The effects of diet quality and dietary acid load on insulin resistance in overweight children and adolescents

array:23 ["pii" => "S2530016421002172" "issn" => "25300164" "doi" => "10.1016/j.endinu.2021.07.008" "estado" => "S300" "fechaPublicacion" => "2022-06-01" "aid" => "1217" "copyright" => "SEEN y SED" "copyrightAnyo" => "2021" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Endocrinol Diabetes Nutr. 2022;69:426-32" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "itemSiguiente" => array:19 [ "pii" => "S2530016421002421" "issn" => "25300164" "doi" => "10.1016/j.endinu.2021.09.005" "estado" => "S300" "fechaPublicacion" => "2022-06-01" "aid" => "1227" "copyright" => "SEEN y SED" "documento" => "article" "crossmark" => 1 "subdocumento" => "rev" "cita" => "Endocrinol Diabetes Nutr. 2022;69:433-41" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "es" => array:12 [ "idiomaDefecto" => true "cabecera" => "REVISIÓN" "titulo" => "Actualización en el tratamiento insulínico y la monitorización de la glucosa en gestantes con diabetes tipo 1" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "433" "paginaFinal" => "441" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Type 1 diabetes and pregnancy: an update on glucose monitoring and insulin treatment" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Judit Amigó, Rosa Corcoy" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Judit" "apellidos" => "Amigó" ] 1 => array:2 [ "nombre" => "Rosa" "apellidos" => "Corcoy" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2530018022001135" "doi" => "10.1016/j.endien.2022.06.008" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2530018022001135?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2530016421002421?idApp=UINPBA00004N" "url" => "/25300164/0000006900000006/v1_202206110728/S2530016421002421/v1_202206110728/es/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S253001642100224X" "issn" => "25300164" "doi" => "10.1016/j.endinu.2021.08.001" "estado" => "S300" "fechaPublicacion" => "2022-06-01" "aid" => "1224" "copyright" => "SEEN y SED" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Endocrinol Diabetes Nutr. 2022;69:418-25" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "ORIGINAL" "titulo" => "Utilidad práctica de los índices no invasivos en la esteatosis hepática metabólica" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "418" "paginaFinal" => "425" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "The practical utility of non-invasive indices in metabolic hepatic steatosis" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1760 "Ancho" => 2500 "Tamanyo" => 152793 ] ] "descripcion" => array:1 [ "es" => "Concordancia entre índices de esteatosis y fibrosis con respectivos coeficientes Kappa de Cohen." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Carla Noemi Tafur Sánchez, Miguel Durá Gil, Andrea Alemán Domínguez del Río, Celia María Hernández Pérez, Natalia Mora Cuadrado, Sara Gómez de la Cuesta, David Primo Martín, Daniel de Luis Román, Rocío Aller de la Fuente" "autores" => array:9 [ 0 => array:2 [ "nombre" => "Carla Noemi" "apellidos" => "Tafur Sánchez" ] 1 => array:2 [ "nombre" => "Miguel" "apellidos" => "Durá Gil" ] 2 => array:2 [ "nombre" => "Andrea" "apellidos" => "Alemán Domínguez del Río" ] 3 => array:2 [ "nombre" => "Celia María" "apellidos" => "Hernández Pérez" ] 4 => array:2 [ "nombre" => "Natalia" "apellidos" => "Mora Cuadrado" ] 5 => array:2 [ "nombre" => "Sara" "apellidos" => "Gómez de la Cuesta" ] 6 => array:2 [ "nombre" => "David" "apellidos" => "Primo Martín" ] 7 => array:2 [ "nombre" => "Daniel" "apellidos" => "de Luis Román" ] 8 => array:2 [ "nombre" => "Rocío" "apellidos" => "Aller de la Fuente" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2530018022001147" "doi" => "10.1016/j.endien.2022.06.009" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2530018022001147?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S253001642100224X?idApp=UINPBA00004N" "url" => "/25300164/0000006900000006/v1_202206110728/S253001642100224X/v1_202206110728/es/main.assets" ] "en" => array:19 [ "idiomaDefecto" => true "cabecera" => "Original article" "titulo" => "The effects of diet quality and dietary acid load on insulin resistance in overweight children and adolescents" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "426" "paginaFinal" => "432" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Zeynep Caferoglu, Busra Erdal, Nihal Hatipoglu, Selim Kurtoglu" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Zeynep" "apellidos" => "Caferoglu" "email" => array:1 [ 0 => "zcaferoglu@erciyes.edu.tr" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Busra" "apellidos" => "Erdal" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Nihal" "apellidos" => "Hatipoglu" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "Selim" "apellidos" => "Kurtoglu" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Department of Nutrition and Dietetics, Faculty of Health Sciences, Erciyes University, Kayseri, Turkey" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Department of Nutrition and Dietetics, Institute of Health Sciences, Erciyes University, Kayseri, Turkey" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Department of Paediatric Endocrinology, Faculty of Medicine, Erciyes University, Kayseri, Turkey" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Los efectos de la calidad de la dieta y la carga ácida de la dieta sobre la resistencia a la insulina en niños y adolescentes con sobrepeso" ] ] "textoCompleto" => "IntroductionIn recent years, the increase in childhood obesity has become a major global public health problem.<a class="elsevierStyleCrossRef" href="#bib0210">1</a> It is known that approximately 110 million children and adolescents are overweight and obese worldwide.<a class="elsevierStyleCrossRef" href="#bib0215">2</a> Unhealthy eating habits, as well as excessive and unbalanced energy intake, have an effect on the emergence of obesity. Thus, a high quality diet plays an important role in the prevention and treatment of obesity.<a class="elsevierStyleCrossRef" href="#bib0220">3</a> Meanwhile, obesity occurring in children and adolescents is a major modifiable risk factor for insulin resistance (IR).<a class="elsevierStyleCrossRef" href="#bib0210">1</a> IR, seen in nearly half of obese children and adolescents, is associated with several metabolic disorders and is an important risk factor for the development of type 2 diabetes (T2D) and cardiovascular diseases in adulthood.<a class="elsevierStyleCrossRefs" href="#bib0210">1,4</a> Therefore, it is important to know and treat the mechanisms that lead to IR.The development of IR is determined by the nutritional habits, lifestyle, and physical activity status of the individuals. A healthy and balanced diet has been shown to improve glucose and insulin homeostasis.<a class="elsevierStyleCrossRef" href="#bib0230">5</a> For this reason, improving diet-related health problems and identifying and changing negative nutritional behaviours provide benefits in preventing the development of IR.<a class="elsevierStyleCrossRef" href="#bib0235">6</a> However, especially in children and adolescents, the consumption of unhealthy foods like refined sugar, sugary drinks, and fatty and salty foods increases with a shift to Western-style diets, while the consumption of healthy foods like vegetables, fruit and whole grains decreases. These dietary habits lead to imbalanced nutrient intake and a reduction in diet quality (DQ).<a class="elsevierStyleCrossRef" href="#bib0240">7</a> It is also known that such diets have a high dietary acid load (DAL) along with low DQ.<a class="elsevierStyleCrossRef" href="#bib0245">8</a> DAL causes metabolic changes and increases the prevalence of obesity as well as metabolic acidosis in children and adults.<a class="elsevierStyleCrossRefs" href="#bib0250">9,10</a> Increased metabolic acidosis has been associated with high adiposity<a class="elsevierStyleCrossRefs" href="#bib0260">11,12</a> and IR.<a class="elsevierStyleCrossRef" href="#bib0255">10</a> It has also been suggested that diets with high DAL may increase the risk of chronic diseases associated with IR.<a class="elsevierStyleCrossRefs" href="#bib0255">10,13</a> Nevertheless, the relationship between DAL and IR in overweight children and adolescents has not yet been ascertained. Therefore, the aim of the current study is to determine the DQ and DAL of overweight children and adolescents and to evaluate the possible association of these parameters with IR.Materials and methodsStudy populationThis cross-sectional study was conducted on 135 overweight children and adolescents aged 6–17 years, who attended the paediatric endocrinology outpatient clinic at the Erciyes University Children's Hospital. The exclusion criteria were having any health problems limiting their physical activity, and using tobacco, alcohol or any medications.Ethical approval was obtained from the Clinical Research Ethics Committee of Erciyes University (reference code: 2010/133). Participants and their families were informed about the research in accordance with the Declaration of Helsinki, and then a written informed consent form was read and signed by the volunteers.Anthropometric measurementsParticipants’ body weight and height were measured according to standard procedures by trained researchers. Body mass index (BMI) was calculated as weight (kg) divided by height squared (m2). Overweight (including obesity) was defined as having a BMI≥85th percentile of Turkish growth reference data,<a class="elsevierStyleCrossRef" href="#bib0275">14</a> and children and adolescents with a BMI≥85th percentile were recruited to this study. WHO Anthro Plus software (version 1.0.4) was used to calculate BMI z-scores. The tri-ponderal mass index (TMI, kg/m3) was also calculated.Clinical assessmentAll participants were examined by the paediatric endocrinologist before the study. Blood glucose, insulin, total cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) levels were measured after 12h of fasting. The HOMA-IR score, a valid tool for evaluating IR in children and adolescents,<a class="elsevierStyleCrossRef" href="#bib0280">15</a> was calculated, and 2.6 and 3.2 were used as the threshold to define IR for prepubertal and pubertal patients, respectively.<a class="elsevierStyleCrossRef" href="#bib0285">16</a>Dietary assessmentA three-day dietary record was taken to evaluate the nutritional status of the participants. They were instructed on how to record diet diaries and were asked to record all foods and drinks (including water) consumed for three days (two weekdays and one weekend day). At the end of this period, the research dietician checked each dietary record and sought clarification about portion sizes using a photographic food atlas. Diet composition was analysed using the BeBiS Nutrition Information System software version 7.2.Determining diet qualityThe Healthy Eating Index 2015 (HEI-2015) score,<a class="elsevierStyleCrossRef" href="#bib0290">17</a> a measure for assessing dietary quality, was calculated using the dietary records. The highest score of HEI-2015 is 100, and it classifies dietary quality≤50 as “poor”, 51–80 as “needs improvement”, and ≥80 as “good”. The HEI-2015 was also revised in accordance with the Turkey Dietary Guidelines (TUBER) recommendations,<a class="elsevierStyleCrossRef" href="#bib0295">18</a> and the HEI-2015-TUBER scores were calculated.Dietary acid load calculationThe DAL was calculated using potential renal acid load (PRAL) and net endogenous acid production (NEAP) algorithms.<a class="elsevierStyleCrossRefs" href="#bib0300">19,20</a> The NEAP score includes protein and potassium as acidity-changing nutrients. The PRAL score estimates the DAL taking into account the intestinal absorption rates of protein and additional minerals taken with the diet. There are no cut-off points, higher PRAL and NEAP scores indicate that the acidic load has increased, while low values indicate that the alkali load has increased.Statistical analysesSample size and power analysis: The statistical software G*Power (version 3.1) was used to calculate sample size and power. Considering 95% power and α=0.05, the minimum required sample size was 130 participants to detect a significant difference (effect size=0.634) in the mean HOMA values between groups.<a class="elsevierStyleCrossRef" href="#bib0280">15</a> When the sample power was calculated for this study according to the difference between the means of groups obtained by the t-test in the HOMA-IR score, the sample size of 135 participants provided 99.9% power at an alpha level of 0.05.Data analysis: Statistical analysis was performed using the IBM SPSS Statistics (version 22.0) software. Data were expressed as the number (n) and percentage (%) for categorical variables, and mean and 95% confidence intervals (CI) for continuous variables. Normality was assessed using the histogram, normal Q–Q plots and the Kolmogorov–Smirnov test. Two independent group comparisons were performed by the Student's t-test and Mann–Whitney U test for continuous variables with and without normal distributions, respectively. Categorical variables were compared by the chi-square test. In addition, logistic regression analyses were performed to determine the effect of DQ and DAL on IR. The non-IR category was considered the reference group, and age was controlled in the regression models. All potential confounding variables (age, gender, etc.) were considered separately using the univariate analysis, and any variables having a significant Wald test at a level of 0.25 were selected for the multivariate analysis.<a class="elsevierStyleCrossRef" href="#bib0310">21</a> Each potential confounder was also tested in the multivariate models and was retained as a confounding variable if it was significant and increased Nagelkerke R2 values or modified the respective association substantially. Odds ratios (OR) with 95% CI were reported, and p values<0.05 were considered statistically significant for all data.ResultsParticipant characteristicsThis study was conducted with 135 overweight children and adolescents (40% boys). In order to determine the effect of IR, the participants were divided into two groups: those with IR and those without IR. The age (p<0.001) and TMI (p=0.001) of the IR group were higher than the non-IR group, while their gender and BMI z-scores were similar (p>0.05). Furthermore, serum triglyceride levels were higher (p=0.002), and HDL-C levels were lower (p=0.003) in the group with IR. No differences were found in total cholesterol and LDL-C (p>0.05) (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>Dietary intake, DQ, and DALThe average daily intake of energy, and macro- and micronutrients was similar between the IR and non-IR (p>0.05) groups. However, the HEI-2015 score according to TUBER was lower in those with IR (p=0.021). In the classification according to both the HEI-2015 and HEI-2015-TUBER scores, the rate of those with poor DQ was higher in the IR group (p=0.034 and p=0.037, respectively). In addition, the PRAL and NEAP scores, indicators of DAL, were higher in the group with IR, while this difference was statistically significant only for the NEAP scores (p=0.060 and p=0.044, respectively) (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).<elsevierMultimedia ident="tbl0010"></elsevierMultimedia>Associations of DQ and DAL with IRWhen DQ, DAL and IR variables were modelled, significant associations were observed in the logistic regression analysis (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>). An increase in the HEI-2015-TUBER score was associated with a decrease of 4.2% in the risk of IR (OR 0.958, 95% CI 0.924, 0.994). Furthermore, greater PRAL (OR 1.033, 95% CI 1.000, 1.067) and NEAP (OR 1.025, 95% CI 1.001, 1.051) scores were associated with higher IR risk.<elsevierMultimedia ident="tbl0015"></elsevierMultimedia>DiscussionObesity is a critical risk factor in the development of IR in both paediatric and adult groups. It is known that IR increases the risk of T2D and cardiovascular disease associated with overweight. IR is also an important component of metabolic syndrome, and its incidence is increasing, especially among obese children and adolescents.<a class="elsevierStyleCrossRefs" href="#bib0210">1,22</a> On the other hand, the eating habits of individuals may affect IR and the development of related complications.<a class="elsevierStyleCrossRef" href="#bib0320">23</a> Therefore, determining the effects of DQ and DAL on IR may be useful for its prevention and treatment. Our study aimed to determine the relationship of DQ and DAL with IR in overweight children and adolescents. The present findings showed that DQ was lower and DAL was higher in those with IR. Additionally, an increase in DQ scores decreased the risk of IR, while increased DAL scores were related to higher IR risk. Considering the importance of preventing the risk of developing IR in childhood obesity, these findings may guide the development of different strategies to improve the nutritional status of children.Insulin resistance is a clinical condition in which the body's response to insulin is inadequate and glucose homeostasis cannot be provided effectively.