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Excess weight (EW) in children has become a severe public health problem. The present study aimed to describe the main lifestyle characteristics and their possible association with nutritional status in a group of schoolchildren enrolled in the GENYAL study, where 221 children in the first or second grade of primary education (6-9 years old) were included. Anthropometric (BMI and bioimpedance), dietary intake (twice-repeated 24 h food record), and physical activity (twice-repeated 24 h physical activity questionnaire) data were collected. Logistic and linear regressions, with p -values adjusted for multiple tests by Bonferroni's method and with sex and age as covariates, were applied. The prevalence of EW was 19%, 25.4%, and 32.2%, according to Orbegozo Foundation, IOFT, and WHO criteria, respectively. The results showed a significant association between schoolchildren's nutritional status and energy balance, defined as the ratio of estimated energy intake to estimated energy expenditure (%), (β = -1.49 (-1.9-1.07), p < 0.01) and KIDMED Mediterranean Diet Quality Index score (β = -0.19 (95% IC -0.38-0), p = 0.04), and between the availability of TV or other technological devices in their room and the child's BMI (β = 1.15 (95% IC 0.20-2.10), p = 0.017) and their fat mass (β = 3.28 (95% IC 0.69-5.87), p = 0.013). The number of dairy servings/day had a protective effect against EW (OR = 0.48 (0.29-0.75), p adjusted = 0.05)). Studying lifestyle factors associated with obesity is essential for developing tools and strategies for obesity prevention in children.

Background: Overweight and obesity are defined by an anomalous or excessive fat accumulation that may compromise health. To find single-nucleotide polymorphisms (SNPs) influencing metabolic phenotypes associated with the obesity state, we analyze multiple anthropometric and clinical parameters in a cohort of 790 healthy volunteers and study potential associations with 48 manually curated SNPs, in metabolic genes functionally associated with the mechanistic target of rapamycin (mTOR) pathway., Results: We identify and validate rs2291007 within a conserved region in the 3'UTR of folliculin-interacting protein FNIP2 that correlates with multiple leanness parameters. The T-to-C variant represents the major allele in Europeans and disrupts an ancestral target sequence of the miRNA miR-181b-5p, thus resulting in increased FNIP2 mRNA levels in cancer cell lines and in peripheral blood from carriers of the C allele. Because the miRNA binding site is conserved across vertebrates, we engineered the T-to-C substitution in the endogenous Fnip2 allele in mice. Primary cells derived from Fnip2 C/C mice show increased mRNA stability, and more importantly, Fnip2 C/C mice replicate the decreased adiposity and increased leanness observed in human volunteers. Finally, expression levels of FNIP2 in both human samples and mice negatively associate with leanness parameters, and moreover, are the most important contributor in a multifactorial model of body mass index prediction., Conclusions: We propose that rs2291007 influences human leanness through an evolutionarily conserved modulation of FNIP2 mRNA levels., (© 2022. The Author(s).)

Background: Diet quality patterns are associated with a lower incidence of insulin resistance (IR) in adults. The aim of this study was to investigate the association between two diet quality indices and IR in schoolchildren and to identify the best diet quality index associated with a lower risk of IR. Methods: A total of 854 schoolchildren (8−13 years) were included in a cross-sectional study, who completed a three-day dietary record to assess their diet. Fasting plasma glucose and insulin were also measured, and anthropometric data were collected. Healthy Eating Index-2015 (HEI-2015), Dietary Approaches to Stop Hypertension (DASH), and adjusted DASH (aDASH) were calculated as diet quality indices. The homeostasis model assessment of insulin resistance (HOMA-IR) was used, and IR was defined as HOMA-IR > 3.16. Results: The prevalence of IR was 5.5%, and it was higher in girls. The mean HEI-2015 and DASH scores were 59.3 and 23.4, respectively, and boys scored lower in both indices. In girls, having a HEI-2015 score above the 33rd percentile was associated with a lower risk of IR (odds ratio [95% CI]: 0.43 [0.19−0.96], p = 0.020). Conclusion: Greater adherence to a healthy dietary pattern, as assessed by a higher HEI-2015 score, was associated with a lower risk of IR in schoolchildren, especially in girls., Competing Interests: Authors declare no conflict of interest.

Fasting exerts beneficial effects in mice and humans, including protection from chemotherapy toxicity. To explore the involved mechanisms, we collect blood from humans and mice before and after 36 or 24 hours of fasting, respectively, and measure lipid composition of erythrocyte membranes, circulating micro RNAs (miRNAs), and RNA expression at peripheral blood mononuclear cells (PBMCs). Fasting coordinately affects the proportion of polyunsaturated versus saturated and monounsaturated fatty acids at the erythrocyte membrane; and reduces the expression of insulin signaling-related genes in PBMCs. When fasted for 24 hours before and 24 hours after administration of oxaliplatin or doxorubicin, mice show a strong protection from toxicity in several tissues. Erythrocyte membrane lipids and PBMC gene expression define two separate groups of individuals that accurately predict a differential protection from chemotherapy toxicity, with important clinical implications. Our results reveal a mechanism of fasting associated with lipid homeostasis, and provide biomarkers of fasting to predict fasting-mediated protection from chemotherapy toxicity., (© 2022. The Author(s).)

