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Background: Adverse reactions to foodstuffs (ARFS), specifically food allergy (FA) and food intolerance (FI), are increasing worldwide and represent a major public health concern. Thus, ARFS management, its identification, evaluation, and intervention, must provide a comprehensive solution., Objectives: (a) To develop a multifactorial strategy for ARFS management in adults with FA and/or FI; (b) to describe the multiple influential variables in ARFS within the realm of ARFS management; and (c) to design a personalized food allergen-specific substitutive diet (FASSD), as a 6-month dietary treatment option for adults with ARFS and as a component of ARFS management., Methods: The ALASKA study will consider the following main variables as part of the ARFS management: (1) demographics and clinical information; (2) symptomatology, food and beverages intake and physical activity; (3) hematobiochemical study; (4) immunology; (5) enzymatic activity; (6) anthropometry, body composition, and physical fitness; (7) QoL; (8) 6-month intervention; (9) end of the study; and (10) other assessments. The FASSD will be designed with special emphasis on the commonly lacking micronutrients in the ARFS population: niacin, Mg, K, P, Ca, Zn, B12, folate, Fe, and fiber., Discussion: The ALASKA study protocol has been developed as a global strategy to manage and evaluate ARFS in Spanish adults older than 18 years of age. Approaching ARFS with multiple assessments, as influencing factors, will lead to a novel strategy for ARFS management. The FASSD has been designed as a personalized tool to avoid crucial micronutrient deficiencies that a current strict food allergen avoidance or elimination diet may provoke., Trial Registration: The protocol has been approved by the Ethics Committee of the UPM (REF.20200602) and registered on ClinicalTrials.gov (NCT05802017)., (© 2024. The Author(s).)

Aims: The present study sought to analyze the effects of 6-month multicomponent training (MCT) combined with a 4-month detraining on metabolic syndrome (MetS) profile among older adults with decreased functional capacity., Methods: This quasi-experimental study included a total of 104 older adults (80.5 ± 6.0 years) and the sample was divided into a training (TRAIN, n = 55) or control group (CON). Harmonized definition was used to diagnose the MetS. Functional capacity, blood biochemical parameters, blood pressure, body composition and anthropometric measurements were assessed 3 times. Analysis of variance for repeated measures and Wilcoxon signed-rank test were used to check the differences within groups., Results: TRAIN decreased diastolic blood pressure (DBP), high-density lipoprotein cholesterol (HDLC) and total fat mass during training period, whereas CON did not show any significant changes. During detraining, TRAIN increased HDLC, systolic blood pressure (SBP), waist circumference (WC) and total fat mass; and decreased glucose and fat free mass, whereas CON increased the concentration of glucose and HDLC. From baseline to post-detraining assessment, CON increased the concentration of triglycerides and the WC, while TRAIN only increased the WC (all p < 0.05)., Conclusions: Exercise can be a key component in the treatment of the MetS, since MCT seems to be effective to decrease DBP and total fat mass. Nevertheless, 4-months of detraining could cause a drop of total fat mass, but no in DBP. To avoid reversibility of the benefits obtained, it could be beneficial to promote continuing exercise programs., Trial Registration: ClinicalTrial.gov identifier: NCT03831841., Competing Interests: Declaration of competing interest None., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Aging leads to physiological changes affecting body composition, mediated by lifestyle. However, the effectiveness of organized physical activities (OPAs) in attenuating or delaying these age-related transformations remains an area of limited understanding. The primary objectives of this study were threefold: (I) to comprehensively assess the evolution of body composition in a cohort of Spanish older adults over an 8-year period; (II) to compare this evolution in the different age groups; and (III) to investigate the influence of active engagement in OPAs on these age-related changes. From a sample of 3136 Spanish older adults recruited in 2008, 651 agreed to participate in the 8-year follow-up. Anthropometric and bioelectrical impedance data were included for 507 females (70.3 ± 4.4 years) and 144 males (77.8 ± 4.5 years). Age groups were categorized as follows: youngest (65-69 years), mid (70-74 years), and oldest (≥75 years). The engagement in OPA was recorded before and after the follow-up. A repeated measures ANOVA was performed to evaluate the 8-year changes. Males increased in hip (98.1 ± 9.3 vs. 101.5 ± 10.2 cm) and waist circumferences (101.2 ± 6.6 vs. 103.2 ± 6.1 cm), specifically in the youngest group ( p < 0.05). Females decreased in weight (67.6 ± 10.0 vs. 66.6 ± 10.5 kg) and fat mass percentage (39.3 ± 5 vs. 38.8 ± 5.4%) and increased in hip circumference (104.4 ± 9.0 vs. 106.5 ± 9.7 cm); these effects were the most remarkable in the oldest group (all p < 0.05). OPA engagement seemed to slow down fat-free mass loses in males, but not in females (grouped by time, p < 0.05). Body composition changes caused by aging seem to happen earlier in males than in females. Moreover, participating in OPAs does not prevent fat-free mass due to aging.

Signs and symptoms attributed to adverse reactions to foodstuffs (ARFS) need tools for research and evaluation in clinical practice. The objectives of this study were (a) to evaluate the most frequent self-reported signs and symptoms attributed to ARFS in Spanish adults, (b) to determine the prevalence of food-specific IgG 4 antibody reactions (AbRs), and (c) to investigate the association between self-reported ARFS symptomatology and food-specific IgG 4 AbRs. Food-specific IgG 4 AbRs against 57 common food and beverages (AESKUCARE-T2FA ® in vitro point-of-care test kit, Aesku.Diagnostics GmbH, Germany) were determined in capillary blood samples of 205 volunteers living in the Region of Madrid (Spain). The most frequent self-reported signs and symptoms were related to skin (43%), digestive (41%), and nervous system (NS, 33%) problems. The prevalence of food-specific IgG 4 AbRs was cow's milk (73%), sheep's milk (70%), casein (66%), and goat's milk (56.10%). Positive IgG 4 AbRs against tomato had a profile consisting of 3/4 of skin problems, more than half of digestive, and 2/5 of NS self-reported signs and symptoms. In conclusion, at least 1/3 of the studied sample reported skin, digestive, and NS signs and symptoms. The most frequent food-specific IgG 4 AbRs were related to dairy. Skin problems were more frequent in positive tomato IgG 4 AbRs.