<a class="elsevierStyleCrossRef" href="#bib0325">24</a> Studies have emphasised that children with IR are more prone to developing T2D, metabolic syndrome and cardiovascular disease in the future.<a class="elsevierStyleCrossRefs" href="#bib0330">25–27</a> Greater IR incidence is observed among overweight/obese individuals<a class="elsevierStyleCrossRefs" href="#bib0345">28,29</a> and a 4.5 fold increased HOMA-IR score was recorded in adolescents with higher body fat percentages.<a class="elsevierStyleCrossRef" href="#bib0355">30</a> For this reason, the use of appropriate and economical screening tools to determine body fat percentage in childhood may provide effective interventions. Although BMI is widely used, it fails in some clinical evaluations because it cannot distinguish between fat and lean mass in the body.<a class="elsevierStyleCrossRef" href="#bib0360">31</a> Peterson et al.<a class="elsevierStyleCrossRef" href="#bib0330">25</a> suggested that a new method, the TMI, predicts fat mass better. TMI has also been suggested as an appropriate method for preventing cardiometabolic comorbidities and evaluating adiposity.<a class="elsevierStyleCrossRef" href="#bib0365">32</a> In line with the literature, in our study, TMI was found to be higher in participants with IR even though there was no difference in BMI between those with IR and those without IR. Therefore, the use of TMI may be beneficial in patients more than 8 years old. Furthermore, since the evaluation of TMI in children is not dependent of age and puberty, its use in the clinic may be more advantageous.<a class="elsevierStyleCrossRefs" href="#bib0360">31,32</a>Obese children and adolescents with IR tend to have a worse metabolic profile than those without IR,<a class="elsevierStyleCrossRef" href="#bib0350">29</a> and higher serum triglyceride levels, lower HDL-C levels and a positive correlation of TG/HDL-C ratio with the HOMA-IR index have been reported.<a class="elsevierStyleCrossRef" href="#bib0370">33</a> Similarly, the present study showed that children and adolescents with IR have higher serum triglyceride levels and lower HDL-C levels. Excess energy intake and a sedentary lifestyle a cause greater waist circumference and fatty liver with a rise in body fat in obese individuals. Consequently, more IR and pro-inflammatory cytokine production are observed. This adverse profile results in increased plasma glucose, triglyceride and blood pressure, and decreased HDL-C level.<a class="elsevierStyleCrossRef" href="#bib0375">34</a>It is known that the consumption of fruit, vegetables and whole-grain foods that enhance DQ in obese individuals is protective against the risk of impaired glucose metabolism and the development of T2D.<a class="elsevierStyleCrossRef" href="#bib0380">35</a> Therefore, there is an increasing relevance in DQ to describe the relationship between childhood obesity and nutrition in the literature.<a class="elsevierStyleCrossRefs" href="#bib0315">22,36</a> High-energy, high-fat and low-dietary fibre dietary habits that reduce DQ in childhood and adolescence were reported as associated with a higher risk of obesity.<a class="elsevierStyleCrossRef" href="#bib0390">37</a> Additionally, the DQ of obese children was found to be poor,<a class="elsevierStyleCrossRef" href="#bib0395">38</a> and an increase in DQ scores was related to a reduced risk of IR.<a class="elsevierStyleCrossRef" href="#bib0315">22</a> Consistent with the literature, our results showed that DQ was lower, and the rate of those with poor DQ was higher in overweight children and adolescents with IR compared to those without IR. Furthermore, a one-unit increase in the HEI-2015-TUBER score was found to be associated with a reduction of 4.2% in IR risk. While consumption of vegetables, fruit and whole grains is generally inadequate in this age group, the energy, saturated fat and sodium intake increase, especially due to the high consumption of processed and packaged foods, which leads to poor DQ.<a class="elsevierStyleCrossRefs" href="#bib0390">37,39</a> Given that compliance with healthy eating habits is efficient in reducing IR in overweight individuals, paying attention to DQ during childhood and adolescence may help to decrease the risk of developing comorbidities and chronic diseases in later life.Western-style diets with a poor DQ cause higher DAL and increase the risk of metabolic disorders, as they contain more animal protein (red meat, processed meat products, etc.) and less fruit and vegetables.<a class="elsevierStyleCrossRefs" href="#bib0245">8,9,40</a> Acid-base balance is important in the development of metabolic disorders,<a class="elsevierStyleCrossRef" href="#bib0260">11</a> and it has been asserted that metabolic acidosis caused by rising DAL may increase IR.<a class="elsevierStyleCrossRefs" href="#bib0405">40,41</a> In a recent study, DAL, reflected by PRAL and NEAP scores, has been determined to associate positively with IR risk in obese adults.<a class="elsevierStyleCrossRef" href="#bib0410">41</a> However, no studies on paediatric groups have been found in the literature. To our knowledge, this is the first research conducted on children and adolescents. In line with the adult study, the present findings indicated that obese individuals with IR had higher PRAL and NEAP scores than those without IR, and a one-unit increase in DAL scores was related to a rise of approximately 3% in IR risk. Although the mechanisms of the relationships between diet-induced metabolic acidosis and IR remain unclear, there are various possible explanations. Firstly, low blood pH could disrupt insulin binding to its receptors, leading to IR. Another mechanism is that metabolic acidosis stimulates the secretion of cortisol and suppresses adiponectin gene expression. Chronically elevated cortisol levels and/or low adiponectin levels may induce IR.<a class="elsevierStyleCrossRef" href="#bib0410">41</a>This study had some limitations. First, a healthy control group was not included in our study. Therefore, the relationship between obesity and DQ or DAL could not be revealed. Second, there was no detailed information about the lifestyle habits of participants, such as their physical activity. Considering the effect of energy expenditure, which plays an important role in the development of obesity, associations between lifestyle factors and IR could not be determined. However, the present study is the first to assess the relationship between DAL, as well as DQ, and IR in overweight children and adolescents. Our findings showed that although energy and nutrient intakes of those with IR and those without IR were similar, high DAL and/or low DQ scores were associated with an increased risk of IR. These results indicate that for the prevention and treatment of IR in obese children and adolescents, it may not be sufficient to control daily energy and nutrient intake and that the quality of diet should also be improved.In conclusion, in contrast to Western-style diets, adequate and balanced nutrition in overweight children is of great importance for both improving DQ and reducing DAL. Thus, by reducing the risk of IR it will be possible to contribute to both the improvement of metabolic control and the prevention of metabolic syndrome and cardiovascular diseases. Therefore, it would be beneficial to provide nutritional education to children and adolescents on the consumption of healthy foods such as vegetables, fruit and whole grains, instead of foods containing high energy, saturated fat, sugar and salt to help them acquire appropriate dietary habits. Moreover, well-planned and long-term studies are needed to clarify the relationship of DQ and DAL with IR in overweight children and adolescents.Authors’ contributionsZ.C. designed the research protocol, conducted the research and statistical analysis, prepared the manuscript, and had primary responsibility for the final content. B.E. contributed to the data analysis and manuscript writing. N.H. and S.K. contributed to the planning and management of the study and the data collection, and reviewed the manuscript. All authors read and approved the final manuscript.FundingThis research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.Conflicts of interestThe authors declare no conflict of interest." "textoCompletoSecciones" => array:1 [ "secciones" => array:13 [ 0 => array:3 [ "identificador" => "xres1729861" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Materials and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1527036" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1729860" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Materiales y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1527037" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Materials and methods" "secciones" => array:7 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Study population" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Anthropometric measurements" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Clinical assessment" ] 3 => array:2 [ "identificador" => "sec0030" "titulo" => "Dietary assessment" ] 4 => array:2 [ "identificador" => "sec0035" "titulo" => "Determining diet quality" ] 5 => array:2 [ "identificador" => "sec0040" "titulo" => "Dietary acid load calculation" ] 6 => array:2 [ "identificador" => "sec0045" "titulo" => "Statistical analyses" ] ] ] 6 => array:3 [ "identificador" => "sec0050" "titulo" => "Results" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0055" "titulo" => "Participant characteristics" ] 1 => array:2 [ "identificador" => "sec0060" "titulo" => "Dietary intake, DQ, and DAL" ] 2 => array:2 [ "identificador" => "sec0065" "titulo" => "Associations of DQ and DAL with IR" ] ] ] 7 => array:2 [ "identificador" => "sec0070" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0075" "titulo" => "Authors’ contributions" ] 9 => array:2 [ "identificador" => "sec0080" "titulo" => "Funding" ] 10 => array:2 [ "identificador" => "sec0085" "titulo" => "Conflicts of interest" ] 11 => array:2 [ "identificador" => "xack610430" "titulo" => "Acknowledgements" ] 12 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2021-05-10" "fechaAceptado" => "2021-07-28" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1527036" "palabras" => array:6 [ 0 => "Adolescent" 1 => "Child" 2 => "Diet quality" 3 => "Dietary acid load" 4 => "Insulin resistance" 5 => "Overweight" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1527037" "palabras" => array:6 [ 0 => "Adolescente" 1 => "Niño" 2 => "Calidad de la dieta" 3 => "Carga ácida de la dieta" 4 => "Resistencia a la insulina" 5 => "Sobrepeso" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "IntroductionThis study aimed to investigate the association of diet quality (DQ) and dietary acid load (DAL) with insulin resistance (IR) in overweight children and adolescents. Materials and methodsThe study was conducted on 135 overweight participants aged 6–17 years. DQ was assessed using the Healthy Eating Index 2015 (HEI-2015) and the HEI-2015-TUBER, revised in accordance with the Turkey Dietary Guidelines (TUBER). Estimation of DAL was made calculating the potential renal acid load (PRAL) and net endogenous acid production (NEAP) scores. ResultsThe HEI-2015-TUBER score was lower in those with IR than in those without IR (p=0.021). Higher PRAL and NEAP scores were found in those with IR (p=0.060 and p=0.044, respectively). Moreover, a one-unit increase in the HEI-2015-TUBER score and the DAL score was associated with a reduction of 4.2% and a rise of approximately 3% in IR risk, respectively. ConclusionsHealthy eating habits in overweight paediatric groups may help to reduce the IR risk, improving DQ and decreasing DAL." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Materials and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "IntroducciónEste estudio tuvo como objetivo investigar la asociación de la calidad de la dieta (CD) y la carga ácida de la dieta (CAD) con la resistencia a la insulina (RI) en niños y adolescentes con sobrepeso. Materiales y métodosEl estudio se realizó en 135 participantes con sobrepeso de entre 6-17 años. La CD se evaluó utilizando el índice de alimentación saludable (HEI)-2015 y el HEI-2015-TUBER, revisado de acuerdo con las Pautas Dietéticas de Turquía (TUBER). La estimación de la CAD se realizó calculando las puntuaciones de carga de ácido renal potencial (PRAL) y la producción neta de ácido endógeno (NEAP). ResultadosLa puntuación HEI-2015-TUBER fue más baja en aquellos con RI que en los que no tenían RI (p=0,021). Se encontraron puntuaciones PRAL y NEAP más altas en aquellos con RI (p=0,060 y p=0,044, respectivamente). Además, un aumento de una unidad en la puntuación HEI-2015-TUBER y las puntuaciones de la CAD se asoció con una reducción del 4,2% y un aumento de aproximadamente el 3% en el riesgo de RI, respectivamente. ConclusionesLos hábitos alimenticios saludables en los grupos pediátricos con sobrepeso pueden ayudar a reducir el riesgo de RI mejorando la CD y disminuyendo la CAD." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Materiales y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "multimedia" => array:3 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "Abbreviations: BMI, body mass index; HDL-C, high density lipoprotein cholesterol; IR, insulin resistance; LDL-C, low density lipoprotein cholesterol; TMI, tri-ponderal mass index." "tablatextoimagen" => array:1 [ 0 => array:1 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variables<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Non-IR(n=77) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">IR(n=58) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p<a class="elsevierStyleCrossRef" href="#tblfn0015">*</a> \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Gender (male), n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30 (39) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24 (41) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.776 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age (years) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10.82 (10.12, 11.51) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12.45 (11.87, 13.02) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">BMI-Z score (SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.61 (2.44, 2.77) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.80 (2.65, 2.95) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.098 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">TMI (kg/m3)<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17.93 (17.49, 18.36) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">19.21 (18.59, 19.82) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Glucose (mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">84.91 (83.27, 86.55) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">89.34 (87.11, 91.58) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Insulin (μU/ml) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9.76 (9.06, 10.46) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26.90 (23.06, 30.74) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001<a class="elsevierStyleCrossRef" href="#tblfn0020">**</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">HOMA-IR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.05 (1.90, 2.19) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.98 (5.05, 6.90) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001<a class="elsevierStyleCrossRef" href="#tblfn0020">**</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Triglycerides (mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">101.93 (90.81, 113.06) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">126.52 (113.22, 139.81) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.002<a class="elsevierStyleCrossRef" href="#tblfn0020">**</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Total cholesterol (mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">175.13 (168.44, 181.82) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">181.67 (174.24, 189.10) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.195 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">HDL-C (mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">46.77 (44.19, 49.35) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">41.56 (39.15, 43.97) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.003<a class="elsevierStyleCrossRef" href="#tblfn0020">**</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">LDL-C (mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">108.38 (102.81, 113.95) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">116.52 (108.44, 124.59) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.090 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] ] ] "notaPie" => array:4 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "Values were given as mean and 95% confidence interval unless otherwise indicated." ] 1 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "b" "nota" => "Children less than 8 years old were excluded from the analysis." ] 2 => array:3 [ "identificador" => "tblfn0015" "etiqueta" => "*" "nota" => "Student's t-test." ] 3 => array:3 [ "identificador" => "tblfn0020" "etiqueta" => "**" "nota" => "Mann–Whitney U test." ] ] ] "descripcion" => array:1 [ "en" => "Participants’ characteristics and