Cognition and the risk of eating disorders in Spanish adolescents: the AVENA and AFINOS studies.

UNLABELLED: Eating disorders (ED) can arise from a combination of biological and psychological factors. Some studies suggest that intellectual factors might be important in the development of ED, although the evidence is still scarce. The aim of this study was to examine the association between cognition measurements (cognitive performance and academic achievement) and the risk of developing ED in adolescents considering their weight status. The sample consisted of 3,307 adolescents (1,756 girls), aged 13-18.5 years, who participated in the AVENA (n = 1,430; 783 girls) and AFINOS (n = 1,877; 973 girls) studies. Cognitive performance was measured by the TEA test in the AVENA study, and academic achievement was self-reported in the AFINOS study. ED risk was evaluated in both studies by using the SCOFF questionnaire. Body mass index was calculated to classify adolescents as non-overweight or overweight (including obesity). Overweight adolescents showed a higher risk of developing ED than non-overweight ones in both studies. In the AVENA study, overweight boys with low performance in reasoning ability showed increased risk of ED (p = 0.05). In the AFINOS study, overweight boys with low academic performance in physical education and non-overweight girls with low academic achievement in all the areas analyzed showed higher risk of ED than their peers (all p < 0.05). CONCLUSION: No association between cognitive performance and ED risk was found in adolescents, while academic achievement was associated with ED risk, especially in non-overweight girls. The non-cognitive traits that accompany academic achievement could influence the likelihood of developing ED in these girls.

Five year trends on total and abdominal adiposity in Spanish adolescents.

OBJECTIVE: To assess five years trends in total and abdominal fat in Spanish adolescents. DESIGN: Two cross-sectional studies: adolescents from the city of Zaragoza (Spain) assessed during 2001-2002 and 2006-2007. SUBJECTS: 399 adolescents in 2001-02 and 392 adolescents in 2006-07. MAIN OUTCOME MEASUREMENTS: Socio-economic status was assessed using the education level of both parents. A complete anthropometric assessment was performed in both surveys using the same methodology: weight, height, skinfold thickness (biceps, triceps, subscapular, suprailiac, thigh and calf) and circumferences (waist and hip). The body mass index (BMI) and the sum of 6 skinfold thicknesses were calculated. Body fat percentage (BF%) was also calculated by the formulas described by Slaughter et al. RESULTS: After adjusting for age and pubertal status, only females showed a significantly decrease in weight, BMI and waist circumference, and a significant increase in the sum of 6 skinfolds (all P < 0.05 and Cohen's d ≥ 0.25) in 2006-2007, when compared to values obtained in 2001-2002. Males did not show any significant change between the two surveys. Concerning centile values, a slight general reduction was observed in weight, BMI and waist circumference for both males and females. On the contrary, the sum of 6 skinfolds and the BF% were higher in 2006-2007 than in 2001-2002. CONCLUSION: According to these results, there might be a levelling-off in the trends of BMI, BF% and waist circumference in male adolescents from Zaragoza. In females, despite a trend towards higher body fat mass, there was a trend towards lower BMI and waist circumference values.

Five year trends on total and abdominal adiposity in Spanish adolescents / Tendencias durante cinco años en la grasa total y abdominal en adolescentes españoles

Objective: To assess five years trends in total and abdominal fat in Spanish adolescents. Design: Two cross-sectional studies: adolescents from the city of Zaragoza (Spain) assessed during 2001-2002 and 2006-2007. Subjects: 399 adolescents in 2001-02 and 392 adolescents in 2006-07. Main outcome measurements: Socio-economic status was assessed using the education level of both parents. A complete anthropometric assessment was performed in both surveys using the same methodology: weight, height, skinfold thickness (biceps, triceps, subscapular, suprailiac, thigh and calf) and circumferences (waist and hip). The body mass index (BMI) and the sum of 6 skinfold thicknesses were calculated. Body fat percentage (BF%) was also calculated by the formulas described by Slaughter et al. Results: After adjusting for age and pubertal status, only females showed a significantly decrease in weight, BMI and waist circumference, and a significant increase in the sum of 6 skinfolds (all P < 0.05 and Cohen's d ≥ 0.25) in 2006-2007, when compared to values obtained in 2001-2002. Males did not show any significant change between the two surveys. Concerning centile values, a slight general reduction was observed in weight, BMI and waist circumference for both males and females. On the contrary, the sum of 6 skinfolds and the BF% were higher in 2006-2007 than in 2001-2002. Conclusion: According to these results, there might be a levelling-off in the trends of BMI, BF% and waist circumference in male adolescents from Zaragoza. In females, despite a trend towards higher body fat mass, there was a trend towards lower BMI and waist circumference values (AU)