Background: Youth is a vulnerable period. To classify lifestyle behaviors and its relationship with health-related outcomes of Spanish children and adolescents., Methods: Cross-sectional study including 3261 children aged 7.5-17.5 y (52.8% females). Physical activity (PA), screen-time, sleep time, adherence to Mediterranean diet (MD), weight status (WS) by validated methods. Cluster analysis was run considering chronological age., Results: Six clusters were identified: C1: high screen time, low adherence to MD and sleep time (n = 431,13.20%); C2: high WS, medium adherence to MD,high sleep time, and low screen time (n = 466,14.30%); C3: young group with low screen time and high PA, adherence to MD and sleep (n = 537,16.40%); C4: worst profile regarding adherence to MD, PA, WS and sleep time (n = 609,18.70%); C5: low screen time and PA, high sleep time (n = 804,24.70%); C6: high PA and screen time, low WS (n = 414,12.70%). Mean absolute values were statistically different among PA levels, screen and sleep time, adherence to MD, age, and WS (all p < 0.001)., Conclusions: The most prevalent pattern was low levels of PA, MD, and screen time, and high sleep time. The second most prevalent was characterized by very low levels of PA, sleep time, and adherence to MD, and high screen time, and WS in adolescents., Impact Statement: The main identified lifestyle behavior was poor physical activity, low adherence to Mediterranean Diet and high screen and sleep time. Children should increase physical activity levels, adherence to Mediterranean diet, decrease screen and sleep the appropriate hours per day. Families, schools, and medical communities must work together to gloss over present and future diseases. Sleep time had not been previously included in cluster analysis with physical activity, sedentary behaviors, obesity, and nutritional status, thus the present data open a new perspective in Spanish population. Health policies should focus on promoting physical activity, Mediterranean diet, adequate sleep and reducing screen time., (© 2023. The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.)

Introduction: Introduction: there is an emerging current necessity of valid questionnaires, encompassing most of food, beverages, diseases, signs and symptoms currently related to the pathogenesis of adverse reactions to foodstuffs (ARFS) in the Spanish population. Objectives: this study aimed to design and validate two questionnaires to assess ARFS in the Spanish population, Food and Beverages Frequency Consumption Questionnaire to Identify Adverse Reactions to Foodstuffs (FBFC-ARFSQ-18); and Pathologies and Symptomatology Questionnaire associated with Adverse Reactions to Foodstuffs (PSIMP-ARFSQ-10). Methods: both questionnaires were designed adapting questionnaires from the literature; and validated, using the expert judgment method, in five phases: questionnaires development, pilot test and reliability, content validity, face validity, and ethical considerations. Questionnaires were developed using the REDCap™ tool hosted at the Universidad Politécnica de Madrid. A total of 20 Spanish experts evaluated the questionnaires. Cronbach's alpha reliability coefficients were calculated using SPSS version 25.0 (IBM Corp., Armonk, NY-USA) and Aiken's V coefficient values were calculated using ICaiken.exe (Visual Basic 6.0, Lima-Perú). Results: a final construct of questions was designed, ensuring no overlap, for FBFC-ARFSQ-18 and PSIMP-ARFSQ-10. Cronbach's alpha reliability coefficients were 0.93 and 0.94; and Aiken's V coefficient values were 0.90 (0.78-0.96 CI) and 0.93 (0.81-0.98 CI) for FBFC-ARFSQ-18 and PSIMP-ARFSQ-10, respectively. Conclusions: both validated questionnaires could be used to analyze the association between certain food and beverages consumption with ARFS, such as food allergies and food intolerances; also, to investigate the link between some specific diseases, signs and symptoms with ARFS.

Physical exercise effects and ageing on fitness may be influenced by nutritional status. This study investigates the effects of a 6-month multicomponent exercise training (MCT) on nutritional status and evaluates if this type of exercise could affect differently body composition and physical fitness depending on the nutritional status of older adults with decreased functional capacity. Ninety-three participants (80.4 ± 6.0 y) were divided into control ( n  = 45) and intervention ( n  = 48) groups. The intervention consisted of a 6-month multicomponent training. Comparisons between changes in body composition and fitness during the 6-months were performed between individuals at risk of malnutrition and those well-nourished, according to the Mini Nutritional Assessment. Model mixed-effect analyses were used to investigate differences after the 6 months of MCT between groups. Well-nourished participants compared with those at risk of malnutrition had higher: arm (13.4 ± 3.5 vs 14.3 ± 33.6 repetitions) and leg strength (9.0 ± 3.0 vs 11.1 ± 3.3 repetitions), maximum walking speed (31.6 ± 13.1 vs 23.7 ± 6.3s), agility (11.9 ± 5.8 vs 8.3 ± 2.1s), and aerobic capacity (31.6 ± 13.1 vs 23.7 ± 6.3 m), at baseline. After the training, those without risk of malnutrition in CON decreased their nutritional status (-1.7 + 0.7 points). Those well-nourished that performed the intervention decreased total fat mass (-1.0 ± 0.3 kg) and body fat percentage (-1.2 ± 0.4%). Both groups of training improved similarly in all tests, except for balance, in which the well-nourished showed improvements of 6.3 ± 1.9s. These results underline the usefulness of MCT in improving physical fitness regardless of nutritional status and preventing nutritional status detriment in well-nourished older adults, who are fitter and benefit more, in terms of body composition. Trial registration: ClinicalTrials.gov identifier: NCT03831841. Highlights Multicomponent exercise programme seems to be effective in delaying detriments in the nutritional status of well-nourished people.Well-nourished older people obtain more benefits in body composition from the multicomponent exercise than those at risk of malnutrition, decreasing adiposity.The positive effect of multicomponent exercise was observed in physical fitness independently of nutritional status.

Objective: To determine the link between physical fitness and body composition with nocturnal and nap time in Spanish older adults. Methods: Eight hundred thirty older adults underwent several tests. Sleep was measured using Jenkins Sleep Scale. Nocturnal sleep was categorized (<7, 7-9, and >9 hours), and nap time (no nap, 1-30 minutes, and >30 minutes).Physical fitness was evaluated using validated tests, and body composition by electric bioimpedance. Results: 75.1% of participants were female, mean age 77.7 ± 5.1 years. Mean nocturnal sleep and nap time was 6.7 hours and 23.3 minutes, respectively. Models showed nocturnal sleep >9 hours was significant and positively associated with body shape index (Odds ratio[ OR ] = 4.07 ( p  = .011)) and waist circumference OR  = 1.04 ( p  = .024) in females. Males' waist and hip circumference were positively significantly related to nap time between 1 and 30 minutes, OR  = 1.08, p  = .009 and OR  = 1.08, p  = .048, respectively. In females, nap time >30 minutes was associated with greater fat mass and body shape index OR  = 1.22, p  = .032 and OR  = 3.95, p  = .027, respectively. Physical fitness showed no associations with sleep outcomes. Conclusions: Sleep patterns do not influence physical fitness but body composition, being more related to female body composition as nocturnal and nap sleep were associated with higher fat mass, waist circumference and body shape index, while only short nap times were related to higher waist and hip circumference in males., Competing Interests: Declaration of Conflicting Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2022.)

