Susceptibilidad genética de obesidad y síndrome metabólico en la infancia

Obesity is one of the major public health problems worldwide. It is a chronic, complex, and multifactorialorigin disease characterised by body fat excess mainly due to an imbalance between dietary intake and energy expenditure. One of the major complications of obesity is metabolic syndrome, which comprises anthropometrical, clinical, and metabolic dysfunctions that predispose the affected individual to the development of type 2 diabetes mellitus and cardiovascular diseases. It is hypothesised that the variability in the susceptibility to obesity-mediated metabolic complications involves both environmental and genetic factors. Whereas advances in the knowledge of the variations in the human genome have led to the identification of susceptibility genes that con - tribute to obesity and related disorders, relatively few studies have specifically focused on the interactions bet - ween obesity and genetic polymorphisms and the development of metabolic complications. Despite these limited efforts, an increasing amount of evidence suggests that the effects of some gene variants on metabolic traits are modified by or present only in the setting of obesity. Fur - thermore, some of these loci may have larger effects on metabolic phenotypes in the presence of certain dietary or lifestyle factors. In the present manuscript, we revie - wed the genes and their variants that have been evidenced to play a role in obesity-associated metabolic complications through genetic association studies, including candidate gene and genome-wide association approaches in adults and children.La obesidad es uno de los principales problemas de salud pública a nivel mundial. Es una enfermedad crónica, compleja y de origen multifactorial que se caracteriza por el exceso de grasa corporal y se desarrolla, fundamentalmente, debido a un desequilibrio entre la ingesta dietética y el gasto energético. Una de las principales complicaciones de la obesidad es el síndrome metabólico, el cual comprende alteraciones antropométricas, clínicas y metabólicas que predisponen el desarrollo de diabetes mellitus tipo 2 y enfermedades cardiovasculares.Existe la hipótesis de que tanto factores ambientales como genéticos participan en la variabilidad a la susceptibilidad de las complicaciones metabólicas mediadas por la obesidad. Mientras que los avances en el conocimiento de las variaciones en el genoma humano, han llevado a la identificación de genes que contribuyen a la susceptibilidad de la obesidad y las enfermedades asociadas, son relativamente pocos los estudios que se han centrado específicamente en la interacción entre la obesidad y polimorfismos genéticos relacionados con el desarrollo de complicaciones metabólicas o directamente con el síndrome metabólico. Además, algunos de estos loci pueden tener mayor efecto en los fenotipos metabólicos cuando está modificado por la dieta u otrosfactores ambientales. En este manuscrito se revisan los genes ylas variantes con mayor evidencia de asociación con las complicaciones metabólicasrelacionadas con la obesidad descritas en estudios de asociación genética, incluyendo estudios de genes candidatos y estudios amplios del genoma humano en adultos y niños.This work was supported by Plan Nacional de Investigación Científica, Desarrollo e Innovación Tecnoló - gi ca (I + D + I) of the Instituto de Salud Carlos III, Fondo de Investigación Sanitaria (PI020826, PI051968), Con - sejería de Innovación y Ciencia of the Junta de Andalucía (P06-CTS 2203), and Ministerio de Universidades y Tecnología of the Instituto de Salud Carlos III, Fondo de Investigaciones Sanitarias, RETIC (Red SAMID RD08/ 0072/0028)

Leptin Receptor Gene Variant rs11804091 Is Associated with BMI and Insulin Resistance in Spanish Female Obese Children: A Case-Control Study

Leptin is an endocrine hormone that has a critical role in body weight homoeostasis and mediates its effects via the leptin receptor (LEPR). Common polymorphisms in the genes coding leptin receptors have been associated with metabolic abnormalities. We assessed the association of 28 LEPR polymorphisms with body mass index (BMI) and their relationship with obesity-related phenotypes, inflammation and cardiovascular disease risk biomarkers. A multicentre case-control study was conducted in 522 children (286 with obesity and 236 with normal-BMI). All anthropometric, metabolic factors and biomarkers were higher in children with obesity except apolipoprotein (Apo)-AI, cholesterol, high-density lipoprotein cholesterol (HDL-c), and adiponectin, which were lower in the obesity group; and glucose, low-density lipoprotein cholesterol (LDL-c), and matrix metalloproteinase-9 that did not differ between groups. We identified the associations between rs11208659, rs11804091, rs10157275, rs9436303 and rs1627238, and BMI in the whole population, as well as the association of rs11804091, rs10157275, and rs1327118 with BMI in the female group, although only the rs11804091 remained associated after Bonferroni correction (p = 0.038). This single nucleotide polymorphisms (SNP) was also associated with insulin (p = 0.004), homeostasis model assessment for insulin resistance (HOMA-IR) (p = 0.006), quantitative insulin sensitivity check index (QUICKI) (p = 0.005) and adiponectin (p = 0.046) after adjusting for age, Tanner stage and BMI. Our results show a sex-specific association between the rs11804091 and obesity suggesting an influence of this SNP on insulin resistance.This work was supported by Plan Nacional de Investigación Científica, Desarrollo e Innovación Tecnológica (I+D+I), Instituto de Salud Carlos III-Fondo de Investigación Sanitaria (PI020826, PI051968, PI1102042, and PI1600871), RETIC (Red SAMID RD12/0026/0015) and Fondo Europeo De Desarrollo Regional (FEDER)

