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Objective: To assess whether breastfeeding during the first months of life is associated with adherence to the Mediterranean dietary (MedDiet) pattern in preschool children. Design: The Seguimiento del Niño para un Desarrollo Óptimo (SENDO) project is an ongoing pediatric cohort with open recruitment, started in 2015 in Spain. Participants, recruited when they are 4 to 5 years old at their primary local health center or school, are followed annually through online questionnaires. For this study, 941 SENDO participants with full data on study variables were included. Breastfeeding history was collected retrospectively at baseline. Adherence to the Mediterranean diet was assessed with the KIDMED index (range −3 to 12). Results: After accounting for multiple sociodemographic and lifestyle confounders, including parental attitudes and knowledge about dietary recommendations for children, breastfeeding was independently associated with a higher adherence to the MedDiet. Compared with children who were never breastfed, children breastfed for ≥6 months had a one-point increase on their mean KIDMED score (Mean difference +0.93, 95%confidence interval [CI]. 0.52–1.34, p for trend

Introduction: Large randomized trials testing the effect of a multifactorial weight-loss lifestyle intervention including Mediterranean diet (MedDiet) on renal function are lacking. Here, we evaluated the 1-year efficacy of an intensive weight-loss intervention with an energy-reduced MedDiet (erMedDiet) plus increased physical activity (PA) on renal function. Methods: Randomized controlled "PREvención con DIeta MEDiterránea-Plus"(PREDIMED-Plus) trial is conducted in 23 Spanish centers comprising 208 primary care clinics. Overweight/obese (n = 6,719) adults aged 55-75 years with metabolic syndrome were randomly assigned (1:1) to an intensive weight-loss lifestyle intervention with an erMedDiet, PA promotion, and behavioral support (intervention) or usual-care advice to adhere to an energy-unrestricted MedDiet (control) between September 2013 and December 2016. The primary outcome was 1-year change in estimated glomerular filtration rate (EGFR). Secondary outcomes were changes in urine albumin-to-creatinine ratio (UACR), incidence of moderately/severely impaired EGFR (, This work was supported by the official Spanish Institutions for funding scientific biomedical research, CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN) and Instituto de Salud Carlos III (ISCIII), through the Fondo de Investigación para la Salud (FIS), which is cofunded by the European Regional Development Fund (5 coordinated FIS projects leaded by J.S.-S and J.V., including the following projects: PI13/00673, PI13/00492, PI13/00272, PI13/01123, PI13/00462, PI13/00233, PI13/02184, PI13/00728, PI13/01090, PI13/01056, PI14/01722, PI14/00636, PI14/00618, PI14/00696, PI14/01206, PI14/01919, PI14/00853, PI14/01374, PI14/00972, PI14/00728, PI14/01471, PI16/00473, PI16/00662, PI16/01873, PI16/01094, PI16/00501, PI16/00533, PI16/00381, PI16/00366, PI16/01522, PI16/01120, PI17/00764, PI17/01183, PI17/00855, PI17/01347, PI17/00525, PI17/01827, PI17/00532, PI17/00215, PI17/01441, PI17/00508, PI17/01732, PI17/00926; PI19/00957, PI19/00386, PI19/00309, PI19/01032, PI19/00576, PI19/00017, PI19/01226, PI19/00781, PI19/01560, and PI19/01332); the Especial Action Project entitled Implementación y evaluación de una intervención intensiva sobre la actividad física Cohorte PREDIMED-Plus grant to J.S.-S.; the European Research Council (Advanced Research Grant 2014–2019; agreement #340918) granted to M.Á.M.-G.; the Recercaixa (No. 2013ACUP00194) grant to J.S.-S.; grants from the Consejería de Salud de la Junta de Andalucía (PI0458/2013, PS0358/2016, and PI0137/2018); the PROMETEO/2017/017 grant from the Generalitat Valenciana; the SEMERGEN grant; funds from the European Regional Development Fund (CB06/03); International Nut & Dried Fruit Council – FESNAD (Long-term effects of an energyrestricted Mediterranean diet on mortality and cardiovascular disease 2014–2015, No. 201302) (PI: M.Á.M.-G.); the AstraZeneca Young Investigators Award in Category of Obesity and T2D 2017 (PI: D.R.); grant of support to research groups No. 35/2011 (Balearic Islands Gov.; FEDER funds) (J.A.T. and C.B.); the JR17/00022 (ISCIII) grant to O.C.; the Boosting young talent call grant program for the development of IISPV research projects 2019–2021 (Ref.: 2019/IISPV/03 grant to A.D.-L.); the Societat Catalana d’Endocrinologia i Nutrició (SCEN) Clinical-Research Grant 2019 (IPs: J.S.-S. and A.D.-L.). Collaborative Nutrition and/or Obesity Project for Young Researchers 2019 supported by CIBEROBN entitled Lifestyle Interventions and Chronic Kidney Disease: Inflammation, Oxidative Stress and Metabolomic Profile (LIKIDI study) grant to A.D.-L.

Background: It has been pointed out that moderate to vigorous exercise improves metabolic syndrome (MetS) criteria; however, studies on functional fitness in subjects with MetS are scarce. Aim: This study aimed to assess functional fitness abilities in MetS and non-MetS subjects. Methods: Cross-sectional study. Participants living in the Balearic Islands (n = 477, 52% men, 55–80 years old) with MetS (n = 333) and without MetS (n = 144). Anthropometric, socioeconomic and lifestyle characteristics were measured, and blood samples were collected. Functional fitness tests included: one leg balance, standing and sitting handgrip, 30-s chair stand, arm curl, chair sit-and-reach, back scratch, 8-foot time up-and-go, 30-m walk, and 6-min walk tests. A Functional Fitness Score was created from tests that measured agility and dynamic balance, static balance, lower-and-upper body strength, lower-and-upper body flexibility, aerobic endurance, and speed. Results: All functional fitness tests were lower in MetS subjects, except for back scratch and standing handgrip test. After adjusting for possible confounders (sex, age, civil status, education level, leisure-time physical activity) MetS subjects were more likely to be below average for a sex and age specific cut-off value of one leg balance (Odds Ratio, OR: 2.37; 95% Confidence Interval, CI: 1.25–4.48), chair stand (OR: 2.30; 95% CI: 1.26–3.20), arm curl (OR: 3.43; 95% CI:1.90–6.26), back scratch (OR: 3.49; 95% CI: 2.31–5.91), 8-foot up-&-go (OR: 13.03; 95% CI: 6.66–25.55), 30-m walk (OR: 8.10; 95% CI: 4.33–15.57) and 6-min walk test (OR: 3.28; 95% CI: 1.76–6.52), whereas they were more likely to be above average for sitting handgrip test (OR:1.69; 95% CI:1.21–2.95). Functional Fitness Score was lower in MetS subjects (5.44 ± 2.40 vs. 7.04 ± 1.72, p < 0.001), independently of sex and age. Conclusion: MetS participants showed lower functional fitness abilities and lower Functional Fitness Score than non-MetS peers, independently of sex, age, body mass index and waist circumference, showing lower ability to perform everyday activities safely and independently.

