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1.
[Factors associated with sedentary lifestyle and physical inactivity in Chile: a qualitative systematic review].
Ahumada Tello, J, Toffoletto, MC
Revista medica de Chile. 2020;(2):233-241
Abstract
BACKGROUND Sedentary lifestyle and physical inactivity in Chile, has become a major problem and a public health priority in the last decade, as it increases the risk of non-communicable diseases. AIM: To identify which factors are associated with sedentary lifestyle and physical inactivity in Chile. MATERIAL AND METHODS Qualitative systematic review of papers published between 2009-2019 in BIREME, SCIELO, WoS, Scopus and Medline databases, retrieving 29,752 and leaving finally five articles for review. RESULTS The main risk factors associated with sedentary lifestyle (according to the Chilean National Health Survey) were: living in an urban area, high income levels, being smoker or ex-smoker, being physically inactive, having a DVD, computer or notebook at home and a motorized vehicle. Physical inactivity was associated with an age ≥ 65 years, hypertension and sedentary lifestyle. There are some common factors such as female sex, obesity, type 2 diabetes mellitus and metabolic syndrome. CONCLUSIONS here are independent factors associated with both sedentary lifestyle and physical inactivity in Chile. Some factors are common for the two unhealthy behaviors such as female gender, obesity, type 2 diabetes mellitus and metabolic syndrome.
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Impact of level of vitamin D in the body on the severity of COVID-19 - review of the literature.
Ręka, G, Korzeniowska, A, Machowiec, P, Maksymowicz, M, Piecewicz-Szczęsna, H
Przeglad epidemiologiczny. 2020;(4):583-595
Abstract
INTRODUCTION The aim of the study is to present the current state of knowledge on the influence of vitamin D levels on the severity of the course of COVID-19. MATERIAL AND METHODS The latest available literature was reviewed until October 30, 2020 from the PubMed database. RESULTS The literature reports that vitamin D has immunomodulatory and anti-inflammatory effects. It reduces the expression of cytokines such as IL-6, TNF-α and INF-γ, regulates the activity of T helper lymphocytes, and other elements of the immune system at the molecular level. The deficiency of this vitamin promotes the activation of the renin-angiotensin-aldosterone system, contributing to the development of acute respiratory distress syndrome. The severity of the course of SARS-CoV-2 infection depends on comorbidities, the development and course of which may also be affected by vitamin D levels (coagulopathies, pulmonary, cardiological, metabolic diseases). Most of the analyzed research studies from different countries indicated a relationship between insufficient vitamin D levels and a more severe course of COVID-19 and an increase in mortality due to it, especially among the elderly. Researchers agree that further analyzes are necessary concerning both the influence of the vitamin D blood serum levels on the morbidity and mortality due to COVID-19 as well as the use of its supplementation in the struggle against SARS-CoV-2 virus. There are reports of possible beneficial interactions of vitamin D with other substances, such as quercetin, estradiol, some microelements, and other vitamins. CONCLUSIONS Maintaining an adequate level of vitamin D has a positive effect on the functioning of the immune system. At the moment, there is insufficient evidence to establish a clear relationship between vitamin D levels and the severity of COVID-19. It is necessary to conduct further research on a larger study group. The literature does not mention the use of vitamin D as a medication for COVID-19. People at risk of vitamin D deficiency should consider vitamin D supplementation at the current time of the pandemic.
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West syndrome: a comprehensive review.