biochemical parameters." ] ] 1 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "Abbreviations: HEI, healthy eating index; IR, insulin resistance; PRAL, potential renal acid load; NEAP, net endogenous acid production; TUBER, Turkey Dietary Guidelines." "tablatextoimagen" => array:1 [ 0 => array:1 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variables<a class="elsevierStyleCrossRef" href="#tblfn0025">a</a> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Non-IR(n=77) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">IR(n=58) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p<a class="elsevierStyleCrossRef" href="#tblfn0030">*</a> \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Energy (kcal) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1874.63 (1752.65, 1996.61) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1946.81 (1806.24, 2087.38) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.440 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Carbohydrates (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50.27 (48.94, 51.60) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">51.30 (49.55, 53.04) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.343 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Proteins (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13.89 (13.37, 14.42) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13.83 (13.21, 14.45) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.875 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Fats (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">35.84 (34.74, 36.94) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">34.92 (33.33, 36.51) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.327 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Vitamin B1 (mg/1000kcal) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.81 (0.75, 0.88) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.78 (0.72, 0.85) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.488 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Vitamin B2 (mg/1000kcal) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.26 (1.17, 1.34) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.23 (1.12, 1.34) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.716 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Vitamin B6 (mg/1000kcal) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.26 (1.11, 1.41) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.20 (1.11, 1.29) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.906<a class="elsevierStyleCrossRef" href="#tblfn0035">**</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Folic Acid (mcg/1000kcal) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">257.95 (238.35, 277.54) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">257.64 (235.68, 279.59) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.983 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Vitamin B12 (mcg/1000kcal) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.86 (3.35, 4.37) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.54 (2.90, 4.18) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.268<a class="elsevierStyleCrossRef" href="#tblfn0035">**</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Vitamin E (mg/1000kcal) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18.67 (16.90, 20.43) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18.43 (16.37, 20.48) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.773<a class="elsevierStyleCrossRef" href="#tblfn0035">**</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Vitamin C (mg/1000kcal) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">104.07 (92.95, 115.19) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100.28 (87.27, 113.29) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.594<a class="elsevierStyleCrossRef" href="#tblfn0035">**</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Calcium (mg/1000kcal) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">676.23 (621.51, 730.96) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">666.58 (597.79, 735.38) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.825 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Magnesium (mg/1000kcal) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">236.90 (219.36, 254.45) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">229.77 (210.57, 248.98) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.588 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Iron (mg/1000kcal) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10.29 (9.60, 10.98) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10.56 (9.92, 11.20) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.585 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Zinc (mg/1000kcal) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.84 (8.25, 9.44) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.98 (8.27, 9.70) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.766 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">HEI-2015 score \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">47.87 (45.86, 49.87) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">45.63 (43.65, 47.62) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.124 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">HEI-2015 score classification (poor), n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">42 (54) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">42 (72) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.034 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">HEI-2015-TUBER score \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">38.69 (36.29, 41.10) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">34.61 (32.18, 37.04) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.021 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">HEI-2015-TUBER score classification (poor), n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">64 (83) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">55 (95) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.037 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PRAL (mEq/day) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.68 (6.17, 11.19) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12.49 (9.30, 15.67) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.060 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NEAP (mEq/day) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">53.02 (49.77, 56.28) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">58.33 (54.16, 62.49) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.044 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] ] ] "notaPie" => array:3 [ 0 => array:3 [ "identificador" => "tblfn0025" "etiqueta" => "a" "nota" => "Values were given as mean and 95% confidence interval unless otherwise indicated." ] 1 => array:3 [ "identificador" => "tblfn0030" "etiqueta" => "*" "nota" => "Student's t-test." ] 2 => array:3 [ "identificador" => "tblfn0035" "etiqueta" => "**" "nota" => "Mann–Whitney U test." ] ] ] "descripcion" => array:1 [ "en" => "Participants’ energy and nutrient intakes, diet quality and dietary acid load." ] ] 2 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at3" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "Abbreviations: HEI, healthy eating index; IR, insulin resistance; PRAL, potential renal acid load; NEAP, net endogenous acid production; TUBER, Turkey Dietary Guidelines." "tablatextoimagen" => array:1 [ 0 => array:1 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variables<a class="elsevierStyleCrossRef" href="#tblfn0040">a</a> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">IROR (95% Cl) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">HEI-2015 score \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.964 (0.922, 1.007) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.099<a class="elsevierStyleCrossRef" href="#tblfn0045">*</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">HEI-2015-TUBER score \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.958 (0.924, 0.994) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.023<a class="elsevierStyleCrossRef" href="#tblfn0045">*</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PRAL (mEq/day) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.033 (1.000, 1.067) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.047<a class="elsevierStyleCrossRef" href="#tblfn0045">*</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NEAP (mEq/day) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.025 (1.001, 1.051) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.045<a class="elsevierStyleCrossRef" href="#tblfn0045">*</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] ] ] "notaPie" => array:2 [ 0 => array:3 [ "identificador" => "tblfn0040" "etiqueta" => "a" "nota" => "Values are odds ratio (95% confidence interval) estimated through logistic regression using the non-IR group as reference. All models were adjusted for age." ] 1 => array:3 [ "identificador" => "tblfn0045" "etiqueta" => "*" "nota" => "p-for trend<0.01." ] ] ] "descripcion" => array:1 [ "en" => "Association of dietary acid load and diet quality scores with risk of insulin resistance." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:41 [ 0 => array:3 [ "identificador" => "bib0210" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Obesity and insulin resistance in children" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "V.M. Tagi" 1 => "F. Chiarelli" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/MOP.0000000000000913" "Revista" => array:6 [ "tituloSerie" => "Curr Opin Pediatr" "fecha" => "2020" "volumen" => "32" "paginaInicial" => "582" "paginaFinal" => "588" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32520824" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0215" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Obesity in children and adolescents" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A.M. Cali" 1 => "S. Caprio" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1210/jc.2008-1363" "Revista" => array:6 [ "tituloSerie" => "Clin Endocrinol Metab" "fecha" => "2008" "volumen" => "93" "numero" => "Suppl. 1" "paginaInicial" => "s31" "paginaFinal" => "s36" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0220" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Association between diet quality and obesity indicators among the working-age adults in Inner Mongolia Northern China: a cross-sectional study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L. Jia" 1 => "H. Lu" 2 => "J. Wu" 3 => "X. Wang" 4 => "W. Wang" 5 => "M. Du" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s12889-020-09281-5" "Revista" => array:5 [ "tituloSerie" => "BMC Public Health" "fecha" => "2020" "volumen" => "20" "paginaInicial" => "1" "paginaFinal" => "10" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0225" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Inverse association between regular milk consumption and insulin resistance in obese children and adolescents" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Z. Caferoglu" 1 => "N. Hatipoglu" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Nutr Diet" "fecha" => "2017" "volumen" => "45" "paginaInicial" => "12" "paginaFinal" => "19" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0230" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dietary support in insulin resistance: an overview of current scientific reports" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "K.D. Golabek" 1 => "B. Regulska-Ilow" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.17219/acem/109976" "Revista" => array:6 [ "tituloSerie" => "Adv Clin Exp Med" "fecha" => "2019" "volumen" => "28" "paginaInicial" => "1577" "paginaFinal" => "1585" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31756065" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0235" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dietary patterns and breakfast consumption in relation to insulin resistance in children. The Healthy Growth Study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "K. Karatzi" 1 => "G. Moschonis" 2 => "A.-A. Barouti" 3 => "C. Lionis" 4 => "G.P. Chrousos" 5 => "Y. Manios" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1017/s1368980013003327" "Revista" => array:6 [ "tituloSerie" => "Public Health Nutr" "fecha" => "2014" "volumen" => "17" "paginaInicial" => "2790" "paginaFinal" => "2797" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24477051" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0240" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evaluation of the Healthy Eating Index (HEI-2010) of obese adolescent children: a tertiary hospital experience" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "K. Nevra" 1 => "H. Yardımcı" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.12956/tjpd.2017.309" "Revista" => array:5 [ "tituloSerie" => "Turk J Pediatr Dis" "fecha" => "2017" "volumen" => "12" "paginaInicial" => "155" "paginaFinal" => "162" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0245" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The role of dietary acid load and mild metabolic acidosis in insulin resistance in humans" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R.S. Williams" 1 => "P. Kozan" 2 => "D. Samocha-Bonet" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.clnu.2015.08.002" "Revista" => array:6 [ "tituloSerie" => "Biochimie" "fecha" => "2016" "volumen" => "124" "paginaInicial" => "171" "paginaFinal" => "177" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26363101" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0250" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Association of dietary acid load with anthropometric indices in children and adolescents" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Z. Aslani" 1 => "M. Bahreynian" 2 => "N. Namazi" 3 => "N. Shivappa" 4 => "J.R. Hebert" 5 => "M.E. Asayesh" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s40519-020-00883-x" "Revista" => array:6 [ "tituloSerie" => "Eat Weight Disord" "fecha" => "2021" "volumen" => "26" "paginaInicial" => "555" "paginaFinal" => "567" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32172506" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0255" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dietary acid load: a novel nutritional target in overweight/obese children with asthma?" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P. Cunha" 1 => "I. Paciencia" 2 => "J. Cavaleiro Rufo" 3 => "F. Castro Mendes" 4 => "M. Farraia" 5 => "R. Barros" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3390/nu11092255" "Revista" => array:4 [ "tituloSerie" => "Nutrients" "fecha" => "2019" "volumen" => "11" "paginaInicial" => "2255" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0260" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Increased body fatness adversely relates to 24-h urine pH during childhood and adolescence: evidence of an adipo-renal axis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Y. Hua" 1 => "D. Krupp" 2 => "J. Esche" 3 => "T. Remer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/ajcn/nqy379" "Revista" => array:5 [ "tituloSerie" => "J Am Diet Assoc" "fecha" => "2019" "volumen" => "109" "paginaInicial" => "1279" "paginaFinal" => "1287" ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0265" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Higher dietary acid load is weakly associated with higher adiposity measures and blood pressure in Japanese adults: The National Health and Nutrition Survey" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "K. Murakami" 1 => "M.B.E. Livingstone" 2 => "H. Okubo" 3 => "S. Sasaki" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.nutres.2017.06.005" "Revista" => array:6 [ "tituloSerie" => "Nutr Res" "fecha" => "2017" "volumen" => "44" "paginaInicial" => "67" "paginaFinal" => "75" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28821319" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0270" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Association between dietary acid load and insulin resistance: Tehran Lipid and Glucose Study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S.K. Moghadam" 1 => "Z. Bahadoran" 2 => "P. Mirmiran" 3 => "M. Tohidi" 4 => "F. Azizi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3746/pnf.2016.21.2.104" "Revista" => array:5 [ "tituloSerie" => "Prev Nutr Food Sci" "fecha" => "2016" "volumen" => "21" "paginaInicial" => "104" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27390726" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0275" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Reference values for weight, height, head circumference, and body mass index in Turkish children" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "O. Neyzi" 1 => "R. Bundak" 2 => "G. Gokcay" 3 => "H. Gunoz" 4 => "A. Furman" 5 => "F. Darendeliler" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.4274/jcrpe.2183" "Revista" => array:4 [ "tituloSerie" => "J Clin Res Pediatr Endocrinol" "fecha" => "2015" "volumen" => "7" "paginaInicial" => "280" ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0280" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Homeostasis