Background and Aims: This study aims to examine the associations of food portion size (PS) with markers of insulin resistance (IR) and clustered of metabolic risk score in European adolescents., Methods: A total of 495 adolescents (53.5% females) from the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study were included. The association between PS from food groups and homeostasis model assessment of insulin resistance (HOMA-IR) index, VO2 max, and metabolic risk score was assessed by multilinear regression analysis adjusting for several confounders. Analysis of covariance (ANCOVA) was used to determine the mean differences of food PS from food groups by HOMA-IR cutoff categories by using maternal education as a covariable., Results: Larger PS from vegetables in both gender and milk, yoghurt, and milk beverages in males were associated with higher VO2 max, while larger PS from margarines and vegetable oils were associated with lower VO2 max (p < 0.05). Males who consumed larger PS from fish and fish products; meat substitutes, nuts, and pulses; cakes, pies, and biscuits; and sugar, honey, jams, and chocolate have a higher metabolic risk score (p < 0.05). Males with lower HOMA-IR cutoff values consumed larger PS from vegetables, milk, yoghurt, and milk beverages (p < 0.05). Females with lower HOMA-IR cutoff values consumed larger PS from breakfast cereals, while those with higher HOMA-IR cutoff values consumed larger PS from butter and animal fats (p = 0.018)., Conclusion: The results show that larger PS from dairy products, cereals, and high energy dense foods are a significant determinant of IR and VO2 max, and larger PS from food with higher content of sugar were associated with higher metabolic risk score., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2022 The Author(s). Published by Elsevier B.V. All rights reserved.)

Metabolic syndrome (MetS) is a cluster of medical conditions associated with several health disorders. MetS and frailty can be related to prolonged physical deconditioning. There is a need to know whether there is concordance between the different ways of diagnosing it and to know their prevalence in Spanish older adults. Thus, the aims of this study were to describe the prevalence of MetS; to analyse the concordance between different definitions to diagnose MetS; and to study the associations between MetS, frailty status, and physical activity (PA) in older adults with decreased functional capacity. This report is a cross-sectional study involving 110 Spanish older adults of ages ≥65 years with decreased functional capacity. Clinical criteria to diagnose MetS was defined by different expert groups. Anthropometric measurements, blood biochemical analysis, frailty status, functional capacity, and PA were assessed. The Kappa statistic was used to determine the agreement between the five MetS definitions used. Student's t -test and the Pearson chi-square test were used to examine differences between sex, frailty, and PA groups. The sex-adjusted prevalence of MetS assessed by the National Cholesterol Education Program-Third Adult Treatment Panel was 39.4% in men and 32.5% in women. The International Diabetes Federation and the Harmonized definitions had the best agreement (k = 1.000). The highest odds ratios (ORs) of cardiometabolic risk factors to develop MetS were elevated triglycerides (37.5) and reduced high-density lipoprotein cholesterol (27.3). Central obesity and hypertension prevalence were significantly higher in the non-active group (70.7% and 26.8%, respectively), compared to the active group (50.0% and 7.7%, respectively). Moreover, the active group (OR = 0.85, 95% CI = 0.35, 2.04) and active women group (OR = 0.77, 95% CI = 0.27, 2.20) appeared to show a lower risk of developing this syndrome. MetS is highly prevalent in this sample and changes according to the definition used. It seems that sex and frailty do not influence the development of MetS. However, PA appears to decrease central obesity, hypertension, and the risk of developing MetS.

Background: Physical fitness and body composition are important health indicators; nevertheless, their combined pattern interrelationships and their association with mortality are poorly investigated., Methods: This longitudinal study is part of the Spanish EXERNET-Elder project. Person-months of follow-up were calculated from the interview date, performed between June 2008 and November 2009, until the date of death or censoring on March 2018 (whichever came first). In order to be included, participants had to fulfill the following criteria: (a) be older than 65 years, (b) live independently at home, (c) not suffer dementia and/or cancer, and (d) have a body mass index above 18.5. Body fat and weight were assessed by a bioelectrical impedance analyzer. Fitness was measured with the Senior Fitness and the one-leg static balance tests. The Spanish Death Index was consulted for the death's identification. Cluster analysis was performed to identify Fat-Fit patterns and traditional cut-points and percentiles to create the Fat-Fit groups. Cox proportional hazards regression models were used to calculate the hazard ratios (HRs) of death in clustered Fat-Fit patterns and in traditional Fat-Fit groups., Results: A total of 2299 older adults (76.8% of women) were included with a baseline mean age of 71.9 ± 5.2 years. A total of 196 deaths (8.7% of the sample) were identified during the 8 years of follow-up. Four clustered Fat-Fit patterns (Low fat-Fit, Medium fat-Fit, High fat-Unfit, and Low fat-Unfit) and 9 traditional Fat-Fit groups emerged. Using the Low fat-Fit pattern as the reference, significantly increased mortality was noted in High fat-Unfit (HR: 1.68, CI: 1.06-2.66) and Low fat-Unfit (HR: 2.01, CI: 1.28-3.16) groups. All the traditional Fit groups showed lower mortality risk when compared to the reference group (obese-unfit group)., Conclusion: Physical fitness is a determinant factor in terms of survival in community-dwelling older adults, independently of adiposity levels., (© The Author(s) 2021. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Introduction: The multiple benefits of physical activity (PA) compared to the current lack of adherence to this behavior in older people makes it necessary to identify the factors related to its long-term dropout, therefore, the aim of this study was: (i) to study the evolution of behavior change for PA through stages of change (SoC) after 8 years and, to identify the associated factors related to the worsening of SoC for PA., Methods: A total of 714 Spanish older adults (>65 years) participated in the Longitudinal elderly EXERNET study 8 years follow-up. SoC for PA from Transtheoretical model of behavior change (TTM), body composition [BMI, fat mass, lean mass, waist circumference (WC), and hip circumference (HC)] and physical fitness (EXERNET battery fitness tests) were recorded. A multivariate binary logistic regression model was used to identify the potential predictive factors of worsening SoC for PA., Results: Three hundred and sixty participants (50.4%) worsening their SoC for PA after 8 years. Predictors factors associated with worsening of SoC were: HC (OR = 1.022; 95% CI: 1.001, 1.044), Lower body strength (OR = 0.940; 95% CI: 0.887, 0.997) and aerobic endurance at the 6 min-walk test (OR = 0.997; 95% CI: 0.995, 0.999)., Conclusion: This study highlights that we need to identify adults with high HC, lower body strength and lower aerobic endurance to design a tailored PA program. Identifying the determinants of losing adherence to PA will help in the creation, design, and evaluation of exercise programs with the goal of reducing older adults' drop-outs rates., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Jiménez-Zazo, Hernández-Martínez, Romero-Blanco, Cabanillas, Pérez-Gómez, Ara, Casajús, Vicente-Rodríguez, Gesteiro, González-Gross and Aznar.)

The aim of this study was to explore the differences among between adherence to physical activity (PA) and sociodemographic variables, body composition, and physical fitness levels in older adults (>65 years). A number of 2712 participants (2086 female; 76.92%) ranging from 65 to 92 years, participated in the study. Stages of change (SoC) for PA from the transtheoretical model of change (TTM), together with different sociodemographic variables, physical fitness tests (Senior Fitness Test), and waist and hip circumferences were evaluated. Significant differences were found in age, gender, educational level, current income, physical fitness test, and body composition (all of them, p < 0.05), according to the different SoC. Greater adherence to PA practice (action and maintenance stages) was related to better academic level, higher economic income, the male gender, better results in the physical fitness test, and healthier anthropometrics perimeters. Future research is needed to identify the relationship between these variables longitudinally.