Background and aims The metabolic syndrome (MetS) is a cluster of coexisting cardiovascular risk factors. The role of specific dietary fats was reemphasized by dietary recommendations. This systematic review aims to assess evidence for the effect of dietary fat intake on MetS occurrence and reversion in adults. Methods and Results The MEDLINE database was used to search the existing literature. We included observational studies that analyzed dietary fat intake in adults with MetS and clinical trials that compared the effects of different dietary fat diets on MetS and/or its components. Thirty articles were selected (14 observational and 16 clinical trials), and we included information of dietary fat and fatty acids as well as MetS, body mass index, cholesterol, hypertension, and diabetes in adults. SFA intake was found to be positively associated with MetS components. Most of the observational reviewed studies found beneficial associations between MUFA and PUFA (including n-3 and n-6 subtypes) intake and MetS components. Clinical trials also supported the benefits of MUFA- or PUFA-enriched diets (including low-fat diets) in reducing MetS. Conclusions The effects of dietary SFAs on MetS will be influenced by other specific nutrients. Replacement of SFA by MUFA and PUFA has been associated with a decrease in MetS. Dietary recommendations should emphasize on different qualities of fat intake, not only to reduce total fat intake, to obtain health benefits in adults.

Chronic and non-healing wounds, especially diabetic foot ulcers and radiation injuries, imply remarkable morbidity with a significant effect on the quality of life and a high sanitary cost. The management of these wounds requires complex actions such as surgical debris, antibiotic treatment, dressings and even revascularization. These wounds are characterized by poor oxygen supply resulting in inadequate oxygenation of the affected tissue. The adjuvant treatment with hyperbaric oxygen therapy (HBOT) may increase tissue oxygenation favoring the healing of wounds which do not respond to the usual clinical care. The increase in the partial pressure of oxygen contributes to cover the energy demands necessary for the healing process and reduces the incidence of infections. Moreover, the increase in oxygen leads to the production of reactive species with hormetic activity, acting on signaling pathways that modulate the synthesis of inflammation mediators, antioxidants and growth factors which can contribute to the healing process. Studies performed with cell cultures and in animal models seem to demonstrate the beneficial effects of HBOT. However, clinical trials do not show such conclusive results; thus, additional randomized placebo-controlled studies are necessary to determine the real efficacy of HBOT and the mechanism of action for various types of wounds.

Objective To adapt and assess reliability of the Chilean version of Nutritional Environment Measurement for Stores (NEMS-S-CHILE) to measure the food environment of stores in urban areas. Design NEMS-S-CHILE was the NEMS-S tool adapted to the Chilean food patterns; foods were grouped according to level of processing in (a) unprocessed or minimally processed foods, (b) processed culinary ingredients, (c) processed foods, and (d) ultra-processed foods, and scored according to NEMS-S-CHILE tool. Reliability inter evaluators was measured. Setting City of Concepción, Bio-Bio region, Chile. Participants Seventeen of a total of 25 supermarkets, and 9 out of 10 street markets according to the municipal registry and the street market trade unions, representing 74.3% of both types of food premises in Concepción. Results Reliability inter evaluators was measured by the following aspects: product availability, price, quality, and variety, through the intraclass correlation coefficient (ICC), percent agreement, and Cohen’s kappa analysis. Reliability was high for availability, where the kappa index and ICC were acceptable, ranging from moderate to high (0.42 to 1.00 for the kappa coefficient and 0.65 to 1.00 for ICC), as well as for prices (ICC: 0.65-1.00 ), variety (kappa: 0.76-1.00) and quality (percent agreement: 68.2- 100%). Conclusions The adapted instrument, NEMS-S-CHILE, has a high reliability inter evaluators and can be useful to measure the availability of foods by the level of processing according to the prevalent food system in developing countries.

Scarce studies described eating habits and diet quality among university students in Lebanon. The aim of this study is to assess the rate of adherence to the Mediterranean diet (MedDiet) among Lebanese university students. A cross-sectional nutritional survey was carried out on 525 students (53% men, 18–25 years old) from the University of Balamand, Lebanon. Adherence to the MedDiet was assessed using a validated 14-item MedDiet adherence score. Mean adherence to the MedDiet was 7.96 (standard deviation 2.2), and it was adequate in 59% of participants. Adherence to the MedDiet was higher in older students and nonsmokers. Legumes, vegetables, fruits, and nuts were consumed according to the MedDiet standards among a minimum of 48.4% and a maximum of 69.5% of participants. Chicken, turkey, or rabbit was preferred by 66.9% of participants instead of beef, pork, hamburgers, or sausages, however, just 56.2% of participants showed adequate intake of red meat, hamburger, or meat products. Only 28.8% of them referred to an adequate intake of fish or shellfish. Most of the participants (86.3%) used olive oil as the main added fat, and 67.2% reported a low intake of butter and derivatives. Sofrito was also very usual among participants (79.6%). Only half of the studied sample reported an adequate intake of sweet or carbonated beverages and commercial sweets or pastries. Among the assessed sample, half the participants showed adequate adherence to the MedDiet, however, the mean of adherence among the sample is low.

Background and aims: Modifiable lifestyle factors, such as physical activity (PA) and Mediterranean diet (MD), decrease metabolic syndrome (MetS). The aim was to assess 1-year changes of leisure-time physical activity (LTPA), sedentary behavior, and diet quality according to MetS severity in older population at high cardiovascular risk. Methods and results: Prospective analysis of 55-75-year-old 4359 overweight/obese participants with MetS (PREDIMED-Plus trial) categorized in tertiles according to 1-year changes of a validated MetS severity score (MetSSS). Anthropometrics, visceral adiposity index, triglycerides and glucose index, dietary nutrient intake, biochemical marker levels, dietary inflammatory index, and depression symptoms were measured. Diet quality was assessed by 17-item MD questionnaire. PAs were self-reported using the Minnesota-REGICOR Short Physical Activity Questionnaire and 30-s chair stand test. Sedentary behaviors were measured using the Spanish version of the Nurses' Health Study questionnaire. After 1-year follow-up, decreasing MetSSS was associated with an anti-inflammatory dietary pattern, high intake of vegetables, fruits, legumes, nuts, whole grain cereals, white fish, and bluefish and low intake of refined cereals, red and processed meat, cookies/sweets, and snacks/ready-to-eat-meals. It resulted in high intake of polyunsaturated fatty acids, omega-3 fatty acids, protein, fiber, vitamins B1, B6, B9, C, D, potassium, magnesium, and phosphorus and low glycemic index and saturated fatty acid, trans fatty acid, and carbohydrates intake. Regarding PA and sedentary behavior, decreasing MetSSS was associated with increased moderate-to-vigorous LTPA, chair stand test, and decreased sedentary and TV-viewing time. Conclusion: Decreasing MetSSS was associated with an anti-inflammatory dietary pattern, high LTPA, high MD adherence, low sedentary time, and low depression risk. 2021 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

[Abstract] The aim of this study is to evaluate if screen time and parents’ education levels are associated with adherence to a Mediterranean dietary pattern. This cross-sectional study analyzed a representative sample of 3333 children and adolescents (8 to 16 years) included in the Physical Activity, Sedentarism, lifestyles and Obesity in Spanish youth (PASOS) study in Spain (which ran from March 2019 to February 2020). Data on screen time (television, computer, video games, and mobile phone) per day, Mediterranean diet adherence, daily moderate or vigorous physical activity, and parents’ education levels were gathered using questionnaires. A descriptive study of the variables according to sex and parents’ education level was performed. Logistic regression models (adjusted by sex and weight status) were fitted to evaluate the independent association between screen time and Kids’ level of adherence to the Mediterranean diet (KIDMED) index, as well as some of its items. A greater amount of screen time was associated with worse adherence to the Mediterranean diet; a lower consumption of fruit, vegetables, fish, legumes, and nuts; and a greater consumption of fast food, sweets, and candies. A lower parents’ education level was associated with worse adherence to the Mediterranean diet. It is necessary to promote the responsible, limited use of screen time, especially in children with parents with a lower education level. The PASOS study was funded by Fundación PROBITAS and the Gasol Foundation. Additional funds were received from the Barça Foundation, Banco Santander, IFA, Vienna and the Fundación Deporte Jóven. J.A.T. and M.M.B. are funded by the official funding agency for biomedical research of the Spanish government, the Institute of Health Carlos III (ISCIII), which is co-funded by the European Regional Development Fund (CIBEROBN CB12/03/30038).