model assessment is more reliable than the fasting glucose/insulin ratio and quantitative insulin sensitivity check index for assessing insulin resistance among obese children and adolescents" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M. Keskin" 1 => "S. Kurtoglu" 2 => "M. Kendirci" 3 => "M.E. Atabek" 4 => "C. Yazici" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1542/peds.2004-1921" "Revista" => array:6 [ "tituloSerie" => "Pediatrics" "fecha" => "2005" "volumen" => "115" "paginaInicial" => "e500" "paginaFinal" => "e503" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15741351" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0285" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Insulin resistance determined by Homeostasis Model Assessment (HOMA) and associations with metabolic syndrome among Chinese children and teenagers" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Yin" 1 => "M. Li" 2 => "L. Xu" 3 => "Y. Wang" 4 => "H. Cheng" 5 => "X. Zhao" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/1758-5996-5-71" "Revista" => array:5 [ "tituloSerie" => "Diabetol Metab Syndr" "fecha" => "2013" "volumen" => "5" "paginaInicial" => "1" "paginaFinal" => "9" ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0290" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Update of the healthy eating index: HEI-2015" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S.M. Krebs-Smith" 1 => "T.E. Pannucci" 2 => "A.F. Subar" 3 => "S. Kirkpatrick" 4 => "J. Lerman" 5 => "J. Tooze" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jand.2018.05.021" "Revista" => array:6 [ "tituloSerie" => "J Acad Nutr Diet" "fecha" => "2018" "volumen" => "118" "paginaInicial" => "1591" "paginaFinal" => "1602" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30146071" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0295" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Turkey dietary guidelines" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A.G. Pekcan" 1 => "N. Sanlıer" 2 => "M. Bas" ] ] ] ] ] "host" => array:2 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2016" "editorial" => "Ministry of Turkey Health Publication" "editorialLocalizacion" => "Ankara" ] ] 1 => array:1 [ "WWW" => array:1 [ "link" => "https://hsgm.saglik.gov.tr/depo/birimler/saglikli-beslenme-hareketli-hayat-db/Yayinlar/kitaplar/Kitaplar-eski/Turkiye-Beslenme-Rehberi-ingilizce.pdf" ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0300" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Potential renal acid load of foods and its influence on urine pH" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "T. Remer" 1 => "F. Manz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0002-8223(95)00219-7" "Revista" => array:6 [ "tituloSerie" => "J Am Diet Assoc" "fecha" => "1995" "volumen" => "95" "paginaInicial" => "791" "paginaFinal" => "797" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7797810" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0305" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Estimation of net endogenous noncarbonic acid production in humans from diet potassium and protein contents" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "L.A. Frassetto" 1 => "K.M. Todd" 2 => "R.C. Morris Jr." 3 => "A. Sebastian" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/ajcn/68.3.576" "Revista" => array:6 [ "tituloSerie" => "Am J Clin Nutr" "fecha" => "1998" "volumen" => "68" "paginaInicial" => "576" "paginaFinal" => "583" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9734733" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0310" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Purposeful selection of variables in logistic regression" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Z. Bursac" 1 => "C.H. Gauss" 2 => "D.K. Williams" 3 => "D.W. Hosmer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/1751-0473-3-17" "Revista" => array:5 [ "tituloSerie" => "Source Code Biol Med" "fecha" => "2008" "volumen" => "3" "paginaInicial" => "1" "paginaFinal" => "8" ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0315" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The relationship between diet quality and insulin resistance in obese children: adaptation of the Healthy Lifestyle-Diet Index in Turkey" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "Y.E. Ozturk" 1 => "R. Bozbulut" 2 => "E. Doger" 3 => "A. Bideci" 4 => "E. Koksal" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1515/jpem-2017-0271" "Revista" => array:6 [ "tituloSerie" => "J Pediatr Endocrinol Metab" "fecha" => "2018" "volumen" => "31" "paginaInicial" => "391" "paginaFinal" => "398" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29494339" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0320" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Insulin resistance in obese children and adolescents: HOMA-IR cut-off levels in the prepubertal and pubertal periods" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "S. Kurtoglu" 1 => "N. Hatipoglu" 2 => "M. Mazıcıoglu" 3 => "M. Kendirici" 4 => "M. Keskin" 5 => "M. Kondolot" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.4274/jcrpe.v2i3.100" "Revista" => array:5 [ "tituloSerie" => "J Clin Res Pediatr Endocrinol" "fecha" => "2010" "volumen" => "2" "paginaInicial" => "100" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21274322" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0325" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Association between frequency of breakfast consumption and insulin resistance using triglyceride-glucose index: a cross-sectional study of the Korea National Health and Nutrition Examination Survey (2016–2018)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "H.J. Joo" 1 => "G.R. Kim" 2 => "E.-C. Park" 3 => "S.-I. Jang" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3390/ijerph17093322" "Revista" => array:4 [ "tituloSerie" => "Int J Environ Res Public Health" "fecha" => "2020" "volumen" => "17" "paginaInicial" => "3322" ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0330" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tri-ponderal mass index vs body mass index in estimating body fat during adolescence" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C.M. Peterson" 1 => "H. Su" 2 => "D.M. Thomas" 3 => "M. Heo" 4 => "A. Golnabi" 5 => "A. Pietrobelli" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/jamapediatrics.2017.0460" "Revista" => array:6 [ "tituloSerie" => "JAMA Pediatr" "fecha" => "2017" "volumen" => "171" "paginaInicial" => "629" "paginaFinal" => "636" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28505241" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0335" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalence of insulin resistance and impaired glucose tolerance in a sample of obese Spanish children and adolescents" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Bahillo-Curieses" 1 => "F. Hermoso-López" 2 => "M. Martinez-Sopena" 3 => "P. Cobreros-Garcia" 4 => "P. Garcia-Saseta" 5 => "M. Trigues-Garcia" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s12020-011-9540-8" "Revista" => array:6 [ "tituloSerie" => "Endocrine" "fecha" => "2012" "volumen" => "41" "paginaInicial" => "289" "paginaFinal" => "295" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21964644" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0340" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hyperinsulinism assessment in a sample of prepubescent children" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "S.F.A. Mieldazis" 1 => "L.A. Azzalis" 2 => "V.B.C. Junqueira" 3 => "F.I.S. Souza" 4 => "R.O.S. Sarni" 5 => "F.L.A. Fonseca" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2223/jped.1993" "Revista" => array:5 [ "tituloSerie" => "J Pediatr (Rio J)" "fecha" => "2010" "volumen" => "86" "paginaInicial" => "245" "paginaFinal" => "249" ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0345" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A study of insulin resistance by HOMA-IR and its cut-off value to identify metabolic syndrome in urban Indian adolescents" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Y. Singh" 1 => "M. Garg" 2 => "N. Tandon" 3 => "R.K. Marwaha" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.4274/jcrpe.1127" "Revista" => array:5 [ "tituloSerie" => "J Clin Res Pediatr Endocrinol" "fecha" => "2013" "volumen" => "5" "paginaInicial" => "245" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24379034" "web" => "Medline" ] ] ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0350" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Metabolic profiles in obese children and adolescents with insulin resistance" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M. Kostovski" 1 => "V. Simeonovski" 2 => "K. Mironska" 3 => "V. Tasic" 4 => "Z. Gucev" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3889/oamjms.2018.097" "Revista" => array:5 [ "tituloSerie" => "Open Access Maced J Med Sci" "fecha" => "2018" "volumen" => "6" "paginaInicial" => "511" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29610610" "web" => "Medline" ] ] ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0355" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Body composition, biochemical and clinical changes of adolescents with excessive adiposity" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "H.M.S. Serrano" 1 => "G.Q. Carvalho" 2 => "P.F. Pereira" 3 => "M.d.C.G. Peluzio" 4 => "S.d.C.C. Franceschini" 5 => "S.E. Priore" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1590/s0066-782x2010005000109" "Revista" => array:6 [ "tituloSerie" => "Arq Bras Cardiol" "fecha" => "2010" "volumen" => "95" "paginaInicial" => "464" "paginaFinal" => "472" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20721518" "web" => "Medline" ] ] ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib0360" "etiqueta" => "31" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Accuracy of tri-ponderal mass index and body mass index in estimating insulin resistance, hyperlipidemia, impaired liver enzymes or thyroid hormone function and vitamin D levels in children and adolescents" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "N. Akcan" 1 => "R. Bundak" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.4274/jcrpe.galenos.2019.2018.0279" "Revista" => array:5 [ "tituloSerie" => "J Clin Res Pediatr Endocrinol" "fecha" => "2019" "volumen" => "11" "paginaInicial" => "366" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30991791" "web" => "Medline" ] ] ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib0365" "etiqueta" => "32" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Leptin is associated with the tri-ponderal mass index in children: a cross-sectional study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "B. Empringham" 1 => "W.J. Jennings" 2 => "R. Rajan" 3 => "A. Flemin" 4 => "C. Portwine" 5 => "D. Johnston" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2147/ahmt.s289973" "Revista" => array:5 [ "tituloSerie" => "Adolesc Health Med Ther" "fecha" => "2021" "volumen" => "12" "paginaInicial" => "9" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33727877" "web" => "Medline" ] ] ] ] ] ] ] ] 32 => array:3 [ "identificador" => "bib0370" "etiqueta" => "33" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Triglyceride to HDL-C ratio is associated with insulin resistance in overweight and obese children" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "N.A.K.Z. Iwani" 1 => "M.Y. Jalaludin" 2 => "R.M.W.M. Zin" 3 => "M.Z. Fuziah" 4 => "J.Y.H. Hong" 5 => "Y. Abqariyah" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/srep40055" "Revista" => array:6 [ "tituloSerie" => "Sci Rep" "fecha" => "2017" "volumen" => "7" "paginaInicial" => "1" "paginaFinal" => "7" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28127051" "web" => "Medline" ] ] ] ] ] ] ] ] 33 => array:3 [ "identificador" => "bib0375" "etiqueta" => "34" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Insulin resistance, prediabetes, metabolic syndrome: what should every pediatrician know?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A. Ighbariya" 1 => "R. Weiss" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.4274/jcrpe.2017.s005" "Revista" => array:6 [ "tituloSerie" => "J Clin Res Pediatr Endocrinol" "fecha" => "2017" "volumen" => "9" "numero" => "Suppl. 2" "paginaInicial" => "49" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29280741" "web" => "Medline" ] ] ] ] ] ] ] ] 34 => array:3 [ "identificador" => "bib0380" "etiqueta" => "35" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Is metabolic health affected from dietary quality and sedentary time in obesity phenotypes?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "B. Pelin" 1 => "S. Öteles" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.21020/husbfd.541591" "Revista" => array:5 [ "tituloSerie" => "Hacettepe Univ Fac Health Sci J" "fecha" => "2019" "volumen" => "6" "paginaInicial" => "39" "paginaFinal" => "54" ] ] ] ] ] ] 35 => array:3 [ "identificador" => "bib0385" "etiqueta" => "36" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Assessment of diet quality, nutrient intake, and dietary behaviours in obese children compared to healthy children" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A. Koziol-Kozakowska" 1 => "M. Kozlowska" 2 => "P. Jagielski" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.5114/pedm.2020.93250" "Revista" => array:6 [ "tituloSerie" => "Pediatr Endocrinol Diabetes Metab" "fecha" => "2020" "volumen" => "26" "paginaInicial" => "27" "paginaFinal" => "38" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32272828" "web" => "Medline" ] ] ] ] ] ] ] ] 36 => array:3 [ "identificador" => "bib0390" "etiqueta" => "37" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Childhood dietary patterns and later obesity: a review of the evidence" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "G.L. Ambrosini" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1017/s0029665113003765" "Revista" => array:7 [ "tituloSerie" => "Proc Nutr Soc" "fecha" => "2014" "volumen" => "73" "paginaInicial" => "137" "paginaFinal" => "146" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24280165" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1053811919300540" "estado" => "S300" "issn" => "10538119" ] ] ] ] ] ] ] 37 => array:3 [ "identificador" => "bib0395" "etiqueta" => "38" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The use of a dietary quality score as a predictor of childhood overweight and obesity" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "C.P. Perry" 1 => "E. Keane" 2 => "R. Layte" 3 => "A.P. Fitzgerald" 4 => "I.J. Perry" 5 => "J.M. Harrington" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s12889-015-1907-y" "Revista" => array:5 [ "tituloSerie" => "BMC Public Health" "fecha" => "2015" "volumen" => "15" "paginaInicial" => "1" "paginaFinal" => "9" ] ] ] ] ] ] 38 => array:3 [ "identificador" => "bib0400" "etiqueta" => "39" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The independent association between diet quality and body composition" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "C. Drenowatz" 1 => "R.P. Shook" 2 => "G.A. Hand" 3 => "J.R. Hebert" 4 => "S.N. Blair" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/srep04928" "Revista" => array:5 [ "tituloSerie" => "Sci Rep" "fecha" => "2014" "volumen" => "4" "paginaInicial" => "1" "paginaFinal" => "6" ] ] ] ] ] ] 39 => array:3 [ "identificador" => "bib0405" "etiqueta" => "40" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Associations between plant-based dietary indices and dietary acid load with cardiovascular risk factors among diabetic patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "E. Daneshzad" 1 => "F. Jahangir" 2 => "J. Heshmati" 3 => "B. Larijani" 4 => "P.J. Surkan" 5 => "L. Azadbakht" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s13410-020-00862-z" "Revista" => array:4 [ "tituloSerie" => "Int J Diabetes Dev Ctries" "fecha" => "2020" "paginaInicial" => "1" "paginaFinal" => "13" ] ] ] ] ] ] 40 => array:3 [ "identificador" => "bib0410" "etiqueta" => "41" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Positive association between dietary acid load and future insulin resistance risk: findings from the Korean Genome and Epidemiology Study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "K.W. Lee" 1 => "D. Shin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s12937-020-00653-6" "Revista" => array:6 [ "tituloSerie" => "Nutr J" "fecha" => "2020" "volumen" => "19" "paginaInicial" => "1" "paginaFinal" => "11" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31901246" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack610430" "titulo" => "Acknowledgements" "texto" => "We are grateful to all the participants and their parents who took part in this study." "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/25300164/0000006900000006/v1_202206110728/S2530016421002172/v1_202206110728/en/main.assets" "Apartado" => array:4 [ "identificador" => "63844" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Originales" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/25300164/0000006900000006/v1_202206110728/S2530016421002172/v1_202206110728/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2530016421002172?idApp=UINPBA00004N"]

