María Portillo - Academia.edu (original) (raw)

Papers by María Portillo

International Journal of Cardiology, Feb 1, 2022

Background:Current recommendations for echocardiographic assessment of diastolic function (2016 g... more Background:Current recommendations for echocardiographic assessment of diastolic function (2016 guidelines of the American Society of Echocardiography (ASE)/European Association of Cardiovascular Imaging (EACVI) in patients with metabolic syndrome and overweight/obesity result in a significant number of patients with indeterminate diastolic dysfunction (LVDD). The aim of this article is to study whether the use of the left atrial strain criterion (LALS) reduces the number of indeterminate patients.Methods:229 patients were studied with a complete echocardiographic study that included left ventricular longitudinal strain (LVLS) analysis, LALS and a maximal ergospirometry test with assessment of oxygen uptake (VO2max).Results:The mean age was 65±5 years, 153 (67%) males, with a mean EF of 60±5%. The mean LVLS was −19.4±2% and the LALS Reservoir was 23.8±7%. There were 140 patients who did not meet LVDD criteria and 82 who did meet the indeterminate LVDD criterion. When the left atrial volume index (LAVI) >34 ml/m2 criterion was replaced in the 2016 ASE/EACVI algorithm by LALS Reservoir ≤20%, the number of indeterminate patients was reduced from 36% to 23% (p<0.001) at the expense of increasing normal studies (61% and 74%). Adding the LALS Reservoir criterion ≤23% in the 82 patients of the indeterminate group resulted in two groups with a different VO2max (11.6±3 and 18±5 ml/kg/min, p:0.081).Conclusions:This study confirms the low prevalence of diastolic dysfunction in overweight/obese patients with metabolic syndrome. Adding left atrial strain criterion to the current recommendations significantly reduces the number of indeterminate patients by reclassifying them as normal.

Revista Española de Cardiología, 2020

Introduccio´n y objetivos: Analizar si variaciones en la actividad física (AF) y las conductas se... more Introduccio´n y objetivos: Analizar si variaciones en la actividad física (AF) y las conductas sedentarias se acompañ an de diferencias en el consumo má ximo de oxígeno (VO 2má x). Me´todos: Estudio transversal prospectivo de 243 voluntarios (82 mujeres; media de edad, 65,0 AE 4,9 años) con síndrome metabó lico y sobrepeso/obesidad que realizaron una prueba de esfuerzo má ximo con aná lisis de gases. La AF se evaluó mediante cuestionarios respondidos por los pacientes (REGICOR y RAPA 1) y mé todos objetivos: test de la silla y acelerometría. El sedentarismo se analizó con el cuestionario del Nurses Health Study y acelerometría. Resultados: Los sujetos que afirmaron cumplir las recomendaciones de las guías sobre AF en el cuestionario REGICOR alcanzaron mayor VO 2má x (21,3 AE 4,6 frente a 18,0 AE 4,4 ml/kg/min; p < 0,001) y los que declararon que realizaban má s AF en el RAPA 1 mostraron un VO 2má x un 18% mayor que el del grupo menos activo (p < 0,001). El test de la silla (> 15 frente a 15 repeticiones) tambié n mostró diferencias significativas en VO 2má x (21,2 AE 4,8 frente a 18,7 AE 4,5 ml/kg/min; p < 0,001). Los índices de correlació n entre variables de AF y el VO 2má x fueron estadísticamente significativos, pero bajos (de r = 0,2 a r = 0,4). En cambio, las actividades sedentarias apenas mostraron relació n con el VO 2má x. Conclusiones: Los sujetos con síndrome metabó lico y sobrepeso/obesidad que afirman cumplir las recomendaciones sobre AF alcanzan mayor VO 2má x. Los cuestionarios de AF respondidos por los pacientes y el test de la silla detectan variaciones significativas en el VO 2má x. Parece que las actividades sedentarias no influyen en el VO 2má x .

Journal of Cachexia, Sarcopenia and Muscle, 2019

BackgroundSarcopenia is a progressive age‐related skeletal muscle disorder associated with increa... more BackgroundSarcopenia is a progressive age‐related skeletal muscle disorder associated with increased likelihood of adverse outcomes. Muscle wasting is often accompanied by an increase in body fat, leading to ‘sarcopenic obesity’. The aim of the present study was to analyse the association of lifestyle variables such as diet, dietary components, physical activity (PA), body composition, and inflammatory markers, with the risk of sarcopenic obesity.MethodsA cross‐sectional analysis based on baseline data from the PREDIMED‐Plus study was performed. A total of 1535 participants (48% women) with overweight/obesity (body mass index: 32.5 ± 3.3 kg/m2; age: 65.2 ± 4.9 years old) and metabolic syndrome were categorized according to sex‐specific tertiles (T) of the sarcopenic index (SI) as assessed by dual‐energy X‐ray absorptiometry scanning. Anthropometrical measurements, biochemical markers, dietary intake, and PA information were collected. Linear regression analyses were carried out to e...