Eating out of home (EOH) is a common practice worldwide but research gaps have been identified. The aims of this review were (a) to find a common definition for EOH, (b) to determine the nutritional contribution of EOH, and (c) to analyze the relationship of EOH with health parameters in adults. Fifty-seven articles were finally selected. The definition of EOH was not harmonized between researchers and the comparison between studies was quite difficult. Restaurant and fast food were the terms most used, followed by chain restaurant, à la carte, sit-down restaurant, eating at table, full service, ready to eat, takeaway, buffet and buffet by weight, bar, cafes, and cafeterias, either alone or attached to at least one of the above. The profile of the main EOH participant was a highly educated, high-income, and unmarried young man. EOH was related to a body mass index (BMI) or being overweight in a different way depending on age, sex, or EOH frequency. A high rate of EOH led to poorer diet quality, characterized by higher intakes of energy, total and saturated fats, sugar, and sodium, as well as lower intakes of fiber, dairy, fruit, vegetables, and micronutrients. Regarding beverages, a higher intake of soft drinks, sugar-sweetened beverages, fruit juices, beer, and other alcohol was observed when EOH. There is a need for a methodological consensus for analyzing the impact of EOH on dietary intake and health to avoid bias. Additionally, measures and policies should be utilized to help consumers to make healthier choices when EOH is compatible with business regarding those running EOH establishments.

Aims: a) To analyze the relationship of known and emerging biomarkers/indicators for early risk identification of cardiometabolic health risk; b) to identify early risk markers to be used in both clinical and nonclinical settings; and c) to propose a definition of early risk identification in terms of pre-metabolic syndrome (PreMetSyn)., Data Synthesis: Pubmed/Medline, Web of Science, Embase, and Cochrane were searched for Systematic Reviews and Meta-analysis. Selected studies were evaluated, and relevant data were extracted and synthesized., Conclusions: Serum uric acid is a good predictive biomarker of metabolic syndrome (MetSyn) and has been associated with non-alcoholic liver fat disease (NAFLD) and type 2 diabetes. NAFLD emerges as an early risk indicator of PreMetSyn by itself. Muscle strength should also be included as an early risk marker of cardiometabolic health. High serum triglycerides and waist circumference confirm their predictive value regarding MetSyn. Indicators related to an inflammatory/pro-inflammatory status usually linked to MetSyn showed limited evidence as robust biomarkers for PreMetSyn. Authors suggest defining PreMetSyn related to cardiometabolic risk. It is also necessary to determine how close people are to the cut-off point of MetSyn components, including emerging indicators proposed by our review. Some biomarkers could be used as indicators of PreMetSyn, before any of the MetSyn components appear, allowing early health interventions to prevent its development. Defining a PreMetSyn status might consider both emerging indicators and those variables already included in the definition of MetSyn. New indicators should be considered to create a new risk score specifically meant for PreMetSyn., Competing Interests: Declaration of competing interest None declared, (Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: Physical fitness levels and the amount of accumulated adipose tissue (fatness) relate to current and future individuals' heath status. Nevertheless, the interrelationships of their combined patterns with polypharmacy and the types of medications consumed have not been sufficiently investigated., Methods: This cross-sectional study was carried out in six Spanish regions between 2008 and 2009 with a sample of older community-dwelling adults (≥65 years old) without dementia or cancer. Fitness was measured with one-leg balance and senior fitness tests, as well as by measuring weight and fat mass with a bioelectrical impedance analyzer. Polypharmacy was defined as the use of five or more medications. An analysis of variance was performed for comparisons between the physical fitness and fatness patterns and the medication consumed., Results: A total of 1709 elders were included in the study (72.1 ± 5.2 years). The two unfit patterns were those with the highest drug consumption. The High-Fat-Unfit pattern was the one that had the most significant consumption and had the highest percentage of polymedicated subjects. The Low-Fat-Fit pattern had a significantly lower percentage of people that did not consume any medications. The highest percentages of drug consumption in 7 of the 10 groups that were included were concentrated in the two unfit patterns., Conclusions: This study highlights the importance of fitness in older adults, as it is at least as important as the avoidance of accumulation of excess fat with respect to the consumption of a smaller number of medicines.

Recreational running (RR) is becoming a popular way to increase physical activity for improving health, together with a higher incidence of knee injuries. The aim was to analyze the effect of a four-week supplementation with a mixture of Harpagophytum procumbens , Zingiber officinale and Bixa orellana on males, middle-aged, RR with an undiagnosed knee discomfort. A randomized triple-blind placebo-control trial was conducted among male RR aged 40-60 years suffering from self-declared knee discomfort after training. Participants were assigned to supplementation (2 g/day in 6 doses; n   =  13; intervention group (IG)) or matched placebo ( n   =  15; control group (CG)) for 4 weeks. At pre- and post-intervention, assessment of routine blood biomarkers, body composition, running biomechanics and body temperature was performed using standardized procedures. Machine learning (ML) techniques were used to classify whether subjects belonged to IG or CG. ML model was able to correctly classify individuals as IG or CG with a median accuracy of 0.857. Leg fat mass decreased significantly ( p = 0.037) and a deeper reduction in knee thermograms was observed in IG ( p < 0.05). Safety evaluation revealed no significant differences in the rest of parameters studied. Subjects belonging to IG or CG are clearly differentiated, pointing into an effect of the supplement of ameliorating inflammation.

Frailty is a reversible condition, which is strongly related to physical function and nutritional status. Different scales are used to screened older adults and their risk of being frail, however, Short Physical Performance Battery (SPPB) may be more adequate than others to measure physical function in exercise interventions and has been less studied. Thus, the main aims of our study were: (1) to describe differences in nutritional intakes by SPPB groups (robust, pre-frail and frail); (2) to study the relationship between being at risk of malnourishment and frailty; and (3) to describe differences in nutrient intake between those at risk of malnourishment and those without risk in the no-frail individuals. One hundred one participants (80.4 ± 6.0 year old) were included in this cross-sectional study. A validated semi-quantitative food frequency questionnaire was used to determine food intake and Mini Nutritional Assessment to determine malnutrition. Results revealed differences for the intake of carbohydrates, n -3 fatty acids (n3), and saturated fatty acids for frail, pre-frail, and robust individuals and differences in vitamin D intake between frail and robust (all p < 0.05). Those at risk of malnutrition were approximately 8 times more likely to be frail than those with no risk. Significant differences in nutrient intake were found between those at risk of malnourishment and those without risk, specifically in: protein, PUFA n -3, retinol, ascorbic acid, niacin equivalents, folic acid, magnesium, and potassium, respectively. Moreover, differences in alcohol were also observed showing higher intake for those at risk of malnourishment (all p < 0.05). In conclusion, nutrients related to muscle metabolism showed to have different intakes across SPPB physical function groups. The intake of these specific nutrients related with risk of malnourishment need to be promoted in order to prevent frailty.

