Motivating pregnant and breastfeeding women in Spain to avoid persistent toxic substances in their diet

The objective of this study was to explore what motivates pregnant and breastfeeding women to make changes in their diet, specifically to examine how their perceptions regarding diet facilitate or act as obstacles to introducing healthy eating habits. For the optimal development of the mother, the fetus, or breastfeeding baby, it is important to avoid foods containing substances, such as persistent toxic substances (PTSs), that are harmful to health during pregnancy and after the baby's birth. This study used a qualitative research methodology, based on semi-structured individual interviews, food diaries, free lists, and focus groups with 111 pregnant and breastfeeding women in Spain. This approach was followed by a systematic and exhaustive exploitation of the qualitative data obtained, following the methodological principles of grounded theory. From the study results, we conclude that the motivation for a change in diet to avoid PTSs is based on the desire to promote good health, beliefs about the importance of having a varied diet, and the avoidance of potential risks. The main obstacles to change can be attributed to inadequate information, contradictory discourses, and socioeconomic diffculties

THE OBESITY EPIDEMIC IN SPAIN: THE RHETORIC OF ITS DISCOURSE AND POTENTIAL RISKS

La obesidad se ha convertido en una prioridad para las políticas de salud pública en España. Basándose en el aumento de su prevalencia ha sido catalogada como una epidemia. A pesar de estas afirmaciones, las investigaciones no parecen siempre tan concluyentes. El objetivo de este artículo es revisar algunas de las ‘verdades’ en torno a la obesidad: a) que la obesidad va en aumento y es una epidemia en España; b) que existe una relación directa entre peso y salud; y c) que la obesidad tenga su consecuencia única en el desequilibrio entre gasto y consumo energético. Además, dado que las ideas vertidas en torno a la epidemia de la obesidad, y el modo exagerado y alarmista en que se produce, pueden tener consecuencias dañinas e impredecibles sobre la salud de las personas, un segundo objetivo es delinear algunos de los posibles riesgos de estas prácticas de comunicación.A obesidade tornou-se uma prioridade para as políticas de saúde pública na Espanha. Com base no aumento da prevalência foi classificada como uma epidemia. Apesar dessas afirmações, as investigações nem sempre parecem tão conclusivas. O objetivo deste artigo é analisar algumas das ‘verdades’ sobre a obesidade: a) que a obesidade está aumentando e é uma epidemia em Espanha; b) existe uma relação direta entre peso e saúde; e c) que a obesidade tenha uma consequência única em um desequilíbrio entre gasto e consumo de energia. Além disso, uma vez expressas as ideias sobre a epidemia da obesidade, a maneira exagerada e alarmista que ocorre pode ter consequências imprevisíveis sobre a saúde das pessoas; um segundo objetivo é delinear alguns dos possíveis riscos dessas práticas de comunicação.   Obesity has become a top priority for public health policies inSpain. Based on increasing prevalence, it has been classified as an epidemic. Despite these claims, research does not always seem so conclusive. The purpose of this article is to review some of the ‘truths’ about obesity: a) that it is on the rise and is an epidemic in Spain; b) that there is a direct relationship between weight and health; c) that its sole effect is the imbalance between energy expenditure and intake. In addition, since the ideas expressed about the obesity epidemic and the exaggerated and alarmist way they are produced might have harmful and unpredictable consequences on people’s health, a second aim is to point out some of the possible risks inherent in those communication practices.

Mutation study of Spanish patients with Hereditary Hemorrhagic Telangiectasia

<p>Abstract</p> <p>Background</p> <p>Hereditary Hemorrhagic Telangiectasia (HHT) is an autosomal dominant and age-dependent vascular disorder characterised mainly by mutations in the Endoglin (ENG) or activin receptor-like kinase-1 (ALK1, ACVRL1) genes.</p> <p>Methods</p> <p>Here, we have identified 22 ALK1 mutations and 15 ENG mutations, many of which had not previously been reported, in independent Spanish families afflicted with HHT.</p> <p>Results</p> <p>We identified mutations in thirty-seven unrelated families. A detailed analysis of clinical symptoms was recorded for each patient analyzed, with a higher significant presence of pulmonary arteriovenous malformations (PAVM) in HHT1 patients over HHT2. Twenty-two mutations in ALK1 and fifteen in ENG genes were identified. Many of them, almost half, represented new mutations in ALK1 and in ENG. Missense mutations in ENG and ALK1 were localized in a tridimensional protein structure model.</p> <p>Conclusion</p> <p>Overall, ALK1 mutations (HHT2) were predominant over ENG mutations (HHT1) in our Spanish population, in agreement with previous data from our country and other Mediterranean countries (France, Italy), but different to Northern Europe or North America. There was a significant increase of PAVM associated with HHT1 over HHT2 in these families.</p