IJC Heart & Vasculature, 2019

Background: Left ventricle diastolic dysfunction (LVDD) is a common finding in high risk individu... more Background: Left ventricle diastolic dysfunction (LVDD) is a common finding in high risk individuals, its presence being associated with reduced exercise capacity (EC). We assessed the prevalence of LVDD, applying the 2016 guidelines of the American Society of Echocardiography (ASE)/European Association of Cardiovascular Imaging (EACVI), in a population with overweight/obesity and metabolic syndrome and its association with EC. Methods and results: This was a prospective, cross-sectional study of a cohort of 235 patients (mean age of 65 ± 5 years old and 33% female) without heart disease and an ejection fraction N50% who underwent a complete echocardiographic assessment and cardiopulmonary exercise testing. Individuals meeting three or more criteria of the 2016 ASE/EACVI guidelines are considered to have LVDD, while tests are considered indeterminate in those meeting only two. Overall, 178 (76%) of our patients met one echocardiographic cutoff value for LVDD, 91 (39%) met two and 7 (3%) three or more. Patients meeting three cutoffs values showed a significant reduction in maximal oxygen uptake (16 ± 3 vs. 19.6 ± 5 ml/kg/min, p b .05), unlike those with indeterminate tests. In multiple regression analysis, meeting three cutoffs was associated with number of METS (ß = −2.2, p = .018). In exploratory analysis, using two criteria based on cutoffs different from those proposed in the guidelines, we identified groups with different EC. Conclusions: The application of 2016 ASE/EACVI guidelines limited the prevalence of LVDD to 3%. This group showed a clear reduction of the EC. New echocardiographic cutoff values proposed in this study allow us to establish subgroups with different levels of EC.

International Journal of Epidemiology, 2018

Clinical nutrition (Edinburgh, Scotland), Jan 6, 2017

To assess the possible association between a validated Dietary Inflammatory Index (DII) and speci... more To assess the possible association between a validated Dietary Inflammatory Index (DII) and specific dietary components with suitable non-invasive markers of liver status in overweight and obese subjects within the PREDIMED study. A cross-sectional study encompassing 794 randomized overweight and obese participants (mean ± SD age: 67.0 ± 5.0 y, 55% females) from the PREDIMED (PREvención con DIeta MEDiterránea) trial was conducted. DII is a validated tool evaluating the effect of diet on six inflammatory biomarkers (IL-1b, IL-4, IL-6, IL-10, TNF-α and C-reactive protein). Furthermore, a validated 137-item food-frequency-questionnaire was used to obtain the information about the food intake. In addition, anthropometric measurements and several non-invasive markers of liver status were assessed and the Fatty Liver Index (FLI) score was calculated. A higher DII and lower adherence to Mediterranean diet (MeDiet) were associated with a higher degree of liver damage (FLI > 60) in obese ...

Nutrients, 2017

Background: Cataract is a leading cause of vision impairment worldwide, and surgery is the only a... more Background: Cataract is a leading cause of vision impairment worldwide, and surgery is the only available treatment. The process that initiates lens opacification is dependent on the oxidative stress experienced by the lens components. A healthy overall dietary pattern, with the potential to reduce oxidative stress, has been suggested as a means to decrease the risk of developing cataract. We aimed to investigate the hypothesis that an intervention with a Mediterranean diet (MedDiet) rather than a low-fat diet could decrease the incidence of cataract surgery in elderly subjects. Methods: We included 5802 men and women (age range: 55-80 years) from the Prevención con Dieta Mediterránea study (multicenter, parallel-group, randomized controlled clinical trial) who had

Obesity, 2016

ObjectiveTo analyze whether a combination of quercetin (Q) and resveratrol (RSV) would induce a w... more ObjectiveTo analyze whether a combination of quercetin (Q) and resveratrol (RSV) would induce a white adipose tissue (WAT) browning effect.MethodsThirty‐six rats were fed an obesogenic diet and divided into four groups: control, treated with RSV (15 mg/kg body weight/day; RSV group), treated with Q (30 mg/kg body weight/day; Q group), or treated with both polyphenols (RSV + Q group).ResultsAfter 6 weeks, body and WAT weights were significantly reduced in the RSV + Q group. In perirenal WAT of the control, RSV, and Q groups, white unilocular adipocytes appeared in the majority of cells, while in the RSV + Q group numerous multilocular adipocytes with positive immunostaining for UCP1 were observed. The presence of UCP1 was confirmed by Western blot. This group also revealed increased mRNA levels of Cidea, Hocx9, Bmp4, Slc27a1, Pat2, Atgl, and Atp5d. Interscapular brown adipose tissue weight showed no differences between groups, but the Cidea mRNA level was increased in the RSV group, ...

Journal of the American Heart Association, 2016

Background Epidemiological evidence suggests a cardioprotective role of α‐linolenic acid ( ALA ),... more Background Epidemiological evidence suggests a cardioprotective role of α‐linolenic acid ( ALA ), a plant‐derived ω‐3 fatty acid. It is unclear whether ALA is beneficial in a background of high marine ω‐3 fatty acids (long‐chain n‐3 polyunsaturated fatty acids) intake. In persons at high cardiovascular risk from Spain, a country in which fish consumption is customarily high, we investigated whether meeting the International Society for the Study of Fatty Acids and Lipids recommendation for dietary ALA (0.7% of total energy) at baseline was related to all‐cause and cardiovascular disease mortality. We also examined the effect of meeting the society's recommendation for long‐chain n‐3 polyunsaturated fatty acids (≥500 mg/day). Methods and Results We longitudinally evaluated 7202 participants in the PRE vención con DI eta MED iterránea ( PREDIMED ) trial. Multivariable‐adjusted Cox regression models were fitted to estimate hazard ratios. ALA intake correlated to walnut consumption ...