Background: Dietary misreporting is the main limitation of dietary assessments and has been associated with BMI during youth. However there are no prior studies assessing misreporting and cardiometabolic risks (CMRs) in adolescence., Objectives: To examine the associations between dietary misreporting and CMR factors in adolescents and to assess the potential bias in the association between CMR and energy intake (EI) driven by dietary misreporting., Methods: Two 24-hour dietary recalls were obtained from 1512 European adolescents (54.8% girls) aged 12.5-17.5 years. Physical activity was measured by accelerometry. Cut-offs suggested by Huang were applied to identify misreporters. Height, waist circumference (WC), the sum of 4 skinfold thicknesses, diastolic blood pressure (DBP), systolic blood pressure (SBP), and cardiorespiratory fitness (CRF) measurements were taken and serum triglycerides and total-/high-density lipoprotein cholesterol ratio were analyzed. A sex- and age-specific clustered CMR score (n = 364) was computed. Associations were investigated by multilevel regression analyses adjusting for age, sex, center, socioeconomic status, and physical activity., Results: Underreporting (24.8% adolescents) was significantly (P < 0.05) associated with a higher WC, waist-to-height ratio (WHeR), and sum of skinfold thickness, whereas overreporting (23.4% adolescents) was significantly associated with a lower WC, WHeR, sum of skinfold thickness, and SBP. Associations between CMR factors and EI were significantly affected by misreporting, considering various approaches. Significant, positive associations became inverse after adjusting for misreporting for WC and WHeR. The opposite was true for the sum of skinfold thickness, SBP, and CMR score. The associations between EI and DBP and CRF did not remain significant after adjusting for misreporting., Conclusions: CMR factors differed among misreporting groups, and both abdominal and total fat mass indicators were more strongly associated with all forms of misreporting than was BMI. Moreover, misreporting seems to bias EI and CMR associations in adolescents. Therefore, energy misreporting should be taken into account when examining diet-CMR associations., (© The Author(s) 2021. Published by Oxford University Press on behalf of the American Society for Nutrition.)

Obesity is the result of interactions between genes and environmental factors. Since monogenic etiology is only known in some obesity-related genes, a genetic risk score (GRS) could be useful to determine the genetic predisposition to obesity. Therefore, the aim of our study was to build a GRS able to predict genetic predisposition to overweight and obesity in European adolescents. A total of 1069 adolescents (51.3% female), aged 11-19 years participating in the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) cross-sectional study were genotyped. The sample was divided in non-overweight (non-OW) and overweight/obesity (OW/OB). From 611 single nucleotide polymorphisms (SNP) available, a first screening of 104 SNPs univariately associated with obesity (p < 0.20) was established selecting 21 significant SNPs (p < 0.05) in the multivariate model. Unweighted GRS (uGRS) was calculated by summing the number of risk alleles and weighted GRS (wGRS) by multiplying the risk alleles to each estimated coefficient. The area under curve (AUC) was calculated in uGRS (0.723) and wGRS (0.734) using tenfold internal cross-validation. Both uGRS and wGRS were significantly associated with body mass index (BMI) (p < .001). Both GRSs could potentially be considered as useful genetic tools to evaluate individual's predisposition to overweight/obesity in European adolescents.

Obesity and metabolic syndrome (MetS) are worldwide major health challenges. The Mediterranean diet (MD) is associated with a better cardiometabolic profile, but these beneficial effects may be influenced by genetic variations, modulating the predisposition to obesity or MetS. The aim was to assess whether interaction effects occur between an obesity genetic risk score (obesity-GRS) and the MD on adiposity and MetS in European adolescents. Multiple linear regression models were used to assess the interaction effects of an obesity-GRS and the MD on adiposity and MetS and its components. Interaction effects between the MD on adiposity and MetS were observed in both sex groups ( p < 0.05). However, those interaction effects were only expressed in a certain number of adolescents, when a limited number of risk alleles were present. Regarding adiposity, a total of 51.1% males and 98.7% females had lower body mass index (BMI) as a result of higher MD adherence. Concerning MetS, only 9.9% of males with higher MD adherence had lower MetS scores. However, the same effect was observed in 95.2% of females. In conclusion, obesity-related genotypes could modulate the relationship between MD adherence and adiposity and MetS in European adolescents; the interaction effect was higher in females than in males.

The aims of the present study were (1) to describe the changes in physical fitness during an 8 year follow-up in a large sample of Spanish adults aged 65 or over that are initially engaged in organized physical activity (OPA), (2) to compare fitness changes according to different age groups (65 to 69 vs. 70 to 74 vs. ≥75 years-old), (3) to evaluate the independent and combined effects of changes in OPA engagement and sitting time (ST) on physical fitness. A total of 642 (147 males) non-institutionalized over 65 years-old participants completed the EXERNET battery fitness tests and completed a validated questionnaire from which information regarding OPA and ST were collected. All participants completed evaluations in 2008-2009 and in 2016-2017. An impairment of fitness-related variables happens after 65 years of age in both males and females, with the older participants (≥75), showing the largest decreases. Males who continued performing OPA demonstrated lower decreases in balance, leg flexibility and agility when compared to those who stopped performing OPA during the follow-up. Females who continued performing OPA demonstrated lower decreases of all variables except for balance when compared to those who stopped performing OPA during the follow-up.

Internationally recognized Spanish experts in the food industry, nutrition, toxicology, sustainability, and veterinary science met in Madrid on July 2018 to develop a consensus about palm oil (PO) as a food ingredient. Their aim was to provide a useful, evidence-based point of reference about PO. Scientific evidence about the role of PO in food safety, nutrition and sustainability was analyzed. Main conclusions were: (1) RSPO foundation responded to the environmental impact of palm crops. The Amsterdam Declaration pursues the use of 100% sustainable PO in Europe by 2020. Awareness about choosing sustainable products will help to maintain local economies and environments in the producing countries; (2) evidence shows that a moderate intake of PO within a healthy diet presents no risks for health. No evidence justifies any change fat intake recommendations; (3) food industry is interested in assuring safe, sustainable and high-quality products. The use of certified sustainable PO is increasing; and (4) there is no evidence associating PO consumption and higher cancer risk, incidence or mortality in humans. Tolerable daily intake (TDI) for toxic contaminants (2-and 3-monochloropropanediols (MCPDs), glycidyl esters (GEs)) have been established by JECFA and EFSA. Consequently, the European Commission has modified the Contaminants Regulation for GEs and it is still working on 3-MCPDs'.

