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Biomedical subjects

Pilar García-Lorda

Publications and source records attributed to Pilar García-Lorda.

10 recordsLinked to original sources

Diet and dietetics in al-Andalus.

Al-Andalus society (711-1492) based its idea of health on the wisdom of Classical Greece, the Hippocratic-Galenic theories, as well as the Persian and Hindu cultures. The twelfth century in al-Andalus is considered to be the most prolific period for works of a scientific and technical nature. At the time, the main treatises on dietetics were written and this science reached its widest expression with such leading figures as Ibn Wāfīd, Avenzoar, Averroes and Maimonides, whose works revealed the first scientific knowledge on the nutritional processes of the human body. Diet was regarded as being essential for health and the prevention of disease. Dietary guidelines were written for different age groups, different body types and different seasons of the year. The amount of food to be ingested, the number of meals recommended and the order in which the food should be consumed were all issues that were discussed. A variety of foods were thought to have medicinal properties, some of which are known today. The diet in al-Andalus was varied and very probably made a substantial contribution to the origin of the present-day Mediterranean diet, rich in olive oil, wholemeal cereals, fruit and vegetables, fish, lamb, poultry, nuts and spices. We also find that many of the terms in current use in diet and agriculture are a living testimony to the Arabic influence, as are many of the dishes of our varied Mediterranean gastronomy.

Diet↗

[Role of calcium intake in obesity].

Recent evidences from epidemiological and intervention trials suggest that a higher calcium intake is associated with a lower body weight and a reduction in total and central body fat. The potential role of calcium intake in the regulation of body adiposity has been explained by the intracellular calcium, which is able to promote adipocyte fat accumulation by exerting a coordinate regulation stimulating lipogenesis and suppressing lipolysis. Moreover, the intracellular calcium has been implicated on the etiopathogenesis of hypertension, insulin resistance and dyslipidemia, appearing as a potential common substrate in the metabolic syndrome. Dietary modulation of intracellular calcium through calciotropic hormones opens an exciting possibility to prevent and tackle obesity and its associated complications by increasing the calcium intake. However, available evidences are mostly indirect and further studies specifically designed for this purpose are needed.

Adipose Tissue↗

Effect of oral administration of a whole formula diet on nutritional and cognitive status in patients with Alzheimer's disease.

AIMS: To evaluate the effect of a whole formula diet on nutritional and cognitive status in Alzheimer's disease patients. METHODS: Patients were randomly assigned to two interventions: a whole formula diet based on lyophilised foods (Treatment Group, n=24) or nutritional advice (Control Group, n=29). Energy intake, body weight, biochemistry, Mini Nutritional Assessment (MNA) and Pfeiffer's tests were determined at baseline and at 3 months of treatment. RESULTS: No differences were observed between groups at baseline. Energy intake tended to increase in the Treatment Group and to decrease in the Control Group, although differences were not significant. The improvement in MNA and Pfeiffer test scores was not significantly different between groups. Body weight increased by 2.06+/-1.9 kg in the Treatment Group and by 0.32+/-3.04 kg in the Control Group (P=0.007). The increases in albumin (P=0.007), haemoglobin (P=0.002) and serum ferritin (P=0.009) were higher in the Treatment Group than in controls. A similar rate of serious adverse events (hospitalisation or death) was observed in both groups. CONCLUSIONS: Administration of this whole formula has a positive impact on nutritional status. The great diversity in textures and tastes enable these formulations to be administered to a wide range of patients with or without liquid dysphagia.

Aged↗

Adiponectin expression and adipose tissue lipolytic activity in lean and obese women.

BACKGROUND: The authors evaluated whether adipose adiponectin expression is related to adipose tissue lipolytic activity and fatty acid oxidation rate in lean and obese women. METHODS: The study consisted of 60 adult females distributed in a wide range of adiposity (BMI 24.0-53.4 kg/m2). Body composition was estimated by bioelectrical impedance. Respiratory quotient was measured by open-circuit indirect calorimetry. RT-PCR assays were performed to measure TNFalpha and adiponectin expression in subcutaneous adipose tissue biopsies. Lipolysis studies were performed in fresh tissue samples obtained from subcutaneous abdominal depots during bariatric surgery in 19 morbidly obese females or by an incisional biopsy or during abdominal elective surgery in normal weight and obese females. Glycerol release was measured with a colorimetric endpoint method. RESULTS: Patients with a higher degree of adiposity showed lower adipose tissue adiponectin expression and hormone-sensitive lipase (HSL) activity than women in the low range of adiposity. HSL activity was positively related to adiponectin expression. No relationship was observed between adiponectin and TNFalpha subcutaneous adipose tissue expression. The positive relationship between respiratory quotient and adiponectin expression was in the limit of statistical significance (P=0.05). Percentage of body fat and mRNA adiponectin explained 26% of the variance of the adipose tissue HSL activity. CONCLUSIONS: Low adipose tissue adiponectin expression observed in obese people may contribute to the progression of obesity and its co-morbidities by modulating hormone-sensitive lipase activity and fatty acid oxidation.

Adiponectin↗

Systemic inflammation, adipose tissue tumor necrosis factor, and leptin expression.