JAMA internal medicine, Jan 14, 2015

Breast cancer is the leading cause of female cancer burden, and its incidence has increased by mo... more Breast cancer is the leading cause of female cancer burden, and its incidence has increased by more than 20% worldwide since 2008. Some observational studies have suggested that the Mediterranean diet may reduce the risk of breast cancer. To evaluate the effect of 2 interventions with Mediterranean diet vs the advice to follow a low-fat diet (control) on breast cancer incidence. The PREDIMED study is a 1:1:1 randomized, single-blind, controlled field trial conducted at primary health care centers in Spain. From 2003 to 2009, 4282 women aged 60 to 80 years and at high cardiovascular disease risk were recruited after invitation by their primary care physicians. Participants were randomly allocated to a Mediterranean diet supplemented with extra-virgin olive oil, a Mediterranean diet supplemented with mixed nuts, or a control diet (advice to reduce dietary fat). Breast cancer incidence was a prespecified secondary outcome of the trial for women without a prior history of breast cancer ...

The Journal of nutritional biochemistry, Jan 26, 2015

Diet-induced obesity is associated to an imbalance in the normal gut microbiota composition. Resv... more Diet-induced obesity is associated to an imbalance in the normal gut microbiota composition. Resveratrol and quercetin, widely known for their health beneficial properties, have low bioavailability, and when they reach the colon, they are targets of the gut microbial ecosystem. Hence, the use of these molecules in obesity might be considered as a potential strategy to modulate intestinal bacterial composition. The purpose of this study was to determine whether trans-resveratrol and quercetin administration could counteract gut microbiota dysbiosis produced by high-fat sucrose diet (HFS) and, in turn, improve gut health. Wistar rats were randomised into four groups fed an HFS diet supplemented or not with trans-resveratrol [15 mg/kg body weight (BW)/day], quercetin (30 mg/kg BW/day) or a combination of both polyphenols at those doses. Administration of both polyphenols together prevented body weight gain and reduced serum insulin levels. Moreover, individual supplementation of trans-...

Genes & nutrition, 2014

DNA methylation is an epigenetic mechanism that can inhibit gene transcription. The aim of this s... more DNA methylation is an epigenetic mechanism that can inhibit gene transcription. The aim of this study was to assess changes induced by an obesogenic diet in the methylation profile of genes involved in adipose tissue triacylglycerol metabolism, and to determine whether this methylation pattern can be altered by resveratrol and pterostilbene. Rats were divided into four groups. The control group was fed a commercial standard diet, and the other three groups were fed a commercial high-fat, high-sucrose diet (6 weeks): the high-fat, high-sucrose group, the resveratrol-treated group (RSV; 30 mg/kg/day), and the pterostilbene-treated group (PT; 30 mg/kg/day). Gene expression was measured by RT-PCR and gene methylation by pyrosequencing. The obesogenic diet induced a significant increase in adipose tissue weight. Resveratrol and pterostilbene partially prevented this effect. Methylation pattern of ppnla2 and pparg genes was similar among the experimental groups. In fasn, significant hypom...

British Journal of Nutrition, 2013

In mammals, the main component of the circadian system is the suprachiasmatic nucleus in the hypo... more In mammals, the main component of the circadian system is the suprachiasmatic nucleus in the hypothalamus. However, circadian clocks are also present in most peripheral tissues, such as adipose tissue. The aim of the present study was to analyse the potential effects of resveratrol on changes induced by high-fat feeding in the expression of clock genes and clock-controlled genes in the white adipose tissue from rats. For this purpose, rats were divided into three groups: a control group, fed a standard diet, and two other groups, either fed a high-fat diet supplemented with resveratrol (RSV) or no resveratrol (HF). The expression of clock genes and clock-controlled genes was analysed by RT-PCR. Protein expression and fatty acid synthase (FAS) activity were also analysed. When comparing the controls, the RSV group showed similar patterns of response to the HF group, except for reverse erythroblastosis virus α (Rev-Erbα), which was down-regulated. The expression of this gene reached t...

Nutrition, Metabolism and Cardiovascular Diseases, 2013

Background and Aims: Epidemiological and clinical studies suggest that lowglycemic index diets co... more Background and Aims: Epidemiological and clinical studies suggest that lowglycemic index diets could protect against weight gain. However, the relationship between these diets and adipokines or inflammatory markers is unclear. In the present study we examine how the dietary glycemic index (GI) and dietary glycemic load (GL) are associated with several adipokines and related metabolic risk markers of obesity and diabetes in a cross-sectional and longitudinal manner. Methods and Results: 511 elderly community-dwelling men and women at high cardiovascular risk were recruited for the PREDIMED trial. Dietary data were collected at baseline and after 1 year of follow-up. The GI and GL were calculated. Plasma leptin, adiponectin and other metabolic risk markers were measured at baseline and after 1 year. At baseline, subjects in the highest quartiles of GI showed significantly higher levels of TNF and IL-6 than those in the lowest quartiles. Dietary GI index was negatively related to plasma leptin and adiponectin levels. After 1 year of follow-up, subjects with a higher increase in dietary GI or GL showed a greater reduction in leptin and adiponectin plasma levels. There was no association between GI or GL and the other metabolic markers measured.