Objetivo: Evaluar las tendencias de cinco años de la grasa total y abdominal de adolescentes españoles. Diseño: Dos estudios transversales: adolescentes de la ciudad de Zaragoza (España) evaluados durante 2001-2002 y 2006-2007. Sujetos: 399 adolescentes en 2001-02 y 392 adolescentes en 2006-07. Principales variables estudiadas: El estado socioeconómico se evaluó usando el nivel educativo de ambos progenitores. Se realizó una evaluación antropométrica completa en ambos estudios con la misma metodología: peso, talla, grosor del pliegue (bíceps, tríceps, subescapular, suprailíaco, muslo y pantorrilla) y circunferencias (cintura y cadera). Se calcularon el índice de masa corporal (IMC) y la suma del grosor de 6 pliegues. También se calculó el porcentaje de grasa corporal (%GC) con las fórmulas descritas por Slaughter et al. Resultados: tras ajustar por edad y estado puberal, sólo las chicas mostraron un descenso significativo del peso, IMC y la circunferencia de la cintura, y un aumento significativo en la suma de los 6 pliegues cutáneos (todos ellos P < 0,05 y d de Cohen ≥ 0,25) en 2006-2007, en comparación con los valores obtenidos en 2001-2002. Los chicos no mostraron cambios significativos entre ambos estudios. Con respecto a los percentiles, se observó una reducción leve del peso, IMC y circunferencia de la cintura en chicos y chicas. Por el contrario, la suma de los 6 pliegues cutáneos y el %GC fueron mayores en 2006-2007 que en 2001-2002. Conclusión: de acuerdo con estos resultados, podría haber un resultado neutro en las tendencias del IMC, %GC y circunferencia de la cintura en los adolescentes varones de Zaragoza. En las chicas, a pesar de una mayor tendencia a una mayor grasa corporal, hubo una tendencia a unos menores valores de IMC y de circunferencia de la cintura (AU)

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.

[Rare diseases: medicine's challenge in the XXI Century]. / Enfermedades raras: el reto de la medicina en el siglo XXI.

Rare diseases (RD) are receiving increasing attention within both the scientific community and society in general. Many RDs are diagnosed during paediatric age and affect the patient throughout his life, but they can also be diagnosed during adult age. Advances in the biochemical, molecular and genetic diagnosis of these diseases are proving essential in improving clinical understanding and therapeutic possibilities. However, their low prevalence makes it difficult to develop suitable medicines for treatment and it is necessary to implement specific social and health protection programs for these medicines, which are called orphan medicines (OM). In general these serious, chronic diseases involving a high degree of disability are difficult to diagnose. For better diagnosis and monitoring it is necessary to develop reference units at the state level that will improve our knowledge of these pathologies. RDs have a direct repercussion on both the family, which in many cases becomes the carer, and on society, which must develop specific social, health and educational programs to support these patients. In short, RDs form a significant challenge of coordination for the scientific community and for society given their significant specific weight in the development of health care in our setting.

[Rare diseases in paediatrics]. / Enfermedades raras en pediatría.

Few areas of paediatric care are as susceptible to the revision of lines of action, and require such professional training, as the care of the child with a rare disease (RD) and his/her family, especially if there are malformations. The lifelong impact, which many RDs entail, make continuous monitoring of the child compulsory, centred both on the evolutionary aspects of the RD and on the family's adaptation to the problem. Besides the sad reality they confront, the parents must frequently make immediate decisions on medical or surgical treatment for their child, or face a lethal or disabling condition that "robs" them of their expectations. Only suitable care for each of the numerous problems faced by these children and their families helps to minimise the potential handicap associated with RDs. In spite of the unquestionable complexity involved in exploring this field, the paediatrician must acquire knowledge of these diseases in order to ground his involvement in the diagnosis and monitoring of these patients. Abstention by the paediatrician in the face of this responsibility would have a negative effect on the care of these patients, which he must share with the corresponding specialists.

