Acronym: FLIO (Fatty Liver in Obesity)

Funding Entity: Department of Health of the Government of Navarre

Reference of project: 61/2015

researcher principal: Mª Ángeles Zulet Alzórriz.

This project is framed within the line of research "Health promotion and lifestyles", with emphasis on hepatic alterations linked to overweight/obesity. goal The aim of this research, is to contribute to a more comprehensive treatment of NAFLD (non-alcoholic fatty liver disease), so that nutritional strategies/lifestyle habits serve as an adjuvant to make a more rational use of current therapy (reduction of costs for pharmacological treatment, hospitalisation, liver transplants). At the same time, the variables/techniques applied will contribute to the advancement of early diagnosis, helping to identify non-invasive biomarkers for early diagnosis of hepatic steatosis, applicable to future patients. To this end, it proposes a personalised nutritional intervention based on two strategies: 1) Conventional, from agreement with the current proposal of the AASLD (American Association for the Study of Liver Diseases) and 2) RESMENA, based on a project subsidised by the group of Nutrition of the University of Navarra (Dpto Salud-GN/48/2009) and whose goal consisted of "REducir el Síndrome MEtabólico en Navarra: RESMENA" (Reducing Metabolic Syndrome in Navarra: RESMENA). After two months of follow-up, it was as effective in reducing metabolic syndrome criteria as proposal by the AHA (association American Heart Association) and even more effective after 6 months of follow-up; particularly in obese volunteers with altered glucose values, significantly reducing LDL-oxidation in RESMENA. Therefore, the application of this strategy in NASH is due to the profile of individuals suffering from this disease: obese, with insulin resistance and cardiovascular risk; moreover, among the mechanisms involved in NASH are oxidative stress and inflammation, aspects that were taken into account in the dietary design . Both strategies will focus on personalised teaching to adopt a comprehensive behavioural modification, both nutritional and lifestyle, respecting the strategy designed in each case.

For its approach, we have the group of Nutrition of the University of Navarra and synergy is proposed with the group of Liver Transplantation and complications of cirrhosis of the Hepatology Unit of the Clínica Universidad de Navarra-CUN and the Digestive Service of the Navarra Hospital Complex; as well as with the group of Liver Oncology of Radiology of the CUN; all the groups are integrated in the area of Digestive and Metabolic Diseases of the IdiSNA (Institute of Health Research of Navarra).

This research:

(1) considers obesity and fatty liver and indirectly cardiovascular risk factors and insulin resistance/diabetes;

2) knowledge multidisciplinary /multicentre, scientific/clinical;

3) addresses personalised strategies with scientific support, at no additional cost to the patient;

4) educates for health and promotes healthy lifestyles;

5) is reproducible and applicable in "Health Promotion and Lifestyles".

All of this with the aim of:

1) to shed more light on the influence of personalised nutritional strategies in NASH;

2) to contribute to their more comprehensive treatment, as an adjuvant to reduce liver diseases and the associated health burden;

3) to enable progress in early diagnosis;

4) contribute to the transfer of knowledge on obesity/EHGNA to the health and scientific community for the benefit of Public Health.

AcronymPREDIMED+DM

Funding Entity: high school de Salud Carlos III and the European Regional Fund (ERDF) development

reference letter: PI17/00926. project de research en Salud (FIS)

