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Treballs Finals de Grau de Nutrició Humana i Dietètica, Facultat de Farmàcia i Ciències de l'Alimentació, Campus de l'Alimentació de Torribera, Universitat de Barcelona. Curs: 2022-2023. Tutor: Carme Caelles Franch, [eng] Obesity-associated insulin resistance and hyperinsulinemia are two interrelated health conditions that have become increasingly prevalent in recent years. For many years, it has been thought that hyperinsulinemia comes after insulin resistance. The truth is that recent data suggests that insulin resistance can follow hyperinsulinemia and vice versa. Obesity is commonly associated with insulin resistance and hyperinsulinemia, but although some molecular mechanisms have been proposed, there is no clear evidence as to which condition occur before in humans. Despite much controversy over the timing of the onset of hyperinsulinemia in obesity, it is well established that the presence of insulin is necessary for obesity to occur and that chronically elevated insulin levels enhance diet-induced obesity. Therefore, the aim of this review is to provide a comprehensive up-to-date on the molecular mechanisms underlying hyperinsulinemia and the relationship between hyperinsulinemia and insulin resistance in obesity. In addition, we will examine the role hyperinsulinemia plays in cellular senescence, cancer and in dysregulating the insulin/IGF-1/GH axis. Finally, we will discuss possible current therapeutic strategies targeting hyperinsulinemia that are being used to treat obesity-associated insulin resistance, including current pharmacological therapies, the effects of multiple dietary interventions, physical exercise, and surgery. We conclude that hyperinsulinemia is a prevalent condition in obesity, but its time of occurrence and relationship with obesity are still under investigation. Dietary interventions, particularly low glycemic load diets and low carbohydrate diets, as well as regular exercise have shown promise in reducing hyperinsulinemia, while the long-term efficacy and potential side effects of pharmacological interventions require further study., [cat] L'obesitat associada a la resistència a la insulina i la hiperinsulinemia són dues condicions de salut interrelacionades que han esdevingut cada vegada més prevalents en els últims anys. Durant molts anys, s'ha pensat que la hiperinsulinèmia ve després de la resistència a la insulina. La veritat és que les dades recents suggereixen que la resistència a la insulina pot seguir la hiperinsulinèmia i viceversa. L'obesitat s'associa comunament amb la resistència a la insulina i la hiperinsulinèmia, però tot i que s'han proposat alguns mecanismes moleculars, no hi ha evidència clara de quina condició ocorre abans en els éssers humans. Malgrat molta controvèrsia sobre el moment de l'aparició de la hiperinsulinèmia en l'obesitat, està ben establert que la presència d'insulina és necessària perquè es produeixi l'obesitat i que els nivells d'insulina crònicament elevats promouen l'obesitat induïda per la dieta. Per tant, l'objectiu d'aquesta revisió és proporcionar una actualització completa dels mecanismes moleculars subjacents a la hiperinsulinèmia i la relació entre la hiperinsulinèmia i la resistència a la insulina en l’obesitat. A més a més, examinarem el paper de la hiperinsulinèmia en la senescència cel·lular, el càncer i en la desregulació de l'eix insulina/IGF-1/GH. Finalment, es discutiran possibles estratègies terapèutiques actuals dirigides a la hiperinsulinemia que s'estan utilitzant per tractar l'obesitat associada a la resistència a la insulina, incloent les teràpies farmacològiques actuals, els efectes de múltiples intervencions dietètiques, l'exercici físic i la cirurgia. Concloem que la hiperinsulinèmia és una condició prevalent en l'obesitat, però el seu inici i relació amb l'obesitat encara estan en investigació. Les intervencions dietètiques, en particular les dietes de baixa càrrega glucèmica i dietes baixes en carbohidrats, a més de l'exercici regular, han demostrat ser prometedores per reduir la hiperinsulinèmia, mentre que l'eficàcia a llarg termini i els possibles efectes secundaris de les intervencions farmacològiques requereixen un estudi addicional.

Ejercicio físico y terapia nutricional en el tratamiento de los trastornos de la conducta alimentaria.Revisión Sistemática. Introducción. Los Trastornos de la Conducta Alimentaria (TCA) son una enfermedad mental grave, causante de morbilidad física y psicosocial. Esta enfermedad tiene una mayor prevalencia entre mujeres jóvenes, y en población deportista. La terapia cognitiva conductual (TCC) es el tratamiento actual más adecuado para este tipo de trastornos, no obstante, cada vez son más los programas que incluyen pautas de ejercicio físico (EF) y Terapia Nutricional (TN) para el tratamiento de los TCA. Objetivo. Realizar una revisión sistemática exploratoria de la literatura que permita conocer el estado actual de los programas de intervención a través del EF y la TN para el tratamiento de los TCA. Materiales y métodos. Se realizó una búsqueda y recopilación de documentos científicos mediante un modelo de acumulación de datos y selección de estudios, en la que se utilizaron las bases de datos informatizadas SCOPUS, Web of Science, y PubMed. En todas las bases de datos consultadas, se empleó la misma frase de búsqueda. Para acotar los resultados, se introdujeron una serie de criterios de inclusión y exclusión. Resultados. La revisión contó con cinco documentos relacionados con la temática de estudio, que cumplían los criterios de inclusión. Conclusión. Las intervenciones con EF y TN para el tratamiento de los TCA suponen una reducción en la severidad de la sintomatología de los pacientes. Estos programas se muestran como una herramienta terapéutica alternativa o complementariaa la terapia convencional. Se requieren más estudios que combinen programas de intervención de EF y TN dirigidos a pacientes con TCA. Arch Latinoam Nutr 2022; 72(1): 60-71. Physical exercise and nutritional therapy in the treatment of eating disorders. Introduction. Eating Disorders (ED) are a severe mental illness that causes physical and psychosocial problems. This illness has a higher prevalence among young women, and between athletes cognitive behavioural therapy (CBT) is the current treatment for this type of disorder. However, more and more programs are including physical exercise (PE) and nutritional therapy (TN) for eating disorders treatment. Objective. To carry out an exploratory systematic review of the literature that allows us to know the current state of intervention programs through physical exercise and nutritional therapy for the treatment of eating disorders. Materials and methods. For the reference search thesame search phrase was used. The terms were entered in English in the following computerized databases: SCOPUS, Web of Science, and PubMed. To limit the search, four inclusion criteria were introduced. Results. The review included five scientific articles related to the study topic, which met the inclusion criteria. Conclusion. Intervention programs for the treatment of eating disorders that include physical exercise and nutritional therapy are shown as an alternative or complementary tool to conventional therapy. These programs involve a reduction in the severity of ED symptoms and an improvement in anthropometric parameters and physical condition. More studies that combine PE and TN programs for people with ED are required. Arch Latinoam Nutr 2022; 72(1): 60-71.

Purpose The COVID-2019 pandemic forced many governments to declare the “to stay at home” which encouraged social distancing and isolation among citizens. The aim of this study was to assess the dietary and lifestyle habit changes that occurred during home confinement in Spain. Methods An European online survey was launched in April 2020. This included 70 questions on sociodemographic characteristics, lifestyle, dietary habits, including key Mediterranean diet (MedDiet) foods. A total of 945 Spanish adults from 1268 European that completed the online survey were included in the analysis. Results Most of the Spanish participants adopted healthier dietary habits during home lockdown, which was translated to a higher MedDiet adherence. However, a negative impact on physical activity levels, sleep quality or smoking rates was observed. Low MedDiet adherence was associated with a higher risk of weight gain (OR = 1.53, CI 1.1–2.1; p = 0.016), while no snacking between meals reduced the risk by 80% (OR = 0.20, CI 0.09–0.45, p Conclusion To conclude, although dietary habits were improved during home lockdown, certain unhealthy behaviours (e.g. increased snacking between meals, increased food intake, and an increase in sedentary behaviour) were increased.

Treballs Finals de Grau de Nutrició Humana i Dietètica, Facultat de Farmàcia i Ciències de l'Alimentació, Campus de l'Alimentació de Torribera, Universitat de Barcelona. Curs: 2022-2023. Tutor: Joana Relat Pardo, [eng] Postprandial studies are essential to understand metabolism functioning after food intake and, the metabolic syndrome is a combination of different cardiovascular risk factors which can endanger human health. Thus, this review aims to describe the relationship between the postprandial metabolism of the organism and its possible connection with metabolic syndrome. An electronic search was performed using the databases “Cercabib”, “PubMed”, “Scopus” and “Google Academy” and articles published after the 2000’s were selected. The data indicate that the postprandial response is linked to the ability to suffer from metabolic syndrome. Alterations in the postprandial metabolism of the organism, adherence to Western diets, decrease in physical activity, etc., they are characteristics that are part of the complex definition of the postprandial state, and it will favor the appearance of metabolic syndrome. The conclusion of this work is that more research is needed to prevent the development of metabolic syndrome. Also, there is a great need to promote healthy life in the community and physical activity., [cat] Els estudis postprandial són essencials per comprendre el funcionament del metabolisme després de la ingesta d'aliments i, la síndrome metabòlica és una combinació de diferents factors de risc cardiovascular que poden posar en perill la salut humana. Així, aquesta revisió pretén descriure la relació entre el metabolisme postprandial de l'organisme i la possible connexió amb la síndrome metabòlica. Es va realitzar una cerca electrònica utilitzant les bases de dades "Cercabib", "PubMed", "Scopus" i "Google Academy" i es van seleccionar els articles publicats després dels anys 2000. Les dades indiquen que la resposta postprandial està vinculada a la capacitat de patir de síndrome metabòlica. Alteracions en el metabolisme postprandial de l'organisme, adherència a dietes occidentals, disminució de l'activitat física, etc., són característiques que formen part de la definició complexa de l'estat postprandial, i afavoriran l'aparició de la síndrome metabòlica. La conclusió d'aquest treball és que cal més investigació per prevenir el desenvolupament de la síndrome metabòlica. A més, hi ha una gran necessitat de promoure la vida saludable a la comunitat i l'activitat física.