[Genetically based diseases]. / Enfermedades de base genética.

Genetics is one of the greatest scientific advances of the XX century, which begins with the rediscovery of Mendel's laws and culminates in the elaboration of the first "draft" of the complete sequence of the human genome. Genetics employs different research strategies, such as the study of twins and adoption, investigating the influence of genetic and environmental factors, and strategies for identifying specific genes (molecular genetics). Besides the significant degree of disability they generate, the social impact of hereditary diseases is enormous, due to their potentially recurrent character in the same family and the high socio-health cost deriving from the enormous care burden they require. The diagnosis of hereditary diseases presents very significant differentiating characteristics since the result of a genetic diagnosis has effects not only on the patient but also on related individuals. Thus the unit of study in genetic diagnosis is the family and the whole process of diagnosis involves family research. It is also useful to bear in mind that the protocols of diagnosis are developed in parallel with the basic research and in general are hardly standardised. The results obtained in genetic studies and the type of information provided to the patient and his family must be qualified within the process of "genetic counselling".

[Needs in rare diseases during paediatric age]. / Necesidades en las enfermedades raras durante la edad pediátrica.

All rare diseases present a common set of challenges to the sufferers and their families: diagnosis, dealing with symptoms, health information, obtaining helpful medical care, availability of medications, disability and emotional impact. Children with rare disorders are an important population from health care services, and social services perspectives, and families are providing long-term care for these chronically ill children. The impact of rare disorders in children is far-reaching, extending beyond the child to all those with whom he/she has contact. Multiple facets of life are affected including social an family relationships, economical well-being and activities of daily living. The assessment of needs for rare disorders treatment is a critical step in providing high quality care and achieving patients' and families' satisfaction. Findings from different studies show that people with rare diseases have medical and social needs. Social needs are becoming more relevant in developed countries where health care services, even with limitations, have greater availability than social services. Furthermore, it seems that health care and social services for persons with rare diseases need to be improved to address the patients' needs and to provide better support to families. Validated tools with good psychometric properties are still needed to assess quality of care on the basis of patients and family needs.

Novel drug nanocarriers combining hydrophilic cyclodextrins and chitosan.

The aim of this study was to explore the possibility of obtaining nanoparticles (NPs) containing high amounts of cyclodextrin (CD) derivatives such as carboxymethyl-ß-CD and sulphobutyl ether-ß-CD. The rationale used was to combine the drug solubilizing and stabilizing properties of cyclodextrins (CDs) with the mucoadhesive properties of chitosan (CS) in a unique nanoparticulate drug delivery system. The size of the resulting NPs was affected by the nature of the CDs, ranging between 275 and 550 nm, whereas the zeta potential of the NPs was always positive and close to +35 mV. The positive zeta values, together with the results from NMR studies, suggest that CS is the major compound on the surface of the NPs, while CD molecules are strongly associated with the NP matrix. The empirical composition of the NPs was quantified by elemental analysis and the results indicated that the amount of CD associated with the NPs was strictly dependent on its electrostatic charge. Finally, in vitro stability studies indicated that the presence of CDs in the NP structure can prevent the aggregation of this nanometric carrier system in simulated intestinal fluid. Overall, this new type of NP represents an attractive drug delivery platform of particular interest for the oral administration of drugs with low bioavailability.

Enfermedades raras: el reto de la medicina en el siglo XXI / Rare diseases: medicine’s challenge in the XXI Century