Dysbiosis of the microbiome has been related to Celiac disease (CeD) progress, an autoimmune disease characterized by gluten intolerance developed in genetically susceptible individuals under certain environmental factors. The microbiome contributes to CeD pathophysiology, modulating the immune response by the action of short-chain fatty acids (SCFA), affecting gut barrier integrity allowing the entrance of gluten-derived proteins, and degrading immunogenic peptides of gluten through endoprolyl peptidase enzymes. Despite the evidence suggesting the implication of gut microbiome over CeD pathogenesis, there is no consensus about the specific microbial changes observed in this pathology. Here, we compiled the largest dataset of 16S prokaryotic ribosomal RNA gene high-throughput sequencing for consensus profiling. We present for the first time an integrative analysis of metataxonomic data from patients with CeD, including samples from different body sites (saliva, pharynx, duodenum, and stool). We found the presence of coordinated changes through the gastrointestinal tract (GIT) characterized by an increase in Actinobacteria species in the upper GIT (pharynx and duodenum) and an increase in Proteobacteria in the lower GIT (duodenum and stool), as well as site-specific changes evidencing a dysbiosis in patients with CeD' microbiota. Moreover, we described the effect of adherence to a gluten-free diet (GFD) evidenced by an increase in beneficial bacteria and a decrease in some Betaproteobacteriales but not fully restoring CeD-related dysbiosis. Finally, we built a Random Forest model to classify patients based on the lower GIT composition achieving good performance., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Arcila-Galvis, Loria-Kohen, Ramírez de Molina, Carrillo de Santa Pau and Marcos-Zambrano.)

Introduction: European Union represents a tenth of the world population, however, it has a quarter of the cancer cases in the world. Without strong action, it is estimated that by 2035 cancer cases will increase by almost 25 %, making this disease the main cause of death. Therefore, the aim of this study is to know the diet and lifestyle guidelines associated to cancer prevention. A literature review has been carried out on the diet and lifestyle guidelines related to a reduction in cancer risk. Strategies to reduce cancer risk include maintaining a healthy weight, being physically active, consuming a diet rich in whole grains, fruits, non-starchy vegetables, and legumes, limit processed and fast food, limit consumption of red meat and eat little, if any, processed meats, drink mostly water and limit the consumption of sugar sweetened drinks, finally reduce, or do not consume alcohol. Prevention is an effective tool to reduce cancer risk. Adequate diet and healthy lifestyle habits can reduce cancer risk as well as other non-communicable diseases and can even have environmental benefits.

Introduction: The gut microbiota has emerged as a key factor on one hand as a mediator of the effects of diet on health and, on the other hand, as a source of intervariability of response to a diet. Moreover, there is a strong bidirectional interaction between our health and the microbiota that inhabit us, with each determining the presence of the other. In this review are named some of the metabolic functions in which the microbiota participates and which have an impact on our health, with particular emphasis on its ability to ferment fiber and produce short-chain fatty acids (SCFA) that provide numerous benefits to our health, but which have also been linked to obesity. Finally, some examples of dietary intervention in which the microbiota has been shown to play a key role in the results obtained are mentioned.

Introduction: Vitamin D is a key nutrient for health. Recent research has shown that it is not only necessary for the maintenance of bone health, but also for the prevention of cardiovascular diseases, insulin resistance, respiratory diseases, infections, and cancer, among others. Solar synthesis of vitamin D is usually insufficient, so it is necessary to provide enough vitamin D through the diet in order to maintain an adequate nutritional status. Studies carried out in Spain and other countries have shown that serum levels of the vitamin were usually insufficient and that average dietary intakes were well below those marked as recommended, while the main food sources of vitamin D were fatty fish, breakfast cereals, eggs, and dairy. Food sources of vitamin D are scarce, and it is naturally located in the fatty part of foods of animal origin, and in the liver and viscera. Fortifying foods that are not natural food sources of vitamin D but are regularly consumed by a significant percentage of the population, is a strategy that could help to increase vitamin D intake. In this regard, dairy products and breakfast cereals are two of the most widely used food matrices for vitamin D fortification, and their incorporation into the usual diet has proven to be an effective strategy to improve the nutritional situation of the population in vitamin D.

Introduction: The consumption of high nutritional quality foods is a key for proper growth and development during childhood. This work aimed to review and analyse the current recommended egg intake in children by different national organisations. Likewise, it intended to standardise a procedure to propose new recommendations for this food. A search of available national online guidelines or recommendations was performed. The Healthy Eating Guide of the Spanish Society of Community Nutrition (SENC), 2018 and the energy requirements of the European Food Safety Authority (2017) for children and adolescents were contemplated, considering a contribution of 15 % of energy as proteins to propose the new recommended egg intake. Two scenarios according to the level of physical activity and three age groups were considered. Based on the current data and evidence, we believe that egg intake recommendations should be reassessed, proposing broader recommendations, especially for children over 13 years old with average energy requirements as well as children over seven years old who perform high physical activity or are in a brief period of growth. It will contribute to breaking down old myths associated with egg consumption and promote the development of coordinated and updated recommendations.

Introduction: In recent decades, there has been an increasing interest in vegetarian diets. It is therefore interesting to analyse the benefits and risks of these diets. To this end, a review has been done on the benefits and risks of vegetarian diets. Vegetarian diets have been associated with different health benefits. On the contrary, nutritional deficiencies has been observed in those people who follow this type of diet, mainly in those risk groups such as pregnant and lactating women, children, adolescents, and elderly. Vegetarian diets may have some health benefits, however further studies are required.