Reported Dietary Intake, Disparity between the Reported Consumption and the Level Needed for Adequacy and Food Sources of Calcium, Phosphorus, Magnesium and Vitamin D in the Spanish Population: Findings from the ANIBES Study

Calcium, phosphorus, magnesium and vitamin D have important biological roles in the body, especially in bone metabolism. We aimed to study the reported intake, the disparity between the reported consumption and the level needed for adequacy and food sources of these four nutrients in the Spanish population. We assessed the reported intake for both, general population and plausible reporters. Results were extracted from the ANIBES survey, n = 2009. Three-day dietary reported intake data were obtained and misreporting was assessed according to the European Food Safety Authority (EFSA). Mean ± SEM (range) total reported consumption of calcium, phosphorus, magnesium, and vitamin D for the whole population were 698 ± 7 mg/day (71–2551 mg/day), 1176 ± 8 mg/day, (331–4429 mg/day), 222 ± 2 mg/day (73–782 mg/day), and 4.4 ± 0.1 µg/day (0.0–74.2 µg/day), respectively. In the whole group, 76% and 66%; 79% and 72%; and 94% and 93% of the population had reported intakes below 80% of the national and European recommended daily intakes for calcium, magnesium and vitamin D, respectively; these percentages were over 40% when the plausible reporters were analysed separately. The main food sources were milk and dairy products for calcium and phosphorus, cereals and grains for magnesium and fish for vitamin D. In conclusion, there is an important percentage of the Spanish ANIBES population not meeting the recommended intakes for calcium, magnesium and vitamin D.The ANIBES study was financially supported by a grant from Coca-Cola Iberia through an agreement with the Spanish Nutrition Foundation (FEN)

A specific protein-enriched enteral formula decreases cortisolemia and improves plasma albumin and amino acid concentrations in elderly patients

<p>Abstract</p> <p>Background</p> <p>Old age is associated with an involuntary and progressive but physiological loss of muscle mass. The aim of this study was to evaluate the effects of exclusive consumption for 6 months of a protein-enriched enteral diet with a relatively high content of branched-chain amino acids on albuminemia, cortisolemia, plasma amino acids, insulin resistance, and inflammation biomarkers in elderly patients.</p> <p>Methods</p> <p>Thirty-two patients from the Clinical Nutrition Outpatient Unit at our hospital exclusively consumed a protein-enriched enteral diet for 6 months. Data were collected at baseline and at 3 and 6 months on anthropometric and biochemical parameters and on plasma concentrations of amino acids, cortisol, adrenocorticotropic hormone, urea, creatinine, insulin resistance, and inflammation biomarkers.</p> <p>Results</p> <p>The percentage of patients with albumin concentration below normal cut-off values decreased from 18% to 0% by the end of the study. At 6 months, concentrations of total plasma (<it>p </it>= 0.008) and essential amino acids (<it>p </it>= 0.011), especially branched-chain amino acids (<it>p </it>= 0.031), were higher versus baseline values, whereas 3-methylhistidine (<it>p </it>= 0.001), cortisol (<it>p </it>= 0.001) and adrenocorticotropic hormone (<it>p </it>= 0.004) levels were lower.</p> <p>Conclusions</p> <p>Regular intake of specific protein-enriched enteral formula increases plasma essential amino acids, especially branched-chain amino acids, and decreases cortisol and 3-methylhistidine, while plasma urea and creatinine remain unchanged.</p

Dietary sources and intakes of folates and vitamin B12 in the Spanish population: Findings from the ANIBES study

