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Evidences from Clinical Trials in Down Syndrome: Diet, Exercise and Body Composition.
Martínez-Espinosa, RM, Molina Vila, MD, Reig García-Galbis, M
International journal of environmental research and public health. 2020;(12)
Abstract
Down syndrome (DS) is related to diseases like congenital heart disease, obstructive sleep apnea, obesity and overweight. Studies focused on DS associated with obesity and overweight are still scarce. The main objective of this work was to analyze the relationship between dietary intervention, physical exercise and body composition, in DS with overweight and obesity. This review is based on the PRISMA guidelines (Preferred Reporting Items for Systematic reviews and Meta-Analyses). Selection criteria for this analysis were: publications between January 1997 and December 2019; DS individuals with overweight and obesity; clinical trials using dietary intervention and physical exercise paying attention to changes in body composition. Selected clinical trials were focused on an exclusive intervention based on physical exercise. The anthropometric measures analyzed were body fat, BMI, waist circumference, body weight and fat free mass. The main conclusion is that prescribing structured physical exercise intervention may be related to a greater variation in body composition. Despite limited number of clinical trials analyzed, it can be assumed that the reported studies have not achieved optimal results and that the design of future clinical trials should be improved. Some guidelines are proposed to contribute to the improvement of knowledge in this field.
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2.
Practical Guidance for Interventions in Adults with Metabolic Syndrome: Diet and Exercise vs. Changes in Body Composition.
Pérez, EA, González, MP, Martínez-Espinosa, RM, Vila, MDM, Reig García-Galbis, M
International journal of environmental research and public health. 2019;(18)
Abstract
(1) Objective: to establish practical guidance for the design of future clinical trials in MS (metabolic syndrome) patients aged 18 and older, based on a systematic review of randomized clinical trials connecting diet, physical exercise and changes in body composition. (2) Method: this systematic review of randomized clinical trials (RCT) is based on the guidelines recommended by PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses). Criteria of selection: ≥18 years of age; patients diagnosed with MS; intervention programs including diet, physical exercise and/or modifications in the style of life as treatment, as well as the magnitude of changes in body composition (BC); randomized clinical trial published between 2004 and 2018. (3) Results: the multidisciplinary interventions describe major changes in BC, and the recurring pattern in these clinical trials is an energy reduction and control in the percentage of intake of macronutrients along with the performance of regularly structured exercise; the most analyzed parameter was waist circumference (88.9% of the trials), followed by body weight (85.2%), BMI (77.8%) and body fat (55.6%). (4) Conclusions: The analysis of the information here reported sheds light for the design of future clinical trials in adults with MS. The best anthropometric parameters and units of measurement to monitor the interventions are related to dietary and physical exercise interventions. A list of practical advice that is easy to implement in daily practice in consultation is here proposed in order to guarantee the best results in changes of body composition.
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3.
Effects of the Usage of l-Cysteine (l-Cys) on Human Health.
Clemente Plaza, N, Reig García-Galbis, M, Martínez-Espinosa, RM
Molecules (Basel, Switzerland). 2018;(3)
Abstract
This review summarizes recent knowledge about the use of the amino acid l-Cysteine (l-Cys) through diet, nutritional supplements or drugs with the aim to improve human health or treat certain diseases. Three databases (PubMed, Scopus, and Web of Science) and different keywords have been used to create a database of documents published between 1950 and 2017 in scientific journals in English or Spanish. A total of 60,885 primary publications were ultimately selected to compile accurate information about the use of l-Cys in medicine and nutritional therapies and to identify the reported benefits of l-Cys on human health. The number of publications about the use of l-Cys for these purposes has increased significantly during the last two decades. This increase seems to be closely related to the rise of nutraceutical industries and personalized medicine. The main evidence reporting benefits of l-Cys usage is summarized. However, the lack of accurate information and studies based on clinical trials hampers consensus among authors. Thus, the debate about the role and effectiveness of supplements/drugs containing l-Cys is still open.
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New Insights about How to Make an Intervention in Children and Adolescents with Metabolic Syndrome: Diet, Exercise vs. Changes in Body Composition. A Systematic Review of RCT.
