Accions metabòliques de la vitamina D molt més enllà del que podíem imaginar fa uns deu anys

La vitamina D és una peça clau en la regulació de l'homeòstasi mineral, protegeix la integritat de l'os i modula el creixement, i la seva deficiència és un problema de salut pública avui dia. Fora de l'os la vitamina D també ha estat associada amb efectes metabòlics, i s'han publicat en els últims anys múltiples estudis que demostren la relació de nivells baixos de vitamina D i obesitat. La concentració de vitamina D està associada a adipositat, però diversos estudis suggereixen que la deficiència de vitamina D pot ser un factor independent relacionat amb la patogènesi de comorbiditats associades a l'obesitat. En aquest article volem revisar la fisiopatologia de la deficiència de la vitamina D amb la seva associació amb l'obesitat i el paper que en representa el dèficit en les comorbiditats relacionades amb l'obesitat.The vitamin D is key in the regulation of the mineral homeostasis, protecting the integrity of the bone and modulating its growth. Its deficiency is currently a public health problem. Out of the bone the vitamin D has been associated with metabolic effects. Recent studies have demonstrated the relation between low levels of vitamin D and obesity. The concentration of vitamin D is associated with adiposity, but several studies suggest that the deficiency of vitamin D can be an independent factor related to the pathogenesis of comorbidities associated with the obesity. In this article, the pathophysiology of vitamin D deficiency and its association with obesity and comorbidities related with obesity are reviewed

La ingesta de sal y el consumo de pan. Una visión amplia de la situación en España

The aim of this study is to review salt intake in Spain (9.6 d/day) and the health problems associated with its excessive consumption. Likewise, the role played by the salt content of bread, and its possible reduction and/or correction, will also be discussed. Finally, the beneficial effects of such changes are highlighted by way of a theoretical calculation in baguette-type wheat bread.As bread is widely considered to be the foodstuff that provides most dietary salt to the diet (19%), it is one of the key public health targets for salt reduction policy. In this respect, it has been shown that a reduction in the salt content of bread is possible, and alternative approach involves partial replacement with other, mainly potassium-based salts, which also counteract the effects of sodium. This replacement should be undertaken on the basis of criteria that maintain the product’s sensory profile and tends to be more successful in breads whit enhanced taste. European legislation in the field of nutrition and health claims allows the positive aspects of this reduction and replacement to be stated. The 30% reduction of salt in bread, viable from a technological point of view, would imply a reduction of 0.6 g in daily salt intake.El objetivo de este trabajo ha sido realizar una revisión de la ingesta de sal en España (9,6 g/día) y los problemas de salud que se derivan de su excesivo consumo. Por otra parte, valorar el papel del pan relacionado con dicha ingesta y su posible reducción y/o corrección desde diferentes enfoques. Finalmente, evidenciar las consecuencias favorables de dicha corrección por medio de un cálculo teórico en un pan tipo baguette.El pan es el alimento que aporta generalmente una mayor cantidad de sal en la dieta (19%), por lo que es uno de los objetivos clave en una política de reducción de su consumo. Se ha comprobado que es posible una disminución escalonada de sal en el pan, sobre todo cuando se parte de valores altos, aunque otra alternativa es su sustitución parcial por otras sales, principalmente potásicas, que tienen además un efecto que contrarresta al sodio (disminución de la relación Na/K). Esta sustitución debe hacerse con criterios de mantenimiento del perfil sensorial y se ve favorecida en panes con un sabor potenciado, ya sea por ingredientes o procesos, dado que ello facilita la reducción del contenido de sal. Por otra parte, la legislación europea en alegaciones nutricionales y de salud permite destacar los aspectos positivos de esta reducción y/o sustitución. La reducción de un 30% de sal en el pan, viable desde un punto de vista tecnológico, implicaría una reducción de la ingesta diaria de sal de 0,6 g

Association of Mediterranean diet with peripheral artery disease: the PREDIMED randomized trial

Association of Mediterranean Diet With Peripheral Artery Disease: The PREDIMED Randomized Trial The role of nutrition in preventing peripheral artery disease (PAD) remains elusive. 1 Mediterranean diets reduce the risk of myocardial infarction and stroke. 2,3. They also may reduce the risk of PAD, but this hypothesis has never been tested in a randomized trial. We assessed the association of Mediterranean diets with the occurrence of symptomatic PAD in an exploratory, nonprespecified analysis of a randomized trial..