Background: Folates and vitamin B12 are key nutrients in one-carbon metabolism and related diseases. Updated and plausible information on population intakes and their major dietary sources is scarce and urgently needed in Spain in order to increase the knowledge that can lead as previous step to prevention by fortification and supplementation policies. Aims: The present study aims to evaluate main dietary folate and vitamin B12 sources and intakes in the Spanish population. Materials and methods: Results were derived from the ANIBES cross-sectional study using a nationally representative sample of the Spanish population (9–75 years, n = 2,009). Results: Food groups with the highest mean proportional contribution to total folate intakes in both males and females were vegetables (21.7–24.9%) and cereals (10.7–11.2%), while meat and meat products (26.4%) and milk and dairy products (27.3%) were for B12. Total median folate and B12 intakes amongst women were 156.3 μg/d and 4.0 μg/d while for men were 163.6 μg/d and 4.5 μg/d, respectively. In all age groups, vitamin intakes were significantly higher in plausible than in non-plausible energy reporters. Conclusion: A limited number of participants had adequate folate intakes, whereas vitamin B12 intakes were adequate for practically the entire population. There is a clear need for improving folates intake in the Spanish population.The study was financially supported by a grant from Coca-Cola Iberia through an agreement with the Spanish Nutrition Foundation (Fundación Española de la Nutrición (FEN))

Biological evaluation of a protein mixture intended for enteral nutrition

La nutrición enteral (NE) es el mejor recurso para complementar la alimentación de los pacientes, siempre que el tracto gastrointestinal este funcional. Cuando se indica NE total, ésta representa la fuente exclusiva de alimento, por lo que es importante asegurar un alto valor biológico de la proteína incluida. Objetivo: Valorar la calidad biológica de una mezcla proteica constituida por 50% de caseinato potásico, 25% de proteínas de suero lácteo y 25% de proteína de guisante para ser utilizada en productos de nutrición enteral. Material y métodos: 40 ratas Wistar (20 hembras y 20 machos), con peso medio de 51 g, divididas en cuatro grupos. Dos de ellos fueron alimentados con dietas específicas para ratas: uno con caseína (Control) y otro con la proteína experimental (Experimental); los otros fueron alimentados con productos de NE diseñados para humanos y adaptados a los requerimientos de las ratas (Normoproteico e Hiperproteico), durante 10 días. Se determinó el índice de eficacia proteica (PER), el coeficiente de digestibilidad aparente (CDA), la relación nitrógeno retenido/ absorbido (R/A) y la relación nitrógeno retenido/ingerido (R/I). Resultados: El grupo experimental y el grupo control presentaron valores similares en todos los índices analizados. Asimismo, estos índices fueron similares entre los grupos normo e hiperproteicos, pero menores respecto a los grupos anteriores, exceptuando al PER, el cual fue a su vez similar entre el grupo normoproteico y el control. Conclusión: La calidad de la mezcla proteica utilizada es alta y adecuada para ser incluida en el desarrollo de nuevos productos para nutrición enteral.Enteral nutrition is the best way to feed or supplement the diet when gastrointestinal tract functions of patients are partially or totally preserved. Whenever total enteral nutrition is needed, it represents the only source of nutrients for patients. Thus, it is mandatory to ensure that high biological value proteins are included in enteral formulae. Objective: To assess the biological quality of a protein blend constituted by 50% potassium caseinate, 25% whey protein and 25% pea protein intended to be used in enteral nutrition products. Materials and methods: Forty Wistar rats (20 male and 20 female), with initial body weight of 51 g, where divided into four groups and feed for 10 days with: casein (Control), experimental protein blend (Experimental), liophylized normo- and hyperproteic enteral nutrition formulae adapted to the animal nutritional requirements (Normoproteic and Hyperproteic). Protein efficiency ratio (PER), apparent digestibility coefficient (ADC), relationship between retained and absorbed nitrogen (R/A) and relationship between retained and consumed nitrogen (R/I) where calculated. Results: Experimental and control groups had similar values for all analysed indices (PER, ADC, R/A and R/I). These indices where also similar between normo and hyperproteic groups, but lower than experimental and control groups, except in PER, where normoproteic group was either similar to control and hiperproteic group. Conclusion: The quality of the protein blend used in this study is high. It is a good protein source to be used in the development of new enteral nutritional products

Iron Intake and Dietary Sources in the Spanish Population: Findings from the ANIBES Study

