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Diet and physical activity (PA) have been studied extensively in epidemiology as single or combined lifestyle factors; however, their interaction has not been studied thoroughly. Studying potential synergisms between lifestyle components with a comprehensive interaction analysis, including additive measures of interaction, provides key insights into the nature of their joint effect and helps target interventions more effectively. First, a comprehensive review was conducted to assess the potential research gap regarding reported interaction analyses conducted in studies assessing the Mediterranean diet (MedDiet) in combination with PA on all-cause mortality. Thereafter, we prospectively assessed the joint association of the MedDiet with PA on all-cause mortality in the Seguimiento Universidad de Navarra (SUN) cohort, followed by both multiplicative and additive interaction analyses. The conjoint effect of low adherence to the MedDiet and low PA observed an increased risk greater than the individual risk factors, suggesting a potential additive interaction or synergism between both exposures, with relative risk due to interaction (RERI) and (95 % confidence interval (95 % CI)) = 0·46 (–0·83 to 1·75) and attributable proportion (95 % CI) due to interaction of 36 % (–0·62, 1·34). No multiplicative interaction was detected. Studying interactions between lifestyle factors, such as the MedDiet and PA, is particularly relevant given the current research gaps in studying the complexities of combined aspects of lifestyle in comparison with isolated behaviours. Our findings underline the important public health message of adhering to both the MedDiet and PA for the prevention of premature mortality.

Cow's milk is a staple food for human consumption at all stages of life. Industrial processing has allowed widespread access to its consumption by the population, which has helped to significantly improve their health. From its composition point of view, milk is a complete and balanced food that provides high nutrient content in relation to its calorie content, so its consumption should be considered necessary from childhood to elderly. The benefits of cow's milk are not limited to its nutritional value, but extend beyond and are a factor of prevention in certain non communicable pathologies as cardiovascular disease, some cancers, high blood pressure or bone or dental pathology. It can also help in the fight against childhood overweight and obesity. In recent years we have seen a worrying decline in milk consumption among the Spanish population, at least in part influenced by misconceptions about its consumption and of other dairy products. This consensus document aims to review the current state of the topic regarding the effects of milk consumption on health, while making a call to the institutions and scientific societies to develop programs and information campaigns about the benefits of milk and dairy products consumption., (Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.)

Objective: To assess the adequacy of predictive equations for estimation of energy expenditure (EE), compared with the EE using indirect calorimetry in a sample of Brazilian and Spanish women with excess body weight., Methods: It is a cross-sectional study with 92 obese adult women [26 Brazilian -G1- and 66 Spanish - G2- (aged 20-50)]. Weight and height were evaluated during fasting for the calculation of body mass index and predictive equations. EE was evaluated using the open-circuit indirect calorimetry with respiratory hood., Results: In G1 and G2, it was found that the estimates obtained by Harris-Benedict, Shofield, FAO/WHO/ ONU and Henry & Rees did not differ from EE using indirect calorimetry, which presented higher values than the equations proposed by Owen, Mifflin-St Jeor and Oxford. For G1 and G2 the predictive equation closest to the value obtained by the indirect calorimetry was the FAO/WHO/ONU (7.9% and 0.46% underestimation, respectively), followed by Harris-Benedict (8.6% and 1.5% underestimation, respectively)., Conclusion: The equations proposed by FAO/WHO/ ONU, Harris-Benedict, Shofield and Henry & Rees were adequate to estimate the EE in a sample of Brazilian and Spanish women with excess body weight. The other equations underestimated the EE., (Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.)

Introduction: The Mexican Institute of Transplantation (IMT) was created in 1999 in response to the need to meet the demand for transplants in the south of the country for patients with limited resources. Thanks to the synergy with private assistance foundations this task has been accomplished., Objective: To describe the IMT experience in kidney transplants., Results: From November 1999 to May 23,2011, 754 kidney transplants were performed in the IMT, of which 733 were from living donors and only 21 from deceased donors. In our experience, the 10-year patient and graft survival were 84.4 and 72.4%, respectively. The average follow-up of patients was 44 months, it was during the first year after transplantation when most of patients were lost. More than 50% of patients have been supported by private assistance foundations. The IMT has participated in research protocols for phase II and phase III, for the development of new immunosuppressants., Conclusion: The synergy between our private medical institution and private assistance foundations has permitted to transplant low income patients, a similar association can be carried out in governmental health institutions that have overcharge in their transplant services.

Oxidative stress is related to an imbalance between the production of reactive species and the antioxidant defenses. In essence, oxidative stress has been defined as a disturbance in the pro-oxidant/antioxidant balance, leading to potential damage. It has been suggested that oxidative stress is involved in the etiology of several chronic diseases including cardiovascular disease, diabetes, cancer and neurodegenerative processes. The antioxidant defenses include nonenzymatic (especially dietary antioxidants) and antioxidant enzymes. Vitamins, minerals and phytochemicals (polyphenols and carotenoids) are among the major dietary antioxidants. The assessment of oxidative stress status though specific biomarkers has acquired great importance. The major biomarkers include the products of the attack of free radicals and reactive species to various substrates: lipids, proteins and nucleic acids. Measurement of antioxidant capacity may also involve the assessment of specific oxidative stress biomarkers. Most of the studies that have examined the association between diet and oxidative stress consider the effects of antioxidant supplements (vitamins and minerals), drinks and foods with bioactive compounds or dietary patterns on oxidative stress biomarkers. Some of these studies have demonstrated beneficial results on oxidative stress markers. However, the role of diet on oxidative stress biomarkers remains unclear and represents a potentially fruitful area for further research in the health area.

