[Review of nutrition and hydration in relation to physical exercise during pregnancy]. / Revisión de la nutrición e hidratación con relación al ejercicio físico en el embarazo.

Studies on nutritional recommendations for pregnant women who exercise are scarce. The objective of this article is not to focus on the diet of pregnant women as a whole, but to review those aspects of it that may be related to physical exercise. To this end, the nutritional and hydration recommendations contained in the main clinical practice guides on physical exercise during pregnancy are collected, including the first Spanish guides. Likewise, the energy requirements required by pregnant women who perform physical exercise during pregnancy for adequate gestational weight gain are addressed, aspects related to macronutrients in the aforementioned population group, and two specific topics, such as nutritional needs in the adolescent who practices physical exercise during pregnancy and eating disorders in pregnant athletes It is concluded by stating that pregnant women who exercise regularly should eat a varied and balanced diet, such as the Mediterranean diet, avoid long periods of fasting to avoid the appearance of hypoglycemia and maintain adequate fluid intake before, during and after physical exercise. Pregnant adolescents who engage in physical exercise require nutritional supervision to achieve adequate gestational weight gain. The pregnant athlete with an eating disorder has a higher risk of complications during pregnancy and childbirth, gynecological, fetal and neonatal, and, therefore, requires close monitoring by specialists in maternal-fetal medicine.

MicroRNA Dysregulation in Early Breast Cancer Diagnosis: A Systematic Review and Meta-Analysis.

Breast cancer continues to be the leading cause of death in women worldwide. Mammography, which is the current gold standard technique used to diagnose it, presents strong limitations in early ages where breast cancer is much more aggressive and fatal. MiRNAs present in numerous body fluids might represent a new line of research in breast cancer biomarkers, especially oncomiRNAs, known to play an important role in the suppression and development of neoplasms. The aim of this systematic review and meta-analysis was to evaluate dysregulated miRNA biomarkers and their diagnostic accuracy in breast cancer. Two independent researchers reviewed the included studies according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. A protocol for this review was registered in PROSPERO with the registration number "CRD42021256338". Observational case-control-based studies analyzing concentrations of microRNAs which have been published within the last 10 years were selected, and the concentrations of miRNAs in women with breast cancer and healthy controls were analyzed. Random-effects meta-analyses of miR-155 were performed on the studies which provided enough data to calculate diagnostic odds ratios. We determined that 34 microRNAs were substantially dysregulated and could be considered biomarkers of breast cancer. Individually, miR-155 provided better diagnostic results than mammography on average. However, when several miRNAs are used to screen, forming a panel, sensitivity and specificity rates improve, and they can be associated with classic biomarkers such us CA-125 or CEA. Based on the results of our meta-analysis, miR-155 might be a promising diagnostic biomarker for this patient population.

Variación del perfil lipídico durante el embarazo y su relación con las enfermedades metabólicas / Changes in lipid profile during pregnancy and their association with metabolic disorders

Introducción: En el embarazo se producen numerosos cambios fisiológicos en las gestantes los cuales pueden llegar a desencadenar potenciales complicaciones y enfermedades cardiovasculares o metabólicas tales como hipertensión gestacional, hiperlipidemia y diabetes mellitus gestacional.Objetivo: Realizar una revisión sistemática de la literatura con objeto de evaluar la relación entre las variaciones del perfil lipídico durante el embarazo y el riesgo de padecer enfermedades metabólicas y cardiovasculares.Métodos: Se ha llevado a cabo una revisión sistemática siguiendo las directrices del modelo PRISMA en la que se incluyeron 22 artículos. Los descriptores empleados incluyeron marcadores del perfil lipídico (HDL, LDL, TG y CT) y las principales patologías metabólicas y cardiovasculares. El idioma se restringió a español e inglés. La revisión fue llevada a cabo durante el año 2019.Resultados: Niveles elevados de colesterol total, LDL y triglicéridos durante el embarazo se asocian con un mayor riesgo de padecer preeclampsia y diabetes mellitus gestacional. Un mayor índice de masa corporal pre gestacional y una mayor ganancia ponderal se relacionan con mayor tasa hiperlipidemia lo cual conlleva a su vez alteraciones vasculares.Conclusiones: Se hace patente la necesidad de reforzar el control preventivo del peso materno trimestral y del perfil lipídico durante la gestación con objeto de prevenir complicaciones del embarazo. Son necesarios estudios centrados en determinados resultados adversos perinatales tales como la macrosomía del recién nacido.(AU)

