Assessing the impact of concurrent high-fructose and high-saturated fat diets on pediatric metabolic syndrome: A review.

High-saturated fat (HF) or high-fructose (HFr) consumption in children predispose them to metabolic syndrome (MetS). In rodent models of MetS, diets containing individually HF or HFr lead to a variable degree of MetS. Nevertheless, simultaneous intake of HF plus HFr have synergistic effects, worsening MetS outcomes. In children, the effects of HF or HFr intake usually have been addressed individually. Therefore, we have reviewed the outcomes of HF or HFr diets in children, and we compare them with the effects reported in rodents. In humans, HFr intake causes increased lipogenesis, hypertriglyceridemia, obesity and insulin resistance. On the other hand, HF diets promote low grade-inflammation, obesity, insulin resistance. Despite the deleterious effects of simultaneous HF plus HFr intake on MetS development in rodents, there is little information about the combined effects of HF plus HFr intake in children. The aim of this review is to warn about this issue, as individually addressing the effects produced by HF or HFr may underestimate the severity of the outcomes of Western diet intake in the pediatric population. We consider that this is an alarming issue that needs to be assessed, as the simultaneous intake of HF plus HFr is common on fast food menus.

Diazoxide improves muscle function in association with improved dyslipidemia and decreased muscle oxidative stress in streptozotocin-induced diabetic rats.

AIM/INTRODUCTION: Diabetes Mellitus is a chronic degenerative disease, and its main biochemical characteristic is hyperglycemia due to impaired insulin secretion, resistance to peripheral actions of insulin, or both. Hyperglycemia causes dyslipidemia and stimulates oxidative damage, leading to the main symptoms, such as fatigue and culminates in diabetic complications. Previous studies have shown that ATP-sensitive potassium channels counteract muscle fatigue and metabolic stress in healthy mouse models. To determine the effect of diazoxide on muscle strength development during diabetes, we tested the effect of diazoxide in streptozotocin-diabetic rats in muscle function, lipid profile and oxidative stress biomarkers. MATERIALS AND METHODS: Wistar rats were divided into 4 groups of six animals each: (1) Control group, (2) diabetes group, (3) Control group + diazoxide, and (4) Diabetic + diazoxide (DB + DZX). 4 weeks after rats were sacrificed, soleus and extensor digitorum longus muscles (EDL) were extracted to prepare homogenates and serum was obtained for biochemical measurements. Oxidative damage was evaluated by the thiobarbituric acid method and the fluorescent for reactive oxygen species (ROS) probe 2,4-H2DCFDA, respectively. RESULTS: Diabetic rats with diazoxide administration showed an increase in the development of muscle strength in both muscles; in turn, the onset of fatigue was longer compared to the group of diabetic rats without treatment. Regarding the lipid profile, diazoxide decreased total cholesterol levels in the group of diabetic rats treated with diazoxide (x̅46.2 mg/dL) compared to the untreated diabetic group (x̅=104.4 mg/dL); secondly, diazoxide decreased triglyceride concentrations (x̅=105.3 mg/dL) compared to the untreated diabetic rats (x̅=412.2 mg/dL) as well as the levels of very low-density lipoproteins (x̅=20.4 mg/dL vs. x̅=82.44 mg/dL). Regarding the various markers of oxidative stress, the diabetic group treated with diazoxide was able to reduce the concentrations of TBARS and total reactive oxygen species as well as preserve the concentrations of reduced glutathione. CONCLUSION: Diazoxide administration in diabetic rats increases muscle strength development in EDL and soleus muscle, decreases fatigue, reduces cholesterol and triglyceride concentrations and improves oxidative stress parameters such as TBARS, ROS, and glutathione status.

Sociocultural differences in the development of obesity in adolescents in Murcia.

