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Diabetes tipo 2 y alimentación · PMID 42748597 · Systematic Review, Meta-Analysis

1. ¿Ensalada antes del arroz? Lo que se sabe del orden de los alimentos

Resumen propuesto

Un equipo reunió 18 ensayos en adultos que comieron verduras antes de los carbohidratos. A los 30 y a los 60 minutos, el azúcar en la sangre subió menos que cuando no comían verduras primero; a las 2 horas, en cambio, quedó un poco más alta. Los propios autores advierten que la certeza de estos resultados es muy baja por las limitaciones de los estudios.

Qué significa para ti. Es una pista interesante, no una regla. Si tienes diabetes y quieres probar cambiar el orden de tu plato, conversa primero con tu nutricionista.

Revisión sistemática y metaanálisis · 18 ensayos aleatorizados · Kampmann-Gongoll K et al. Clin Nutr, 2026

Abstract original

Effect of eating vegetables before carbohydrates on glucose, insulin and glycemic control - A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND AND AIMS: It is discussed that eating vegetables before carbohydrates may reduce the increase of postprandial glucose and improve insulin secretion. However, findings of studies investigating the effectiveness are inconclusive. Therefore, the aim of this systematic review and meta-analysis was to assess the effects on glycemic control in adults with and without health conditions. METHODS: PubMed and the Cochrane Library were searched until September 2025. Randomized controlled trials (RCTs) examining the effect of a vegetable preload before carbohydrate consumption on postprandial and fasting glucose, insulin and HbA1c levels in adults were selected. RESULTS: In total, we included 18 RCTs. Using risk of bias tool RoB 2 ten trials were rated with moderate risk of bias and eight with a high risk. With very low certainty of evidence the intervention reduced postprandial glucose and insulin concentration after 30 min (MD (95% CI): -1.21 mmol/L [-1.75, -0.68] and -13.14 μU/mL [-18.63, -7.65]) and 60 min (-0.52 mmol/L [-0.67, -0.37]; and -12.03 μU/mL [-18.27, -5.78]) compared to their controls without vegetable preloads. After 120 min, postprandial glucose and insulin values were higher compared to the controls (0.24 mmol/L [0.06, 0.42] and 7.10 μU/mL [1.94, 12.26]). In people with type 2 diabetes, the intervention reduced HbA1c (baseline: 8.3 ± 1.7%, after 24 months: 6.8 ± 0.8%). CONCLUSION: Although this meta-analysis shows short-term improvements in glucose and insulin concentrations and individual studies indicate beneficial effects on HbA1c, the interpretability of these results is severely restricted due to methodological limitations. PROSPERO registration number: CRD42024529101.
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Ultraprocesados y etiquetado frontal · PMID 42157575 · Systematic Review

2. Los sellos de advertencia bajan el azúcar que se compra, pero no está claro si ayudan a todos por igual

Resumen propuesto

De 7.701 estudios encontrados, 10 cumplieron los requisitos de esta revisión, y la mayoría evaluó sellos de advertencia en el frente del envase. Todos encontraron que el consumo de azúcar bajó a nivel de la población. Pero no hubo acuerdo sobre si el beneficio fue mayor en personas con más o con menos ingresos, y la calidad de los estudios fue baja.

Qué significa para ti. Los sellos son una herramienta para comparar productos. Que funcionen igual para todos todavía no está demostrado, y por eso se sigue estudiando.

Revisión sistemática · 10 estudios incluidos · Ge Z et al. Obes Rev, 2026

Abstract original

The Impact of Front-of-Pack Labeling on Social Inequality in Sugar Consumption and Purchase: A Systematic Review.

OBJECTIVE: This systematic review examined the impact of front-of-pack labeling (FOPL) on social inequality in sugar consumption and purchase. METHODS: We searched Ovid MEDLINE, Scopus, EMBASE, and Web of Science for studies published in English since 2005. Eligible studies included randomized controlled trials and observational studies. The screening was conducted independently by at least two reviewers. Data extraction and quality assessments were cross-checked. The risk of bias was assessed using ROBINS-E, RoB2, and CHEERS 2022. A narrative synthesis summarized the findings. RESULTS: Of the total of 7701 studies identified, 10 studies were included. All included studies were conducted in high- and upper-middle-income countries, and primarily evaluated one specific type of FOPL, specifically warning labels (n = 8). All studies reported FOPL reduced sugar consumption at the population level. However, findings on social inequality were inconsistent. Five studies showed greater benefit among higher-socioeconomic groups, four among lower-socioeconomic groups, two identified a U-shaped effect, and two found no differential effect by socioeconomic status. The overall quality of studies was poor. DISCUSSION: FOPL, in particular warning labels, can reduce sugar consumption, but its effects on socioeconomic inequalities were inconsistent. Evaluation of high-quality longitudinal research is needed to ensure FOPL interventions are inclusive and effective across socioeconomic groups.
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Dieta mediterránea · PMID 42906553 · Randomized Controlled Trial