Background: Various changes occur during pregnancy that, when exacerbated, could progress to metabolic and cardiovascular disorders such as gestational hypertension, hyperlipidemia, and gestational diabetes mellitus.Objective: To conduct a systematic review of the literature that evaluates the association between changes in lipid profile during pregnancy and the risk of developing metabolic and cardiovascular disorders.Methods: We conducted a PRISMA systematic review of scientific databases. A total of 22 articles were finally included. Used search terms consisted of lipid profile biomarkers (HDL, LDL, triglycerides, total cholesterol) in combination with the most important metabolic and cardiovascular disorders. Language was restricted to Spanish and English. The review was conducted during 2019.Results: High levels of total cholesterol, LDL and triglycerides during pregnancy were found to be associated with increased risk of developing preeclampsia and gestational diabetes mellitus. Higher pre-gestational BMI and elevated gestational weight gain were associated with increase rates of hyperlipidemia which is closely related to vascular pathologies.Conclusions: Fostering routine control of maternal weight during all trimesters of gestation and monitoring the lipid profile throughout pregnancy is necessary to prevent pregnancy adverse outcomes. New studies focused on specific perinatal outcomes such as neonatal macrosomia are required.(AU)

Effects of physical activity on quality of life in overweight and obese children / Efectos de la actividad física sobre la calidad de vida en niños con sobrepeso y obesidad

Background: in recent years the prevalence of obesity in infants, children, and adolescents has increased alarmingly, which may affect their health, educational level, and quality of life. Objectives: the aim of this study was to determine whether a program with physical activity and nutritional recommendations may improve health-related quality of life (HRQL) in overweight and obese children. Material and methods: the design of this study was that of a randomized clinical trial (RCT). The sample consisted of 54 children with a median age of 10.65 years, all of them overweight or obese. They were divided into a study (SG) and a control (CG) group, with 27 children each. The study group received physical activity and nutritional advice, while the control group only received theoretical-practical sessions on nutrition during 9 months. Families participated in the workshops on nutritional recommendations in both groups. Results: there was a significant difference in fat percentage before and after the intervention in the study group compared to the children who did not engage in sports activity. In the SF-10 quality-of-life perception questionnaire, statistically significant differences in both the physical and mental components may be seen at the end of the study between both groups (p < 0.001). Conclusions: an educational intervention with physical activity based on play and nutritional advice improved quality of life in overweight and obese children. Family involvement is vital for children to improve their life habits, and achieve favorable results in the reduction of overweight and obesity. (AU)

Introducción: en los últimos años, la prevalencia de la obesidad en los bebés, niños y adolescentes ha aumentado de forma alarmante, lo que podría afectar a su salud, nivel educativo y calidad de vida. Objetivos: el objetivo de este estudio fue determinar si un programa con actividad física y recomendaciones nutricionales puede mejorar la calidad de vida relacionada con la salud (CVRS) en niños con sobrepeso y obesidad. Material y métodos: el diseño de este estudio fue el de un ensayo clínico aleatorizado (ECA). La muestra consistió en 54 niños de 10,65 años de edad mediana con sobrepeso u obesidad. Se dividieron en grupos de estudio (SG) y de control (CG), ambos con 27 niños. El grupo de estudio recibió actividad física y asesoramiento nutricional mientras que el grupo de control solo recibió las sesiones de nutrición teórico-prácticas durante 9 meses. Las familias participaron en los talleres sobre recomendaciones nutricionales en ambos grupos. Resultados: hubo una diferencia significativa en el porcentaje de grasa antes y después de la intervención en el grupo de estudio en comparación con los niños que no participaron en la actividad deportiva. En el cuestionario de calidad de vida SF-10 se puede observar que existen diferencias estadísticamente significativas en los componentes físicos y mentales al final del estudio entre ambos grupos (p < 0,001). Conclusiones: una intervención educativa con actividad física basada en el juego y asesoramiento nutricional mejoró la calidad de vida de estos niños obesos y con sobrepeso. La participación familiar es vital para que los niños mejoren sus hábitos de vida y logren resultados favorables en la reducción del sobrepeso y la obesidad. (AU)

Effects of physical activity on quality of life in overweight and obese children.