Pavone, P, Polizzi, A, Marino, SD, Corsello, G, Falsaperla, R, Marino, S, Ruggieri, M
Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology. 2020;(12):3547-3562
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Abstract
Since its first clinical description (on his son) by William James West (1793-1848) in 1841, and the definition of the classical triad of (1) infantile spasms; (2) hypsarrhythmia, and (3) developmental arrest or regression as "West syndrome", new and relevant advances have been recorded in this uncommon disorder. New approaches include terminology of clinical spasms (e.g., infantile (IS) vs. epileptic spasms (ES)), variety of clinical and electroencephalographic (EEG) features (e.g., typical ictal phenomena without EEG abnormalities), burden of developmental delay, spectrum of associated genetic abnormalities, pathogenesis, treatment options, and related outcome and prognosis. Aside the classical manifestations, IS or ES may present with atypical electroclinical phenotypes (e.g., subtle spasms; modified hypsarrhythmia) and may have their onset outside infancy. An increasing number of genes, proteins, and signaling pathways play crucial roles in the pathogenesis. This condition is currently regarded as a spectrum of disorders: the so-called infantile spasm syndrome (ISs), in association with other causal factors, including structural, infectious, metabolic, syndromic, and immunologic events, all acting on a genetic predisposing background. Hormonal therapy and ketogenic diet are widely used also in combination with (classical and recent) pharmacological drugs. Biologically targeted and gene therapies are increasingly studied. The present narrative review searched in seven electronic databases (primary MeSH terms/keywords included West syndrome, infantile spasms and infantile spasms syndrome and were coupled to 25 secondary clinical, EEG, therapeutic, outcomes, and associated conditions terms) including MEDLINE, Embase, Cochrane Central, Web of Sciences, Pubmed, Scopus, and OMIM to highlight the past knowledge and more recent advances.
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Effect of supplementation with vitamins D3 and K2 on undercarboxylated osteocalcin and insulin serum levels in patients with type 2 diabetes mellitus: a randomized, double-blind, clinical trial.
Aguayo-Ruiz, JI, García-Cobián, TA, Pascoe-González, S, Sánchez-Enríquez, S, Llamas-Covarrubias, IM, García-Iglesias, T, López-Quintero, A, Llamas-Covarrubias, MA, Trujillo-Quiroz, J, Rivera-Leon, EA
Diabetology & metabolic syndrome. 2020;:73
Abstract
BACKGROUND Patients with type 2 diabetes mellitus (T2DM) are characterized by chronic hyperglycemia as a consequence of decreased insulin sensitivity, which contributes to bone demineralization and could also be related to changes in serum levels of osteocalcin and insulin, particularly when coupled with a deficiency in the daily consumption of vitamins D3 and K2. The objective of this study was to evaluate the effect of vitamin D3 and vitamin K2 supplements alone or in combination on osteocalcin levels and metabolic parameters in patients with T2DM. METHODS A double-blind, randomized clinical trial was carried out in 40 patients aged between 30 and 70 years old for 3 months. Clinical and laboratory assessment was carried out at the beginning and at the end of the treatment. The patients were divided into three groups: (a) 1000 IU vitamin D3 + a calcinated magnesium placebo (n = 16), (b) 100 µg of Vitamin K2 + a calcinated magnesium placebo (n = 12), and (c) 1000 IU vitamin D3 + 100 µg vitamin K2 (n = 12). RESULTS After treatment in the total studied population, a significant decrease in glycemia (p = 0.001), HOMA-IR (Homeostatic model assessment-insulin resistance) (p = 0.040), percentage of pancreatic beta cells (p < 0.001), uOC/cOC index and diastolic blood pressure (p = 0.030) were observed; in vitamin D3 group, differences in serum undercarboxylated osteocalcin (p = 0.026), undercarboxylated to carboxylated osteocalcin index (uOC/cOC) (p = 0.039) glucose (p < 0.001) and % of functional pancreatic beta cells (p < 0.001) were demonstrated. In vitamin K2 group a significant decrease in glycemia (p = 0.002), HOMA-IR (p = 0.041), percentage of pancreatic beta cells (p = 0.002), and in cOC (p = 0.041) were observed, conversely cOC concentration was found high. Finally, in the vitamins D3 + K2 a significant decrease in glycemia (p = 0.002), percentage of pancreatic beta cells (p = 0.004), and in the uOC/cOC index (p = 0.023) were observed. CONCLUSION Individual or combined supplementation with vitamins D3 and K2 significantly decreases the glucose levels and % of functional pancreatic beta cells, while D3 and D3 + K2 treatments also induced a reduction in the uOC/cOC index. Only in the group with vitamin D3 supplementation, it was observed a reduction in undercarboxylated osteocalcin while vitamin K2 increased the carboxylated osteocalcin levels.Trial registration NCT04041492.