Treballs Finals de Grau de Nutrició Humana i Dietètica, Facultat de Farmàcia i Ciències de l'Alimentació, Campus de l'Alimentació de Torribera, Universitat de Barcelona. Curs: 2022-2023. Tutor: Maria Grau Magaña, [cat] L’adhesió a un patró alimentari saludable i sostenible, com la Dieta Mediterrània, forma part del tractament de persones que han sofert un esdeveniment cardiovascular. Pot ajudar a la seva prompta recuperació a més de a prevenir l’aparició d’un altre episodi advers. Els objectius d’aquest treball són: (1) adaptar un protocol d’educació nutricional destinat a pacients supervivents d’un episodi cardiovascular isquèmic; (2) avaluar la usabilitat i factibilitat d’aquest programa. S’ha adaptat un protocol d’una intervenció d’educació nutricional per promoure hàbits dietètics saludables dissenyat prèviament per la Xarxa Fit4foodBcn. A continuació, s’ha realitzat aquesta intervenció a 3 pacients ingressats per infart agut de miocardi en un hospital de tercer nivell. S’han avaluat els materials utilitzats, la informació transmesa i el desenvolupament de les diferents sessions del programa a través de qüestionaris i entrevistes. D’aquestes s’extreuen suggeriments de millora i també observacions dels educadors durant les sessions. L’hospital com a emplaçament de la intervenció comporta dificultats, tal com l’estat d’ànim i de salut del pacient al moment de realitzar les sessions, però alhora és un facilitador, degut a que el pacient no s’ha de desplaçar i té temps disponible per realitzar les sessions. Els participants manifesten un nivell alt de satisfacció amb la intervenció, així com una adequada comprensibilitat i utilitat de la informació i els materials, pel qual la intervenció resulta factible de realitzar en aquest hospital., [eng] Adherence to a healthy and sustainable dietary pattern, such as the Mediterranean Diet, is part of the treatment for people who have suffered a cardiovascular event. It can faster their recovery and prevent the appearance of another adverse episode. The aims of this project are: (1) adapt a nutritional education protocol intended for patients who have survived an ischemic cardiovascular episode; (2) evaluate the usability and feasibility of this program. It has been adapted a protocol of a nutritional education intervention to promote healthy dietary habits previously designed by the Fit4foodBcn Network. Then, this intervention was performed on 3 inpatients admitted for myocardial infarction in a third-level hospital. The materials used, the information transmitted, and the development of the different sessions of the program have been evaluated through questionnaires and interviews. Suggestions for improvement including observations of the educators during the sessions are extracted. The hospital as the place of the intervention entails difficulties, such as the patient’s state of mind and health at the time of the sessions but is also a facilitator since the patient does not have to travel and has time available to carry out the sessions. The participants express a high level of satisfaction with the intervention, just as well as adequate comprehensibility and usefulness to the information and materials, which makes the program feasible to perform in this hospital.

[spa] Debido al incremento sostenido de la prevalencia del asma y la presencia de fenotipos graves, resulta de interés el desarrollo de modelos animales que permitan estudiar nuevos tratamientos y coadyuvantes. En los últimos años, el cacao ha demostrado influir en el sistema inmunitario, modificando la composición de linfocitos y la producción de anticuerpos y citocinas. En base a estos factores, el objetivo de la presente tesis ha sido establecer el efecto antiasmático del cacao, en particular de cuatro cacaos nativos del Perú procedentes de distintas regiones del país: Blanco de Piura (BPC), Amazonas Perú (APC), Criollo de Montaña (CMC) y Chuncho (CCC). Para lograr este objetivo, se desarrolló un modelo de asma alérgica que permitiera la inducción y la cuantificación objetiva de una respuesta anafiláctica utilizando ovoalbúmina como alérgeno y alum y toxina Bordetella pertussis como adyuvantes. Paralelamente se determinaron los compuestos bioactivos de los cacaos y se estudió el efecto in vitro en células del sistema inmune, macrófagos peritoneales y linfocitos del bazo. Los resultados mostraron una mayor concentración de polifenoles, metilxantinas, capacidad antioxidante y efecto antiinflamatorio en los cacaos Amazonas Perú y Criollo de Montaña, por lo que fueron seleccionados para su estudio en el modelo de asma alérgica desarrollado. A continuación, se determinó el efecto de una dieta enriquecida al 10% de cacao Amazonas Perú, Criollo de Montaña o un cacao ordinario no autóctono en el modelo de asma alérgica establecido. Los resultados demuestran que las dietas ricas en cacao son capaces de reducir la síntesis de anticuerpos asociados a la respuesta inmunitaria Th2, sin embargo, el cacao ordinario mostró un efecto mayor que los cacaos nativos, siendo capaz de reducir la concentración de IgE sistémica y respiratoria. La dieta con Criollo de Montaña disminuyó la concentración de IgE en lavado broncoalveolar, con una tendencia en suero, y la dieta con Amazonas Perú solo mostró un cierto efecto a nivel respiratorio. Resultados similares se observaron en la concentración de proteasa mastocitaria II, indicativa de la degranulación mastocitaria. Las tres dietas ricas en cacao redujeron la producción de IgG1 sistémica y eosinófilos y leucotrienos en la vía respiratoria de forma similar, mientras que la dieta con Amazonas Perú mostró un efecto mayor que el resto de las dietas en la reducción de IgG2a. Las dietas con cacao Criollo de Montaña y cacao ordinario, pero no dieta con Amazonas Perú, disminuyeron la concentración de IgA mucosal. Por consiguiente, los cacaos fueron capaces de paliar la respuesta inmunitaria Th2, especialmente la síntesis de IgE y la degranulación de los mastocitos, aunque se observaron diferencias entre los cacaos que no se pueden atribuidos a un solo compuesto bioactivo, debiendo influir tanto el contenido en teobromina como la concentración y perfil de flavonoides de cada cacao, que varía según su origen., [eng] Due to the sustained increase in the prevalence of asthma and the presence of severe phenotypes, the development of animal models that allow the study of new treatments and adjuvants, such as cocoa, which in recent years has been shown to influence the immune system, is of interest. Based on these factors, the objective of this thesis has been to establish the anti-asthmatic effect of four native Peruvian cocoas from different regions of the country: Blanco de Piura (BPC), Amazonas Peru (APC), Criollo de Montaña (CMC) and Chuncho (CCC). To achieve this, an allergic asthma model was developed that would allow the induction and objective quantification of an anaphylactic response using ovalbumin as allergen. At the same time, the bioactive compounds of cocoa were determined and the in vitro effect on immune cells was studied. The results showed a higher concentration of polyphenols, methylxanthines, antioxidant capacity and anti-inflammatory effect in Amazonas Peru and Criollo de Montaña cocoas. Next, the effect of diets enriched with 10% of these cocoas or a non-native ordinary cocoa was determined in the model of allergic asthma. The results show that cocoa diets are able to reduce the synthesis of antibodies associated with the Th2 immune response, however, ordinary cocoa showed a greater effect than native cocoa, being able to reduce the concentration of systemic and respiratory IgE. The Criollo de Montaña diet decreased the concentration of IgE in bronchoalveolar lavage fluid, while the Amazonas Peru diet only showed a tendency. Similar results were observed in the concentration of mast cell protease II. All cocoa diets reduced the production of systemic IgG1 and eosinophils and leukotrienes in the respiratory tract similarly, while the diet with Amazonas Peru showed a greater effect in reducing IgG2a. The diets with Criollo de Montaña cocoa and ordinary cocoa decreased the concentration of mucosal IgA . Therefore, the cocoas were able to palliate the Th2 immune response, although differences were observed between the cocoas, influencing both the theobromine content and flavonoid concentration and profile of each cocoa, which varies according to its origin.

Background: Epidemiological studies have demonstrated an association between the degree of food processing in our diet and the risk of various chronic diseases. Much of this evidence is based on the international Nova classification system, which classifies food into four groups based on the type of processing: (1) Unprocessed and minimally processed foods, (2) Processed culinary ingredients, (3) Processed foods, and (4) “Ultra-processed” foods (UPF). The ability of the Nova classification to accurately characterise the degree of food processing across consumption patterns in various European populations has not been investigated so far. Therefore, we applied the Nova coding to data from the European Prospective Investigation into Cancer and Nutrition (EPIC) in order to characterize the degree of food processing in our diet across European populations with diverse cultural and socio-economic backgrounds and to validate this Nova classification through comparison with objective biomarker measurements. Methods: After grouping foods in the EPIC dataset according to the Nova classification, a total of 476,768 participants in the EPIC cohort (71.5% women; mean age 51 [standard deviation (SD) 9.93]; median age 52 [percentile (p)25– p75: 58–66] years) were included in the cross-sectional analysis that characterised consumption patterns based on the Nova classification. The consumption of food products classified as different Nova categories were compared to relevant circulating biomarkers denoting food processing, measured in various subsamples (N between 417 and 9,460) within the EPIC cohort via (partial) correlation analyses (unadjusted and adjusted by sex, age, BMI and country). These biomarkers included an industrial transfatty acid (ITFA) isomer (elaidic acid; exogenous fatty acid generated during oil hydrogenation and heating) and urinary 4-methyl syringol sulfate (an indicator for the consumption of smoked food and a component of liquid smoke used in UPF). Results: Contributions of UPF intake to the overall diet in % grams/day varied across countries from 7% (France) to 23% (Norway) and their contributions to overall % energy intake from 16% (Spain and Italy) to >45% (in the UK and Norway). Differences were also found between sociodemographic groups; participants in the highest fourth of UPF consumption tended to be younger, taller, less educated, current smokers, more physically active, have a higher reported intake of energy and lower reported intake of alcohol. The UPF pattern as defined based on the Nova classification (group 4;% kcal/day) was positively associated with blood levels of industrial elaidic acid (r = 0.54) and 4-methyl syringol sulfate (r = 0.43). Associations for the other 3 Nova groups with these food processing biomarkers were either inverse or non-significant (e.g., for unprocessed and minimally processed foods these correlations were –0.07 and –0.37 for elaidic acid and 4-methyl syringol sulfate, respectively). Conclusion: These results, based on a large pan-European cohort, demonstrate sociodemographic and geographical differences in the consumption of UPF. Furthermore, these results suggest that the Nova classification can accurately capture consumption of UPF, reflected by stronger correlations with circulating levels of industrial elaidic acid and a syringol metabolite compared to diets high in minimally processed foods., International Agency for Research on Cancer (IARC), Imperial College London, NIHR Imperial Biomedical Research Centre (BRC), Danish Cancer Society (Denmark), Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l’Education Nationale, Institut National de la Santé et de la Recherche Médicale (INSERM) (France), German Cancer Aid, German Cancer Research Center (DKFZ), German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Federal Ministry of Education and Research (BMBF) (Germany), Associazione Italiana per la Ricerca sul Cancro- AIRC-Italy, Compagnia di SanPaolo and National Research Council (Italy), Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (Netherlands), Health Research Fund (FIS) - Instituto de Salud Carlos III (ISCIII), Regional Governments of Andalucía, Asturias, Basque Country, Murcia and Navarra, and the Catalan Institute of Oncology - ICO (Spain), Swedish Cancer Society, Swedish Research Council and County Councils of Skåne and Västerbotten (Sweden), Cancer Research UK (14136 to EPIC-Norfolk; C8221/A29017 to EPIC-Oxford), Medical Research Council (1000143 to EPIC-Norfolk; MR/M012190/1 to EPIC-Oxford) (United Kingdom)

ObjectivesThe aim of this cross-sectional study was to investigate the association between sleep dimensions (duration, patterns, and disturbances) with body mass index (BMI), diet quality, and eating behaviors in school-aged children. Additionally, we aimed to investigate whether obesogenic eating behaviors (higher food responsiveness, lower satiety responsiveness, and less slowness in eating) and poor diet quality could mediate the potential association between sleep and obesity in school-aged children.Materials and methodsFor all participants (n = 588 children, age 5–12 years; 51% girls) we evaluated: sleep dimensions, BMI, diet quality, eating behaviors (food responsiveness, satiety responsiveness and slowness in eating). Linear regression models were used to test associations between exposure and outcome variables. Additionally, path analysis was conducted to test whether eating behaviors mediated the relationship between sleep and obesity.ResultsShorter sleep duration (β = −0.722, p = 0.009) and greater sleep disturbances (β = 0.031, p = 0.012) were significantly associated with BMI. Additionally, we observed that diet quality was significantly associated with sleep duration (β = 0.430, p = 0.004), the midpoint of sleep (β = −0.927, p < 0.001), and sleep disturbances (β = −0.029, p < 0.001). Among other findings, greater sleep disturbances were associated with food responsiveness (β = 0.017, p < 0.001), satiety responsiveness (β = 0.015, p < 0.001), and slowness in eating (β = 0.012, p < 0.001). Importantly, food responsiveness was found as significant mediator of the relationship between sleep and BMI (R = 0.427, R2 = 0.182, p < 0.001).ConclusionsLate sleep patterns, short sleep duration, and greater sleep disturbances are significantly related with what and how school-aged children eat. Importantly, poor diet quality was significantly related to all three sleep dimensions, while eating behaviors had a significant relationship with greater sleep disturbances. These findings may be relevant to the development of behavioral targets to prevent childhood obesity, including sleep hygiene guidelines as a strategy to improve children's eating habits, as well as their BMI.

