Metabolomic Profiling in Children with Celiac Disease: Beyond the Gluten-Free Diet

FEDER/Junta de Andalucía-Consejería de Transformación Económica, Industria, Conocimiento y Universidades Projects FEDER No B-AGR-658 and Excelencia P21_00101Investigation grant program by the Association of Celiacs and Sensitive to Gluten of the Community of Madrid” and the Government of Catalonia: Agency for the Management of University and Resarch Grants (2021SGR00990)Nutrición y Ciencias de los Alimentos” from the University of Granad

Oral supplementation with omega-3 fatty acids and inflammation markers in patients with chronic kidney disease in hemodialysis

Chronic kidney disease (CKD) is an increasingly common public health problem that increases the risk of death because of cardiovascular complications by 2–3 times compared with the general population. This research concerns a prospective, randomized, double-blind study in patients with CKD undergoing hemodialysis. The participants were assigned to 1 of 2 groups: the study group (group A; 46 patients) received 4 capsules (2.4 g) of omega-3 fatty acids daily during the 12-week intervention, while patients in the control group (group B; 47 patients) received 4 capsules of paraffin oil. The patients’ general characteristics, nutritional indicators, renal disease markers and inflammatory markers (C-reactive protein, interleukin (IL)-6, IL-10, and tumour necrosis factor alpha (TNF-)) were evaluated. No differences were found between the general characteristics of the patients (P < 0.05), and no differences were shown in the nutritional indicators and markers of kidney disease (P < 0.05). Patients in group A showed significant decreases in levels of C-reactive protein, IL-6, TNF-, and the IL-10/IL-6 ratio after 12 weeks of supplementation (P < 0.05). Patients in group B did not show any significant changes in concentrations of inflammatory markers during the intervention (P < 0.05). In conclusion, oral supplementation with omega-3 fatty acids produces a significant decrease in the concentrations of inflammation markers in patients with chronic kidney disease on hemodialysis.La maladie du rein chronique (« CKD ») est un problème de santé publique de plus en plus courant qui augmente de 2 à 3 fois, chez les patients aux prises avec cette maladie, le risque de décès dû aux complications cardiovasculaires comparativement à la population générale. Cette recherche est une étude prospective, randomisée, en double insu chez des patients atteints de CKD subissant une hémodialyse. Les participants sont répartis dans l’un des deux groupes: le groupe d’étude (groupe A, 46 patients) reçoit quatre capsules (2,4 g) d’acides gras oméga-3 par jour au cours de l’intervention de 12 semaines et les patients du groupe témoin (groupe B, 47 patients) reçoivent quatre capsules d’huile de paraffine. Les caractéristiques générales des patients, les indicateurs nutritionnels, les marqueurs des maladies rénales et les marqueurs inflammatoires (protéine C-réactive, interleukine (« IL »-6, IL-10 et facteur de nécrose tumorale alpha (« TNF- ») sont évalués. Aucune différence n’est observée entre les caractéristiques générales des patients (P < 0,05) et aucune différence n’apparait dans les indicateurs nutritionnels et les marqueurs de la maladie rénale (P < 0,05). Après 12 semaines de supplémentation, les patients du groupe A présentent une diminution significative des niveaux de protéine C-réactive, d’IL-6, de TNF- et du ratio IL-10/IL-6 (P < 0,05). Les patients du groupe B ne présentent aucun changement significatif des concentrations de marqueurs inflammatoires pendant l’intervention (P < 0,05). En conclusion, une supplémentation orale en acides gras oméga-3 produit une diminution significative des concentrations de marqueurs de l’inflammation chez les patients atteints d’une maladie du rein chronique et sous hémodialyse.University of Granad

A Mediterranean Dietary Pattern Is Associated with Greater Participation in Physical Activity and Better Health-Related Quality of Life among Students and Professors at the Melilla Campus (University of Granada)

