Endocrine Disruptors in Food: Impact on Gut Microbiota and Metabolic Diseases

The results presented in this article constitute part of Yolanda Gálvez-Ontiveros doctoral thesis, performed in the Nutrition and Food Sciences Doctorate Program of the University of Granada.Endocrine disruptors (EDCs) have been associated with the increased incidence of metabolic disorders. In this work, we conducted a systematic review of the literature in order to identify the current knowledge of the interactions between EDCs in food, the gut microbiota, and metabolic disorders in order to shed light on this complex triad. Exposure to EDCs induces a series of changes including microbial dysbiosis and the induction of xenobiotic pathways and associated genes, enzymes, and metabolites involved in EDC metabolism. The products and by-products released following the microbial metabolism of EDCs can be taken up by the host; therefore, changes in the composition of the microbiota and in the production of microbial metabolites could have a major impact on host metabolism and the development of diseases. The remediation of EDC-induced changes in the gut microbiota might represent an alternative course for the treatment and prevention of metabolic diseases.This work was carried out within the frame of GP/EFSA/ENCO/380 2018/03/G04: OBEMIRISK: Knowledge platform for assessing the risk of Bisphenols on gut microbiota and its role in obesogenic phenotype: looking for biomarkers. This research was also funded by Plan Estatal de I+D+I 2013-2016, Proyecto cofinanciado FEDER-ISCIII PI17/01758, Proyecto cofinanciado FEDER-Consejería de Salud y Familias, Junta de Andalucía PE-0250-2019 and by Fundación Mapfre MAPFRE2018

Hábitos dietéticos de los escolares e incidencia de caries dental

Introduction: healthy dietary habits are considered to improve oral health and tooth quality. Caries treatment comprises tooth restoration with dental composites and sealants, almost all (> 90%) of which contain bisphenol A (BPA). Study hypotheses were: a) breakfast and oral hygiene habits are important factors in dental caries development; and b) dental caries treatment with epoxy-resins entails a risk of oral exposure to monomers migrating from the polymeric material. We evaluated caries in the teeth of a Spanish school population and determined the percentage treated with dental composites. Objective: to relate consumption of breakfast components and oral hygiene habits to dental caries and determine the presence of sealants/composites as potential sources of BPA exposure. Methods: subjects: 582 schoolchildren from Granada city (Southern Spain) aged 7 yrs; mean (SD) of 7.55 (0.64) yrs. Results: caries was detected in 21.7% of their teeth. Mean breakfast quality index (BQI) score, based on nutritional questionnaires, was 5.18 (1.29). Breakfast with foods rich in simple sugars representing > 5% of total daily energy was consumed by 24% of the population and was significantly associated with caries frequency in binary logistic regression analysis. Biscuit consumption was reported by 35.8% and significantly associated with caries frequency. Breakfast intake of bakery products/ cereals and of dairy products showed a significant inverse association with caries frequency. No significant relationship was observed between caries and BQI score or oral hygiene factors. Conclusion: further research is required to elucidate the role of diet in caries and the associated risk of exposure to estrogenic xenobiotics such as BPA.Introducción: los hábitos alimentarios saludables influyen sobre la salud oral. El tratamiento de la caries comprende la restauración dental con selladores y composites dentales, la mayoría con bisfenol A (BPA). Hipótesis: a) el desayuno y hábitos de higiene oral son factores importantes en el desarrollo de caries; b) el tratamiento de la caries con epoxirresinas conlleva riesgo de exposición oral a monómeros plásticos. Objetivo: relacionar la ingesta del desayuno y los hábitos de higiene oral con la caries dental y determinar la presencia de selladores/composites como fuentes potenciales de exposición al BPA. Métodos: se analizaron 582 niños/as en edad escolar de Granada (sur de España) de 7 años de edad (7,55 [0,64] años). Se empleó un cuestionario de frecuencia de consumo de alimentos, 3 recordatorios de 24 h y variables de estilo de vida, incluyendo la higiene bucodental. La calidad del desayuno fue estimada con el Breakfast Quality Index (BQI). Resultados: se detectó un 21,7% de caries. El valor medio del BQI fue 5,18 (1,29). El 24% de la población realizó un desayuno con alimentos ricos en azúcares simples (> 5% de la energía total), asociado significativamente con la frecuencia de caries en el análisis de regresión logística. El 35,8% de los participantes tomaron galletas; asociado significativamente con la frecuencia de caries. La ingesta de productos de panadería, cereales y lácteos mostró una asociación inversamente significativa con la frecuencia de caries. Conclusión: se necesitan más investigaciones para aclarar el papel de la dieta en la caries y el riesgo de exposición a xenobióticos estrogénicos, como el BPA.This is a joint project between research group AGR255 and Granada City Council (health area) contract C-3507-00, Granada City Council- Universidad Empresa. This work was supported by grants from the Spanish Ministry of Health (FIS, - PI14/01040)