Statistics

Original article

The effects of diet quality and dietary acid load on insulin resistance in overweight children and adolescents

Los efectos de la calidad de la dieta y la carga ácida de la dieta sobre la resistencia a la insulina en niños y adolescentes con sobrepeso

Zeynep Caferoglua,

Corresponding author

zcaferoglu@erciyes.edu.tr

Corresponding author.

, Busra Erdalb, Nihal Hatipogluc, Selim Kurtogluc

a Department of Nutrition and Dietetics, Faculty of Health Sciences, Erciyes University, Kayseri, Turkey

b Department of Nutrition and Dietetics, Institute of Health Sciences, Erciyes University, Kayseri, Turkey

c Department of Paediatric Endocrinology, Faculty of Medicine, Erciyes University, Kayseri, Turkey

Read

1012

Times
was read the article

262

Total PDF

750

Total HTML

Share statistics

 array:23 [
  "pii" => "S2530016421002172"
  "issn" => "25300164"
  "doi" => "10.1016/j.endinu.2021.07.008"
  "estado" => "S300"
  "fechaPublicacion" => "2022-06-01"
  "aid" => "1217"
  "copyright" => "SEEN y SED"
  "copyrightAnyo" => "2021"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "fla"
  "cita" => "Endocrinol Diabetes Nutr. 2022;69:426-32"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:1 [
    "total" => 0
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S2530016421002421"
    "issn" => "25300164"
    "doi" => "10.1016/j.endinu.2021.09.005"
    "estado" => "S300"
    "fechaPublicacion" => "2022-06-01"
    "aid" => "1227"
    "copyright" => "SEEN y SED"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "rev"
    "cita" => "Endocrinol Diabetes Nutr. 2022;69:433-41"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "es" => array:12 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">REVISI&#211;N</span>"
      "titulo" => "Actualizaci&#243;n en el tratamiento insul&#237;nico y la monitorizaci&#243;n de la glucosa en gestantes con diabetes tipo 1"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "tieneResumen" => array:2 [
        0 => "es"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "433"
          "paginaFinal" => "441"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Type 1 diabetes and pregnancy&#58; an update on glucose monitoring and insulin treatment"
        ]
      ]
      "contieneResumen" => array:2 [
        "es" => true
        "en" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Judit Amig&#243;, Rosa Corcoy"
          "autores" => array:2 [
            0 => array:2 [
              "nombre" => "Judit"
              "apellidos" => "Amig&#243;"
            ]
            1 => array:2 [
              "nombre" => "Rosa"
              "apellidos" => "Corcoy"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S2530018022001135"
        "doi" => "10.1016/j.endien.2022.06.008"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2530018022001135?idApp=UINPBA00004N"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2530016421002421?idApp=UINPBA00004N"
    "url" => "/25300164/0000006900000006/v1_202206110728/S2530016421002421/v1_202206110728/es/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S253001642100224X"
    "issn" => "25300164"
    "doi" => "10.1016/j.endinu.2021.08.001"
    "estado" => "S300"
    "fechaPublicacion" => "2022-06-01"
    "aid" => "1224"
    "copyright" => "SEEN y SED"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "Endocrinol Diabetes Nutr. 2022;69:418-25"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "es" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">ORIGINAL</span>"
      "titulo" => "Utilidad pr&#225;ctica de los &#237;ndices no invasivos en la esteatosis hep&#225;tica metab&#243;lica"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "tieneResumen" => array:2 [
        0 => "es"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "418"
          "paginaFinal" => "425"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "The practical utility of non-invasive indices in metabolic hepatic steatosis"
        ]
      ]
      "contieneResumen" => array:2 [
        "es" => true
        "en" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figura 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1760
              "Ancho" => 2500
              "Tamanyo" => 152793
            ]
          ]
          "descripcion" => array:1 [
            "es" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Concordancia entre &#237;ndices de esteatosis y fibrosis con respectivos coeficientes Kappa de Cohen&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Carla Noemi Tafur S&#225;nchez, Miguel Dur&#225; Gil, Andrea Alem&#225;n Dom&#237;nguez del R&#237;o, Celia Mar&#237;a Hern&#225;ndez P&#233;rez, Natalia Mora Cuadrado, Sara G&#243;mez de la Cuesta, David Primo Mart&#237;n, Daniel de Luis Rom&#225;n, Roc&#237;o Aller de la Fuente"
          "autores" => array:9 [
            0 => array:2 [
              "nombre" => "Carla Noemi"
              "apellidos" => "Tafur S&#225;nchez"
            ]
            1 => array:2 [
              "nombre" => "Miguel"
              "apellidos" => "Dur&#225; Gil"
            ]
            2 => array:2 [
              "nombre" => "Andrea"
              "apellidos" => "Alem&#225;n Dom&#237;nguez del R&#237;o"
            ]
            3 => array:2 [
              "nombre" => "Celia Mar&#237;a"
              "apellidos" => "Hern&#225;ndez P&#233;rez"
            ]
            4 => array:2 [
              "nombre" => "Natalia"
              "apellidos" => "Mora Cuadrado"
            ]
            5 => array:2 [
              "nombre" => "Sara"
              "apellidos" => "G&#243;mez de la Cuesta"
            ]
            6 => array:2 [
              "nombre" => "David"
              "apellidos" => "Primo Mart&#237;n"
            ]
            7 => array:2 [
              "nombre" => "Daniel"
              "apellidos" => "de Luis Rom&#225;n"
            ]
            8 => array:2 [
              "nombre" => "Roc&#237;o"
              "apellidos" => "Aller de la Fuente"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S2530018022001147"
        "doi" => "10.1016/j.endien.2022.06.009"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2530018022001147?idApp=UINPBA00004N"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S253001642100224X?idApp=UINPBA00004N"
    "url" => "/25300164/0000006900000006/v1_202206110728/S253001642100224X/v1_202206110728/es/main.assets"
  ]
  "en" => array:19 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
    "titulo" => "The effects of diet quality and dietary acid load on insulin resistance in overweight children and adolescents"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "426"
        "paginaFinal" => "432"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Zeynep Caferoglu, Busra Erdal, Nihal Hatipoglu, Selim Kurtoglu"
        "autores" => array:4 [
          0 => array:4 [
            "nombre" => "Zeynep"
            "apellidos" => "Caferoglu"
            "email" => array:1 [
              0 => "zcaferoglu@erciyes.edu.tr"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Busra"
            "apellidos" => "Erdal"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Nihal"
            "apellidos" => "Hatipoglu"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Selim"
            "apellidos" => "Kurtoglu"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:3 [
          0 => array:3 [
            "entidad" => "Department of Nutrition and Dietetics&#44; Faculty of Health Sciences&#44; Erciyes University&#44; Kayseri&#44; Turkey"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Department of Nutrition and Dietetics&#44; Institute of Health Sciences&#44; Erciyes University&#44; Kayseri&#44; Turkey"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Department of Paediatric Endocrinology&#44; Faculty of Medicine&#44; Erciyes University&#44; Kayseri&#44; Turkey"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Los efectos de la calidad de la dieta y la carga &#225;cida de la dieta sobre la resistencia a la insulina en ni&#241;os y adolescentes con sobrepeso"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">In recent years&#44; the increase in childhood obesity has become a major global public health problem&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">1</span></a> It is known that approximately 110 million children and adolescents are overweight and obese worldwide&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">2</span></a> Unhealthy eating habits&#44; as well as excessive and unbalanced energy intake&#44; have an effect on the emergence of obesity&#46; Thus&#44; a high quality diet plays an important role in the prevention and treatment of obesity&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">3</span></a> Meanwhile&#44; obesity occurring in children and adolescents is a major modifiable risk factor for insulin resistance &#40;IR&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">1</span></a> IR&#44; seen in nearly half of obese children and adolescents&#44; is associated with several metabolic disorders and is an important risk factor for the development of type 2 diabetes &#40;T2D&#41; and cardiovascular diseases in adulthood&#46;<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">1&#44;4</span></a> Therefore&#44; it is important to know and treat the mechanisms that lead to IR&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">The development of IR is determined by the nutritional habits&#44; lifestyle&#44; and physical activity status of the individuals&#46; A healthy and balanced diet has been shown to improve glucose and insulin homeostasis&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">5</span></a> For this reason&#44; improving diet-related health problems and identifying and changing negative nutritional behaviours provide benefits in preventing the development of IR&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">6</span></a> However&#44; especially in children and adolescents&#44; the consumption of unhealthy foods like refined sugar&#44; sugary drinks&#44; and fatty and salty foods increases with a shift to Western-style diets&#44; while the consumption of healthy foods like vegetables&#44; fruit and whole grains decreases&#46; These dietary habits lead to imbalanced nutrient intake and a reduction in diet quality &#40;DQ&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">7</span></a> It is also known that such diets have a high dietary acid load &#40;DAL&#41; along with low DQ&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">8</span></a> DAL causes metabolic changes and increases the prevalence of obesity as well as metabolic acidosis in children and adults&#46;<a class="elsevierStyleCrossRefs" href="#bib0250"><span class="elsevierStyleSup">9&#44;10</span></a> Increased metabolic acidosis has been associated with high adiposity<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">11&#44;12</span></a> and IR&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">10</span></a> It has also been suggested that diets with high DAL may increase the risk of chronic diseases associated with IR&#46;<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">10&#44;13</span></a> Nevertheless&#44; the relationship between DAL and IR in overweight children and adolescents has not yet been ascertained&#46; Therefore&#44; the aim of the current study is to determine the DQ and DAL of overweight children and adolescents and to evaluate the possible association of these parameters with IR&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Study population</span><p id="par0015" class="elsevierStylePara elsevierViewall">This cross-sectional study was conducted on 135 overweight children and adolescents aged 6&#8211;17 years&#44; who attended the paediatric endocrinology outpatient clinic at the Erciyes University Children&#39;s Hospital&#46; The exclusion criteria were having any health problems limiting their physical activity&#44; and using tobacco&#44; alcohol or any medications&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Ethical approval was obtained from the Clinical Research Ethics Committee of Erciyes University &#40;reference code&#58; 2010&#47;133&#41;&#46; Participants and their families were informed about the research in accordance with the Declaration of Helsinki&#44; and then a written informed consent form was read and signed by the volunteers&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Anthropometric measurements</span><p id="par0025" class="elsevierStylePara elsevierViewall">Participants&#8217; body weight and height were measured according to standard procedures by trained researchers&#46; Body mass index &#40;BMI&#41; was calculated as weight &#40;kg&#41; divided by height squared &#40;m<span class="elsevierStyleSup">2</span>&#41;&#46; Overweight &#40;including obesity&#41; was defined as having a BMI<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>85th percentile of Turkish growth reference data&#44;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">14</span></a> and children and adolescents with a BMI<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>85th percentile were recruited to this study&#46; WHO Anthro Plus software &#40;version 1&#46;0&#46;4&#41; was used to calculate BMI <span class="elsevierStyleItalic">z</span>-scores&#46; The tri-ponderal mass index &#40;TMI&#44; kg&#47;m<span class="elsevierStyleSup">3</span>&#41; was also calculated&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Clinical assessment</span><p id="par0030" class="elsevierStylePara elsevierViewall">All participants were examined by the paediatric endocrinologist before the study&#46; Blood glucose&#44; insulin&#44; total cholesterol&#44; triglyceride&#44; high-density lipoprotein cholesterol &#40;HDL-C&#41; and low-density lipoprotein cholesterol &#40;LDL-C&#41; levels were measured after 12<span class="elsevierStyleHsp" style=""></span>h of fasting&#46; The HOMA-IR score&#44; a valid tool for evaluating IR in children and adolescents&#44;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">15</span></a> was calculated&#44; and 2&#46;6 and 3&#46;2 were used as the threshold to define IR for prepubertal and pubertal