Abete, I. (Itziar)
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- Energy-restricted diets based on a distinct food selection affecting the glycemic index induce different weight loss and oxidative response(Elsevier, 2008) Martinez, J.A. (José Alfredo); Parra, M.D. (M. D.); Abete, I. (Itziar)Background and aims: Low glycemic index (GI) based diets could influence the accompanying physiological adaptations to energy restriction in the treatment of obesity. It was aimed to investigate the effects of two energy-restricted diets with different food distribution and GI values on weight loss and energy metabolism in the nutritional treatment of obesity. Subjects and Methods: Participants (n=32;BMI:32.5±4.3kg/m2) were randomly assigned to follow two energy-restricted diets with higher-GI or lower-GI for 8 weeks. The energy restriction was -30% in relation to energy expenditure. Anthropometry, energy expenditure and mitochondrial oxidation were assessed at baseline and at the endpoint of the intervention. Body weight was also measured one year after the treatment. The work was approved by the ethical committees of the University of Navarra (54/2006).Results: Volunteers consuming the lower-GI diet showed a significantly higher weight loss than their counterparts (-5.3±2.6% vs -7.5±2.9%;p=0.032), although the decrease in resting energy expenditure (REE) was similar between groups (p=0.783). Mitochondrial oxidation was significantly affected by the type of diet (p=0.001), being activated after the lower-GI treatment (p=0.022). Interestingly, one year after the nutritional intervention weight regain was only statistically significant in the higher-GI group (p=0.033).Conclusions: Lower-GI energy-restricted diets achieved through a specific differential food selection can improve the energy adaptations during obesity treatment, favouring weight loss and probably weight maintenance compared with higher-GI hypocaloric diets.
- Starches, sugars and obesity(MDPI, 2011) Martinez, J.A. (José Alfredo); Aller, E.E.J.G. (Erik E.J.G.); Van-Baak, M.A. (M.A.); Astrup, A. (Arne); Abete, I. (Itziar)The rising prevalence of obesity, not only in adults but also in children and adolescents, is one of the most important public health problems in developed and developing countries. As one possible way to tackle obesity, a great interest has been stimulated in understanding the relationship between different types of dietary carbohydrate and appetite regulation, body weight and body composition. The present article reviews the conclusions from recent reviews and meta-analyses on the effects of different starches and sugars on body weight management and metabolic disturbances, and provides an update of the most recent studies on this topic. From the literature reviewed in this paper, potential beneficial effects of intake of starchy foods, especially those containing slowly-digestible and resistant starches, and potential detrimental effects of high intakes of fructose become apparent. This supports the intake of whole grains, legumes and vegetables, which contain more appropriate sources of carbohydrates associated with reduced risk of cardiovascular and other chronic diseases, rather than foods rich in sugars, especially in the form of sugar-sweetened beverages.
- The reduction of the metabolyc syndrome in Navarra-Spain (RESMENA-S) study; a multidisciplinary strategy based on chrononutrition and nutritional education, together with dietetic and psychological control(Sociedad Española de Nutrición Parenteral y Enteral, 2011) Zulet, M.A. (María Ángeles); Navas-Carretero, S. (Santiago); Abete, I. (Itziar); Forga, L. (Luis); Lopez-Legarrea, P. (Patricia); Iglesia, R. (Rocío) de la; Bondia-Pons, I. (I.)Introduction: The high prevalence of metabolic syndrome (MS) in Spain requires additional efforts for prevention and treatment. Objective: The study RESMENA-S aims to improve clinical criteria and biomarkers associated with MS though an integral therapy approach. Methods: The study is a randomized prospective parallel design in which is expected to participate a total of 100 individuals. The RESMENA-S group (n = 50) is a personalized weight loss (30% energy restriction) diet, with a macronutrient distribution (carbohydrate / fat / protein) of 40/30/30, high meal frequency (7 / day), low glycemic index/load and high antioxidant capacity as well as a high adherence to the Mediterranean diet. The control group (n = 50) is assigned to a diet with the same energy restriction and based on the American Heart Association pattern. Both experimental groups are under dietary and psychological control during 8 weeks. Likewise, for an additional period of 16 weeks of self-control, is expected that volunteers will follow the same pattern but with no dietary advice. Results: Anthropometrical data and body composition determinations as well as blood and urine samples are being collected at the beginning and end of each phase. This project is registered at www.clinicaltrials.gov with the number NCT01087086 and count with the Research Ethics Committee of the University of Navarra approval (065/2009). Conclusions: Intervention trials to promote the adoption of dietary patterns and healthy lifestyle are of great importance to identify the outcomes and nutritional mechanisms that might explain the link between obesity, metabolic syndrome and associated complications.
