Depósito Académico
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- Highlighting the interplay of microRNAs from Leishmania parasites and infected-host cells(Cambridge University Press, 2021) Carrera-Silva, E.A. (Eugenio Antonio); Ali-Hassanzadeh, M. (Mohammad); Ghani, E. (Esmaeel); Karimazar, M. (Mohammadreza); Mansouri, R. (Reza); Barazesh, A. (Afshin); Nguewa, P.A. (Paul Alain); Rashidi, S. (Sajad)Leishmania parasites, the causative agents of leishmaniasis, are protozoan parasites with the ability to modify the signalling pathway and cell responses of their infected host cells. These parasite strategies alter the host cell environment and conditions favouring their replication, survival and pathogenesis. Since microRNAs (miRNAs) are able to post-transcriptionally regulate gene expression processes, these biomolecules can exert critical roles in controlling Leishmania-host cell interplay. Therefore, the identification of relevant miRNAs differentially expressed in Leishmania parasites as well as in infected cells, which affect the host fitness, could be critical to understand the infection biology, pathogenicity and immune response against these parasites. Accordingly, the current review aims to address the differentially expressed miRNAs in both, the parasite and infected host cells and how these biomolecules change cell signalling and host immune responses during infection. A deep understanding of these processes could provide novel guidelines and therapeutic strategies for managing and treating leishmaniasis.
- Nutritional and culinary habits to empower families (n-CHEF): a feasibility study to increase consumption and home cooking of plant-based foods(Cambridge University Press, 2024) Simonin, L. (Luca); Goñi, L. (Leticia); Kury-Guzman, I. (Isabella); Ruiz-Canela, M. (Miguel); Martín‐Calvo, N. (Nerea); Rovayo, A. (Anacristina)Objective: To analyse the feasibility and acceptability of a culinary nutritional intervention aimed at increasing plant-based foods consumption in the context of the Mediterranean diet in parent-child dyads. Design: The Nutritional and Culinary Habits to Empower Families (n-CHEF) is a 9-month feasibility study that included four culinary nutritional workshops (two face to face, two online) led by a chef and a dietitian-nutritionist. These workshops combined cooking with plant-based foods, with nutritional advice and experimental activities. The main outcomes were retention, quality of the intervention (monitoring workshops, acceptability and perceived impact) and changes in dietary and cooking habits. Setting: Parent-child dyads, Spain. Participants: Parent-child (aged 10-14 years) dyads. Results: Fifteen parent-child dyads were recruited, of which thirteen were retained during the 6-month follow-up. All but one parent-child dyads attended the four workshops. The overall assessment of the workshops was positive, although the online workshops were rated lower than the face to face. In general, parent-child dyads reported benefits in terms of nutrition and cooking aspects. Parents significantly increased their adherence to the Mediterranean diet, but non-significant changes were observed in children. However, children increased their consumption of vegetables and legumes and reduced snacks and ready meals. Parents also changed some of their culinary habits and increased their confidence in cooking at home. Conclusions: The n-CHEF showed that the culinary nutritional intervention had good levels of recruitment, retention and acceptability among parent-child dyads. In addition, dietary and culinary knowledge and habits can be improved, although further studies are needed to know the long-term effects in larger populations.
- Impact of a longitudinal course on medical professionalism on the empathy of medical students(Elsevier, 2024) García-del-Barrio, L. (Loreto); Rodriguez-Diez, M.C. (María Cristina); Arbea, L. (Leire); Diez-Goñi, N. (Nieves); Gea, A. (Alfredo); Pereira, J. (José)Objective: Medical education should enhance empathy. We examined, using self-assessment instruments and standardized patients (SPs), the impact on empathy, of a multi-year intervention (years 4–6 of medical training) that uses reflective learning approaches. Methods: 241 final-year medical students participated; 110 from the 2018 graduation class (non-intervention group) and 131 from the 2019 graduation class (intervention group). Participants completed two self-reported empathy questionnaires – the Jefferson Scale of Empathy-Students (JSE-S) and the Interpersonal Reactivity Index (IRI) – and a personality questionnaire, the NEO Five-Factor Inventory. Additionally, SPs in a simulated station assessed participants’ empathy with two patient-reported instruments: the Consultation and Relational Empathy (CARE) scale and the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE). Results: Empathy scores were significantly higher in the intervention group compared to the non-intervention group when assessed by the SP (p < 0.001). No differences were found in self-reported questionnaires between the two groups. Conclusion: A longitudinal, multi-year reflection-based intervention enhanced empathy amongst medical students as assessed by SPs, but not when assessed by student self-reported measures. Practice Implications: Multi-year reflective learning interventions during clinical training nurture empathy in medical students. Assessments completed by SPs or patients may enhance the evaluation of empathy.
