Open Access
Independent and joined association between socioeconomic indicators and pediatric obesity in Spain: the PASOS study
(MDPI, 2023) Homs, Clara; Berruezo, Paula; Arcarons, Albert; Wärnberg, Julia; Osés Recalde, Maddi; González Gross, Marcela; Gusi, Narcís; Aznar, Susana; Marín-Cascales, Elena; González Valeiro, Miguel A.; Serra-Majem, Lluis; Terrados, Nicolás; Tur, Josep A.; Segú, Marta; Fitó, Montserrat; Benavente-Marín, Juan C.; Labayen Goñi, Idoia; Zapico, Augusto G.; Sánchez-Gómez, Jesús; Jiménez-Zazo, Fabio; Alcaraz, Pedro E.; Sevilla-Sánchez, Marta; Herrera-Ramos, Estefanía; Pulgar, Susana; Bouzas, Cristina; Milà, Raimon; Schröder, Helmut; Gómez, Santiago F.; Institute on Innovation and Sustainable Development in Food Chain - ISFOOD
Childhood obesity is a public health problem worldwide. An important determinant of child and adolescent obesity is socioeconomic status (SES). However, the magnitude of the impact of different SES indicators on pediatric obesity on the Spanish population scale is unclear. The aim of this study was to assess the association between three SES indicators and obesity in a nationwide, representative sample of Spanish children and adolescents. A total of 2791 boys and girls aged 8 to 16 years old were included. Their weight, height, and waist circumference were measured. SES was assessed using two parent/legal guardian self-reported indicators (educational level -University/non-University- and labor market status -Employed/Unemployed-). As a third SES indicator, the annual mean income per person was obtained from the census section where the participating schools were located (≥12.731€/<12.731€). The prevalence of obesity, severe obesity, and abdominal obesity was 11.5%, 1.4%, and 22.3%, respectively. Logistic regression models showed an inverse association of both education and labor market status with obesity, severe obesity, and abdominal obesity (all p < 0.001). Income was also inversely associated with obesity (p < 0.01) and abdominal obesity (p < 0.001). Finally, the highest composite SES category (University/Employed/≥12.731€ n = 517) showed a robust and inverse association with obesity (OR = 0.28; 95% CI: 0.16–0.48), severe obesity (OR = 0.20; 95% CI: 0.05–0.81), and abdominal obesity (OR = 0.36; 95% CI: 0.23–0.54) in comparison with the lowest composite SES category (Less than University/Unemployed/<12.731€; n = 164). No significant interaction between composite SES categories and age and gender was found. SES is strongly associated with pediatric obesity in Spain.
Open Access
Effects of time-restricted eating and resistance training on skeletal muscle tissue quantity, quality and function in postmenopausal women with overweight or obesity: a study protocol
(Elsevier, 2024-12-30) Alfaro-Magallanes, Víctor Manuel; Medrano Echeverría, María; Echarte Medina, Jon; Osés Recalde, Maddi; Izquierdo Rodríguez, Claudia; Concepción Álvarez, Mara de la Caridad; Galbete Jiménez, Arkaitz; Idoate, Fernando; Zugasti Murillo, Ana; Petrina Jáuregui, María Estrella; Goñi Gironés, María Elena; Ribelles, María Jesús; Amasene, María; Arenaza Etxeberría, Lide; Tejada Garrido, Clara Isabel; Elejalde, E.; Azcárate Jiménez, Unai Xabier; Ruiz Sarrias, Oskitz; Sayar-Beristain, Onintza; García-Ramos, Amador; Martínez Labari, Cristina; Armendáriz Brugos, Cristina; Villanueva Larre, Arantxa; Ruiz, Jonatan R.; Cabeza Laguna, Rafael; Labayen Goñi, Idoia; Ciencias de la Salud; Osasun Zientziak; Institute of Smart Cities - ISC; Ingeniería Eléctrica, Electrónica y de Comunicación; Ingeniaritza Elektrikoa, Elektronikoa eta Telekomunikazio Ingeniaritza; Estadística, Informática y Matemáticas; Estatistika, Informatika eta Matematika; Institute on Innovation and Sustainable Development in Food Chain - ISFOOD