BACKGROUND: Childhood obesity presents alarming numbers in our country, being even higher in the population of immigrant origin. The main objective was to analyse the excess weight numbers both in native adolescents and in those children of immigrants and to determine the ethnic influence on lifestyle habits that could condition these differences in weight overload. METHODS: Adolescents from 1st year of Obligatory Secondary Education (E.S.O.) participated; somatometry was determined and classified according to BMI (with WHO references) and parental origin. Parents completed the survey on healthy habits (ENHASA). An analysis of variance was performed for each of the 4 dimensions of the questionnaire. RESULTS: A total of 416 adolescents participated (12.8±0.62 years). Excess weight was detected in 41.2% of the participants, with significant differences between groups (p 0.018): 36.7% in Spanish, 42.9% in North Africa and 58.2% in South America. The ANOVA analysis showed differences in the section "physical activity" (p 0.003), highlighting the maximum disparity in the performance of extracurricular sports activities, with a lower score in both non-native groups. CONCLUSION: We found significant differences according to ethnic origin in the number of overweight children and the amount of physical activity they do; South American adolescents are the most sedentary. We must design interventions that guarantee the access of all adolescents to sports activities to prevent the development of obesity.

Importancia y rendimiento de los hábitos implicados en el desarrollo de exceso de peso según género / Importance and performance of habits involved in the development of excess weight according to gender

Introducción: la obesidad afecta cada vez más a los adolescentes. La clave de la prevención sigue siendo el control de los factores de riesgo modificables. El objetivo fue realizar un análisis mediante mapas de importancia-rendimiento de las principales conductas que condicionan la aparición de exceso de peso en adolescentes en función del género, una técnica estadística que representa gráficamente la importancia y el rendimiento de cada uno de los factores involucrados en el desarrollo del exceso de peso. Material y métodos: se administró un cuestionario sobre hábitos saludables (ENHASA) a padres de adolescentes de 12-14 años de Murcia (España). Posteriormente, fueron clasificados según estado ponderal siguiendo los criterios de la Organización Mundial de la Salud (OMS). Se realizaron un análisis multivariante y mapas de importancia-rendimiento según género. Resultados: participaron 416 adolescentes, detectándose un 40,6% de exceso de peso, sin diferencias significativas por género. El análisis mostró un R2 de 0,123 en adolescentes hombres y de 0,156 en adolescentes mujeres. Se reveló la falta de actividad física como el factor más importante para el desarrollo de exceso de peso en los adolescentes hombres, aunque los hábitos con mayor capacidad de mejora en ellos fueron los relacionados con el uso de televisión y horas de pantalla. En las adolescentes mujeres, lo más condicionante fue el ambiente socioescolar, siendo también los hábitos con menor rendimiento los relacionados con el uso de pantallas. Conclusiones: existen diferencias de género en los hábitos que condicionan el exceso de peso. Se debería tener en cuenta una perspectiva de género a la hora de diseñar nuevas estrategias de prevención (AU)

Introduction: obesity affects more adolescents every day. The key to prevention remains the control of modifiable risk factors. The objective of the work was to carry out an analysis using importance-performance maps of the main behaviors that condition the appearance of excess weight in adolescents according to gender. An statistical technique that draws on a map the importance and performance of each of the risk factors involved in the development of excess weight.Material and methods: we collected information from 416 adolescents between 12 and 14 years of age in Murcia (Spain) using the ENHASA healthy habits questionnaire. Later, we determined their somatometry and they were classified following the criteria of the World Health Organization (WHO). A multivariate analysis and importance-performance maps according to gender were performed.Results: 416 adolescents participated. We obtained 40,6% excess weight without significant differences by sex. The analysis showed an R2 of 0,123 in boys and 0,156 in girls. Lack of physical activity revealed as the most important factor for the development of excess weight in boys, although the habits with the greatest capacity for improvement were those related to the use of television and screen time. In girls, the most determining dimension was the socio-school environment; and the habits with the lowest performance were also those related to the use of screens.Conclusions: there are gender differences in the habits that determine overweight and obesity. It is important to take gender perspective into account when designing new more efficient prevention. (AU)

Proposal of a Multi-Criteria Model for the Evaluation of Territorial Development Plans: An Application in Chile's Lagging Areas.