- Predicted vitamin D levels and risk of depression in the SUN Project: A prospective cohort study(Elsevier, 2024) Martinez-Gonzalez, M.A. (Miguel Ángel); Pons-Izquierdo, J.J. (Juan José); Bes-Rastrollo, M. (Maira); Silva-Sabiao, T. (Thaís) da; Cardoso-Carraro, J.C. (Julia Cristina); Sanchez-Villegas, A. (Almudena); Valer-Martínez, A. (Ana); Sayon-Orea, C. (Carmen)The current study aimed to investigate the association between predicted vitamin D status and depression in a prospective Spanish cohort of university graduates. The SUN Project is a dynamic cohort study designed to investigate multiple aspects of health and lifestyle. Participants were asked to complete a comprehensive questionnaire consisting of 556 items, that included a validated food-frequency questionnaire. Participants initially free of depression were classified as incident cases if they reported a medical diagnosis of depression during follow-up. Serum vitamin D levels were predicted by a previously validated equation. Vitamin D deficiency was defined as vitamin D levels below 20 ng/mL. Cox models were used to estimate adjusted hazard ratios (HR) and 95% confidence intervals (95% CI). We included 15,175 Spanish university graduates [mean (SD) age: 36.9 year (11.5)] followed-up for a median of 12.7 years. Among 192,976 person-years of follow-up, we identified 753 incident cases of depression. Participants with vitamin D deficiency had a 27% higher risk of depression as compared to those with vitamin D sufficiency (HR: 1.27, 95% CI: 1.09–1.48; p = 0.002) after adjusting for potential confounders. Furthermore, a significant effect modification by female sex was observed with higher depression risks associated with vitamin D deficiency in women than in men (p for interaction = 0.034). In educated middle-aged Spanish adults, we observed a direct association between vitamin D deficiency and the risk of depression, that was stronger among women.
- Macronutrient quality and its association with micronutrient adequacy in children(Elsevier, 2024) Martinez-Gonzalez, M.A. (Miguel Ángel); García-Blanco, L. (Lorena); Zazpe, I. (Itziar); Martín‐Calvo, N. (Nerea); De-la-O-Pascual, V. (Víctor); Fabios, E. (Elise)Background & aims: The double burden of malnutrition compels us to reconsider macronutrients from a diet quality perspective. The Macronutrient Quality Index (MQI) has been designed to reflect overall macronutrient quality and is based on three sub-indexes: the carbohydrate quality index (CQI), the healthy plate protein quality index (HPPQI) and the fat quality index (FQI). Nutritional adequacy is an essential aspect of diet quality that should be captured by reliable dietary indexes. Methods: We analyzed the association between the Macronutrient Quality Index (MQI) and micronutrient adequacy. Participants were children aged 4 and 5 years, recruited in the SENDO cohort. Baseline information was collected through a self-administered online questionnaire, which included information on sociodemographic, dietary, and lifestyle variables. Dietary information was obtained using a 147-item validated semi-quantitative food frequency questionnaire. Participants were categorized into tertiles based on their MQI score. We evaluated the intake of 20 micronutrients and assessed the probability of micronutrient adequacy using the Estimated Average Requirement cut-off point. Results: Children in the highest tertile of MQI had 0.33-fold lower odds (95%CI 0.17e0.66) of having 3 inadequate micronutrient intakes than their peers in the lowest tertile, after adjusting for potential confounders. The adjusted proportions of children with inadequate intake of 3 micronutrients were 18%, 14% and 11% in the first, second, and third tertiles of MQI respectively. The MQI appears to be capable of capturing nutrient adequacy in children, although our results suggest that a modified MQI, with eggs and dairy products weighted positively, might be more adequate for the pediatric population.
