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1. Adherence to the Mediterranean Lifestyle and Desired Body Weight Loss in a Mediterranean Adult Population with Overweight: A PREDIMED-Plus Study

Author

Josep A. Tur, Itziar Abete, José J. Gaforio, Jordi Salas-Salvadó, Nerea Becerra-Tomás, Francisco J. Tinahones, Albert Goday, Xavier Pintó, Maria Dolors Zomeño, Julia Wärnberg, Alejandro Oncina-Canovas, Carmen Saiz, Jessica Pérez-López, Dolores Corella, Clotilde Vázquez, Lucas Tojal-Sierra, Leyre Notario-Barandiaran, Marga Morey, Lidia Daimiel, Aurora Bueno-Cavanillas, José Manuel Santos-Lozano, José Lapetra, F. Javier Basterra-Gortari, Julia Muñoz, Alicia Julibert, Marian Martín, M. Rosa Bernal-Lopez, Sara Castro-Barquero, Ana Galera, Josep Vidal, Vicente Martín-Sánchez, Miguel Ruiz-Canela, Maria C Belló-Mora, Emilio Ros, Ignacio M. Gimenez-Alba, Antonio García Ríos, Tamara Casañas-Quintana, Ángel M. Alonso-Gómez, Jesús García-Gavilán, Josep Basora, Jesús Vioque, Ramon Estruch, Dora Romaguera, Luis Serra-Majem, Cesar I Fernandez-Lazaro, Pilar Matía-Martín, Escarlata Angullo-Martinez, Cristina Bouzas, Carmen Sayón-Orea, J. Alfredo Martínez, Olga Castañer, Maria del Mar Bibiloni, [Bouzas,C, Bibiloni,MM, Julibert,A, Ruiz-Canela,M, Salas-Salvadó,J, Corella,D, Zomeño,MD, Romaguera,D, Alonso-Gómez,ÁM, Wärnberg,J, Martínez,JA, Serra-Majem,L, Estruch,R, Tinahones,FJ, Lapetra,J, Pintó,X, García Ríos,A, Vázquez,C, Ros,E, Fernandez-Lázaro,CI, Becerra-Tomás,N, Gimenez-Alba,IM, Muñoz,J, Morey,M, Pérez-López,J, Abete,I, Casañas-Quintana,T, Castro-Barquero,S, Bernal-López,MR, Santos-Lozano,JM, Galera,A, Angullo-Martinez,E, Basterra-Gortari,FJ, Basora,J, Saiz,C, Castañer,O, Martín,M, Belló-Mora,MC, Sayón-Orea,C, García-Gavilán,J, Goday,A, Tur,JA] CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. [Bouzas,C, Tojal-Sierra,L, Tur,JA] Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, Guillem Colom Bldg, Campus, Palma de Mallorca, Spain. [Bouzas,C, Tur,JA] Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain. [Ruiz-Canela,M, Sayón-Orea,C] Department of Preventive Medicine and Public Health, IdISNA, University of Navarra, Pamplona, Spain. [Salas-Salvadó,J, García-Gavilán,J] Universitat Rovira i Virgili, Department of Biochemistry and Biotechnology, Human Nutrition Unit, Reus, Spain. [Salas-Salvadó,J] Institut d’Investigació Sanitària Pere Virgili (IISPV), Reus, Spain. [Corella,D, Saiz,C] Department of Preventive Medicine, University of Valencia, Valencia, Spain. [Zomeño,MD, Goday,A] Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d’Investigació Mèdica (IMIM), Barcelona, Spain. [Zomeño,MD] Blanquerna School of Health Sciences, Universitat Ramon Llull, Barcelona, Spain. [Vioque,J, Oncina-Canovas,A, Notario-Barandiarán,L] Unit of Nutritional Epidemiology, Miguel Hernández University, ISABIAL-UMH, Alicante, Spain. [Vioque,J, Bueno-Cavanillas,A, Gaforio,JJ, Notario-Barandiarán,L] CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. [Alonso-Gómez,ÁM, Belló-Mora,MC] Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain. [Wärnberg,J, Pérez-López,J] Department of Nursing, School of Health Sciences, University of Málaga-IBIMA, Málaga, Spain. [Martínez,JA] Precision Nutrition Program, IMDEA Food, CEI UAM + CSIC, Madrid, Spain. [Martínez,JA, Abete,I] Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, Pamplona, Spain. [Serra-Majem,L, Casañas-Quintana,T] Institute for Biomedical Research, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain. [Estruch,R, Castro-Barquero,S] Department of Internal Medicine, IDIBAPS, Hospital Clinic, University of Barcelona, Barcelona, Spain. [Tinahones,FJ, Bernal-López,MR] Virgen de la Victoria Hospital, Department of Endocrinology, Biomedical Research Institute of Málaga (IBIMA), University