INTRODUCTION: Background: in recent years the prevalence of obesity in infants, children, and adolescents has increased alarmingly, which may affect their health, educational level, and quality of life. Objectives: the aim of this study was to determine whether a program with physical activity and nutritional recommendations may improve health-related quality of life (HRQL) in overweight and obese children. Material and methods: the design of this study was that of a randomized clinical trial (RCT). The sample consisted of 54 children with a median age of 10.65 years, all of them overweight or obese. They were divided into a study (SG) and a control (CG) group, with 27 children each. The study group received physical activity and nutritional advice, while the control group only received theoretical-practical sessions on nutrition during 9 months. Families participated in the workshops on nutritional recommendations in both groups. Results: there was a significant difference in fat percentage before and after the intervention in the study group compared to the children who did not engage in sports activity. In the SF-10 quality-of-life perception questionnaire, statistically significant differences in both the physical and mental components may be seen at the end of the study between both groups (p < 0.001). Conclusions: an educational intervention with physical activity based on play and nutritional advice improved quality of life in overweight and obese children. Family involvement is vital for children to improve their life habits, and achieve favorable results in the reduction of overweight and obesity.

INTRODUCCIÓN: Introducción: en los últimos años, la prevalencia de la obesidad en los bebés, niños y adolescentes ha aumentado de forma alarmante, lo que podría afectar a su salud, nivel educativo y calidad de vida. Objetivos: el objetivo de este estudio fue determinar si un programa con actividad física y recomendaciones nutricionales puede mejorar la calidad de vida relacionada con la salud (CVRS) en niños con sobrepeso y obesidad. Material y métodos: el diseño de este estudio fue el de un ensayo clínico aleatorizado (ECA). La muestra consistió en 54 niños de 10,65 años de edad mediana con sobrepeso u obesidad. Se dividieron en grupos de estudio (SG) y de control (CG), ambos con 27 niños. El grupo de estudio recibió actividad física y asesoramiento nutricional mientras que el grupo de control solo recibió las sesiones de nutrición teórico-prácticas durante 9 meses. Las familias participaron en los talleres sobre recomendaciones nutricionales en ambos grupos. Resultados: hubo una diferencia significativa en el porcentaje de grasa antes y después de la intervención en el grupo de estudio en comparación con los niños que no participaron en la actividad deportiva. En el cuestionario de calidad de vida SF-10 se puede observar que existen diferencias estadísticamente significativas en los componentes físicos y mentales al final del estudio entre ambos grupos (p < 0,001). Conclusiones: una intervención educativa con actividad física basada en el juego y asesoramiento nutricional mejoró la calidad de vida de estos niños obesos y con sobrepeso. La participación familiar es vital para que los niños mejoren sus hábitos de vida y logren resultados favorables en la reducción del sobrepeso y la obesidad.

Reporting of Perinatal Outcomes in Probiotic Randomized Controlled Trials. A Systematic Review and Meta-Analysis.

The use of probiotic microorganisms in clinical practice has increased in recent years and a significant number of pregnant women are regular consumers of these products. However, probiotics might modulate the immune system, and whether or not this modulation is beneficial for perinatal outcomes is unclear. We performed a systematic review and meta-analysis to evaluate the reporting of perinatal outcomes in randomized controlled trials including women supplemented with probiotic microorganisms during pregnancy. We also analyzed the effects that the administration of probiotic microorganisms exerts on perinatal outcomes. In the review, 46 papers were included and 25 were meta-analyzed. Reporting of perinatal outcomes was highly inconsistent across the studies. Only birth weight, cesarean section, and weeks of gestation were reported in more than 50% of the studies. Random effects meta-analysis results showed that the administration of probiotic microorganisms during pregnancy did not have any a positive or negative impact on the perinatal outcomes evaluated. Subgroup analysis results at the strain level were not significantly different from main analysis results. The administration of probiotic microorganisms does not appear to influence perinatal outcomes. Nonetheless, future probiotic studies conducted in pregnant women should report probiotic strains and perinatal outcomes in order to shed light upon probiotics' effects on pregnancy outcomes.