There is currently no treatment for early/intermediate Age-related Macular Degeneration (AMD) but Eye Care Professionals (ECPs) are recommended to advise patients about modifiable lifestyle factors, including dietary changes, that can slow disease progression. The aim of this review was to understand advice currently given to patients with AMD by ECPs and to evaluate evidence regarding patient compliance. A systematic review was conducted of literature published in electronic databases: CINAHL, MEDLINE, PsycINFO, PyscARTICLES, EMBASE, AMED. Methods followed PRISMA guidelines (PROSPERO registration number: CRD42020223724). Twenty-four reports were eligible for inclusion, 12 focused on ECP experience, 7 on patient experience, and 6 on impact of advice (one paper reported on the ECP and patient experience). Studies reported that a substantial proportion of patients did not recall receiving lifestyle modification advice from their ECP (57.95%, range 2–95% across patient based studies). Practitioners were most likely to provide advice about nutritional supplements (80%, range 67–93% across ECP studies), and least likely about smoking (44%, range 28–71% across ECP studies), however supplements advised did not always comply with evidence-based guidelines. The main reason for patients not following lifestyle advice was lack of provision by the ECP (54.5%, range 21–94% across studies on the impact of advice). The review highlighted a need for more studies to understand patient preferences for receiving advice and research on ECP perceived barriers to advice provision. S.D. is funded by The Macular Society

The education sector is a cornerstone in the battle against malnutrition in children. However, there are still no consolidated protocols that outline strategies for how nutrition programs in low- and middle-income countries can be delivered through the education sector. Establishing the correct community diagnosis is essential prior to the elaboration of an intervention plan for a school population that takes into account more than just traditional variables related to the nutritional status. A total of 574 boys and girls aged 3–11 years from three educational institutions in different municipalities in Ecuador participated in the study. Sociodemographic, anthropometric (weight and height) and coproparasitological data were obtained. Nutrimetry, which is a combination of two classical anthropometrics indicators, was used for the analysis of the nutritional status, and the indicators’ frequencies varied among the schools. In order to improve the nutritional status of children, we proposed a framework mainly focusing on establishing alliances with the education sector and taking into account gender equality; respect for the environment; and the customs, beliefs and traditions of each population. The results obtained from the analyses of other variables demonstrated the importance of an adequate diagnosis prior to any type of intervention at the nutritional level, since characteristics could vary by local area and have an impact on the successfulness of the intervention.

Purpose: Malnutrition is a common problem among pancreatic cancer (PC) patients that negatively impacts on their quality of life (QoL) and clinical outcomes. The main objective of this consensus is to address the role of Medical Nutrition Therapy (MNT) into the comprehensive therapeutic management of PC patients. Methods: A Spanish multidisciplinary group of specialists from the areas of Medical Oncology; Radiation Oncology; Endocrinology and Nutrition; and General Surgery agreed to assess the role of MNT as part of the best therapeutic management of PC patients. Results: The panel established different recommendations focused on nutritional screening and nutritional screening tools, MNT strategies according to PC status, and MNT in palliative treatment. Conclusions: There is an unmet need to integrate nutritional therapy as a crucial part of the multimodal care process in PC patients. Health authorities, health care professionals, cancer patients, and their families should be aware of the relevance of nutritional status and MNT on clinical outcomes and QoL of PC patients, Open Access funding provided thanks to the CRUE-CSIC agreement with Springer Nature. Logistics of the meetings and the assistance with the medical writing have been provided by unrestricted Grant from Baxter Laboratories

[CA] La facturació del sector dels negocis esportius ha crescut durant els últims anys degut a que les persones cada volta més elegeixen realitzar algun tipus d´activitat física. La transformació digital juntament amb la pandèmia de Covid-19 han provocat canvis exponencials en el comportament dels consumidors i dels proveïdors de serveis esportius, donant pas a noves tendències. Molts operadors s'han hagut de reorganitzar amb la nova situació per continuar rendibilitzant les seues operacions. L'adaptació a les condicions de l'entorn fa que cada vegada més apreciem altres característiques que no necessàriament radiquen en el medi per al qual han estat creats inicialment aquests serveis. L'objectiu principal que es persegueix amb el treball següent és elaborar un pla d´empresa que servisca com a mapa de ruta i permeta avaluar la viabilitat d'una idea de negoci que sorgeix davant l auge d'una nova visió per comercialitzar els serveis fitness oferts fins ara. Consisteix a crear una plataforma digital que proporcione plans d´entrenament i assessoria nutricional totalment personalitzats en funció de les necessitats dels clients, tant de forma independent com conjunta, així com vídeos d´exercicis i diverses rutines per a tot tipus d´usuaris, des de principiants fins a nivells més avançats. Per fer aquest pla s´analitzen els elements clau del negoci que permeten materialitzar la idea. En primer lloc, s´examina el mercat de fitness, tendències i situació actual. Posteriorment es realitza un anàlisi del mercat centrant-se en l'entorn i la competència complementant-ho amb la matriu DAFO. A continuació es du a terme un estudi de mercat per conèixer-lo millor, minimitzar els riscos i que servisca de base per a les decisions a prendre a posteriori, aconseguint així que la idea arribe de la millor manera i siga acceptada pel públic objectiu. D'altra banda, es detalla el pla d'operacions i els recursos humans per definir l'equip i l'estructura. Seguidament, es descriuen les estratègies concretes del pla de màrqueting així com una projecció econòmica-financera per conèixer des d un punt de vista quantitatiu la viabilitat., [EN] Turnover in the sports business sector has grown over the past few years as people increasingly choose to engage in some form of physical activity. Digital transformation coupled with the Covid-19 pandemic has led to exponential changes in the behavior of consumers and sports service providers, giving rise to new trends. Many operators have had to reorganize with the new situation to continue making their operations profitable. Adaptation to the changing environment means that we increasingly appreciate other characteristics that are not necessarily rooted in the environment for which these services were initially created. The main objective pursued with the following work is to develop a business plan that serves as a roadmap and allows to assess the feasibility of a business idea that arises from the rise of a new vision to market the fitness services offered so far. It consists of creating a digital platform that provides training plans and nutritional advice fully customized according to the needs of customers, both independently and together, as well as exercise videos and various routines for all types of users, from beginners to more advanced levels. To make this plan, the key elements of the business that allow the idea to materialize are analyzed. First, the fitness market, trends and current situation are examined. Subsequently, a market analysis is carried out focusing on the environment and competition, complemented by the SWOT matrix. Next, a market study is carried out to get to know the market better, minimize the risks and serve as a basis for the decisions to be taken later, so that the idea arrives in the best way and is accepted by the target audience. On the other hand, the operations plan and human resources are detailed to define the team and structure. Next, the specific strategies of the marketing plan are described as well as an economic-financial projection to know from a quantitative point of view the viability.

Background: Despite extensive research, our knowledge on the relationship between nutrition and healthy ageing is limited. The aim of this study was to evaluate the associations between the intake of macronutrients and a single measure of healthy ageing (ATHLOS Healthy Ageing Scale). Methods: A cross-sectional analysis was performed using data from 9906 randomly selected citizens of Krakow (Poland) who were 45–69 years of age and participants of the Health, Alcohol and Psychosocial factors in Eastern Europe (HAPIEE) study. Macronutrient intake was evaluated using a food frequency questionnaire. ATHLOS Health Ageing Scale was estimated from 41 variables in pooled data from 16 cohorts. Standardized beta coefficients were estimated using multivariable linear regression models. Results: In multivariable adjusted models, there were significant positive associations between the ATHLOS Healthy Ageing Scale score and intake of protein (b = 0.030, 95% CI 0.001; 0.059 in men; b = 0.056, 95% CI 0.027; 0.085 in women), monounsaturated fatty acids (MUFA) (b = 0.042, 95% CI 0.013; 0.071 in men; b = 0.035, 95% CI 0.006; 0.064 in women), polyunsaturated fatty acids (PUFA) (b = 0.053, 95% CI 0.024; 0.082 in men; b = 0.063, 95% CI 0.034; 0.092 in women), and omega-3 PUFA (b = 0.031, 95% CI 0.002;0.060 in men; b = 0.054, 95% CI 0.026; 0.082 in women). Carbohydrate intake was inversely associated with the ATHLOS Healthy Ageing Scale in women. Total fat intake was positively associated with the ATHLOS Healthy Ageing Scale in men. Conclusions: A number of nutrients were associated with the healthy ageing score, suggesting that dietary habits may play an important role in healthy ageing. Further research in other settings and with a prospective design is strongly warranted.

This study aimed to observe if quinoa could produce a benefit on postprandial glycemia that would result in less progression to type 2 diabetes (T2D). A cross-over design pilot clinical study with a nutritional intervention for 8 weeks was performed: 4 weeks on a regular diet (RD) and 4 weeks on a quinoa diet (QD). Nine subjects aged ≥65 years with prediabetes were monitored during the first 4 weeks of RD with daily dietary records and FreeStyle Libre®. Subsequently, participants started the QD, where quinoa and 100% quinoa-based products replaced foods rich in complex carbohydrates that they had consumed in the first 4 weeks of RD. The glycemic measurements recorded by the sensors were considered as functions of time, and the effects of nutrients consumed at the intended time period were analyzed by means of a function-on-scalar regression (fosr) model. With QD participants, decreased body weight (−1.6 kg, p = 0.008), BMI (−0.6 kg/m2p = 0.004) and waist circumference (−1.5 cm, p = 0.015) were observed. Nutrients intake changed during QD, namely, decreased carbohydrates (p = 0.004) and increased lipids (p = 0.004) and some amino acids (p < 0.05). The fosr model showed a reduction in postprandial glycemia in QD despite intrapersonal differences thanks to the joint action of different nutrients and the suppression of others consumed on a regular diet. We conclude that in an old age and high T2D-risk population, a diet rich in quinoa reduces postprandial glycemia and could be a promising T2D-preventive strategy.

