Miguel Martín-Matillas

Interplay Between Weight Loss and Gut Microbiota Composition in Overweight Adolescents

The aim of this study was to determine the influence of an obesity treatment program on the gut microbiota and body weight of overweight adolescents. Thirty‐six adolescents (13–15 years), classified as overweight according to the International Obesity Task Force BMI criteria, were submitted to a calorie‐restricted diet (10–40%) and increased physical activity (15–23 kcal/kg body weight/week) program over 10 weeks. Gut bacterial groups were analyzed by quantitative real‐time PCR before and after the intervention. A group of subjects (n = 23) experienced >4.0 kg weight loss and showed significant BMI (P = 0.030) and BMI z‐score (P = 0.035) reductions after the intervention, while the other group (n = 13) showed <2.0 kg weight loss. No significant differences in dietary intake were found between both groups. In the whole adolescent population, the intervention led to increased Bacteroides fragilis group (P = 0.001) and Lactobacillus group (P = 0.030) counts, and to decreased Clostridium coccoides group (P = 0.028), Bifidobacterium longum (P = 0.031), and Bifidobacterium adolescentis (P = 0.044) counts. In the high weight–loss group, B. fragilis group and Lactobacillus group counts also increased (P = 0.001 and P = 0.007, respectively), whereas C. coccoides group and B. longum counts decreased (P = 0.001 and P = 0.044, respectively) after the intervention. Total bacteria, B. fragilis group and Clostridium leptum group, and Bifidobacterium catenulatum group counts were significantly higher (P < 0.001–0.036) while levels of C. coccoides group, Lactobacillus group, Bifidobacterium, Bifidobacterium breve, and Bifidobacterium bifidum were significantly lower (P < 0.001–0.008) in the high weight–loss group than in the low weight–loss group before and after the intervention. These findings indicate that calorie restriction and physical activity have an impact on gut microbiota composition related to body weight loss, which also seem to be influenced by the individuals microbiota.

Shifts in clostridia, bacteroides and immunoglobulin-coating fecal bacteria associated with weight loss in obese adolescents

Objective:To evaluate the effects of a multidisciplinary obesity treatment programme on fecal microbiota composition and immunoglobulin-coating bacteria in overweight and obese adolescents and their relationship to weight loss.Design:Longitudinal intervention study based on both a calorie-restricted diet (calorie reduction=10–40%) and increased physical activity (calorie expenditure=15–23 kcal/kg body weight per week) for 10 weeks.Participants:Thirty-nine overweight and obese adolescents (BMI mean 33.1 range 23.7–50.4; age mean 14.8 range, 13.0–16.0).Measurements:BMI, BMI z-scores and plasma biochemical parameters were measured before and after the intervention. Fecal microbiota was analyzed by fluorescent in situ hybridization. Immunoglobulin-coating bacteria were detected using fluorescent-labelled F(ab′)2 antihuman IgA, IgG and IgM.Results:Reductions in Clostridium histolyticum and E. rectale-C. coccoides proportions significantly correlated with weight and BMI z-score reductions in the whole adolescent population. Proportions of C. histolyticum, C. lituseburense and E. rectale-C. coccoides dropped significantly whereas those of the Bacteroides-Prevotella group increased after the intervention in those adolescents who lost more than 4 kg. Total fecal energy was almost significantly reduced in the same group of adolescents but not in the group that lost less than 2.5 kg. IgA-coating bacterial proportions also decreased significantly in participants who lost more than 6 kg after the intervention, paralleled to reductions in C. histolyticum and E. rectale-C. coccoides populations. E. rectale-C. coccoides proportions also correlated with weight loss and BMI z-score reduction in participants whose weight loss exceeded 4 kg.Conclusions:Specific gut bacteria and an associated IgA response were related to body weight changes in adolescents under lifestyle intervention. These results suggest interactions between diet, gut microbiota and host metabolism and immunity in obesity.

Cardiorespiratory Fitness and Sedentary Activities Are Associated with Adiposity in Adolescents

Objective: To determine whether physical activity, sedentary activities, and/or cardiorespiratory fitness are related to waist circumference in adolescents, as previously reported in adults.