In this paper, we propose a family of indistinguishability operators, that we have called Yager Possibilitic Response Functions (YPRFs for short), as an appropriate tool for allocating tasks to a collective of agents. In order to select the best agent to carry out each task, we have used the so-called response threshold method, where each agent decides the next task to perform following a probabilistic Markov process and, in addition, involves a response function which models how appropriate the task is for the agent. In previous works, we developed a new response threshold method which incorporates the use of indistinguishability operators as response functions and possibility theory instead of probability, for task allocation from a very general perspective without taking into account the specific characteristics of the agents except their limitations to carry out a task. Such an allocation is modelled by means of possibilistic, instead of probabilisitic, Markov chains. We show that possibilistic Markov chains outperform its probabilistic counterparts for the aforementioned propose. All the indistinguishability operators considered in previous papers were not able to take into account the agents&rsquo, restrictions for moving from a task to another one, or equivalently to carry out a task instead of another one. In order to avoid this handicap, we introduce a new kind of response functions, YPRFs, which are modelled by means of indistinguishability operators obtained via Yager t-norms. This new type of response functions drops to zero when an agent, due to its limitations, is not able to execute a task and, therefore, is able to model a generic multi-agent system with restrictions. The performed simulation, under Matlab, allows us to compare the results obtained using the new YPRFs with those obtained applying celebrated response functions also generated via indistinguishability operators (that we call Original Possibilitic Response Functions, OPRFs for short). Moreover, the results confirm that the YPRFs are able to take into account agent&rsquo, s restrictions while the OPRFs are not able. Finally, in the light of the experimental results, we can confirm that those systems modelled.

The online version contains supplementary material available at https://doi.org/10.1186/s12966-021-01169-w Additional file 1 Supplementary Table 1.Characteristics of the validation study participants and the remaining participants of the population-based PASOS cohort. Additional file 2 Supplementary Table 2.Correlation coefficients and between-method agreement of moderate to vigorous physical activity measurements derived by the Physical Activity Unit 7-item screener, non-calibrated and calibrated, and the reference method (accelerometer),stratified by age [Abstract] Background Validation of self-reported tools, such as physical activity (PA) questionnaires, is crucial. The aim of this study was to determine test-retest reliability, internal consistency, and the concurrent, construct, and predictive validity of the short semi-quantitative Physical Activity Unit 7 item Screener (PAU-7S), using accelerometry as the reference measurement. The effect of linear calibration on PAU-7S validity was tested. Methods A randomized sample of 321 healthy children aged 8–16 years (149 boys, 172 girls) from the nationwide representative PASOS study completed the PAU-7S before and after wearing an accelerometer for at least 7 consecutive days. Weight, height, and waist circumference were measured. Cronbach alpha was calculated for internal consistency. Test-retest reliability was determined by intra-class correlation (ICC). Concurrent validity was assessed by ICC and Spearman correlation coefficient between moderate to vigorous PA (MVPA) derived by the PAU-7S and by accelerometer. Concordance between both methods was analyzed by absolute agreement, weighted kappa, and Bland-Altman statistics. Multiple linear regression models were fitted for construct validity and predictive validity was determined by leave-one-out cross-validation. Results The PAU-7S overestimated MVPA by 18%, compared to accelerometers (106.5 ± 77.0 vs 95.2 ± 33.2 min/day, respectively). A Cronbach alpha of 0.76 showed an acceptable internal consistency of the PAU-7S. Test-retest reliability was good (ICC 0.71 p

Objective: Cardiorespiratory fitness (CRF) and a healthy diet may be part of an overall healthy lifestyle. The association between cardiorespiratory fitness and adherence to an overall Mediterranean Diet (MedD) pattern and specific MedD foods has been assessed. Design: Subjects completed a lifestyle survey and dietary pattern, using the validated MedD Adherence 14-item questionnaire and two self-reported 24-h dietary recalls. Participants&rsquo, height, body weight, waist circumference (WC), and CRF (maximum oxygen uptake, VO2max, ml/kg/min) were measured. Setting: University of C&aacute, diz, Spain. Subjects: A sample of young adults (n = 275, 22.2 &plusmn, 6.3 years). Results: Mean VO2max was 43.9 mL/kg/min (SD 8.5 mL/kg/min). Most participants had healthy CRF (75.9%). The average MedD score was 6.2 points (SD 1.8 points). Participants who consumed more servings of nuts had higher VO2max. Those who showed low CRF performed less physical activity (PA) and had a higher body mass index (BMI) and WC compared with those classified as having healthy CRF. Nut consumption was positively associated with VO2max (&beta, = 0.320, 95% CI 2.4, 10.7, p &lt, 0.002), adjusting for sex, age, smoking PA, BMI, WC, and energy intake, showing the subjects who consumed more nuts were fitter than young adults who consumed less. Conclusions: CRF is positively associated with nut consumption but not with the overall MedD pattern and all other MedD foods in the young adults. The subjects who consumed more servings of nuts were fitter than young adults who consumed less. Moreover, fitter subjects performed more PA and had a lower BMI and WC than those who had lower fitness levels.

The aim of this study was to assess the association between physical fitness (PF) and energy and nutrient intake in Spanish older adults. Three hundred and twenty-four participants (59.9% females, aged over 55 years) performed a battery of four validated PF tests and participants were divided into three: low, medium, and high PF. Dietary intake was assessed by two non-consecutive 24 h dietary recalls. Energy and nutrient intake was calculated using the ALIMENTA software. Energy expenditure (EE) was calculated using a validated questionnaire. Median energy intake (EI) was 2135, 1999, and 2111 kcal/day in the low, medium, and high PF in males, respectively. In females, the median EI was 1576, 1564, and 1625 kcal/day in the low, medium, and high PF groups. There were significant and positive associations between participants in the high PF group and intake of phosphorous, selenium, vitamin B6, C, D, E, niacin, and folates (all p