The evaluation of Territorial Development Plans (TDP) is a challenge most Latin American countries face. The problem arises in establishing a model to evaluate TDP that meets the criteria and indicators established in a national policy or regulatory framework under local needs. This study proposes an application to evaluate the TDP of the lagging areas in Chile based on the AHP multi-criteria methodology. This methodology allows to objectively unify the evaluation of the different plans, combining the different dimensions, objectives, scales, and judgments of the experts present in the evaluation process without sacrificing the quality, reliability, and participation of the actors involved. The model is flexible to changes in the criteria, as it can be updated according to the needs over time. An efficient and effective tool is provided to support decision-makers in formulating better development plans to bridge the gaps in territorial groups with high vulnerability.

Comparative Effect of Three Different Exercise Intensities in Combination with Diazoxide on Contraction Capacity and Oxidative Stress of Skeletal Muscle in Obese Rats.

Obesity is a chronic disease that impairs skeletal muscle function, affects the ability to contract, and promotes the development of fatigue. For this reason, the study of treatments that seek to reduce the harmful effects of obesity on muscle tissue has been deepened. Diazoxide treatment and various exercise protocols have been proposed to protect skeletal muscle against oxidative stress and its effects. However, the intensity and duration of exercise combined with diazoxide that would obtain the best results for improving skeletal muscle function in obese rats is unknown. To this end, this study evaluated the effects of three different exercise intensities combined with diazoxide on contraction capacity, resistance to fatigue, markers of oxidative stress, lipid peroxidation, ROS, and glutathione redox status of skeletal muscle. The results showed that treatments with diazoxide and exercise at different intensities improved muscle contraction capacity by reducing oxidative stress during obesity, with the best results being obtained with low-intensity exercise in combination with diazoxide. Therefore, these results suggest that diazoxide and low-intensity exercise improve muscle function during obesity by decreasing oxidative stress with the same efficiency as a moderate-intensity exercise protocol.

Dietary Iron Restriction Improves Muscle Function, Dyslipidemia, and Decreased Muscle Oxidative Stress in Streptozotocin-Induced Diabetic Rats.

Diabetes mellitus is a chronic degenerative disease characterized by hyperglycemia and oxidative stress. Iron catalyzes free radical overproduction. High iron concentrations have previously been reported to promote an increase in oxidative stress; however, the effect of iron restriction in diabetes has not yet been explored, so we tested to see if iron restriction in diabetic rats reduces oxidative damage and improved muscle function. Wistar rats were assigned to 4 groups: Control; Diabetic; Diabetic rats with a high iron diet, and Diabetic with dietary iron restriction. After 8 weeks the rats were sacrificed, the muscles were extracted to prepare homogenates, and serum was obtained for biochemical measurements. Low iron diabetic rats showed an increase in the development of muscle strength in both muscles. Dietary iron restriction decreased triglyceride concentrations compared to the untreated diabetic rats and the levels of extremely low-density lipoproteins. Aggravation of lipid peroxidation was observed in the diabetic group with a high iron diet, while these levels remained low with iron restriction. Iron restriction improved muscle strength development and reduced fatigue times; this was related to better lipid profile control and decreased oxidant stress markers.

Influence of Lifestyle Habits in the Development of Obesity during Adolescence.

Background: The alarming increase in childhood obesity is a global public health problem since it has significant health consequences. This cross-sectional study aimed to identify the potentially modifiable risk factors for developing excess weight and determine the importance of developing certain habits to prevent childhood overweight and obesity. Methods: The sample included 416 students between the ages of 12 and 14 (12.8 ± 0.62) first-year high school students from Murcia in Spain. Data were collected on their lifestyle habits through the ENHASA questionnaire, and the somatometry of the participants was measured. Such data were studied through structural equation modeling and importance-performance map analyses. Results: The modifiable risk factors that presented the greatest potency directly regarding when developing excess weight in adolescents were 'use of electronic devices' and 'not performing physical activity' (p < 0.001). 'Social and school environment' and 'diet' showed relationships but no significant differences with overweight or obesity. Globally, the lifestyle habit of the greatest importance for not being overweight was 'engagement in extracurricular physical activities'. On the other hand, the habits related to using new technologies in a sedentary way showed the best capacity for improvement. Therefore, it would be very efficient to focus on them to control excess weight. Conclusion: Responsible and limited use of screens and engaging in extracurricular physical activities may be the most remarkable and cost-effective strategies for obesity prevention programs.