Ingesta de alimentos y hábitos nutricionales entre adolescentes españoles que practican y no practican esquí

Background: Increasing obesity among adolescents in the industrialized world may result from poor nutritional habits and inadequate exercise. Aim: To determine differences in food intake, nutritional habits, and body mass index between Spanish adolescents who engage in ski activity and those who do not. Methods: A socio-demographic survey, food frequency questionnaire, 24-hr dietary recall, and physical activity questionnaire were completed by 300 Spanish schoolchildren aged 10 to 18 yrs. Results were compared (Student’s t, chi-square and Fisher’s exact test) between adolescents engaged (SP) and not engaged (N-SP) in skiing according to their sex. Results: SP adolescents devoted > 4 h/day to physical activity versus < 1 h for N-SP adolescents. No significant differences were found in nutrient intake or nutritional habits between SP and N-SP adolescents. Protein and fat intakes of both groups were above recommended levels. A higher proportion of N-SP than SP males were overweight. Logistic regression analysis showed that the maintenance of a normal weight was favored by the practice of skiing, the consumption of sugar-free drinks, and supplementation with vitamins/mineral salts and was negatively associated with body weight dissatisfaction, intake of nutritional supplements other than vitamins or minerals, and the consumption of snacks. Conclusions: The diet of this adolescent population was poorly balanced. Engagement in physical activity appears to be a key factor in maintaining a healthy body mass index.Antecedentes: El aumento de la obesidad entre los adolescentes en países desarrollados puede ser consecuencia de malos hábitos alimentarios y falta de actividad. Objetivo: Determinar las diferencias en la ingesta de alimentos, hábitos nutricionales e índice de masa corporal entre adolescentes españoles que practican esquí y los que no lo hacen. Métodos: Una muestra de 300 adolescentes españoles de 10 a 18 años completó una encuesta que incluyó variables sociodemográficas, un cuestionario de frecuencia de consumo de alimentos, recordatorio de 24h y un cuestionario de actividad física. Se utilizaron test de comparación paramétricos y no paramétricos para comparar los resultados entre adolescentes que practican (SP) y no practican (N-SP) esquí, en función al sexo. Resultados: Los adolescentes SP dedicaron más de 4h diarias a la realización de actividad física mientras que los adolescentes N-SP dedicaron menos de 1 hora diaria a la actividad física. No se encontraron diferencias significativas en la ingesta de nutrientes o los hábitos nutricionales entre adolescentes SP y N-SP. La ingesta de proteínas y lípidos de ambos grupos estuvo por encima de los niveles recomendados. El sobrepeso fue más frecuente entre adolescentes N-SP. El análisis de regresión logística mostró que el mantenimiento de un peso normal se ve favorecido por la práctica del esquí, el consumo de bebidas sin azúcar y la suplementación con vitaminas/minerales y se asoció negativamente con la insatisfacción con el peso corporal, el consumo de suplementos nutricionales distintos a vitaminas o minerales y el consumo de aperitivos. Conclusiones: La dieta de esta población adolescente fue desequilibrada. La participación en la actividad física parece ser un factor clave en el mantenimiento de un índice de masa corporal saludable

Comparación de dos métodos para evaluar la calidad de la dieta mediterránea en una muestra representativa de jóvenes del sur de España