The authors especially thank the PREDIMED-Plus participants for their enthusiastic collaboration, the PREDIMED-Plus personnel for outstanding support, and the personnel of all associated primary care centres for their exceptional effort. CIBEROBN, CIBERESP and CIBERDEM are initiatives of Instituto de Salud Carlos III, Spain. We thank the PREDIMED-Plus Biobank Network, part of the National Biobank Platform of Instituto de Salud Carlos III for storing and managing biological samples., Healthy lifestyle factors, such as physical activity (PA) and Mediterranean diet (MD), decrease the likelihood of developing metabolic syndrome (MetS). The aim of this study was to report main lifestyle components and related factors according to the MetS severity. Cross-sectional analysis was done of baseline lifestyle factors from 5739 participants with overweight/obesity and MetS features (aged 55–75 years) included in the PREDIMED-PLUS primary cardiovascular prevention randomized trial. Participants were categorized in tertiles according to a validated MetS severity score (MetSSS). Anthropometrics, visceral adiposity index, dietary nutrient intake, biochemical marker levels, as well as a Dietary Inflammatory Index and depression symptoms (Beck Depression Inventory-II) were measured. Diet quality was assessed using a 17-item energy-restricted MD questionnaire. Duration and intensity of PA was self-reported using the Minnesota-REGICOR Short Physical Activity Questionnaire. Sedentary behaviours were measured using the Spanish version of the Nurses’ Health Study questionnaire. The 30 s chair stand test was also assessed. Participants with highest MetSSS showed higher values of cardiovascular risk factors (except for total cholesterol and LDL cholesterol), depression risk, sedentary and TV viewing time, and lower moderate and vigorous leisure-time physical activity (LTPA). Highest MetSSS participants tended to a pro-inflammatory dietary pattern and tended to lower MD adherence. In addition, they showed lower carbohydrate and nut intake and higher intake of protein, saturated and trans fatty acids, cholesterol, iodine, sodium, red and processed meat products, other oils different from olive oil and spirit alcoholic drinks. The highest MetS severity score was associated with lower moderate and vigorous LTPA and higher sedentary time and depression risk, as they tended to a pro-inflammatory dietary pattern and lower MD adherence., The PREDIMED-Plus trial was supported by the official funding agency for biomedical research of the Spanish government, ISCIII, through the Fondo de Investigación para la Salud (FIS), which is co-funded by the European Regional Development Fund [five coordinated FIS projects led by Jordi Salas-Salvadó and Josep Vidal, including the following projects: PI13/00673, PI13/00492, PI13/00272, PI13/01123, PI13/00462, PI13/00233, PI13/02184, PI13/00728, PI13/01090, PI13/01056, PI14/01722, PI14/00636, PI14/00618, PI14/00696, PI14/01206, PI14/01919, PI14/00853, PI14/01374, PI14/00972, PI14/00728, PI14/01471, PI16/00473, PI16/00662, PI16/01873, PI16/01094, PI16/00501, PI16/00533, PI16/00381, PI16/00366, PI16/01522, PI16/01120, PI17/00764, PI17/01183, PI17/00855, PI17/01347, PI17/00525, PI17/01827, PI17/00532, PI17/00215, PI17/01441, PI17/00508, PI17/01732, PI17/00926, PI19/00957, PI19/00386, PI19/00309, PI19/01032, PI19/00576, PI19/00017, PI19/01226, PI19/00781, PI19/01560, and PI19/01332], the Especial Action Project entitled: Implementación y evaluación de una intervención intensiva sobre la actividad física Cohorte PREDIMED-Plus grant to Jordi Salas-Salvadó, the European Research Council (Advanced Research Grant 2014–2019, 340918) to Dr. Miguel A. Martínez-González, the Recercaixa Grant to Jordi Salas-Salvadó (2013ACUP00194), Grants from the Consejería de Salud de la Junta de Andalucía (PI0458/2013, PS0358/2016, and PI0137/2018), a Grant from the Generalitat Valenciana (PROMETEO/2017/017), a SEMERGEN Grant, EU-COST Action CA16112, a Grant of support to research groups no. 35/2011 from the Balearic Islands Government, Grants from Balearic Islands Health Research Institute IDISBA [FOLIUM, PRIMUS, SYNERGIA, and LIBERI], funds from the European Regional Development Fund (CIBEROBN CB06/03 and CB12/03) and from the European Commission (EAT2BENICE_H2020_SFS2016). Fundació La Marató TV3 (projects no. PI044003 and 201630.10). Laura Gallardo-Alfaro and Catalina M. Mascaró received FPU PhD Grants from the Spanish Ministry of Education. The funding sponsors had no role in the design of the study, in the collection, analyses, or interpretation of the data; in the writing of the manuscript, and in the decision to publish the results.

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

One-year dietary quality change according to the preceding maximum weight in a lifestyle intervention program (PREDIMED-Plus trial, 55–75-year-old overweight or obese adults; n = 5695) was assessed. A validated food frequency questionnaire was used to assess dietary intake. A total of 3 groups were made according to the difference between baseline measured weight and lifetime maximum reported weight: (a) participants entering the study at their maximum weight, (b) moderate weight loss maintainers (WLM), and (c) large WLM. Data were analyzed by General Linear Model. All participants improved average lifestyle. Participants entering the study at their maximum weight were the most susceptible to improve significantly their dietary quality, assessed by adherence to Mediterranean diet, DII and both healthful and unhealthful provegetarian patterns. People at maximum weight are the most benefitted in the short term by a weight management program. Long term weight loss efforts may also reduce the effect of a weight management program., European Research Council (ERC) 340918, Official funding agency for biomedical research of the Spanish government, ISCIII, through the Fondo de Investigacion para la Salud (FIS), Junta de Andalucia PI0458/2013 PS0358/2016 PI0137/2018, Especial Action Project entitled: Implementacion y evaluacion de una intervencion intensive sobre la actividad fisica Cohorte PREDIMED-Plus grant, Recercaixa Grant 2013ACUP00194, Generalitat Valenciana PROMETEO/2017/017, SEMERGEN Grant, European Union (EU) European Cooperation in Science and Technology (COST) CA16112, Balearic Islands Government 35/2011, Balearic Islands Health Research Institute (IDISBA), European Union (EU) CIBEROBN CB06/03 CB12/03 PI13/00673 PI13/00492 PI13/00272 PI13/01123 PI13/00462 PI13/00233 PI13/02184 PI13/00728 PI13/01090 PI13/01056 PI14/01722 PI14/00636 PI14/00618 PI14/00696 PI14/01206 PI14/01919 PI14/00853 PI14/01374 PI14/00972 PI14/00728, European Commission European Commission Joint Research Centre EAT2BENICE_H2020_SFS2016, Fernando Tarongi Bauza Grant, PI16/00473, PI16/00662, PI16/01873, PI16/01094, PI16/00501, PI16/00533, PI16/00381, PI16/00366, PI16/01522, PI16/01120, PI17/00764, PI17/01183, PI17/00855, PI17/01347, PI17/00525, PI17/01827, PI17/00532, PI17/00215, PI17/01441, PI17/00508, PI14/01471, PI17/01732, PI17/00926, PI19/00957, PI19/00386, PI19/00309, PI19/01032, PI19/00576, PI19/00017, PI19/01226, PI19/00781, PI19/01560, PI19/01332

The aim of this study was to assess free fatty acids&rsquo, (FAs) ex vivo anti-/proinflammatory capabilities and their influence on inflammatory gene expression and H2O2 production by human peripheral blood mononuclear cells (PBMCs). Anthropometric and clinical measurements were performed in 26 participants with metabolic syndrome. Isolated PBMCs were incubated ex vivo for 2 h with several free fatty acids&mdash, palmitic, oleic, &alpha, linolenic, &gamma, linolenic, arachidonic and docosahexaenoic at 50 &mu, M, and lipopolysaccharide (LPS) alone or in combination. H2O2 production and IL6, NF&kappa, B, TLR2, TNF&alpha, and COX-2 gene expressions were determined. Palmitic, &gamma, linolenic, and arachidonic acids showed minor effects on inflammatory gene expression, whereas oleic, &alpha, linolenic, and docosahexaenoic acids reduced proinflammatory gene expression in LPS-stimulated PBMCs. Arachidonic and &alpha, linolenic acids treatment enhanced LPS-stimulated H2O2 production by PBMCs, while palmitic, oleic, &gamma, linolenic, and docosahexaenoic acids did not exert significant effects. Oleic, &alpha, linolenic, and docosahexaenoic acids induced anti-inflammatory responses in PBMCs. Arachidonic and &alpha, linolenic acids enhanced the oxidative status of LPS-stimulated PBMCs. In conclusion, PBMC ex vivo assays are useful to assess the anti-/proinflammatory and redox-modulatory effects of fatty acids or other food bioactive compounds.