of Málaga, Málaga, Spain. [Lapetra,J, Santos-Lozano,JM] Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain. [Pintó,X, Galera,A] Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain. [García Ríos,A] Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain. [Bueno-Cavanillas,A] Department of Preventive Medicine, University of Granada, Granada, Spain. [Gaforio,JJ] Department of Health Sciences, Centro de Estudios Avanzados en Olivar y Aceites de Oliva, University of Jaen, Jaen, Spain. [Matía-Martín,P] Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain. [Daimiel,L] Nutritional Genomics and Epigenomics Group, IMDEA Food, CEI UAM + CSIC, Madrid, Spain. [Martín-Sánchez,V] CIBER Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. [Martín-Sánchez,V] Institute of Biomedicine (IBIOMED), University of León, León, Spain. [Vidal,J] Department of Endocrinology, IDIBAPS, Hospital Clinic, University of Barcelona, Barcelona, Spain. [Vázquez,C] Department of Endocrinology, Fundación Jiménez-Díaz, Madrid, Spain. [Ros,E] Lipid Clinic, Department of Endocrinology and Nutrition, Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain. [Angullo-Martinez,E] Escola Graduada Primary Health Care Center, IBSalut, Palma de Mallorca, Spain. [Basterra-Gortari,FJ, Sayón-Orea,C] Servicio Navarro de Salud, Osasunbidea, Pamplona, Spain., The PREDIMED-Plus trial was supported by the official funding agency for biomedical research of the Spanish government, ISCIII, through the Fondo de Investigación para la Salud (FIS), which is co-funded by the European Regional Development Fund (five coordinated FIS projects led by J.S.-S. and J.Vidal, including the following projects: PI13/00673, PI13/00492, PI13/00272, PI13/01123, PI13/00462, PI13/00233, PI13/02184, PI13/00728, PI13/01090, PI13/01056, PI14/01722, PI14/00636, PI14/00618, PI14/00696, PI14/01206, PI14/01919, PI14/00853, PI14/01374, PI14/00972, PI14/00728, PI14/01471, PI16/00473, PI16/00662, PI16/01873, PI16/01094, PI16/00501, PI16/00533, PI16/00381, PI16/00366, PI16/01522, PI16/01120, PI17/00764, PI17/01183, PI17/00855, PI17/01347, PI17/00525, PI17/01827, PI17/00532, PI17/00215, PI17/01441, PI17/00508, PI17/01732, PI17/00926, PI19/00957, PI19/00386, PI19/00309, PI19/01032, PI19/00576, PI19/00017, PI19/01226, PI19/00781, PI19/01560, and PI19/01332, the Especial Action Project entitled: Implementación y evaluación de una intervención intensiva sobre la actividad física Cohorte PREDIMED-Plus grant to J.S.-S., the European Research Council (Advanced Research Grant 2013–2018, 340918) to Miguel Ángel Martínez-González, the Recercaixa Grant to J.S.-S. (2013ACUP00194), Grants from the Consejería de Salud de la Junta de Andalucía (PI0458/2013, PS0358/2016, and PI0137/2018), a Grant from the Generalitat Valenciana (PROMETEO/2017/017), a SEMERGEN Grant, EU-COST Action CA16112, a Grant of support to research groups no. 35/2011 from the Balearic Islands Government, Grants from Balearic Islands Health Research Institute (IDISBA), funds from the European Regional Development Fund (CIBEROBN CB06/03 and CB12/03) and from the European Commission (EAT2BENICE_H2020_SFS2016). M. Rosa Bernal-López was supported by 'Miguel Servet Type I' program (CP15/00028) from the ISCIII-Madrid (Spain), cofinanced by the European Regional Development Fund. Jordi Salas-Salvadó is partially supported by ICREA under the ICREA Academia programme. Cristina Bouzas received a Fernando Tarongí Bauzà PhD Grant. I.M Gimenez-Alba received a grant FPU from the Ministry of Science, Innovation and Univesities (reference FPU 18/01703). The funding sponsors had no role in the design of the study, in the collection, analyses, or interpretation of the data, and in the writing of the manuscript, and in the decision to publish the results.

