Pedro Andres

Chronic obstructive pulmonary disease (COPD) is one of the most important and prevalent diseases suffered by the elderly. Evidence exists that its onset and severity might be conditioned by antioxidant status. The aim of the present study was to investigate the relationship between antioxidant status and COPD in institutionalised elderly people. In all, 183 elderly people aged >65 years (twenty-one had COPD and 160 healthy controls) were studied. The subjects’ diets were investigated via the use of precise individual weighing for 7 d. Body weight, height, and biceps and triceps skinfold thickness were measured, and body fat (kg) and BMI (kg/m²) were calculated. Serum retinol, α-tocopherol, β-carotene and vitamin C levels were determined. Subjects with COPD ate less fruits than healthy controls (117 (sd 52) v. 192 (sd 161) g/d), their coverage of the recommended intake of vitamin C was smaller (150 (sd 45) v. 191 (sd 88) %; note that both exceeded 100 %) and their diets had a lower antioxidant capacity (6558 (sd 2381) v. 9328 (sd 5367) mmol trolox equivalent/d). Those with COPD had lower serum vitamin C and α-tocopherol concentrations than healthy controls (32·4 (sd 15·3) v. 41·5 (sd 14·8) µmol/l and 12·1 (sd 3·2) v. 13·9 (sd 2·8) µmol/l, respectively). In addition, subjects with α-tocopherol P<0·05), taking sex, age, use of tobacco, body fat and vitamin E intake as covariables. Subjects with COPD had diets of poorer antioxidant quality, especially with respect to vitamins C and E, compared with healthy controls.

Objective: Obesity has been associated with vitamin D deficiency and increased oxidative stress, which can lead to the dysregulation of adipokines and inflammation. The aim of the present work was to examine the association of vitamin D status [25(OH)D] on inflammatory related markers in overweight/obese children. Subjects/Methods: A total of 137 Spanish schoolchildren between 9 and 12 years of age (31.4 % with overweight/obesity) were studied. Being overweight was defined as BMI ≥ 85th percentile and obesity as BMI ≥ 97th percentile using the reference tables of Hernández. Serum 25(OH)D concentrations were measured by chemiluminescent assay. Plasma tumor necrosis factor (TNF-α) and interleukin-6 (IL-6) were measured by immunoenzyme assay. Serum adiponectin was determined using an ELISA kit. Serum high-sensitivity C-reactive protein (hs-PCR) was tested by immunonephelometry. Results: IL-6 concentrations were higher in the overweight/obese children with deficient serum 25(OH)D (< 20 ng/mL) than in those in this group but whose serum 25(OH)D concentrations were adequate (≥ 20 ng/mL). Serum 25(OH)D was inversely associated with IL-6 concentrations in the overweight/obese subjects taking into account different covariates; thus, for every 1 ng/mL rise in the former, the latter fell by 0.160 pg/mL (β = - 0.160 ± 0.068; R² = 0.131; p = 0.023). The obese subjects with concentrations of ≥ 25 ng/mL had lower hs-CRP values compared to those with concentrations of < 25 ng/mL (0.053 ± 0.035 vs. 0.356 ± 0.613 mg/dL; p = 0.035). Conclusion: Low serum 25(OH)D was significantly associated high serum IL-6 in overweight/obese children, and with increased hs-CRP in obese children.