European Journal of Clinical Nutrition, 2014

Nutrients, 2017

Overweight and obesity have been steadily increasing in recent years and currently represent a se... more Overweight and obesity have been steadily increasing in recent years and currently represent a serious threat to public health. Few human studies have investigated the relationship between polyphenol intake and body weight. Our aim was to assess the relationship between urinary polyphenol levels and body weight. A cross-sectional study was performed with 573 participants from the PREDIMED (Prevención con Dieta Mediterránea) trial (ISRCTN35739639). Total polyphenol levels were measured by a reliable biomarker, total urinary polyphenol excretion (TPE), determined by the Folin-Ciocalteu method in urine samples. Participants were categorized into five groups according to their TPE at the fifth year. Multiple linear regression models were used to assess the relationships between TPE and obesity parameters; body weight (BW), body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR). After a five years follow up, significant inverse correlations were observed between TPE at the 5th year and BW (β = −1.004; 95% CI: −1.634 to −0.375, p = 0.002), BMI (β = −0.320; 95% CI: −0.541 to −0.098, p = 0.005), WC (β = −0.742; 95% CI: −1.326 to −0.158, p = 0.013), and WHtR (β = −0.408; 95% CI: −0.788 to −0.028, p = 0.036) after adjustments for potential confounders. To conclude, a greater polyphenol intake may thus contribute to reducing body weight in elderly people at high cardiovascular risk.

Antioxidants, 2021

Opuntia stricta var. Dillenii’s prickly pears are an underutilized fruit with a high content of b... more Opuntia stricta var. Dillenii’s prickly pears are an underutilized fruit with a high content of betalains and phenolic compounds that could bring potential health benefits for humans. The aim of this study is the optimization of the “green” extraction of betalains and phenolic compounds from Opuntia stricta var. Dillenii’s whole fruits by ultrasound-assisted extraction (UAE), using a response surface methodology (RSM) by a central composite design (CCD) in order to obtain extracts rich in betalains and phenolic compounds with proven biological activities. For UAE optimization, the extraction temperature (20–50 °C), the amplitude (20–50%) and the ethanol volume in extraction solvent (15–80%, v/v) were selected as independent variables. All combinations were conducted at 2, 5, 10, 20 and 30 min to determinate the time effect. The betalain and phenolic compound content in Opuntia stricta var. Dillenii’s whole fruits and UAE extracts were identified by HPLC-DAD-ESI/MS and HPLC-DAD-MS/QT...

Journal of Physiology and Biochemistry, 2016

The prevalence of obesity has increased rapidly during recent years and has reached epidemic prop... more The prevalence of obesity has increased rapidly during recent years and has reached epidemic proportions. As a result, the scientific community is interested in active biomolecules which are naturally present in plants and foodstuffs and may be useful in body weight management. In recent years, polyphenols have made up one of the most frequently studied groups among these molecules. Numerous studies have been carried out on animals to analyse the potential anti-obesity effects of resveratrol, a non-flavonoid polyphenol, and a general consensus concerning the body-fatlowering effect of this compound exists. By contrast, studies in humans have been few so far. Moreover, in these studies, the effectiveness of resveratrol is low. The aims of the present review are to summarize the results reported so far on this topic and to justify the differences observed between animals and humans. It seems that the reduced response to resveratrol in humans cannot be attributed to the use of lower doses in humans because the doses that induce body-fat-lowering effects in rodents are in the same range as those used in human studies. With regard to the experimental period length, treatments were longer in animal studies than in human studies. This can be one of the reasons contributing to the reduced responses observed in humans. Moreover, animals used in the reported studies are young while volunteers participating in human studies are adults, suggesting that resveratrol may be more efficient in young individuals. In addition to differences in the experimental designs, metabolic differences between animals and human cannot be discarded.

Journal of Physiology and Biochemistry, 2015

The present review focuses on the role of miRNAs in the control of white adipose tissue browning,... more The present review focuses on the role of miRNAs in the control of white adipose tissue browning, a process which describes the recruitment of adipocytes showing features of brown adipocytes in white adipose tissue. MicroRNAs (miRNAs) are a class of short non-coding RNAs (19-22 nucleotides) involved in gene regulation. Although the main effect of miRNAs is the inhibition of the translational machinery, thereby preventing the production of the protein product, the activation of protein translation has also been described in the literature. In addition to modifying translation, miRNAs binding to its target mRNAs also trigger the recruitment and association of mRNA decay factors, leading to mRNA destabilization, degradation, and thus to the decrease in expression levels. Although a great number of miRNAs have been reported to potentially regulate genes that play important roles in the browning process, only a reduced number of studies have demonstrated experimentally an effect on this process associated to changes in miRNA expressions, so far. These studies have shown, by using either primary adipocyte cultures or experimental models of mice (KO mice, mice overexpressing a specific miRNA), that miR-196a and miR-30 are needed for browning process development. By contrast, miR-155, miR-133, miR-27b, miR-34, and miR-26 act as negative regulators of this process. Further studies are needed to fully describe the miRNA network-involved white adipose tissue browning regulation.