Background: Iron deficiency is one of the most common nutritional problems in the world. It is frequent in both developed and developing countries and mainly affects women of childbearing age and children. Methods: Results were derived from the ANIBES cross-sectional study using a nationally-representative sample of the Spanish population (9–75 years, n = 2009). A three-day dietary record, collected by means of a tablet device, was used to obtain information about food and beverage consumption and leftovers. Results: Total median dietary iron intake was 9.8 mg/day for women and 11.3 mg/day for men. Highest intakes were observed among plausible adolescent reporters (13.3 mg/day), followed by adults (13.0 mg/day), elderly (12.7 mg/day), and children (12.2 mg/day). Prevalence of adequacy for iron intakes as assessed by EFSA criteria was higher than for the Spanish Recommended Iron Intake values in all age groups. Females had lower adequacy than males for both criteria, 27.3% and 17.0% vs. 77.2% and 57.0% respectively. Cereals or grains (26.7%–27.4%), meats and derivatives (19.8%–22.7%), and vegetables (10.3%–12.4%) were the major iron contributors. Conclusion: Higher iron intakes were observed in adolescents and were highest for non-heme iron. The prevalence of adequate iron intake according to EFSA criteria was higher than compared to national recommendations, and women had the lowest intakes. Therefore, there is a need to define standard dietary reference intake to determine inadequate iron intakes in the Spanish population.The study was financially supported by a grant from Coca-Cola, Iberia through an agreement with the Spanish Nutrition Foundation (Fundación Española de la Nutrición (FEN))

Reported Dietary Intake and Food Sources of Zinc, Selenium, and Vitamins A, E and C in the Spanish Population: Findings from the ANIBES Study

Zinc, selenium, and the vitamins A, E and C, all have specific biological functions that are involved mainly in the antioxidant defence system, which has important implications for the development of chronic diseases. We aimed to assess the reported intake of those six nutrients, as well as the food that contributes to their sources of intakes. Data were obtained from the Spanish ANIBES (“Anthropometry, Intake and Energy Balance in Spain”) study, n = 2009 (9–75 years old). The analyses were performed in the whole population and in the plausible energy reporters after a misreporting analysis according to the European Food and Safety Authority (EFSA) protocol. A validated, photo-based three-day food record was used to collect the data. Mean (max−min) reported intake for the whole population of zinc was 8.1 ± 0.1 mg/day, (2.3–27.3 mg/day), selenium 75 ± 1 µg/day, (14–265 µg/day), vitamin A 668 µg RE/day (2–11,017 µg RE/day), retinol 364 ± 18 µg/day (0–10,881 µg/day), carotenes 1735 ± 35 µg/day (13–13,962 µg/day), vitamin E 7.0 ± 0.1 mg α-TE/day (0.7–55.2 mg α-TE/day) and vitamin C 84.4 ± 1.4 mg/day (5.0–802.7 mg/day). The main source intakes for zinc were meat and meat products, for selenium cereals and grains, for vitamin E oils and fat, and for vitamin A and C vegetables. There is an elevated percentage of the Spanish ANIBES population not meeting the EFSA recommended intakes for all analysed micronutrients: zinc (83%), vitamin A (60%), vitamin E (80%), vitamin C (36%) and selenium (25%).The authors would like to thank Coca-Cola Iberia and IPSOS for its support and technical advice, particularly Rafael Urrialde and Javier Ruiz

Changes in Oxidative Stress and Inflammatory Biomarkers in Fragile Adults over Fifty Years of Age and in Elderly People Exclusively Fed Enteral Nutrition

We aim to evaluate whether exclusive feeding of an enteral formula enriched with n-3 long chain polyunsaturated fatty acids (n-3 LC-PUFA) affects oxidative stress and the antioxidant defence system and may improve the levels of some relevant inflammatory, and cardiovascular biomarkers in frail adults over fifty years of age and in elderly subjects. Fifty-five patients were divided into two groups and were exclusively fed a newly designed normoproteic and isocaloric enteral formula enriched with eicosapentaenoic (98 mg/d) and docosahexaenoic acids (46 mg/d) (n=26) or a reference enteral diet (n=29). Oxidative, inflammatory and cardiovascular risk biomarkers and red blood cell fatty acid profiles were determined at the beginning and after 90 and 180 days of feeding. The n-3 LC-PUFA percentage tended to be higher (P=0.053) in the experimental group than in the reference group. Administration of the n-3 LC-PUFA diet did not increase oxidative stress or modify plasma antioxidant capacity but decreased antioxidant enzymatic activities. MMP-9 plasma concentration decreased with both formulae, whereas tPAI-1 tended to decrease (P=0.116) with the administration of the experimental formula. In conclusion, administration of the new n-3 LC-PUFA-enriched product for 6 months did not negatively alter the oxidative status and improved some cardiovascular risk biomarkers