- Seafood Consumption, Omega-3 Fatty Acids Intake, and Life-Time Prevalence of Depression in the PREDIMED-Plus Trial(MDPI, 2018-12-18) Babio, N. (Nancy); Martinez, J.A. (José Alfredo); Martinez-Gonzalez, M.A. (Miguel Ángel); Izquierdo, M. (Marisol); Garcia-Rios, A. (Antonio); Fito, M. (Montserrat); Daimiel, L. (Lidia); Tinahones, F.J. (Francisco J.); Vioque, J. (Jesús); Ortega-Azorin, C. (Carolina); García Hera, M (Manoli) de la; Tur, J.A. (Josep A.); Toledo, E. (Estefanía); Romaguera, D. (Dora); Lecea, O. (Oscar); Vázquez, C. (Clotilde); Zomeño, M.D. (María Dolores); Bueno-Cavanillas, A. (Aurora); Muñoz, M.A. (Miguel Angel); Delgado-Rodriguez, M. (Miguel); López-Miranda, J. (José); Matia, P. (Pilar); Ros, E. (Emilio); Ruiz-Canela, M. (Miguel); Alvarez Perez, J. (Jacqueline); Ortega-Calvo, M. (Manuel); Estruch, R. (Ramón); Diaz-Lopez, A. (Andres); Pérez-Lopez, J. (Jessica); Sanchez-Villegas, A. (Almudena); Serra-Majem, L. (Luis); Corella, D. (Dolores); Abete, I. (Itziar); Vidal, J. (Josep); Pinto, X. (Xavier); Salas-Salvado, J. (Jordi); Martin, V. (Vicente); Aros, F. (Fernando)Background: The aim of this analysis was to ascertain the type of relationship between fish and seafood consumption, omega-3 polyunsaturated fatty acids (ω-3 PUFA) intake, and depression prevalence. Methods: Cross-sectional analyses of the PREDIMED-Plus trial. Fish and seafood consumption and ω-3 PUFA intake were assessed through a validated food-frequency questionnaire. Self-reported life-time medical diagnosis of depression or use of antidepressants was considered as outcome. Depressive symptoms were collected by the Beck Depression Inventory-II. Logistic regression models were used to estimate the association between seafood products and ω-3 PUFA consumption and depression. Multiple linear regression models were fitted to assess the association between fish and long-chain (LC) ω-3 PUFA intake and depressive symptoms. Results: Out of 6587 participants, there were 1367 cases of depression. Total seafood consumption was not associated with depression. The odds ratios (ORs) (95% confidence intervals (CIs)) for the 2nd, 3rd, and 4th quintiles of consumption of fatty fish were 0.77 (0.63–0.94), 0.71 (0.58–0.87), and 0.78 (0.64–0.96), respectively, and p for trend = 0.759. Moderate intake of total LC ω-3 PUFA (approximately 0.5–1 g/day) was significantly associated with a lower prevalence of depression. Conclusion: In our study, moderate fish and LC ω-3 PUFA intake, but not high intake, was associated with lower odds of depression suggesting a U-shaped relationship.
- Obesity and ischemic stroke modulate the methylation levels of KCNQ1 in white blood cells(Oxford University Press, 2015) Martinez, J.A. (José Alfredo); Gomez-Uriz, A.M. (Ana María); Blazquez, V. (Vanessa); De-Arce, A. (Ana); Milagro-Yoldi, F.I. (Fermín Ignacio); Goyenechea, E. (Estíbaliz); Cordero, P. (Paul); Mansego-Talavera, M.L. (María Luisa); Martinez-Zabaleta, M. (Maite); Abete, I. (Itziar); Campión-Zabalza, J. (Javier); Lopez-de-Munain, A. (Adolfo)ABSTRACT Obesity and stroke are multifactorial diseases in which genetic, epigenetic and lifestyle factors are involved. The research aims were, first, the description of genes with differential epigenetic regulation obtained by an “omics” approach in patients with ischemic stroke and, second, to determine the importance of some regions of these selected genes in biological processes depending on the BMI. A case-control study using two populations was designed. The first population consisted of 24 volunteers according to stroke/non-stroke and normal weight/obesity conditions. The second population included 60 stroke patients and 55 controls classified by adiposity. DNA from the first population was analyzed with a methylation microarray, showing 80 CpG sites differentially methylated in stroke and 96 CpGs in obesity, whereas 59 CpGs showed interaction. After validating these data by MassArray Epityper, the promoter region of PM20D1 gene was significantly hypermethylated in stroke patients. One CpG site at CALD1 gene showed an interaction between stroke and obesity. Two CpGs located in the genes WT1 and KCNQ1 were significantly hypermethylated in obese patients. In the second population, KCNQ1 was also hypermethylated in the obese subjects. Two CpGs of this gene were subsequently validated by methylation-sensitive high-resolution melting. Moreover, KCNQ1 methylation levels were associated with plasma KCNQ1 protein concentrations. In conclusion, obesity induced changes in the KCNQ1 methylation pattern which were also dependent on stroke. Furthermore, the epigenetic marks differentially methylated in the stroke patients were dependent on the previous obese state. These DNA methylation patterns could be used as future potential stroke biomarkers.
