Galarregui-Miquelarena, C. (Cristina)
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- Both macronutrient food composition and fasting insulin resistance affect postprandial glycemic responses in senior subjects(Royal Society of Chemistry, 2021) Martinez, J.A. (José Alfredo); Zulet, M.A. (María Ángeles); Gonzalez-Navarro, C.J. (Carlos Javier); Galarregui-Miquelarena, C. (Cristina); Navas-Carretero, S. (Santiago); Abete, I. (Itziar)Introduction: Postprandial hyperglycemia is a risk factor for type 2 diabetes. Insulin resistance (IR) might affect metabolic responses in non-fasting states. Dietary intake and food composition influence postprandial glucose homeostasis. The aims of this study were to evaluate the effects of different test foods varying in the macronutrient composition on postprandial glycemic responses and whether these outcomes are conditioned by the basal glycemic status in senior subjects. Methods: In a randomized, controlled crossover design, thirty-four adults consumed a test food, a high protein product (n = 19) or a high carbohydrate (CHO) product (n = 15), using the oral glucose tolerance test (OGTT) as a reference. Blood glucose and insulin were measured at fasting and at 15, 30, 45, 60, 90, and 120 min after starting the food intake. For each type of food, the incremental area under the curve (iAUC) for glucose and insulin was calculated. IR was measured using the Homeostatic Model Assessment of IR (HOMA-IR). Results: Consumption of a high protein product significantly lowered the peak and Δ blood glucose concentrations compared to the high CHO product (p < 0.001). Concerning the insulin response, no significant differences between both foods were observed. Fasting glucose was positively correlated with the glucose iAUC only for the high protein product. Positive associations of both fasting insulin and HOMA-IR with the insulin iAUC for all the cases were observed. Linear regression models showed significant positive associations between the glucose iAUC and fasting glucose after adjusting for age and sex. Regarding the insulin iAUC, positive associations were found with fasting insulin and HOMA-IR. Regression models also evidenced that both food test consumptions were able to decrease the glucose and insulin iAUC values when compared with the OGTT product. Conclusion: Our research found that not only is the nutritional composition of foods important, but also the baseline glycemic state of individuals when assessing glycemic index estimations and addressing precision nutritional strategies to prevent and treat IR-associated disturbances.
- Association between an oxidative balance score and mortality: a prospective analysis in the SUN cohort(Springer, 2023) Martinez-Gonzalez, M.A. (Miguel Ángel); Fuente-Arrillaga, C. (Carmen) de la; Hernández-Ruiz, Á; Galarregui-Miquelarena, C. (Cristina); Ruiz-Canela, M. (Miguel); Fernández-Lázaro, C.I. (César I.); Sotos-Prieto, M. (Mercedes); Talavera-Rodríguez, I. (Irene); Hershey-de-la-Cruz, M.S. (María Soledad)Purpose We aimed to prospectively investigate the association of an overall oxidative balance score (OBS) with all-cause death and cause-specifc mortality among participants in the Seguimiento Universidad de Navarra (SUN) Study, a Mediterranean cohort of Spanish graduates. Methods Using baseline information on 12 a priori selected dietary and non-dietary lifestyle pro- and antioxidants exposures—vitamins C and E, β-carotenes, selenium, zinc, heme iron, polyphenols, total antioxidant capacity, body mass index, alcohol, smoking, and physical activity—we constructed an equally weighted OBS categorized into quartiles, with higher scores representing greater antioxidant balance. Cox proportional hazards models were ftted to evaluate the association between the OBS and mortality. Results A total of 18,561 participants (mean [SD] age, 38.5 [12.4] years; 40.8% males) were included in the analysis. During a median follow-up of 12.2 years (interquartile range 8.3–14.9), 421 deaths were identifed, including 80 deaths from cardiovascular disease (CVD), 215 from cancer, and 126 from other causes. After adjustment for potential confounders, the hazard ratios and 95% confdence interval (CIs) between the highest quartile (predominance of antioxidants) vs. the lowest quartile (reference category) were 0.35 (95% CI 0.22–0.54, P-trend<0.001) for all-cause mortality, 0.18 (95% CI 0.06–0.51, P-trend=0.001) for CVD mortality, 0.35 (95% CI 0.19–0.65, P-trend=0.002) for cancer mortality, and 0.45 (95% CI 0.20–1.02, P-trend=0.054) for other-cause mortality. Conclusion Our fndings suggest a strong inverse association between the OBS and all-cause, CVD, and cancer mortality. Individuals exposed to both antioxidant dietary and lifestyle factors may potentially experience the lowest mortality risk.