The objective of this study was to compare the usefulness of two methods to evaluate diet quality in young people in Southern Spain: a new Mediterranean Diet Pattern (MDP) and a modification of the Diet Quality Index-International (DQI-I) for the Mediterranean area. The study population was 3190 schoolchildren aged 8-15 yrs. The questionnaires used were first validated (Bland-Altman plot and Wilcoxon tests) in a randomized sample. The DQI gives a more detailed evaluation of food components, whereas the MDS gives global information on food groups but includes foods characteristically consumed in the Mediterranean region. Highly similar results were obtained using the MDP and the adapted DQI-I, which appear to be equally useful to evaluate diet quality in a Mediterranean population. The fact that we selected the same types of food for both indices may explain the similar overall evaluations. According to these results, both methods appear to be equally appropriate for evaluating diet quality in a Mediterranean population.El objetivo de este estudio fue comparar la utilidad de dos métodos para evaluar la calidad de la dieta de jóvenes en el sur de España: un nuevo patrón de dieta mediterránea (MDP) y una modificación de la dieta del índice de calidad-Internacional (ICD-I) para el área Mediterránea. La población de estudio fue 3.190 escolares de entre 8-15 años. Los cuestionarios utilizados fueron validados primero (gráfico de Bland-Altman y las pruebas de Wilcoxon) en una muestra tomada al azar. El ICD-I ofrece una evaluación más detallada de los componentes de los alimentos, mientras que el MDP proporciona información global sobre los grupos de alimentos, que incluye alimentos típicamente consumidos en la región mediterránea. Se obtuvieron resultados similares utilizándole MDP y la adaptación del ICD-I, que parecen ser igualmente útiles para evaluar la calidad de una dieta en una población mediterránea. El hecho de que se seleccionaron los mismos tipos de alimentos para ambos índices podría explicar la similitud de las evaluaciones globales. De acuerdo con estos resultados, ambos métodos parecen ser igualmente apropiado para evaluar la calidad de la dieta en una población mediterránea.This study was supported by the Health Department of Granada City Council, Spain, the Junta de Andalucia, Spain (Research Group AGR-255) and the University of Granada, Spain (Postdoctoral Grant)

Validation of questionnaires for the study of food habits and bone mass

Antecedentes: La pérdida de masa y densidad de los huesos esta influenciada por factores nutricionales, actuando sobre el pico de masa ósea, la pérdida ósea relacionada con la edad y la fortaleza muscular. El objetivo del presente estudio es validar un cuestionario de frecuencia de consumo de alimentos aplicado a la estimación de la relación entre los hábitos alimentarios y la densidad mineral ósea de una población adulta sana. Métodos: Los resultados obtenidos mediante el cuestionario de frecuencia de consumo de alimentos se compararon con los de recordatorios de 24 horas. Las medidas de la densidad mineral ósea se realizaron mediante densitometría de calcáneo. Resultados: Se demuestra la validez del cuestionario al obtener coeficientes de correlación de Spearman entre 0,014 y 0,467. Asimismo el test de Bland-Altman muestra que no existe variación entre los dos métodos para las variables analizadas. El análisis de correlación muestra que la densidad mineral ósea está asociada significativamente al consumo de vitamina D, vitamina A, vitamina B12, folato, tiamina y hierro. El consumo de lípidos totales no fue asociado con la densidad mineral ósea, sin embargo la ingesta de ácidos grasos monoinsaturados, EPA y DHA y colesterol muestra una correlación estadísticamente significativa. Conclusión: El cuestionario estima el consumo de energía y nutrientes con adecuada validez. Su aplicación nos ha permitido deducir la importancia de una dieta rica en vitaminas del grupo B, vitamina D, calcio, hierro y ácidos grasos monoinsaturados y n-3 en la salud ósea.Background: The loss of bone mass and density is influenced by nutritional factors that act on the bone mass peak, age-related bone loss and muscle strength. The objective of the present study was to validate a food frequency questionnaire applied to estimate the relationship between food habits and bone mineral density (BMD) in a healthy adult population. Methods: The results of the food frequency questionnaire were compared with 24-hr recall findings. Calcaneus BMD was measured by densitometry. Results: The validity of the questionnaire was demonstrated, with Spearman correlation coefficients of 0.014 to 0.467. The Bland-Altman test also found no differences in study variables between the two methods. Correlation analysis showed that the BMD was significantly associated with the intake of vitamin D, vitamin A, vitamin B12, folate, thiamine and iron. Total fat consumption was not associated with BMD but the intake of monounsaturated fatty acids, EPA, DHA and cholesterol showed a significant correlation. Conclusion: The questionnaire evaluates the consumption of energy and nutrients with adequate validity. Its application revealed the importance for bone health of a diet rich in B-group vitamins, vitamin D, calcium, iron, monounsaturated fatty acids and n-3.Este estudio forma parte de un proyecto de investigación que se esta realizando en colaboración con el Excmo. Ayuntamiento de Granada (Estudio de la situación nutricional de la unidad familiar en la ciudad de Granada. Contrato Universidad de Granada y Ayuntamiento de Granada. Años: 2007-2009)

Dietary exposure to parabens and body mass index in an adolescent Spanish population