International Journal of Cardiology, Feb 1, 2022

Background:Current recommendations for echocardiographic assessment of diastolic function (2016 g... more Background:Current recommendations for echocardiographic assessment of diastolic function (2016 guidelines of the American Society of Echocardiography (ASE)/European Association of Cardiovascular Imaging (EACVI) in patients with metabolic syndrome and overweight/obesity result in a significant number of patients with indeterminate diastolic dysfunction (LVDD). The aim of this article is to study whether the use of the left atrial strain criterion (LALS) reduces the number of indeterminate patients.Methods:229 patients were studied with a complete echocardiographic study that included left ventricular longitudinal strain (LVLS) analysis, LALS and a maximal ergospirometry test with assessment of oxygen uptake (VO2max).Results:The mean age was 65±5 years, 153 (67%) males, with a mean EF of 60±5%. The mean LVLS was −19.4±2% and the LALS Reservoir was 23.8±7%. There were 140 patients who did not meet LVDD criteria and 82 who did meet the indeterminate LVDD criterion. When the left atrial volume index (LAVI) >34 ml/m2 criterion was replaced in the 2016 ASE/EACVI algorithm by LALS Reservoir ≤20%, the number of indeterminate patients was reduced from 36% to 23% (p<0.001) at the expense of increasing normal studies (61% and 74%). Adding the LALS Reservoir criterion ≤23% in the 82 patients of the indeterminate group resulted in two groups with a different VO2max (11.6±3 and 18±5 ml/kg/min, p:0.081).Conclusions:This study confirms the low prevalence of diastolic dysfunction in overweight/obese patients with metabolic syndrome. Adding left atrial strain criterion to the current recommendations significantly reduces the number of indeterminate patients by reclassifying them as normal.

Revista Española de Cardiología, 2020

Introduccio´n y objetivos: Analizar si variaciones en la actividad física (AF) y las conductas se... more Introduccio´n y objetivos: Analizar si variaciones en la actividad física (AF) y las conductas sedentarias se acompañ an de diferencias en el consumo má ximo de oxígeno (VO 2má x). Me´todos: Estudio transversal prospectivo de 243 voluntarios (82 mujeres; media de edad, 65,0 AE 4,9 años) con síndrome metabó lico y sobrepeso/obesidad que realizaron una prueba de esfuerzo má ximo con aná lisis de gases. La AF se evaluó mediante cuestionarios respondidos por los pacientes (REGICOR y RAPA 1) y mé todos objetivos: test de la silla y acelerometría. El sedentarismo se analizó con el cuestionario del Nurses Health Study y acelerometría. Resultados: Los sujetos que afirmaron cumplir las recomendaciones de las guías sobre AF en el cuestionario REGICOR alcanzaron mayor VO 2má x (21,3 AE 4,6 frente a 18,0 AE 4,4 ml/kg/min; p < 0,001) y los que declararon que realizaban má s AF en el RAPA 1 mostraron un VO 2má x un 18% mayor que el del grupo menos activo (p < 0,001). El test de la silla (> 15 frente a 15 repeticiones) tambié n mostró diferencias significativas en VO 2má x (21,2 AE 4,8 frente a 18,7 AE 4,5 ml/kg/min; p < 0,001). Los índices de correlació n entre variables de AF y el VO 2má x fueron estadísticamente significativos, pero bajos (de r = 0,2 a r = 0,4). En cambio, las actividades sedentarias apenas mostraron relació n con el VO 2má x. Conclusiones: Los sujetos con síndrome metabó lico y sobrepeso/obesidad que afirman cumplir las recomendaciones sobre AF alcanzan mayor VO 2má x. Los cuestionarios de AF respondidos por los pacientes y el test de la silla detectan variaciones significativas en el VO 2má x. Parece que las actividades sedentarias no influyen en el VO 2má x .

Journal of Cachexia, Sarcopenia and Muscle, 2019

BackgroundSarcopenia is a progressive age‐related skeletal muscle disorder associated with increa... more BackgroundSarcopenia is a progressive age‐related skeletal muscle disorder associated with increased likelihood of adverse outcomes. Muscle wasting is often accompanied by an increase in body fat, leading to ‘sarcopenic obesity’. The aim of the present study was to analyse the association of lifestyle variables such as diet, dietary components, physical activity (PA), body composition, and inflammatory markers, with the risk of sarcopenic obesity.MethodsA cross‐sectional analysis based on baseline data from the PREDIMED‐Plus study was performed. A total of 1535 participants (48% women) with overweight/obesity (body mass index: 32.5 ± 3.3 kg/m2; age: 65.2 ± 4.9 years old) and metabolic syndrome were categorized according to sex‐specific tertiles (T) of the sarcopenic index (SI) as assessed by dual‐energy X‐ray absorptiometry scanning. Anthropometrical measurements, biochemical markers, dietary intake, and PA information were collected. Linear regression analyses were carried out to e...

