Effectiveness of a multifactorial intervention in increasing adherence to the mediterranean diet among patients with diabetes mellitus type 2: a controlled and randomized study (EMID Study)

The Mediterranean diet (MD) is recognized as one of the healthiest dietary patterns and has benefits such as improving glycaemic control among patients with type 2 diabetes (T2DM). Our aim is to assess the effectiveness of a multifactorial intervention to improve adherence to theMD, diet quality and biomedical parameters. The EMID study is a randomized and controlled clinical trial with two parallel groups and a 12-month follow-up period. The study included 204 subjects between 25–70 years with T2DM. The participants were randomized into intervention group (IG) and control group (CG). Both groups received brief advice about healthy eating and physical activity. The IG participants additionally took part in a food workshop, five walks and received a smartphone application for three months. The population studied had a mean age of 60.6 years. At the 3-month follow-up visit, there were improvements in adherence to the MD and diet quality of 2.2 and 2.5 points, compared to the baseline visit, respectively, in favour of the IG. This tendency of the improvement was maintained, in favour of the IG, at the 12-month follow-up visit. In conclusion, the multifactorial intervention performed could improve adherence to the MD and diet quality among patients with T2DM.Regional Health Management through the 2016 grants to carry out research projects in biomedicine, health management and socio-health care (GRS 1276/B/16), the 2016 program for the professional development of nurses in their research activity (BOCYL-D-11022016-2) and the 2015 incentive program for nurses who have completed their residency (ORDER SAN / 360/2015). The study was also co-financed by the Carlos III Health Institute and the European Regional Development Fund (ERDF) (RD 16/0007/0003)

Observation of two-proton radioactivity of Mg19 by tracking the decay products

We have observed the two-proton radioactivity of the previously unknown 19Mg ground state by tracking the decay products in-flight. For the first time, the trajectories of the 2p-decay products, 17Ne+p+p, have been measured by using tracking microstrip detectors which allowed us to reconstruct the 2p-decay vertices and fragment correlations. The half-life of 19Mg deduced from the measured vertex distribution is 4.0(15) ps in the system of 19Mg. The Q value of the 2p decay of the 19Mg ground state inferred from the measured p−p−17Ne correlations is 0.75(5) MeV.MEC FPA2003-05958 FPA2006-13807-C02-0

Cocoa intake and arterial stiffness in subjects with cardiovascular risk factors

<p>Abstract</p> <p>Background</p> <p>To analyze the relationship of cocoa intake to central and peripheral blood pressure, arterial stiffness, and carotid intima-media thickness in subjects with some cardiovascular risk factor.</p> <p>Findings</p> <p>Design: A cross-sectional study of 351 subjects (mean age 54.76 years, 62.4% males). Measurements: Intake of cocoa and other foods using a food frequency questionnaire, central and peripheral (ambulatory and office) blood pressure, central and peripheral augmentation index, pulse wave velocity, ambulatory arterial stiffness index, carotid intima-media thickness, and ankle-brachial index.</p> <p>Results: Higher pulse wave velocity and greater cardiovascular risk were found in non-cocoa consumers as compared to high consumers (<it>p </it>< 0.05). In a multivariate analysis, these differences disappeared after adjusting for age, gender, the presence of diabetes, systolic blood pressure and antihypertensive and lipid-lowering drug use. All other arterial stiffness measures (central and peripheral augmentation index, ambulatory arterial stiffness index, ankle-brachial index, and carotid intima-media thickness) showed no differences between the different consumption groups.</p> <p>Conclusions</p> <p>In subjects with some cardiovascular risk factors, cocoa consumption does not imply improvement in the arterial stiffness values.</p> <p>Trial Registration</p> <p>Clinical Trials.gov Identifier: <a href="http://www.clinicaltrials.gov/ct2/show/NCT01325064">NCT01325064</a>.</p

Smart Industrial Metabolism: a literature review and future directions

Corporate and academic interest in the concept of industrial metabolism has risen considerably in recent years. This can be observed in the number of papers published. In order to go deep into current and future trends in this field, the paper objective is multiple. Firstly, the purpose of this paper is to carry out a literature review on industrial metabolism. Secondly, this paper offers a summary of the research in this field, performing a descriptive analysis based on identifying temporal distribution of publications, journals in which papers are published and classifying different applications of industrial metabolism concept. Thus, this paper seeks to provide a review of the main approaches to industrial metabolism. Finally, an overview of immense opportunities for the implementation of industrial metabolism based on Industry 4.0 is presented