- Possible metabolic interplay between quality of life and fecal microbiota in a presenior population: Preliminary results(Elsevier, 2022) Martinez, J.A. (José Alfredo); Riezu-Boj, J.I. (José Ignacio); Zulet, M.A. (María Ángeles); Cuevillas, B. (Begoña) de; Milagro-Yoldi, F.I. (Fermín Ignacio); Gonzalez-Navarro, C.J. (Carlos Javier); Galarregui-Miquelarena, C. (Cristina); Navas-Carretero, S. (Santiago); Abete, I. (Itziar)Objectives: The number of people aged 60 y is increasing worldwide, so establishing a relationship between lifestyle and health-associated factors, such as gut microbiota in an older population, is important. This study aimed to characterize the gut microbiota of a presenior population, and analyze the association between some bacteria and quality of life with the Short Form (SF) 36 questionnaire. Methods: Participants were adult men and women ages 50 to 80 y (n = 74). In addition to the SF-36 question- naire, fecal samples were collected in cryotubes, and 16S RNA gene sequencing was performed to character- ize microbial features. Participants were classified into two groups according to SF-36 punctuation. Linear and logistic regression models were performed to assess the possible association between any bacterial bowl and SF-36 score. Receiver operating characteristics curves were fitted to define the relative diagnostic strength of different bacterial taxa for the correct determination of quality of life. Results: A positive relationship was established between SF-36 score and Actinobacteria (P = 0.0310; R = 0.2510) compared with Peptostreptococcaceae (P = 0.0259; R = 0.2589), which increased with decreasing quality of life. Logistic regressions models and receiver operating characteristics curves showed that the rela- tive abundance of Actinobacteria and Peptostreptococcaceae may be useful to predict quality of life in a prese- nior population (area under the curve: 0.71). Conclusions: Quality of life may be associated with the relative abundance of certain bacteria, especially Acti- nobacteria and Peptostreptococcaceae, which may have a specific effect on certain markers and health care, which is important to improve quality of life in older populations.
- 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).
- Estrategias de guía e ingredientes dietéticos de precisión para enfermedades crónicas en población pre-sénior y sénior(NCBI, 2018) Martinez, J.A. (José Alfredo); Loria-Kohen, V. (Viviana); Zulet, M.A. (María Ángeles); Ramirez-de-Molina, A. (Ana); Galarregui-Miquelarena, C. (Cristina); Navas-Carretero, S. (Santiago); Reglero, G. (Guillermo); Abete, I. (Itziar)El envejecimiento de la población supone un importante reto, económico y cualitativo, para el sistema de salud orientándolo hacia una atención de tipo preventivo, en la que la nutrición de precisión (NP) y la prescripción de hábitos saludables adquieren relevancia capital. El fin de la NP es procurar una nutrición adaptada a cada individuo, entendiendo que la prevención o el tratamiento de trastornos crónicos (obesidad, diabetes, enfermedad cardiovascular, etc.) deben abordarse de un modo integral, considerando información personal y clínica relevante, edad y características feno- y genotípicas. La elaboración de la presente guía surge de la necesidad de desarrollar modelos nutricionales de precisión que permitan la individualización del tratamiento nutricional, con énfasis en el adulto mayor. Las necesidades nutricionales, las recomendaciones dietéticas y los ingredientes para una NP en las personas pre-sénior y sénior quedan resumidas en realizar al menos 3 comidas diarias, reducir las calorías totales, optar por una alimentación variada y equilibrada con alimentos frescos y de alta densidad nutricional, incorporar verduras, legumbres y pescado, consumir productos lácteos y fibra, preferir carnes blancas en lugar de rojas, evitar frituras, embutidos y alimentos procesados, moderar el consumo de sal, café y alcohol, e hidratarse adecuadamente.