- Association between pre-conceptional carbohydrate quality index and the incidence of gestational diabetes: the SUN cohort study(Cambridge University Press on behalf of The Nutrition Society, 2023) Martinez-Gonzalez, M.A. (Miguel Ángel); Bes-Rastrollo, M. (Maira); Santiago, S. (Susana); Fernández-González, E. (Elena); Suescun-Elizalde, D. (David); Gea, A. (Alfredo); Basterra-Gortari, F.J. (Francisco Javier)The aim of the study was to investigate the association between pre-gestational carbohydrate quality index (CQI) and the incidence of gestational diabetes mellitus (GDM). Data from the ‘Seguimiento Universidad de Navarra’ (SUN) cohort were used, which includes 3827 women who notified at least one pregnancy between December 1999 and December 2019. We used a validated semicuantitative 136-item FFQ to evaluate dietary exposures at baseline and at 10-year follow-up. The CQI was defined by four criteria: glycaemic index, whole-grain/total-grain carbohydrate, dietary fibre intake and solid/total carbohydrate ratio. We fitted generalised estimating equations with repeated measurements of the CQI to assess its relationship with incident GDM. A total of 6869 pregnancies and 202 new cases of incident GDM were identified. The inverse association between the global quality of carbohydrate and the development of GDM was not statistically significant: OR the highest v. the lowest CQI category: 0·67, 95 % CI (0·40, 1·10), Pfor trend = 0·10. Participants at the highest CQI category and with daily carbohydrate amounts ≥50 % of total energy intake had the lowest incidence of GDM (OR = 0·29 (95 % CI (0·09, 0·89)) compared with those with the lowest quality (lowest CQI) and quantity (≤40 %). Further studies are needed to overcome the limitations of our study. Those studies should jointly consider the quality and the quantity of dietary carbohydrates, as the quality might be of importance, especially in women with a higher intake of carbohydrates.
- Vitamin D and risk of developing type 2 diabetes in the SUN project: a prospective cohort study(Springer Nature, 2024) Martinez, J.A. (José Alfredo); Martinez-Gonzalez, M.A. (Miguel Ángel); Bes-Rastrollo, M. (Maira); Valer-Martínez, A. (Ana); Basterra-Gortari, F.J. (Francisco Javier); Sayon-Orea, C. (Carmen)Purpose: Vitamin D deficiency has been associated with multiple chronic diseases, including metabolic disorders such as insulin resistance and type 2 diabetes (T2D). The aim of the study was to analyze the association between validated predicted serum vitamin D status and the risk of developing T2D in a large prospective cohort based on a Mediterranean population. Methods: The SUN project is a prospective and dynamic Spanish cohort that gathers university graduates who have answered lifestyle questionnaires, including a validated Food Frequency Questionnaire. The association between predicted serum vitamin D and the risk of T2D was assessed through Cox regression models according to quartiles (Q) of predicted vitamin D at baseline. The models were adjusted for potential confounders and sensitivity analyses were performed to ensure the robustness of our findings. Results: Our study included a total of 18,594 participants and after a total follow-up of 238,078 person-years (median follow-up of 13.5 years), 209 individuals were diagnosed with incident T2D. We found a significant inverse association between predicted levels of serum vitamin D and the risk of developing T2D, after adjusting for potential confounders and performing different sensitivity analyses (hazard ratio Q4 vs. Q1: 0.48, 95% CI 0.26-0.88; p for trend = 0.032). Conclusion: The outcomes suggest that higher levels of vitamin D at baseline may be associated with a reduced risk of developing T2D.
- Doctor, why is my lung gurgling?(Elsevier, 2024) Ortega-Claici, A. (Aura); Martínez-Gómez, N. (Nicolás); Rodríguez-Pérez, M. (María); Sánchez-Osorio, D. (Daniel)A 40-year-old male consulted complaining of progressive dys- pnea worsening over the last 4 years. During history, the patient mentioned motor-vehicle incidents at the ages of 6 and 12 years and posteriorly left diaphragmatic paralysis at 14. In 2019, he was hospitalized on the grounds of a respiratory infection. Upon pul- monary auscultation, borborygmi were found. A thoracoabdominal Computed Tomography (CT) was taken, revealing a diaphragmatic hernia of approximately 6.5 cm × 4.5 cm. The hernial sac contained abdominal viscera in the left hemithorax. A comparison of the 2023 CT scan with the one obtained in 2019 demonstrates progression of the herniation.