Subjects
Male, Mediterranean diet, Obesidad, ejercicio físico, Body Mass Index, Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], 0302 clinical medicine, Surveys and Questionnaires, Antineoplastic Combined Chemotherapy Protocols, Medicine, mediana edad, education.field_of_study, anciano, Health Care::Health Care Quality, Access, and Evaluation::Quality of Health Care::Epidemiologic Factors::Age Factors [Medical Subject Headings], dieta, protocolos de quimioterapia antineoplásica combinada, 3. Good health, Older adults, metotrexato, programas de reducción de peso, Obesitat, lcsh:Nutrition. Foods and food supply, Personas mayores frágiles, Ideal weight, Lifestyles, Check Tags::Male [Medical Subject Headings], lcsh:TX341-641, Article, Estilo de vida, 03 medical and health sciences, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Physical Examination::Body Constitution::Body Weights and Measures::Body Size::Body Weight::Overweight [Medical Subject Headings], Anthropology, Education, Sociology and Social Phenomena::Human Activities::Exercise [Medical Subject Headings], ifosfamida, Humans, cisplatino, Ifosfamide, education, Exercise, Aged, conducta alimentaria, Diseases::Nutritional and Metabolic Diseases::Metabolic Diseases::Metabolic Syndrome X [Medical Subject Headings], Persons::Persons::Age Groups::Adult::Middle Aged [Medical Subject Headings], Psychiatry and Psychology::Behavior and Behavior Mechanisms::Psychology, Social::Life Style [Medical Subject Headings], PREDIMED-Plus, medicine.disease, Obesity, Methotrexate, Check Tags::Female [Medical Subject Headings], Desired weight loss, Metabolic syndrome, Cisplatin, Body mass index, Demography, obesity, cumplimiento del paciente, humanos, Phenomena and Processes::Physiological Phenomena::Body Constitution::Body Weights and Measures::Body Mass Index [Medical Subject Headings], Ideal Body Weight, desired weight loss, Health Care::Health Care Facilities, Manpower, and Services::Health Promotion::Weight Reduction Programs [Medical Subject Headings], Overweight, Diet, Mediterranean, Mediterranean lifestyle, Health Care::Health Care Facilities, Manpower, and Services::Health Services::Preventive Health Services::Health Promotion::Healthy People Programs [Medical Subject Headings], Weight loss, 030212 general & internal medicine, Psychiatry and Psychology::Behavior and Behavior Mechanisms::Behavior::Health Behavior::Patient Compliance [Medical Subject Headings], Abdominal obesity, older adults, Persons::Persons::Age Groups::Adult::Aged [Medical Subject Headings], 2. Zero hunger, Nutrition and Dietetics, mediterranean lifestyle, sobrepeso, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Nutrition Therapy::Diet Therapy::Diet, Mediterranean [Medical Subject Headings], Age Factors, ideal weight, Middle Aged, Peso corporal ideal, Phenomena and Processes::Physiological Phenomena::Body Constitution::Body Weights and Measures::Body Size::Body Weight::Ideal Body Weight [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cross-Sectional Studies [Medical Subject Headings], Weight Reduction Programs, Body image, Female, medicine.symptom, peso corporal ideal, Estils de vida, doxorrubicina, body image, Population, Imagen corporal, 030209 endocrinology & metabolism, Psychiatry and Psychology::Behavior and Behavior Mechanisms::Behavior::Feeding Behavior [Medical Subject Headings], overweight, Healthy Lifestyle, Geographical Locations::Geographic Locations::Europe::Spain [Medical Subject Headings], business.industry, índice de masa corporal, Feeding Behavior, Dieta mediterránea, Diet, Doxorubicin, Sobrepeso, Patient Compliance, Psychiatry and Psychology::Psychological Phenomena and Processes::Mental Processes::Perception::Body Image [Medical Subject Headings], business, Food Science
Abstract