IJC Heart & Vasculature, 2019

Background: Left ventricle diastolic dysfunction (LVDD) is a common finding in high risk individu... more Background: Left ventricle diastolic dysfunction (LVDD) is a common finding in high risk individuals, its presence being associated with reduced exercise capacity (EC). We assessed the prevalence of LVDD, applying the 2016 guidelines of the American Society of Echocardiography (ASE)/European Association of Cardiovascular Imaging (EACVI), in a population with overweight/obesity and metabolic syndrome and its association with EC. Methods and results: This was a prospective, cross-sectional study of a cohort of 235 patients (mean age of 65 ± 5 years old and 33% female) without heart disease and an ejection fraction N50% who underwent a complete echocardiographic assessment and cardiopulmonary exercise testing. Individuals meeting three or more criteria of the 2016 ASE/EACVI guidelines are considered to have LVDD, while tests are considered indeterminate in those meeting only two. Overall, 178 (76%) of our patients met one echocardiographic cutoff value for LVDD, 91 (39%) met two and 7 (3%) three or more. Patients meeting three cutoffs values showed a significant reduction in maximal oxygen uptake (16 ± 3 vs. 19.6 ± 5 ml/kg/min, p b .05), unlike those with indeterminate tests. In multiple regression analysis, meeting three cutoffs was associated with number of METS (ß = −2.2, p = .018). In exploratory analysis, using two criteria based on cutoffs different from those proposed in the guidelines, we identified groups with different EC. Conclusions: The application of 2016 ASE/EACVI guidelines limited the prevalence of LVDD to 3%. This group showed a clear reduction of the EC. New echocardiographic cutoff values proposed in this study allow us to establish subgroups with different levels of EC.

International Journal of Epidemiology, 2018

Clinical nutrition (Edinburgh, Scotland), Jan 6, 2017

To assess the possible association between a validated Dietary Inflammatory Index (DII) and speci... more To assess the possible association between a validated Dietary Inflammatory Index (DII) and specific dietary components with suitable non-invasive markers of liver status in overweight and obese subjects within the PREDIMED study. A cross-sectional study encompassing 794 randomized overweight and obese participants (mean ± SD age: 67.0 ± 5.0 y, 55% females) from the PREDIMED (PREvención con DIeta MEDiterránea) trial was conducted. DII is a validated tool evaluating the effect of diet on six inflammatory biomarkers (IL-1b, IL-4, IL-6, IL-10, TNF-α and C-reactive protein). Furthermore, a validated 137-item food-frequency-questionnaire was used to obtain the information about the food intake. In addition, anthropometric measurements and several non-invasive markers of liver status were assessed and the Fatty Liver Index (FLI) score was calculated. A higher DII and lower adherence to Mediterranean diet (MeDiet) were associated with a higher degree of liver damage (FLI > 60) in obese ...

Nutrients, 2017

Background: Cataract is a leading cause of vision impairment worldwide, and surgery is the only a... more Background: Cataract is a leading cause of vision impairment worldwide, and surgery is the only available treatment. The process that initiates lens opacification is dependent on the oxidative stress experienced by the lens components. A healthy overall dietary pattern, with the potential to reduce oxidative stress, has been suggested as a means to decrease the risk of developing cataract. We aimed to investigate the hypothesis that an intervention with a Mediterranean diet (MedDiet) rather than a low-fat diet could decrease the incidence of cataract surgery in elderly subjects. Methods: We included 5802 men and women (age range: 55-80 years) from the Prevención con Dieta Mediterránea study (multicenter, parallel-group, randomized controlled clinical trial) who had

Obesity, 2016

ObjectiveTo analyze whether a combination of quercetin (Q) and resveratrol (RSV) would induce a w... more ObjectiveTo analyze whether a combination of quercetin (Q) and resveratrol (RSV) would induce a white adipose tissue (WAT) browning effect.MethodsThirty‐six rats were fed an obesogenic diet and divided into four groups: control, treated with RSV (15 mg/kg body weight/day; RSV group), treated with Q (30 mg/kg body weight/day; Q group), or treated with both polyphenols (RSV + Q group).ResultsAfter 6 weeks, body and WAT weights were significantly reduced in the RSV + Q group. In perirenal WAT of the control, RSV, and Q groups, white unilocular adipocytes appeared in the majority of cells, while in the RSV + Q group numerous multilocular adipocytes with positive immunostaining for UCP1 were observed. The presence of UCP1 was confirmed by Western blot. This group also revealed increased mRNA levels of Cidea, Hocx9, Bmp4, Slc27a1, Pat2, Atgl, and Atp5d. Interscapular brown adipose tissue weight showed no differences between groups, but the Cidea mRNA level was increased in the RSV group, ...

Journal of the American Heart Association, 2016

Background Epidemiological evidence suggests a cardioprotective role of α‐linolenic acid ( ALA ),... more Background Epidemiological evidence suggests a cardioprotective role of α‐linolenic acid ( ALA ), a plant‐derived ω‐3 fatty acid. It is unclear whether ALA is beneficial in a background of high marine ω‐3 fatty acids (long‐chain n‐3 polyunsaturated fatty acids) intake. In persons at high cardiovascular risk from Spain, a country in which fish consumption is customarily high, we investigated whether meeting the International Society for the Study of Fatty Acids and Lipids recommendation for dietary ALA (0.7% of total energy) at baseline was related to all‐cause and cardiovascular disease mortality. We also examined the effect of meeting the society's recommendation for long‐chain n‐3 polyunsaturated fatty acids (≥500 mg/day). Methods and Results We longitudinally evaluated 7202 participants in the PRE vención con DI eta MED iterránea ( PREDIMED ) trial. Multivariable‐adjusted Cox regression models were fitted to estimate hazard ratios. ALA intake correlated to walnut consumption ...