This work was carried out in line with 'GP/EFSA/ENCO/380 2018/03/G04: OBEMIRISK: Knowledge platform for assessing the risk of Bisphenols on gut microbiota and its role in obesogenic phenotype: looking for biomarkers'. This research was also funded by Plan Estatal de I + D + I 2013-2016 and co-funded by FEDER-ISCIII PI17/01758, FEDER-Consejeria de Salud y Familias, Junta de Andalucia PE-0250-2019, FEDER/Junta de Andalucia-Consejeria de Transformacion Economica, Industria, Conocimiento y Universidades/Proyecto P18-RT-4247. All individuals participating in this research signed an informed consent form and the study protocol was approved by the Ethics Com-mittee of the University of Granada.Parabens are alkyl esters of p-hydroxybenzoic acid which are extensively used in cosmetics, pharmaceuticals and foodstuffs due to their antimicrobial properties. The most commonly used parabens are methyl-(MeP), ethyl- (EtP), propyl-(PrP) and butyl-(BuP) paraben. Most human exposure to parabens is achieved through the consumption of food or pharmaceutical products and the use of personal care products. However, studies on dietary parabens exposure and the associated factors are very scarce. The main aim of the present study was to explore factors associated with dietary exposure to parabens in Spanish adolescents according to gender. Dietary data and anthropometric measures were collected from 585 adolescents (53.4% boys) aged 12–16 years. Parabens exposure through diet was assessed using a food frequency questionnaire with food products providing more than 95% of energy and macronutrient intake being included in analysis. Stepwise regression was used to identify the foods that most contributed to parabens intake. Logistic regression was used to evaluate factors predicting higher dietary exposure to parabens. The main contributors to dietary MeP, EtP, PrP and BuP exposure in adolescent boys were eggs (41.9%), canned tuna (46.4%), bakery and baked goods products (57.3%) and pineapple (61.1%). In adolescent girls, the main contributors were apples and pears (35.3%), canned tuna (42.1%), bakery and baked goods products (55.1%) and olives (62.1%). Overweight/obese girls were more likely to belong to the highest tertile of overall parabens intake (odds ratio [OR]: 3.32; 95% confidence interval [95% CI]: 1.21–9.15) and MeP (OR: 3.05; 95% CI: 1.14–8.12) than those with a body mass index lower than 25 kg/m2. These findings suggest a positive association between dietary exposure to parabens and overweight/obesity in adolescent girls.Plan Estatal de I + D + I 2013-2016FEDER-ISCIII PI17/01758FEDER-Consejeria de Salud y FamiliasJunta de Andalucia PE-0250-2019FEDER/Junta de Andalucia-Consejeria de Transformacion Economica, Industria, Conocimiento y Universidades/Proyecto P18-RT-424

Levels of Bisphenol A and its analogs in nails, saliva, and urine of children: a case control study

Introduction: A growing number of studies link the increase in overweight/ obesity worldwide to exposure to certain environmental chemical pollutants that display obesogenic activity (obesogens). Since exposure to obesogens during the first stages of life has been shown to have a more intense and pronounced effect at lower doses, it is imperative to study their possible effects in childhood. The objective here was to study the association of Bisphenol A (BPA) and 11 BPA analogs in children, using three biological matrices (nails, saliva and urine), and overweight and obesity (n = 160). Methods: In this case–control study, 59 overweight/obese children and 101 controls were included. The measuring of Bisphenols in the matrices was carried out by ultra-high performance liquid chromatography coupled with triple quadrupole tandem mass spectrometry (UHPLC-MS/MS). Logistic regression was used to study the association between overweight/obesity and Bisphenol exposure. Results: The results suggested that BPF in nails is associated with overweight/ obesity in children (OR:4.87; p = 0.020). In saliva, however, the highest detected concentrations of BPAF presented an inverse association (OR: 0.06; p = 0.010) with overweight/obesity. No associations of statistical significance were detected between exposure to BPA or its other analogs and overweight/obesity in any of the biological matrices.FEDER-Consejería de Salud y Familias’ of the Junta de Andalucía PE-0250-201

Bisphenol A Analogues in Food and Their Hormonal and Obesogenic Effects: A Review