Effects of sardine-enriched diet on metabolic control, inflammation and gut microbiota in drug-naïve patients with type 2 diabetes: a pilot randomized trial

Nutrition therapy is the cornerstone of treating diabetes mellitus. The inclusion of fish (particularly oily fish) at least two times per week is recommended by current international dietary guidelines for type 2 diabetes. In contrast to a large number of human studies examining the effects of oily fish on different cardiovascular risk factors, little research on this topic is available in patients with type 2 diabetes. The aims of this pilot study were to investigate the effects of a sardine-enriched diet on metabolic control, adiponectin, inflammatory markers, erythrocyte membrane fatty acid (EMFA) composition, and gut microbiota in drug-naïve patients with type 2 diabetes. METHODS: 35 drug-naïve patients with type 2 diabetes were randomized to follow either a type 2 diabetes standard diet (control group: CG), or a standard diet enriched with 100 g of sardines 5 days a week (sardine group: SG) for 6 months. Anthropometric, dietary information, fasting glycated hemoglobin, glucose, insulin, adiponectin, inflammatory markers, EMFA and specific bacterial strains were determined before and after intervention. RESULTS: There were no significant differences in glycemic control between groups at the end of the study. Both groups decreased plasma insulin (SG: -35.3%, P = 0.01, CG: -22.6%, P = 0.02) and homeostasis model of assessment--insulin resistance (HOMA-IR) (SG: -39.2%, P = 0.007, CG: -21.8%, P = 0.04) at 6-months from baseline. However only SG increased adiponectin in plasma compared to baseline level (+40.7%, P = 0.04). The omega-3 index increased 2.6% in the SG compared to 0.6% in the CG (P = 0.001). Both dietary interventions decreased phylum Firmicutes (SG and CG: P = 0.04) and increased E. coli concentrations (SG: P = 0.01, CG: P = 0.03) at the end of the study from baseline, whereas SG decreased Firmicutes/Bacteroidetes ratio (P = 0.04) and increased Bacteroides-Prevotella (P = 0.004) compared to baseline. CONCLUSIONS: Although enriching diet with 100 g of sardines 5 days a week during 6 months to a type 2 diabetes standard diet seems to have neutral effects on glycemic control in drug-naïve patients with type 2 diabetes, this nutritional intervention could have beneficial effects on cardiovascular risk. Furthermore, both dietary interventions decreased HOMA-IR and altered gut microbiota composition of drug-naïve patients with type 2 diabetes

Effects of sardine-enriched diet on metabolic control, inflammation and gut microbiota in drug-naïve patients with type 2 diabetes: a pilot randomized trial

Nutrition therapy is the cornerstone of treating diabetes mellitus. The inclusion of fish (particularly oily fish) at least two times per week is recommended by current international dietary guidelines for type 2 diabetes. In contrast to a large number of human studies examining the effects of oily fish on different cardiovascular risk factors, little research on this topic is available in patients with type 2 diabetes. The aims of this pilot study were to investigate the effects of a sardine-enriched diet on metabolic control, adiponectin, inflammatory markers, erythrocyte membrane fatty acid (EMFA) composition, and gut microbiota in drug-naïve patients with type 2 diabetes. Methods 35 drug-naïve patients with type 2 diabetes were randomized to follow either a type 2 diabetes standard diet (control group: CG), or a standard diet enriched with 100 g of sardines 5 days a week (sardine group: SG) for 6 months. Anthropometric, dietary information, fasting glycated hemoglobin, glucose, insulin, adiponectin, inflammatory markers, EMFA and specific bacterial strains were determined before and after intervention. Results There were no significant differences in glycemic control between groups at the end of the study. Both groups decreased plasma insulin (SG: −35.3 %, P = 0.01, CG: −22.6 %, P = 0.02) and homeostasis model of assessment - insulin resistance (HOMA-IR) (SG: −39.2 %, P = 0.007, CG: −21.8 %, P = 0.04) at 6-months from baseline. However only SG increased adiponectin in plasma compared to baseline level (+40.7 %, P = 0.04). The omega-3 index increased 2.6 % in the SG compared to 0.6 % in the CG (P = 0.001). Both dietary interventions decreased phylum Firmicutes (SG and CG: P = 0.04) and increased E. coli concentrations (SG: P = 0.01, CG: P = 0.03) at the end of the study from baseline, whereas SG decreased Firmicutes/Bacteroidetes ratio (P = 0.04) and increased Bacteroides-Prevotella (P = 0.004) compared to baseline. Conclusions Although enriching diet with 100 g of sardines 5 days a week during 6 months to a type 2 diabetes standard diet seems to have neutral effects on glycemic control in drug-naïve patients with type 2 diabetes, this nutritional intervention could have beneficial effects on cardiovascular risk. Furthermore, both dietary interventions decreased HOMA-IR and altered gut microbiota composition of drug-naïve patients with type 2 diabete