JAMA internal medicine, Jan 14, 2015

Breast cancer is the leading cause of female cancer burden, and its incidence has increased by mo... more Breast cancer is the leading cause of female cancer burden, and its incidence has increased by more than 20% worldwide since 2008. Some observational studies have suggested that the Mediterranean diet may reduce the risk of breast cancer. To evaluate the effect of 2 interventions with Mediterranean diet vs the advice to follow a low-fat diet (control) on breast cancer incidence. The PREDIMED study is a 1:1:1 randomized, single-blind, controlled field trial conducted at primary health care centers in Spain. From 2003 to 2009, 4282 women aged 60 to 80 years and at high cardiovascular disease risk were recruited after invitation by their primary care physicians. Participants were randomly allocated to a Mediterranean diet supplemented with extra-virgin olive oil, a Mediterranean diet supplemented with mixed nuts, or a control diet (advice to reduce dietary fat). Breast cancer incidence was a prespecified secondary outcome of the trial for women without a prior history of breast cancer ...

The Journal of nutritional biochemistry, Jan 26, 2015

Diet-induced obesity is associated to an imbalance in the normal gut microbiota composition. Resv... more Diet-induced obesity is associated to an imbalance in the normal gut microbiota composition. Resveratrol and quercetin, widely known for their health beneficial properties, have low bioavailability, and when they reach the colon, they are targets of the gut microbial ecosystem. Hence, the use of these molecules in obesity might be considered as a potential strategy to modulate intestinal bacterial composition. The purpose of this study was to determine whether trans-resveratrol and quercetin administration could counteract gut microbiota dysbiosis produced by high-fat sucrose diet (HFS) and, in turn, improve gut health. Wistar rats were randomised into four groups fed an HFS diet supplemented or not with trans-resveratrol [15 mg/kg body weight (BW)/day], quercetin (30 mg/kg BW/day) or a combination of both polyphenols at those doses. Administration of both polyphenols together prevented body weight gain and reduced serum insulin levels. Moreover, individual supplementation of trans-...

Genes & nutrition, 2014

DNA methylation is an epigenetic mechanism that can inhibit gene transcription. The aim of this s... more DNA methylation is an epigenetic mechanism that can inhibit gene transcription. The aim of this study was to assess changes induced by an obesogenic diet in the methylation profile of genes involved in adipose tissue triacylglycerol metabolism, and to determine whether this methylation pattern can be altered by resveratrol and pterostilbene. Rats were divided into four groups. The control group was fed a commercial standard diet, and the other three groups were fed a commercial high-fat, high-sucrose diet (6 weeks): the high-fat, high-sucrose group, the resveratrol-treated group (RSV; 30 mg/kg/day), and the pterostilbene-treated group (PT; 30 mg/kg/day). Gene expression was measured by RT-PCR and gene methylation by pyrosequencing. The obesogenic diet induced a significant increase in adipose tissue weight. Resveratrol and pterostilbene partially prevented this effect. Methylation pattern of ppnla2 and pparg genes was similar among the experimental groups. In fasn, significant hypom...

British Journal of Nutrition, 2013

In mammals, the main component of the circadian system is the suprachiasmatic nucleus in the hypo... more In mammals, the main component of the circadian system is the suprachiasmatic nucleus in the hypothalamus. However, circadian clocks are also present in most peripheral tissues, such as adipose tissue. The aim of the present study was to analyse the potential effects of resveratrol on changes induced by high-fat feeding in the expression of clock genes and clock-controlled genes in the white adipose tissue from rats. For this purpose, rats were divided into three groups: a control group, fed a standard diet, and two other groups, either fed a high-fat diet supplemented with resveratrol (RSV) or no resveratrol (HF). The expression of clock genes and clock-controlled genes was analysed by RT-PCR. Protein expression and fatty acid synthase (FAS) activity were also analysed. When comparing the controls, the RSV group showed similar patterns of response to the HF group, except for reverse erythroblastosis virus α (Rev-Erbα), which was down-regulated. The expression of this gene reached t...

Nutrition, Metabolism and Cardiovascular Diseases, 2013

Background and Aims: Epidemiological and clinical studies suggest that lowglycemic index diets co... more Background and Aims: Epidemiological and clinical studies suggest that lowglycemic index diets could protect against weight gain. However, the relationship between these diets and adipokines or inflammatory markers is unclear. In the present study we examine how the dietary glycemic index (GI) and dietary glycemic load (GL) are associated with several adipokines and related metabolic risk markers of obesity and diabetes in a cross-sectional and longitudinal manner. Methods and Results: 511 elderly community-dwelling men and women at high cardiovascular risk were recruited for the PREDIMED trial. Dietary data were collected at baseline and after 1 year of follow-up. The GI and GL were calculated. Plasma leptin, adiponectin and other metabolic risk markers were measured at baseline and after 1 year. At baseline, subjects in the highest quartiles of GI showed significantly higher levels of TNF and IL-6 than those in the lowest quartiles. Dietary GI index was negatively related to plasma leptin and adiponectin levels. After 1 year of follow-up, subjects with a higher increase in dietary GI or GL showed a greater reduction in leptin and adiponectin plasma levels. There was no association between GI or GL and the other metabolic markers measured.