3. Dieta mediterránea e inflamación: en este estudio pesó más bajar de peso

Resumen propuesto

53 adultos con factores de riesgo metabólico fueron sorteados a dieta mediterránea, con toda la comida entregada, o a seguir con su dieta habitual. En las primeras 8 semanas, solo con la dieta, el marcador de inflamación medido no cambió, aunque las grasas en la sangre ya habían mejorado. En las 8 semanas siguientes se sumaron dos días de ayuno por semana, y la inflamación bajó en el grupo mediterráneo comparado con el otro, junto con más baja de peso, mejor respuesta a la insulina y presión más baja.

Qué significa para ti. Los autores concluyen que, en 8 semanas, la calidad de la dieta por sí sola no bajó la inflamación. El estudio no dice que tengas que ayunar: eso se conversa con tu nutricionista.

Ensayo aleatorizado · 53 participantes · Warmbrunn MV et al. Cell Metab, 2026

Abstract original

Weight loss during intermittent fasting, not Mediterranean diet quality alone, is associated with lower inflammation: A randomized controlled trial.

Whether the anti-inflammatory effects of a Mediterranean diet reflect diet quality itself or accompanying weight loss is unclear. In a 16-week randomized controlled-feeding trial, 53 adults (77% female; mean age 54.7 years) with metabolic risk factors received a fully provided Mediterranean diet or their habitual western diet for 8 weeks, then added twice-weekly fasting days for a further 8 weeks. The primary outcome, high-sensitivity C-reactive protein, did not change during the diet-only phase despite clear dietary separation. After fasting began, C-reactive protein fell in the Mediterranean-diet group relative to controls, alongside greater weight loss, improved insulin sensitivity, and lower blood pressure; lipid improvements had already emerged during the diet-only phase. Multi-omic analyses showed parallel reductions in inflammatory signaling, with gut microbiome composition largely stable. Thus, diet quality alone does not lower inflammation over 8 weeks; negative energy balance and weight loss during fasting appear to be the stronger drivers. This study was registered at ClinicalTrials.gov (NCT02148458).
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Proteína en adultos mayores · PMID 42942938 · Systematic Review

4. Músculo después de los 60: qué dicen los estudios de suplementos

Resumen propuesto

Esta revisión juntó 20 ensayos con 2.160 personas mayores con pérdida de músculo y fuerza, o en riesgo de tenerla. En conjunto, los suplementos nutricionales mejoraron la masa muscular, la fuerza de la mano y la velocidad al caminar. La mezcla de proteína de suero con vitamina D y leucina mostró resultados favorables en varias de esas medidas, pero la certeza fue de baja a muy baja.

Qué significa para ti. Los autores piden leerlo como una señal, no como un ranking de suplementos. Si te preocupa perder fuerza, consúltalo con tu nutricionista o tu médico antes de comprar nada.

Revisión sistemática y metaanálisis en red · 20 ensayos aleatorizados, 2.160 participantes · Zhang X et al. Nutrients, 2026

Abstract original

Comparative Effectiveness of Nutritional Strategies for Sarcopenia-Related Outcomes in Older Adults: A Systematic Review and Network Meta-Analysis.