Bisphenol A (BPA) is the most well-known compound from the bisphenol family. As BPA has recently come under pressure, it is being replaced by compounds very similar in structure, but data on the occurrence of these BPA analogues in food and human matrices are limited. The main objective of this work was to investigate human exposure to BPA and analogues and the associated health effects. We performed a literature review of the available research made in humans, in in vivo and in vitro tests. The findings support the idea that exposure to BPA analogues may have an impact on human health, especially in terms of obesity and other adverse health effects in children.This research was funded by Plan Estatal de I+D+I 2013-2016 Proyecto cofinanciado FEDER-ISCIII PI17/01758 and by Fundación Mapfre MAPFRE2018

Factors Associated with Exposure to Dietary Bisphenols in Adolescents

Obesogenic endocrine-disrupting chemicals, such as bisphenol A (BPA) and its analogue bisphenol S (BPS), seem to play an important role in the development of obesity, although contradictory results have been reported. The aim of the present study was to conduct a gender analysis of the factors associated with exposure to dietary bisphenols in 585 Spanish adolescents. Dietary BPA and BPS exposure was assessed using a food frequency questionnaire. Foods and macronutrients accounting for more than 95% of energy intake were selected for analysis. Stepwise regression was used to estimate the foods that most contributed to dietary bisphenol exposure in the sample. Gender-related factors associated with greater dietary bisphenol exposure were evaluated using multivariate logistic regression models. Canned tuna was the main dietary source of BPA and BPS in both adolescent boys and girls. Overweight/obese girls showed a higher risk of high dietary exposure to BPA (odds ratio (OR): 3.38, 95% confidence interval (CI): 1.25–9.07) and total bisphenols (OR: 2.81, 95% CI: 1.03–7.67) in comparison with girls with a BMI lower than 25 kg/m2 . Present results indicate a positive association of dietary exposure to both total bisphenols and BPA with being overweight/obese in adolescent girls.GP/EFSA/ENCO/380 2018/03/G04: OBEMIRISK: Knowledge platform for assessing the risk of bisphenol on gut microbiota and its role in obesogenic phenotypes: looking for biomarkers’ frameworkPlan Estatal de I + D + I 2013–2016FEDER-ISCIII PI17/01758FEDER-Consejería de Salud y FamiliasJunta de Andalucía PE-0250–2019FEDER-Junta de Andalucía-Consejería de Transformación Económica, Industria, Conocimiento y Universidades/ Proyecto P18-RT-4247Fundación Mapfre MAPFRE201

Diverse Large HIV-1 Non-subtype B Clusters Are Spreading Among Men Who Have Sex With Men in Spain

In Western Europe, the HIV-1 epidemic among men who have sex with men (MSM) is dominated by subtype B. However, recently, other genetic forms have been reported to circulate in this population, as evidenced by their grouping in clusters predominantly comprising European individuals. Here we describe four large HIV-1 non-subtype B clusters spreading among MSM in Spain. Samples were collected in 9 regions. A pol fragment was amplified from plasma RNA or blood-extracted DNA. Phylogenetic analyses were performed via maximum likelihood, including database sequences of the same genetic forms as the identified clusters. Times and locations of the most recent common ancestors (MRCA) of clusters were estimated with a Bayesian method. Five large non-subtype B clusters associated with MSM were identified. The largest one, of F1 subtype, was reported previously. The other four were of CRF02_AG (CRF02_1; n = 115) and subtypes A1 (A1_1; n = 66), F1 (F1_3; n = 36), and C (C_7; n = 17). Most individuals belonging to them had been diagnosed of HIV-1 infection in the last 10 years. Each cluster comprised viruses from 3 to 8 Spanish regions and also comprised or was related to viruses from other countries: CRF02_1 comprised a Japanese subcluster and viruses from 8 other countries from Western Europe, Asia, and South America; A1_1 comprised viruses from Portugal, United Kingom, and United States, and was related to the A1 strain circulating in Greece, Albania and Cyprus; F1_3 was related to viruses from Romania; and C_7 comprised viruses from Portugal and was related to a virus from Mozambique. A subcluster within CRF02_1 was associated with heterosexual transmission. Near full-length genomes of each cluster were of uniform genetic form. Times of MRCAs of CRF02_1, A1_1, F1_3, and C_7 were estimated around 1986, 1989, 2013, and 1983, respectively. MRCA locations for CRF02_1 and A1_1 were uncertain (however initial expansions in Spain in Madrid and Vigo, respectively, were estimated) and were most probable in Bilbao, Spain, for F1_3 and Portugal for C_7. These results show that the HIV-1 epidemic among MSM in Spain is becoming increasingly diverse through the expansion of diverse non-subtype B clusters, comprising or related to viruses circulating in other countries