Background & aims: Few studies have compared micronutrient intake and fulfilment of average requirements (EAR) in non-diabetic, pre-diabetic and diabetic adults at high cardiovascular risk. We assessed these variables in a large sample of participants in the PREDIMED-PLUS randomized trial of primary cardiovascular prevention with diet and physical activity. Design: Baseline assessment of nutritional adequacy in n = 5792 men and women, aged 55-75 years, with overweight/obesity and some metabolic syndrome features. Methods: Participants were categorised as non-diabetic (n = 2390), pre-diabetic (n = 1322) or diabetic (n = 2080) by standard criteria. Food and nutrient intake were assessed using a validated food frequency questionnaire. Micronutrients examined were vitamins B1, B2, B3, B6, B12, A, C, D, E and folic acid; Ca, K, P, Mg, Fe, Se, Cr, Zn, and iodine. The proportion of micronutrient inadequacy was evaluated using the EAR or adequate intake (AI) cut-offs. Diet quality was also determined using a 17-item energy-restricted Mediterranean diet (MedDiet) questionnaire. Results: Compared to non-diabetic participants, those with pre-diabetes had lower intakes of total carbohydrates (CHO) and higher intakes of total fat and saturated fatty acids (SFA) and were more likely to be below EAR for folic, while diabetic participants had lower intakes of total CHO and higher intakes of protein, total fat, monounsaturated fatty acids, SFA and cholesterol and were less likely to be below EAR for vitamins B2, and B6, Ca, Zn and iodine. Diabetic participants disclosed higher adherence to the MedDiet than the other two groups. Conclusions: Older Mediterranean individuals with metabolic syndrome and diabetes had better nutrient adequacy and adherence to the MedDiet than those with pre-diabetes or no diabetes. (C) 2019 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

[Background]: Overall quality of dietary carbohydrate intake rather than total carbohydrate intake may determine the risk of cardiovascular disease (CVD)., [Objective]: We examined 6- and 12-mo changes in carbohydrate quality index (CQI) and concurrent changes in several CVD risk factors in a multicenter, randomized, primary-prevention trial (PREDIMED-Plus) based on an intensive weight-loss lifestyle intervention program., [Methods]: Prospective analysis of 5373 overweight/obese Spanish adults (aged 55–75 y) with metabolic syndrome (MetS). Dietary intake information obtained from a validated 143-item semiquantitative food-frequency questionnaire was used to calculate 6- and 12-mo changes in CQI (categorized in quintiles), based on 4 criteria (total dietary fiber intake, glycemic index, whole grain/total grain ratio, and solid carbohydrate/total carbohydrate ratio). The outcomes were changes in intermediate markers of CVD., [Results]: During the 12-mo follow-up, the majority of participants improved their CQI by increasing their consumption of fruits, vegetables, legumes, fish, and nuts and decreasing their consumption of refined cereals, added sugars, and sugar-sweetened beverages. After 6 mo, body weight, waist circumference (WC), systolic and diastolic blood pressure (BP), fasting blood glucose, glycated hemoglobin (HbA1c), triglyceride levels, triglycerides and glucose (TyG) index, and TyG-WC decreased across successive quintiles of improvement in the CQI. After 12 mo, improvements were additionally observed for HDL cholesterol and for the ratio of total to HDL cholesterol. Favorable improvements (expressed in common units of SD and 95% CI) for quintile 5 compared with quintile 1 of CQI change were observed for most risk factors, including TyG-WC (SD −0.20; 95% CI −0.26, −0.15), HbA1c (SD −0.16; 95% CI −0.23, −0.10), weight (SD −0.12; 95% CI −0.14, −0.09), systolic BP (SD −0.11; 95% CI −0.19, −0.02) and diastolic BP (SD −0.11; 95% CI −0.19, −0.04)., [Conclusions]: Improvements in CQI were strongly associated with concurrent favorable CVD risk factor changes maintained over time in overweight/obese adults with MetS. This trial was registered as ISRCTN 89898870., The PREDIMED-Plus trial was supported by the European Research Council (advanced research grant 2013–2018, 340918 to MAM-G as PI) and by the official Spanish Institutions for funding scientific biomedical research, CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn) and Instituto de Salud Carlos III (ISCIII), through the Fondo de Investigación en Salud (FIS), which is cofunded by the European Regional Development Fund (4 coordinated FIS projects), the Especial Action Project entitled Implementación y evaluación de una intervención intensiva sobre la actividad física Cohorte PREDIMED-Plus grant, the Recercaixa grant (2013ACUP00194), grants from the Consejería de Salud de la Junta de Andalucía, a grant from the Generalitat Valenciana, a SEMERGEN grant, and funds from the European Regional Development Fund (CB06/03)

PREDIMED-PLUS investigators: et al., [Background]: High nut consumption has been previously associated with decreased prevalence of metabolic syndrome (MetS) regardless of race and dietary patterns., [Objectives]: The aim of this study was to assess whether changes in nut consumption over a 1-y follow-up are associated with changes in features of MetS in a middle-aged and older Spanish population at high cardiovascular disease risk., [Methods]: This prospective 1-y follow-up cohort study, conducted in the framework of the PREvención con DIeta MEDiterránea (PREDIMED)-Plus randomized trial, included 5800 men and women (55–75 y old) with overweight/obesity [BMI (in kg/m2) ≥27 and, [Results]: As nut consumption increased, between each tertile there was a significant decrease in WC, TG, systolic blood pressure, weight, and BMI (P < 0.05), and a significant increase in HDL cholesterol (only in women, P = 0.044). The interaction effect between time and group was significant for total energy intake (P < 0.001), adherence to the Mediterranean diet (MedDiet) (P < 0.001), and nut consumption (P < 0.001). Across tertiles of increasing nut consumption there was a significant increase in extra virgin olive oil intake and adherence to the MedDiet; change in energy intake, on the other hand, was inversely related to consumption of nuts., [Conclusions]: Features of MetS and excess weight were inversely associated with nut consumption after a 1-y follow-up in the PREDIMED-Plus study cohort. This trial was registered at isrctn.com as ISRCTN89898870., The PREDIMED-Plus trial was supported by the official funding agency for biomedical research of the Spanish government, Instituto de Salud Carlos III (ISCIII), through the Fondo de Investigación para la Salud (FIS), which is cofunded by the European Regional Development Fund (5 coordinated FIS projects led by JS-S and J Vidal, including projects PI13/00673, PI13/00492, PI13/00272, PI13/01123, PI13/00462, PI13/00233, PI13/02184, PI13/00728, PI13/01090, PI13/01056, PI14/01722, PI14/00636, PI14/00618, PI14/00696, PI14/01206, PI14/01919, PI14/00853, PI14/01374, PI14/00972, PI14/00728, PI14/01471, PI16/00473, PI16/00662, PI16/01873, PI16/01094, PI16/00501, PI16/00533, PI16/00381, PI16/00366, PI16/01522, PI16/01120, PI17/00764, PI17/01183, PI17/00855, PI17/01347, PI17/00525, PI17/01827, PI17/00532, PI17/00215, PI17/01441, PI17/00508, PI17/01732, PI17/00926, PI19/00957, PI19/00386, PI19/00309, PI19/01032, PI19/00576, PI19/00017, PI19/01226, PI19/00781, PI19/01560, and PI19/01332); the Special Action Project entitled Implementación y evaluación de una intervención intensive sobre la actividad física Cohorte PREDIMED-Plus grant (to JS-S); European Research Council Advanced Research Grant 2013–2018, 340918 (to MÁM-G); Recercaixa Grant 2013ACUP00194 (to JS-S); Consejería de Salud de la Junta de Andalucía grants PI0458/2013, PS0358/2016, and PI0137/2018; Generalitat Valenciana grant PROMETEO/2017/017; a SEMERGEN grant; EU-COST Action CA16112; Balearic Islands Government grant of support to research groups 35/2011; Balearic Islands Health Research Institute (IdISBa) grants; European Regional Development Fund funds CIBEROBN CB06/03 and CB12/03; and European Commission fund EAT2BENICE_H2020_SFS2016. PH-A is supported by Juan de la Cierva-Formación postdoctoral fellowship FJCI-2017-32205. AC is supported by IdISBa “TECH” fellowship TECH18/03, funded by the 2018 Sustainable Tourism Tax annual plan. LG-A is supported by a FPU PhD program from the Spanish Ministry of Education.

