Childhood obesity has reached epidemic levels and is a serious health concern associated with metabolic syndrome, nonalcoholic fatty liver disease, and gut microbiota alterations. Physical exercise is known to counteract obesity progression and modulate the gut microbiota composition. This study aims to determine the effect of a 12-week strength and endurance combined training program on gut microbiota and inflammation in obese pediatric patients. Thirty-nine obese children were assigned randomly to the control or training group. Anthropometric and biochemical parameters, muscular strength, and inflammatory signaling pathways in mononuclear cells were evaluated. Bacterial composition and functionality were determined by massive sequencing and metabolomic analysis. Exercise reduced plasma glucose levels and increased dynamic strength in the upper and lower extremities compared with the obese control group. Metagenomic analysis revealed a bacterial composition associated with obesity, showing changes at the phylum, class, and genus levels. Exercise counteracted this profile, significantly reducing the Proteobacteria phylum and Gammaproteobacteria class. Moreover, physical activity tended to increase some genera, such as Blautia, Dialister, and Roseburia, leading to a microbiota profile similar to that of healthy children. Metabolomic analysis revealed changes in short-chain fatty acids, branched-chain amino acids, and several sugars in response to exercise, in correlation with a specific microbiota profile. Finally, the training protocol significantly inhibited the activation of the obesity-associated NLRP3 signaling pathway. Our data suggest the existence of an obesity-related deleterious microbiota profile that is positively modified by physical activity intervention. Exercise training could be considered an efficient nonpharmacological therapy, reducing inflammatory signaling pathways induced by obesity in children via microbiota modulation.

The purpose of this study was to determine which strategy of embryo transfer has a better trade-off in live birth delivery rate versus multiple pregnancy considering patient acceptance: elective single embryo transfer (eSET) or elective double embryo transfer (eDET). In all, 199 women <38 years of age undergoing their first IVF treatment in a private centre were included in a prospective open-label randomised controlled trial. Patients were randomised into four groups: (1) eSET on Day 3; (2) eSET on Day 5; (3) eDET on Day 3; and (4) eDET on Day 5. Per patient, main analysis included acceptance of assigned group, as well as multiple and live birth delivery rates of the fresh cycle. Secondary analysis included the rates of subsequent cryotransfers and the theoretical cumulative success rate. Of 98 patients selected for eSET, 40% refused and preferred eDET. The live birth delivery rate after eDET was significantly higher after eDET versus eSET (65% vs 42%, respectively; odds ratio=1.6, 95% confidence interval 1.1-2.1). No multiple births were observed after eSET, compared with 35% after eDET. Although live birth delivery is higher with eDET, the increased risk of multiple births is avoided with eSET. Nearly half the patients refused eSET even after having been well informed about its benefits.

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La prevalencia de la obesidad infantil ha aumentado a nivel global de forma preocupante, especialmente por las consecuencias que se pueden manifestar en la edad adulta. Se ha demostrado que esta afección aumenta el estrés de retículo endoplásmico(ERE) y, por lo tanto, activa la respuesta a proteínas mal plegadas (UPR). El ejercicio físico es una de las principales propuestas para atajar este reto de salud pública y, específicamente, para resolver el ERE. Por consiguiente, el objetivo de este estudio fue la evaluación del efecto de un programa de entrenamiento combinado de fuerza y resistencia de 12 semanas sobre la UPR en células mononucleares de la sangre periférica (PBMC) de pacientes pediátricos obesos. Para ello, se distribuyeron aleatoriamente 12 niños obesos (9 – 11 años) en un grupo entrenado (GE, n =8), que se sometió al protocolo de entrenamiento, y un grupo control (GC, n = 4), que mantuvo sus rutinas habituales. Se analizaron proteínas de la UPR (ATF4, ATF6 p50, BiP, CHOP, p-eIF2α, p-IRE1 y XBP1s) por Western Blot antes y después del periodo de entrenamiento. Los resultados demostraron que el entrenamiento atenuó el aumento en la fosforilación de eIF2α e IRE1 en comparación con el GC. Además, se observó un efecto tiempo x grupo en la expresión de CHOP tras el entrenamiento. Sin embargo, no se encontraron diferencias en la expresión de ATF4, ATF6 p50, BiPo XBP1 tras el periodo de entrenamiento. En conclusión, los resultados sugieren que el programa de entrenamiento promueve un alivio en el ERE de los pacientes pediátricos obesos. No obstante, se necesitan nuevas investigaciones para determinar la eficacia de programas de entrenamiento alternativos