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Review of Factors Contributing to Nodular Goiter and Thyroid Carcinoma.
Yildirim Simsir, I, Cetinkalp, S, Kabalak, T
Medical principles and practice : international journal of the Kuwait University, Health Science Centre. 2020;(1):1-5
Abstract
There is an increased incidence of thyroid nodules and cancer. In this article, the reasons for this increase are evaluated and discussed. The factors causing increases in the incidence of nodules are the same as those causing increases in thyroid cancer. There are publications from all over the world regarding the rising incidence of thyroid cancer; it is especially associated with papillary cancer. The literature was reviewed and evaluated with regard to this significant phenomenon. Thyroid-stimulating hormone (TSH) is the main mitotic factor. Any agent that elevates TSH will stimulate nodule formation. Therefore, the incidence of thyroid nodules is high in endemic goiter regions due to iodine deficiency. This paper has described many of the factors causing this higher incidence. Of note, metabolic syndrome and insulin resistance are important factors associated with the increased incidence of nodular goiter and papillary thyroid cancer today. However, these data must be confirmed by other studies in the future.
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Non-HDL Cholesterol or apoB: Which to Prefer as a Target for the Prevention of Atherosclerotic Cardiovascular Disease?
Langlois, MR, Sniderman, AD
Current cardiology reports. 2020;(8):67
Abstract
PURPOSE OF REVIEW Guidelines propose using non-HDL cholesterol or apolipoprotein (apo) B as a secondary treatment target to reduce residual cardiovascular risk of LDL-targeted therapies. This review summarizes the strengths, weaknesses, opportunities, and threats (SWOT) of using apoB compared with non-HDL cholesterol. RECENT FINDINGS Non-HDL cholesterol, calculated as total-HDL cholesterol, includes the assessment of remnant lipoprotein cholesterol, an additional risk factor independent of LDL cholesterol. ApoB is a direct measure of circulating numbers of atherogenic lipoproteins, and its measurement can be standardized across laboratories worldwide. Discordance analysis of non-HDL cholesterol versus apoB demonstrates that apoB is the more accurate marker of cardiovascular risk. Baseline and on-treatment apoB can identify elevated numbers of small cholesterol-depleted LDL particles that are not reflected by LDL and non-HDL cholesterol. ApoB is superior to non-HDL cholesterol as a secondary target in patients with mild-to-moderate hypertriglyceridemia (175-880 mg/dL), diabetes, obesity or metabolic syndrome, or very low LDL cholesterol < 70 mg/dL. When apoB is not available, non-HDL cholesterol should be used to supplement LDLC.
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An Overview of the Beneficial Effects of Exercise on Health and Performance.
Kramer, A
Advances in experimental medicine and biology. 2020;:3-22
Abstract
Life expectancy is steadily increasing in modern societies, and so are noncommunicable diseases such as cardiovascular diseases, diabetes, obesity, and cancer, accounting for more than 70% of all deaths globally. The costs associated with these diseases are enormous, but it has been estimated that the majority of these noncommunicable diseases are preventable. In addition to an unhealthy diet, tobacco use, and harmful use of alcohol, physical inactivity is a key risk factor. Consequently, physical activity is a logical remedy, and in this chapter an overview of the numerous beneficial effects of physical activity on health and performance is given.The chapter is divided into three parts: First, the basics of physical activity and exercise are discussed, for instance exercise classification, exercise intensity operationalization, energy supply, and the acute effects of exercise such as blood flow redistribution and increased cardiac output. In the second part, the effects of exercise on physical performance are summarized. Specifically, it is discussed how endurance, strength, power, and balance can be improved. This discussion includes recommendations regarding the type, intensity, and duration of the exercise leading to improvements in one of these aspects of physical performance, as well as the mechanisms causing these adaptations. In the third part, the beneficial effects of physical activity on physical and mental health are outlined, with particular attention to cardiovascular diseases, the metabolic syndrome, musculoskeletal diseases, mood, anxiety, depression, and dementia.It can be concluded that with adequate programming, regular physical activity is an effective way to improve physical performance, improve physical and mental health, and reduce the risk factors for many noncommunicable diseases such as cardiovascular diseases, metabolic syndrome, sarcopenia, osteoporosis, and depression. In contrast to medication, physical exercise has no negative side effects, costs very little, and targets many health issues at once. If the multitude of beneficial effects of regular exercise were to be combined in a single low-cost drug, it would be prescribed for almost all types of physical and mental health issues.