Background and Purpose The enzyme α/β‐hydrolase domain containing 6 (ABHD6), a new member of the endocannabinoid system, is a promising therapeutic target against neuronal‐related diseases. However, how ABHD6 activity is regulated is not known. ABHD6 coexists in protein complexes with the brain‐specific carnitine palmitoyltransferase 1C (CPT1C). CPT1C is involved in neuro‐metabolic functions, depending on brain malonyl–CoA levels. Our aim was to study CPT1C–ABHD6 interaction and determine whether CPT1C is a key regulator of ABHD6 activity depending on nutritional status. Experimental Approach Co‐immunoprecipitation and FRET assays were used to explore ABHD6 interaction with CPT1C or modified malonyl–CoA‐insensitive or C‐terminal truncated CPT1C forms. Cannabinoid CB1 receptor‐mediated signalling was investigated by determining cAMP levels. A novel highly sensitive fluorescent method was optimized to measure ABHD6 activity in non‐neuronal and neuronal cells and in brain tissues from wild‐type (WT) and CPT1C–KO mice. Key Results CPT1C interacted with ABHD6 and negatively regulated its hydrolase activity, thereby regulating 2‐AG downstream signalling. Accordingly, brain tissues of CPT1C–KO mice showed increased ABHD6 activity. CPT1C malonyl–CoA sensing was key to the regulatory role on ABHD6 activity and CB1 receptor signalling. Fasting, which attenuates brain malonyl–CoA, significantly increased ABHD6 activity in hypothalamus from WT, but not CPT1C–KO, mice. Conclusions and Implications Our finding that negative regulation of ABHD6 activity, particularly in the hypothalamus, is sensitive to nutritional status throws new light on the characterization and the importance of the proteins involved as potential targets against diseases affecting the CNS., We thank Dr. Gemma Fabriàs and Alexandre García from the Research Unit of BioActive Molecules (Institut de Química Avançada de Catalunya, IQAC) for technical assistance in the analysis of endocannabinoid levels. We also thank Prof. Kenneth Mackie from the Department of Psychological and Brain Sciences, Indiana University Bloomington (USA), for providing ABHD6 antibody for western blotting assays in brain tissue. This work was supported by the Ministerio de Economía, Industria y Competitividad (MINECO), Agencia Estatal de Investigación (AEI) and Fondo Europeo de Desarrollo Regional (FEDER) (SAF2017‐83813‐C3‐3‐R to N.C. and R.R.‐R.), Joint Bilateral Project Japan‐Spain/AEI (PCI2018‐092997/AEI to R.R.‐R.) and Fundació La Marató de TV3 (Grant 87/C/2016 to N.C.). A.F. and C.R. are recipients of a fellowship from the Agència de Gestió d'Ajuts Universitaris i de la Recerca (AGAUR) in Catalonia.

Epidemiologic studies have indicated that cruciferous vegetables can influence the cancer risk; therefore, we examined with a cross-sectional approach the correlation between the frequent consumption of the total cruciferous vegetables and the formation of bulky DNA damage, a biomarker of carcinogen exposure and cancer risk, in the Gen-Air study within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. DNA damage measurements were performed in the peripheral blood of 696 of those apparently healthy without cancer controls, including 379 never-smokers and 317 former smokers from seven European countries by the 32P-postlabeling assay. In the Gen-Air controls, the median intake of cruciferous vegetables was 6.16 (IQR 1.16–13.66) g/day, ranging from 0.37 (IQR 0–6.00) g/day in Spain to 11.34 (IQR 6.02–16.07) g/day in the UK. Based on this information, participants were grouped into: (a) high consumers (>20 g/day), (b) medium consumers (3–20 g/day) and (c) low consumers (

Flavonoids are bioactive plant compounds that are widely present in the human diet. Estimating flavonoid intake with a high degree of certainty is challenging due to the inherent limitations of dietary questionnaires and food composition databases. This study aimed to evaluate the degree of reliability among flavonoid intakes estimated using four different approaches based on the two most comprehensive flavonoid databases, namely, United States Department of Agriculture (USDA) and Phenol Explorer (PE). In 678 individuals from the MAX study, a subcohort of the Diet, Cancer and Health-Next Generations cohort, dietary data were collected using three 24-h diet recalls over 1 year. Estimates of flavonoid intake were compared using flavonoid food content from PE as (1) aglycones (chromatography with hydrolysis), (2) aglycones transformed (converted from glycosides by chromatography without hydrolysis), (3) as they are in nature (glycosides, aglycones, and esters), and 4) using flavonoid content from USDA as aglycones (converted). Spearman's intra-class correlation (ICC) coefficient and weighted kappa (K) coefficient were calculated for the reliability analysis. When comparing PE total aglycones to USDA total aglycones, there was a moderate reliability when a continuous variable was used [ICC: 0.73, 95% confidence interval (CI): 0.70–0.76] and an excellent reliability when flavonoid intake was modeled as a categorical variable (K: 0.89, 95% CI: 0.88–0.90). The degree of reliability among all methods of estimated flavonoid intakes was very similar, especially between database pairs, for the flavanol subclass, while larger differences were observed for flavone, flavonol, and isoflavone subclasses. Our findings indicate that caution should be taken when comparing the results of the associations between flavonoid intakes and health outcomes from studies, when flavonoid intakes were estimated using different methods, particularly for some subclasses.

Nutrition education resources are of interest for cancer patients and survivors throughout the cancer continuum. We examined the web-based nutrition information in Spanish for cancer patients and survivors provided by national cancer organizations (NCOs). The Guide to Internet Resources for Cancer and the membership list of the Union for International Cancer Control were searched to identify the NCOs. The International Patients Decisions Aid Standards (IPDAS) was used to describe the quality of the available information. We identified 20 NCOs that provided nutrition information aimed at a general audience on their websites. Web-based resources of nine NCOs were selected for presentation in this review. Website scores ranged between 20 and 24 in the IPDAS scale (maximum score = 31). The selected NCOs offered reliable and safe information. Healthy eating information for cancer patients and management of side-effects was provided by all websites. Information was more limited for cancer survivors. We recommend that NCOs increase the possibilities for personalized recommendations and interaction with the content by including instrumental tools on their websites.

Background: Metabolomics is a powerful tool for investigating the association between nutrition and health status. Although urine is commonly employed for studying the metabolism and transformation of food components, the use of blood samples could be preferable to gain new insights into the bioavailability of diet-derived compounds and their involvement in health. However, the chemical complexity of blood samples hinders the analysis of this biological fluid considerably, which makes the development of novel and comprehensive analytical methods mandatory. Methods: In this work, we optimized a multi-targeted metabolomics platform for the quantitative and simultaneous analysis of 450 food-derived metabolites by ultra-high performance liquid chromatography coupled to tandem mass spectrometry. To handle the chemical complexity of blood samples, three complementary extraction methods were assayed and compared in terms of recovery, sensitivity, precision and matrix effects with the aim of maximizing metabolomics coverage: protein precipitation, reversed solid-phase extraction, and hybrid protein precipitation with solid-phase extraction-mediated phospholipid removal. Results: After careful optimization of the extraction conditions, protein precipitation enabled the most efficient and high-throughput extraction of the food metabolome in plasma, although solid-phase extraction-based protocols provided complementary performance for the analysis of specific polyphenol classes. The developed method yielded accurate recovery rates with negligible matrix effects, and good linearity, as well as high sensitivity and precision for most of the analyzed metabolites. Conclusions: The multi-targeted metabolomics platform optimized in this work enables the simultaneous detection and quantitation of 450 dietary metabolites in short-run times using small volumes of biological sample, which facilitates its application to epidemiological studies.

Diet is an important, modifiable lifestyle factor of cardiometabolic disease risk, and an improved diet can delay or even prevent the onset of disease. Recent evidence suggests that individuals could benefit from diets adapted to their genotype and phenotype: that is, personalized nutrition. A novel strategy is to tailor diets for groups of individuals according to their metabolic phenotypes (metabotypes). Randomized controlled trials evaluating metabotype-specific responses and nonresponses are urgently needed to bridge the current gap of knowledge with regard to the efficacy of personalized strategies in nutrition. In this Perspective, we discuss the concept of metabotyping, review the current literature on metabotyping in the context of cardiometabolic disease prevention, and suggest potential strategies for metabotype-based nutritional advice for future work. We also discuss potential determinants of metabotypes, including gut microbiota, and highlight the use of metabolomics to define effective markers for cardiometabolic disease–related metabotypes. Moreover, we hypothesize that people at high risk for cardiometabolic diseases have distinct metabotypes and that individuals grouped into specific metabotypes may respond differently to the same diet, which is being tested in a project of the Joint Programming Initiative: A Healthy Diet for a Healthy Life.

Aim. To investigate the relation between malnutrition and nosocomial infections (NI) in hospitalized cancer patients. Methods. This observational, cross-sectional, noninterventional, descriptive study was conducted in a 500-bed university hospital in Valencia (Spain). Adult cancer patients admitted to the oncology ward were consecutively enrolled regardless of their nutritional status between November 2019 and March 2020. Patients were nutritionally assessed 24 to 48 hours after admission. Body weight, height and BMI, body composition through measurement of bioelectrical impedance analysis (BIA), and muscle strength and functionality using hand grip strength (HGS) were prospectively collected. The diagnosis of malnutrition and sarcopenia was assessed using the Global Leadership Initiative on Malnutrition (GLIM) criteria and the European Working Group on Sarcopenia in Older People (EWGSOP) criteria, respectively. Patients were followed up during their hospital stay or outpatient oncology visits to identify possible NI. Results. A total of 107 patients were included in this study (mean age 66 years; 66.4% were men). The most frequent reason for admission was cancer treatment (19.6%), followed by infections (18.7%) and digestive tract symptoms (18.7%). Overall, 77.5% (83/107) of the patients were malnourished at admission according to the GLIM criteria, while 52.3% (56/107) were sarcopenic. Nosocomial infections (NI) were significantly more frequent in malnourished (52.1%; 25/48) and severely malnourished (42.1%; 8/19) patients, compared with well-nourished patients without malnutrition (25%; 10/40; p = 0.035 ). The mean length of hospital stay was 13.9 days, significantly longer in patients with an NI compared to those without infections (18.6 vs. 10.8 days, p < 0.024 ). Conclusion. This study evidenced the need to implement a routine protocol for the nutritional assessment and support of cancer patients at risk of malnutrition and sarcopenia to reduce the risk of NI during their hospital stay.

Altres ajuts: Departament d'Universitats, Recerca i Societat de la Informació de la Generalitat de Catalunya (expedient 2017 SGR 1721) The impact of diet and digestive disorders in flatus composition remains largely unexplored. This is partially due to the lack of standardized sampling collection methods, and the easy atmospheric contamination. This paper describes a method to quantitatively determine the major gases in flatus and their application in a nutritional intervention. We describe how to direct sample flatus into Tedlar bags, and simultaneous analysis by gas chromatography-thermal conductivity detection (GC-TCD). Results are analyzed by univariate hypothesis testing and by multilevel principal component analysis. The reported methodology allows simultaneous determination of the five major gases with root mean measurement errors of 0.8% for oxygen (O), 0.9% for nitrogen (N), 0.14% for carbon dioxide (CO), 0.11% for methane (CH), and 0.26% for hydrogen (H). The atmospheric contamination was limited to 0.86 (95% CI: [0.7-1.0])% for oxygen and 3.4 (95% CI: [1.4-5.3])% for nitrogen. As an illustration, the method has been successfully applied to measure the response to a nutritional intervention in a reduced crossover study in healthy subjects.

This is a reprint of articles from the Special Issue published online in the open access journal Nutrients (ISSN 2072-6643) (available at: https://www.mdpi.com/journal/nutrients/special issues/ Nutrition ADHD).