researcher principal: Mª Ángeles Zulet Alzórriz

Finding prevention strategies applicable in the routine clinical internship is a priority to reduce the health impact of diabetes subject 2 (DM2). Both lifestyle change programs that favor weight loss and the promotion of a patron saint of per diem expenses Mediterranean diet (DietMed) without associated weight loss have been shown to be effective in the prevention of DM2. However, to date there is no clinical essay that has combined both strategies in a prevention study in an overweight or obese population at increased risk of DM2. The PREDIMED+DM study was designed with the goal to determine the effect on DM2 incidence of an intensive weight loss intervention based on a patron saint of traditional hypocaloric DietMed, physical activity and behavioral therapy versus DietMed counseling in the context of usual health care. The methodology proposal was that of a randomized, multicenter, parallel-group, clinical essay with at least 3-year follow-up of at least 3600 overweight/obese men and women aged 55 to 75 years, without DM2 but with metabolic syndrome, comparing the effect of the two interventions described. The aim was to compare the incidence of DM2 between the two groups 6, 12, 24, and 36 months after initiation of the intervention, as well as to evaluate possible underlying mechanisms and the safety of the intervention. The proposal , which in this case has been granted, is an extension of funding for fill in the PREDIMED+DM study in which, after Closed recruitment, 4958 volunteers without DM2 but with metabolic syndrome have been included. The PREDIMED+DM study is part of the PREDIMED-PLUS study, a randomized clinical trial essay that assesses the effect of the same therapeutic strategies used in this study over a 6-year period on primary cardiovascular prevention in patients with metabolic syndrome and overweight or obesity. The coordinated PREDIMED+DM study should be considered in the broad sense of the assessment of cardiovascular disease prevention strategies in our country. It is a coordinated project (12 centers, including our group of the University of Navarra). coordinator Josep Vidal Cortada, August Pi i Sunyer Biomedical Research Institute (Barcelona).

Within the coordinated project , the specific objectives of our group are the following:
1. To evaluate the effect of the intervention on body composition.
2. To analyse the evolution of liver damage using non-invasive techniques, as well as the lipidic profile as a criterion for metabolic syndrome.
3. To analyse the inflammatory status as a mechanism linked to adiposity, hepatic steatosis and depression.
4. To assess the psychological state and relate it to body composition, inflammation and liver damage.
5. Epigenetic analysis of candidate genes linked to inflammation, steatosis and depression.

Acronym: NUTRIPRECISION

Funding entity: Centro para el development Tecnológico e Industrial (CDTI) and the European Regional development Fund (ERDF).

Reference: IDI-20160734. Programme research and development+I CIEN of CDTI.

The increase in the prevalence of chronic non-communicable diseases such as obesity and related comorbidities (diabetes mellitus subject 2, cardiovascular disease, non-alcoholic fatty liver disease, etc.), is a major public health issue challenge . At the same time, between 2015 and 2050, the percentage of individuals over 60 years of age will almost double from 12% to 22%, representing a clear ageing of the population.

This status is leading to development of nutritional strategies aimed at establishing a balanced diet and a healthy lifestyle in older age groups. However, it is necessary to personalise nutritional treatment to the individual needs of each person. This task is being addressed by "Precision Nutrition", a new operational concept, whose ultimate goal is to provide a specific and characteristic nutrition for each individual, taking into account relevant staff and clinical information, age, phenotypic and genotypic facets. In this context, the issue of research focused on the active search for healthy and functional foods is increasing. Thus, the development of new food products could be core topic and of great interest in the design of precision nutritional models that allow the individualisation of nutritional treatment for each subject in order to improve the response to treatment and ultimately written request, their health status.

The framework of project NUTRIPRECISION aims to design precision nutritional strategies aimed at the effective prevention of ailments associated with ageing in the pre-senior and senior population. To this end, the precision nutritional intervention will be based on the inclusion of functional foods.

In thissense, the project addresses two main phases:

Phase I: programs of study postprandial
The design of functional foods will be carried out through the companies participating in the project. After the development of the precision foods, the UNAV Nutrition group will carry out postprandial, double-blind, crossover programs of study in adult men and women, in which the efficacy of the designed food will be assessed against its original, unmodified counterpart.

Phase II: Precision nutritional intervention
After completion of the postprandial programs of study , the global intervention study will be addressed. In this sense, the precision nutritional intervention will be a prospective, randomised study where the effectiveness of different nutritional strategies on the overall health status of the senior and/or pre-senior population with metabolic disorders will be analysed.

This research:

1) considers ageing and associated metabolic diseases (obesity, insulin resistance, cardiovascular disease, etc);

2) brings together scientific and business knowledge ;

3) addresses precision personalised nutritional strategies with scientific support;

4) educates for health and promotes healthy lifestyles tailored to the specific needs of each individual;

5) is reproducible and applicable in "Health Promotion and Lifestyles".


Theaim isto:

1) shed more light on the influence of personalised nutritional strategies on ageing and associated pathologies;

2) to provide a specific and characteristic nutrition for each individual, taking into account relevant information staff and clinical information, age and phenotypic and genotypic characteristics.

3) contribute to the transfer of knowledge on precision nutrition to the health and scientific community for the benefit of Public Health.