Glycemic Dysregulations Are Associated With Worsening Cognitive Function in Older Participants at High Risk of Cardiovascular Disease: Two-Year Follow-up in the PREDIMED-Plus Study

Introduction: Type 2 diabetes has been linked to greater cognitive decline, but other glycemic parameters such as prediabetes, diabetes control and treatment, and HOMA-IR and HbA1c diabetes-related biomarkers have shown inconsistent results. Furthermore, there is limited research assessing these relationships in short-term studies. Thus, we aimed to examine 2-year associations between baseline diabetes/glycemic status and changes in cognitive function in older participants at high risk of cardiovascular disease. Methods: We conducted a 2-year prospective cohort study (n=6,874) within the framework of the PREDIMED-Plus study. The participants (with overweight/obesity and metabolic syndrome; mean age 64.9 years; 48.5% women) completed a battery of 8 cognitive tests, and a global cognitive function Z-score (GCF) was estimated. At baseline, participants were categorized by diabetes status (no-diabetes, prediabetes, and <5 or ≥5-year diabetes duration), and also by diabetes control. Furthermore, insulin resistance (HOMA-IR) and glycated hemoglobin (HbA1c) levels were measured, and antidiabetic medications were recorded. Linear and logistic regression models, adjusted by potential confounders, were fitted to assess associations between glycemic status and changes in cognitive function. Results: Prediabetes status was unrelated to cognitive decline. However, compared to participants without diabetes, those with ≥5-year diabetes duration had greater reductions in GCF (β=-0.11 (95%CI -0.16;-0.06)], as well as in processing speed and executive function measurements. Inverse associations were observed between baseline HOMA-IR and changes in GCF [β=-0.0094 (95%CI -0.0164;-0.0023)], but also between HbA1c levels and changes in GCF [β=-0.0085 (95%CI -0.0115, -0.0055)], the Mini-Mental State Examination, and other executive function tests. Poor diabetes control was inversely associated with phonologic fluency. The use of insulin treatment was inversely related to cognitive function as measured by the GCF [β=-0.31 (95%CI -0.44, -0.18)], and other cognitive tests. Conclusions: Insulin resistance, diabetes status, longer diabetes duration, poor glycemic control, and insulin treatment were associated with worsening cognitive function changes in the short term in a population at high cardiovascular risk

Metabolomics for Biomarkers of Type 2 Diabetes Mellitus: Advances and Nutritional Intervention Trends

Abstract Metabolic characterization of type 2 diabetes mellitus (T2DM) is crucial for the identification of individuals at risk for developing diabetes and T2DM-related vascular complications as well as for monitoring disease progression. The application of metabolomics to diabetes research may lead to the identification and discovery of diagnostic and prognostic T2DM biomarkers, in addition to elucidating disease pathways. In the present review, we summarize the distinct classes of metabolites that have been proposed as potential biomarkers for progressing stages of T2DM by metabolomic approaches. Several studies have demonstrated that the metabolism of carbohydrates, lipids, and amino acids is considerably altered in prediabetes and continue to vary over the course of T2DM progression. The identification of intermediate metabolites involved in glycolysis, gluconeogenesis, the tricarboxylic acid cycle, lipolysis, and proteolysis have provided evidence of these metabolic dysfunctions. Finally, given the increasing worldwide incidence of T2DM and its related complications, research should focus on the impact of lifestyle factors, particularly diet, at the metabolomic level for better understanding and improved healthcare strategie

Knowledge, attitude, and patient advice on sustainable diets among Spanish health professionals

Current dietary patterns, especially in high-income countries, are unsustainable. Health professionals, due to their credibility and close contact with the general population, could serve as agents of change for the adoption of sustainable diets. The objective of this study was to assess the knowledge and attitude regarding sustainable diets among the health professionals in Spain. A 24-item online questionnaire was designed for this purpose, and sent to health professionals (i.e., dietitians-nutritionists, nurses, physicians, and pharmacists). From September 2021 to May 2022, 2,545 health professionals answered the survey completely. One-fifth of them had never heard the term “sustainable diet”, and most of them recognized having limited knowledge about it. They considered promoting sustainable diets when making dietary recommendations important, and pointed out that they would like to be trained on the topic. Indeed, they reported that all health professionals, independent of their career background, should be educated on sustainable diets. Efforts should be stressed on implementing training courses, at university level but also as continuous post-graduate training, providing health professionals in Spain the necessary knowledge to promote the adoption of sustainable diets among the population