New states in 18Na and 19Mg observed in the two-proton decay of 19Mg

Previously unknown states in 18Na and 19Mg have been studied by measuring the trajectories of their decay products with microstrip detectors. Analyzing angular correlations of the fragments provided information on decay energies and widths of the parent states. The ground state of 18Na has been detected and its one-proton decay energy of 1.23(15) MeV determined. Four previously unknown states in 19Mg at 2.1, 2.9, 3.6, and 5.2 MeV have been observed. The competition between simultaneous and sequential two-proton emission of states in 19Mg is discussed, and the conclusion of a direct mechanism of 2p radioactivity of the 19Mg ground state is confirmed.MEC EC-I3 FPA2006-13807-C02-01Ministerio de Economía y Competitividad FPA2009-0884

Increased plasma soluble endoglin levels as an indicator of cardiovascular alterations in hypertensive and diabetic patients

<p>Abstract</p> <p>Background</p> <p>Endoglin is involved in the regulation of endothelial function, but there are no studies concerning its relation with hypertension- and diabetes-associated pathologies. Thus, we studied the relationship between plasma levels of soluble endoglin and cardiovascular alterations associated with hypertension and diabetes.</p> <p>Methods</p> <p>We analyzed 288 patients: 64 with type 2 diabetes, 159 with hypertension and 65 healthy patients. We assessed the relationship of soluble endoglin plasma levels measured by enzyme-linked immunosorbent assay with basal glycemia, glycosylated hemoglobin, blood pressure, endothelial dysfunction (assessed by pressure wave velocity), hypertensive retinopathy (by Keith-Wagener classification), left ventricular hypertrophy (by Cornell and Sokolow indexes), cardiovascular risk and target organ (heart, vascular, kidney) damage.</p> <p>Results</p> <p>There are significant correlations between endoglin and glycemia, systolic blood pressure, pulse pressure, pressure wave velocity and electrocardiographically assessed left ventricular hypertrophy. Endoglin levels were significantly higher in patients with diabetes who had nondipper and extreme dipper circadian blood pressure patterns than in dipper circadian patterns, in patients with hypertension and diabetes who had riser pattern than in the other patients, and in patients with diabetes but not hypertension who had extreme dipper pattern than in dipper, nondipper and riser groups. There was also a significant correlation between plasma-soluble endoglin and lower levels of systolic night-day ratio. Higher endoglin levels were found in patients with diabetes who had retinopathy, in patients with diabetes who had a high probability of 10-year cardiovascular risk, and in patients with diabetes and hypertension who had three or more damaged target organs (heart, vessels, kidney) than in those with no organs affected.</p> <p>Conclusions</p> <p>This study shows that endoglin is an indicator of hypertension- and diabetes-associated vascular pathologies as endothelial dysfunction and cardiovascular damage.</p

Long-Term Effectiveness of a Smartphone App and a Smart Band on Arterial Stiffness and Central Hemodynamic Parameters in a Population with Overweight and Obesity (Evident 3 Study): Randomised Controlled Trial

Background: mHealth technologies could help to improve cardiovascular health; however, their effect on arterial stiffness and hemodynamic parameters has not been explored to date. Objective: To evaluate the effect of a mHealth intervention, at 3 and 12 months, on arterial stiffness and central hemodynamic parameters in a sedentary population with overweight and obesity. Methods: Randomised controlled clinical trial (Evident 3 study). 253 subjects were included: 127 in the intervention group (IG) and 126 in the control group (CG). The IG subjects were briefed on the use of the Evident 3 app and a smart band (Mi Band 2, Xiaomi) for 3 months to promote healthy lifestyles. All measurements were recorded in the baseline visit and at 3 and 12 months. The carotid-femoral pulse wave velocity (cfPWV) and the central hemodynamic parameters were measured using a SphigmoCor System® device, whereas the brachial-ankle pulse wave velocity (baPWV) and the Cardio Ankle Vascular Index (CAVI) were measured using a VaSera VS-2000® device. Results: Of the 253 subjects who attended the initial visit, 237 (93.7%) completed the visit at 3 months of the intervention, and 217 (85.3%) completed the visit at 12 months of the intervention. At 12 months, IG showed a decrease in peripheral augmentation index (PAIx) (−3.60; 95% CI −7.22 to −0.00) and ejection duration (ED) (−0.82; 95% CI −1.36 to −0.27), and an increase in subendocardial viability ratio (SEVR) (5.31; 95% CI 1.18 to 9.44). In CG, cfPWV decreased at 3 months (−0.28 m/s; 95% CI −0.54 to −0.02) and at 12 months (−0.30 m/s, 95% CI −0.54 to −0.05), central diastolic pressure (cDBP) decreased at 12 months (−1.64 mm/Hg; 95% CI −3.19 to −0.10). When comparing the groups we found no differences between any variables analyzed. Conclusions: In sedentary adults with overweight or obesity, the multicomponent intervention (Smartphone app and an activity-tracking band) for 3 months did not modify arterial stiffness or the central hemodynamic parameters, with respect to the control group. However, at 12 months, CG presented a decrease of cfPWV and cDBP, whereas IG showed a decrease of PAIx and ED and an increase of SEVR