The objective of this study was to assess Mediterranean diet (MD) scores (i.e., alignment with a MD pattern) among students and professors, in addition to assessing how adherence to the MD was associated with other lifestyle behaviors. A cross-sectional observational study was conducted with a sample of 127 university professors and 272 students of the Melilla Campus at the University of Granada (Spain). Students were more physically active than professors (mean difference = 1058 METs, p < 0.001) and reported lower negative affect (NA; mean difference = −1.70, p < 0.001) whereas professors reported nominally better perceived mental health. For the total sample, the physical health component (β = 0.03, p = 0.03) and physical activity (β = 0.0001, p = 0.01) were significantly associated with higher MD scores. Health behaviors, including MD scores and physical activity, were suboptimal among both students and professors. The results suggest that a dietary pattern reflective of the MD is positively associated with both physical and mental health outcomes among students and professors, though the direction of the associations remains to be clarified

Vitamin D and Calcium as Key Potential Factors Related to Colorectal Cancer Prevention and Treatment: A Systematic Review

Colorectal cancer (CRC) is currently considered one of the most common and lethal types of tumors. Nutrition is of notorious relevance, given its influence in CRC prevention and treatment. This systematic review aimed to revise and update the state of knowledge regarding the potential role of vitamin D and calcium as key factors involved in the prevention and treatment of CRC. A literature search was performed in PubMed and Web of Science. A total of eight studies were finally included in the present review. Vitamin D showed a protective role by promoting transcriptomic changes associated with antitumor effects. However, no significant effects of vitamin D were noted in the relapse-free survival of patients at 5 years. On the other hand, previous scientific evidence demonstrated that calcium regulates the expression of colonic proteins that decrease cell proliferation and increase cell differentiation. Nevertheless, an increased risk of associated serrated adenomas was found in response to calcium and calcium + vitamin D supplementation. Moreover, supplementation with both nutrients showed positive changes on relevant CRC biomarkers including TGFα, TGFβ1, APC, β-catenin and E-cadherin. In conclusion, vitamin D supplementation seems to have a protective effect in the prevention and treatment of CRC, while calcium intake showed contradictory effects as a prevention or treatment tool; therefore, further studies are necessary to well understand its relevance in patients with CRC.This research is derived from a Master’s Thesis (Master in Human Nutrition at the University of Granada

The Importance of an Early Evaluation after Establishing a Gluten-Free Diet in Children with Celiac Disease

The following are available online at https://www.mdpi.com/article/ 10.3390/nu15071761/s1This research was funded by the FEDER/Junta de Andalucía-Consejería de Transformación Económica, Industria, Conocimiento y Universidades/ Project No B-AGR-658. It was also partially funded with the grant “Investigation grant program by the Association of Celiacs and Sensitive to Gluten of the Community of Madrid”. It also was partially funded by BIOMEDAL S.L.A gluten-free diet (GFD) is the only treatment available for celiac disease (CD); hence, it is important to ensure correct adherence to the diet and adequate monitoring of the diet. The present study aims to assess the importance of an early follow-up of celiac patients after diagnosis of the disease, identify the role of stool gluten immunogenic peptides (GIPs) in the assessment of GFD adherence, and analyze possible nutritional imbalances or deficiencies in the GFD. This is a cross-sectional study carried out in pediatric patients with newly diagnosed CD in a tertiary hospital in Spain. Of the 61 patients included, 14% had positive stool GIPS at 4 months after CD diagnosis, Among them, 88% had negative stool GIPS at 9 months after diagnosis, following dietary advice. We found nutritional deficiencies in the GFD, such as vitamin D (with only 27% of patients with adequate intakes), folate, calcium, magnesium, and fiber. Similarly, we found imbalances: excess protein and fat intakes and a high percentage of total daily energy intake came from ultra-processed foods (UPF). These findings emphasize the importance of early follow-up of children after diagnosis of CD. It is also crucial to identify patients with poor GFD compliance based on stool GIPS and analyze GFD nutritional imbalances and deficits. Our findings may contribute to the development of specific strategies for the early follow-up of patients with CD, including appropriate nutritional counselling.FEDER/Junta de Andalucía-Consejería de Transformación Económica, Industria, Conocimiento y Universidades/ B-AGR-658"Investigation grant program by the Association of Celiacs and Sensitive to Gluten of the Community of Madrid"BIOMEDAL S.L