Background & aims: time-restricted eating (TRE) shows promise for weight loss and improving menopauserelated body composition and cardiometabolic health, but its effects on skeletal muscle tissue (SMT) in postmenopausal women are unknown. This study investigates the effects of three weight loss interventions over 12 weeks on SMT quantity, quality, function, and cardiometabolic health in postmenopausal women with overweight/obesity, with effects persistence evaluated at a 12-month follow-up. Methods and results: in this randomized controlled trial, 78 postmenopausal women (50–65 years; BMI 25–40 kg/m2; sedentary lifestyle; eating window ≥12 h/day; no severe metabolic impairments) will be recruited. Participants will be randomly assigned to one of three groups for 12 weeks: TRE, TRE + resistance training, or CR + resistance training. The TRE groups will reduce their eating window to 8 h and receive nutritional advice to adhere to a Mediterranean diet. The CR group will follow a personalized hypocaloric diet (− 500 kcal/day). Resistance training groups will perform supervised resistance training 3 times/week. Primary Outcome: Change in SMT quantity measured by MRI at baseline and after 12 weeks. Secondary Outcomes: intermuscular adipose tissue (IMAT), strength, power, body weight and composition, and cardiometabolic risk factors. Conclusion: this study will illustrate the effects of TRE and TRE combined with resistance exercise compared with the currently recommended obesity-lifestyle treatment on SMT quantity, quality, function, and cardiometabolic markers. The results will offer insights into dietary strategies to combat obesity and metabolic diseases without increasing sarcopenia risk in postmenopausal women, a sparsely studied and particularly affected population.
Open Access
Effects of exercise in addition to a family-based lifestyle intervention program on hepatic fat in children with overweight
(American Diabetes Association, 2020) Labayen Goñi, Idoia; Medrano Echeverría, María; Arenaza Etxeberría, Lide; Maiz, Edurne; Osés Recalde, Maddi; Martínez Vizcaíno, Vicente; Ruiz, Jonatan R.; Ortega, Francisco B.; Institute on Innovation and Sustainable Development in Food Chain - ISFOOD
OBJECTIVE Pediatric hepatic steatosis is highly prevalent and closely related to type 2 diabetes. This study aimed to determine whether the addition of supervised exercise to a family-based lifestyle and psycho-educational intervention results in greater reduction of percentage of hepatic fat (HF), adiposity, and cardiometabolic risk factors in children with overweight/obesity. RESEARCH DESIGN AND METHODS The study subjects of this nonrandomized, two-arm, parallel design clinical trial were 116 overweight/obese children (10.6 +/- 1.1 years of age, 53.4% girls) living in Vitoria-Gasteiz (Spain). For 22 weeks, they followed either a lifestyle and psycho-education program (control intervention [CInt], N = 57), consisting of two family-based education sessions/month, or the same plus supervised exercise (intensive intervention [II], N = 59) focused mainly on high-intensity aerobic workouts (3 sessions/week, 90 min/session). The primary outcome was the change in percentage of HF (as measured by MRI) between baseline and the end of the intervention period. Secondary outcomes included changes in BMI, fat mass index (FMI), abdominal fat (measured by DEXA), blood pressure, triglycerides, HDL, LDL, gamma-glutamyl transferase, glucose, and insulin concentrations. RESULTS A total of 102 children completed the trial (N = 53 and N = 49 in the CInt and II groups, respectively). Percentage of HF decreased only in the II group (-1.20 +/- 0.31% vs. 0.04 +/- 0.30%, II and CInt groups, respectively), regardless of baseline value and any change in adiposity (P < 0.01). BMI, FMI, abdominal fat (P <= 0.001), and insulin (P < 0.05) were reduced in both groups. CONCLUSIONS Multicomponent intervention programs that include exercise training may help to reduce adiposity, insulin resistance, and hepatic steatosis in overweight/obese children.