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HMGB1 is increased in adolescents with polycystic ovary syndrome (PCOS) and decreases after treatment with myo-inositol (MYO) in combination with alpha-lipoic acid (ALA).
Cirillo, F, Catellani, C, Lazzeroni, P, Sartori, C, Tridenti, G, Vezzani, C, Fulghesu, AM, Madeddu, E, Amarri, S, Street, ME
Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology. 2020;(7):588-593
Abstract
PCOS treatment should be based on pathophysiology. High-mobility-group-box-1 (HMGB1) was shown to increase in PCOS patients as a consequence of reduced cystic-fibrosis-transmembrane-conductance-regulator (CFTR) expression in the ovary, and was associated with insulin resistance and inflammation, both features of PCOS. Inositols and ALA derivatives could have positive effects on insulin sensitivity, reduce androgens, and improve ovulation rhythm. The aim of this study was to verify changes in HMGB1, in metabolic and endocrine parameters in adolescents with PCOS compared with controls and after treatment with a combination of MYO + ALA. Twenty-three PCOS adolescents and 21 controls matched for age and BMI were enrolled. In all subjects, metabolic and hormonal parameters were assayed. Homeostatic index (HOMA-IR) and the triglyceride/HDL-cholesterol ratio were calculated. Ovarian volumes were evaluated. Patients were treated with MYO + ALA for 6 months. HMGB1 was measured using a specific ELISA assay. HMGB1 was increased in PCOS compared with controls (19.76 ± 5.99 versus 5.65 ± 1.88 ng/ml; p < .05) and normalized after treatment (2.27 ± 0.36 ng/ml, p < .05). Treatment significantly reduced insulin (24.0 ± 4.11 versus 12.13 ± 2.13 uU/ml), HOMA-IR (3.91 ± 0.41 versus 2.42 ± 0.45), and 17-hydroxyprogesterone (1.20 ± 0.15 versus 0.78 ± 0.11 ng/ml). Cholesterol, luteinizing hormone, 17-β-estradiol, delta 4-androstenedione, and testosterone were unchanged. Circulating HMGB1 was increased in PCOS adolescents, and treatment was effective in normalizing HMGB1.
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Intermittent fasting from dawn to sunset for four consecutive weeks induces anticancer serum proteome response and improves metabolic syndrome.