- Meeting the 24‐h movement recommendations and its relationship with Mediterranean dietary patterns in early childhood: the SENDO project(Springer, 2024) López-Gil, J.F. (José Francisco); Martín‐Calvo, N. (Nerea); Fabios, E. (Elise)The aim of this study was twofold: (1) to assess the association between meeting all three 24-h movement recommendations and adherence to the Mediterranean diet (MedDiet) in early childhood and (2) to examine whether participants who meet all three 24-h movement recommendations have greater adherence to the individual MedDiet foods/components than those who do not meet these recommendations. A cross-sectional study was conducted using a sample of 822 participants from the Seguimiento del Niño para un Desarrollo Óptimo (SENDO) project (Pamplona, Spain). Physical activity was assessed through a questionnaire that covered 17 different types of activities. Screen time was assessed by averaging the daily hours spent on activities such as watching TV, using a computer, or playing video games. Sleep duration was determined by taking the average of sleep durations during both weekdays and weekends. Adherence to the MedDiet was evaluated using the Mediterranean Diet Quality Index in children and adolescents (KIDMED). Greater odds of having an optimal adherence to the MedDiet were found for participants meeting all three 24-h movement recommendations (odds ratio (OR)=1.96, 95% confidence interval (CI) 1.33–2.87, p=0.001) in comparison with their counterparts not meeting these recommendations. Specifically, significant differences were found for “fruit or fruit juice every day” (p=0.012), “second fruit every day” (p=0.001), and “fresh or cooked vegetables regularly once a day” (p=0.018) in relation to meeting all three 24-h movement recommendation status. Conclusions: This study provides further evidence of the potential importance of meeting all three 24-h movement recommendations to adopt a healthier eating pattern.
- Association of monetary diet cost of foods and diet quality in Spanish older adults(Frontiers, 2023) Martinez, J.A. (José Alfredo); Martinez-Gonzalez, M.A. (Miguel Ángel); Riquelme-Gallego, B. (Blanca); Pastor, R. (Rosario); Tinahones, F.J. (Francisco J.); Vioque, J. (Jesús); Bes-Rastrollo, M. (Maira); Romaguera, D. (Dora); Romero-Secin, A. (Anny); Lapetra, J. (José); Bouzas, C. (Cristina); Schröder, H. (Helmut); López-Miranda, J. (José); Ruiz-Canela, M. (Miguel); Alonso-Gomez, A. (Ángel); Wärnberg, J. (Julia); Estruch, R. (Ramón); Serra-Majem, L. (Luis); Corella, D. (Dolores); Abete, I. (Itziar); Salas-Salvado, J. (Jordi); Monserrat-Mesquida, M. (Margalida); Garcia, S. (Silvia); Garcia-Arellano, A. (Ana)Background: A major barrier to a healthy diet may be the higher price of healthy foods compared to low-quality foods. Objectives: This study aimed to assess the association between the monetary cost of food and diet quality in Spanish older adults at high risk of cardiovascular disease. Methods: Cross-sectional analysis was carried out in Spanish older adults (n = 6,838; 48.6% female). A validated food frequency questionnaire was used to assess dietary intake. Metabolic syndrome severity, adherence to the Mediterranean diet (MedDiet), adherence to a provegetarian dietary pattern, and dietary inflammatory index were assessed. The economic cost of the foods was obtained from the Spanish Ministry of Agriculture Fisheries and Food database (2015–2017, the period of time when the participants were recruited). The total cost of diet adjusted per 1,000 kcal was computed. Results: The healthier dietary pattern was associated with a higher cost of the diet. Higher adherence to the MedDiet, anti-inflammatory diet, and the healthy version of the provegetarian dietary pattern were related to higher costs of the diet. Conclusion: Higher diet quality was associated with a higher dietary cost of the diet per 1,000 kcal/day. Food prices can be an important component of interventions and policies aimed at improving people's diets and preventing diet-related chronic diseases.