Objective: This article describes the methodology and summarizes some preliminary results of the GENYAL study aiming to design and validate a predictive model, considering both environmental and genetic factors, that identifies children who would benefit most from actions aimed at reducing the risk of obesity and its complications., Design: The study is a cluster randomized clinical trial with 5-year follow-up. The initial evaluation was carried out in 2017. The schools were randomly split into intervention (nutritional education) and control schools. Anthropometric measurements, social and health as well as dietary and physical activity data of schoolchildren and their families are annually collected. A total of 26 single nucleotide polymorphisms (SNPs) were assessed. Machine Learning models are being designed to predict obesity phenotypes after the 5-year follow-up., Settings: Six schools in Madrid., Participants: A total of 221 schoolchildren (6-8 years old)., Results: Collected results show that the prevalence of excess weight was 19.0, 25.4, and 32.2% (according to World Health Organization, International Obesity Task Force and Orbegozo Foundation criteria, respectively). Associations between the nutritional state of children with mother BMI [β = 0.21 (0.13-0.3), p (adjusted) <0.001], geographical location of the school [OR = 2.74 (1.24-6.22), p (adjusted) = 0.06], dairy servings per day [OR = 0.48 (0.29-0.75), p (adjusted) = 0.05] and 8 SNPs [rs1260326, rs780094, rs10913469, rs328, rs7647305, rs3101336, rs2568958, rs925946; p (not adjusted) <0.05] were found., Conclusions: These baseline data support the evidence that environmental and genetic factors play a role in the development of childhood obesity. After 5-year follow-up, the GENYAL study pretends to validate the predictive model as a new strategy to fight against obesity., Clinical Trial Registration: This study has been registered in ClinicalTrials.gov with the identifier NCT03419520, https://clinicaltrials.gov/ct2/show/NCT03419520., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Marcos-Pasero, Aguilar-Aguilar, de la Iglesia, Espinosa-Salinas, Molina, Colmenarejo, Martínez, Ramírez de Molina, Reglero and Loria-Kohen.)

Introduction: Childhood obesity is an important public health problem, also in Spain. The ALADINO study, in the context of the COSI strategy of the WHO European office, monitors the weight status of Spanish schoolchildren aged 6 to 9 years, and analyzes the associated factors. Data from the 2019 wave indicate that 23.3 % of schoolchildren are overweight, and 17.3 % are obese. A high percentage of schoolchildren eat breakfast regularly, although breakfast quality can be improved. The frequency of consumption of fruits and vegetables is low, even lower than that of other countries participating in the COSI strategy. In terms of lifestyle, more than 70 % of schoolchildren are active, although this percentage is lower than the European average. Screen exposure time is also shorter than in other countries, but this habit may be improved in a high percentage of schoolchildren. There is a lower percentage of schoolchildren with obesity who have breakfast or are active compared to those of normal weight, while they are more sedentary, spend fewer hours sleeping, and are more likely to have a TV or electronic devices in their room. It is a priority to promote access to healthier diets and the promotion of more active and less sedentary lifestyles, both in the family and at school, from an early age.

Introduction: The immune system is a complex and integrated system whose main function is to protect the body from external aggression by microorganisms, allergens, or toxic agents. Different studies show that maintaining optimal amounts of different nutrients in the body is essential to ensure the synthesis of different factors related to the immune system. Most interesting nutrients and bioactive compounds include: vitamins A, B6, B12, C, D, E, folic acid (B9) and biotin (B7); minerals such as zinc, iron, selenium, magnesium and copper; proteins (lactoferrin) and bioactive peptides; omega-3 fatty acids; and other nutrients and bioactive compounds such as fiber, polyphenols, carotenoids, probiotics, etc. Following a varied and balanced diet, including the servings recommended by food guides for each food group, is essential to achieve nutrient requirements. Food groups to which special attention should be paid are: fruits and vegetables (because of their high content in micronutrients and antioxidant compounds), fatty fish (because it contains omega-3 fatty acids), and dairy products (because this group contains a large number of nutrients). In particular, milk-especially enriched milk-contains many of the nutrients mentioned above. Moreover, their daily consumption, within a balanced diet, can help significantly cover their nutrient reference values. Finally, it is important to consider kind of milks as a good dietary alternative to increase the intake of some important nutrients for the proper functioning of the immune system, most especially some of them such as vitamin D, since a large percentage of the population have nutritional deficiencies.

Introduction: Nutrition education (NE), as part of the treatment of eating disorders (EDs), plays a crucial role in helping patients to change their food attitudes and routines, lose fears, and recover a healthy eating pattern. All these changes may contribute to improving their nutritional status. However, there is a lack of consensus and standardization concerning the procedures to teach it. This work's objective was to elaborate a consensual protocol for NE implementation in the treatment of EDs to help in decision-making regarding which patients are appropriate candidates to receive NE, the agents (family, school community) and professionals involved, and the areas in the healthcare system that are best suited for implementation. Moreover, it would help in selecting the the topics to be imparted, and in following up treatment progression.

The increased prevalence of childhood obesity is expected to translate in the near future into a concomitant soaring of multiple cardio-metabolic diseases. Obesity has a complex, multifactorial etiology, that includes multiple and multidomain potential risk factors: genetics, dietary and physical activity habits, socio-economic environment, lifestyle, etc. In addition, all these factors are expected to exert their influence through a specific and especially convoluted way during childhood, given the fast growth along this period. Machine Learning methods are the appropriate tools to model this complexity, given their ability to cope with high-dimensional, non-linear data. Here, we have analyzed by Machine Learning a sample of 221 children (6-9 years) from Madrid, Spain. Both Random Forest and Gradient Boosting Machine models have been derived to predict the body mass index from a wide set of 190 multidomain variables (including age, sex, genetic polymorphisms, lifestyle, socio-economic, diet, exercise, and gestation ones). A consensus relative importance of the predictors has been estimated through variable importance measures, implemented robustly through an iterative process that included permutation and multiple imputation. We expect this analysis will help to shed light on the most important variables associated to childhood obesity, in order to choose better treatments for its prevention.