Background. Body weight dissatisfaction is a hindrance to following a healthy lifestyle and it has been associated with weight concerns. Objectives. The aim of this study was to assess the association between the adherence to the Mediterranean lifestyle (diet and exercise) and the desired body weight loss in an adult Mediterranean population with overweight. Methods. Cross-sectional analysis in 6355 participants (3268 men; 3087 women) with metabolic syndrome and BMI (Body mass index) between 27.0 and 40.0 kg/m2 (55–75 years old) from the PREDIMED-Plus trial. Desired weight loss was the percentage of weight that participants wished to lose. It was categorized into four cut-offs of this percentage (Q1, European Research Council (ERC) 340918, Recercaixa Grant 2013ACUP00194, Junta de Andalucia PI0458/2013 PS0358/2016 PI0137/2018, Generalitat Valenciana PROMETEO/2017/017, SEMERGEN Grant, European Union (EU) European Cooperation in Science and Technology (COST) CA16112, Balearic Islands Government 35/2011, Balearic Islands Health Research Institute (IDISBA), European Union (EU) CIBEROBN CB06/03 CB12/03 PI13/00673 PI13/00492 PI13/00272 PI13/01123 PI13/00462 PI13/00233 PI13/02184 PI13/00728 PI13/01090 PI13/01056, European Commission Joint Research Centre EAT2BENICE_H2020_SFS2016, "Miguel Servet Type I" program from the ISCIII-Madrid (Spain) CP15/00028, ICREA under the ICREA Academia programme, Fernando Tarongi Bauza PhD Grant, FPU from the Ministry of Science, Innovation and Univesities FPU 18/01703, Spanish government, ISCIII, through the Fondo de Investigacion para la Salud (FIS), Especial Action Project entitled: Implementacion y evaluacion de una intervencion intensiva sobre la actividad fisica Cohorte PREDIMED-Plus grant, PI14/01722, PI14/00636, PI14/00618, PI14/00696, PI14/01206, PI14/01919, PI14/00853, PI14/01374, PI14/00972, PI14/00728, PI14/01471, PI16/00473, PI16/00662, PI16/01873, PI16/01094, PI16/00501, PI16/00533, PI16/00381, PI16/00366, PI16/01522, PI16/01120, PI17/00764, PI17/01183, PI17/00855, PI17/01347, PI17/00525, PI17/01827, PI17/00532, PI17/00215, PI17/01441, PI17/00508, PI17/01732, PI17/00926, PI19/00957, PI19/00386, PI19/00309, PI19/01032, PI19/00576, PI19/00017, PI19/01226, PI19/00781, PI19/01560, PI19/01332

Published
2020

2. Nitrite Attenuates the In Vitro Inflammatory Response of Immune Cells to the SARS-CoV-2 S Protein without Interfering in the Antioxidant Enzyme Activation.

Author

Ferrer MD, Reynés C, Jiménez L, Malagraba G, Monserrat-Mesquida M, Bouzas C, Sureda A, Tur JA, and Pons A

Subjects
Humans, Lipopolysaccharides pharmacology, Nitrites, Antioxidants metabolism, Leukocytes, Mononuclear metabolism, Enzyme Activation, Toll-Like Receptor 4 metabolism, SARS-CoV-2 metabolism, Cytokines metabolism, Anti-Inflammatory Agents, Metabolic Syndrome, COVID-19, Spike Glycoprotein, Coronavirus
Abstract

SARS-CoV-2 induces a hyperinflammatory reaction due to the excessive release of cytokines during the immune response. The bacterial endotoxin lipopolysaccharide (LPS) contributes to the low-grade inflammation associated with the metabolic syndrome, enhancing the hyperinflammatory reaction induced by the SARS-CoV-2 infection. The intake of sodium nitrate, a precursor of nitrite and nitric oxide, influences the antioxidant and pro-inflammatory gene expression profile after immune stimulation with LPS in peripheral blood mononuclear cells from metabolic syndrome patients. We aimed to assess the inflammatory and antioxidant responses of immune cells from metabolic syndrome patients to exposure to the SARS-CoV-2 spike protein (S protein) together with LPS and the effect of nitrite in these responses. Whole blood samples obtained from six metabolic syndrome patients were cultured for 16 h at 37 °C with four different media: control medium, control medium plus LPS (100 ng/mL), control medium plus LPS (100 ng/mL) plus S protein (10 ng/mL), and control medium plus LPS (100 ng/mL) plus S protein (10 ng/mL) plus nitrite (5 µM). Immune stimulation with the LPS/S protein enhanced nitrate biosynthesis from nitrite oxidation and probably from additional organic precursors. In vitro incubations with the LPS/S protein enhanced the expression and/or release of pro-inflammatory TNFα, IL-6, IL-1β, and TLR4, as well as the expression of the anti-inflammatory IL-1ra and IL-10 and antioxidant enzymes. Nitrite attenuated the pro- and anti-inflammatory response induced by the S protein without interfering with the activation of TLR4 and antioxidant enzyme expression, raising the possibility that nitrite could have potential as a coadjutant in the treatment of COVID-19.