Open Access
Effects of exercise on bone marrow adipose tissue in children with overweight/obesity: role of liver fat
(Oxford University Press, 2024-08-07) Labayen Goñi, Idoia; Cadenas-Sánchez, Cristina; Idoate, Fernando; Gracia-Marco, Luis; Medrano Echeverría, María; Alfaro-Magallanes, Víctor Manuel; Alcántara Alcántara, Juan Manuel; Rodríguez Vigil, Beatriz; Osés Recalde, Maddi; Ortega, Francisco B.; Ruiz, Jonatan R.; Cabeza Laguna, Rafael; Ingeniería Eléctrica, Electrónica y de Comunicación; Ingeniaritza Elektrikoa, Elektronikoa eta Telekomunikazio Ingeniaritza; Agronomía, Biotecnología y Alimentación; Agronomia, Bioteknologia eta Elikadura; Ciencias de la Salud; Osasun Zientziak; Institute of Smart Cities - ISC; Institute on Innovation and Sustainable Development in Food Chain - ISFOOD; Gobierno de Navarra / Nafarroako Gobernua
Context: Exercise reduces adiposity, but its influence on bone marrow fat fraction (BMFF) is unknown; nor is it known whether a reduction in liver fat content mediates this reduction. Objectives: This work aimed to determine whether incorporating exercise into a lifestyle program reduces the lumbar spine (LS) BMFF and to investigate whether changes in liver fat mediate any such effect.Methods Ancillary analysis of a 2-arm, parallel, nonrandomized clinical trial was conducted at primary care centers in Vitoria-Gasteiz, Spain. A total of 116 children with overweight/obesity were assigned to a 22-week family-based lifestyle program (control group [n = 57]) or the same program plus an exercise intervention (exercise group [n = 59]). The compared interventions consisted of a family-based lifestyle program (two 90-minute sessions/month) and the same program plus supervised exercise (three 90-minute sessions/week). The primary outcome examined was the change in LS-BMFF between baseline and 22 weeks, as estimated by magnetic resonance imaging. The effect of changes in hepatic fat on LS-BMFF were also recorded.Results Mean weight loss difference between groups was 1.4 +/- 0.5 kg in favor of the exercise group. Only the children in the exercise group experienced a reduction in LS-BMFF (effect size [Cohen d] -0.42; CI, -0.86 to -0.01). Importantly, 40.9% of the reductions in LS-BMFF were mediated by changes in percentage hepatic fat (indirect effect: beta=-0.104; 95% CI, -0.213 to -0.019). The effect of changes in hepatic fat on LS-BMFF was independent of weight loss.Conclusion The addition of exercise to a family-based lifestyle program designed to reduce cardiometabolic risk improves bone health by reducing LS-BMFF in children with overweight or obesity. This beneficial effect on bone marrow appears to be mediated by reductions in liver fat.
Open Access
Peripheral blood mononuclear cells-expressed miRNA profiles derived from children with metabolic-associated fatty liver disease and insulin resistance
(Wiley, 2022) Osés Recalde, Maddi; Medrano Echeverría, María; Margareto, Javier; Portillo, María P.; Aguilera, Concepción María; Altmäe, Signe; Labayen Goñi, Idoia; Institute on Innovation and Sustainable Development in Food Chain - ISFOOD; Gobierno de Navarra / Nafarroako Gobernua
Background: miRNA have been proposed as potential biomarkers of metabolic diseases. Objectives: To identify potential miRNA biomarkers of early metabolic-associated fatty liver disease (MAFLD) and/or insulin resistance (IR) in preadolescent children. Methods: A total of 70 preadolescents, aged 8.5–12 years old participated in the study. Hepatic fat was assessed by magnetic resonance imaging. Fasting blood biochemical parameters were measured and HOMA-IR calculated. Peripheral blood mononuclear cells (PBMC)-derived miRNA profiles associated with MAFLD (≥5.5% hepatic fat) and IR (HOMA-IR ≥2.5) were identified using untargeted high-throughput miRNAs sequencing (RNA-seq). Results: A total of 2123 PBMC-derived miRNAs were identified in children with (21.4%) or without MAFLD. Among them, hsa-miR-143-3p, hsa-miR-142-5p and hsamiR-660-5p were up-regulated, and p-hsa-miR-247, hsa-let-7a-5p and hsa-miR6823-3p down-regulated. Importantly, children with MAFLD had consistently higher miR-660-5p expression levels than their peers without it (p < 0.01), regardless of weight status. A total of 2124 PBMC-derived miRNA were identified in children with IR (28.6%) versus children without IR, where thirteen of them were dysregulated (p < 0.05) in children with IR. In addition, children with IR showed higher levels of miR-374a-5p and miR-190a-5p (p < 0.01) and lower levels of miR-4284 and miR4791 (p < 005), than their peers without IR in both the whole sample and in those with overweight or obesity. Conclusions: Our study results suggest circulating miR-660-5p as a potential biomarker of the presence of MAFLD in preadolescent children while circulating miR320a, miR-142-3p, miR-190a-5p, miR-374a-5p and let-7 family miRNAs could serve as potential biomarkers of IR in children.