Zn plays a key role in the synthesis and action of insulin. The aim of the present work was to determine whether a poorer Zn status was associated with insulin resistance in a group of 357 Spanish schoolchildren. Zn intake was determined by using a 3 d food record (i.e. Sunday to Tuesday). The body weight, height and waist and hip circumferences of all subjects were recorded and fasting plasma glucose, insulin and Zn concentrations were determined. Insulin resistance was determined using the homoeostasis model assessment (HOMA) marker. Children (11·5 %) with Zn deficiency (serum Zn concentration < 10·7 μmol/l) had higher HOMA values than those with a more satisfactory Zn status (1·73 (sd0·93)) compared with 1·38 (sd0·90;P < 0·05). An inverse correlation was found between the HOMA value and the serum Zn concentration (r− 0·149,P < 0·05). The risk of having a greater insulin resistance value (HOMA greater than the 75th percentile) increased with age (OR 1·438; 95 % CI 1·021, 2·027) and BMI (OR 1·448; 95 % CI 1·294, 1·619) and decreased as Zn serum levels increased (OR 0·908; 95 % CI 0·835, 0·987;P < 0·001). Moreover, an inverse relationship was observed between HOMA values and Zn dietary density (r− 0·122), and the Zn intakes of male children with a HOMA value of >3·16 made a significantly smaller contribution to the coverage of those recommended (59·7 (sd14·7) %) than observed in children with lower HOMA values (73·6 (sd18·2) %;P < 0·05). Taking into account that Zn intake was below than that recommended in 89·4 % of the children, it would appear that increasing the intake of Zn could improve the health and nutritional status of these children, and thus contribute to diminish problems of insulin resistance.

The present study reports the Na intake of a representative sample of Spanish young and middle-aged adults aged 18–60 years (n418, 53·1 % women, selected from the capitals of fifteen provinces and the surrounding semi-urban/rural area), measured with a 24 h urinary Na excretion method. To validate the paper collection of 24 h urine, the correlation between fat-free mass determined by electrical bioimpedance (50·8 (sd11·3) kg) and that determined via urinary creatinine excretion (51·5 (sd18·8) kg) was calculated (r0·633,P < 0·001). Urinary Na excretion correlated with systolic and dyastolic blood pressure data (r0·243 and 0·153, respectively). Assuming that all urinary Na (168·0 (sd78·6) mmol/d) comes from the diet, Na excretion would correspond with a dietary salt intake of 9·8 (sd4·6) g/d, and it would mean that 88·2 % of the subjects had salt intakes above the recommended 5 g/d. Logistic regression analysis, adjusted for sex, age and BMI, showed male sex (OR 3·678, 95 % CI 2·336, 5·791) and increasing BMI (OR 1·069, 95 % CI 1·009, 1·132) (P < 0·001) to be associated with excreting >200 mmol/d urinary Na – a consequence of the higher salt intake in men and in participants with higher BMI. The present results help us to know the baseline salt intake in the Spanish young and middle-aged adult population, and can be used as the baseline to design policies to reduce salt consumption.

Obesity has been linked with poorer vitamin D status. The aim of this work was to analyze the changes in vitamin D status and body weight of 61 young, overweight/obese women following two different weight control programs. The study subjects were randomly assigned to one of two slightly hypocaloric diets: diet V, in which the consumption of greens and vegetables was increased, or diet C, in which the consumption of cereals (some of which were enriched with vitamin D) was increased. Dietary, anthropometric, and biochemical data were collected at the start of the study and at 2 weeks. At the beginning of the study, when taking into account only those women with a vitamin D intake below that recommended, obese women had a significantly lower mean serum 25(OH)D concentration than those who were lighter. Dietary intervention led to a greater reduction in energy intake among group C subjects; their weight was also that which was most reduced. In addition, the vitamin D intake and serum 25(OH)D values were increased only in group C women. Excess body weight was associated with deterioration in vitamin D status, especially when the intake of this vitamin was lower than that recommended. Subjects with higher serum vitamin D at the beginning of the study lost more weight than those subjects with lower initial values. Diet C was associated with a greater weight loss than diet V, and led to a greater increase in vitamin D intake and serum 25(OH)D levels. This might be of interest in the improvement of health in people trying to lose weight.

Objective: To analyze folate status changes in a group of overweight/obese young women following two different weight control programs. Methods: Fifty-seven women (BMI=24-35 kg/m²) were randomly assigned to one of two slightly hypocaloric diets: diet V, in which the consumption of vegetables was increased, or diet C, in which the consumption of cereals (especially breakfast cereals) was increased. Dietetic, anthropometric and biochemical data were collected at the start of the study and again at 6 wk. Results: At the beginning of the study, the obese women (BMI≥30 kg/m²) were at greater risk of showing serum folic acid concentrations of 2.5 kg; this was the case of the subjects as a whole and of those who followed the C diet. Among those who lost the most weight (>2.5 kg), the chances of having an increased serum folate concentration were higher, although no significant differences were seen in folate intake with respect to women who lost less weight. Conclusions: Following a hypocaloric diet could lead to a better folate status through increased intake, but especially among those who lose the most body weight.