Mindikoglu, AL, Abdulsada, MM, Jain, A, Jalal, PK, Devaraj, S, Wilhelm, ZR, Opekun, AR, Jung, SY
Scientific reports. 2020;(1):18341
Abstract
Metabolic syndrome is characterized by central obesity, insulin resistance, elevated blood pressure, and dyslipidemia. Metabolic syndrome is a significant risk factor for several common cancers (e.g., liver, colorectal, breast, pancreas). Pharmacologic treatments used for the components of the metabolic syndrome appear to be insufficient to control cancer development in subjects with metabolic syndrome. Murine models showed that cancer has the slowest progression when there is no food consumption during the daily activity phase. Intermittent fasting from dawn to sunset is a form of fasting practiced during human activity hours. To test the anticancer effect of intermittent fasting from dawn to sunset in metabolic syndrome, we conducted a pilot study in 14 subjects with metabolic syndrome who fasted (no eating or drinking) from dawn to sunset for more than 14 h daily for four consecutive weeks. We collected serum samples before 4-week intermittent fasting, at the end of 4th week during 4-week intermittent fasting and 1 week after 4-week intermittent fasting. We performed serum proteomic analysis using nano ultra-high performance liquid chromatography-tandem mass spectrometry. We found a significant fold increase in the levels of several tumor suppressor and DNA repair gene protein products (GP)s at the end of 4th week during 4-week intermittent fasting (CALU, INTS6, KIT, CROCC, PIGR), and 1 week after 4-week intermittent fasting (CALU, CALR, IGFBP4, SEMA4B) compared with the levels before 4-week intermittent fasting. We also found a significant reduction in the levels of tumor promoter GPs at the end of 4th week during 4-week intermittent fasting (POLK, CD109, CAMP, NIFK, SRGN), and 1 week after 4-week intermittent fasting (CAMP, PLAC1) compared with the levels before 4-week intermittent fasting. Fasting from dawn to sunset for four weeks also induced an anti-diabetes proteome response by upregulating the key regulatory proteins of insulin signaling at the end of 4th week during 4-week intermittent fasting (VPS8, POLRMT, IGFBP-5) and 1 week after 4-week intermittent fasting (PRKCSH), and an anti-aging proteome response by upregulating H2B histone proteins 1 week after 4-week intermittent fasting. Subjects had a significant reduction in body mass index, waist circumference, and improvement in blood pressure that co-occurred with the anticancer, anti-diabetes, and anti-aging serum proteome response. These findings suggest that intermittent fasting from dawn to sunset actively modulates the respective genes and can be an adjunct treatment in metabolic syndrome. Further studies are needed to test the intermittent fasting from dawn to sunset in the prevention and treatment of metabolic syndrome-induced cancers.
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Leisure-Time Physical Activity, Sedentary Behaviour and Diet Quality are Associated with Metabolic Syndrome Severity: The PREDIMED-Plus Study.
Gallardo-Alfaro, L, Bibiloni, MDM, Mascaró, CM, Montemayor, S, Ruiz-Canela, M, Salas-Salvadó, J, Corella, D, Fitó, M, Romaguera, D, Vioque, J, et al
Nutrients. 2020;(4)
Abstract
Healthy lifestyle factors, such as physical activity (PA) and Mediterranean diet (MD), decrease the likelihood of developing metabolic syndrome (MetS). The aim of this study was to report main lifestyle components and related factors according to the MetS severity. Cross-sectional analysis was done of baseline lifestyle factors from 5739 participants with overweight/obesity and MetS features (aged 55-75 years) included in the PREDIMED-PLUS primary cardiovascular prevention randomized trial. Participants were categorized in tertiles according to a validated MetS severity score (MetSSS). Anthropometrics, visceral adiposity index, dietary nutrient intake, biochemical marker levels, as well as a Dietary Inflammatory Index and depression symptoms (Beck Depression Inventory-II) were measured. Diet quality was assessed using a 17-item energy-restricted MD questionnaire. Duration and intensity of PA was self-reported using the Minnesota-REGICOR Short Physical Activity Questionnaire. Sedentary behaviours were measured using the Spanish version of the Nurses' Health Study questionnaire. The 30 s chair stand test was also assessed. Participants with highest MetSSS showed higher values of cardiovascular risk factors (except for total cholesterol and LDL cholesterol), depression risk, sedentary and TV viewing time, and lower moderate and vigorous leisure-time physical activity (LTPA). Highest MetSSS participants tended to a pro-inflammatory dietary pattern and tended to lower MD adherence. In addition, they showed lower carbohydrate and nut intake and higher intake of protein, saturated and trans fatty acids, cholesterol, iodine, sodium, red and processed meat products, other oils different from olive oil and spirit alcoholic drinks. The highest MetS severity score was associated with lower moderate and vigorous LTPA and higher sedentary time and depression risk, as they tended to a pro-inflammatory dietary pattern and lower MD adherence.