¿Se asocia el consumo de refrescos azucarados con la composición corporal? Estudio transversal en adolescentes españoles

Objectives: Published data about the association between the consumption of sweetened soft-drinks (SSD) and obesity in childhood are controversial and still inconsistent. In addition, data are lacking in the Spanish population. The purpose of this study was therefore, to explore the cross-sectional association between body composition- related parameters and SSD consumption in Spanish adolescents. Subjects and methods: A representative sample of 1,523 adolescents (768 boys and 755 girls), with complete dietary data as well as anthropometric measurements, were included in this study. Weight, height, waist circumferences, and 6 skinfolds were measured, and BMI and percentage body fat were calculated. From a 24h dietary recall the subjects were grouped in 3 groups according to their SSD consumption: 1) Non-consumers (0 g of SSD consumption); 2) Moderate consumption (< 336 g/day of SSD, equivalent to the average SSD portion size); and 3) High consumption (> 336 g/day of SSD). Results: 67% males and 75% females did not consume any SSD the day before the dietary recall interview. Males consumed more SSD than females. Regarding the association between SSD consumption and measures of obesity, no difference was observed between the three groups of SSD consumption in any of the anthropometric measurement, BMI or body fat. Conclusion: As no association was present between SSD consumption and obesity in our cross-sectional study we suggest that dietary patterns and habits as well as lifestyle factors such as physical activity should be present when examining cross-sectional or longitudinal relationships with obesity. Multidisciplinary intervention studies are crucial when trying to develop solutions against the increasing obesity epidemic.Objetivos: Los datos publicados sobre la asociación entre el consumo de refrescos azucarados (SSD) y la obesidad en la infancia son controvertidos y todavía inconsistentes. Además, estos datos son muy escasos en la población española. Por ello, el propósito de este estudio ha sido estudiar la asociación entre los parámetros relacionados con la composición corporal y el consumo de SSD en adolescentes españoles. Sujetos y métodos: Se ha realizado el estudio en una muestra de 1.523 adolescentes (768 chicos y 755 chicas) que tenían cumplimentados los datos dietéticos y los parámetros antropométricos (peso, altura, circunferencias de cintura, y 6 pliegues). Se calculó el IMC y el porcentaje de grasa corporal. La dieta ha sido calculada a partir de un recordatorio de 24h. Los sujetos fueron divididos en grupos dependiendo de la cantidad de SSD que consumían: 1) No consumidores (0 g de consumo SSD); 2) Consumo moderado (< 336 g/día de SSD, equivalente a una bebida al día de SSD); y 3) Consumo alto (> 336 g/día de SSD). Resultados: El 67% de los varones y el 75% de las mujeres indican no consumir este tipo de bebidas el día anterior a la encuesta. Los varones en general consumieron más SSD que las mujeres. En cuanto a la asociación entre consumo SSD y medidas antropométricas y de composición corporal, no se encontraron diferencias significativas entre los tres grupos de estudio en los parámetros antropométricos, IMC o grasa corporal. Conclusión: Dado que no se ha encontrado en este estudio ninguna asociación entre el consumo de SSD y la obesidad, sugerimos que los patrones y hábitos dietarios así como los factores del estilo de vida, y la actividad física, deberían tenerse en cuenta al examinar las relaciones transversales o longitudinales con la obesidad, y que los estudios de intervención multidisciplinar son cruciales cuando se trata de desarrollar soluciones contra el incremento de una epidemia como la obesidad.The AVENA study was supported by Spanish Ministry of Health (00/0015) and by grants from the Spanish Higher Sports Council (05/UPB32/01, 09/UPB31/03 and 13/UPB20/04), the Spanish Ministry of Education (AP2003-2128 and AP2004-2745), Coca-Cola, Panrico SA, Madaus SA and Procter & Gamble SA