The scarcity of the results obtained for the treatment of obesity leads us to consider new strategies, contemplating all the factors involved in the development of the disease. One of the key molecules for controlling body weight and energy homeostasis is the brain-derived neurotrophic factor (BDNF). This work summarizes the mechanisms in which BDNF gene regulates this multifactorial disease. In addition, we discuss the role of other BDNF polymorphisms as genetic determinants of obesity. In this context, a total of 14 SNPs near or inside BDNF/BDNF-AS related to BMI were identified in various GWASs. Finally, we assess gene-diet interaction as a novel tool to prevent obesity and formulate solid and personalized nutritional management. Our research group has performed the first study on the association of BDNF-AS rs925946 polymorphism and calcium intake as potential modulators of the nutritional status. Although these results should be confirmed in future studies, they open the path for new prevention opportunities., (© 2021. The Author(s), under exclusive license to Springer Nature Switzerland AG.)

Fibromyalgia (FM), chronic fatigue syndrome (CFS) and multiple chemical sensitivity (MCS) are some of the central sensitization syndromes (CSSs). The complexity of their diagnosis, the high interindividual heterogeneity and the existence of multi-syndromic patients requires a multifaceted treatment. The scientific literature is contradictory regarding the role of food in CSS, and evidence on the role of nutrition in MCS is particularly scarce. This review consists in gathering information about the current status of dietary recommendations (i.e., special dietary interventions, the role of additives, presence of micronutrient deficiencies, nutritional supplements and elimination of other nutrients and substances) and discussing the scientific evidence in depth to shed light on appropriate nutritional treatment managements for CSS patients. Current indications show that dietary modifications may vastly improve the patients' quality of life at a low cost. We suggest personalized treatment, taking into consideration the severity of the disease symptoms, quality of life, coexistence with other diseases, pharmacological treatment, changing clinical characteristics, nutritional status, energy requirements and food tolerances, among others, as the best ways to tailor specific dietary interventions. These approaches will partially overcome the lack of scientific and clinical research on MSC. Patients should also be advised on the serious consequences of following dietary guidelines without a dietitian's and clinician's supervision.

Sport performance is influenced by several factors, including genetic susceptibility. In the past years, specific single nucleotide polymorphisms have been associated to sport performance; however, these effects should be considered in multivariable prediction systems since they are related to a polygenic inheritance. The aim of this study was to design a genetic endurance prediction score (GES) of endurance performance and analyze its association with anthropometric, nutritional and sport efficiency variables in a cross-sectional study within fifteen male cyclists. A statistically significant positive relationship between GES and the VO 2 maximum ( P = 0.033), VO 2 VT1 ( P = 0.049) and VO 2 VT2 ( P < 0.001) was observed. Moreover, additional remarkable associations between genotype and the anthropometric, nutritional and sport performance variables, were achieved. In addition, an interesting link between the habit of consuming caffeinated beverages and the GES was observed. The outcomes of the present study indicate a potential use of this genetic prediction algorithm in the sports' field, which may facilitate the finding of genetically talented athletes, improve their training and food habits, as well as help in the improvement of physical conditions of amateurs., (Copyright © 2020 de la Iglesia, Espinosa-Salinas, Lopez-Silvarrey, Ramos-Alvarez, Segovia, Colmenarejo, Borregon-Rivilla, Marcos-Pasero, Aguilar-Aguilar, Loria-Kohen, Reglero and Ramirez-de Molina.)

Chronobiological aspects controlled by CLOCK genes may influence obesity incidence. Although there are studies that show an association between the expression of these genes and energy intake, waist circumference or abdominal obesity phenotypes, interactions with appetite have been insufficiently investigated in relation to chrononutrition. The objective was to identify interactions between CLOCK genetic variants involved in appetite status. A total of 442 subjects (329 women, 113 men; aged 18 to 65 years) were recruited. Anthropometric, dietary and lifestyle data were collected by trained nutritionists. Participants were classified according to their appetite feelings with a Likert scale. Multiple linear regression models were used to examine associations of the type genotype x appetite status on adiposity-related variables. p values were corrected by the Bonferroni method. A significant influence was found concerning the effects of appetite on waist circumference with respect to rs3749474 CLOCK polymorphism ( p < 0.001). An additive model analysis (adjusted by age, gender, exercise and energy intake) showed that risk allele carriers, increased the waist circumference around 14 cm ( β = 14.1, CI = 6.3-22.0) by each increment in the level of appetite. The effects of appetite on waist circumference may be partly modulated by the rs3749474 CLOCK polymorphism.

(1) Background: Childhood rapid weight gain during development has been postulated as a predictor of obesity. The objective of this study was to investigate the effect of single nucleotide polymorphisms (SNPs) on the annual weight gain and height growth, as well as identifying possible lifestyle factors involved. (2) Methods: As part of the GENYAL study, 221 children (6-8 years old) of Madrid (Spain) were enrolled. A total of 11 SNPs associated with high childhood body mass indexes (BMIs) were assessed. Anthropometric measurements, dietary and physical activity data, were collected in 2017 and 2018. Bonferroni-corrected linear models were used to fit the data. (3) Results: A significant association between the Q223R LEPR and the weight growth was found, showing a different behavior between GA and GG genotypes ( p = 0.001). Regarding lifestyle factors, an interaction between Q223R genotypes and total active weekly hours/week to predict the weight growth (kg/year) was observed ( p = 0.023). In all the genotypes, a beneficial effect against rapid weight growth was observed, but the effect size of the interaction was much more significant in homozygous (GG) minor homozygous (β = -0.61 (-0.95, -0.26) versus heterozygous (AG) and wild-type homozygous (AA) genotypes (β = -0.07 (-0.24, 0.09) and β = -0.12 (-0.32, 0.08), respectively). (4) Conclusions: These results may contribute to more personalized recommendations to prevent childhood obesity., Competing Interests: The authors declare no conflicts of interest.