Selective Alterations Within Executive Functions in Adolescents With Excess Weight

Increasing evidence underscores overlapping neurobiological pathways to addiction and obesity. In both conditions, reward processing of preferred stimuli is enhanced, whereas the executive control system that would normally regulate reward‐driven responses is altered. This abnormal interaction can be greater in adolescence, a period characterized by relative immaturity of executive control systems coupled with the relative maturity of reward processing systems. The aim of this study is to explore neuropsychological performance of adolescents with excess weight (n = 27, BMI range 24–51 kg/m2) vs. normal‐weight adolescents (n = 34, BMI range 17–24 kg/m2) on a comprehensive battery of executive functioning tests, including measures of working memory (letter‐number sequencing), reasoning (similarities), planning (zoo map), response inhibition (five‐digit test (FDT)–interference and Stroop), flexibility (FDT–switching and trail‐making test (TMT)), self‐regulation (revised‐strategy application test (R‐SAT)), and decision‐making (Iowa gambling task (IGT)). We also aimed to explore personality traits of impulsivity and sensitivity to reward. Independent sample t‐ and Z Kolmogorov–Smirnov tests showed significant differences between groups on indexes of inhibition, flexibility, and decision‐making (excess‐weight participants performed poorer than controls), but not on tests of working memory, planning, and reasoning, nor on personality measures. Moreover, regression models showed a significant association between BMI and flexibility performance. These results are indicative of selective alterations of particular components of executive functions in overweight adolescents.

Television watching, videogames, and excess of body fat in Spanish adolescents: The AVENA study

OBJECTIVE We assessed the individual association of sedentary behaviors with the risk of overweight and excess body fat (overfat) in adolescents. METHODS A representative sample (1960 subjects, 1012 males, age 13-18.5 y) of Spanish adolescents was studied within the framework of the Alimentación y Valoración del Estado Nutricional de los Adolescentes (AVENA) study. Television (TV) watching, videogame and computer usage, doing homework, and the way students got to school, physical activity, and socioeconomic status were analyzed. Anthropometrics were measured to describe overweight (International Obesity Task Force cutoffs for body mass index) and overfat (body fat percentage >85th percentile). RESULTS When all subjects were considered as an entire group, the overweight risk increased by 15.8% (P < 0.05) per increasing hour of TV watching. The overweight risks decreased by 32.5% in females, 22% per increasing year of age, and 12.5% by increasing socioeconomic status by 1 U (all Ps < 0.05). The obesity risks decreased with age by 17.8% per year in males and 27.1% in females (both Ps < 0.05). The overfat risks increased by 26.8% and 9.4% per increasing hour of TV and weekend videogame usage, respectively (both Ps < 0.05). In males, the overfat risk increased by 21.5% per increasing hour in weekend videogame usage (P < 0.05). Each hour of TV use increased the overfat risks by 22% in males and 28.3% in females (both Ps < 0.05). CONCLUSIONS Time spent watching TV increased the risk of overweight and obesity in Spanish adolescents, but the effect was influenced by age, sex, and socioeconomic status. Moreover, an excess of body fat was more directly explained by the time spent watching TV and playing videogames during the weekend.

Socio-economic factors and active commuting to school in urban Spanish adolescents: the AVENA study

BACKGROUND This study aimed: (i) to describe the patterns of commuting to school in urban Spanish adolescents; and (ii) to examine the associations between active commuting to school (ACS) and socio-economic factors. METHODS From the AVENA Study, 2183 adolescents (1142 females) aged 13-18.5 years were gathered. Mode and time of transportation to school were self-reported by the adolescents. Parental education level (primary, secondary or university degree), parental professional level (managerial, skilled worker or unskilled worker/unemployed) and the type of school (public or private) were self-reported by the parents. The relationships between ACS and socio-economic factors were analysed by binary logistic regression. RESULTS Nearly <65% of the adolescents reported ACS and 83% of them spent <15 min travelling to school. In male adolescents, maternal primary education level showed an odds ratio (OR) of 1.55 (95% confidence interval, 1.12-2.15), with respect to mothers with a university degree. In female adolescents, mothers with a primary education level showed an OR of 0.68 (0.50-0.92), with respect to mothers with a university degree. Low maternal professional level showed an OR of 1.70 (1.29-2.24), with respect to high maternal professional levels. Students attending public schools showed an OR of 3.47 (2.46-4.90), with respect to students from private schools. CONCLUSION Most of the adolescents actively commuted to school, yet the time spent commuting was low. Socio-economic level seems to be inversely related to the ACS in adolescents. Type of school and maternal educational level were the main predictors of ACS.