Una qüestió fonamental per al benestar és mantenir els animals clínicament sans, sense estrès, i correctament alimentats, sobretot durant la cria, per a millorar la producció i la qualitat dels productes derivats. Cal tenir en compte que l'estat nutricional i metabòlic de la mare és determinant per al creixement fetal, i que alteracions de la dieta canvien l'homeòstasi metabòlica de l'organisme. La restricció del creixement intrauterí (IUGR) es caracteritza per un dèficit en el creixement i en el pes a causa de la manca de nutrients, oxigen o alteracions a la placenta que provoquen manca de components essencials per al desenvolupament. A causa de la IUGR, el fetus adapta el seu metabolisme i fisiologia per sobreviure. La principal adaptació és el "brain-sparing", que prioritza el desenvolupament cerebral, però no en garanteix el desenvolupament normal ni la funció. Alhora, hi ha altres alteracions sistèmiques que afecten el metabolisme energètic, induint així l'aparició del "thrifty phenotype", responsable d'alteracions metabòliques que es prolonguen fins a l'edat adulta, augmentant la incidència de malalties metabòliques. Aquest treball consta de 4 estudis on es van analitzar les conseqüències de diferents canvis nutricionals aplicats a la mare gestant o directament sobre les cries. En tres es va utilitzar un model porcí de IUGR prestant especial atenció al sistema nerviós, on es va avaluar: l'efecte de la suplementació de la dieta materna amb l'antioxidant hidroxitirosol (HTX) a diferents edats prenatal i postnatal; l'efecte produït per la IUGR al cervell de fetus de 100 dies de gestació dels quals les seves mares havien estat tractades amb HTX; i l'efecte a llarg termini de la IUGR quan s'administra una dieta alta en greixos (HFD) als individus ja adults. Al primer estudi, es va analitzar el perfil de neurotransmissors en diverses àrees cerebrals, així com la morfologia de l'hipocamp mitjançant marcadors moleculars de neurones immadures i madures. Els resultats van mostrar que els efectes de la suplementació materna amb HTX estan restringits al període prenatal, ja que només es van observar canvis en fetus de 100 dies, i no es van observar efectes del HTX en porcs d'un mes i sis mesos, indicant que es necessita la presència contínua del HTX per a mantenir els seus efectes al cervell. La restricció calòrica a partir del segon trimestre de gestació afecta el desenvolupament fetal i indueix un menor pes en néixer, sent un bon model animal de IUGR. Els resultats del segon estudi van indicar que la IUGR modificava el perfil de neurotransmissors als fetus, així com el desenvolupament de l'hipocamp. La suplementació materna amb HTX va revertir aquests canvis, fent ambdues característiques més semblants als fetus no afectats per la IUGR. En tercer lloc, els animals afectats per la IUGR durant la gestació, quan tenien un any van respondre diferent a una HFD en comparació als animals control a causa del "thrifty phenotype": va augmentar la concentració d'aminoàcids lliures en plasma, però no la dels lípids. A la majoria d'àrees cerebrals va augmentar la concentració de serotonina, a diferència dels animals no afectats per la IUGR. En quant al proteoma de l'hipocamp, encara que la HFD va modificar diverses pathways de manera similar, en el grup IUGR també va afectar al splicing del mRNA, al transport vesicular i a la via mTOR. Finalment, es va avaluar l'efecte de la suplementació amb triptòfan a la dieta de vedells lactants, així com la seva funcionalitat per a millorar-ne el creixement i el desenvolupament. Els resultats van mostrar que la suplementació amb triptòfan no afectava al rendiment ni al comportament dels vedells durant el procés de deslletament, i tampoc va provocar canvis metabòlics. Una cuestión fundamental para el bienestar es mantener a los animales clínicamente sanos, sin estrés, y correctamente alimentados, sobre todo durante la cría, para mejorar la producción y la calidad de los productos derivados. Hay que tener en cuenta que el estado nutricional y metabólico de la madre es determinante para el crecimiento fetal, y que alteraciones en la dieta cambian la homeostasis metabólica del organismo. La restricción del crecimiento intrauterino (IUGR) se caracteriza por un déficit en el crecimiento y en el peso debido a la falta de nutrientes, oxígeno o alteraciones en la placenta que provocan carencia de componentes esenciales para el desarrollo. Debido a la IUGR, el feto adapta su metabolismo y fisiología para sobrevivir. La principal adaptación es el "brain-sparing", que prioriza el desarrollo cerebral, sin embargo, no garantiza su desarrollo normal ni su función. A su vez, hay otras alteraciones sistémicas que afectan el metabolismo energético, induciendo así la aparición del "thrifty phenotype", responsable de alteraciones metabólicas que se prolongan hasta la edad adulta, aumentando la incidencia de enfermedades metabólicas. Este trabajo consta de 4 estudios donde se analizaron las consecuencias de distintos cambios nutricionales aplicados a las madres gestantes o directamente sobre las crías. En tres de ellos se utilizó un modelo porcino de IUGR prestando especial atención al sistema nervioso, donde se evaluaron: el efecto de la suplementación de la dieta materna con el antioxidante hidroxitirosol (HTX) a diferentes edades prenatal y postnatal; el efecto producido por la IUGR en el cerebro de fetos de 100 días de gestación cuyas madres habían sido tratadas con HTX; y el efecto a largo plazo de la IUGR cuando se administra una dieta alta en grasas (HFD) a individuos ya adultos. En el primer estudio, se analizó el perfil de neurotransmisores en diversas áreas cerebrales, así como la morfología del hipocampo mediante marcadores moleculares de neuronas inmaduras y maduras. Los resultados mostraron que los efectos de la suplementación materna con HTX están restringidos al período prenatal, ya que solo se observaron cambios en fetos de 100 días, y no se observaron efectos del HTX en cerdos de 1 mes y 6 meses de edad, indicando que se necesita la presencia continua del HTX para mantener sus efectos en el cerebro. La restricción calórica a partir del segundo trimestre de gestación afecta al desarrollo fetal e induce menor peso al nacer, siendo un buen modelo animal de IUGR. Los resultados del segundo estudio indicaron que la IUGR modificó el perfil de neurotransmisores en los fetos, así como el desarrollo del hipocampo. La suplementación materna con HTX revertió estos cambios, haciendo ambas características más similares a los fetos no afectados por la IUGR. En tercer lugar, los animales afectados por la IUGR durante la gestación, cuando tenían un año respondieron diferente a una HFD en comparación a los animales control debido al "thrifty phenotype": aumentó la concentración de aminoácidos libres en plasma, pero no la de los lípidos. En la mayoría de las áreas cerebrales aumentó la concentración de serotonina, a diferencia de los animales no afectados por la IUGR. En cuanto al proteoma del hipocampo, aunque la HFD modificó varios pathways de manera similar, en el grupo IUGR también afectó al splicing del mRNA, al transporte vesicular y a la vía mTOR. Finalmente, se evaluó el efecto de la suplementación con triptófano en la dieta de terneros lactantes, así como su funcionalidad para mejorar su crecimiento y desarrollo. Los resultados mostraron que la suplementación con triptófano no afectaba al rendimiento ni al comportamiento de los terneros durante el proceso de destete, y tampoco provocó cambios metabólicos. A fundamental issue for animal welfare is to keep them clinically healthy, stress-free, and properly fed, especially during rearing, to improve production and quality of derived products. It must be considered that the nutritional and metabolic state of the mother is decisive for foetal growth, and that alterations in the diet change the metabolic homeostasis of the organism. Intrauterine growth restriction (IUGR) is characterized by a deficit in growth and weight due to a lack of nutrients, oxygen or an alteration in the placenta that causes a lack of essential components for development. Due to IUGR the foetus adapts its metabolism and physiology to survive. The main adaptation is "brain-sparing", which prioritizes brain development, however, it does not guarantee its normal development or function. In turn, there are other systemic alterations that affect energy metabolism, thus inducing the appearance of the "thrifty phenotype", responsible for metabolic alterations that last into adulthood, increasing the incidence of metabolic diseases. This work consists of 4 studies in which the consequences of different nutritional changes are analysed, whether applied to the pregnant mother or directly to the offspring. In three of them, a porcine IUGR model was used, paying special attention to the nervous system, where the following were evaluated: the effect of supplementing the maternal diet with the antioxidant hydroxytyrosol (HTX) at different prenatal and postnatal ages; the effect produced by IUGR in the brain of foetuses of 100 days of gestation whose mothers had been treated with HTX; and the long-term effect of IUGR when a high-fat diet (HFD) is administered to adult individuals. In the first study, the neurotransmitter profile in various brain areas was analysed, as well as the morphology of the hippocampus using molecular markers of immature and mature neurons. The results showed that the effects of maternal supplementation with HTX are restricted to the prenatal period, since changes were only observed in foetuses of 100 days, and no effects of HTX were observed in pigs of 1 month and 6 months of age, indicating that the continued presence of HTX is needed to maintain its effects in the brain. Caloric restriction from the second trimester of gestation affects foetal development and induces lower birth weight in new-borns, being a good animal model of IUGR. The results of the second study indicated that IUGR modified the neurotransmitter profile in foetuses, as well as the development of the hippocampus. Maternal HTX supplementation reversed these changes, making both characteristics more like foetuses unaffected by IUGR. Third, animals affected by IUGR during gestation, when they were one year old, responded differently to an HFD compared to the control animals due to the "thrifty phenotype": the concentration of free amino acids in plasma increased, but not that of the lipids. In most areas of the brain, the concentration of serotonin increased, unlike in animals not affected by IUGR. Regarding the hippocampal proteome, although HFD modified several pathways in a similar way, in the IUGR group it also affected mRNA splicing, vesicular transport and mTOR pathway. Finally, the effect of tryptophan supplementation in the diet of suckling calves, as well as its functionality to improve their growth and development, was evaluated. The results showed that tryptophan supplementation did not affect the performance or behaviour of the calves during the weaning process, nor did it cause metabolic changes.

Background: The importance of artificial nutritional therapy is underrecognized, typically being considered an adjunctive rather than a primary therapy. We aimed to evaluate the influence of nutritional therapy on mortality in critically ill patients.Methods: This multicenter prospective observational study included adult patients needing artificial nutritional therapy for >48 h if they stayed in one of 38 participating intensive care units for ≥72 h between April and July 2018. Demographic data, comorbidities, diagnoses, nutritional status and therapy (type and details for ≤14 days), and outcomes were registered in a database. Confounders such as disease severity, patient type (e.g., medical, surgical or trauma), and type and duration of nutritional therapy were also included in a multivariate analysis, and hazard ratios (HRs) and 95% confidence intervals (95%CIs) were reported.Results: We included 639 patients among whom 448(70.1%) and 191(29.9%) received enteral and parenteral nutrition, respectively. Mortality was 25.6%, with non-survivors having the following characteristics: older age; more comorbidities; higher Sequential Organ Failure Assessment (SOFA) scores (6.6±3.3 vs 8.4±3.7; P); greater nutritional risk (Nutrition Risk in the Critically Ill [NUTRIC] score: 3.8±2.1 vs 5.2±1.7; P); more vasopressor requirements (70.4% vs 83.5%; P=0.001); and more renal replacement therapy (12.2% vs 23.2%; P=0.001). Multivariate analysis showed that older age (HR: 1.023; 95% CI: 1.008–1.038; P=0.003), higher SOFA score (HR: 1.096; 95% CI: 1.036–1.160; P=0.001), higher NUTRIC score (HR: 1.136; 95% CI: 1.025–1.259; P=0.015), requiring parenteral nutrition after starting enteral nutrition (HR: 2.368; 95% CI: 1.168–4.798; P=0.017), and a higher mean Kcal/Kg/day intake (HR: 1.057; 95% CI: 1.015–1.101; P=0.008) were associated with mortality. By contrast, a higher mean protein intake protected against mortality (HR: 0.507; 95% CI: 0.263–0.977; P=0.042).Conclusions: Old age, higher organ failure scores, and greater nutritional risk appear to be associated with higher mortality. Patients who need parenteral nutrition after starting enteral nutrition may represent a high-risk subgroup for mortality due to illness severity and problems receiving appropriate nutritional therapy. Mean calorie and protein delivery also appeared to influence outcomes.Trial Registration: ClinicaTrials.gov NCT: 03634943.