The aim of this study was to evaluate the distribution of energy intake and macronutrients consumption throughout the day, and how its effect on nutritional status can be modulated by the presence of the rs3749474 polymorphism of the CLOCK gene in the Cantoblanco Platform for Nutritional Genomics ("GENYAL Platform"). This cross-sectional study was carried out on 898 volunteers between 18 and 69 years old (65.5% women). Anthropometric measurements, social issues and health, dietary, biochemical, genetic, and physical activity data were collected. Subsequently, 21 statistical interaction models were designed to predict the body mass index (BMI) considering seven dietary variables analyzed by three genetic models (adjusted by age, sex, and physical activity). The average BMI was 26.9 ± 4.65 kg/m 2 , 62.14% presented an excess weight (BMI > 25 kg/m 2 ). A significant interaction was observed between the presence of the rs3749474 polymorphism and the evening carbohydrate intake (% of the total daily energy intake [%TEI]) (adjusted p = 0.046), when predicting the BMI. Participants carrying TT/CT genotype showed a positive association between the evening carbohydrate intake (%TEI) and BMI (β = 0.3379, 95% CI = (0.1689,0.5080)) and (β = 0.1529, 95% CI = (-0.0164,0.3227)), respectively, whereas the wild type allele (CC) showed a negative association (β = -0.0321, 95% CI = (-0.1505,0.0862)). No significant interaction with the remaining model variables was identified. New dietary strategies may be implemented to schedule the circadian distribution of macronutrients according to the genotype. Clinical Trial number: NCT04067921.

Background & Aims: Calcium and dairy products have multiple health benefits. The objective of this work was to evaluate the association between calcium/dairy intake, blood pressure, the BDNF-AS rs925946 polymorphism and nutritional status in a group of schoolchildren., Methods: As part of the GENYAL study to childhood obesity prevention, 221 children belonging to different areas of the Community of Madrid were enrolled. Anthropometric and dietary data were collected, and children were genotyped according to the rs925946 polymorphism. Adjusted logistic and linear models were used to describe the data., Results: A significantly lower consumption of calcium in overweight versus normal weight children was observed (811.0 ± 174.1; 859.0 ± 195.9; 954.0 ± 223.1 mg; for obesity, overweight and normal weight, respectively, p = 0.010). Moreover, an inverse association between blood pressures and calcium intake was detected (β = -0.006 (-0.011, -3e -4 )), p = 0.040. The number of dairy servings/day showed a protective effect against overweight (OR = 0.48 (0.29, 0.75), p = 0.001). Finally, common homozygous children (GG) showed an inverse association between the calcium intake and the BMI (β = -0.003 (-0.006, -0.001), p = 0.004), which was not observed in children carrying the T allele (β = -1.3e -4 (-0.0022, 0.0024), p = 0.93)., Conclusion: Calcium and dairy were strongly associated with the nutritional status and blood pressure. The identification of differential effects of calcium/dairy consumption on the nutritional status according to genetics may contribute to the personalization of future nutritional advice., Trial Registration: This study is registered at www.clinicaltrials.govNCT03419520., (Copyright © 2018 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

Bioactive supplements display relevant therapeutic properties when properly applied according to validated molecular effects. Our previous research efforts established the basis to develop a dietary supplement based on a Rosmarinus officinalis supercritical extract. This was enriched in phenolic diterpenes (RE) with proven properties against signaling pathways involved in colon tumorigenesis, and shark liver oil rich in alkylglycerols (AKG) as a bioactive lipid vehicle to improve RE bioavailability and synergize with the potential therapeutic action of the extract. Herein, we have investigated the tolerability and safety of the supplement and the biological and molecular effects from an immuno-nutritional perspective. Sixty healthy volunteers participated in a six week, double-blind, randomized parallel pilot study with two study arms: RE-AKG capsules (CR) and control capsules (CC). Mean age (±SD) of volunteers was 28.32 (±11.39) and 27.5 (±9.04) for the control and the study groups, respectively. Safety of the CR product consumption was confirmed by analyzing liver profile, vital constants, and oxidation markers (LDLox in blood and isoprostanes and thromboxanes in urine). The following were monitored: (1) the phenotyping of plasmatic leukocytes and the ex vivo response of lipopolysaccharide (LPS)-stimulated peripheral blood mononuclear cells (PBMCs); (2) expression of genes associated with immune-modulation, inflammation, oxidative stress, lipid metabolism, and tumorigenesis; and (3) the correlation of selected genetic variants (SNPs) with the differential responses among individuals. The lack of adverse effects on liver profile and oxidation markers, together with adequate tolerability and safe immunological adaptations, provide high-quality information for the potential use of CR as co-adjuvant of therapeutic strategies against colorectal cancer.