Vascular and cognitive effects of cocoa-rich chocolate in postmenopausal women: a study protocol for a randomised clinical trial

Introduction The intake of polyphenols has certain health benefits. This study will aim to assess the effect of adding a daily amount of chocolate high in cocoa content and polyphenols to the normal diet on blood pressure, vascular function, cognitive performance, quality of life and body composition in postmenopausal women. Methods and analysis Here we plan a randomised clinical trial with two parallel groups involving a total of 140 women between 50 and 64 years in the postmenopausal period, defined by amenorrhoea of at least 12 consecutive months. The main variable will be the change in blood pressure. Secondary variables will be changes in vascular function, quality of life, cognitive performance and body composition. The intervention group will be given chocolate containing 99% cocoa, with instructions to add 10 g daily to their normal diet for 6 months. The daily nutritional contribution of this amount of chocolate is 59 kcal and 65.4 mg of polyphenols. There will be no intervention in the control group. All variables will be measured at the baseline visit and 3 and 6 months after randomisation, except cognitive performance and quality of life, which will only be assessed at baseline and at 6 months. Recruitment is scheduled to begin on 1 June 2018, and the study will continue until 31 May 2019. Ethics and dissemination This study was approved by the Clinical Research Ethics Committee of the Health Area of Salamanca, Spain (‘CREC of Health Area of Salamanca’), in February 2018. A SPIRIT checklist is available for this protocol. The clinical trial has been registered at ClinicalTrials. gov provided by the US National Library of Medicine, number NCT03492983. The results will be disseminated through open access peer-reviewed journals, conference presentations, broadcast media and a presentation to stakeholders.Gerencia Regional de Castilla y León (GRS 1583/B/1

Combined use of smartphone and smartband technology in the improvement of lifestyles in the adult population over 65 years: study protocol for a randomized clinical trial (EVIDENT-Age study)

Background The increasing use of smartphones by older adults also increases their potential for improving different aspects of health in this population. Some studies have shown promising results in the improvement of cognitive performance through lifestyle modification. All this may have a broad impact on the quality of life and carrying out daily living activities. The objective of this study is to evaluate the effectiveness of combining the use of smartphone and smartband technology for 3 months with brief counseling on life habits, as opposed to providing counseling only, in increasing physical activity and improving adherence to the Mediterranean diet. Secondary objectives are to assess the effect of the intervention on body composition, quality of life, independence in daily living activities and cognitive performance. Methods This study is a two-arm cluster-randomized trial that will be carried out in urban health centers in Spain. We will recruit 160 people aged between 65 and 80 without cardiovascular disease or cognitive impairment (score in the Mini-mental State Examination ≥24). On a visit to their center, intervention group participants will be instructed to use a smartphone application for a period of 3 months. This application integrates information on physical activity received from a fitness bracelet and self-reported information on the patient’s daily nutritional composition. The primary outcome will be the change in the number of steps measured by accelerometer. Secondary variables will be adherence to the Mediterranean diet, sitting time, body composition, quality of life, independence in daily living activities and cognitive performance. All variables will be measured at baseline and on the assessment visit after 3 months. A telephone follow-up will be carried out at 6 months to collect self-reported data regarding physical activity and adherence to the Mediterranean diet. Discussion Preventive healthy aging programs should include health education with training in nutrition and lifestyles, while stressing the importance of and enhancing physical activity; the inclusion of new technologies can facilitate these goals. The EVIDENT-AGE study will incorporate a simple, accessible intervention with potential implementation in the care of older adults.This study was supported in part by grants funded by the Instituto de Salud Carlos III, Institute of Biomedical Research of Salamanca (IBSAL)-IBY17/00003, and the Spanish Research Network for Preventive Activities and Health Promotion in Primary Care (REDIAPP)-RD16/0007