Las Enfermedades Raras (ER) vienen siendo objetode atención cada vez mayor tanto dentro de la comunidadcientífica como en la sociedad en general. Muchasde ellas se diagnostican en la edad pediátrica y acompañanal paciente durante toda su vida, pero tambiénpueden ser diagnosticadas en la edad adulta.El avance en el diagnóstico bioquímico, moleculary genético de estas enfermedades está siendo fundamentalpara mejorar la comprensión clínica y las posibilidadesterapéuticas. Sin embargo, la baja prevalenciadificulta el desarrollo de medicamentos adecuadospara el tratamiento y se hace necesario la implementaciónde programas socio-sanitarios específicos de proteccióna estos medicamentos denominados medicamentoshuérfanos (MH).En general, se trata de enfermedades de difícildiagnóstico, graves, crónicas y con un alto grado deinvalidez. Para su mejor diagnóstico y seguimiento sehace necesario desarrollar unidades de referencia anivel estatal que mejoren nuestro conocimiento sobreestas patologías. Las ER repercuten de forma directa,tanto en la familia –que se convierte en muchos casosen sus cuidadores– como en la sociedad que tiene quedesarrollar programas socio-sanitarios y educativosespecíficos de apoyo a estos enfermos.En definitiva, las ER suponen un importante retode coordinación para la comunidad científica y para lasociedad dado su importante peso específico en eldesarrollo de la atención médica en nuestro medio

Rare diseases (RD) are receiving increasing attentionwithin both the scientific community and societyin general. Many RDs are diagnosed during paediatricage and affect the patient throughout his life, but theycan also be diagnosed during adult age.Advances in the biochemical, molecular and geneticdiagnosis of these diseases are proving essential inimproving clinical understanding and therapeutic possibilities.However, their low prevalence makes it difficultto develop suitable medicines for treatment and itis necessary to implement specific social and healthprotection programs for these medicines, which arecalled orphan medicines (OM).In general these serious, chronic diseases involvinga high degree of disability are difficult to diagnose.For better diagnosis and monitoring it is necessary todevelop reference units at the state level that willimprove our knowledge of these pathologies. RDs havea direct repercussion on both the family, which in manycases becomes the carer, and on society, which mustdevelop specific social, health and educational programsto support these patients.In short, RDs form a significant challenge of coordinationfor the scientific community and for societygiven their significant specific weight in the developmentof health care in our setting

Enfermedades raras en pediatría / Rare diseases in paediatrics

Pocas áreas de la asistencia pediátrica son tan susceptiblesde revisión en cuanto a las pautas de actuación,y de tan necesaria formación por parte del profesional,como la asistencia a un niño y a su familia conuna enfermedad rara (ER), muy especialmente si setrata de un niño malformado. El impacto de por vida,que conllevan muchas ER, obliga a un seguimiento continuadodel niño, centrado tanto en los aspectos evolutivosdel mismo como en la adaptación de la familia alproblema. Además de la triste realidad a la que seenfrentan, los padres frecuentemente deben tomardecisiones inmediatas sobre el tratamiento médico oquirúrgico de su hijo, o enfrentarse a una condiciónletal o incapacitante que les «roba» sus expectativas.Sólo una adecuada atención a cada uno de los múltiplesproblemas a los que se enfrentan estos niños y susfamilias ayuda a minimizar el potencial handicap asociadoa las ER. A pesar de la indudable complejidad queconlleva la profundización en este campo, el pediatradebe introducirse en el conocimiento de estas enfermedadescon la finalidad de fundamentar su implicaciónen el diagnóstico y seguimiento de los pacientes.Su abstención ante esta responsabilidad repercutiríanegativamente en la atención a estos enfermos, quedeberá compartir con los especialistas correspondientes

Few areas of paediatric care are as susceptible tothe revision of lines of action, and require suchprofessional training, as the care of the child with a raredisease (RD) and his/her family, especially if there aremalformations. The lifelong impact, which many RDsentail, make continuous monitoring of the childcompulsory, centred both on the evolutionary aspectsof the RD and on the family’s adaptation to theproblem. Besides the sad reality they confront, theparents must frequently make immediate decisions onmedical or surgical treatment for their child, or face alethal or disabling condition that “robs” them of theirexpectations. Only suitable care for each of thenumerous problems faced by these children and theirfamilies helps to minimise the potential handicapassociated with RDs. In spite of the unquestionablecomplexity involved in exploring this field, thepaediatrician must acquire knowledge of thesediseases in order to ground his involvement in thediagnosis and monitoring of these patients. Abstentionby the paediatrician in the face of this responsibilitywould have a negative effect on the care of thesepatients, which he must share with the correspondingspecialists