Exercise performance is influenced by genetics. However, there is a lack of knowledge about the role played by genetic variability in the frequency of physical exercise practice. The objective was to identify genetic variants that modulate the commitment of people to perform physical exercise and to detect those subjects with a lower frequency practice. A total of 451 subjects were genotyped for 64 genetic variants related to inflammation, circadian rhythms, vascular function as well as energy, lipid and carbohydrate metabolism. Physical exercise frequency question and a Minnesota Leisure Time Physical Activity Questionnaire (MLTPAQ) were used to qualitatively and quantitatively measure the average amount of physical exercise. Dietary intake and energy expenditure due to physical activity were also studied. Differences between genotypes were analyzed using linear and logistic models adjusted for Bonferroni. A significant association between GCKR rs780094 and the times the individuals performed physical exercise was observed ( p = 0.004). The carriers of the minor allele showed a greater frequency of physical exercise in comparison to the major homozygous genotype carriers (OR: 1.86, 95% CI: 1.36-2.56). The analysis of the GCKR rs780094 variant suggests a possible association with the subjects that present lower frequency of physical exercise. Nevertheless, future studies are needed to confirm these findings.

Scope: The gut microbiota ellagitannin-metabolizing phenotypes (i.e., urolithin metabotypes [UMs]) are proposed as potential cardiovascular disease (CVD) risk biomarkers because the host blood lipid profile is reported to be associated with specific UMs. However, the link for this association remains unknown so far., Methods and Results: The gut microbiome of 249 healthy individuals is analyzed using 16S rDNA sequencing analysis. Individuals are also stratified by UMs (UM-A, UM-B, and UM-0) and enterotypes (Bacteroides, Prevotella, and Ruminococcus). Associations of UMs discriminating bacteria with CVD risk markers are investigated. Distribution and gut microbiota composition of UMs and enterotypes are not coincident. Almost half of the discriminating genera between UM-A and UM-B belongs to the Coriobacteriaceae family. UM-B individuals present higher blood cholesterol levels and higher alpha-diversity, including Coriobacteriaceae family, than those of UM-A. Coriobacteriaceae, whose abundance is the highest in UM-B, is positively correlated with total cholesterol, LDL cholesterol, and body mass index., Conclusions: Results herein suggest that the family Coriobacteriaceae could be a link between individuals' UMs and their blood cholesterol levels. Further research is needed to explore the mechanisms of the host metabolic phenotype, including cholesterol excretion products, to modulate this bacterial family., (© 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

Background and Objective: Multiple chemical sensitivity (MCS) is a complex, acquired, chronic syndrome of multifactorial etiology with multiple symptoms. The aim of the study was to assess the nutritional habits, dietary characteristics and physical activity, as well as their determinants, of a population diagnosed with MCS, which may allow for a more precise approach to nutritional improvement., Patients and Method: A descriptive, cross-sectional study in patients diagnosed with MCS. Information was collected using adapted questionnaires. Data included presence of comorbidities, nutritional (use of supplements, types of diet) and food purchasing habits. Dietary intake, food intolerances, and physical activity were also recorded., Results: The study included of 52 patients (48 female) aged 50.9±10.3 years. Diagnosis of MCS was commonly associated to chronic fatigue syndrome (70.1%), fibromyalgia (65.4%), or electrosensitivity (51.9%). The most common comorbidities were irritable bowel, gastroesophageal reflux, and depression/anxiety-depressive disorder. Exclusion diets were followed by 57.7%, 52.1% commonly used supplements (6.4±5.2 per person), and 16.0% took more than 10 daily. A high proportion of volunteers did not take the recommended amounts of dairy products (84.3%), fruit (82.3%), and cereals (64.7%), the foods to which intolerance was greatest. As regards physical activity, active subjects only represented 12.5%., Conclusions: The data collected support the need to improve food pattern and to perform physical activity according to individual characteristics. Nutritional education and diet personalization could prevent incomplete, monotonous, and unbalanced diets which impair quality of life and physiological status., (Copyright © 2018 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.)

The aging of the population underlines an important challenge for the health system not only from sanitary and economic reasons but also by quality perspectives concerning preventive care, where precision nutrition (PN) and the prescription or advice on healthy habits becomes relevant. PN focuses on provide nutrition adapted to each individual, understanding that the prevention or treatment of chronic disorders (obesity, diabetes, cardiovascular disease, etc.) must be addressed in a comprehensive way, considering not only relevant personal and clinical information, but also healthy aging and phenotypical and genotypical features. This guide was prepared due to the need to develop precision nutritional models that allow individualized nutritional treatment for each subject and physiopathological particularities with emphasis on the elderly. Therefore, the requirements of the Spanish pre-senior and senior populations, dietary recommendations and precision foods are reviewed in this document: have at least three daily meals, reduce total calories, choose a varied and balanced diet with fresh foods and high nutritional density, add vegetables, legumes and fish, consume dairy products and fiber, prefer white meat instead of red, avoid fried foods, sausages and processed foods, moderate the consumption of salt, coffee and alcohol, and get hydrated.

Eating disorders (ED) are characterized by persistent changes in eating habits that negatively affect a person's health and psychosocial abilities. They are considered psychiatric disorders, highly variable in their presentation and severity, with a huge impact on nutrition, which conditions various therapeutic approaches within a key multidisciplinary context. A group of experts in nutrition, we decided to set up a task force adscribed to the "Sociedad Española de Nutrición Parenteral y Enteral" (SENPE), which has stated as one of its goals the development of a consensus document to generate a protocol based on the best scientific evidence and professional experience available in order to improve health care in this field.

