Improvement of Lipoprotein Profile and Metabolic Endotoxemia by a Lifestyle Intervention That Modifies the Gut Microbiota in Subjects With Metabolic Syndrome.

Background Metabolic syndrome (MetS) is a serious health problem over the world; thus, the aim of the present work was to develop a lifestyle intervention to decrease the dysbiosis of gut microbiota and reduce the biochemical abnormalities of MetS. Methods and Results The prevalence of MetS was evaluated in 1065 subjects of Mexico City, Mexico, and the gut microbiota in a subsample. Subjects with MetS were selected for a pragmatic study based on a lifestyle intervention with a low-saturated-fat diet, reduced-energy intake, with functional foods and physical activity, and a second group was selected for a randomized control-placebo study to assess the gut microbiota after the dietary intervention. Prevalence of MetS was 53%, and the higher the body mass index, the higher the gut microbiota dysbiosis. The higher the Homeostatic Model Assessment for Insulin Resistance, the lower the high-density lipoprotein cholesterol concentration. The pragmatic study revealed that after 15 days on a low-saturated-fat diet, there was a 24% reduction in serum triglycerides; and after a 75-day lifestyle intervention, MetS was reduced by 44.8%, with a reduction in low-density lipoprotein cholesterol, small low-density lipoprotein particles, glucose intolerance, lipopolysaccharide, and branched-chain amino acid. The randomized control-placebo study showed that after the lifestyle intervention, there was a decrease in the dysbiosis of the gut microbiota associated with a reduction in the Prevotella/ Bacteroides ratio and an increase in the abundance of Akkermansia muciniphila and Faecalibacterium prausnitzii. Conclusions A lifestyle intervention significantly decreased MetS components, small low-density lipoprotein particle concentration, gut microbiota dysbiosis, and metabolic endotoxemia, reducing the risk of atherosclerosis. Clinical Trial Registration URL: https://www.clinicaltrials.gov. Unique identifier: NCT03611140.

Prevalencia de alteraciones nutricionales en pacientes con cáncer en un hospital de Tercer Nivel / Prevalence of nutritional alterations in cancer patients in a third level hospital

Introducción: Los pacientes diagnosticados con cáncer son susceptibles a diferentes enfermedades nutricionales, como la desnutrición, la sarcopenia y la caquexia, que tienen valores pronósticos. Objetivo: El objetivo del presente estudio es evaluar la prevalencia de alteraciones nutricionales en sujetos con cáncer. Métodos: Se realizó un estudio con diseño transversal. Pacientes adultos de ambos sexos fueron seleccionados y luego fueron sometidos a evaluaciones médicas y nutricionales en el servicio de oncología ambulatoria. Se realizó el diagnóstico nutricional, así como el diagnóstico de sarcopenia o caquexia de acuerdo a criterios internacionales. Resultados: Se incluyeron a un total de 119 sujetos, el 57,1% eran mujeres. La edad fue de 55,9 ± 14,2 años, y el índice de masa corporal (IMC) promedio fue de 25,0 ± 4,88 kg / m2. De la población total estudiada, el 25,2% tenía cáncer de mama, el 17,6% de cáncer gastrointestinal y el 16,8% de cáncer hematológico y otras neoplasias. De acuerdo a la clasificación de la OMS, el 14% de los sujetos tenían bajo peso, el 40% tenían peso normal, el 30% tenían sobrepeso y el 16% obesidad. La prevalencia de sarcopenia fue del 26,1%. Se observó que los voluntarios masculinos tenían un mayor riesgo de presentar sarcopenia [OR 13,1 (IC 95% 4,5-37,9, p <0,001)] y 47,6% de estos pacientes tenían cáncer gastrointestinal [OR 3,3 (IC 95% 1,3-8,9) p <0,05] Finalmente, el 12% de todos los sujetos fueron diagnosticados con caquexia. Conclusión: La prevalencia de malnutrición, sarcopenia y caquexia son altas en pacientes oncológicos atendidos en el servicio ambulatorio, especialmente en hombres y en aquellos diagnosticados con cáncer gastrointestinal

Introduction: Patients who are diagnosed with cancer are subjected to different nutritional maladies, such as malnutrition, sarcopenia, and cachexia that have prognostic values. Objective: The aim of the present study is to evaluate the prevalence of nutritional alterations in subjects with cancer. Methods: The study has a cross-sectional design. Adult volunteers of both sexes were recruited and then underwent medical and nutritional assessments at the ambulatory oncology service. Diagnoses of sarcopenia and cachexia were made according to international criteria. Results: A total of 119 subjects were recruited, 57.1% were women. The mean age was 55.9 ± 14.2 years, and the mean body mass index was 25.0 ± 4.88 kg/m2. Of the total population studied, 25.2% had breast cancer, 17.6% gastrointestinal cancer, and 16.8% hematologic cancer and other neoplasms. According to the WHO guidelines for body mass index, 14% of subjects were underweight, 40% had normal weight, 30% were overweight and 16% were obese. The prevalence of sarcopenia was 26.1%; we observed that male volunteers had a higher risk of presenting sarcopenia [OR 13.1 (IC 95% 4.5-37.9, p<0.001)] and 47.6% of those subjects had gastrointestinal cancer [OR 3.3 (IC 95% 1.3-8.9, p<0.05)]. Finally, 12% of all of the subjects were diagnosed with cachexia. Conclusion: The prevalence of malnutrition, sarcopenia, and cachexia are high in oncological patients treated in the ambulatory service, especially in men and in those diagnosed with gastrointestinal cancer