El uso de sustancias ergogénicas en la práctica de deportes de resistencia es una práctica ampliamente extendida. Los complementos alimenticios derivados de la remolacha se contemplan como ayuda ergogénica en este tipo de actividad deportiva, por su alto contenido en nitratos. Los nitratos se metabolizan en óxido nítrico, que actúa sobre el nucleótido guanosin monofosfato y mejora el rendimiento deportivo aumentando la vasodilatación y favoreciendo la contracción muscular. El objetivo de esta revisión bibliográfica es revisar la evidencia científica en cuanto al efecto ergogénico de los complementos alimenticios derivados de la remolacha sobre e rendimiento en deportes de resistencia, además de concretar sobre qué parámetros fisiológicos específicos se presentan mayores mejoras y a través de qué dosis aplicada se observan estas mejoras. Se realizó una búsqueda a través de palabras clave en las bases de datos electrónicas PubMed, Google Scholar, Scielo, y CINAHL de los ensayos clínicos publicados entre 2012 y 2022, de la que se seleccionaron finalmente 7 artículos. Los resultados obtenidos no permitieron la extracción de evidencias con la suficiente potencia estadística como para la realización de conclusiones concretas. Siendo la única correlación posible la mejora de resultados en esfuerzos de fuerza resistencia cuando se consumió zumo de remolacha en una dosis única entre dos y tres horas antes del esfuerzo. Son necesarios futuros estudios que puedan confirmar esta posible correlación. The use of ergogenic substances in the practice of endurance sports is a very common practice. Beet-derived food supplements are considered an ergogenic aid in this type of sports activity, due to their high nitrate content. Nitrates are metabolized into nitric oxide, which acts on the nucleotide guanosine monophosphate and improves sports performance by increasing vasodilation and favoring muscle contraction. The objective of this bibliographic review is to review the scientific evidence regarding the ergogenic effect of food supplements derived from beetroot on performance in endurance sports, in addition to specify which physiological parameters show greater improvements specifically and through which dose applied these improvements are observed. A key search was performed in the electronic databases PubMed, Google Scholar, Scielo, and CINAHL of clinical trials published between 2012 and 2022, from which 7 articles were finally selected. The results obtained did not allow the extraction of evidence with sufficient statistical power to draw specific conclusions. The only possible connection being the improvement of results in resistance strength efforts when beet juice was consumed in a single dose between two and three hours before the effort. Future studies are needed to confirm this possible connection. L'ús de substàncies ergogèniques en la pràctica d'esports de resistència és una pràctica àmpliament estesa. Els complements alimentosos derivats de la remolatxa es contemplen com a ajuda ergogènica en aquesta mena d'activitat esportiva, pel seu alt contingut en nitrats. Els nitrats es metabolizan en òxid nítric, que actua sobre el nucleòtid guanosin monofosfato i millora el rendiment esportiu augmentant la vasodilatació i afavorint la contracció muscular. L'objectiu d'aquesta revisió bibliogràfica és revisar l'evidència científica quant a l'efecte ergogènic dels complements alimentosos derivats de la remolatxa sobre e rendiment en esports de resistència, a més de concretar sobre quins paràmetres fisiològics específics es presenten majors millores i a través de quina dosi aplicada s'observen aquestes millores. Es va realitzar una cerca a través de paraules clau en les bases de dades electròniques PubMed, Google Scholar, Scielo, i CINAHL dels assajos clínics publicats entre 2012 i 2022, de la qual es van seleccionar finalment 7 articles. Els resultats obtinguts no van permetre l'extracció d'evidències amb la suficient potència estadística com per a la realització de conclusions concretes. Sent l'única correlació possible la millora de resultats en esforços de força resistència quan es va consumir suc de remolatxa en una dosi única entre dues i tres hores abans de l'esforç. Són necessaris futurs estudis que puguin confirmar aquesta possible correlació.

A large number of scientists and health professionals recognize that balanced nutrition is fundamental for a good state of physical health [...]

Background: Diets high in acid load may contribute to kidney function impairment. This study aimed to investigate the association between dietary acid load and 1-year changes in glomerular filtration rate (eGFR) and urine albumin/creatinine ratio (UACR). Methods: Older adults with overweight/obesity and metabolic syndrome (mean age 65 ± 5 years, 48% women) fromthe PREDIMED-Plus study who had available data on eGFR (n = 5,874) or UACR (n = 3,639) at baseline and after 1 year of follow-up were included in this prospective analysis. Dietary acid load was estimated as potential renal acid load (PRAL) and net endogenous acid production (NEAP) at baseline froma food frequency questionnaire. Linear and logistic regression models were fitted to evaluate the associations between baseline tertiles of dietary acid load and kidney function outcomes. One year- changes in eGFR and UACR were set as the primary outcomes.We secondarily assessed 10% eGFR decline or 10% UACR increase. Results: After multiple adjustments, individuals in the highest tertile of PRAL or NEAP showed higher one-year changes in eGFR (PRAL, b: – 0.64 ml/min/1.73 m2; 95% CI: –1.21 to –0.08 and NEAP, b: –0.56 ml/min/1.73 m2; 95% CI: –1.13 to 0.01) compared to those in the lowest category. No associations with changes in UACR were found. Participants with higher levels of PRAL and NEAP had significantly higher odds of developing 10% eGFR decline (PRAL, OR: 1.28; 95% CI: 1.07–1.54 and NEAP, OR: 1.24; 95% CI: 1.03–1.50) and 10 % UACR increase (PRAL, OR: 1.23; 95% CI: 1.04–1.46) compared to individuals with lower dietary acid load. Conclusions: Higher PRAL and NEAP were associated with worse kidney function after 1 year of follow-up as measured by eGFR and UACR markers in an older Spanish population with overweight/obesity andmetabolic syndrome., CIBER Fisiopatologia de la Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III (ISCIII), through the Fondo de Investigacion para la Salud (FIS), European Commission 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, Especial Action Project, European Research Council (ERC) European Commission 340918, La Caixa Foundation 2013ACUP00194, Junta de Andalucia PI0458/2013 PS0358/2016 PI0137/2018, Center for Forestry Research & Experimentation (CIEF), European Commission PROMETEO/2017/017 PROMETEO/2021/021 AICO/2021/347 2022 FI_B100108, SEMERGEN grant, Boosting young talent call grant program for the development of IISPV research projects 2019-2021 2019/IISPV/03, Societat Catalana d'Endocrinologia i Nutricio (SCEN) Clinical-Research Grant 2019, CIBEROBN, ICREA under the ICREA Academia programme, Generalitat de Catalunya 2022 FI_B100108, European Commission 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 PI13/00233 PI13/02184 PI13/00728 PI13/01090 PI13/01056 PI14/01722 PI14/00636 PI14/00618 PI14/00696 PI14/01206 PI14/01919 PI14/00853 PI19/01560 PI19/01332 PI20/01802 PI20/00138 PI20/01532 PI20/00456 PI20/00339 PI20/00557 PI20/00886 PI20/01158 PI14/01374 PI14/00972 PI14/00728 PI14/01471 PI16/00473 PI16/00662 PI16/01873 PI16/01094 PI16/00501 PI16/00533 PI16/00381 PI16/00366