Background and Objectives: Multiple chemical sensitivity (MCS) is a chronic, multisystem syndrome of unknown etiology. The aim of the present study was to describe the nutritional status and quality of life of patients suffering from MCS, as well as to identify potential polymorphisms associated with this illness., Patients and Methods: A cross-sectional, descriptive study was performed on patients with a diagnosis of MCS. Data on anthropometric and body composition variables, hand muscle strength and quality of life were collected. The selection of single nucleotide polymorphisms (SNPs) was based on genes previously associated with MCS and genes involved in inflammatory and oxidative stress pathways., Results: A total of 52 patients (93.2% female), with a mean age of 50.9 (10.3) years were included in the study. Among them, based on their BMI, 48% had an inadequate nutritional status (17% were underweight and 32% were overweight or obese). Thirty percent of patients had a low muscle mass for their age, 84% had muscle strength below the tenth percentile, and 51.8% had a high fat mass percentage. Regarding quality of life, all median scores were lower than those of other illnesses assessed for every subscale assessed. Statistically significant differences between patient cases and controls were found with respect to rs1801133 (MTHFR), rs174546 (FADS1) and rs1801282 (PPARγ) polymorphisms., Conclusion: A high percentage of patients had a poor nutritional status, low muscle strength and decreased muscle mass. These facts exacerbate the already-lower quality of life of these patients. Specific genetic polymorphisms associated with the syndrome or its pathogenesis were not identified., (Copyright © 2017 Elsevier España, S.L.U. All rights reserved.)

Metabolic syndrome (MetS) is established as the combination of central obesity and different metabolic disturbances, such as insulin resistance, hypertension and dyslipidemia. This cluster of factors affects approximately 10%-50% of adults worldwide and the prevalence has been increasing in epidemic proportions over the last years. Thus, dietary strategies to treat this heterogenic disease are under continuous study. In this sense, diets based on negative-energy-balance, the Mediterranean dietary pattern, n-3 fatty acids, total antioxidant capacity and meal frequency have been suggested as effective approaches to treat MetS. Furthermore, the type and percentage of carbohydrates, the glycemic index or glycemic load, and dietary fiber content are some of the most relevant aspects related to insulin resistance and impaired glucose tolerance, which are important co-morbidities of MetS. Finally, new studies focused on the molecular action of specific nutritional bioactive compounds with positive effects on the MetS are currently an objective of scientific research worldwide. The present review summarizes some of the most relevant dietary approaches and bioactive compounds employed in the treatment of the MetS to date., Competing Interests: The authors declare no conflict of interest.

Objectives: The aim of this study was to assess the effect of a weight loss treatment on obesity- associated variables with respect to the CLOCK and FTO genotypes., Methods: In all, 179 volunteers (78% female) participated in a 12-week calorie-restriction program; hypocaloric diets of between 5442 and 10048 kJ/d were individually prescribed to all participants. Dietetic, anthropometric, and biochemical data were collected at baseline and at the end of the intervention. When treatment was over, five single nucleotide polymorphisms (SNPs) were sought in CLOCK and FTO in all participants who provided consent. Bonferroni-corrected linear regression models were used to examine the influence of interactions of the type genotype × dietetic change on obesity-associated variables., Results: Variation in the CLOCK and FTO genotypes had no significant influence on the change in obesity-associated variables. The interaction genotype × percentage intake of dietary fat had a significant influence on body mass index (BMI; adjusted P = 0.03). Participants carrying CLOCK rs3749474 (TT + CT) showed a positive association between the change in percentage intake of dietary fat and change in BMI (β = 0.044; 95% confidence interval [CI], 0.0119-0.0769; P = 0.008), whereas participants homozygous for the wild-type allele (CC) showed a negative, although nonsignificant association (β = -0.032; 95% CI, -0.0694 to 0.036; P = 0.077)., Conclusion: The possession of CLOCK rs3749474 may influence the effect of reducing the percentage intake of dietary fat on obesity-associated variables. Participants carrying this SNP might benefit more than others from weight loss treatment involving dietary fat restriction. The treatment of obesity might therefore be customized, depending on the alleles carried., (Copyright © 2016 Elsevier Inc. All rights reserved.)