OBJECTIVES: To explore the links between tumor necrosis factor alpha (TNFalpha) and leptin adipose tissue expression and low-grade systemic inflammation and to determine the relationship between inflammation and the degree of adiposity, the presence of type 2 diabetes, and other cardiovascular risk factors. RESEARCH METHODS AND PROCEDURES: Ninety-one women (BMI 19 to 65 kg/m(2)) were divided into tertiles of CRP. Insulin resistance was calculated using the HOMA method. Albumin, fibrinogen, C-reactive protein (CRP), interleukin-6, sTNFR1, sTNFR2, and leptin levels were measured in serum and plasma samples. TNFalpha and leptin expression were measured by reverse transcription-polymerase chain reaction in abdominal subcutaneous adipose tissue samples. RESULTS: CRP was positively related to BMI and upper distribution of adiposity. TNFalpha and leptin adipose tissue expression were higher in the upper tertile of CRP. Also, peripheral levels of both soluble TNFRs and leptin were higher in patients with the greatest inflammation degree. Diabetes, dislipidemia, and hypertension were most prevalent in patients in the upper CRP tertile. Inflammatory markers of diabetic women were significantly different from those of nondiabetic women, even after adjusting for differences in body fat. BMI, type 2 diabetes, and adipose TNFalpha mRNA levels were significant predictors of serum CRP levels (r(2) = 0.28, p < 0.001). DISCUSSION: These results are in agreement with the hypothesis that the synthesis of adipose tissue TNFalpha and leptin could induce the production of interleukin-6, CRP, and other acute-phase reactants, thus contributing to the maintenance of chronic low-grade inflammation state involved in the progression of obesity and its associated comorbidities.

Adipose Tissue↗

Bakery products enriched with phytosterol esters, alpha-tocopherol and beta-carotene decrease plasma LDL-cholesterol and maintain plasma beta-carotene concentrations in normocholesterolemic men and women.

The hypocholesterolemic effects of phytosterols have not been evaluated in bakery products, and the addition of liposoluble antioxidants to the carrier has never been tested. We investigated the effects of consuming croissants and magdalenas (Spanish muffins) enriched with sterol esters, alpha-tocopherol and beta-carotene on plasma lipid and fat-soluble antioxidant concentrations in normocholesterolemic, habitual consumers of bakery products following their usual diet and lifestyle. Using a randomized, double-blind, placebo-controlled design, the control (C) group (n = 29) received two pieces daily (standard croissant and muffin) and the sterol ester (SE) group (n = 28), the same products with sterol esters added (3.2 g/d) for 8 wk. Total and LDL cholesterol (LDL-C) decreased in the SE group by 0.24 mmol/L (P < 0.01) and 0.26 mmol/L (P < 0.005), respectively, whereas these variables did not change in the control group. The total difference in total and LDL-C changes between groups was 0.38 mmol/L (8.9%) and 0.36 mmol/L (14.7%), respectively (P < 0.001). Within-group changes in HDL cholesterol, triacylglycerol or lipoprotein(a) concentrations did not differ. Similarly, within-group changes over time in plasma tocopherol and carotenoid concentrations did not differ between groups. Our findings suggest that bakery products are excellent carriers for phytosterols, and their consumption is associated with a decrease in total and LDL-C concentrations, with no changes in alpha-tocopherol and beta-carotene. The ability of bakery products to include sufficient quantities of beta-carotene to compensate for a potential deficiency, and the fact that their efficacy was not associated with the time of day at which they were consumed, are interesting findings.

Adult↗

Prevalence of co-morbidities in obese patients before bariatric surgery: effect of race.

BACKGROUND: We evaluated the prevalence of co-morbidities, in particular diabetes, in a diverse population of morbidly obese patients who underwent gastric bypass surgery at our institution in New York City. METHODS: A retrospective study of 300 patients who had bariatric surgery between January 2001 and April 2002 was conducted. RESULTS: 57% of the patients had at least one metabolic complication, 30% had diabetes, 38% hypertension and 35% dyslipidemia. Our population was ethnically diverse, with 40% Hispanic, 34% Caucasian, 25% African-American and 1% Asian. There was no difference in the prevalence of diabetes among races. However, Caucasians had the highest prevalence of hyperlipidemia, and the Hispanic patients were the least hypertensive. Among patients with diabetes, one-third were undiagnosed and 50% untreated. Similarly, 45% of the hypertensive patients and 51% of those with hyperlipidemia remained undiagnosed. Men had more co-morbidities than women. CONCLUSION: These results suggest a high prevalence of co-morbid conditions in severely obese patients undergoing bariatric surgery. Age, ethnicity and gender influence the type of co-morbid conditions. More research is needed to understand why diabetes and other metabolic complications remain undiagnosed and untreated in a large number of these high risk patients.

Adolescent↗

[Micronutrients in HIV-infection and the relationship with the inflammatory response].

BACKGROUND: Our aim was to measure the plasma concentrations of various vitamins and micronutrients involved in the immune response and antioxidant systems of an HIV+ population and to determine how they are related to the inflammatory response. PATIENTS AND METHOD: We studied 86 subjects with known HIV-infection who were divided into three groups (asymptomatic HIV+; AIDS without opportunistic infection; and AIDS with active opportunistic infection) which were compared with a control group. Serum concentrations of vitamin A, vitamin E, copper and zinc were measured, as well as several inflammatory parameters. Absorption tests for fat and sugar were performed in all patients. RESULTS: Serum vitamin A and E levels were below the reference range in 36.4% and 14.3% patients, respectively, but not in controls subjects. The prevalence of vitamin A deficiency increased with the severity of the disease. Fewer patients than controls had values below the reference range regarding serum copper. AIDS patients with active opportunistic infection showed significantly lower serum concentrations of vitamin A (p < 0.001) and significantly higher serum concentrations of copper (p < 0.0001). Both serum concentrations of vitamin A and copper were correlated with various inflammatory parameters. CONCLUSIONS: Micronutrient deficiencies are prevalent in HIV-infected patients including asymptomatic patients. Vitamin A and copper were significantly correlated with inflammatory parameters, suggesting that their serum concentrations have more to do with the inflammatory response than with the nutritional status.

Adult↗