[Abstract] Introduction: Physical activity (PA) is essential to healthy mental and physical development in early life. However, the prevalence of physical inactivity, which is considered a key modifiable driver of childhood obesity, has reached alarming levels among European youth. There is a need to update the data for Spain, in order to establish if current measures are effective or new approaches are needed. Methods and analysis: We present the protocol for Physical Activity, Sedentarism, lifestyles and Obesity in Spanish youth (PASOS). This observational, nationally representative, multicentre study aims to determine the PA levels, sedentary behaviours and prevalence of physical inactivity (defined as

Background and aim Lifestyle factors heavily influence the development of cardiovascular disease (CVD); therefore, interventions delivering adequate lifestyle changes may improve the prognosis among patients at cardiovascular (CV) risk. Recently published research on the effectiveness of dietary and exercise intervention programmes, alone or combined, on reducing risk factors associated with CVD as well as preventing CV events have been now assessed. Methods and results Using the Medline database via PubMed, we searched for prospective studies published between January 2000 and January 2020 assessing the efficacy of dietary interventions alone or in combination with exercise on reducing CV risk factors or events in human adults at risk. Study quality was assessed using the American Dietetic Association Quality Criteria Checklist. From 934 articles, 21 prospective experimental design studies (15 randomized controlled trials (RCTs), one cluster RCT, and five quasi-experimental intervention studies with a control group) met inclusion and exclusion criteria. Most interventions improved at least some markers of CV risk and the most improvement was time devoted to physical activity increased. A low-fat intervention diet seemed to be effective only when coupled with moderate intensity exercise and weight loss, while a Mediterranean diet (MedDiet) intervention without physical activity, decreased both systolic and diastolic blood pressure, major CV events rate and risk of developing type 2 diabetes. Conclusion The MedDiet appears to have the most beneficial effect on CV events and increased hours of physical training are strongly related to greater improvement of risk factors; nevertheless, adherence to intervention is fundamental as it directly relates to health outcomes.

[EN] The education plans of the universities represent a coincidence in the subject of Human Physiology (Physiotherapy, Biology, Biochemistry, Nursing and Medicine degrees), in which teaching for small groups are a good strategy to achieve certain skills that could not be achieved during large groups time. The main methodology followed is the realization of monographic works. During the 2018-2019 academic year, the University of the Balearic Islands awarded a teaching innovation project in which the design and coordination of seminars was proposed through an active learning methodology through the resolution of practical cases that would help students to acquire skills in critical thinking, leadership, emotional intelligence, adaptability and management of new technologies. The students had to solve a supposed clinical case, exposing the normal physiological process and the physiological alteration associated with the proposed case. The results obtained (n = 174 students) indicated an improvement in the acquisition of knowledge (average of 8.2) and in the satisfaction (average of 8.1) obtained by the students, who preferred this methodology to monographic expositions or the use of simulators by computer. In conclusion, the methodology contributed was received with a high degree of satisfaction for its innovative application in the small groups., [ES] Los planes docentes de diversas titulaciones suponen una coincidencia en la asignatura de Fisiología Humana (grados: Fisioterapia, Biología, Bioquímica y Medicina), en los cuales las horas docentes destinadas a grupos pequeños suponen una buena estrategia para alcanzar determinadas competencias que no se podrían alcanzar con grupos grandes. La realización de trabajos monográficos es la principal metodología seguida. Durante el curso 2018/2019, la Universidad de las Islas Baleares concedió un proyecto de innovación docente donde se planteó el diseño y la coordinación de la realización de seminarios mediante una metodología activa de aprendizaje a través de resolución de casos prácticos con el objetivo de adquirir destrezas en pensamiento crítico, liderazgo, inteligencia emocional, adaptabilidad y manejo de las nuevas tecnología. Los alumnos debían resolver un supuesto caso clínico, exponiendo el proceso fisiológico normal y la alteración fisiológica asociada al caso propuesto. Los resultados obtenidos (n=174 alumnos) indicaron una mejora en la adquisición de conocimientos (media de 8,2) y en la satisfacción (media de 8,1)obtenida por parte del alumnado, que prefirió esta metodología a las exposiciones monográficas o el uso de simuladores por ordenador. En conclusión, la metodología aportada fue recibida con alto grado de satisfacción por su aplicación innovadora en los grupos pequeños.

Resumen Objetivos: analizar la prevalencia de salud metabólica en pacientes obesos de Mallorca. Métodos: los participantes se clasificaron en obesos sanos metabólicamente (OSM) y obesos no sanos metabólicamente (ONSM) en función de si presentaban o no síndrome metabólico (SMet), definido según los criterios del NCEP ATP III. Se evaluaron hábitos alimentarios, tóxicos y estilo de vida, tiempo de evolución de la obesidad, antecedentes de lactancia materna, obesidad en la infancia y familiares de obesidad y diabetes mellitus, así como glucosa, colesterol total, colesterol-HDL y triglicéridos plasmáticos en 457 pacientes obesos residentes en Mallorca. Resultados: la prevalencia de OSM fue del 49,2% y la de ONSM fue del 50,8%. El fenotipo de OSM disminuyó con la edad. Todos los pacientes presentaron hábitos inadecuados. Ambos grupos presentaron similar consumo de frutas, ensaladas y verduras, hábito tabáquico y práctica de actividad física. El 37,4% de los sujetos consumía bebidas azucaradas y el 52,9% consumía alcohol, más en ONSM (4,3%) que en OSM (0,4%). Los sujetos ONSM presentaron mayores valores de índice de masa corporal (IMC), circunferencia abdominal, porcentaje de grasa e índice de grasa visceral (IGV) y variables metabólicas estudiadas que los OSM. Conclusiones: más de la mitad de la población obesa analizada presentó complicaciones metabólicas, aunque toda la población obesa mostró similares hábitos alimentarios y de estilo de vida inadecuados. El incremento de edad, el bajo nivel educativo, los años de evolución de la obesidad y la localización visceral de la grasa se asocian a un estado metabólico no saludable. Deberían aunarse criterios para definir y tipificar el estado metabólico de los sujetos obesos. Abstract Aims: to assess the prevalence of metabolic health in Mallorca obese patients. Methods: participants were classified in metabolically healthy obese (MHO) and metabolically non-healthy obese (MNHO). Food, toxic and lifestyle habits, time of obesity evolution, breastfeeding, obesity in childhood and family history of obesity and diabetes mellitus, as well as glycemia, total cholesterol, HDL-cholesterol and triglyceridemia were evaluated in 457 obese patients. Results: prevalence of MHO was 49.2% and that of MNHO was 50.8%. MHO phenotype decreased with age. All patients showed inadequate habits. Consumption of fruits, salads and vegetables, tobacco and physical activity were similar between both groups; 37.4% of patients consumed sugary sweet drinks, and 52.9% consumed alcohol, higher in MNHO (4.3%) than in MHO (0.4%). MNHO showed higher values of BMI, abdominal circumference, fat percentage and visceral fatty index, as well as all metabolically studied outcomes. Conclusions: more than half of assessed obese population showed metabolic complications, but all obese population showed similar inadequate food and lifestyle habits. Increase of age, low educational level, years of obesity evolution, and visceral localization of fat are associated with a metabolically non-healthy status. Criteria to define and typify the metabolic state of obese subjects should be unified.