European Journal of Clinical Nutrition, 2014

Nutrients, 2017

Overweight and obesity have been steadily increasing in recent years and currently represent a se... more Overweight and obesity have been steadily increasing in recent years and currently represent a serious threat to public health. Few human studies have investigated the relationship between polyphenol intake and body weight. Our aim was to assess the relationship between urinary polyphenol levels and body weight. A cross-sectional study was performed with 573 participants from the PREDIMED (Prevención con Dieta Mediterránea) trial (ISRCTN35739639). Total polyphenol levels were measured by a reliable biomarker, total urinary polyphenol excretion (TPE), determined by the Folin-Ciocalteu method in urine samples. Participants were categorized into five groups according to their TPE at the fifth year. Multiple linear regression models were used to assess the relationships between TPE and obesity parameters; body weight (BW), body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR). After a five years follow up, significant inverse correlations were observed between TPE at the 5th year and BW (β = −1.004; 95% CI: −1.634 to −0.375, p = 0.002), BMI (β = −0.320; 95% CI: −0.541 to −0.098, p = 0.005), WC (β = −0.742; 95% CI: −1.326 to −0.158, p = 0.013), and WHtR (β = −0.408; 95% CI: −0.788 to −0.028, p = 0.036) after adjustments for potential confounders. To conclude, a greater polyphenol intake may thus contribute to reducing body weight in elderly people at high cardiovascular risk.

Antioxidants, 2021

Opuntia stricta var. Dillenii’s prickly pears are an underutilized fruit with a high content of b... more Opuntia stricta var. Dillenii’s prickly pears are an underutilized fruit with a high content of betalains and phenolic compounds that could bring potential health benefits for humans. The aim of this study is the optimization of the “green” extraction of betalains and phenolic compounds from Opuntia stricta var. Dillenii’s whole fruits by ultrasound-assisted extraction (UAE), using a response surface methodology (RSM) by a central composite design (CCD) in order to obtain extracts rich in betalains and phenolic compounds with proven biological activities. For UAE optimization, the extraction temperature (20–50 °C), the amplitude (20–50%) and the ethanol volume in extraction solvent (15–80%, v/v) were selected as independent variables. All combinations were conducted at 2, 5, 10, 20 and 30 min to determinate the time effect. The betalain and phenolic compound content in Opuntia stricta var. Dillenii’s whole fruits and UAE extracts were identified by HPLC-DAD-ESI/MS and HPLC-DAD-MS/QT...

Journal of Physiology and Biochemistry, 2016

The prevalence of obesity has increased rapidly during recent years and has reached epidemic prop... more The prevalence of obesity has increased rapidly during recent years and has reached epidemic proportions. As a result, the scientific community is interested in active biomolecules which are naturally present in plants and foodstuffs and may be useful in body weight management. In recent years, polyphenols have made up one of the most frequently studied groups among these molecules. Numerous studies have been carried out on animals to analyse the potential anti-obesity effects of resveratrol, a non-flavonoid polyphenol, and a general consensus concerning the body-fatlowering effect of this compound exists. By contrast, studies in humans have been few so far. Moreover, in these studies, the effectiveness of resveratrol is low. The aims of the present review are to summarize the results reported so far on this topic and to justify the differences observed between animals and humans. It seems that the reduced response to resveratrol in humans cannot be attributed to the use of lower doses in humans because the doses that induce body-fat-lowering effects in rodents are in the same range as those used in human studies. With regard to the experimental period length, treatments were longer in animal studies than in human studies. This can be one of the reasons contributing to the reduced responses observed in humans. Moreover, animals used in the reported studies are young while volunteers participating in human studies are adults, suggesting that resveratrol may be more efficient in young individuals. In addition to differences in the experimental designs, metabolic differences between animals and human cannot be discarded.

Journal of Physiology and Biochemistry, 2015

The present review focuses on the role of miRNAs in the control of white adipose tissue browning,... more The present review focuses on the role of miRNAs in the control of white adipose tissue browning, a process which describes the recruitment of adipocytes showing features of brown adipocytes in white adipose tissue. MicroRNAs (miRNAs) are a class of short non-coding RNAs (19-22 nucleotides) involved in gene regulation. Although the main effect of miRNAs is the inhibition of the translational machinery, thereby preventing the production of the protein product, the activation of protein translation has also been described in the literature. In addition to modifying translation, miRNAs binding to its target mRNAs also trigger the recruitment and association of mRNA decay factors, leading to mRNA destabilization, degradation, and thus to the decrease in expression levels. Although a great number of miRNAs have been reported to potentially regulate genes that play important roles in the browning process, only a reduced number of studies have demonstrated experimentally an effect on this process associated to changes in miRNA expressions, so far. These studies have shown, by using either primary adipocyte cultures or experimental models of mice (KO mice, mice overexpressing a specific miRNA), that miR-196a and miR-30 are needed for browning process development. By contrast, miR-155, miR-133, miR-27b, miR-34, and miR-26 act as negative regulators of this process. Further studies are needed to fully describe the miRNA network-involved white adipose tissue browning regulation.