Alteraciones y efectos del sueño durante el embarazo / Sleep disorders during pregnancy

INTRODUCCIÓN: El embarazo es un proceso fisiológico que produce alteraciones en los patrones del sueño. A nivel fisiológico la falta de sueño se relaciona con problemas de salud tales como hipertensión, enfermedad coronaria, diabetes y depresión. En el embarazo, las alteraciones del sueño son más frecuentes siendo su prevalencia mayor durante el tercer trimestre. La deprivación del mismo durante el embarazo empeora significantemente las condiciones preexistentes de la mujer disminuyendo la actividad física diaria, la productividad y aumentando los síntomas relacionados con el estrés. Las alteraciones del sueño en el embarazo se pueden relacionar con comorbilidad en el recién nacido y resultados adversos materno-fetales. OBJETIVOS: Determinar qué alteraciones del sueño ocurren durante el embarazo, cuáles son sus causas y qué posibles consecuencias podría tener el déficit de sueño durante la gestación a nivel materno-fetal y neonatal. METODOLOGÍA: Se llevó a cabo una revisión sistemática siguiendo los principios de la declaración PRISMA. Se recogieron tanto estudios observacionales como de intervención así como revisiones sistemáticas y meta-análisis y se llevó a cabo un análisis crítico de los resultados. RESULTADOS Y DISCUSIÓN: Se incluyeron finalmente un total de 19 artículos que trataban sobre los efectos de las alteraciones del sueño en los resultados materno-fetales y neonatales y sus causas. Las principales causas de las alteraciones del sueño son los cambios hormonales y fisiológicos propios del embarazo como es el aumento de peso que se hacen más prevalentes conforme progresa la gestación. Las consecuencias maternas engloban principalmente trastornos respiratorios, alteraciones cardiovasculares e inflamatorias y resultados adversos del embarazo como es la cesárea. Los resultados adversos en el recién nacido más estudiados son partos prematuros y recién nacidos con bajo peso para la edad gestacional. CONCLUSIÓN: Con este trabajo se observa que existe una relación entre los trastornos del sueño durante el embarazo y los problemas materno-fetales. Sin embargo, los estudios llevados a cabo hasta la fecha son heterogéneos, emplean herramientas subjetivas y sus conclusiones resultan en ocasiones contradictorias

INTRODUCTION: Pregnancy is a physiologic stage of the women that modifies sleep patterns. Sleep deprivation is associated with pathologies namely hypertensive disorders, coronary artery disease, diabetes and depression. Amongst pregnant women sleep disorders are more frequent being its prevalence higher during the third trimester of gestation. Furthermore, sleep deprivation worsens previous conditions such as low degree of physical activity, productivity and increases stress-related symptoms. Sleep disorders could be associated with comorbidities in the newborn as well as pregnancy/perinatal adverse outcomes. OBJECTIVES: To determine which sleep disorders are associated with pregnancy, their causes and the potential effects that sleep deprivation could exert on pregnancy outcomes and the newborn. METHODOLOGY: We conducted a systematic review following the PRISMA statement. Observational, interventional and systematic reviews/meta-analyses were included and a critical analysis of the results was performed. RESULTS AND DISCUSSION: 19 papers about sleep disorders and pregnancy/perinatal outcomes were finally included. Mains causes of sleep disorders during pregnancy consisted of hormonal changes and weight gain which are more prevalent as gestation progresses. Maternal outcomes associated to sleep disorders comprised respiratory, cardiovascular and inflammatory disorders along with pregnancy adverse outcomes namely caesarean section. Main perinatal adverse outcomes were preterm delivery and small for gestational age. CONCLUSION: We observed an association between sleep disorders during gestation, pregnancy and perinatal adverse outcomes. However, studies conducted to date are heterogeneous and they tend to use subjective tools to assess sleep patterns being results occasionally inconclusive or contradictory