The aim of this study was to analyse the thiamine status in a group of young, overweight/obese women and to analyse the changes in this status produced by two weight-control programmes based on approximating the diet to the theoretical ideal, increasing the relative consumption of vegetables (V) or cereals (C) (especially breakfast cereals). The study subjects were 57 Spanish women with a body mass index (BMI) of 24–35 kg/m², all of whom were randomly assigned to one of two slightly hypocaloric diets. Dietetic, anthropometric and biochemical data were collected at the beginning of the study and at 2 and 6 weeks. C and V subjects showed a reduction in their energy intake, body weight and BMI, both at 2 and 6 weeks. Thiamine intake and blood thiamine levels only increased with diet C (both at 2 and 6 weeks). 21.8% cf the women, 21.8% had blood thiamine levels <150 nmol/L at the beginning of the study, but at 6 weeks of intervention only 3.7% of the women in diet C, as compared with 30.8% of the women in diet V, showed blood thiamine levels <150 nmol/L. Although both diet C and diet V induced weight loss and a reduction in BMI, diet C would appear to be more useful in the maintenance of an adequate thiamine status.

The aim of this work was to compare the efficacy of two strategies designed to improve folate status: increasing the intake of vegetables, and the consumption of a folic acid-fortified food. Residents (126) from three old people's homes in the Madrid region (Spain) were studied. To each centre a dietary intervention was assigned to be followed for 6 months: (1) the consumption of margarine fortified with 200 μg folic acid/10 g portion (centre M), (2) increasing the consumption of vegetables to three servings per day (centre V), (3) control (centre C). At the beginning and end of the intervention period the subjects' intakes, serum and erythrocyte concentrations of folate were measured. The use of fortified margarine (centre M) led to a significant increase in folate intake (260·9 μg/d), serum concentration (10·3 (sd8·3) nmol/l) and erythrocyte concentration (638·4 nmol/l). At centre V the increase in total vegetable intake achieved was very poor; these foods met with very poor acceptance, although the intake of certain vegetables particularly rich in folate improved. Therefore, the intake of this vitamin increased a little (26·7 (sd33·0) μg/d); erythrocyte folate concentration also increased somewhat (460·5 nmol/l), althought less than centre M. The daily consumption of margarine fortified with folic acid was the more effective strategy for improving the folate status of the study subjects.

Objective: Design: Subjects: Measurements: Results: Conclusions:

The loss of weight was analysed in a group of sixty overweight/obese women of childbearing age (20–35 years) according to their initial vitamin D status. Subjects were randomly assigned to one of two slightly hypocaloric diets: Diet V, in which the consumption of vegetables was increased, or Diet C, in which the relative consumption of cereals (especially breakfast cereals) was increased. Dietetic, anthropometric and biochemical data were collected at the start of the study and again at 2 weeks after dividing the women into groups depending on their having an initial serum 25-hydroxyvitamin D (25(OH)D) concentration of < 50 nmol/l (LD) or ≥ 50 nmol/l (HD). Dietary intervention led to a reduction in energy intake, body weight and BMI in all groups. The HD women showed greater body fat losses during the study than the LD women (1·7 (sd 1·8) kg compared to 0·5 (sd 0·8) kg). A better vitamin D status therefore aided the loss of body fat over the experimental period (OR 0·462; CI 0·271, 0·785; P < 0·001). However, when the dietary groups were analysed separately, this effect was only seen in the C subjects (OR 0·300; CI 0·121, 0·748; P < 0·001). The present results suggest that women with a better vitamin D status respond more positively to hypocaloric diets and lose more body fat; this was especially clear among the C subjects who had a greater vitamin D supply during the experimental period.