Gender differences in the development of childhood obesity in young teenagers in Murcia, Spain.

BACKGROUND: The number of overweight children is increasing at an alarming rate. This issue requires effective action plans, as childhood obesity has become a problem in which addressing environmental factors is decisive. Significant differences have also been shown in lifestyle habits that determine overweight based on sex. This study therefore aimed to examine these risk factors according to sex. METHODS: The sample included first-year high school students from Murcia, Spain. Information was collected through the "Questionnaire on Healthy Habits in Adolescents," validated for this age range, and the weight, height, and waist circumference of the participants were obtained. Data were analyzed through partial least squares structural equation modeling to determine which modifiable risk factors promoted the appearance of excess weight and in what magnitude. RESULTS: A total of 421 students participated in the study, and 40.6% of overweight patients were detected according to their body mass index. No differences were found between the sexes and weights. The environment and the use of new technologies that do not involve sitting were significant only in girls (P < 0.05). Conversely, physical activity was significantly higher in boys (P < 0.05). Dietary factors and sedentary activities did not differ according to sex. CONCLUSIONS: The social and school environment, the use of new technologies (for girls), and physical activity (for boys) condition nutritional status. Identifying gender disparities in behaviors that involve health should be a priority for new prevention programs. Targeting young people's health from a gender perspective has considerable potential to reduce overweight problems in adulthood.

Avocado oil alleviates non-alcoholic fatty liver disease by improving mitochondrial function, oxidative stress and inflammation in rats fed a high fat-High fructose diet.

Non-alcoholic fatty liver disease (NAFLD) is characterized by lipid accumulation in hepatocytes, and in advanced stages, by inflammation and fibrosis. Excessive ROS production due to mitochondrial dysfunction contributes to NAFLD development, making the decrease in mitochondrial ROS production an emerging target to alleviate NAFLD. Previously, we have shown that avocado oil, a source of several bioactive compounds with antioxidant effects, decreases oxidative stress by improving the function of the mitochondrial electron transport chain (ETC) and decreasing ROS levels in mitochondria of diabetic and hypertensive rats. Therefore, we tested in this work whether avocado oil alleviates NAFLD by attenuating mitochondrial dysfunction, oxidative stress and inflammation. NAFLD was induced in rats by a high fat-high fructose (HF) diet administered for six (HF6) or twelve (HF12) weeks. Hepatic steatosis, hypertrophy and inflammation were detected in both the HF6 and HF12 groups. Hyperglycemia was observed only in the HF12 group. The HF6 and HF12 groups displayed dyslipidemia, impairments in mitochondrial respiration, complex III activity, and electron transfer in cytochromes in the complex III. This led to an increase in the levels of ROS and lipid peroxidation. The substitution of the HF6 diet by standard chow and avocado oil for 6 weeks (HF6+AVO + D), or supplementation of the HF12 diet with avocado oil (HF12 + AVO), ameliorated NAFLD, hyperglycemia, dyslipidemia, and counteracted mitochondrial dysfunctions and oxidative stress. The substitution of the HF6 diet by standard chow without avocado oil did not correct many of these abnormalities, confirming that the removal of the HF diet is not enough to counteract NAFLD and mitochondrial dysfunction. In summary, avocado oil decreases NAFLD by improving mitochondrial function, oxidative stress, and inflammation.

Economic Evaluation of Emotional and Personal Support in the Health Care of Women with Disabilities.

