not infuence the day-to-day reproducibility of the energy metabolism response, possibly because the Omnical’s accuracy was~100%. Conclusion Our study demonstrates that the energy metabolism response to an OGTT is poorly reproducible (CVs>20%) even using a very accurate metabolic cart. Furthermore, the postcalorimetric correction procedure did not infuence the day-to-day reproducibility. Trial registration NCT04320433; March 25, 2020.Funding for open access charge: Universidad de Granada / CBUA. Supported by the Spanish Ministry of Economy and Competitiveness via Retos de la Sociedad grant DEP2016-79512-R (to JRR), and European Regional Development Funds (ERDF); Spanish Ministry of Education grant (FPU15/04059 to JMAA; and FPU19/01609 to LJ-F); the University of Granada Plan Propio de Investigación 2016-Excellence actions: Unit of Excellence on Exercise and Health (to JRR)—Plan Propio de Investigación 2018 and 2020 Programa Contratos-Puente and Programa Perfeccionamiento de Doctores (to GS-D, and to JMAA respectively); Junta de Andalucía, Consejería de Conocimiento, Investigación y Universidades grant SOMM17/6107/UGR (to JRR) via the ERDF; and the Fundación Alfonso Martín Escudero (to GS-D)