Celiac Disease Is a Risk Factor for Mature T and NK Cell Lymphoma: A Mendelian Randomization Study

Celiac disease (CeD) is an immune-mediated disorder triggered by gluten ingestion that damages the small intestine. Although CeD has been associated with a higher risk for cancer, the role of CeD as a risk factor for specific malignancies, such as enteropathy-associated T-cell lymphoma (EATL), remains controversial. Using two-sample Mendelian randomization (2SMR) methods and the summarized results of large genome-wide association studies from public repositories, we addressed the causal relationship between CeD and eight different malignancies. Eleven non- HLA SNPs were selected as instrumental variables (IVs), and causality estimates were obtained using four 2SMR methods: random-effects inverse variance-weighted, weighted median estimation, MR-Egger regression, and MR pleiotropy residual sum and outlier (MR-PRESSO).We identified a significant causal relationship between CeD and mature T/NK cell lymphomas. Under a multivariate Mendelian randomization model, we observed that the causal effect of CeD was not dependent on other known lymphoma risk factors. We found that the most instrumental IV was located in the TAGAP locus, suggesting that aberrant T cell activation might be relevant in the T/NK cell malignization process. Our findings provide new insights into the connection between immune imbalance and the development of severe comorbidities, such as EATL, in patients with CeD.Ministry of Science and Innovation, Spain (MICINN) IJC2018-038026-IEuropean CommissionSpanish Ministry of Science and Innovation through the Spanish National Plan for Scientific and Technical Research and Innovation PY20_00212Andalusian Government B-CTS-584-UGR20 B-AGR-658FEDER/Junta de Andalucia-Consejeria de Transformacion Economica, Industria, Conocimiento y UniversidadesGrant "Investigation grant program by the Association of Celiacs and Sensitive to Gluten of the Community of Madrid" PID2020-120157RB-I0

Influence of Ultra-Processed Foods Consumption on Redox Status and Inflammatory Signaling in Young Celiac Patients

The current study was designed to assess the influence of consumption of ultra-processed (UPF) on oxidative/antioxidant balance and evoked inflammatory signaling in young patients with celiac disease (CD). The study included 85 children. The celiac group (n = 53) included children with CD with a long (>18 months, n = 17) or recent (<18 months, n = 36) adherence to a gluten-free diet (GFD). The control group (n = 32) included healthy children with a significantly lower consumption of UPF compared to the CD group, both expressed as kcal/day (p = 0.043) and as percentage of daily energy intake (p = 0.023). Among children with CD, the group with the lowest consumption of UPF (below the 50% of daily energy intake) had a greater Mediterranean diet (MD) adherence and higher moderate physical activity levels. In addition, CD children with the lowest consumption of UPF had healthier redox (lower soluble superoxide dismutase-1 and 15-F2t-isoprostanes) and inflammatory profiles (lower macrophage inflammatory protein-1 ) compared to the group with the highest consumption of UPF (all, p < 0.05) regardless of the time on a GFD. These findings highlight the importance of a correct monitoring of the GFD. An unbalanced GFD with high consumption of UPF and an unhealthy pattern with less physical activity and worse adherence to MD results in a worse inflammatory profile, which could act as a parallel pathway that could have important consequences on the pathophysiology of the disease.Regional Government of Andalusia, Excellence Research Project P12-AGR-2581University of Granada PP2017-PIP14Spanish Ministry of Education, Culture and Sports FPU17/0371

Is a Gluten-Free Diet Enough to Maintain Correct Micronutrients Status in Young Patients with Celiac Disease?