- Neck circumference for NAFLD assessment during a 2-year nutritional intervention: the FLiO study(2022) Martinez, J.A. (José Alfredo); Benito-Boilos, A. (Alberto); Zulet, M.A. (María Ángeles); Tur, J.A. (Josep A.); Marin-Alejandre, B.A. (Bertha Araceli); Herrero, J.I. (José Ignacio); Monreal, J.I. (José Ignacio); Elorz, M. (Mariana); Abete, I. (Itziar); Pérez-Díaz-Campo, N. (Nuria) delNeck circumference (NC) and its relationship to height (NHtR) and weight (NWtR) appear to be good candidates for the non-invasive management of non-alcoholic fatty liver disease (NAFLD). This study aimed to evaluate the ability of routine variables to assess and manage NAFLD in 98 obese subjects with NAFLD included in a 2-year nutritional intervention program. Different measurements were performed at baseline, 6, 12 and 24 months. The nutritional intervention significantly improved the anthropometric, metabolic and imaging variables. NC was significantly associated with the steatosis degree at baseline (r = 0.29), 6 m (r = 0.22), 12 m (r = 0.25), and 24 m (r = 0.39) (all p < 0.05). NC was also significantly associated with visceral adipose tissue at all the study time-points (basal r = 0.78; 6 m r = 0.65; 12 m r = 0.71; 24 m r = 0.77; all p < 0.05). NC and neck ratios combined with ALT levels and HOMA-IR showed a good prediction ability for hepatic fat content and hepatic steatosis (at all time-points) in a ROC analysis. The model improved when weight loss was included in the panel (NC-ROC: 0.982 for steatosis degree). NC and ratios combined with ALT and HOMA-IR showed a good prediction ability for hepatic fat during the intervention. Thus, their application in clinical practice could improve the prevention and management of NAFLD.
- 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.
- Chronologically scheduled snacking with high-protein products within the habitual diet in type-2 diabetes patients leads to a fat mass loss: a longitudinal study.(BioMed Central, 2011) Martinez, J.A. (José Alfredo); Zulet, M.A. (María Ángeles); Navas-Carretero, S. (Santiago); Abete, I. (Itziar)Background: Obesity is the most relevant overnutrition disease worldwide and is associated to different metabolic disorders such as insulin resistance and type-2 diabetes. Low glycemic load foods and diets and moderately high protein intake have been shown to reduce body weight and fat mass, exerting also beneficial effects on LDL-cholesterol, triglyceride concentrations, postprandial glucose curve and HDL-cholesterol levels. The present study aimed at studying the potential functionality of a series of low glycemic index products with moderately high protein content, as possible coadjuvants in the control of type-2 diabetes and weight management following a chronologically planned snacking offer (morning and afternoon). Methods: The current trial followed a single group, sequential, longitudinal design, with two consecutive periods of 4 weeks each. A total of 17 volunteers participated in the study. The first period was a free living period, with volunteers' habitual ad libitum dietary pattern, while the second period was a free-living period with structured meal replacements at breakfast, morning snack and afternoon snack, which were exchanged by specific products with moderately high protein content and controlled low glycemic index, following a scheduled temporal consumption. Blood extractions were performed at the beginning and at the end of each period (free-living and intervention). Parameters analysed were: fasting glucose, insulin, glycosylated hemoglobin, total-, HDL- and LDL-cholesterol, triglyceride, C - reactive protein and Homocysteine concentrations. Postprandial glucose and insulin were also measured. Anthropometrical parameters were monitored each 2 weeks during the whole study. Results: A modest but significant (p = 0.002) reduction on body weight (1 kg) was observed during the intervention period, mainly due to the fat mass loss (0.8 kg, p = 0.02). This weight reduction was observed without apparently associated changes in total energy intake. None of the biochemical biomarkers measured was altered throughout the whole study. Conclusions: Small changes in the habitual dietary recommendations in type-2 diabetes patients by the inclusion of specific low-glycemic, moderately high-protein products in breakfast, morning and afternoon snacks may promote body weight and fat-mass loss, without apparently altering biochemical parameters and cardiovascular risk-related factors.