It is generally accepted that people with disabilities make greater use of health services. Moreover, certain social circumstances alter the intensity of such use. This manuscript seeks to analyze the existing differences in the use of healthcare among women with and without disabilities, to study the impact of emotional and personal support (EPS) on such use and to assess the reduction of the economic cost that this factor entails. Data from the Spanish National Health Survey (SNHS-2017) and updated unit costs of health services have been used to estimate the differences in use attributable to disability and the economic impact of emotional and personal support. The empirical results show an association between disability and perceived EPS, the latter being less common among Spanish women with disabilities. In addition, within this group, EPS significantly influences the levels of use of health services. Finally, the net effect of a perceived EPS increase would translate into a reduction in the economic costs of health care for women with disabilities.

Intimate Partner Violence against Women with Disabilities in Spain: A Public Health Problem.

Violence against women with disabilities is a social problem with important consequences for their physical and mental health. The World Health Organization (WHO) declared violence against women as a public health priority issue in 1996 and the fact that violence is used by the intimate partner and upon women with disabilities exacerbates the situation. Therefore, this is an issue that must be addressed from a public health viewpoint. Violence is studied from various aspects: Physical, psychological, sexual, or social control, and its multiple consequences in women's health and the use of health services. In this perspective, with the data from the VI Violence against Women Macro-survey 2019 (VWM-2019) and adjusted to Spain, this study examines the incidence of intimate partner violence and its consequences in the health of women with disabilities and its impact on health services. Using binary logistic regression, the greater vulnerability of this group to these attacks is stated and the need to address this issue to improve the health of these people is brought to light.

Ferritin levels and COVID-19

[Extract]. Ferritin is a key mediator of immune dysregulation, especially under extreme hyperferritinemia, via direct immune-suppressive and pro-inflammatory effects, contributing to the cytokine storm1. It has been reported that fatal outcomes by COVID-19 are accompanied by cytokine storm syndrome, thereby it has been suggested that disease severity is dependent of the cytokine storm syndrome2. Many individuals with diabetes exhibit elevated serum ferritin levels3-5, and it is known that they face a higher probability to experience serious complications from COVID-196. On this basis, we briefly review evidence supporting the hypothesis that ferritin levels might be a crucial factor influencing the severity of COVID-19.

Interplay between NADH oxidation by complex I, glutathione redox state and sirtuin-3, and its role in the development of insulin resistance.

Metabolic diseases are characterized by high NADH/NAD+ ratios due to excessive electron supply, causing defective mitochondrial function and impaired sirtuin-3 (SIRT-3) activity, the latter driving to oxidative stress and altered fatty acid ß-oxidation. NADH is oxidized by the complex I in the electron transport chain, thereby factors inhibiting complex I like acetylation, cardiolipin peroxidation, and glutathionylation by low GSH/GSSG ratios affects SIRT3 function by increasing the NADH/NAD+ ratio. In this review, we summarized the evidence supporting a role of the above events in the development of insulin resistance, which is relevant in the pathogenesis of obesity and diabetes. We propose that maintenance of proper NADH/NAD+ and GSH/GSSG ratios are central to ameliorate insulin resistance, as alterations in these redox couples lead to complex I dysfunction, disruption of SIRT-3 activity, ROS production and impaired ß-oxidation, the latter two being key effectors of insulin resistance.

The severity of rat liver injury by fructose and high fat depends on the degree of respiratory dysfunction and oxidative stress induced in mitochondria.