Open Access
Effects of early, late and self-selected time-restricted eating on visceral adipose tissue and cardiometabolic health in participants with overweight or obesity: a randomized controlled trial
(Nature Research, 2025-01-07) Dote-Montero, Manuel; Clavero-Jimeno, Antonio; Merchán Ramírez, Elisa; Osés Recalde, Maddi; Echarte Medina, Jon; Camacho-Cardenosa, Alba; Concepción Álvarez, Mara de la Caridad; Amaro Gahete, Francisco J.; Alcántara Alcántara, Juan Manuel; López-Vázquez, Alejandro; Cupeiro, Rocío; Migueles, Jairo H.; De la O, Alejandro; García Pérez, Patricia Virginia; Contreras-Bolivar, Victoria ; Muñoz-Garach, Araceli; Zugasti Murillo, Ana; Petrina Jáuregui, María Estrella; Álvarez de Eulate, Natalia; Goñi Gironés, María Elena; Armendáriz Brugos, Cristina; González Cejudo, María Trinidad; Martín-Rodríguez, José L.; Idoate, Fernando; Cabeza Laguna, Rafael; Carneiro-Barrera, Almudena; Cabo, Rafael de; Muñoz Torres, Manuel; Labayen Goñi, Idoia; Ruiz, Jonatan R.; Ciencias de la Salud; Osasun Zientziak; Institute on Innovation and Sustainable Development in Food Chain - ISFOOD; Ingeniería Eléctrica, Electrónica y de Comunicación; Ingeniaritza Elektrikoa, Elektronikoa eta Telekomunikazio Ingeniaritza; Agronomía, Biotecnología y Alimentación; Agronomia, Bioteknologia eta Elikadura; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa; Gobierno de Navarra / Nafarroako Gobernua
The optimal eating window for time-restricted eating (TRE) remains unclear, particularly its impact on visceral adipose tissue (VAT), which is associated with cardiometabolic morbidity and mortality. We investigated the effects of three TRE schedules (8 h windows in the early day, late day and participant-chosen times) combined with usual care (UC, based on education about the Mediterranean diet) versus UC alone over 12 weeks in adults with overweight or obesity. The primary outcome was VAT changes measured by magnetic resonance imaging. A total of 197 participants were randomized to UC (n = 49), early TRE (n = 49), late TRE (n = 52) or self-selected TRE (n = 47). No significant differences were found in VAT changes between early TRE (mean difference (MD): −4%; 95% confidence interval (CI), −12 to 4; P = 0.87), late TRE (MD: −6%; 95% CI, −13 to 2; P = 0.31) and self-selected TRE (MD: −3%; 95% CI, −11 to 5; P ≥ 0.99) compared with UC, nor among the TRE groups (all P ≥ 0.99). No serious adverse events occurred; five participants reported mild adverse events. Adherence was high (85–88%) across TRE groups. These findings suggest that adding TRE, irrespective of eating window timing, offers no additional benefit over a Mediterranean diet alone in reducing VAT. TRE appears to be a safe, well-tolerated and feasible dietary approach for adults with overweight or obesity. ClinicalTrials.gov registration: NCT05310721.