The authors thank the patients for their participation in the current study. We are grateful to Ana Yara Postigo Fuentes for her assistance with the English language.The current study assesses whether the use of a gluten-free diet (GFD) is sufficient for maintaining correct iron status in children with celiac disease (CD). The study included 101 children. The celiac group (n = 68) included children with CD, with long (> 6 months) (n = 47) or recent (< 6 months) (n = 21) adherence to a GFD. The control group (n = 43) included healthy children. Dietary assessment was performed by a food frequency questionnaire and a 3-day food record. Celiac children had lower iron intake than controls, especially at the beginning of GFD (p < 0.01). The group CD-GFD >6 months showed a higher intake of cobalamin, meat derivatives and fish compared to that of CD-GFD <6 months (all, p < 0.05). The control group showed a higher consumption of folate, iron, magnesium, selenium and meat derivatives than that of children CD-GFD >6 months (all, p < 0.05). Control children also showed a higher consumption of folate and iron compared to that of children CD-GFD <6 months (both, p < 0.05). The diet of celiac children was nutritionally less balanced than that of the control. Participation of dietitians is necessary in the management of CD to guide the GFD as well as assess the inclusion of iron supplementation and other micronutrients that may be deficient.This study was partially funded by the Regional Government of Andalusia, Excellence Research Project No P12-AGR-2581. This study was also supported by the University of Granada Research and Knowledge Transfer Fund (PPIT)2016, Excellence Actions Programme: Scientific Units of Excellence (UCEES), and the Regional Ministry of Economy, Knowledge, Enterprises and University, European Regional Development Funds (ref. SOMM17/6107/UGR). MFA was additionally funded by the Spanish Ministry of Education, Culture and Sports (Grant number FPU17/03715)

Influence of Mediterranean Diet Adherence and Physical Activity on Bone Health in Celiac Children on a Gluten-Free Diet

We aimed to assess the influence of the Mediterranean Diet adherence and physical activity (PA) on body composition, with a particular focus on bone health, in young patients with celiac disease (CD). The CD group (n = 59) included children with CD with a long (>18 months, n = 41) or recent (<18 months, n = 18) adherence to a gluten-free diet (GFD). The non-celiac group (n = 40) included non-celiac children. After adjusting for potential confounders, the CD group showed lower body weight (p = 0.034), lean mass (p = 0.003), bone mineral content (p = 0.006), and bone Z-score (p = 0.036) than non-celiac children, even when the model was further adjusted for adherence to a GFD for at least 18 months. Among CD children, spending greater time in vigorous physical activity was associated with higher lean mass (p = 0.020) and bone mineral density with evidence of statistical significance (p = 0.078) regardless of the time they followed a GFD. In addition, a greater Mediterranean Diet adherence was associated with a higher bone Z-score (p = 0.020). Moreover, lean mass was strongly associated with bone mineral density and independently explained 12% of its variability (p < 0.001). These findings suggest the importance of correctly monitoring lifestyle in children with CD regarding dietary habits and PA levels to improve lean mass and, consequently, bone quality in this population.Regional Government of Andalusia, Excellence Research Project No P12-AGR-2581Project from the University of Granada Ref. PP2017-PIP14Spanish Ministry of Education, Culture, and Sports (Grant number FPU17/03715

Time Following a Gluten-Free Diet, Ultra-Processed Food Consumption and Quality of Life in Children with Celiac Disease

Maintaining a strict gluten-free diet (GFD) may affect the quality of life of children with celiac disease (CD) and promote a less healthy diet by substituting gluten-containing foods with ultra-processed foods. We aimed to assess the influences of the GFD and ultra-processed food consumption on parents' perception of the quality of life of children with CD. Fifty-eight children (mean age 8.6 +/- 4.1 years) were included. The participants were divided into groups based on the time following a GFD: = 12 months (n = 37). Their dietary consumption was assessed through a three-day food record. The 20-item Celiac Disease Quality Of Life survey (CD-QOL), which contains four subscales (limitations, dysphoria, health concerns, and inadequate treatment) was used to assess the quality of life. The children who followed a GFD for >= 12 months presented poorer scores in the limitations subscale than those who followed a GFD for <6 months (p = 0.010). The mean % of the energy intake from ultra-processed foods was 47.3 +/- 13.5. Children with CD consuming more than 50% of their total energy from ultra-processed foods showed poorer scores for the limitation and inadequate treatment (both, p = 0.019) subscales than their counterparts. According to parents' perceptions, those children who consumed more than 50% of their energy through ultra-processed foods had more limitations, and their treatment was perceived as less effective.European Commission B-AGR-658Association of Celiacs and Sensitive to Gluten of the Community of MadridSpanish Government FPU17/0371