- Interplay of glycemic index, glycemic load, and dietary antioxidant capacity with insulin resistance in subjects with a cardiometabolic risk profile(MDPI AG, 2018) 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)Background: Dietary total antioxidant capacity (TAC), glycemic index (GI), and glycemic load (GL) are accepted indicators of diet quality, which have an effect on diet–disease relationships. The aim of this study was to evaluate potential associations of dietary TAC, GI, and GL with variables related to nutritive status and insulin resistance (IR) risk in cardiometabolic subjects. Methods: A total of 112 overweight or obese adults (age: 50.8 ± 9 years old) were included in the trial. Dietary intake was assessed by a validated 137-item food frequency questionnaire (FFQ), which was also used to calculate the dietary TAC, GI, and GL. Anthropometrics, blood pressure, body composition by dual-energy X-ray absorptiometry (DXA), glycemic and lipid profiles, C-reactive protein (CRP), as well as fatty liver quantification by magnetic resonance imaging (MRI) were assessed. Results: Subjects with higher values of TAC had significantly lower circulating insulin concentration and homeostatic model assessment of insulin resistance (HOMA-IR). Participants with higher values of HOMA-IR showed significantly higher GI and GL. Correlation analyses showed relevant inverse associations of GI and GL with TAC. A regression model evidenced a relationship of HOMA-IR with TAC, GI, and GL. Conclusion: This data reinforces the concept that dietary TAC, GI, and GL are potential markers of diet quality, which have an impact on the susceptible population with a cardiometabolic risk profile.
- Strategies for improving the quality of life in age-related diseases: precision nutrition approaches(Universidad de Navarra, 2022-01-11) Galarregui-Miquelarena, C. (Cristina); Abete, I. (Itziar)A projected doubling in the global human population aged 60 years and over by 2050 has a dramatic impact on overall health and economics. Global nutrition recommendations are not having the expected beneficial effect on reducing the incidence of chronic disease and burdens of unhealthy ageing. Effective nutritional strategies are required in the prevention and management of age-related chronic diseases, focusing on an early diagnosis and prognosis of all these diseases. Nutritional research and guidelines focus on population averages. However, the high inter-person variability in response to foods and diets demands the development of group-based nutrition and precision approaches to optimize the quality of diet and food intake in adults. Thus, the general objective of the current research was to evaluate the plausible role of nutritional factors and dietary patterns in the development and management of age-related chronic diseases including obesity, insulin resistance (IR) and non-alcoholic fatty liver disease (NAFLD), as well as to assess the potential role of blood biomarkers for an early detection of these age-related diseases, to promote an active and healthy ageing. In Chapter 1, the acute effects of different test foods varying in the macronutrient composition on postprandial glycemic response were assessed. Whether these outcomes are influenced by the basal state of the subjects or not were also explored. We found that postprandial glycemic responses were affected not only by the macronutrient composition of foods but also by the glucose metabolism of the subjects in adults, reinforcing the importance of the identification of impaired postprandial glucose metabolism in apparently metabolically healthy adults. In Chapter 2, the potential associations of different dietary indices -total antioxidant capacity (TAC), glycemic index (GI), and glycemic load (GL)- with IR traits in subjects with overweight/obesity and NAFLD were evaluated. Cross-sectional analyses suggested that participants with a higher dietary GI and GL showed increased HOMA-IR values. Moreover, dietary TAC was associated with lower insulin, HOMA-IR, and hepatic fat content. Importantly, the dietary TAC was inversely associated with the GI and GL. Potential associations of specific dietary amino acids -aromatic amino acids (AAA), branched-chain amino acids (BCAA) and sulphur amino acids (SAA)- with hepatic, glucose, and iron metabolism markers were analysed in these participants (Chapter 3). A higher intake of dietary BCAA, SAA and AAA was associated with worse liver health and, to a lesser extent with impaired glucose metabolism. Dietary patterns should consider BCAA, SAA and AAA levels for the management of NAFLD and associated IR. The potential associations of ferritin with hepatic and glucose alterations were explored and the usefulness of different blood biomarkers including ferritin for an early diagnosis of NAFLD in subjects with overweight or obesity was investigated (Chapter 4). Serum ferritin was associated with impaired liver health and glucose metabolism. Moreover, a panel combination consisting of serum ferritin, alanine aminotransferase (ALT) and glucose showed the major predictive ability for liver fat quantification. Finally, the effects of a personalised dietary intervention based on the inclusion of functional foods and digital tools on general health status was assessed within a 3-month follow-up in subjects with overweight/obesity (Chapter 5). Interestingly, the precision nutrition approach enhanced quality of life and emotional well-being, with additional improvements in body composition and metabolic health. Overall, the results of the present investigation have demonstrated that personalised nutrition strategies are effective for a better prevention, management, and diagnosis of age-related diseases including obesity, IR and NAFLD, to enhance the quality of life and reduce the burden from chronic disease.