Aims: To examine the association between UCP1, UCP2, and UCP3 gene polymorphisms with adiposity markers in European adolescents and to test if there were gene interactions with objectively measured physical activity and adiposity., Methods: A cross-sectional study that involves 1.057 European adolescents (12-18 years old) from the Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional Study. A total of 18 polymorphisms in UCP1, UCP2, and UCP3 genes were genotyped. We measured weight, height, waist, and hip circumferences and triceps and subscapular skinfold thickness. Physical activity was objectively measured by accelerometry during 7 days., Results: The C allele of the UCP1 rs6536991 polymorphism was associated with a lower risk of overweight (odds ratio [OR]: T/C + C/C vs T/T) = 0.72; 95% confidence interval [CI]: 0.53-0.98; P = 0.034; false discovery rate [FDR] = 0.048). There was a significant interaction between UCP1 rs2071415 polymorphism and physical activity with waist-to-hip ratio (P = 0.006; FDR = 0.026). Adolescents who did not meet the physical activity recommendations (less than 60 min/day of moderate to vigorous physical activity) and carrying the C/C genotype had higher waist-to-hip ratio (+ 0.067; 95% CI, 0.028-0.106; P = 0.003), while no differences across genotypes were observed in adolescents meeting the recommendations., Conclusions: Two UCP1 polymorphisms were associated with adiposity in European adolescents. Meeting the daily physical activity recommendations may overcome the effect of the UCP1 rs2071415 polymorphism on obesity-related traits., (© 2019 World Obesity Federation.)

Palm oil is obtained from Elaeis guineensis, E. oleifera or the hybrid OxG palm fruits. When crude, it contains high carotenoid concentrations (responsible for the red color), tocopherols and tocotrienols, but most of them are eliminated during its refining. Palm oil main components are palmitic and oleic acids, both near 50%, but their proportion changes depending on the fraction used. Fatty acids absorption and the effect on blood lipid profile depend on the position in the triacylglycerol, especially in the sn-2 position. The location of the monounsaturated or saturated fatty acids varies depending on the type of palm oil or fraction used. We critically review the two main reviews published about palm oil, which analyze 67 publications, and several studies that are more recent. Most of the studies were performed in non-European countries where palm oil is the main culinary oil. The effect on cardiovascular risk factors depends on the fat used as counterpart. Palm oil improves lipid profile after a diet rich in trans and saturated fats, while it impairs lipid profile after a diet rich in monounsaturated and polyunsaturated fats. Relevant methodological errors have been identified, such as not differentiating between palm oil, palm kernel oil and their fractions, comparing single fatty acids with whole oils or fats, or not considering physical activity or other factors that can affect blood lipids. No studies considering palm oil as an ingredient in a Mediterranean diet context, where olive oil is the main culinary oil, were found, so extrapolation of data is currently very difficult.

The study aims to assess the utility of the triglyceride-glucose index (TyG) as a marker of insulin resistance (IR) in neonates. TyG and the homeostatic model assessment (HOMA-IR) values were compared in 196 singleton, term normoweight and without distress newborns. A Decision Tree procedure (CHAID) was used to classify cases into groups or predict values of a dependent (Ln HOMA-IR) variable. Three nodes were drawn for TyG: ≤ 6.7, > 6.7-7.8 and > 7.8 (p < 0.0001; F = 20.52). The predictability of those TyG values vs HOMA-IR was statistically significant (p < 0.0001). It was neither affected by gender (p = 0.084), glucose challenge test (p = 0.138) classifications nor by the TyG node* glucose challenge test and TyG node*gender interactions (p = 0.456 and p = 0.209, respectively). Glucose, HOMA-IR, and the triglyceride/HDL cholesterol ratio increased progressively from node 1 to 3 for TyG while QUICKI decreased., Conclusion: In conclusion, TyG appears to be a suitable tool for identifying IR at birth, justifying the further insulin determination in those neonates. TyG ≥ 7.8 is recommended as cut-off point in neonates. The need for a follow-up study to confirm the TyG as early IR marker is desirable., What Is Known: • HOMA-IR and the triglyceride-glucose index (TyG) show a high correlation. • The TyG has been used as an insulin resistance marker in adults., What Is New: • This is the first study where TyG has been assessed in neonates. • TyG appears to be a suitable and cheap tool for identifying insulin resistance at birth.

Metabolic syndrome (MS) has a multifactorial and not yet fully clarified origin. Insulin resistance is a key element that connects all the accepted components of MS (obesity, dyslipemia, high blood pressure, and hyperglycemia). There is strong evidence that epigenetic changes during fetal development are key factors in the development of MS. These changes are induced by maternal nutrition, among different factors, affecting the intrauterine environment. The Mediterranean diet has been shown to be a healthy eating pattern that protects against the development of MS in adults. Similarly, the Mediterranean diet could have a similar action during pregnancy, protecting the fetus against the development of MS throughout life. This review assembles studies carried out, both in animals and humans, on the epigenetic modifications associated with the consumption, during pregnancy, of Mediterranean diet main components. The relationship between these modifications and the occurrence of factors involved in development of MS is also explained. In addition, the results of our group relating adherence to the Mediterranean diet with MS markers are discussed. The paper ends suggesting future actuation lines in order to increase knowledge on Mediterranean diet adherence as a prevention tool of MS development.

The influence of maternal fat mass and obesity (FTO) gene polymorphism on neonatal insulin sensitivity/resistance biomarkers and lipoprotein profile has not been tested. The study aimed to assess the association between the FTO rs9939609 polymorphism in mother-neonate couples and neonatal anthropometrical measurements, insulin sensitivity/resistance, and lipid and lipoprotein concentrations at birth. Fifty-three term, appropriate-for-gestational-age, Caucasian newborns together with their respective mothers participated in a cross-sectional study. Sixty-six percent of mothers and neonates carried the A allele (being AA or AT). TT mothers gained less weight during pregnancy, but non-significant maternal gene influence was found for neonatal bodyweight, body mass index, or ponderal index. Neonates from AA + AT mothers showed lower glucose, insulin, and homeostatic model assessment insulin resistance (HOMA-IR) but higher homeostatic model assessment insulin sensitivity (HOMA-IS) and homocysteine than neonates whose mothers were TT. AA + AT neonates had higher insulin and HOMA-IR than TT. The genotype neonatal × maternal association was tested in the following four groups of neonates: TT neonates × TT mothers (nTT × mTT), TT neonates × AA + AT mothers (nTT × mAA + AT), AA + AT neonates × TT mothers (nAA + AT × mTT), and AA + AT neonates × AA + AT mothers (nAA + AT × mAA + AT). Non-significant interactions between neonatal and maternal alleles were found for any parameter tested. However, maternal alleles affected significantly glucose, insulin, HOMA-IR, and homocysteine while neonatal alleles the arylesterase activity. Most significant differences were found between nATT + AA × mTT and nATT + AA × mAA + AT. Glycemia, insulinemia, and HOMA-IR were lower, while the Mediterranean diet adherence (MDA) was higher in the mAA + AT vs. mTT whose children were AA + AT. This dietary fact seems to counterbalance the potential negative effect on glucose homeostasis of the obesogenic A allele in neonates.

