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Low energy availability (LEA) causes impaired physiological functioning. Cross-country running is a weight-sensitive sport, making athletes more prone to LEA. We aimed to estimate the prevalence of elite European cross-country athletes at risk of LEA using the LEA in Females Questionnaire (LEAF-Q) and to analyze demographic and physical characteristics that are associated with LEA. Athletes ≥ 18 years competing at the 26th European Cross-Country Championships (n = 602) were invited to complete a questionnaire (sociodemographic, training, anthropometric characteristics, and LEAF-Q). A total of 207 valid surveys were collected (83 females, 22.1 (4.0) years, and 124 males, 22.3 (4.1) years), and 16 surveys were excluded. A high prevalence of athletes at risk of LEA (64.3%) was observed, being higher in females than in males (79.5 and 54.0% respectively, p < 0.001). More than half of athletes (54.1%, n = 112) reported bowel movements once a week or more rarely, while 33 female athletes (41.3%) did not report normal menstruation. Overall, cross-country athletes are at high risk of LEA. Moreover, a high prevalence of gastrointestinal and menstrual impairments was reported. Hence, athletes should be followed by multidisciplinary teams to inform, prevent, and treat LEA and its effects.

Adipose tissue dysfunction is a key mechanism that leads to adiposity-based chronic disease. This study aimed to investigate the feasibility of the adiponectin/leptin ratio (AdipoQ/Lep) as an adipose tissue and metabolic function biomarker in adults with obesity, without diabetes. Data were collected from a clinical trial conducted in 28 adults with obesity (mean body mass index: 35.4±3.7 kg/m2) (NCT02169778). Using a forward stepwise multiple linear regression model to explore the relationship between AdipoQ/Lep and HOMA-IR, it was observed that 48.6% of HOMA-IR variance was explained by triacylglycerols, AdipoQ/Lep and waist-to-hip ratio (P<0.001), being AdipoQ/Lep the strongest independent predictor (Beta = -0.449, P<0.001). A lower AdipoQ/Lep was correlated with a higher body mass index (Rs = -0.490, P<0.001), body fat mass (Rs = -0.486, P<0.001), waist-to-height ratio (RS = -0.290, P=0.037), and plasma resistin (Rs = -0.365, P=0.009). These data highlight the central role of adipocyte dysfunction in the pathogenesis of insulin resistance and emphasize that AdipoQ/Lep may be a promising early marker of insulin resistance development in adults with obesity.

BACKGROUND/OBJECTIVES Indole-3-propionic acid (IPA) is a tryptophan-derived microbial metabolite that has been associated with protective effects against inflammatory and metabolic diseases. However, there is a lack of knowledge regarding the effects of IPA under physiological conditions and at the intestinal level. MATERIALS/METHODS Human intestinal epithelial Caco-2 cells were treated for 2, 24, and/or 72 h with IPA or its precursors – indole, tryptophan, and propionate – at 1, 10, 100, 250, or 500 μM to assess cell viability, integrity, differentiation, and proliferation. RESULTS IPA induced cell proliferation and this effect was associated with a higher expression of extracellular signal-regulated kinase 2 (ERK2) and a lower expression of c-Jun. Although indole and propionate also induced cell proliferation, this involved ERK2 and c-Jun independent mechanisms. On the other hand, both tryptophan and propionate increased cell integrity and reduced the expression of claudin-1, whereas propionate decreased cell differentiation. CONCLUSIONS In conclusion, these findings suggested that IPA and its precursors distinctly contribute to the proliferation, differentiation, and barrier function properties of human intestinal epithelial cells. Moreover, the pro-proliferative effect of IPA in intestinal epithelial cells was not explained by its precursors and is rather related to its whole chemical structure. Maintaining IPA at physiological levels, e.g., through IPA-producing commensal bacteria, may be important to preserve the integrity of the intestinal barrier and play an integral role in maintaining metabolic homeostasis.

Introduction: The Mediterranean diet (MD) is widely known as a healthy eating pattern for preventing and reducing childhood obesity. School has been described as a privileged setting for modulating eating habits and health promotion. Objective: The study aimed to analyse the effects of a nutrition education programme on the nutritional status and MD adherence in children and adolescents from São Miguel Island, Azores. Methods: A total of 298 students from the 1st to the 3rd cycle were included. An anthropometric assessment (height, weight, and waist circumference) was performed, and participants completed a questionnaire which included KIDMED Index at baseline and after the intervention. This programme had grade-appropriate nutritional education activities, promoting the Mediterranean food pattern. Results: After the intervention, students with a higher education level showed improvements in nutritional status. We verified an increase in the obesity prevalence in 1st cycle students (26.7% vs 32.2%) and a decrease in the 2nd and 3rd cycles (26.4% vs 20.7% and 21.5% vs 20.7%, respectively). Concerning to KIDMED index, in 1st cycle students, we observed a decrease in the percentage of optimal adherence (52.2% vs 47.8%). Otherwise, in 2nd and 3rd cycles, students enhanced their optimal MD adherence (31.0% vs 35.6% and 27.3% vs 30.6%, respectively). It was found a negatively correlation between MD adherence and body mass index (RS = - 0.154, p = 0.010) and between MD adherence and waist circumference (RS = - 0.138, p = 0.021). Conclusion: Our findings suggest that a nutrition education programme is more effective in improving nutritional status and MD adherence in adolescents, compared with children.