La nutrició exerceix un paper important en la modulació de la immunitat de les espècies ramaderes. L'objectiu d'aquesta tesi és avaluar els efectes de diferents molècules dietètiques sobre la immunitat de mamífers i ocells. Es van implementar anàlisis funcionals in vitro, i proteòmica i miRNAómica per a una caracterització integral de l'impacte de les molècules en la resposta immune dels animals. Específicament es va avaluar l'impacte in vitro de l'àcid linoleic conjugat (CLA) n-6, la pectina cítrica (CP) i els exosomas de llet porcina i els àcids grassos poliinsaturats (PUFA) n-3 sobre la resposta immune de les cèl·lules mononuclears bovines, de pollastre i porcines, respectivament. Primer, es va avaluar l'activitat in vitro del CLA sobre l'apoptosi, quimiotaxis, fagocitosi, capacitat de matar i producció d'espècies reactives d'oxigen (ROS) extracelul·lars dels monòcits bovins. Es van observar efectes anti-apoptóticos i un augment de la producció extracelul·lar de ROS durant condicions pro-inflamatòries experimentals, només quan es va utilitzar la mescla dels dos isòmers principals de CLA en proporcions iguals (50:50). Els resultats van demostrar que el CLA té efectes immunomoduladors sobre algunes funcions dels monòcits bovins in vitro i que la mescla de CLA (50:50) és més eficaç que els isòmers de CLA per separat. L'anàlisi proteómico realitzat en cèl·lules mononuclears de sang perifèrica bovina (PBMC) va revelar que la mescla de CLA (50:50) modula el proteoma de les PBMC bovines, recolzant els efectes anti-apoptóticos i immunomoduladors observats en l'estudi in vitro anterior en monòcits bovins, i proposant un potencial paper cito protector de la mescla de CLA (50:50) contra l'estrès oxidatiu. Segon, es va avaluar l'activitat in vitro de CP sobre la viabilitat, apoptosi, quimiotaxis i fagocitosi dels monòcits de pollastre. L'estudi va demostrar que CP inhibeix la quimiotaxis i fagocitosi dels monòcits in vitro, suggerint una potencial activitat anti-inflamatòria. L'anàlisi proteómico en PBMC de pollastre va proporcionar un rerefons proteómico a l'activitat anti-inflamatòria de CP, demostrant que la reducció in vitro de la fagocitosi i quimiotaxis està associada a canvis en les proteïnes relacionades amb el citoesquelet d'actina. Tercer, es va avaluar l'activitat in vitro dels exosomas de llet porcina sobre la viabilitat, apoptosi, quimiotaxis, fagocitosi, capacitat de matar i producció extracelul·lar de ROS dels monòcits porcins. Aquest estudi va demostrar que els exosomas de llet porcina poden ser internalitzats per monòcits porcins in vitro i que poden modular la resposta immune de la cèl·lula, disminuint la seva quimiotaxis i fagocitosi; i augmentant la seva producció de ROS en condicions de repòs i pro-inflamatòries. L'anàlisi proteómico de les PBMC porcines va demostrar que els exosomas de llet porcina poden modular el proteoma de les PBMC porcines in vitro, enriquint els processos biològics relacionats amb la immunitat innata i els processos de captació de exosomas, recolzant els efectes immunomoduladors i la internalització de exosomas observats en l'estudi in vitro anterior. Quart, es va avaluar l'activitat in vitro dels PUFA n-3, l'àcid docosahexaenoic (DHA) i àcid eicosapentaenoico (EPA), sobre la viabilitat, apoptosi, quimiotaxis, fagocitosi i producció de ROS dels monòcits porcins. Els resultats de l'estudi van mostrar que DHA i EPA poden exercir efectes immunomoduladors diferencials in vitro en porcs, en disminuir la quimiotaxis dels monòcits i potenciar la seva explosió oxidativa intracel·lular, respectivament. Finalment, es presenta un primer cop d'ull als resultats de les anàlisis bioinformàtiques de les dades de la miRNAómica de la resta dels estudis. En conclusió, en aquesta tesi es va proporcionar una caracterització fenotípica i molecular de l'impacte in vitro d'aquestes molècules dietètiques en les respostes immunitàries de bovins, porcins i pollastres. La nutrición desempeña un papel importante en la modulación de la inmunidad de las especies ganaderas. El objetivo de esta tesis es evaluar los efectos de diferentes moléculas dietéticas sobre la inmunidad de mamíferos y aves. Se implementaron análisis funcionales in vitro, y proteómica y miRNAómica para una caracterización integral del impacto de las moléculas en la respuesta inmune de los animales. Específicamente se evaluó el impacto in vitro del ácido linoleico conjugado (CLA) n-6, la pectina cítrica (CP) y los exosomas de leche porcina y los ácidos grasos poliinsaturados (PUFA) n-3 sobre la respuesta inmune de las células mononucleares bovinas, de pollo y porcinas, respectivamente. Primero, se evaluó la actividad in vitro del CLA sobre la apoptosis, quimiotaxis, fagocitosis, capacidad de matar y producción de especies reactivas de oxígeno (ROS) extracelulares de los monocitos bovinos. Se observaron efectos anti-apoptóticos y un aumento de la producción extracelular de ROS durante condiciones pro-inflamatorias experimentales, sólo cuando se utilizó la mezcla de los dos isómeros principales de CLA en proporciones iguales (50:50). Los resultados demostraron que el CLA tiene efectos inmunomoduladores sobre algunas funciones de los monocitos bovinos in vitro y que la mezcla de CLA (50:50) es más eficaz que los isómeros de CLA por separado. El análisis proteómico realizado en células mononucleares de sangre periférica bovina (PBMC) reveló que la mezcla de CLA (50:50) modula el proteoma de las PBMC bovinas, respaldando los efectos anti-apoptóticos e inmunomoduladores observados en el estudio in vitro anterior en monocitos bovinos, y proponiendo un potencial papel cito protector de la mezcla de CLA (50:50) contra el estrés oxidativo. Segundo, se evaluó la actividad in vitro de CP sobre la viabilidad, apoptosis, quimiotaxis y fagocitosis de los monocitos de pollo. El estudio demostró que CP inhibe la quimiotaxis y fagocitosis de los monocitos in vitro, sugiriendo una potencial actividad anti-inflamatoria. El análisis proteómico en PBMC de pollo proporcionó un trasfondo proteómico a la actividad anti-inflamatoria de CP, demostrando que la reducción in vitro de la fagocitosis y quimiotaxis está asociada a cambios en las proteínas relacionadas con el citoesqueleto de actina. Tercero, se evaluó la actividad in vitro de los exosomas de leche porcina sobre la viabilidad, apoptosis, quimiotaxis, fagocitosis, capacidad de matar y producción extracelular de ROS de los monocitos porcinos. Este estudio demostró que los exosomas de leche porcina pueden ser internalizados por monocitos porcinos in vitro y que pueden modular la respuesta inmune de la célula, disminuyendo su quimiotaxis y fagocitosis; y aumentando su producción de ROS en condiciones de reposo y pro-inflamatorias. El análisis proteómico de las PBMC porcinas demostró que los exosomas de leche porcina pueden modular el proteoma de las PBMC porcinas in vitro, enriqueciendo los procesos biológicos relacionados con la inmunidad innata y los procesos de captación de exosomas, respaldando los efectos inmunomoduladores y la internalización de exosomas observados en el estudio in vitro anterior. Cuarto, se evaluó la actividad in vitro de los PUFA n-3, el ácido docosahexaenoico (DHA) y ácido eicosapentaenoico (EPA), sobre la viabilidad, apoptosis, quimiotaxis, fagocitosis y producción de ROS de los monocitos porcinos. Los resultados del estudio mostraron que DHA y EPA pueden ejercer efectos inmunomoduladores diferenciales in vitro en cerdos, al disminuir la quimiotaxis de los monocitos y potenciar su explosión oxidativa intracelular, respectivamente. Por último, se presenta un primer vistazo a los resultados de los análisis bioinformáticos de los datos de la miRNAómica del resto de los estudios. En conclusión, en esta tesis se proporcionó una caracterización fenotípica y molecular del impacto in vitro de estas moléculas dietéticas en las respuestas inmunitarias de bovinos, porcinos y pollos. Nutrition plays an important role in modulating livestock species immunity. This thesis aimed at evaluating the effects of different dietary molecules on mammalian and avian immunity. In vitro functional analyses, and proteomics and miRNAomics were implemented for an integral characterization of the molecules' impact on the animals' immune response. In this thesis the in vitro impact of the n-6 conjugated linoleic acid (CLA), citrus pectin (CP), and porcine milk exosomes and n-3 polyunsaturated fatty acids (PUFA) on bovine, chicken and porcine mononuclear cells immune response was evaluated, respectively. In the first study, the in vitro activity of CLA on bovine monocytes apoptosis and immune activities, including chemotaxis, phagocytosis, killing capability, and extracellular reactive oxygen species (ROS) production was assessed. Anti-apoptotic effects and an increase in extracellular ROS production during experimental pro-inflammatory conditions were observed, only when using the mixture of the two main isomers of CLA in equal proportions (50:50). The results demonstrated for the first time that CLA does have immunomodulatory effects on some functions of bovine monocytes in vitro and that the CLA (50:50) mixture is more effective than the CLA isomers individually. The proteomics analysis performed on bovine peripheral blood mononuclear cells (PBMC) revealed that CLA (50:50) mixture does modulate bovine PBMC proteome, supporting the antiapoptotic and immunomodulatory effects observed in the previous in vitro study on bovine monocytes, and propose a potential cytoprotective role of CLA (50:50) mixture against oxidative stress. In the second study, the in vitro activity of CP on chicken monocytes viability, apoptosis, chemotaxis and phagocytosis was assessed. The study demonstrated for the first time that CP inhibits monocytes' chemotaxis and phagocytosis in vitro, suggesting a potential anti-inflammatory activity. The proteomics analysis on chicken PBMC provided a proteomics background to the anti-inflammatory activity of CP, demonstrating that the in vitro reduction of phagocytosis and chemotaxis is associated with changes in proteins related to the actin cytoskeleton. In the third study, the in vitro activity of porcine milk exosomes on porcine monocytes viability, apoptosis, chemotaxis, phagocytosis, killing capability and extracellular ROS production was assessed. Milk exosomes were purified from sows' milk and characterized using their size, concentration, morphology, and exosome protein markers. This study reported for the first time that porcine milk exosomes can be internalized by porcine monocytes in vitro and that they can modulate the cell's immune response, by decreasing their chemotaxis and phagocytosis; and increasing their ROS production under resting and pro-inflammatory conditions. The proteomics analysis on porcine PBMC demonstrated for the first time that porcine milk exosomes can modulate porcine PBMC proteome in vitro. Moreover, the gene ontology functional analyses revealed that porcine milk exosomes enrich biological processes related to innate immune-related processes and exosome uptake processes, supporting the immunomodulatory effects and the exosome internalization observed in the previous in vitro study. Lastly, the in vitro activity of the n-3 PUFA, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), on porcine monocytes viability, apoptosis, chemotaxis, phagocytosis, and ROS production was assessed. The results of the study showed that DHA and EPA at the highest concentration decreased porcine monocytes' viability. It was also reported for the first time that DHA and EPA can exert differential in vitro immunomodulatory effects in pigs, by dampening monocytes' chemotaxis and potentiating their intracellular oxidative burst, respectively. The proteomics and miRNAomics analyses were not performed for this study. Instead, a first glance on the results from the bioinformatic analyses of the miRNAomics data of all the rest of the studies is presented. In conclusion, a phenotypical and molecular characterization of the in vitro impact of these dietary molecules on bovine, porcine and chicken immune responses was provided.