Background: Mediterranean diet consumption is associated to low prevalence of major degenerative diseases. Low Mediterranean-diet-adherence (MDA) score has been related to high insulin and homeostatic model assessment-insulin resistance levels at birth. The relationship between maternal MDA and offspring lipoprotein profile at birth has been scarcely reported., Methods: Cross-sectional study aimed to study the relationship between pregnancy diet quality and serum lipid, arylesterase and homocysteine values at birth. Cord blood of the offspring of 35 women whose diets were classified as "adequate" or "inadequate" according to their 13-point MDA-score (≥7 or <7, respectively) were studied., Results: MDA-scores did not significantly change through pregnancy. Low-MDA-score diets presented a higher atherogenic index, contained less fiber and folates, and had a lower (polyunsaturated + monounsaturated)/saturated fatty acids (PUFA + MUFA/SFA) ratio, more cholesterol, and higher SFA/carbohydrates (SFA/CHO) and ω-6/ω-3 PUFA ratios than their respective high-MDA-score counterparts. Mothers at the low MDA-score delivered neonates with high LDL-c (P = 0.049), Apo B (P = 0.040), homocysteine (P = 0.026) and Apo A1/Apo B ratio (P = 0.024)., Conclusions: Neonates whose mothers consumed low MDA diets presented impaired lipoprotein and increased homocysteine levels at birth. A follow-up study on early cardiovascular disease prevention is needed to understand the importance of present findings later in life.

Background: The relationship between serum minerals and homocysteine, lipoprotein and glucose homeostasis markers at birth has been scarcely reported. This study aims to determine a) the relationship between calcium, magnesium, cardiovascular disease (CVD) markers (e.g. lipids, lipoproteins, homocysteine) and insulin sensitivity/ resistance markers (e.g. glucose, insulin, HOMA) in cord serum; and b) to find out the possible influence of reduced or increased levels of serum calcium and magnesium on those markers., Subjects and Methods: Forty-eight eutocic, normoweight and appropriated-for-gestational age, full-term, singleton without foetal distress newborns from the Mérida Study were studied. Parameter percentiles for serum calcium and magnesium as well as for the Ca/Mg ratio were stated. CVD and insulin sensitivity/resistance markers in neonates within the first quartile for calcium, magnesium and their ratio were compared with those of neonates within the forth quartile for these minerals., Results: Serum calcium negative correlated with HDL-c (p<0.05), arylesterase (AE) (p<0.01), the Apo A1/Apo B (p<0.05) and AE/HDL-c (p<0.05) ratios. Also, negative and significant correlations were found between the Ca/Mg ratio and AE (p<0.01), and AE/HDL-c (p<0.05). Neonates within the highest quartile for Mg displayed significantly higher levels of LDL-c and homocysteine (p<0.05). Newborns within the Ca/Mg ratio first quartile presented higher activities of AE while those of with high Ca/Mg ratio showed low levels of insulin., Conclusions: Calcium and magnesium levels appear related to CVD and insulin sensitivity/resistance markers at birth. Future follow-up studies, mostly in neonates, with high magnesemia and/or high Ca/Mg ratio at birth are recommended., (Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.)

Early alterations in glucose homeostasis increase the risk of developing insulin resistance and obesity later in life. The concurrence of altered lipids and insulin sensitivity/resistance markers at birth has been scarcely investigated. The study aimed to ascertain level ranges of homocysteine (tHcyt), arylesterase (AE), lipids/lipoproteins, and insulin resistance/sensitivity markers in full-term neonates and to determine the concurrence effect of dyslipaemia and dysglycaemia on those parameters at birth. Participants were 197 full-term, 2.5 to <4.0 kg, without foetal distress Spanish newborns from the Mérida Study. Parameter percentiles for males and females were stated. The effect of the concurrence high glucose/high triglycerides (high glucose/high TG) or high glucose/low cholesterol transported by HDL (HDL-c) on tHcyt, LDL-c, HDL-c, lipoprotein (a) (Lp(a)), oxidised LDL (oxLDL), AE, glucose, insulin sensitivity (QUICKI) and insulin resistance index (HOMA-IR) was studied. Females had higher total cholesterol (TC), HDL-c, Apo A1, Lp(a) and HDL-c/Apo A1, but lower relative transport of TC (%TC) by the very low lipoprotein fraction than males. No gender differences were found for glucose, HOMA-IR and QUICKI. Neonates at the 2.5- to 2.999-kg range display more adequate HOMA-IR and QUICKI levels that their >3.0 kg counterparts. The concurrence of high glucose/high TG or high glucose/low HDL-c increased TC/HDL-c and HOMA-IR, but decreased, oxLDL, oxLDL/LDL-c and QUICKI with respect to that of low glucose/low TG or glucose/high HDL-c. The concurrence glucose/TG has predictive value for low QUICKI, whilst that of glucose/HDL-c for low QUICKI and high HOMA-IR, suggesting the importance of routine TG, HDL-c and glucose screening at birth as it would identify candidates for insulin resistance.

Pregnancy is a vital period where several hyperplasic, hypertrophic processes together with metabolic adaptation and preparation for extra-uterine life take place. Present review accounts for central aspects of nutrition throughout gestation on the embryonic and fetal periods. It is centered in the major changes occurring in fetal pancreas, with special mention to the susceptibility of this main glucose homeostasis organ to support nutritional changes during maturation and development. Studies performed in animal models as human are commented considering the role of maternal nutrition on β-cell mass size, insulin and other pancreatic hormones production, and insulin sensitivity. Details of both the thrifty genotype and phenotype hypothesis are given, indicating that hypo/subnutrition causes metabolic adaptations that permit the future body to grow and develop itself in limited environmental and energetic conditions. The Barker hypothesis is considered suggesting that this metabolic hypothesis is a double-edged sword in the actual abundance World. Lastly the review, taking into account our own research and other papers, analyses less known aspects that relate maternal diet with insulin resistance/sensitivity markers at delivery. Particularly the role of the saturated fatty acid/carbohydrate and omega-6/omega-3 ratios in the frame of maternal diet is reviewed considering the quality of those diets under the Healthy Eating Index and the Adherence to Mediterranean Diet scores and the relationship with insulin resistance profile at birth. Present review ends indicating that nutritional habits should be strongly stated before gestation in order to assure a proper nutrition since the first moment of pregnancy. This will support an adequate fetal and pancreatic growth and development, and in turn, adequate glucose homeostasis during pregnancy and later in life, slowing down or preventing from degenerative diseases related with metabolic syndrome and type 2 diabetes mellitus., (Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.)