Enfermedades de base genética / Genetically based diseases

La genética constituye uno de los mayores avancescientíficos del siglo XX, que comienza con el redescubrimientode las leyes de Mendel y termina con la elaboracióndel primer “borrador” de la secuencia completadel genoma humano. La genética utiliza diferentesestrategias de investigación, como los estudios degemelos y de adopción, que investigan la influencia delos factores genéticos y ambientales, y las estrategiaspara identificar genes específicos (genética molecular).Además del importante grado de discapacidad quegeneran, el impacto social de las enfermedades hereditariases enorme, por su carácter potencialmente recurrenteen una misma familia y por el elevado costesocio-sanitario derivado de la enorme carga de cuidadosque requiere. El diagnóstico de las enfermedadeshereditarias presenta características diferenciadorasmuy significativas ya que el resultado de un diagnósticogenético tiene no sólo efectos sobre el paciente sinotambién sobre todos los individuos emparentados. Portanto, la unidad de estudio en el diagnóstico genéticoes la familia y todo proceso de diagnóstico implica unainvestigación familiar. También conviene tener en cuentaque los protocolos de diagnóstico se desarrollan deforma paralela a la investigación básica y generalmenteestán poco estandarizados. Los resultados obtenidosen los estudios genéticos y el tipo de información quese facilita al paciente y a su familia deben ser matizadosdentro del proceso del “consejo genético”

Genetics is one of the greatest scientific advancesof the XX century, which begins with the rediscovery ofMendel’s laws and culminates in the elaboration of thefirst “draft” of the complete sequence of the humangenome. Genetics employs different researchstrategies, such as the study of twins and adoption,investigating the influence of genetic andenvironmental factors, and strategies for identifyingspecific genes (molecular genetics). Besides thesignificant degree of disability they generate, the socialimpact of hereditary diseases is enormous, due to theirpotentially recurrent character in the same family andthe high socio-health cost deriving from the enormouscare burden they require. The diagnosis of hereditarydiseases presents very significant differentiatingcharacteristics since the result of a genetic diagnosishas effects not only on the patient but also on relatedindividuals. Thus the unit of study in genetic diagnosisis the family and the whole process of diagnosisinvolves family research. It is also useful to bear inmind that the protocols of diagnosis are developed inparallel with the basic research and in general arehardly standardised. The results obtained in geneticstudies and the type of information provided to thepatient and his family must be qualified within theprocess of “genetic counselling”

Necesidades en las enfermedades raras durante la edad pediátrica / Needs in rare diseases during paediatric age

Las enfermedades raras plantean una serie de retos a los afectados y sus familias: el diagnóstico, afrontar los síntomas, la información sobre la enfermedad, obtención de atención sanitaria adecuada, disponibilidad de fármacos, discapacidad e impacto emocional. Los niños con enfermedades raras constituyen un grupo poblacional muy importante desde el punto de vista de los servicios sanitarios y sociales, y las familias deben proporcionar cuidados durante largo tiempo a estos niños enfermos. La repercusión de las enfermedades raras en los niños es de gran alcance, extendiéndose más allá de ellos mismos, a todas las personas de su entorno. Son múltiples las facetas de la vida afectadas, incluyendo las relaciones familiares y sociales, el bienestar económico o las actividades cotidianas. La evaluación de las necesidades en las enfermedades raras es una fase crítica para proporcionar una atención sanitaria de alta calidad y conseguir la satisfacción del enfermo y su familia. Los hallazgos de diferentes estudios han puesto de manifiesto que las personas con enfermedades raras tienen necesidades médicas y sociales. Las necesidades sociales están adquiriendo una gran relevancia en los países desarrollados, en los que los servicios sanitarios, aún con limitaciones, tienen mayor disponibilidad que los servicios sociales. Por consiguiente, parece necesario que los servicios sanitarios y sociales para las personas con enfermedades raras deben mejorarse para abordar las necesidades de los pacientes y proporcionar mejor apoyo a las familias. En este sentido, sigue siendo necesario disponer de instrumentos validados con buenas propiedades psicométricas para valorar la calidad de la asistencia en función delas necesidades de los pacientes y sus familias (AU)