Are Muscular and Cardiovascular Fitness Partially Programmed at Birth? Role of Body Composition

OBJECTIVE To determine whether birth weight is associated with handgrip strength and cardiovascular fitness in adolescence and, if so, how these associations are influenced by current body composition. STUDY DESIGN A total of 1801 adolescents (983 females), age 13 to 18.5 years, from the AVENA (Alimentación y Valoración del Estado Nutricional de los Adolescentes Españoles [Food and Assessment of the Nutritional Status of Spanish Adolescents]) study were evaluated. Handgrip strength and cardiovascular fitness were assessed using the handgrip test and the 20-m shuttle run test, respectively. RESULTS Birth weight was positively associated with handgrip strength in females after controlling for current age, gestational age, breast-feeding, and adolescent body mass index (P = .002), body fat percentage (P < .001), or waist circumference (P = .005), but not after controlling for fat-free mass. The associations were similar yet weaker in males. Females with high birth weight (>90th percentile) had greater handgrip strength than those with normal (10th to 90th percentile) or low (<10th percentile) birth weight, after adjusting for body fat percentage (P = .004). All of the differences became nonsignificant after adjusting for adolescent fat-free mass. Birth weight was not associated with cardiovascular fitness. CONCLUSIONS High birth weight is associated with greater handgrip strength in adolescents, especially in females, yet these associations seem to be highly explained by fat-free mass.

Extracurricular physical activity participation modifies the association between high TV watching and low bone mass

OBJECTIVES To examine whether different sedentary behaviours are associated with the risk of low bone mineral content in adolescents, and if so, whether extracurricular physical-sporting activity influences this association. MATERIALS AND METHODS A total of 277 adolescents from Zaragoza (168 females and 109 males) aged 13.0-18.5 yr within frame work of the multicentre AVENA study participated in this study. Bone mineral content (BMC), lean mass, and fat mass were measured with DXA. Physical activity and sedentary independent variables: participation in extracurricular physical-sporting activity (PA), h/d of television watching, playing video/computer games during school days and on weekend days and doing homework/studying. They all were assessed by questionnaire. The main outcome was low BMC, as defined by BMC Z-score for age and sex < percentile 10. Logistic regression was used to test the interaction and association of PA and sedentary variables with low BMC, after controlling for confounders like height, maturational status or lean mass. RESULTS Among the sedentary variables studied, only television watching > or =3 h/d was associated with an increased risk for low BMC in males (OR, 95% CI: 7.01, 1.73 to 28.40), after controlling for sexual maturation. When PA was in the models, television watching was not any longer associated with low BMC, while PA was so (OR, 95% CI: 0.23, 0.09 to 0.55). Involvement in such activity reduced the risk of low bone mass by 76% (P<0.01) independently of body mass, height and fat mass, but not of the lean mass. CONCLUSION Watching television for 3 or more h/d seems to be associated with an increased risk for low BMC in male adolescents. However, this association is mediated by participation in PA, suggesting that negative consequences of excessive television watching on adolescent bone health could be counteracted by sport participation. Longitudinal data and randomized controlled trials will confirm or contrast our findings.

Effects of a multicomponent behavioral intervention on impulsivity and cognitive deficits in adolescents with excess weight.