Background: Metabolic syndrome (MetS) is a cluster of risk factors for cardiovascular disease, atherosclerosis and diabetes mellitus type 2 which may be reduced by practicing regular physical activity. Objective: To assess the leisure-time physical activity (LTPA) of older adults with MetS and without MetS. Methods: Cross-sectional study of older adults (55&ndash, 80 years old) from Balearic Islands (Spain) with MetS (n = 333, 55% men) and without MetS (n = 144, 43.8% men). LTPA was assessed with the validated Spanish version of the Minnesota LTPA Questionnaire. Two criteria of physically active were used: &gt, 150 min/week of moderate physical activity or &gt, 75 min/week of vigorous physical activity or a combination of both, and total leisure-time energy expenditure of &gt, 300 MET&middot, min/day. Sociodemographic and lifestyle characteristics, anthropometric variables, MetS components, and adherence to the Mediterranean diet (MD) were also measured. Results: MetS subjects showed lower energy expenditure in LTPA, lower adherence to the MD, higher obesity and waist circumference, and were less active than non-MetS peers. LTPA increased as participants got older and there was higher LTPA intensity as educational level increased. Adherence to MD was as high as LTPA was. Conclusions: MetS is associated with physical inactivity and unhealthy diet. To increase LTPA recommendations and raise awareness in the population about the health benefits of PA and high adherence to MD is highly recommended.

By the official funding agency for biomedical research of the Spanish government, Institute of Health Carlos III (ISCIII) through the Fondo de Investigacion para la Salud (FIS), which is co-funded by the European Regional Development Fund (Projects PI11/01791, PI14/00636 and PI17/01827, Red Predimed-RETIC RD06/0045/1004, and CIBEROBN CB12/03/30038), Grant of support to research groups no. 35/2011 (Balearic Islands Gov.), Fundacio La Marato TV3 (Spain) project ref. 201630.10, and EU COST Action CA16112. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Lecturers of the Faculty of Sciences at the University of the Balearic Islands (Spain) have critically reviewed the first-year laboratory lectures of science for Biology, Biochemistry, Chemistry, Physics and engineering degrees. In all the studies, the experiments conducted in the laboratory help in the achievement of specific, generic and basic skills of each degree. We found that for the sciences degrees the organization of the laboratory sessions (6 ECTS credits) was very close, although the experiments and the techniques used were different. In all cases, the first session is mainly devoted to inform about the security rules, the delivery works and the grading. Before each laboratory session, students must read the protocol of the experiments to be done with a detailed explanation of all the steps, measurements and computations required in the session. In some cases (Chemistry and Biology) all the experimental activities have to be reported in a laboratory notebook, a tool that is commonly used in the research of these fields. The assessment mainly consists on delivering works for each experiment, writing an extended report of one single experiment, a practical and/or theoretical exam and the evaluation of the attitude/ability during the sessions, all of them with different weights to compute the final mark. The organization of the laboratory sessions in engineering is slightly different because they are part of a science course with other theory and practical lectures. As a result, to compute the final mark of the course the laboratory lectures weight about 25%. The methodology is like the one of sciences degrees but the assessment only consists on deliver a single extended report of a randomly selected experiment. Some of the improvements/changes discussed for the sciences degrees are: (i) the proposal of a coordinator lecturer to guarantee that all the groups are operating in the same way (specially the assessment); (ii) the preparation of a questionnaire to be answered by the students before starting the experiment to ensure that they have understood the goal and the methodology; (iii) to guarantee that students receive feedback of deliverable works as soon as possible in order to improve their quality as the course progresses); (iv) to check that the document with the explanation of the experiment is clear (improve the layout and incorporate some short videos); (v) to define some items to assess quantitatively the students' attitude/ability during the different laboratory sessions. Particularly, for engineering degrees some other aspects could be changed/improved, such as: (i) strengthen the links between the experimental and theoretical lectures in order to deepen the knowledge of the contents of the course; (ii) use the first session to explain the organization of the laboratory lectures, the methodology and the assessment, with special emphasis in the deliverable works (the computations and results therein); (iii) use deliverable works for the assessment of every experiment made during all the sessions (instead of one extended report) to guarantee that the students have understood all the experiments; (iv) set a minimum mark to avoid that students pass the course without attending to the practical lectures. The aim of the proposed guidelines is to improve the organization, the methodology and the assessment of the laboratory lectures of first-year courses of science and engineering degrees.

Background: Metabolic Syndrome (MetS) is associated with higher rates of cardiovascular disease (CVD), type 2 diabetes mellitus, and cancer worldwide. Objective: To assess fat intake in older adults with or without MetS. Design: Cross-sectional nutritional survey in older adults living in the Balearic Islands (n = 477, 48% women, 55&ndash, 80 years old) with no previous CVD. Methods: Assessment of fat (total fat, MUFA, PUFA, SFA, TFA, linoleic acid, &alpha, linolenic acid, marine and non-marine &omega, 3 FA, animal fat and vegetable fat, cholesterol) and macronutrient intake using a validated food frequency questionnaire, and its comparison with recommendations of the US Institute of Medicine (IOM) and the Spanish Society of Community Nutrition (SENC). Results: Participants with MetS showed higher BMI, lower physical activity, higher total fat and MUFA intake, and lower intake of energy, carbohydrates, and fiber than participants without MetS. Men and women with MetS were below the Acceptable Macronutrient Distribution Range (AMDR) proposed by IOM for carbohydrates and above the AMDR for total fat and MUFAs, and women were below the AMDR proposed for &alpha, linolenic acid (ALA) compared with participants without MetS. Conclusions: Subjects with MetS were less likely to meet IOM and SENC recommendations for fat and macronutrient intakes as compared to non-MetS subjects.

Background: The effect of dietary fat intake on the metabolic syndrome (MetS) and in turn on cardiovascular disease (CVD) remains unclear in individuals at high CVD risk. Objective: To assess the association between fat intake and MetS components in an adult Mediterranean population at high CVD risk. Design: Baseline assessment of nutritional adequacy in participants (n = 6560, men and women, 55&ndash, 75 years old, with overweight/obesity and MetS) in the PREvenci&oacute, n con DIeta MEDiterr&aacute, nea (PREDIMED)-Plus randomized trial. Methods: Assessment of fat intake (total fat, monounsatured fatty acids: MUFA, polyunsaturated fatty acids: PUFA, saturated fatty acids: SFA, trans-fatty acids: trans-FA, linoleic acid, &alpha, linolenic acid, and &omega, 3 FA) using a validated food frequency questionnaire, and diet quality using 17-item Mediterranean dietary questionnaire and fat quality index (FQI). Results: Participants in the highest quintile of total dietary fat intake showed lower intake of energy, carbohydrates, protein and fiber, but higher intake of PUFA, MUFA, SFA, TFA, LA, ALA and &omega, 3 FA. Differences in MetS components were found according to fat intake. Odds (5th vs. 1st quintile): hyperglycemia: 1.3&ndash, 1.6 times higher for total fat, MUFA, SFA and &omega, 3 FA intake, low high-density lipoprotein cholesterol (HDL-c): 1.2 higher for LA, hypertriglyceridemia: 0.7 lower for SFA and &omega, 3 FA intake. Conclusions: Dietary fats played different role on MetS components of high CVD risk patients. Dietary fat intake was associated with higher risk of hyperglycemia.