All rare diseases present a common set of challenges to the sufferers and their families: diagnosis,dealing with symptoms, health information, obtaining helpful medical care, availability of medications,disability and emotional impact. Children with rare disorders are an important population from health care services, and social services perspectives, and families are providing long-term care for these chronically ill children. The impact of rare disorders in children is far reaching, extending beyond the child to all those with whom he/she has contact. Multiple facets of life are affected including social an family relationships,economical well-being and activities of daily living. The assessment of needs for rare disorders treatment is a critical step in providing high quality care and achieving patients’ and families’ satisfaction. Findings from different studies show that people with rare diseases have medical and social needs. Social needs are becoming more relevant in developed countries where health care services, even with limitations, have greater availability than social services. Furthermore, it seems that health care and social services for persons with rare diseases need to be improved to address the patients’ needs and to provide better support to families. Validated tools with good psychometric properties are still needed to assess quality of care on the basis of patients and family needs (AU)

Aversiones y preferencias alimentarias de los adolescentes de 14 a 18 años de edad, escolarizados en la ciudad de Santander / Nutritional aversions and preferences of 14-18 years old adolescents, schooled at the city of Santander

Objetivo: Describir las aversiones y preferencias alimentarias de los adolescentes, de 14 a 18 años de edad, escolarizados en Santander y analizar los cambios ocurridos en las mismas en la última década. Sujetos: Se realizó un estudio transversal, analizando una muestra de 1.134: 549 varones (48,4%, IC-95%:45,5% a 51,3%) y 585 mujeres (51,6%, IC-95%: 48,7%a 54,5%), de edades comprendidas entre los 14 y los 18años, escolarizados en siete centros de enseñanza secundaria de Santander, mediante un cuestionario. Resultados: Las verduras y hortalizas (54,7%) y las legumbres (18,7%) constituyen las principales aversiones alimentarias de los adolescentes. Por otro lado, los cereales (53,3%) y la carne (14,6%) son los grupos de alimentos preferidos. Las lentejas, la lechuga, la fresa, el agua y la pasta en general fueron los alimentos más valorados dentro de sus respectivos grupos de alimentos y bebidas. Conclusión: Las aversiones y preferencias alimentarias de los adolescentes santanderinos son, en líneas generales, bastante similares a las observadas en otros estudios, y no han sufrido cambios sustanciales a lo largo de la última década. Los datos obtenidos pueden ser útiles para observar las futuras tendencias sobre preferencias alimentarias, que conjuntamente con otros parámetros permitan caracterizar el comportamiento alimentario de nuestros adolescentes

Objective: To describe the nutritional aversions and preferences of 14-18 years old adolescents schooled at Santander and analyze the changes taking place within the last decade. Subjects: A cross-sectional study was carried out analyzing a sample of 1134 adolescents: 549 males(48.4%, 95% CI: 45.5%-5.3%) and 585 females (5.6%,95% CI: 48.7%-54.5%), ages comprised between 14 and18 years, and schooled at centers of secondary educational level from Santander, by means of a questionnaire. Results: vegetables (54.7%) and legumes (18.7%) represent the main nutritional aversions of adolescents. On the other hand, grains (53.3%) and meats (14.6%) are the preferred foods. Lentils, lettuce, strawberry, water, and pasta generally were the best-valued foods within the groups of foods and drinks to which they belong. Conclusion: nutritional aversions and preferences of adolescents from Santander generally are very similar to those observed in other studies and we have not observed important changes within the last decade. The data obtained may be useful to observe future trends on nutritional preferences that, together with other parameters, may help characterized the nutritional behavior of our adolescents

Protection of the peptide glutathione by complex formation with alpha-cyclodextrin: NMR spectroscopic analysis and stability study.