Published
2024
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3. Association between the Use of Health Services, Cardiovascular Risk Factors and Metabolic Syndrome in Mexican Adults.

Author

Ortiz-Rodríguez MA, Aldaz-Rodríguez MV, González-Robledo LM, Villa A, Bouzas C, Pastor R, and Tur JA

Subjects
Adult, Cross-Sectional Studies, Female, Health Services, Heart Disease Risk Factors, Humans, Male, Mexico epidemiology, Prevalence, Risk Factors, Young Adult, Cardiovascular Diseases epidemiology, Hypertension epidemiology, Metabolic Syndrome epidemiology
Abstract

Background : The use of health services is a complex behavioral phenomenon affected by multiple factors (availability, distance, cost, quality, attitudes, cultural beliefs, socioeconomic characteristics, and individuals' self-perception of health). Mexico has a segmented health system, and the access to it depends on the labor insertion and the population's ability to pay. Objective : To assess association between use of health services and cardiovascular and metabolic syndrome risk factors among Mexican adults. Methods : Analytical cross-sectional nationally representative study carried out on Mexican adults (≥20-year-old adults of both sexes; n = 4595). Socioeconomic factors, geographic area, health care coverage, information about the use of health services, previous medical diagnoses of diabetes and hypertension, and smoking were assessed. Anthropometrics, triglyceride, total cholesterol, HDL-cholesterol, and glucose plasma levels were measured. Metabolic syndrome (MetS) and cardiovascular risk factors were assessed. Prevalences were expressed in terms of percentages, and significant differences were calculated using χ 2 test. Univariate and multivariate analysis was performed to evaluate the association between the use of health services and cardiovascular risk factors and sociodemographic variables. Results : The probability of using health services is higher and more significant in subjects with obesity, diabetes (OR (95% CI): 1.73 (1.49-2.00; p < 0.001), hypertension (OR (95% CI): 1.29 (1.14-1.45; p < 0.001), hypertriglyceridemia (OR (95% CI): 1.30 (1.15-1.46; p < 0.001), and in those with hypercholesterolemia (OR (95% CI): 1.23 (1.03-1.39; p = 0.001). Conclusions : Among health service users, there is a positive significant association between the use of health services and the presence of metabolic syndrome, obesity, diabetes, hypertension, hypertriglyceridemia, and hypercholesterolemia.

Published
2021
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4. Relationship between Body Image and Body Weight Control in Overweight ≥55-Year-Old Adults: A Systematic Review.

Author

Bouzas C, Bibiloni MDM, and Tur JA

Subjects
Humans, Middle Aged, Body Image, Overweight psychology
Abstract

Objective : To assess the scientific evidence on the relationship between body image and body weight control in overweight ≥55-year-old adults. Methods: The literature search was conducted on MEDLINE database via PubMed, using terms related to body image, weight control and body composition. Inclusion criteria were scientific papers, written in English or Spanish, made on older adults. Exclusion criteria were eating and psychological disorders, low sample size, cancer, severe diseases, physiological disorders other than metabolic syndrome, and bariatric surgery. Results: Fifty-seven studies were included. Only thirteen were conducted exclusively among ≥55-year-old adults or performed analysis adjusted by age. Overweight perception was related to spontaneous weight management, which usually concerned dieting and exercising. More men than women showed over-perception of body image. Ethnics showed different satisfaction level with body weight. As age increases, conformism with body shape, as well as expectations concerning body weight decrease. Misperception and dissatisfaction with body weight are risk factors for participating in an unhealthy lifestyle and make it harder to follow a healthier lifestyle. Body image disturbance also made it more likely to underreport calorie intake. Conclusions: Aging is associated with a decrease in weight concerns and lower overweight perception, especially in women. However, when designing a program to improve body image in overweight ≥55-year-old adults, three items ought to be considered: physical activity, dietary and behavioral treatments.

Published
2019
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