Genetic landscape of 6089 inherited retinal dystrophies affected cases in Spain and their therapeutic and extended epidemiological implications

Inherited retinal diseases (IRDs), defined by dysfunction or progressive loss of photoreceptors, are disorders characterized by elevated heterogeneity, both at the clinical and genetic levels. Our main goal was to address the genetic landscape of IRD in the largest cohort of Spanish patients reported to date. A retrospective hospital-based cross-sectional study was carried out on 6089 IRD affected individuals (from 4403 unrelated families), referred for genetic testing from all the Spanish autonomous communities. Clinical, demographic and familiar data were collected from each patient, including family pedigree, age of appearance of visual symptoms, presence of any systemic findings and geographical origin. Genetic studies were performed to the 3951 families with available DNA using different molecular techniques. Overall, 53.2% (2100/3951) of the studied families were genetically characterized, and 1549 different likely causative variants in 142 genes were identified. The most common phenotype encountered is retinitis pigmentosa (RP) (55.6% of families, 2447/4403). The most recurrently mutated genes were PRPH2, ABCA4 and RS1 in autosomal dominant (AD), autosomal recessive (AR) and X-linked (XL) NON-RP cases, respectively; RHO, USH2A and RPGR in AD, AR and XL for non-syndromic RP; and USH2A and MYO7A in syndromic IRD. Pathogenic variants c.3386G > T (p.Arg1129Leu) in ABCA4 and c.2276G > T (p.Cys759Phe) in USH2A were the most frequent variants identified. Our study provides the general landscape for IRD in Spain, reporting the largest cohort ever presented. Our results have important implications for genetic diagnosis, counselling and new therapeutic strategies to both the Spanish population and other related populations.This work was supported by the Instituto de Salud Carlos III (ISCIII) of the Spanish Ministry of Health (FIS; PI16/00425 and PI19/00321), Centro de Investigación Biomédica en Red Enfermedades Raras (CIBERER, 06/07/0036), IIS-FJD BioBank (PT13/0010/0012), Comunidad de Madrid (CAM, RAREGenomics Project, B2017/BMD-3721), European Regional Development Fund (FEDER), the Organización Nacional de Ciegos Españoles (ONCE), Fundación Ramón Areces, Fundación Conchita Rábago and the University Chair UAM-IIS-FJD of Genomic Medicine. Irene Perea-Romero is supported by a PhD fellowship from the predoctoral Program from ISCIII (FI17/00192). Ionut F. Iancu is supported by a grant from the Comunidad de Madrid (CAM, PEJ-2017-AI/BMD7256). Marta del Pozo-Valero is supported by a PhD grant from the Fundación Conchita Rábago. Berta Almoguera is supported by a Juan Rodes program from ISCIII (JR17/00020). Pablo Minguez is supported by a Miguel Servet program from ISCIII (CP16/00116). Marta Corton is supported by a Miguel Servet program from ISCIII (CPII17/00006). The funders played no role in study design, data collection, data analysis, manuscript preparation and/or publication decisions

Effects of sardine-enriched diet on metabolic control, inflammation and gut microbiota in drug-naïve patients with type 2 diabetes : a pilot randomized trial