The aim of this study was to explore the effects of a multidisciplinary behavioral intervention including cognitive behavioral therapy, structured physical activity, and dietary counseling on impulsive personality and cognitive skills and subsequent BMI loss in excess weight adolescents. Forty-two adolescents with excess weight (14 males and 28 females, range 12–17 years), as defined by the International Obesity Task Force Criteria, participated in our study. We used a longitudinal observational design with two assessments: before and after treatment. We collected baseline measures of impulsive personality (UPPS-P scale), cognitive performance (letter number sequencing, Stroop and Iowa gambling task), and biometric parameters. After 12 weeks of intervention, parallel measures were used to determine whether treatment-induced changes in impulsivity and cognition predicted changes in BMI. BMI showed a statistically significant reduction after treatment [from mean (SD) 29.36 (4.51) to 27.31 (4.41), Cohen’s d=0.5]. Greater reductions in negative urgency (negative-emotion-driven impulsivity) and greater improvement in cognitive inhibitory control skills were associated with greater reductions in BMI. Because the design was correlational and lacked a control group, future studies should clarify whether these associations reflect a causal effect or just overlapping improvements associated with a third variable (e.g. increases in attention procurement or motivation).

Incremento del consumo de tabaco y disminución del nivel de práctica de actividad física en adolescentes españoles: Estudio AVENA