Obesity and its comorbidities have been associated with a low grade proinflammatory state, in which the adipose tissue seems to be involved. In fact, this tissue produces different proinflammatory cytokines, such as IL-6 and others. High circulating concentrations of IL-6 have been related to high body mass index, to diabetes mellitus type 2, to lipid abnormalities and to high blood pressure. There are some studies, which reported a relationship between IL-6 and energy metabolism, so this cytokine and its -174G>C gene polymorphism could be factors involved in the development of obesity. Different studies have associated the G allele of the IL-6 gene with obesity, with insulin resistance and with different cardiovascular risk factors. However, other published reports have associated the C allele of this gene to these metabolic disturbances and pathologies. This paper reviews recently published evidences about IL-6 and its physiopathological involvement in obesity and comorbidities, with emphasis on the role of the -174G>C polymorphism in the aetiology of these disturbances, in which obesity is a major risk factor.

Epidemiological research has consistently shown that physical activity decreases the risk of coronary heart disease, hypertension and stroke. The finding that a low level of physical activity is a major determinant of the growing epidemics of obesity is also firm and consistent. The direct association existing between a sedentary lifestyle and the incidence of diabetes mellitus is solid and of great importance for public health. Additional benefits from a a physically active lifestyle are a reduction in the incidence and prevalence of osteoporosis, lower risk of falls and fractures in the elderly, and a lower risk of anxiety and depression. Although evidence is less consistent, low levels of physical activity have been related to a higher risk of colon, breast and lung cancer. Some preliminary evidence relates physical activity with a lower risk of dementia. During the last three decades a huge amount of epidemiological research has led to uniform conclusions about the benefits of a physically active lifestyle. In spite of this fact, the prevalence of sedentary lifestyles is rising. Therefore, health promotion interventions are urgently needed to reach the objective of engaging in regular and moderate physical activity for at least 30 minutes per day in most, preferably all, days of the week.

Prebiotics were defined in 1995 as non-digestible food ingredients beneficially affecting the host by stimulating the growth and/or activity of one or more bacteria in the colon, thus improving health. The proliferation of certain bacteria by fermentation of non-digestible carbohydrates has been shown to be able to inhibit the colonization of the intestine by pathogens, thus giving a protective effect vis-à-vis acute or chronic intestinal disorders. The fermentation of prebiotics may promote some specific physiological functions through the release of metabolites from the bacteria, especially short chain fatty acids (acetate, propionate, butyrate, lactate, etc.) into the lumen of the intestine. Short chain fatty acids may act directly or indirectly (by modifying the pH) on intestinal cells and may be involved in the control of various processes such as the proliferation of mucosa, inflammation, colorectal carcinogenesis, mineral absorption and the elimination of nitrogenated compounds. Curiously, numerous papers have hinted at the possibility that prebiotics may have systemic physiological effects that are related to beneficial effects on lipid metabolism and various cardiovascular risk factors.

Aim: To identify attitudes and practices in the Spanish population regarding physical activity, and to compare the situation in Spain with that of other member stages of the European Union (EU)., Design: Descriptive, cross-sectional study., Setting: European Union (representative samples of all 15 member stages). Participants. From each member stage we obtained a representative sample of approximately 1000 subjects older than 15 years. A total of 15 239 individuals were asked to complete a questionnaire on attitudes regarding physical activity, body weight and health. Main measures. We classified participants into 6 possible stades of change toward physical activity, and subsequently regrouped them into static (precontemplation and relapse) and dynamic stages (contemplation, decision, action and maintenance). Multivariate analysis with unconditional logistic regression was used to determine which sociodemographic variables were related with static stages., Results: Static stages of change were more prevalent in Spain than in the rest of the EU. Spanish participants of both sexes who had received primary education, were married, were smokers or were obese were more likely to be in a static stage with regard to physical activity., Conclusions: The proportion of Spaniards with a poor attitude toward changing their level of physical activity was higher than in the rest of the EU, and Spanish citizens were less perseverant in achieving positive changes.

Objective: To compare body image perception with body mass index (BMI) calculated from the weight and size declared by subjects, and to evaluate its usefulness in classifying the nutritional status., Material and Methods: A representative sample of the Spanish population was selected consisting of 517 males and 483 females older than 15 years of age. Variables were sex, age, educational level, BMI and perceived body image. Differences between groups were estimated with the chi 2 test. Specificity and sensitivity of the agreement between body mass and image were assessed., Results: The nutritional status for both indicators revealed higher overweight prevalence in males and obesity in females, which increase with age and decrease with greater educational level. Perceived body image differed between sexes, and among ages and educational levels (p < 0.01). Sensitivity and specificity as well as positive and negative predictive values were higher than 0.90 in subjects belonging to extreme cases. Precision was higher for sensitivity than for specificity. In all groups, categorization was better in females than in males and so was Spearman's correlation (p < 0.001). The Kendall W coefficient ranked high for both groups., Conclusions: Body image allowed the identification of individuals with normal, excessive or lean nutrition. This indicator can therefore be useful in epidemiological surveys, considering some limitations for individualized diagnoses.

Background: Protein-caloric malnutrition occurs commonly in patients undergoing hemodialysis (HD) therapy and can be detected by several methods., Methods: In this work, anthropometric techniques are employed to assess the nutritional status of 15 maintenance HD ambulatory patients. Measurements of weight, triceps skinfold thickness and arm muscle area were obtained and followed at 8 and 19 months., Results: In the beginning, 70% of patients had body weight within normal limits, but 53% of them showed reductions in skinfold thickness, more strikingly in women, and 87% of male patients evidenced some degree of muscle wasting. Longitudinal data showed a tendency to fat depletion., Conclusions: These results point out the need of appropriate diets in these patients to avoid further deterioration in their nutritional status.