Background/objectives: Few studies have used healthy eating index (HEI) and mediterranean diet adherence (MDA) scores to evaluate the diet quality during pregnancy. To determine the relationship between first trimester diet quality and insulin sensitivity/resistance biomarkers at birth., Subjects/methods: Cord-blood insulin sensitivity/resistance biomarkers of the offspring of 35 women whose diets were 'adequate' or 'inadequate' according to their HEI score (>70 or ≤ 70, respectively) and their 13-point MDA score (≥ 7 or <7, respectively)., Results: Low HEI-score diets contained less (g/1000 kcal) carbohydrates (CHO; P=0.027) and fibre (P=0.011), and more fats (P<0.001) and cholesterol (P<0.001), and contributed (percentage contribution to total energy (%En)) fewer CHO (P=0.005), more fats (P=<0.001) and saturated fatty acid (SFA; P=0.002) than their high HEI-score counterparts. Low MDA-score diets contained less (g/1000 kcal) fibre (P<0.001) and more cholesterol (P=0.05), had lower polyunsaturated fatty acids+monounsaturated fatty acid/SFA (PUFA+MUFA/SFA; P=0.05) and higher SFA/CHO (P=0.021) and ω-6/ω-3 PUFA ratios (P=0.044) than their respective counterparts. Women consuming the low HEI- or low MDA-score diets had low-fasting glycaemia (P=0.016 or P=0.025, respectively) but delivered infants with high insulinaemia (P=0.048 or P=0.017, respectively), homeostatic model assessment for insulin resistance (HOMA-IR; P=0.031 or P=0.049, respectively) and glycaemia (P=0.018 or P=0.048, respectively). The relative risk (RR) of high-neonatal glycaemia and insulinaemia were 7.6 (P=0.008) and 6.7 (P=0.017) for low vs high HEI-score groups. High HOMA-IR and high glucose RR were, respectively, 3.4 (P=0.043) and 3.9 (P=0.016) in neonates from the <7 MDA- vs ≥ 7 MDA-score group. These RRs were not affected by potential confounders., Conclusion: Maternal diets with low HEI- or MDA-scores during the first trimester of pregnancy negatively affect insulin resistance markers at birth.

Apolipoprotein (Apo) A5 is a protein involved in the activation of lipoprotein lipase (LPL) and the metabolism of triglyceride (TG)-rich lipoproteins. LPL plays a major role in the metabolism of TG-rich lipoproteins, and placental LPL activity is known to correlate positively with foetal fat deposition and size. We examine the association between the common APOA5 S19W polymorphism and neonatal anthropometrical measurements, lipoprotein and hormone concentrations, and insulin sensitivity in 58 normal weight Caucasian newborns from the Mérida cohort. Neonates with the W allele displayed lower BMI (P < 0.001), ponderal index (P < 0.001), birth weight (P < 0.01), insulin levels (P < 0.05), the insulin/cortisol ratio (P < 0.05), HOMA-R (P < 0.05) and Apo B values (P < 0.01), but higher oxidised LDL (LDLox) values and a higher LDLox/low-density lipoprotein (LDL) ratio (both P < 0.05) than S-homozygous newborns. The APOA5 S19W polymorphism was associated with foetal growth as well as with glucose and lipoprotein metabolism in the neonates. Concurrence of the S19W polymorphism in neonates and their mothers did not affect neonatal lipid and lipoprotein concentrations but was associated with impaired foetal growth. Specifically, W allele carriers displayed a higher degree of LDL oxidation and lower body weight, plasma insulin values, insulin/cortisol ratio and Apo B concentrations than homozygotes for the common S allele. In conclusion, these findings suggest that the W allele carriers received a less optimal nutrition during gestation and that their lipoprotein antioxidant status was inferior to that of their homozygous S allele counterparts.

Introduction: Differences in neonatal insulin sensitivity/ resistance markers due to the maternal impaired glucose tolerance (IGT) have not been tested. The Healthy Eating Index (HEI) score has been employed for evaluating pregnancy diet quality., Aims: To study, the effect of neonatal insulinemia, maternal IGT and diet HEI score upon insulin sensitivity/ resistance at birth., Methods: 176 singleton, normoweight, full-term, Caucasian Spanish neonates, delivered without fetal distress whose mothers were screened for gestational IGT were studied. Quantitative Insulin Sensitivity Check Index (QUICKI) and Homeostatic Model Assessment (HOMAIR) were calculated. Diet followed during the third month of pregnancy was recorded and the respective HEI score calculated in a sample of 29 mothers., Results: As quartile for cord blood insulin levels increased, glucose, the insulin/cortisol ratio and HOMA-IR (all p < 0.001) and IGF-I (p < 0.01) increased while QUICKI and the glucose/insulin ratio (both p < 0.001) and GH (p < 0.05) decreased. Neonates from IGT mothers had higher insulin, HOMA-IR (both p < 0.01) and insulin/cortisol ratio (p < 0.05) and lower GH, QUICKI (both p < 0.01) and glucose/ insulin ratio (p < 0.05) than their normal maternal glucose tolerance (NGT) counterparts. Neonatal insulinemia influences more than IGT on the insulin resistance/sensitivity markers at birth. Mothers of hyperinsulinemic neonates showed lower HEI scores (p < 0.05)., Conclusion: A large percentage of full-term normoweight infants with hyperinsulinemia showed altered insulin resistance markers. Their mothers consumed low quality diets. Screening strategies focused on neonatal glycemia and insulinemia together with maternal nutritional assessment and advice during pregnancy should be considered.

Several endocrine regulators are implicated in the development of metabolic syndrome. The aim of our study was to assess normal ranges for glucose, growth hormone (GH), insulin-like growth factor-1 (IGF-1), cortisol, insulin and the yet-to-be-published quantitative insulin sensitivity check index (QUICKI) for newborns and a number of homeostatic model assessment (HOMA)-related equations that have been proposed as indicators of insulin sensitivity (HOMA-S) and insulin resistance (HOMA-R). The study included 115 (54 males, 61 females) singleton, normoweight, Spanish Caucasian neonates delivered without foetal distress from mothers of the Mérida (Spain) Birth Cohort who tested negative in the O'Sullivan screen. Neonatal normal values given as the mean (95% confidence interval) were: glucose, 75.3 mg/dL (68.29-82.29); cortisol, 7.4 microg/dL (6.85-7.97); GH, 16.7 ng/mL (14.87-18.60); insulin, 5.5 microUI/mL (4.12-6.88), IGF-155.2 ng/mL (50.82-59.53); QUICKI, 0.45 (0.43-0.48); HOMA-R, 1.36 (0.84-1.88); HOMA-S, 4.07 (2.66-5.49), the glucose/insulin ratio, 33.6 (24.58-42.67); the insulin/cortisol ratio, 0.8 (0.61-1.05). Hormone ranges (except for cortisol, whose values were lower) were equivalent to those of other studies. Cortisolaemia values cannot be associated with the type of delivery, as only three births (2.6%) were by caesarean section, while 20 (17.4%) were instrumental deliveries. Neonates from the lowest quartile of the insulin/cortisol ratio presented higher (p < 0.001) HOMA-S and QUICKI and lower (p < 0.01) HOMA-R values. The results of our study indicate normal ranges for insulin resistance and sensitivity at birth. The insulin/cortisol ratio at birth appears to be a good early indicator of insulin resistance.