Albert Pérez, E, Mateu Olivares, V, Martínez-Espinosa, RM, Molina Vila, MD, Reig García-Galbis, M
Nutrients. 2018;10(7)
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Metabolic Syndrome is the term used to group a cluster of health concerns including overweight, obesity, hypertension, elevated cholesterol, blood glucose intolerance and insulin resistance which together can contribute to the development of Type II Diabetes and Cardiovascular Disease. Diagnosis is usually given if a patient has three or more of these conditions however the diagnosis in children and adolescents is often inconsistent, and so guidelines for therapeutic strategies for metabolic syndrome also vary greatly. This review looked at 9 studies of children aged up to 19 years old, all diagnosed with metabolic syndrome, and given dietary, physical, psychological, and pharmacological interventions, to try and understand what the best clinical approach might be. It was found that a balanced diet combined with aerobic and resistance exercise helped to significantly reduce body mass, more so than the trials which included treatment with Metformin. A balance diet included calorie restriction and carbohydrate reduction, carefully planned around the daily exercise program of 2-3 resistance sessions each week and frequent cardio sessions of differing intensity and duration. They concluded that a minimum of 6 months was needed to reach optimal weight loss and body fat loss. Overall, the findings of this study support diet and physical exercise as beneficial clinical interventions, whilst the use of medication is still unclear.
Abstract
OBJECTIVE To record which interventions produce the greatest variations in body composition in patients ≤19 years old with metabolic syndrome (MS). METHOD search dates between 2005 and 2017 in peer reviewed journals, following the PRISMA method (Preferred Reporting Items for Systematic reviews and Meta-Analyses). The selection criteria were: diagnostic for MS or at least a criterion for diagnosis; randomized clinical trials, ≤19 years of age; intervention programs that use diet and/or exercise as a tool (interventions showing an interest in body composition). RESULTS 1781 clinical trials were identified under these criteria but only 0.51% were included. The most frequent characteristics of the selected clinical trials were that they used multidisciplinary interventions and were carried out in America. The most utilized parameters were BMI (body mass index) in kg/m² and BW (body weight) in kg. CONCLUSIONS Most of the clinical trials included had been diagnosed through at least 2 diagnostic criteria for MS. Multidisciplinary interventions obtained greater changes in body composition in patients with MS. This change was especially prevalent in the combinations of dietary interventions and physical exercise. It is proposed to follow the guidelines proposed for patients who are overweight, obese, or have diabetes type 2, and extrapolate these strategies as recommendations for future clinical trials designed for patients with MS.
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[ENTERAL NUTRITION ON THE NUTRITIONAL STATUS OF CANCER].
Escortell Sánchez, R, Reig García-Galbis, M
Nutricion hospitalaria. 2015;(4):1408-16
Abstract
OBJECTIVE to identify what effect causes enteral nutrition on nutritional status of cancer. METHOD a search was performed using the keywords "Cancer" AND "Enteral Nutrition" AND "Supplementation" in four document databases: Pubmed, EBSCO, ProQuest, and Web of Science. INCLUSION CRITERIA age of the sample, major than 18 years; submitted to surgery for cancer; that the intervention program was including diet and employment or not of nutritional Supplementation; clinical trials published between January 2004 and December 2014, in scientific journals indexed. RESULTS we analyzed 660 articles, of which only 2% has been included. 58% of intervention programs are applied outside Spain; 84% of the interventions was carried out in a hospitable ambient; 58% of the sample is formed by adults older than 54 years; 33% of the interventions were multidisciplinary and its duration ranges between 1 and 4 years. DISCUSSION we found just a few national interventions in cancer participants and there two types of interventions: by exclusive polymeric enteral formula or mixed with immunonutrition. CONCLUSIONS enteral nutrition shows against the parenteral and its introduction at an early stage, it helps to improve nutritional status of the patient; polymeric formulas next immunonutrition, it helps to reduce the time of hospitalization; the analytical parameters are shown as a measurement pattern when assessing the improvement in nutritional status in cancer. It is recommended to increase the research in this field, especially in children.
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[ENERGY AND MACRONUTRIENT INTAKE IN FEMALE ATHLETES].