BACKGROUND: High fat or fructose induces non-alcoholic fatty liver disease (NAFLD) accompanied of mitochondrial dysfunction and oxidative stress. Controversy remains about whether fructose or fat is more deleterious for NAFLD development. To get more insights about this issue and to determine if the severity of liver disease induced by fructose or fat is related to degree of mitochondrial dysfunction, we compared the effects of diets containing high fat (HF), fructose (Fr) or high fat plus fructose (HF + Fr) on NAFLD development, mitochondrial function, ROS production and lipid peroxidation. METHODS: Wistar rats were assigned to four groups: Control, fed with standard rodent chow; High fat (HF), supplemented with lard and hydrogenated vegetable oil; Fructose (Fr), supplemented with 25% fructose in the drinking water; High fat plus fructose group (HF + Fr), fed with both HF and Fr diets. Rats were sacrificed after 6 weeks of diets consumption and the liver was excised for histopathological analysis by hematoxylin and eosin staining and for mitochondria isolation. Mitochondrial function was evaluated by measuring both mitochondrial respiration and complex I activity. Lipid peroxidation and ROS production were evaluated in mitochondria by the thiobarbituric acid method and with the fluorescent ROS probe 2,4-H2DCFDA, respectively. RESULTS: Fr group underwent the lower degree of both liver damage and mitochondrial dysfunction that manifested like less than 20% of hepatocytes with microvesicular steatosis and partial decrease in state 3 respiration, respectively. HF group displayed an intermediate degree of damage as it showed 40% of hepatocytes with microvesicular steatosis and diminution of both state 3 respiration and complex I activity. HF + Fr group displayed more severe damage as showed microvesicular steatosis in 60% of hepatocytes and inflammation, while mitochondria exhibited fully inhibited state 3 respiration, impaired complex I activity and increased ROS generation. Exacerbation of mitochondrial lipid peroxidation was observed in both the Fr and HF + Fr groups. CONCLUSION: Severity of liver injury induced by fructose or fat was related to the degree of dysfunction and oxidative damage in mitochondria. Attention should be paid on the serious effects observed in the HF + Fr group as the typical Western diet is rich in both fat and carbohydrates.

Satisfaction with healthcare services among Spanish people with disabilities.

BACKGROUND: Several studies show the relationship between patient satisfaction and quality of health services and also between disabling conditions and healthcare access, but none sufficiently analyze the factors that contribute to satisfaction among patients with disabilities. OBJECTIVE/HYPOTHESES: The primary aim of this paper is to quantify the impact of social factors, perceived health status and access on satisfaction with healthcare services among Spanish people with disabilities. METHODS: This paper uses data from the European Health Survey 2009 to construct latent variables related to satisfaction, use and health status among Spanish patients with disabilities. Next, partial least squares path modeling is used for quantifying the effects of certain social factors, service use, and health status on patient satisfaction with received healthcare services. RESULTS: Satisfaction with healthcare services among people with disabilities is correlated (Nagelkerke R(2) of 0.175) with certain demographic factors (age, gender and town size), assistance support and patient use of these services. Education level and income were not found to have significant effects. CONCLUSIONS: People with disabilities generally show a high level of satisfaction with healthcare services, influenced by a positive valuation of the differentiated use given their specific care needs. Subjective aspects of care have a notable influence, linked with the perception of the person's own state of health and emotional status, on these positive valuations; patients' individual perceptions can reduce care needs and the use patients make of healthcare services and tend to increase their level of satisfaction with these services when they do seek them.

Impact of social factors on labour discrimination of disabled women.

Disabled women suffer from a double labour discrimination due to their gender and their disability. In rural areas, in addition, they also suffer from a lack of specific services, the isolation of the disabled associations, problems with public transport, the dispersion of population centres, and a limited access to information that could improve their chances of entering the labour market. The current work adopts a constructivist perspective on disability and offers a preliminary examination of the influence of social factors, such as the rural or urban nature of the disabled women's place of residence, the assistance they receive from their family or outside the family, the quantity of information they receive about the labour market, and their educational level, on the activity and employment status of this group of people.

An approach to the socio-labour situation of disabled women in rural communities in a Spanish region.

Disabled women suffer socio-labour discrimination because of both their gender and their disability. The situation is gradually improving, thanks to the national and supranational organisations, which in the past few decades have made considerable progress in improving the legislation, providing financial resources and encouraging social awareness. Despite this, few studies quantify this double discrimination in order to permit the evaluation of the socio-labour situation of this group of people. This scarcity is even more pronounced for rural areas, where many other factors hinder the integration of disabled women into the labour market and generate some specific problems that the specialist literature seldom addresses. The current work presents the results of a survey on the socio-economic situation of disabled women in a strongly rural area: the Spanish region of Castilla-La Mancha. It stresses the fundamental difficulties of these women in integrating into the labour market and the most urgent political measures needed to help this group.