The main objective of this work was to investigate the complexation mechanism of the tripeptide glutathione with alpha-cyclodextrin (alpha-CyD). The final purpose was to explore the possibility of using this complexation approach for preserving the stability of this peptide in all biological environments relevant for oral drug delivery. The complexes between the peptide and alpha-CyD were formed in aqueous solution and the complexation mechanism was investigated using different (1)H NMR experimental approaches. The resulting complexes were also studied with respect to their ability to protect the peptide against proteolytic degradation by the exopeptidase, gamma-glutamyltranspeptidase. The NMR experiment, 1D-saturation transfer NOE difference (STD), evidenced the interaction between alpha-CyD and glutathione. The binding constants, calculated by a titration method, were in the range of 55-70 M(-1) at 25 degrees C and in the range 68-72 M(-1) at 37 degrees C. Moreover, from the 1D-pulse field gradient spin echo-transverse-rotating frame nuclear Overhauser (PFGSE-T ROESY) spectra it was concluded that alpha-CyD binds preferably to the l-glutamate (side chain) moiety of glutathione, leaving the glycine residue exposed to the external medium. This result was consistent with those of the in vitro stability study, which indicated that the degradation of glutathione was markedly reduced to the half in 2h upon inclusion in alpha-CyD. Overall, these results show the possibility of protecting specific peptide groups by their inclusion in CyDs as well as the utility of NMR experiments for the understanding of this stabilization strategy.

[Breakfast and snack of schooled adolescents in Santander]. / Desayuno y almuerzo de los adolescentes escolarizados de Santander.

OBJECTIVE: To study the breakfast model and food intake at mid-morning (snack) in schooled adolescents at Santander city. SUBJECTS: A cross-sectional study was performed analyzing a sample of 403 adolescents: 232 girls (58%; 95% CI: 52%-62%) and 171 boys (42%; 95% CI: 38%-48%), with ages between 12 and 19 years, schooled at 12 second degree education centers of Santander, by means of a closed questionnaire and a recall 24 hours later. RESULTS: Five percent (95% CI: 3.1%-7.6%) of the adolescents referred neglecting breakfast. The most consumed foods were milk (47%; 95% CI: 42%-52%), chocolate milk (40%; 95% CI: 36%-45%), and cookies (45%; 95%CI: 36%-45%). On the other hand, 63% of adolescents consume whole milk (95% CI: 58%-70%), 21% semi-skimmed milk (95%CI: 17%-26%), and 11% skimmed milk (95% CI: 8%-15%). A decreasing lineal tendency in whole milk consumption is observed and a parallel increase in consumption of milks with a lower fat content as the academic year of adolescents advances (Armitage's chi-square test for lineal tendency = 2.32; p = 0.02). Boys consume an average of 3.0 (SD = 1.35) different foods during breakfast and girls 2.4 (SD = 1.20). Forty-three percent (95% CI: 38%-48%) of adolescents have a snack, which means that 2% of adolescents do not have breakfast or a snack (95% CI: 1%-4%). Breakfast represents 18% (95% CI: 16%-19%) of the total daily energy intake, whereas for snack, this percentage is 16% (95% CI: 14%-17%). CONCLUSION: it is necessary to promote consumption of a healthy breakfast and snack that provide an appropriate quantitative and qualitative intake.

Desayuno y almuerzo de los adolescentes escolarizados de Santander / Breakfast and snack of schooled adolescents in Santander

Objetivo: Estudiar el modelo de desayuno e ingesta alimentaria de media mañana (almuerzo) de los adolescentes escolarizados de la ciudad de Santander. Sujetos: Se realizó un estudio transversal, analizando una muestra de 403 adolescentes: 232 mujeres (58%; IC-95%:52%-62%) y 171 varones (42%; IC-95%: 38%-48%), de edades comprendidas entre los 12 y los 19 años, escolarizados en 12 centros de enseñanza secundaria de Santander, mediante un cuestionario cerrado y un recuerdo de 24 horas. Resultados: El 5% (IC-95%: 3,1%-7,6%) de los jóvenes manifestó no desayunar. Los alimentos más consumidos son la leche (47%; IC-95%: 42%-52%), la leche chocolateada (40%: IC-95%: 36%-45%) y las galletas (45%; IC-95%: 36%-45%). Por otro lado, el 63% (IC-95%:58%-70%) de los jóvenes consume leche entera, el 21% (IC-95%:17%-26%) leche semidesnatada y el 11% (IC-95%:8%-15%) leche desnatada. Se aprecia una tendencia lineal decreciente en el consumo de leche entera, y un aumento paralelo en el consumo de leches con menos fracción grasa conforme aumenta el curso académico de los adolescentes (test r2 de tendencia lineal de Armitage = 2,32; p = 0,02). Los varones consumen una media de 3,0 (DE=1,35) alimentos diferentes en el desayuno y las mujeres 2,4 (DE=1,20). El 43% (IC-95%:38%-48%) de los adolescentes almuerza, lo que implica que un 2% (IC-95%: 1%-4%) de los jóvenes ni desayuna ni almuerza. El desayuno representa el 18% (IC-95%: 16%-19%) del total de la ingesta energética diaria, mientras que para el almuerzo este porcentaje es del 16% (IC-95%:14%-17%). Conclusión: Es necesario fomentar el consumo de un desayuno y almuerzo saludables que proporcionen una ingesta cuantitativa y cualitativa adecuadas (AU)