- Inflammatory markers as diagnostic and precision nutrition tools for metabolic dysfunction-associated steatotic liver disease: Results from the Fatty Liver in Obesity trial(Elsevier, 2024) Martinez, J.A. (José Alfredo); Riezu-Boj, J.I. (José Ignacio); Tobaruela-Resola, A.L. (Ana Luz); Benito-Boíllos, A. (Alberto); Zulet, M.A. (María Ángeles); Tur, J.A. (Josep A.); Mogna-Peláez, P. (Paola); Milagro-Yoldi, F.I. (Fermín Ignacio); Herrero, J.I. (José Ignacio); Elorz, M. (Mariana); Abete, I. (Itziar)Background & aims: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a growing public health concern. The disease is silent, and its diagnosis is often delayed. Inflammatory markers constitute an interesting tool to act as subrogate, non-invasive markers. This study aimed to evaluate the changes of inflammatory markers throughout a two-year dietary intervention in subjects presenting MASLD, to determine which of the markers are suitable to predict the disease, and act as a customizing tool for MASLD's dietary treatment. Methods: Ninety-eight subjects with MASLD and forty-five controls from the Fatty Liver in Obesity (FLiO) Study were analyzed. MASLD was diagnosed and graded by ultrasound. The MASLD subjects were randomly assigned to two different dietary strategies, the American Heart Association (AHA diet) or a dietary strategy based on the Mediterranean pattern, which was specially designed for the study (FLiO diet), and then followed for two years. Hepatic status was additionally assessed through Magnetic Resonance Imaging (MRI), elastography, and determination of transaminases. Results & discussion: Inflammatory markers improved throughout the intervention in the MASLD sub- jects and managed to reach similar levels to controls, especially at 6 and 12 months. Additionally, leptin, adiponectin, M30, and LECT2 managed to significantly diagnose the disease at all time marks of the intervention, making them candidates for subrogate non-invasive markers of the disease. Moreover, baseline chemerin, leptin, LECT2, and M65 were used to build a predictive score to achieve greater weight loss, and therefore, which strategy could be more useful for MASLD ‘s treatment. The predictive score was significantly able assign a specific diet to 55% of the study participants, meaning that the remaining 45% could achieve the same amount of weight loss following either diet equally. Conclusion: Inflammatory markers constitute a potential non-invasive tool to be used in MASLD screening and could also constitute an interesting tool for MASLD's treatment customization, being able to predict the effectiveness of a dietary strategy based on the initial inflammatory state of each subject. Trial registration: www.clinicaltrials.gov (NCT03183193).
- Predictive value of serum ferritin in combination with alanine aminotransferase and glucose levels for noninvasive assessment of NAFLD: Fatty liver in obesity (FLiO) study(MDPI AG, 2020) Martinez, J.A. (José Alfredo); Benito-Boíllos, A. (Alberto); Zulet, M.A. (María Ángeles); Tur, J.A. (Josep A.); Marin-Alejandre, B.A. (Bertha Araceli); Galarregui-Miquelarena, C. (Cristina); Herrero, J.I. (José Ignacio); Monreal, J.I. (José Ignacio); Elorz, M. (Mariana); Abete, I. (Itziar); Cantero-González, I. (Irene); Pérez-Díaz-Campo, N. (Nuria) delThe identification of affordable noninvasive biomarkers for the diagnosis and characterization of nonalcoholic fatty liver disease (NAFLD) is a major challenge for the research community. This study aimed to explore the usefulness of ferritin as a proxy biomarker of NAFLD condition, alone or in combination with other routine biochemical parameters. Subjects with overweight/obesity and ultrasound-confirmed liver steatosis (n = 112) from the Fatty Liver in Obesity (FLiO) study were assessed. The hepatic evaluation considered magnetic resonance imaging, ultrasonography, and credited routine blood liver biomarkers. Anthropometry and body composition, dietary intake (by means of a validated 137-item food frequency questionnaire), and specific biochemical markers were also determined. Serum ferritin levels were analyzed using a chemiluminescent microparticle immunoassay kit. Lower serum ferritin concentrations were associated with general better liver health and nutritional status. The evaluation of ferritin as a surrogate of liver damage by means of quantile regression analyses showed a positive association with alanine aminotransferase (ALT) (β = 19.21; p ≤ 0.001), liver fat content (β = 8.70; p = 0.008), and hepatic iron (β = 3.76; p ≤ 0.001), after adjusting for potential confounders. In receiver operating characteristic (ROC) analyses, the panel combination of blood ferritin, glucose, and ALT showed the best prediction for liver fat mass (area under the curve (AUC) 0.82). A combination of ferritin and ALT showed the higher predictive ability for estimating liver iron content (AUC 0.73). This investigation demonstrated the association of serum ferritin with liver health as well as with glucose and lipid metabolism markers in subjects with NAFLD. Current findings led to the identification of ferritin as a potential noninvasive predictive biomarker of NAFLD, whose surrogate value increased when combined with other routine biochemical measurements (glucose/ALT).