Objective: To investigate the prevalence of trematode Aspidogastrea in the freshwater mussels in the Yangtze River basin within Anhui province, China. Methods: We initially harvested the freshwater mussels living in the Yangtze River running through Anhui area, and labeled them with corresponding number. Then the samples were dissected for isolating the flukes, which were identified by conventional staining. Results: Infection rate of trematode Aspidogastrea in freshwater mussels in the Yangtze River basin within the territory of Anhui province was 30.38℅(103/339)in general, and a total of 912 flukes of Aspidogastrea were detected in the 103 mussels, with average infection rate of 8.85 for each mussel. Conclusion: Trematode Aspdogastrea is prevalent in the freshwater bivalves living in the Yangtze River basin running through Anhui area, and the treamatode was identified as Aspidogaster sp. belong to Aspidogaste under Aspidogastridae of Aspidogastrea.Objective: to assess the use of oral nutritional supplements analyzing the reason for prescription and its implication in caloric-protein intake. Setting: study performed at a university hospital of 350 beds with medical and surgical specialties. Subjects, patients: Patients inclusion was done by selecting all starting oral nutritional supplement prescription. Exclusion criteria were being younger than 18 years, being admitted to the Intensive Care Unit, having cognition or communication impairments, being on concomitant parenteral nutrition or requiring complete enteral diet, and/or using nasogastric tube for feeding. We also excluded special enteral diets, specifically designed for certain conditions. Interventions: One-year long prospective study on prescription of oral nutritional supplements. Through clinical chart review and personal interview, we recorded demographic data, nutritional parameters, characteristics of the diet and supplement, and caloricprotein intake prescribed and ingested. The data were introduced in an Access97 database and processed by means of SPSS software for Windows®. We performed a descriptive study of quantitative and qualitative variables, a χ2 analysis between qualitative variables, and a comparative analysis between means of all paired data by means of the student’s t test, and variance analysis between quantitative variables. The significance level was set at p < 0.05. Results: we were only able to analyze 77 out of 130 prescriptions for nutritional supplements since we could not adequately interview the remaining patients, mainly due to neurological impairments. Mean age was 74.8 years (SD = 12) and 50.6% were women. The departments prescribing the highest number of supplements were hematology (22.1%) and internal medicine (20.8%). GI neoplasm was the most frequent diagnosis at admission (27.3%). The most frequent indication was kwashiorkor (45.5%), with 15.6% of patients being well nourished. Mean therapy duration was 11 days (SD = 11.1), and the main reason for termination was hospital discharge (70.1%). The supplement was concomitantly prescribed with the meals in 70.6% of the cases, and more than halfMaterial y metodos: Estudio retrospectivo de 55 pacientes de 65,4 ± 14,7 anos, 35,7% mujeres y 64,3% varones con un IMC 27,87 ± 5,56 kg/m (0% con IMC 30 kg/m ) en tratamiento con NPT con una duracion de 28 ± 5 dias (mas de 20 dias en el 75% de los casos). El 16,1% presentaba Diabetes Mellitus previa al inicio de NPT. En el 64,3% de los pacientes, la fistula ocurria tras cirugia reciente: en un 38.8% tras reseccion de colon, 16,6% de intestino delgado y 13,9% de estomago. La NPT se planificaba para aportar diariamente 1,5 × Gasto Energetico Basal, 1,5 g/kg/dia de proteinas, 6 mg de vitamina B 12 y 414 μg de acido folico. Ninguna solucion contenia hierro.Objective. To assess the impact of weight loss in clinical progression of the comorbidities in a group of morbid obese patients submitted to surgical treatment with the duodenal switch technique. Study setting. Between 2001-2006, we have operated by the duodenal crossing technique a total of 118 morbid obese patients (97 women and 21 men), mean age 42.6 years. Average pre-surgical BMI was 49.7, with average overweight of 69.1 kg. After surgical intervention, we have prospectively assessed the progression of the main comorbidities (arterial hypertension, diabetes, OSAS, osteoarticular pathology, dyslipidemia), according to the subscale of the BAROS scoring system. Postsurgical controls are done at months 3, 6, 12, 18, and 24 and annually thereafter. We have followed-up 110 patients, of whom 90 presented comorbidities, being the ones studied. Results. At 3 months post-surgery, we observed a decrease in the mean value of %WL to 31%, and a mean BMI value of 41.3, the percentage of lost BMI being 40.3%. Most of the weight loss occurred within 2 years, with %WL of 74.8% and a percentage of lost BMI of 97.7%. In 68 patients (75.5%) there was resolution of their comorbidities, 14.4% having improvement, and 10% with no improvement in spite of the surgery. Of patients achieving complete resolution, almost all of them achieved it within two years after surgery. Cure rates correlate with weight loss, so that at 3 months, with a mean weight loss of 25 kg (BMI decrease of 8.4 points) the comorbidity resolution rate is 45.5%. At 12 months, with a mean decrease in BMI of 16.4 points, %WL of 61.6% and % of lost BMI of 70.4%, the comorbidity resolution rate is 89.7%. At two years, by the time most of the main comorbidities resolved (68 patients), the BMI decreased by 22.4 points, the %WL 74.8% and the % of lost BMI 97.9%. Conclusion. The aim of bariatric surgery is weight loss and overweight-associated comorbidities improvement. In our study, most of the comorbidities improvement started at the third month, with the highest improvement rate occurring within two years, verifying that there is a direct relationship between post-surgical weight loss comorbidities improvement and resolution in most of the cases.Objective: To investigate the breeding rate and breeding density of Carpoglyphus lactis in stored Fructus Jujubae in Anhui, China in order to provide a scientific basis for prevention of Carpoglyphus lactis(C. lactis) from spoiling the dried fruit of such category. Methods： By the breeding nature of C. lactis, we collected samples of Fructus Jujubae, which were kept over 6 months in general, from the dried fruit shop and (or) Chinese herbal medicine warehouse, and isolated C. lactis from those samples. The mite specimens were prepared, and microscopically and morphologically identified. Species classification was done in accordance with Hughes (1976). Result:C. lactis was identified in 19 of the 300 samples, with breeding density and breeding rate of 6.52 heads/g and 6.33%. Constitute ratio at distinct developmental phase was associated with adult (including nymph, 85.71%), larva(12.27%), hypopus (0.56%) and egg(1.45%), respectively. The richness index, diversity index and evenness index was1.644, 1.644 and 0.923, respectively. Conclusion： Carpoglyphus lactis appears infesting in large quantity in the Fructus Jujubae stored in the above places in Anhui province, and the density is higher. Therefore, it is urgent to take effective measures to prevent C. lactis from spreading over other dried products stored in the same room and potential human intestinal acariasis as a result of the biological contamination.Objective: To determine possible associations between the risk of breast cancer in Brazilian women and demographic, social and economical variables, and past dietary intake. Methods: A case-control study was conducted in Joinville, Santa Catarina, Brazil, between june and november 2003 involving a group of 33 women recently diagnosed with breast cancer and a control group of 33 healthy women volunteers. Personal details, health history and past dietary intake were obtained via questionnaires and interviews. Data between groups were compared using χ2, Fisher, and Student’s t test, whilst associations were evaluated using a non-conditional logistic regression method and odds ratio (OR). Results: Statistically significant differences between the two groups were revealed with respect to age distribution (P = 0.007), family income level (P = 0.02), educational level (P 45 years), low family income (<