Attention-deficit hyperactivity disorder (ADHD) has been related to nutrient deficiencies and 'unhealthy' diets, and to date there is only one study that examined the relationship between the Mediterranean diet and ADHD. The aim was to determine the association between those environmental, nutritional, and body composition factors that may affect the pathogenesis and symptomatology of patients with ADHD in Spain. A total of 89 children and adolescents (41 with diagnosed ADHD and 48 controls) were studied in an observation case-control study. Anthropometry, nutritional status, adherence to a Mediterranean diet, sedentary behaviour, and sleep were measured. Lower adherence to a Mediterranean diet was associated with ADHD diagnosis. Individuals with ADHD more often missed having a second serving of vegetables daily and showed reduced intakes of fish, pulses, and pasta or rice almost every day when compared with controls. Statistically significant differences (P < 0.05) were found for fish, cereal, no breakfast and commercially baked goods consumption. There were also statistically significant differences between ADHD individuals and controls when analysing sedentary behaviours and BMI (P < 0.05). Low adherence to a Mediterranean diet might play a role in ADHD development. Not only specific nutrients but also the whole diet should be considered in ADHD. No clear association was found for anthropometry and sedentary behaviours.

Background: The aetiology of Attention Deficit Hyperactivity Disorder (ADHD) continues to be debated, although several contributing factors have been acknowledged. Objective: Assess the association between weight, birth attributes, exercise and sleep habits, dietary intake and adherence to a Mediterranean diet, and impulsive behaviour on Spanish ADHD children. Establish whether specific food groups (not just adherence to the Mediterranean diet) associate with impulsive behaviour. Methods: This observational cross-sectional study included 57 ADHD children from Madrid (Spain). Demographic, clinical data, sleep, exercise and technology-use habits were obtained. Anthropometric measurements included height and weight. Adherence to the Mediterranean diet was assessed using the KIDMED test. Barratt Impulsivity Scale version-11c was used to assess impulsivity. Subjects were divided into three groups for analysis, according to their age (6–10 years, children; 11–13 years, pre-adolescents; 14–16 years, adolescents). Results: There were clear associations between those who had higher BIS scores and who slept less at weekends (49.4 ± 10.16 vs. 43.8 ± 12.51), who adhered poorly to the Mediterranean diet (49.9 ± 11.72 vs. 41.6 ± 16.52), who used internet and technological devices for >3 h/day (45.5 ± 13.6 vs. 44.7 ± 12.11), who were born with >2.5 kg (46.1 ± 11.61 vs. 42.9 ± 15.29), who were delivered by caesarean (45.1 ± 12.78 vs. 44.7 ± 12.5) and who were not breastfed (45.0 ± 13.38 vs. 44.8 ± 12.39). Subjects exercising more than 3 days a week also scored slightly higher (45.4±14.02 vs. 44.6±11.85) in the BIS. Conclusion: There is a need to follow up the link between ADHD and sleep onset difficulties, dietary patterns, technological habits, perinatal factors, breastfeeding and birth delivery mode.

The prognosis of refractory or relapsed pediatric solid tumors is very poor, and there is no standard treatment for this condition. The combination of irinotecan and temozolomide has proved useful in adults as a second-line treatment of different solid tumors. In pediatric patients, this combination has been effective in Ewing's sarcoma, neuroblastoma, and relapsed or refractory rhabdomyosarcoma. A retrospective study was conducted on 32 pediatric patients with refractory or relapsed solid tumors, who were treated with irinotecan and temozolomide in the Oncology Department at Children's Hospital Niño Jesus from September 2005 to June 2012. The clinical characteristics, treatment performed, toxicity and outcome, were analyzed. Thirty-two patients received a total of 180 cycles. Of the 30 evaluable patients, 10 (33%) had a positive response (2 complete remission and 8 partial remission), and in 8 (27%) the disease remained stable. Almost all (94%) of the patients achieved a response in the first four cycles. Of the 180 cycles analyzed, only 50 (28%) had toxicity, and of these only 15 (8%) were grade iii-iv. The most common toxicity was diarrhea appearing in 18 patients. All patients received ambulatory treatment, except three of them who required hospitalization due to symptoms of their underlying disease. The combination of irinotecan and temozolomide is well tolerated and active against pediatric refractory or relapsed solid tumors.

Raised serum cholesterol concentration is a well-established risk factor in cardiovascular disease. In addition, genetic load may have an indirect influence on cardiovascular risk. Plant-based sterol-supplemented foods are recommended to help reduce the serum low-density lipoprotein cholesterol level. The objective was to analyse the influence of different polymorphisms in hypercholesterolemia patients following a dietary treatment with plant sterols. A randomised double-blind cross-over controlled clinical trial was carried out in 45 people (25 women). Commercial milk, containing 2.24 g of sterols, was ingested daily during a 3-week period, and then the same amount of skim milk, without sterols, was consumed daily during the 3-week placebo phase. Both phases were separated by a washout period of 2 weeks. At the beginning and end of each phase, blood draws were performed. Genes LIPC C-514T and APOA5 C56G are Ser19Trp carriers and greatly benefit from sterol intake in the diet. LIPC C-514T TT homozygous carriers had lower low-density lipoprotein cholesterol (LDL-c) levels than CC homozygote and CT heterozygote carriers after the ingestion of plant sterols (p = 0.001). These two genes also showed statistically significant changes in total cholesterol levels (p = 0.025; p = 0.005), and no significant changes in high-density lipoprotein (HDL) cholesterol levels (p = 0.032; p = 0.003), respectively. No statistically significant differences were observed for other genes. Further studies are needed to establish which genotype combinations would be the most protective against hypercholesterolemia.

Introducción: la hipercolesterolemia es uno de los principales factores de riesgo en la enfermedad cardiovascular. Los esteroles vegetales sehan postulado como agentes reguladores y benefi ciosos para el control de esta.Objetivo: analizar el efecto de los esteroles vegetales añadidos en una leche en la reducción del colesterol plasmático en adultos jóvenes.Métodos: ensayo clínico, controlado, aleatorizado, doble ciego y cruzado. Los esteroles (2,24 g diarios) fueron administrados en dos tomasde 350 ml de una leche comercial desnatada, durante dos periodos de 3 semanas, separados por una “fase de lavado” de 2 semanas, en elgrupo experimental. Al grupo control se le administró la misma cantidad de leche desnatada, sin esteroles. Tanto al inicio como al fi nal de cadaperiodo de intervención se extrajeron muestras sanguíneas. Se analizaron la composición corporal, hábitos de salud y los siguientes marcadoressanguíneos: perfi l lipídico, hematológico, infl amación, etc.Resultados: se incluyeron 54 personas en el estudio con una edad media de 38,8 ± 7,3 años. La diferencia porcentual entre los marcadoresbasales y fi nales para el colesterol total, colesterol-LDL, colesterol-HDL, triglicéridos y colesterol no-HDL fueron del 9,73%, 12,5%, 1,9%, 3,15%y 13,2%, respectivamente. Se obtuvieron diferencias estadísticamente signifi cativas entre el grupo experimental y el grupo control, para todoslos marcadores analizados excepto para los triglicéridos.Conclusión: los esteroles vegetales suministrados en un alimento de consumo habitual, como la leche, pueden ser una estrategia terapéuticano farmacológica para el control de la hipercolesterolemia de alto interés sanitario.