patients&#44; respectively&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">16</span></a></p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Dietary assessment</span><p id="par0035" class="elsevierStylePara elsevierViewall">A three-day dietary record was taken to evaluate the nutritional status of the participants&#46; They were instructed on how to record diet diaries and were asked to record all foods and drinks &#40;including water&#41; consumed for three days &#40;two weekdays and one weekend day&#41;&#46; At the end of this period&#44; the research dietician checked each dietary record and sought clarification about portion sizes using a photographic food atlas&#46; Diet composition was analysed using the BeBiS Nutrition Information System software version 7&#46;2&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Determining diet quality</span><p id="par0040" class="elsevierStylePara elsevierViewall">The Healthy Eating Index 2015 &#40;HEI-2015&#41; score&#44;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">17</span></a> a measure for assessing dietary quality&#44; was calculated using the dietary records&#46; The highest score of HEI-2015 is 100&#44; and it classifies dietary quality<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>50 as &#8220;poor&#8221;&#44; 51&#8211;80 as &#8220;needs improvement&#8221;&#44; and &#8805;80 as &#8220;good&#8221;&#46; The HEI-2015 was also revised in accordance with the Turkey Dietary Guidelines &#40;TUBER&#41; recommendations&#44;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">18</span></a> and the HEI-2015-TUBER scores were calculated&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Dietary acid load calculation</span><p id="par0045" class="elsevierStylePara elsevierViewall">The DAL was calculated using potential renal acid load &#40;PRAL&#41; and net endogenous acid production &#40;NEAP&#41; algorithms&#46;<a class="elsevierStyleCrossRefs" href="#bib0300"><span class="elsevierStyleSup">19&#44;20</span></a> The NEAP score includes protein and potassium as acidity-changing nutrients&#46; The PRAL score estimates the DAL taking into account the intestinal absorption rates of protein and additional minerals taken with the diet&#46; There are no cut-off points&#44; higher PRAL and NEAP scores indicate that the acidic load has increased&#44; while low values indicate that the alkali load has increased&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Statistical analyses</span><p id="par0050" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Sample size and power analysis&#58;</span> The statistical software G&#42;Power &#40;version 3&#46;1&#41; was used to calculate sample size and power&#46; Considering 95&#37; power and <span class="elsevierStyleItalic">&#945;</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#44; the minimum required sample size was 130 participants to detect a significant difference &#40;effect size<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;634&#41; in the mean HOMA values between groups&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">15</span></a> When the sample power was calculated for this study according to the difference between the means of groups obtained by the <span class="elsevierStyleItalic">t</span>-test in the HOMA-IR score&#44; the sample size of 135 participants provided 99&#46;9&#37; power at an alpha level of 0&#46;05&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Data analysis&#58;</span> Statistical analysis was performed using the IBM SPSS Statistics &#40;version 22&#46;0&#41; software&#46; Data were expressed as the number &#40;<span class="elsevierStyleItalic">n</span>&#41; and percentage &#40;&#37;&#41; for categorical variables&#44; and mean and 95&#37; confidence intervals &#40;CI&#41; for continuous variables&#46; Normality was assessed using the histogram&#44; normal <span class="elsevierStyleItalic">Q</span>&#8211;<span class="elsevierStyleItalic">Q</span> plots and the Kolmogorov&#8211;Smirnov test&#46; Two independent group comparisons were performed by the Student&#39;s <span class="elsevierStyleItalic">t</span>-test and Mann&#8211;Whitney <span class="elsevierStyleItalic">U</span> test for continuous variables with and without normal distributions&#44; respectively&#46; Categorical variables were compared by the chi-square test&#46; In addition&#44; logistic regression analyses were performed to determine the effect of DQ and DAL on IR&#46; The non-IR category was considered the reference group&#44; and age was controlled in the regression models&#46; All potential confounding variables &#40;age&#44; gender&#44; etc&#46;&#41; were considered separately using the univariate analysis&#44; and any variables having a significant Wald test at a level of 0&#46;25 were selected for the multivariate analysis&#46;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">21</span></a> Each potential confounder was also tested in the multivariate models and was retained as a confounding variable if it was significant and increased Nagelkerke <span class="elsevierStyleItalic">R</span><span class="elsevierStyleSup">2</span> values or modified the respective association substantially&#46; Odds ratios &#40;OR&#41; with 95&#37; CI were reported&#44; and <span class="elsevierStyleItalic">p</span> values<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05 were considered statistically significant for all data&#46;</p></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Results</span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Participant characteristics</span><p id="par0060" class="elsevierStylePara elsevierViewall">This study was conducted with 135 overweight children and adolescents &#40;40&#37; boys&#41;&#46; In order to determine the effect of IR&#44; the participants were divided into two groups&#58; those with IR and those without IR&#46; The age &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; and TMI &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; of the IR group were higher than the non-IR group&#44; while their gender and BMI <span class="elsevierStyleItalic">z</span>-scores were similar &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46; Furthermore&#44; serum triglyceride levels were higher &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;002&#41;&#44; and HDL-C levels were lower &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;003&#41; in the group with IR&#46; No differences were found in total cholesterol and LDL-C &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Dietary intake&#44; DQ&#44; and DAL</span><p id="par0065" class="elsevierStylePara elsevierViewall">The average daily intake of energy&#44; and macro- and micronutrients was similar between the IR and non-IR &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41; groups&#46; However&#44; the HEI-2015 score according to TUBER was lower in those with IR &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;021&#41;&#46; In the classification according to both the HEI-2015 and HEI-2015-TUBER scores&#44; the rate of those with poor DQ was higher in the IR group &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;034 and <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;037&#44; respectively&#41;&#46; In addition&#44; the PRAL and NEAP scores&#44; indicators of DAL&#44; were higher in the group with IR&#44; while this difference was statistically significant only for the NEAP scores &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;060 and <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;044&#44; respectively&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Associations of DQ and DAL with IR</span><p id="par0070" class="elsevierStylePara elsevierViewall">When DQ&#44; DAL and IR variables were modelled&#44; significant associations were observed in the logistic regression analysis &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46; An increase in the HEI-2015-TUBER score was associated with a decrease of 4&#46;2&#37; in the risk of IR &#40;OR 0&#46;958&#44; 95&#37; CI 0&#46;924&#44; 0&#46;994&#41;&#46; Furthermore&#44; greater PRAL &#40;OR 1&#46;033&#44; 95&#37; CI 1&#46;000&#44; 1&#46;067&#41; and NEAP &#40;OR 1&#46;025&#44; 95&#37; CI 1&#46;001&#44; 1&#46;051&#41; scores were associated with higher IR risk&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Discussion</span><p id="par0075" class="elsevierStylePara elsevierViewall">Obesity is a critical risk factor in the development of IR in both paediatric and adult groups&#46; It is known that IR increases the risk of T2D and cardiovascular disease associated with overweight&#46; IR is also an important component of metabolic syndrome&#44; and its incidence is increasing&#44; especially among obese children and adolescents&#46;<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">1&#44;22</span></a> On the other hand&#44; the eating habits of individuals may affect IR and the development of related complications&#46;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">23</span></a> Therefore&#44; determining the effects of DQ and DAL on IR may be useful for its prevention and treatment&#46; Our study aimed to determine the relationship of DQ and DAL with IR in overweight children and adolescents&#46; The present findings showed that DQ was lower and DAL was higher in those with IR&#46; Additionally&#44; an increase in DQ scores decreased the risk of IR&#44; while increased DAL scores were related to higher IR risk&#46; Considering the importance of preventing the risk of developing IR in childhood obesity&#44; these findings may guide the development of different strategies to improve the nutritional status of children&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Insulin resistance is a clinical condition in which the body&#39;s response to insulin is inadequate and glucose homeostasis cannot be provided effectively&#46;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">24</span></a> Studies have emphasised that children with IR are more prone to developing T2D&#44; metabolic syndrome and cardiovascular disease in the future&#46;<a class="elsevierStyleCrossRefs" href="#bib0330"><span class="elsevierStyleSup">25&#8211;27</span></a> Greater IR incidence is observed among overweight&#47;obese individuals<a class="elsevierStyleCrossRefs" href="#bib0345"><span class="elsevierStyleSup">28&#44;29</span></a> and a 4&#46;5 fold increased HOMA-IR score was recorded in adolescents with higher body fat percentages&#46;<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">30</span></a> For this reason&#44; the use of appropriate and economical screening tools to determine body fat percentage in childhood may provide effective interventions&#46; Although BMI is widely used&#44; it fails in some clinical evaluations because it cannot distinguish between fat and lean mass in the body&#46;<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">31</span></a> Peterson et al&#46;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">25</span></a> suggested that a new method&#44; the TMI&#44; predicts fat mass better&#46; TMI has also been suggested as an appropriate method for preventing cardiometabolic comorbidities and evaluating adiposity&#46;<a class="elsevierStyleCrossRef" href="#bib0365"><span class="elsevierStyleSup">32</span></a> In line with the literature&#44; in our study&#44; TMI was found to be higher in participants with IR even though there was no difference in BMI between those with IR and those without IR&#46; Therefore&#44; the use of TMI may be beneficial in patients more than 8 years old&#46; Furthermore&#44; since the evaluation of TMI in children is not dependent of age and puberty&#44; its use in the clinic may be more advantageous&#46;<a class="elsevierStyleCrossRefs" href="#bib0360"><span class="elsevierStyleSup">31&#44;32</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">Obese children and adolescents with IR tend to have a worse metabolic profile than those without IR&#44;<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">29</span></a> and higher serum triglyceride levels&#44; lower HDL-C levels and a positive correlation of TG&#47;HDL-C ratio with the HOMA-IR index have been reported&#46;<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">33</span></a> Similarly&#44; the present study showed that children and adolescents with IR have higher serum triglyceride levels and lower HDL-C levels&#46; Excess energy intake and a sedentary lifestyle a cause greater waist circumference and fatty liver with a rise in body fat in obese individuals&#46; Consequently&#44; more IR and pro-inflammatory cytokine production are observed&#46; This adverse profile results in increased plasma glucose&#44; triglyceride and blood pressure&#44; and decreased HDL-C level&#46;<a class="elsevierStyleCrossRef" href="#bib0375"><span class="elsevierStyleSup">34</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">It is known that the consumption of fruit&#44; vegetables and whole-grain foods that enhance DQ in obese individuals is protective against the risk of impaired glucose metabolism and the development of T2D&#46;<a class="elsevierStyleCrossRef" href="#bib0380"><span class="elsevierStyleSup">35</span></a> Therefore&#44; there is an increasing relevance in DQ to describe the relationship between childhood obesity and nutrition in the literature&#46;<a class="elsevierStyleCrossRefs" href="#bib0315"><span class="elsevierStyleSup">22&#44;36</span></a> High-energy&#44; high-fat and low-dietary fibre dietary habits that reduce DQ in childhood and adolescence were reported as associated with a higher risk of obesity&#46;<a class="elsevierStyleCrossRef" href="#bib0390"><span class="elsevierStyleSup">37</span></a> Additionally&#44; the DQ of obese children was found to be poor&#44;<a class="elsevierStyleCrossRef" href="#bib0395"><span class="elsevierStyleSup">38</span></a> and an increase in DQ scores was related to a reduced risk of IR&#46;<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">22</span></a> Consistent with the literature&#44; our results showed that DQ was lower&#44; and the rate of those with poor DQ was higher in overweight children and adolescents with IR compared to those without IR&#46; Furthermore&#44; a one-unit increase in the HEI-2015-TUBER