Nutrition therapy is the cornerstone of treating diabetes mellitus. The inclusion of fish (particularly oily fish) at least two times per week is recommended by current international dietary guidelines for type 2 diabetes. In contrast to a large number of human studies examining the effects of oily fish on different cardiovascular risk factors, little research on this topic is available in patients with type 2 diabetes. The aims of this pilot study were to investigate the effects of a sardine-enriched diet on metabolic control, adiponectin, inflammatory markers, erythrocyte membrane fatty acid (EMFA) composition, and gut microbiota in drug-naïve patients with type 2 diabetes. 35 drug-naïve patients with type 2 diabetes were randomized to follow either a type 2 diabetes standard diet (control group: CG), or a standard diet enriched with 100 g of sardines 5 days a week (sardine group: SG) for 6 months. Anthropometric, dietary information, fasting glycated hemoglobin, glucose, insulin, adiponectin, inflammatory markers, EMFA and specific bacterial strains were determined before and after intervention. There were no significant differences in glycemic control between groups at the end of the study. Both groups decreased plasma insulin (SG: −35.3 %, P = 0.01, CG: −22.6 %, P = 0.02) and homeostasis model of assessment - insulin resistance (HOMA-IR) (SG: −39.2 %, P = 0.007, CG: −21.8 %, P = 0.04) at 6-months from baseline. However only SG increased adiponectin in plasma compared to baseline level (+40.7 %, P = 0.04). The omega-3 index increased 2.6 % in the SG compared to 0.6 % in the CG (P = 0.001). Both dietary interventions decreased phylum Firmicutes (SG and CG: P = 0.04) and increased E. coli concentrations (SG: P = 0.01, CG: P = 0.03) at the end of the study from baseline, whereas SG decreased Firmicutes/Bacteroidetes ratio (P = 0.04) and increased Bacteroides-Prevotella (P = 0.004) compared to baseline. Although enriching diet with 100 g of sardines 5 days a week during 6 months to a type 2 diabetes standard diet seems to have neutral effects on glycemic control in drug-naïve patients with type 2 diabetes, this nutritional intervention could have beneficial effects on cardiovascular risk. Furthermore, both dietary interventions decreased HOMA-IR and altered gut microbiota composition of drug-naïve patients with type 2 diabetes

Relación entre la Dieta Mediterránea y el Síndrome Metabólico en pacientes con obesidad mórbida. Asociación con niveles séricos de miRNAs.

Además, se encontró asociación del consumo de determinados alimentos considerados saludables con la realización de ejercicio físico, y con un mayor nivel educacional en estos pacientes. Estos factores se relacionan con un estilo de vida más saludable y una menor prevalencia de síndrome metabólico. Entre los pacientes con obesidad mórbida más adherentes a la dieta mediterránea encontramos niveles en suero de mir-590 significativamente más altos. Por otro lado, encontramos niveles significativamente más bajos de mir-590 y mir-let7a en los sujetos con obesidad mórbida que cumplían el criterio de colesterol HDL del síndrome metabólico. Respecto al mir-192, encontramos niveles significativamente más altos asociados a la presencia de DM2, a niveles más altos de triglicéridos y niveles más bajos de colesterol HDL. Estudios como éste, nos ayudan a conocer más en profundidad los cambios y efectos que los componentes bioactivos de la dieta como la mediterránea, pueden producir sobre el metabolismo a través de su efecto modulador en los miRNAs. Este tipo de resultados pueden brindar la posibilidad de elaborar programas más efectivos y personalizados para la prevención y tratamiento de enfermedades metabólicas en grupos específicos de sujetos dentro de la población general.La obesidad es considerada por la Federación Internacional de Trabajo de la Obesidad (IOTF) y la Organización Mundial de la Salud (OMS) como la epidemia del siglo XXI debido al impacto sobre la morbimortalidad, la calidad de vida y el gasto sanitario que ha ido adquiriendo a lo largo de las últimas décadas. Igualmente contribuye de manera importante a la aparición de enfermedades crónicas, como las enfermedades cardiovasculares. Los principales causantes de esta epidemia son la falta de actividad física, el estilo de vida sedentario y la globalización del sistema alimentario. La dieta mediterránea se caracteriza por un elevado consumo de verduras, frutas, cereales y frutos secos y el empleo del aceite de oliva como grasa principal. Una alta adherencia a esta dieta ayuda a predecir la prevalencia de DM2 y síndrome metabólico. También, se ha demostrado que la actividad física junto con un plan de alimentación estructurado, mejora la salud y previene las enfermedades cardiovasculares. Del mismo modo, sabemos que determinados nutrientes abundantes en la dieta mediterránea contienen componentes bioactivos, los cuales son los responsables de producir estos efectos protectores y beneficiosos para la salud. Estos componentes bioactivos tendrían la capacidad de modular la expresión de determinados miRNAs con el consecuente efecto sobre vías involucradas en el metabolismo. Por todo esto, se analizó en un grupo de sujetos con obesidad mórbida, la asociación entre la dieta mediterránea, el síndrome metabólico y el estilo de vida, además de estudiar una posible asociación con niveles de ciertos miRNAs medidos en suero. Entre los resultados del estudio se observó que existe una asociación significativa entre la adherencia a la dieta mediterránea y los distintos criterios que definen la presencia de síndrome metabólico