El rendiment productiu i l'eficiència alimentària són crucials per la sostenibilitat de la producció porcina. El període de creixement-finalització representa més del 65% del cost total de producció, sent el període més costós en la producció porcina. Per tant, petites millores en aquesta etapa resulten en un augment dels guanys pels productors de porcs. En aquesta tesi doctoral, s'han realitzat diversos estudis sobre diferents estratègies nutricionals i de maneig per millorar el rendiment productiu i l'eficiència alimentària en porcs de creixement-finalització. El Capítol 3 va investigar l'efecte del pes viu al naixement i al deslletament en el rendiment productiu dels porcs, i identificar valors de tall per al pes viu al naixement i al deslletament, per tal de reconèixer els porcs de creixement lent en etapes inicials del cicle productiu. Els porcs que van néixer i van ser deslletats petits van tenir un baix rendiment productiu, però la mateixa eficiència alimentària que els altres porcs més pesats. El Capítol 4 va comparar el rendiment dels porcs de creixement lent i ràpid, en base a augmentar els nivells de lisina digestible (SID Lys) / aminoàcids (AA) en dietes isoenergètiques. L'eficiència alimentària dels porcs de creixement lent, va millorar quan es van augmentar els nivells de SID Lys/AA de 0,92 a 1,45%, però no va millora la dels porcs de creixement ràpid. Els requeriments dels nutrients poden variar segons la velocitat de creixement a la mateixa edat, i els porcs de creixement lent poden requerir de nivells més alts de SID AA en la dieta per poder aconseguir una millora en el rendiment productiu. El Capítol 5 va investigar l'efecte de la densitat per corral (DC) i la barreja sobre el rendiment productiu i les lesions corporals, en corrals de 10 a 14 porcs amb una menjadora amb un sistema d'alimentació humit-sec i un sol espai. Barrejar els porcs va tenir un efecte en el rendiment productiu, mentre que la DC no el va afectar. L'alt número de lesions corporals en les DC inferiors va indicar que una DC igual o inferior a 0,78 m2/porc és perjudicial per al benestar dels porcs, malgrat seguir la legislació de la UE. El Capítol 6 va estudiar l'efecte de la DC, la barreja i l'alimentació per fases (AF) en el rendiment productiu de porcs allotjats en el mateix tipus de corral que en el Capítol 5. Barrejar i reduir la relació SID Lys/Energia Neta de 0,95 a 0,82 g/MJ a les 15-16 setmanes d'edat, té un impacte més marcat en el rendiment productiu que una reducció de la DC de 0,96 a 0,78 m2/porc. El Capítol 7 va investigar els perfils metabòlits sanguinis, i els dels àcids grassos volàtils (AGV) fecals, per avaluar ineficiències alimentàries segons el contingut de proteïna, AA i energia de la dieta en porcs de creixement i finalització. Els canvis en la dieta i l'edat dels porcs va afectar els perfils d'AGV fecals i dels metabòlits sanguinis. El nitrogen ureic sèric és el millor indicador relacionat amb l'eficiència proteica, el qual augmenta quan els porcs en creixement i finalització són alimentats amb dietes altes en proteïna no balancejades per AA. També, els àcids grassos de cadena ramificada van augmentar en els porcs en creixement alimentats amb dietes altes en proteïna, però no va demostrar la mateixa consistència que el nitrogen ureic sèric. El Capítol 8 va avaluar l'ús de l'espectroscòpia d'infraroig proper (NIRS) per predir els components químics de les femtes i els coeficients de digestibilitat total aparent dels nutrients, en la granja. Els resultats obtinguts van ser similars utilitzant femtes liofilitzades, però sense moldre, fet que facilita l'ús del NIRS. El rendimiento productivo y la eficiencia alimenticia son cruciales para la sostenibilidad de la producción porcina. El período de crecimiento-finalización representa más del 65% del coste total de producción, siendo el período más costoso en la producción porcina. Por lo tanto, pequeñas mejoras en esta etapa resultan en un aumento de las ganancias de los productores de cerdos. En la presente tesis doctoral, se han realizado varios estudios sobre diferentes estrategias nutricionales y de manejo para mejorar el rendimiento productivo y la eficiencia alimenticia en cerdos de crecimiento y finalización. El Capítulo 3 investigó el efecto del peso vivo al nacimiento y al destete en el rendimiento productivo de los cerdos, e identificó valores de corte para el peso vivo al nacer y al destete con tal de reconocer los cerdos de crecimiento lento en etapas tempranas del ciclo productivo. Los cerdos que nacieron y fueron destetados pequeños mostraron un bajo rendimiento productivo, pero tuvieron la misma eficiencia alimenticia que los otros cerdos más pesados. El Capítulo 4 comparó el rendimiento de los cerdos de crecimiento lento y rápido, en base a aumentar los niveles de lisina digestible (SID Lys) / aminoácidos (AA) en dietas isoenergéticas. La eficiencia alimenticia de los cerdos de crecimiento lento mejoró aumentado los niveles de SID Lys/AA de 0,92 a 1,45%, pero no mejoró en los cerdos de crecimiento rápido. Los requerimientos de nutrientes pueden variar dependiendo de la velocidad de crecimiento a la misma edad, y los cerdos de crecimiento lento pueden requerir niveles más altos de SID AA en la dieta para mejorar su desempeño productivo. El Capítulo 5 investigó el efecto de la densidad por corral (DC) y la mezcla sobre el rendimiento productivo y las lesiones corporales, en corrales de 10-14 cerdos con un comedero húmedo-seco de un solo espacio. La mezcla de cerdos tuvo un efecto considerable en el rendimiento productivo, mientras que la DC no lo afectó. Sin embargo, el alto número de lesiones corporales en DC inferiores indicó que una DC igual o inferior a 0,78 m2/cerdo es perjudicial para el bienestar de los cerdos, a pesar de seguir la legislación de la UE. El Capítulo 6 estudió el efecto de la DC, la mezcla y la alimentación por fases (AF) sobre el rendimiento productivo en corrales de 10-14 cerdos con un solo espacio de comedero húmedo-seco. Mezclar y reducir la relación SID Lys/Energía Neta de 0,95 a 0,82 g/MJ a las 15-16 semanas de edad, tiene un impacto más marcado en el rendimiento productivo que una reducción de la DC de 0,96 a 0,78 m2/cerdo. El Capítulo 7 investigó los perfiles de los metabolitos sanguíneos y de los ácidos grasos volátiles (AGV) fecales, para evaluar ineficiencias alimenticias en base a cambios en el contenido de energía, proteína y AA de la dieta en cerdos. Los cambios en la dieta y la edad de los cerdos afectaron los perfiles de AGV fecales y de metabolitos sanguíneos. El nitrógeno ureico sérico es el mejor indicador relacionado con la eficiencia proteica que aumenta en cerdos en crecimiento y finalización cuando son alimentados mediante dietas con niveles altos en proteína y no balanceadas en AA. Los ácidos grasos de cadena ramificada aumentaron en los cerdos en crecimiento alimentados con dietas altas en proteína, pero sin demostraron la misma consistencia. El Capítulo 8 evaluó el uso de la espectroscopia de infrarrojo cercano (NIRS) para predecir los componentes químicos de las heces y los coeficientes de digestibilidad total aparente de los nutrientes en granja. Los resultados obtenidos fueron similares utilizando heces liofilizadas, pero sin moler, facilitando el uso del NIRS. Productive performance and feed efficiency are crucial for sustainability in pig production. The grower-finisher period accounts for over 65% of the total cost of production and it is the most expensive period in pig production. Thus, minor improvements in this stage result in important increases in profit for farmers. In the current thesis, several studies were conducted to improve our knowledge on different management and nutritional strategies to improve the productive performance and feed efficiency in grower-finisher pigs. Slow growing pigs within a batch may be one of the most important factors affecting pig production and they cause increases in body weight (BW) variability within the batch of pigs. In Chapter 3, we investigated the effect of birth and weaning BW on key performance indicators of grower-finisher pigs, and determined the cut-off values for birth and weaning BW to identify slow growing pigs early in life. Pigs born and weaned small showed a poor productive performance up to slaughter, but were as feed efficient as their heavier counterparts. Chapter 4 compared the response in performance of slow and fast growing pigs to an increase of dietary standardized ileal digestible (SID) lysine (Lys) / amino acid (AA) levels in isoenergetic diets. Slow growing pigs' feed efficiency was improved when dietary SID AA levels were increased from 0.92 up to 1.45% SID Lys/AA. The latter was not observed in fast growing pigs. Nutrient requirements may vary depending on growth rate at the same age, and slow growing pigs may require higher dietary SID AA levels than fast growing pigs to present a better productive performance. Chapters 5 and 6 focused on common management strategies, such as space allowance (SA), mixing and phase feeding (PF), to understand and optimize the productive performance and feed efficiency of the whole batch. Chapter 5 investigated the effect of SA and mixing on productive performance and body lesions in grower-finisher pigs, housed in pens of 10-14 pigs with a single space wet-dry feeder. Mixing appeared to have considerable effect on growth performance, while SA did not affect performance. Nevertheless, high number of body lesions in the lower SA indicated that SA equal or below 0.78 m2/pig are detrimental to the welfare of pigs despite following the EU legislation. Chapter 6 studied the effect of SA, mixing and PF on productive performance in grower-finisher pigs, housed in pens of 10-14 pigs with a single space wet-dry feeder. Mixing and reducing SID Lys:Net Energy ratio from 0.95 to 0.82 g/MJ at 15-16 weeks of age, have a more marked impact on productive performance than a reduction in SA from 0.96 to 0.78 m2/pig. Chapter 7 and 8 studied fast analysis methods to assess feed efficiency at farm level to optimise diet formulation and productive performance of grower-finisher pigs. Chapter 7 studied blood serum metabolite and faecal volatile fatty acid (VFA) profiles to assess feed inefficiencies in protein, AA and energy dietary content. Dietary changes and the pigs' age affected both blood metabolite and faecal VFA profiles. The main findings from this chapter were that serum urea nitrogen is the best indicator related to protein efficiency, increasing in growing and finishing pigs fed high protein diets with unbalances in AA profiles. Branched-chain fatty acids also increased in growing pigs fed high protein diets, but did not show the same consistency as urea. Chapter 8 evaluated the potential use of near infrared reflectance spectroscopy (NIRS) to predict faeces chemical components and apparent total tract digestibility (ATTD) coefficients of nutrients at farm level. The results obtained were similar using freeze-dried faeces but without grounding them, which facilitates NIRS applicability.

Introducción: La incidencia de cáncer de mama se ha convertido en el cáncer femenino más diagnosticado en España en los últimos años. Uno de sus pilares, la alimentación, ejerce una asociación directa con el aumento de riesgo de este tumor. Objetivos: En el ámbito de la nutrición aún existe controversia sobre si un patrón dietético adecuado es capaz de prevenir el cáncer de mama. El objetivo de este trabajo es valorar el nivel de evidencia científica que existe sobre la relación casual entre grupos determinados de alimentos y el riesgo de cáncer de mama. Metodología: Para poder llevar a cabo la investigación, se ha realizado una revisión sistemática de artículos científicos consultando la base de datos PudMed que se hayan publicado entre 2016 y 2021, ambos inclusive. Siguiendo las directrices de la declaración PRISMA 2020. Se han revisado los abstracts y en los casos necesarios los artículos completos, teniendo en cuenta finalmente todos los artículos que cumplían con los criterios de inclusión, encontrando un total de 18 artículos. Resultados/conclusiones: La mayoría de los resultados señalan consistentemente que, el consumo de determinado grupos de alimentos y la realización de ejercicio físico interfieren en la aparición del riesgo de cáncer de mama. En el caso de ciertos nutrientes no queda claro la relación directa sobre la prevención, lo que sí parece evidente es que, llevar un estilo de vida saludable mejora la prevención, el pronóstico y la morbilidad de este tumor. Introduction: The incidence of breast cancer has become the most diagnosed female cancer in Spain in recent years. One of its pillars, nutrition, has a direct association with the increased risk of this tumor. Objectives: In the field of nutrition there is still controversy as to whether an adequate dietary pattern is capable of preventing breast cancer. The aim of this study is to assess the level of scientific evidence on the casual relationship between certain food groups and breast cancer risk. Methodology: In order to carry out the research, a systematic review of scientific articles has been performed by consulting the PudMed database that have been published between 2016 and 2021, inclusive. Following the guidelines of the PRISMA 2020 statement. Abstracts and where necessary full articles have been reviewed, finally taking into account all articles that met the inclusion criteria, finding a total of 18 articles. Results/conclusions: Most of the results consistently point out that, the consumption of certain food groups and the performance of physical exercise interfere in the occurrence of breast cancer risk. In the case of certain nutrients, the direct relationship on prevention is not clear, but what does seem evident is that a healthy lifestyle improves the prevention, prognosis and morbidity of this tumor. Introducció: La incidència de càncer de mama s'ha convertit en el càncer femení més diagnosticat a Espanya en els últims anys. Un dels seus pilars, l'alimentació, exerceix una associació directa amb l'augment de risc d'aquest tumor. Objectius: En l'àmbit de la nutrició encara existeix controvèrsia sobre si un patró dietètic adequat és capaç de prevenir el càncer de mama. L'objectiu d'aquest treball és valorar el nivell d'evidència científica que existeix sobre la relació casual entre grups determinats d'aliments i el risc de càncer de mama. Metodologia: Per a poder dur a terme la recerca, s'ha realitzat una revisió sistemàtica d'articles científics consultant la base de dades PudMed que s'hagin publicat entre 2016 i 2021, tots dos inclusivament. Seguint les directrius de la declaració PRISMA 2020. S'han revisat els abstracts i en els casos necessaris els articles complets, tenint en compte finalment tots els articles que complien amb els criteris d'inclusió, trobant un total de 18 articles. Resultats/conclusions: La majoria dels resultats assenyalen consistentment que, el consum de determinat grups d'aliments i la realització d'exercici físic interfereixen en l'aparició del risc de càncer de mama. En el cas d'uns certs nutrients no queda clar la relació directa sobre la prevenció, la qual cosa sí que sembla evident és que, portar un estil de vida saludable millora la prevenció, el pronòstic i la morbiditat d'aquest tumor.