score was found to be associated with a reduction of 4&#46;2&#37; in IR risk&#46; While consumption of vegetables&#44; fruit and whole grains is generally inadequate in this age group&#44; the energy&#44; saturated fat and sodium intake increase&#44; especially due to the high consumption of processed and packaged foods&#44; which leads to poor DQ&#46;<a class="elsevierStyleCrossRefs" href="#bib0390"><span class="elsevierStyleSup">37&#44;39</span></a> Given that compliance with healthy eating habits is efficient in reducing IR in overweight individuals&#44; paying attention to DQ during childhood and adolescence may help to decrease the risk of developing comorbidities and chronic diseases in later life&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Western-style diets with a poor DQ cause higher DAL and increase the risk of metabolic disorders&#44; as they contain more animal protein &#40;red meat&#44; processed meat products&#44; etc&#46;&#41; and less fruit and vegetables&#46;<a class="elsevierStyleCrossRefs" href="#bib0245"><span class="elsevierStyleSup">8&#44;9&#44;40</span></a> Acid-base balance is important in the development of metabolic disorders&#44;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">11</span></a> and it has been asserted that metabolic acidosis caused by rising DAL may increase IR&#46;<a class="elsevierStyleCrossRefs" href="#bib0405"><span class="elsevierStyleSup">40&#44;41</span></a> In a recent study&#44; DAL&#44; reflected by PRAL and NEAP scores&#44; has been determined to associate positively with IR risk in obese adults&#46;<a class="elsevierStyleCrossRef" href="#bib0410"><span class="elsevierStyleSup">41</span></a> However&#44; no studies on paediatric groups have been found in the literature&#46; To our knowledge&#44; this is the first research conducted on children and adolescents&#46; In line with the adult study&#44; the present findings indicated that obese individuals with IR had higher PRAL and NEAP scores than those without IR&#44; and a one-unit increase in DAL scores was related to a rise of approximately 3&#37; in IR risk&#46; Although the mechanisms of the relationships between diet-induced metabolic acidosis and IR remain unclear&#44; there are various possible explanations&#46; Firstly&#44; low blood pH could disrupt insulin binding to its receptors&#44; leading to IR&#46; Another mechanism is that metabolic acidosis stimulates the secretion of cortisol and suppresses adiponectin gene expression&#46; Chronically elevated cortisol levels and&#47;or low adiponectin levels may induce IR&#46;<a class="elsevierStyleCrossRef" href="#bib0410"><span class="elsevierStyleSup">41</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">This study had some limitations&#46; First&#44; a healthy control group was not included in our study&#46; Therefore&#44; the relationship between obesity and DQ or DAL could not be revealed&#46; Second&#44; there was no detailed information about the lifestyle habits of participants&#44; such as their physical activity&#46; Considering the effect of energy expenditure&#44; which plays an important role in the development of obesity&#44; associations between lifestyle factors and IR could not be determined&#46; However&#44; the present study is the first to assess the relationship between DAL&#44; as well as DQ&#44; and IR in overweight children and adolescents&#46; Our findings showed that although energy and nutrient intakes of those with IR and those without IR were similar&#44; high DAL and&#47;or low DQ scores were associated with an increased risk of IR&#46; These results indicate that for the prevention and treatment of IR in obese children and adolescents&#44; it may not be sufficient to control daily energy and nutrient intake and that the quality of diet should also be improved&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">In conclusion&#44; in contrast to Western-style diets&#44; adequate and balanced nutrition in overweight children is of great importance for both improving DQ and reducing DAL&#46; Thus&#44; by reducing the risk of IR it will be possible to contribute to both the improvement of metabolic control and the prevention of metabolic syndrome and cardiovascular diseases&#46; Therefore&#44; it would be beneficial to provide nutritional education to children and adolescents on the consumption of healthy foods such as vegetables&#44; fruit and whole grains&#44; instead of foods containing high energy&#44; saturated fat&#44; sugar and salt to help them acquire appropriate dietary habits&#46; Moreover&#44; well-planned and long-term studies are needed to clarify the relationship of DQ and DAL with IR in overweight children and adolescents&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Authors&#8217; contributions</span><p id="par0110" class="elsevierStylePara elsevierViewall">Z&#46;C&#46; designed the research protocol&#44; conducted the research and statistical analysis&#44; prepared the manuscript&#44; and had primary responsibility for the final content&#46; B&#46;E&#46; contributed to the data analysis and manuscript writing&#46; N&#46;H&#46; and S&#46;K&#46; contributed to the planning and management of the study and the data collection&#44; and reviewed the manuscript&#46; All authors read and approved the final manuscript&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Funding</span><p id="par0115" class="elsevierStylePara elsevierViewall">This research did not receive any specific grant from funding agencies in the public&#44; commercial or not-for-profit sectors&#46;</p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Conflicts of interest</span><p id="par0120" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:13 [
        0 => array:3 [
          "identificador" => "xres1729861"
          "titulo" => "Abstract"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Introduction"
            ]
            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Materials and methods"
            ]
            2 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "Results"
            ]
            3 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Conclusions"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec1527036"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres1729860"
          "titulo" => "Resumen"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Introducci&#243;n"
            ]
            1 => array:2 [
              "identificador" => "abst0030"
              "titulo" => "Materiales y m&#233;todos"
            ]
            2 => array:2 [
              "identificador" => "abst0035"
              "titulo" => "Resultados"
            ]
            3 => array:2 [
              "identificador" => "abst0040"
              "titulo" => "Conclusiones"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec1527037"
          "titulo" => "Palabras clave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:3 [
          "identificador" => "sec0010"
          "titulo" => "Materials and methods"
          "secciones" => array:7 [
            0 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Study population"
            ]
            1 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Anthropometric measurements"
            ]
            2 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "Clinical assessment"
            ]
            3 => array:2 [
              "identificador" => "sec0030"
              "titulo" => "Dietary assessment"
            ]
            4 => array:2 [
              "identificador" => "sec0035"
              "titulo" => "Determining diet quality"
            ]
            5 => array:2 [
              "identificador" => "sec0040"
              "titulo" => "Dietary acid load calculation"
            ]
            6 => array:2 [
              "identificador" => "sec0045"
              "titulo" => "Statistical analyses"
            ]
          ]
        ]
        6 => array:3 [
          "identificador" => "sec0050"
          "titulo" => "Results"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0055"
              "titulo" => "Participant characteristics"
            ]
            1 => array:2 [
              "identificador" => "sec0060"
              "titulo" => "Dietary intake&#44; DQ&#44; and DAL"
            ]
            2 => array:2 [
              "identificador" => "sec0065"
              "titulo" => "Associations of DQ and DAL with IR"
            ]
          ]
        ]
        7 => array:2 [
          "identificador" => "sec0070"
          "titulo" => "Discussion"
        ]
        8 => array:2 [
          "identificador" => "sec0075"
          "titulo" => "Authors&#8217; contributions"
        ]
        9 => array:2 [
          "identificador" => "sec0080"
          "titulo" => "Funding"
        ]
        10 => array:2 [
          "identificador" => "sec0085"
          "titulo" => "Conflicts of interest"
        ]
        11 => array:2 [
          "identificador" => "xack610430"
          "titulo" => "Acknowledgements"
        ]
        12 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2021-05-10"
    "fechaAceptado" => "2021-07-28"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1527036"
          "palabras" => array:6 [
            0 => "Adolescent"
            1 => "Child"
            2 => "Diet quality"
            3 => "Dietary acid load"
            4 => "Insulin resistance"
            5 => "Overweight"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec1527037"
          "palabras" => array:6 [
            0 => "Adolescente"
            1 => "Ni&#241;o"
            2 => "Calidad de la dieta"
            3 => "Carga &#225;cida de la dieta"
            4 => "Resistencia a la insulina"
            5 => "Sobrepeso"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">This study aimed to investigate the association of diet quality &#40;DQ&#41; and dietary acid load &#40;DAL&#41; with insulin resistance &#40;IR&#41; in overweight children and adolescents&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Materials and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The study was conducted on 135 overweight participants aged 6&#8211;17 years&#46; DQ was assessed using the Healthy Eating Index 2015 &#40;HEI-2015&#41; and the HEI-2015-TUBER&#44; revised in accordance with the Turkey Dietary Guidelines &#40;TUBER&#41;&#46; Estimation of DAL was made calculating the potential renal acid load &#40;PRAL&#41; and net endogenous acid production &#40;NEAP&#41; scores&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The HEI-2015-TUBER score was lower in those with IR than in those without IR &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;021&#41;&#46; Higher PRAL and NEAP scores were found in those with IR &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;060 and <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;044&#44; respectively&#41;&#46; Moreover&#44; a one-unit increase in the HEI-2015-TUBER score and the DAL score was associated with a reduction of 4&#46;2&#37; and a rise of approximately 3&#37; in IR risk&#44; respectively&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Healthy eating habits in overweight paediatric groups may help to reduce the IR risk&#44; improving DQ and decreasing DAL&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introduction"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Materials and methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusions"
          ]
        ]
      ]
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducci&#243;n</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Este estudio tuvo como objetivo investigar la asociaci&#243;n de la calidad de la dieta &#40;CD&#41; y la carga &#225;cida de la dieta &#40;CAD&#41; con la resistencia a la insulina &#40;RI&#41; en ni&#241;os y adolescentes con sobrepeso&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Materiales y m&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">El estudio se realiz&#243; en 135 participantes con sobrepeso de entre 6-17 a&#241;os&#46; La CD se evalu&#243; utilizando el &#237;ndice de alimentaci&#243;n saludable &#40;HEI&#41;-2015 y el HEI-2015-TUBER&#44; revisado de acuerdo con las Pautas Diet&#233;ticas de Turqu&#237;a &#40;TUBER&#41;&#46; La estimaci&#243;n de la CAD se realiz&#243; calculando las puntuaciones de carga de &#225;cido renal potencial &#40;PRAL&#41; y la producci&#243;n neta de &#225;cido end&#243;geno &#40;NEAP&#41;&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">La puntuaci&#243;n HEI-2015-TUBER fue m&#225;s baja en aquellos con RI que en los que no ten&#237;an RI &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;021&#41;&#46; Se encontraron puntuaciones PRAL y NEAP m&#225;s altas en aquellos con RI &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;060 y p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;044&#44; respectivamente&#41;&#46; Adem&#225;s&#44; un aumento de una unidad en la puntuaci&#243;n HEI-2015-TUBER y las puntuaciones de la CAD se asoci&#243; con una reducci&#243;n del 4&#44;2&#37; y un aumento de aproximadamente el 3&#37; en el riesgo de RI&#44; respectivamente&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Los h&#225;bitos alimenticios saludables en los grupos pedi&#225;tricos con sobrepeso pueden ayudar a reducir el riesgo de RI mejorando la CD y disminuyendo la CAD&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Introducci&#243;n"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Materiales y m&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
    ]
    "multimedia" => array:3 [