Bernad Asencio, L, Reig García-Galbis, M
Nutricion hospitalaria. 2015;(5):1936-48
Abstract
UNLABELLED Objetive: to determine the adequate intake of macronutrients to improve the nutritional status of women athletes and their sports performance. METHODS a search was performed in four databases: EBSCO, Proquest, Pubmed and OvidSP, using the keywords "protein intake" AND "athletes", "endurance athletes" AND "nutrition". SELECTION CRITERIA original articles about protein intake in female athletes, published between 2009 and 2014, and whose source are indexed scientific journals. RESULTS 722 articles were identified, of which only 1.4% were considered to be included. 100% were completed clinical trials and published abroad, 50% in the US. 20% were exclusive studies of female athletes and 80% included men and women in the sample. In 70% of studies female athletes presented energy deficiencies; in protein intake, 70% met the dietary recommendations; carbohydrate intake was inadequate in 90% of clinical trials and in 50% of cases women had a high intake of fat. CONCLUSION there is lack about nutrition in female athletes in Europe and internationally. Female athletes consume less energy and macronutrients that male athletes. There is no consensus on the recommended protein range and there are differences in consumption depending on the type of exercise being performed. It is recommended to carry out an agreement between scientific institutions about energy intake and macronutrient in sport, with particular emphasis on women.
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[Glycemic control through physical exercise in type 2 diabetes systematic review].
Quílez Llopiz, P, Reig García-Galbis, M
Nutricion hospitalaria. 2015;(4):1465-72
Abstract
INTRODUCTION In Spain, nearly 14% of the population is diabetic, 95% corresponds to Type 2 Diabetes Mellitus patients. Poor glycemic control increases morbidity and mortality. There are three pillars in the treatment of type 2 diabetes: diet, medication and exercise. However, the potential for prescribing exercise training has not been fully exploited. OBJECTIVE To analyze the effect of different exercise modalities (AE, RT, Combo, HIIT) on glycemic control in patients with type 2 diabetes mellitus. METHODS The reserch was performed in 3 electronic databases (Pubmed, Scopus and Proquest), including publications from 2011 to the present, publications undertaking interventions with AE, RT, Combo or HIIT, and those that measured capillary glucose, CGMS or HbA1c. RESULTS Of the 386 articles found, 14 met the inclusion criteria. These items were classified according to exercise intervention modality (AE, RT, Combo, HIIT) and whether glycemic control was measured as a result of continued training or 24-48h post-workout. CONCLUSIONS EA, RT, Combo and HIIT show efficacy in glycemic control in both the continuous training and 24-48h post-training. To achieve certain benefits in glycemic control, prescribing a structured frequency, volume and intensity training is required. Combo is the modality that gets better results through continued training.
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[Measurement units used in treatments to reduce weight and obesity. Systematic review].
Gutiérrez Hervás, AI, Reig García-Galbis, M, Rizo Baeza, MM, Cortés Castell, E, Mur Villar, N, Aguilar Cordero, MJ
Nutricion hospitalaria. 2014;(3):478-85
Abstract
INTRODUCTION There are different parameters to express the loss of weight in the treatment of overweight and obesity: absolute loss, percentage of loss, decrease in BMI, etc. OBJECTIVE To determine the magnitudes more used in the bibliography in order to establish criteria for uniformity in the expression of those results. METHODS a systematic review of the last five years has made at Proquest, CINHAL, Scopus, with descriptors "body fat distribution" and "diet" and "diet, reducing" and "weight loss". Articles published in English, French and Spanish were selected. Inclusion criteria were used: articles only dietary treatment of overweight in humans, and exclusion criteria: not dietary treatments, metabolic diseases, less than 50 patients and less than 8 weeks of treatment. Title, summary, methodology, results and discussion have been analysed by two researchers independently. RESULTS AND DISCUSSION 854 items found, only 61 met the criteria. These were grouped into 5 subgroups, as they expressed the weight loss (weight or fat loss in kg; weight and fat loss in kg; weight or fat loss in %; weight loss in % and fat loss in kg or vice versa; weight and far loss in%). The results show a lack of homogeneity in the loss, being the percentage the most used expression. CONCLUSIONS There is great heterogeneity in the expression of results of the treatments for weight loss; the diet is one of the least used tools; the analysis of clinical trials of intervention reflects a high quality in subjects older than 18 years, highlighting the lack of this type of research lines in children under 18 years. Therefore, it should standardize the magnitudes of expression of the success of these treatments and increase the lines of research on this topic.