The proportion of fat has increased at the expense of carbohydrates in the past years, and we aimed to assess total fat and fatty acids intake and their food sources among Mediterranean older adults and compare them to national and international recommendations. This study was conducted in 211 participants to determine lipid and fatty acid intake using a Spanish food database. The mean daily intake of lipids was 68.6g/d (standard deviation [SD]: 24.6; 34.4%, SD: 7.0 of total energy consumed). Men, younger participants, and those with higher education ingested more lipids than their peers. Fatty acids were ingested as follows (expressed as percentage of total energy intake): monounsaturated fatty acids (MUFA) (16.7%, SD: 4.1), saturated fatty acids (SFA) (9.6%, SD: 2.6), and polyunsaturated fatty acids (PUFA) (5.0%, SD: 1.7). Oils and seeds were the highest contributors in the intake of lipids (38.8%, SD: 16.0), MUFA (53.9%, SD: 18.7), and PUFA (33.0%, SD: 16.4). The total fat intake (34.4%, SD: 7.0) was within the range of International and Spanish recommendations among Mediterranean older adults; however, the intake of fatty acids did not abide by the international (PUFA) and Spanish recommendations (SFA, MUFA). α-Linoleic acid, eicosapentaenoic acid, and docosahexaenoic acid intake were lower than recommendations, but cholesterol intake (243.9mg, SD: 140.4) was within the range of recommendations. Therefore, public health campaigns are needed to encourage older adults to decrease SFA intake and increase adherence to the Mediterranean diet pattern for a better health.

Objective: To assess the scientific evidence on the relationship between body image and body weight control in overweight 55-year-old adults. Methods: The literature search was conducted on MEDLINE database via PubMed, using terms related to body image, weight control and body composition. Inclusion criteria were scientific papers, written in English or Spanish, made on older adults. Exclusion criteria were eating and psychological disorders, low sample size, cancer, severe diseases, physiological disorders other than metabolic syndrome, and bariatric surgery. Results: Fifty-seven studies were included. Only thirteen were conducted exclusively among 55-year-old adults or performed analysis adjusted by age. Overweight perception was related to spontaneous weight management, which usually concerned dieting and exercising. More men than women showed over-perception of body image. Ethnics showed different satisfaction level with body weight. As age increases, conformism with body shape, as well as expectations concerning body weight decrease. Misperception and dissatisfaction with body weight are risk factors for participating in an unhealthy lifestyle and make it harder to follow a healthier lifestyle. Body image disturbance also made it more likely to underreport calorie intake. Conclusions: Aging is associated with a decrease in weight concerns and lower overweight perception, especially in women. However, when designing a program to improve body image in overweight 55-year-old adults, three items ought to be considered: physical activity, dietary and behavioral treatments., Instituto de Salud Carlos III through the Fondo de Investigacion para la Salud (FIS), which is co-funded by the European Regional Development Fund (Projects PI14/00636 and PI17/01827, Red Predimed-RETIC RD06/0045/1004, and CIBEROBN CB12/03/30038), EU-COST Action CA16112, Grant of support to research groups no. 35/2011 (Balearic Islands Gov.), and Fundacio La Marato TV3 (Spain) project ref. 201630.10. Cristina Bouzas received a Fernando Tarongi Bauza Grant. The funding sponsors had no role in the design of the study, in the collection, analyses, or interpretation of the data; in the writing of the manuscript, and in the decision to publish the results.

Supplemental Digital Content is available in the text, Background: The increase in overweight and obese children and adolescents may be linked to increased rates of dyslipidaemia. The aim was to assess the serum lipid profile, the prevalence of dyslipidaemia, and associated risk factors among the North Mexican adolescent population. Methods: Two hundred and ninety-three subjects (47.8% girls) ages 11 to 16 years took part in the Nuevo León State Survey of Nutrition and Health 2011–2012. According to the 2011 Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents, dyslipidaemia was defined as a presence of ≥1 of the following levels (mg/dL): Total cholesterol ≥200, low-density lipoprotein cholesterol ≥130, non–high-density lipoprotein cholesterol

[Purpose]: To assess the association between the consumption of non-soy legumes and different subtypes of non-soy legumes and serum uric acid (SUA) or hyperuricemia in elderly individuals with overweight or obesity and metabolic syndrome. [Methods]:A cross-sectional analysis was conducted in the framework of the PREDIMED-Plus study. We included 6329 participants with information on non-soy legume consumption and SUA levels. Non-soy legume consumption was estimated using a semi-quantitative food frequency questionnaire. Linear regression models and Cox regression models were used to assess the associations between tertiles of non-soy legume consumption, different subtypes of non-soy legume consumption and SUA levels or hyperuricemia prevalence, respectively., [Results]: Individuals in the highest tertile (T3) of total non-soy legume, lentil and pea consumption, had 0.14 mg/dL, 0.19 mg/dL and 0.12 mg/dL lower SUA levels, respectively, compared to those in the lowest tertile (T1), which was considered the reference one. Chickpea and dry bean consumption showed no association. In multivariable models, participants located in the top tertile of total non-soy legumes [prevalence ratio (PR): 0.89; 95% CI 0.82–0.97; p trend = 0.01, lentils (PR: 0.89; 95% CI 0.82–0.97; p trend = 0.01), dry beans (PR: 0.91; 95% C: 0.84–0.99; p trend = 0.03) and peas (PR: 0.89; 95% CI 0.82–0.97; p trend = 0.01)] presented a lower prevalence of hyperuricemia (vs. the bottom tertile). Chickpea consumption was not associated with hyperuricemia prevalence., [Conclusions]: In this study of elderly subjects with metabolic syndrome, we observed that despite being a purine-rich food, non-soy legumes were inversely associated with SUA levels and hyperuricemia prevalence., The PREDIMED-Plus trial was supported by the official funding agency for biomedical research of the Spanish government, ISCIII, through the Fondo de Investigación para la Salud (FIS), which is co-funded by the European Regional Development Fund (four coordinated FIS projects led by J.S.-S. and J.Vid., including the following projects: PI13/00673, PI13/00492, PI13/00272, PI13/01123, PI13/00462, PI13/00233, PI13/02184, PI13/00728, PI13/01090, PI13/01056, PI14/01722, PI14/00636, PI14/00618, PI14/00696, PI14/01206, PI14/01919, PI14/00853, PI14/01374, PI14/00972, PI14/00728, PI14/01471, PI16/00473, PI16/00662, PI16/01873, PI16/01094, PI16/00501, PI16/00533, PI16/00381, PI16/00366, PI16/01522, PI16/01120, PI17/00764, PI17/01183, PI17/00855, PI17/01347, PI17/00525, PI17/01827, PI17/00532, PI17/00215, PI17/01441, PI17/00508, PI17/01732, and PI17/00926), the Especial Action Project entitled: Implementación y evaluación de una intervención intensiva sobre la actividad física Cohorte PREDIMED-Plus grant to J.S.-S., the European Research Council (Advanced Research Grant 2013–2018, 340918) to M.Á.M.-G., the Recercaixa Grant to J.S.-S. (2013ACUP00194), Grants from the Consejería de Salud de la Junta de Andalucía (PI0458/2013, PS0358/2016, and PI0137/2018), a Grant from the Generalitat Valenciana (PROMETEO/2017/017), a SEMERGEN Grant, and funds from the European Regional Development Fund (CB06/03). O.C. is supported by ISCIII Grant JR17/00022. M Rosa Bernal-Lopez was supported by “Miguel Servet Type I” program (CP15/00028) from the ISCIII-Madrid (Spain), cofinanced by the Fondo Europeo de Desarrollo Regional-FEDER