Objective: To study the breakfast model and food intake at mid-morning (snack) in schooled adolescents at Santander city. Subjects: A cross-sectional study was performed analyzing a sample of 403 adolescents: 232 girls (58%; 95%CI: 52%-62%) and 171 boys (42%; 95%CI: 38%-48%), with ages between 12 and 19 years, schooled at 12 second degree education centers of Santander, by means of a closed questionnaire and a recall 24 hours later. Results: Five percent (95%CI: 3.1%-7.6%) of the adolescents referred neglecting breakfast. The most consumed foods were milk (47%; 95%CI: 42%-52%), chocolate milk (40%; 95%CI: 36%-45%), and cookies (45%; 95%CI: 36%-45%). On the other hand, 63% of adolescents consume whole milk (95%CI: 58%-70%), 21% semi-skimmed milk (95%CI: 17%-26%), and 11% skimmed milk (95%CI: 8%-15%). A decreasing lineal tendency in whole milk consumption is observed and a parallel increase in consumption of milks with a lower fat content as the academic year of adolescents advances (Armitage's r2 test for lineal tendency = 2.32; p = 0.02). Boys consume an average of 3.0 (SD = 1.35) different foods during breakfast and girls 2.4 (SD = 1.20). Forty-three percent (95%CI: 38%-48%) of adolescents have a snack, which means that 2% of adolescents do not have breakfast or a snack (95%CI: 1%-4%). Breakfast represents 18% (95%CI: 16%-19%) of the total daily energy intake, whereas for snack, this percentage is 16% (95%CI: 14%-17%). Conclusion: it is necessary to promote consumption of a healthy breakfast and snack that provide an appropriate quantitative and qualitative intake (AU

A comparative study of the potential of solid triglyceride nanostructures coated with chitosan or poly(ethylene glycol) as carriers for oral calcitonin delivery.

We have previously reported the formation and characterization of poly(ethylene glycol) (PEG)-coated and chitosan (CS)-coated lipid nanoparticles. In the present work our goal was to study the interaction of these surface-modified lipid nanoparticles with Caco-2 cells and to evaluate the potential of these nanostructures as oral delivery systems for salmon calcitonin (sCT). The interaction of rhodamine-loaded nanoparticles with the Caco-2 cell monolayers was evaluated quantitatively and qualitatively by confocal laser scanning microscopy and fluorimetry, respectively. The ability of these nanoparticles to reversibly enhance the transport of hydrophilic macromolecules through the monolayers was investigated by measuring the transepithelial electric resistance and the permeability to Texas Red-dextran. Finally, in vivo studies of the response to sCT-loaded nanoparticles were performed in rats. The results showed that the association of rhodamine-loaded nanoparticles to the Caco-2 cell monolayer was independent of the surface coating of the nanoparticles (CS-coated versus PEG-coated nanoparticles). However, while PEG-coated nanoparticles did not affect the permeability of Caco-2 monolayers, CS-coated nanoparticles produced a dose-dependent reduction in the transepithelial electric resistance, simultaneously to an enhanced dextran transport. The results obtained following oral administration of sCT-loaded CS-coated nanoparticles to rats showed a significant and prolonged reduction in the serum calcium levels as compared to those obtained for control (sCT solution). In contrast, the hypocalcemic response of sCT-loaded PEG-coated nanoparticles was not significantly different of that provided by the control (sCT solution). Therefore, these results indicate that the surface composition of the particles is a key factor in the improvement of the efficiency of oral sCT formulations. Moreover, the encouraging results obtained for CS-coated nanoparticles underline their potential as carriers for peptide delivery.

Enfermedades raras y coordinación asistencial / Rare diseases and health care coordination

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