The notion that (poly)phenols act as direct free radical scavengers is being challenged by mere chemical and biochemical considerations such as bioavailability and intracellular concentrations. An alternative hypothesis that is gaining considerable traction is that (poly)phenols are processed by the body as xenobiotics via the Keap1/Nrf2/ARE signaling axis, leading to the induction of Phase II enzymes. However, there are no solid human data to confirm this interesting supposition. In this study, we tested the activities of hydroxytyrosol (HT) on Phase II enzymes' expression in a double-blind, randomized, placebo-controlled study. We tested two HT doses, i.e. 5 and 25mg/d, vs. placebo following a Latin square design. We report that HT is well tolerated but does not significantly modify Phase II enzyme expression in peripheral blood mononuclear cells. Moreover, we were unable to record significant effects on a variety of surrogate markers of cardiovascular disease such as lipid profile and inflammation and oxidation markers. Available evidence indicates that the "hormesis hypothesis" that (poly)phenols activate Phase II enzymes requires solid human confirmation that might be provided by future trials. This study is registered at ClinicalTrials.gov (identifier: NCT02273622)., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Objective: The association of dairy food consumption with the risk for developing cardiovascular disease (CVD) has been investigated in many studies, but results often have been contradictory. The aim of the present study was to determine whether genetic polymorphisms are associated with interindividual variation in the response of CVD risk biomarker values after milk consumption., Methods: Fourteen single nucleotide polymorphisms (SNPs) in nine genes related to lipid metabolism were examined in 161 volunteers randomly allocated to consume either 500 mL/d of skimmed (S) or semi-skimmed (SS) milk for 1 year in addition to their usual diets. Total cholesterol/high-density lipoprotein cholesterol (TC/HDL-C) and low-density lipoprotein/HDL-C ratios were used as biomarkers of CVD risk. Three-way repeated-measures analysis of variance was used to examine the effect of time, treatment (S or SS), and genotype on these biomarkers., Results: A TT genotype for the proliferator-activated receptor alpha polymorphism (PPARA rs135549 SNP) was significantly associated with a reduction in the TC/HDL and LDL/HDL ratios after 12 mo of S milk intake (mean reduction -0.29, 95% confidence interval [CI], -0.63 to 0.05; P = 0.0015 and -0.31, 95% CI, -0.58 to -0.03; P = 0.0005, respectively). However, no differences were observed after consuming either S or SS milk in the C allele carriers., Conclusions: Saturated fatty acid consumption has long been linked to an increased risk for CVD; indeed, the consumption of saturated fat-free products is recommended as a means of reducing this risk. However, the present results suggest that many individuals might not benefit from such general recommendations. Genetic analysis of PPARA rs135549 might help identify those individuals who are more likely to benefit from reducing the saturated fatty acid content of their diet., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Background & Aims: Inflammation markers (IM) have been associated with the development of chronic diseases. This study compares the effects on IM of three exercise programs combined with a hypocaloric diet., Methods: 119 overweight participants (73 women, 46 men) aged 18-50 years were randomised into four treatment groups: strength training (S; n = 30), endurance training (E; n = 30), combined S + E (SE; n = 30), and a diet and physical activity recommendations group (D; n = 29). Energy intake, anthropometric variables (AV), training variables (VO2peak, strength index, dynamometric strength index [DSI]) and plasma IM were recorded at baseline and after 22 weeks of treatment., Results: 84 participants completed the study. At 22 weeks, all groups showed a significantly reduced energy intake (P < 0.001) and improved AV (P < 0.001). VO2peak significantly increased in all groups (P < 0.01). DSI increased in the exercise groups only (P < 0.05). Plasma leptin fell significantly (P < 0.001) in the S and E groups, but not significantly in the SE group (P = 0.029) (no significant differences between these groups). Tumour necrosis factor-α (TNF-α), and C-reactive protein (CRP) concentrations decreased in all groups when examined together, but not when examined separately. No significant differences were seen in interleukin-6 (IL-6)., Conclusions: Combining strength or endurance training with a hypocaloric diet improved AV and reduced plasma leptin concentrations. No differences were seen between groups in terms of TNF-α, IL-6 or CRP reduction. This trial was registered at clinical trials.gov as NCT01116856. http://clinicaltrials.gov/., (Copyright © 2012 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

Background & Aims: Several authors have reported low folate intake in patients with eating disorders (ED). This vitamin plays an essential role in synthesis reactions for neurotransmitters and structural elements of neurons, and therefore its deficiency has been associated with the presence of different disorders linked to mental function. The aim of this study was to determine the effect of folic acid supplementation on homocysteine levels and the cognitive and depressive status of a group of patients with eating disorders with low folate intake., Subjects/methods: The study was designed as a randomised, prospective clinical trial, which included 24 participants assigned to two treatment groups for six months: supplemented group (SG) (10 mg/day of folic acid [ACFOL]) and a placebo group (PG). Both groups maintained their medical, dietary and psychological treatment. At baseline and end of the intervention, anthropometric, dietary and biochemical parameters (plasma homocysteine [Hcy], serum and red blood cell folate) were recorded. Cognitive and depressive status questionnaires were administered (Stroop Test, Trail Making Test and Beck Depression Inventory)., Results: Twenty-two patients completed the study (SG: 12, PG: 10, mean age: 24.2 ± 8.8 years, BMI 18.9 ± 3.5 kg/m2). The SG significantly increased their serum and red blood cell folate levels and lowered Hcy levels (9.4 ± 2.4 μmol/l vs. 7.5 ± 1.7 μmol/l, P < 0.01). The SG also significantly improved most of their test scores for cognitive and depressive status. The PG showed no significant changes in any of the evaluated variables., Conclusions: The results show that folic acid supplementation may be used as another tool within the comprehensive and multidisciplinary treatment applied to patients with ED., (Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.)

Background & Aims: Despite the lack of scientific evidence, bread is one of the most restricted foods in popular hypocaloric diets. The aim of this study was to compare two nutrition strategies (with or without bread) designed to promote weight loss in overweight/obese women., Methods: A clinical, prospective and randomised study in which 122 women >18 years, BMI ≥ 25 < 40 kg/m(2) were divided into two groups: intervention group (BREAD, n = 61) and control group (NO BREAD, n = 61). Both groups received a low-calorie diet (with or without bread), nutrition education and physical activity guidelines, and were monitored for 16 weeks., Results: 104 women completed the study (48.4 ± 9 years, 29.8 ± 3.5 kg/m(2)). Anthropometric and biochemical markers improved after the intervention without significant differences between groups. BREAD group significantly increased total cereal consumption (3.2 ± 1.3 to 3.7 ± 0.5 servings/day, P < 0.05) and the percentage of energy from carbohydrates (41.2 ± 6.4 vs. 45.9 ± 5.0% P < 0.001) and reduced fat (39.0 ± 6.6 vs. 32.7 ± 5.1% P < 0.001). In contrast, NO BREAD group increased the discrepancy with recommended consumption. NO BREAD group had the most dropouts (21.3% vs. 6.6%, P < 0.05)., Conclusion: The bread inclusion in a low-calorie diet designed for weight loss favoured a better evolution of dietetic parameters and greater compliance with the diet with fewer dropouts. Registered under ClinicalTrials.gov Identifier no. NCT01223989., (Copyright © 2011 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)