Objective: This study compared the relative effects of distinct nutritional strategies on muscle mass, muscle strength, and physical performance in older adults with sarcopenia or at high risk of sarcopenia. Methods: PubMed, Embase, the Cochrane Library, Web of Science, and CNKI were systematically searched for randomized controlled trials (RCTs). Random-effects pairwise meta-analysis and network meta-analysis (NMA) were performed. The surface under the cumulative ranking curve (SUCRA) was used to summarize relative rankings, and CINeMA was applied to assess the certainty of evidence. Results: Twenty RCTs involving 2160 participants were included, forming 17 network nodes. Nutritional interventions collectively improved appendicular skeletal muscle mass index (ASMI), grip strength, and gait speed, whereas the pooled effect on the five-times sit-to-stand test (5STS) was not statistically significant. In the NMA, whey protein + vitamin D + leucine improved ASMI (SMD = 0.29, 95% CI: 0.06 to 0.52) and grip strength (SMD = 0.82, 95% CI: 0.13 to 1.50), and it reduced 5STS completion time (SMD = -1.41, 95% CI: -2.63 to -0.18). Omega-3 fatty acids + leucine + Lactobacillus paracasei PS23 improved ASMI (SMD = 0.67, 95% CI: 0.10 to 1.25) and grip strength (SMD = 1.84, 95% CI: 0.39 to 3.28), although this node was supported by a single RCT. Leucine + vitamin D + medium-chain triglycerides improved gait speed (SMD = 1.28, 95% CI: 0.13 to 2.43), although this node was also supported by a single RCT. Sensitivity analyses indicated that the magnitude and precision of some formulation-specific estimates varied with the exclusion of individual trials or restriction to participants with confirmed sarcopenia. The certainty of evidence for the principal comparisons ranged from low to very low. Conclusions: Nutritional supplementation showed overall benefits for ASMI, grip strength, and gait speed, while formulation-specific effects varied across outcomes. Whey protein + vitamin D + leucine showed favorable effects across several outcomes, whereas omega-3 fatty acids + leucine + Lactobacillus paracasei PS23 and leucine + vitamin D + medium-chain triglycerides showed additional formulation-specific signals based on single-study nodes. Given the sparse network and very low certainty of evidence for the principal comparisons, these findings should be regarded as candidate signals rather than evidence of a definitive treatment hierarchy.
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Dieta mediterránea · PMID 42942971 · Randomized Controlled Trial

5. La avellana chilena, a prueba

Resumen propuesto

Adultos con colesterol alto siguieron por 6 meses una dieta mediterránea adaptada a Chile con avellana chilena, o bien una dieta baja en grasa. De 106 personas que partieron, 81 terminaron. Los dos grupos mejoraron por igual algunos marcadores de daño celular medidos en la sangre, sin diferencias entre ellos.

Qué significa para ti. Según los autores, mejorar la calidad de la grasa que comes podría ayudar, pero el aporte propio de la avellana chilena necesita más estudio. No hay un alimento estrella.

Ensayo aleatorizado · 106 participantes (81 terminaron) · González-Contreras C et al. Nutrients, 2026

Abstract original

Effects of a Chilean Hazelnut-Supplemented Diet on Oxidative Stress and Cytokine Expression in PBMCs of Hypercholesterolemic Adults: A Randomized Controlled Trial.

BACKGROUND/OBJECTIVES: Hypercholesterolemia is characterized by alterations in lipid metabolism, oxidative stress, and inflammatory status. Nuts have been shown to mitigate these alterations; however, limited evidence is available regarding their effects in the Chilean population using a native nut species. This study aimed to assess the impact of a six-month Chilean-adapted Mediterranean diet supplemented with Gevuina avellana Molina, compared with a low-fat regimen, on oxidative stress and inflammatory markers in peripheral blood mononuclear cells (PBMCs) from adults with hypercholesterolemia. METHODS: A randomized controlled trial was conducted with a 6-month nutritional intervention. Of 106 hypercholesterolemic adults randomized, 81 completed the study, allocated to two groups: one following a Chilean diet supplemented with Chilean hazelnuts (n = 47) and the other a low-fat diet (n = 34) (ClinicalTrials.gov: NCT07087704). Oxidative stress markers and inflammatory markers in PBMCs were assessed as secondary outcomes. In PBMCs, reactive oxygen species (ROS) production and the enzymatic activities of superoxide dismutase (SOD), catalase (CAT), and glutathione reductase (GRd) were analysed, along with oxidative damage markers (malondialdehyde, carbonyls, and nitrotyrosine) and gene expression (SOD, CAT, GRd, IL-10, and TNF-α). RESULTS: Both dietary interventions were associated with similar improvements in PBMC redox status, characterized by reduced oxidative damage and enhanced antioxidant defence capacity. Malondialdehyde and carbonyl levels decreased in both groups following the dietary intervention. In addition, antioxidant enzyme activities increased, with SOD showing a concomitant increase in gene expression level, whereas CAT gene expression decreased despite enhanced enzymatic activity. No significant differences between groups were observed for the assessed oxidative stress, antioxidant, or inflammatory markers. CONCLUSIONS: A Chilean diet supplemented with Chilean hazelnuts and a low-fat diet produced similar improvements in PBMC redox status in hypercholesterolemic adults. These findings suggest that improving dietary fat quality and increasing antioxidant-rich food intake may contribute to favourable changes in cellular redox homeostasis, although the specific contribution of Chilean hazelnuts requires further investigation.
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