Adopting a High-Polyphenolic Diet Is Associated with an Improved Glucose Profile: Prospective Analysis within the PREDIMED-Plus Trial

The prevalence of diabetes is experiencing an increasing trend, and in 2019 it was the ninth leading cause of death in the world. Additionally, individuals with diabetes are more likely to suffer from other noncommunicable diseases such as heart attacks, strokes, or kidney disease. The expectations for the forthcoming years are not encouraging since the prevalence of diabetes has been increasing over the past decades. Nevertheless, type-2 diabetes (T2D), the most prevalent type, can be prevented by modifying harmful behavioral risk factors such as smoking, an unhealthy diet, sedentarism, and alcohol abuse [1]. In the search for the best dietary pattern to prevent or stop the progression of T2D, plant-based diets such as Mediterranean-style, vegetarian or vegan diets have been studied in several prospective observational studies and clinical trials [2]. Healthy plant-based diets are based on the consumption of large amounts of whole grains, fruits, vegetables, legumes, and nuts, as well as healthy fats such as extra virgin olive oil, which are associated with a lower risk of developing cardiovascular disease and T2D [3]. A trait all these foods have in common is a richness in polyphenols, bioactive plant secondary metabolites with a vast structural diversity. According to their structure, polyphenols are classified into two main groups: flavonoids and non-flavonoids. Polyphe nols in the flavonoid group share the C6-C3-C6 structure and can be divided into the following subgroups: flavones, flavonols, theaflavins, catechins, proanthocyanidins (poly meric forms), flavanones, anthocyanidins, and isoflavones, whereas the non-flavanoids are classified as phenolic acids, lignans, and stilbenes [4]. Protective effects of polyphenols against the incidence and complications of T2D are supported by mechanistic studies conducted in animals [5] as well as clinical and epidemiological studies [6], although the available evidence is still limited and inconsistent. Furthermore, no previous study has examined the association between changes in the intake of all polyphenolic groups and subgroups and T2D-related parameters in a population with or at high-risk of T2D. The aim of the present work was to determine whether changing to a high polyphenol diet is associated with an improved glucose profile. Due to the heterogeneity of polyphenols in terms of bioavailability and metabolism, they were studied in separate groups

Vitamin D Intake and the Risk of Colorectal Cancer: An Updated Meta-Analysis and Systematic Review of Case-Control and Prospective Cohort Studies

Obesity, a sedentary lifestyle, high red meat consumption and alcohol, and tobacco are considered the driving factors behind colorectal cancer (CRC) worldwide. Both diet and lifestyle are recognized to play an important role in the prevention of CRC. Forty years later, the vitamin D-cancer hypothesis is considered consistent. However, the relationship between low vitamin D intake and CRC is still controversial. The aim of this meta-analysis is to determine the associations between Vitamin D intake and CRC. MEDLINE-PubMed and Cochrane databases were searched up to May 2020 for studies evaluating the association between vitamin D intake (from foods and supplements) and CRC. Two reviewers, working independently, screened all titles and abstracts to identify the studies that met the inclusion criteria (case-control or prospective cohort (PC) studies published in English). Data were pooled by the generic inverse variance method using a random or fixed effect model. Heterogeneity was identified using the Cochran Q-test and quantified by the I2 statistic. A total of 31 original studies were included for the quantitative meta-analysis, comprising a total 47.540 cases and 70.567 controls in case-control studies, and a total of 14.676 CRC-incident cases (out of 808.130 subjects in PC studies) from 17 countries. A significant 25% lower risk was reported comparing the highest vs. the lowest dietary vitamin D consumption and CRC risk (odds ratio (95% confidence interval): 0.75 (0.67; 0.85)) in case-control studies, whereas a non-significant association was reported in case of prospective studies (hazard ratio (95% confidence interval): 0.94 (0.79; 1.11). The present meta-analysis demonstrates that high dietary vitamin D is associated to CRC prevention. However, larger and high-quality prospective studies and clinical trials are warranted to confirm this association. View Full-Text Keywords: vitamin D intake; meta-analysis; systematic review; colorectal cancer; incidence; case-control; prospectiv