      0 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Abbreviations&#58; BMI&#44; body mass index&#59; HDL-C&#44; high density lipoprotein cholesterol&#59; IR&#44; insulin resistance&#59; LDL-C&#44; low density lipoprotein cholesterol&#59; TMI&#44; tri-ponderal mass index&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:1 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variables<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Non-IR&#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>77&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">IR&#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>58&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span><a class="elsevierStyleCrossRef" href="#tblfn0015">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Gender &#40;male&#41;&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 &#40;39&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24 &#40;41&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;776&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Age &#40;years&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#46;82 &#40;10&#46;12&#44; 11&#46;51&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#46;45 &#40;11&#46;87&#44; 13&#46;02&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">BMI-<span class="elsevierStyleItalic">Z</span> score &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;61 &#40;2&#46;44&#44; 2&#46;77&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;80 &#40;2&#46;65&#44; 2&#46;95&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;098&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">TMI &#40;kg&#47;m<span class="elsevierStyleSup">3</span>&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&#46;93 &#40;17&#46;49&#44; 18&#46;36&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19&#46;21 &#40;18&#46;59&#44; 19&#46;82&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Glucose &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">84&#46;91 &#40;83&#46;27&#44; 86&#46;55&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">89&#46;34 &#40;87&#46;11&#44; 91&#46;58&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Insulin &#40;&#956;U&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#46;76 &#40;9&#46;06&#44; 10&#46;46&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#46;90 &#40;23&#46;06&#44; 30&#46;74&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HOMA-IR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;05 &#40;1&#46;90&#44; 2&#46;19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46;98 &#40;5&#46;05&#44; 6&#46;90&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Triglycerides &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">101&#46;93 &#40;90&#46;81&#44; 113&#46;06&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">126&#46;52 &#40;113&#46;22&#44; 139&#46;81&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;002<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Total cholesterol &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">175&#46;13 &#40;168&#46;44&#44; 181&#46;82&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">181&#46;67 &#40;174&#46;24&#44; 189&#46;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;195&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HDL-C &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">46&#46;77 &#40;44&#46;19&#44; 49&#46;35&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">41&#46;56 &#40;39&#46;15&#44; 43&#46;97&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;003<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">LDL-C &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">108&#46;38 &#40;102&#46;81&#44; 113&#46;95&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">116&#46;52 &#40;108&#46;44&#44; 124&#46;59&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;090&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
            ]
          ]
          "notaPie" => array:4 [
            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Values were given as mean and 95&#37; confidence interval unless otherwise indicated&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0010"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Children less than 8 years old were excluded from the analysis&#46;</p>"
            ]
            2 => array:3 [
              "identificador" => "tblfn0015"
              "etiqueta" => "&#42;"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Student&#39;s <span class="elsevierStyleItalic">t</span>-test&#46;</p>"
            ]
            3 => array:3 [
              "identificador" => "tblfn0020"
              "etiqueta" => "&#42;&#42;"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0020">Mann&#8211;Whitney <span class="elsevierStyleItalic">U</span> test&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Participants&#8217; characteristics and biochemical parameters&#46;</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Abbreviations&#58; HEI&#44; healthy eating index&#59; IR&#44; insulin resistance&#59; PRAL&#44; potential renal acid load&#59; NEAP&#44; net endogenous acid production&#59; TUBER&#44; Turkey Dietary Guidelines&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:1 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variables<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Non-IR&#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>77&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">IR&#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>58&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span><a class="elsevierStyleCrossRef" href="#tblfn0030">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Energy &#40;kcal&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1874&#46;63 &#40;1752&#46;65&#44; 1996&#46;61&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1946&#46;81 &#40;1806&#46;24&#44; 2087&#46;38&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;440&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Carbohydrates &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50&#46;27 &#40;48&#46;94&#44; 51&#46;60&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">51&#46;30 &#40;49&#46;55&#44; 53&#46;04&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;343&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Proteins &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#46;89 &#40;13&#46;37&#44; 14&#46;42&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#46;83 &#40;13&#46;21&#44; 14&#46;45&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;875&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Fats &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35&#46;84 &#40;34&#46;74&#44; 36&#46;94&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34&#46;92 &#40;33&#46;33&#44; 36&#46;51&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;327&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Vitamin B<span class="elsevierStyleInf">1</span> &#40;mg&#47;1000<span class="elsevierStyleHsp" style=""></span>kcal&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;81 &#40;0&#46;75&#44; 0&#46;88&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;78 &#40;0&#46;72&#44; 0&#46;85&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;488&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Vitamin B<span class="elsevierStyleInf">2</span> &#40;mg&#47;1000<span class="elsevierStyleHsp" style=""></span>kcal&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;26 &#40;1&#46;17&#44; 1&#46;34&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;23 &#40;1&#46;12&#44; 1&#46;34&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;716&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Vitamin B<span class="elsevierStyleInf">6</span> &#40;mg&#47;1000<span class="elsevierStyleHsp" style=""></span>kcal&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;26 &#40;1&#46;11&#44; 1&#46;41&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;20 &#40;1&#46;11&#44; 1&#46;29&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;906<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Folic Acid &#40;mcg&#47;1000<span class="elsevierStyleHsp" style=""></span>kcal&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">257&#46;95 &#40;238&#46;35&#44; 277&#46;54&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">257&#46;64 &#40;235&#46;68&#44; 279&#46;59&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;983&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Vitamin B<span class="elsevierStyleInf">12</span> &#40;mcg&#47;1000<span class="elsevierStyleHsp" style=""></span>kcal&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;86 &#40;3&#46;35&#44; 4&#46;37&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;54 &#40;2&#46;90&#44; 4&#46;18&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;268<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Vitamin E &#40;mg&#47;1000<span class="elsevierStyleHsp" style=""></span>kcal&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#46;67 &#40;16&#46;90&#44; 20&#46;43&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#46;43 &#40;16&#46;37&#44; 20&#46;48&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;773<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Vitamin C &#40;mg&#47;1000<span class="elsevierStyleHsp" style=""></span>kcal&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">104&#46;07 &#40;92&#46;95&#44; 115&#46;19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&#46;28 &#40;87&#46;27&#44; 113&#46;29&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;594<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Calcium &#40;mg&#47;1000<span class="elsevierStyleHsp" style=""></span>kcal&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">676&#46;23 &#40;621&#46;51&#44; 730&#46;96&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">666&#46;58 &#40;597&#46;79&#44; 735&#46;38&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;825&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Magnesium &#40;mg&#47;1000<span class="elsevierStyleHsp" style=""></span>kcal&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">236&#46;90 &#40;219&#46;36&#44; 254&#46;45&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">229&#46;77 &#40;210&#46;57&#44; 248&#46;98&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;588&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Iron &#40;mg&#47;1000<span class="elsevierStyleHsp" style=""></span>kcal&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#46;29 &#40;9&#46;60&#44; 10&#46;98&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#46;56 &#40;9&#46;92&#44; 11&#46;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;585&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Zinc &#40;mg&#47;1000<span class="elsevierStyleHsp" style=""></span>kcal&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;84 &#40;8&#46;25&#44; 9&#46;44&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;98 &#40;8&#46;27&#44; 9&#46;70&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;766&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HEI-2015 score&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">47&#46;87 &#40;45&#46;86&#44; 49&#46;87&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45&#46;63 &#40;43&#46;65&#44; 47&#46;62&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;124&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HEI-2015 score classification &#40;poor&#41;&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42 &#40;54&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42 &#40;72&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;034&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HEI-2015-TUBER score&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">38&#46;69 &#40;36&#46;29&#44; 41&#46;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34&#46;61 &#40;32&#46;18&#44; 37&#46;04&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;021&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HEI-2015-TUBER score classification &#40;poor&#41;&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">64 &#40;83&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">55 &#40;95&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;037&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PRAL &#40;mEq&#47;day&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;68 &#40;6&#46;17&#44; 11&#46;19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#46;49 &#40;9&#46;30&#44; 15&#46;67&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;060&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NEAP &#40;mEq&#47;day&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">53&#46;02 &#40;49&#46;77&#44; 56&#46;28&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">58&#46;33 &#40;54&#46;16&#44; 62&#46;49&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;044&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
            ]
          ]
          "notaPie" => array:3 [
            0 => array:3 [
              "identificador" => "tblfn0025"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0025">Values were given as mean and 95&#37; confidence interval unless otherwise indicated&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0030"
              "etiqueta" => "&#42;"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0030">Student&#39;s <span class="elsevierStyleItalic">t</span>-test&#46;</p>"
            ]
            2 => array:3 [
              "identificador" => "tblfn0035"
              "etiqueta" => "&#42;&#42;"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0035">Mann&#8211;Whitney <span class="elsevierStyleItalic">U</span> test&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Participants&#8217; energy and nutrient intakes&#44; diet quality and dietary acid load&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at3"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Abbreviations&#58; HEI&#44; healthy eating index&#59; IR&#44; insulin resistance&#59; PRAL&#44; potential renal acid load&#59; NEAP&#44; net endogenous acid production&#59; TUBER&#44; Turkey Dietary Guidelines&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:1 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variables<a class="elsevierStyleCrossRef" href="#tblfn0040"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">IROR &#40;95&#37; Cl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HEI-2015 score&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;964 &#40;0&#46;922&#44; 1&#46;007&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;099<a class="elsevierStyleCrossRef" href="#tblfn0045">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HEI-2015-TUBER score&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;958 &#40;0&#46;924&#44; 0&#46;994&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;023<a class="elsevierStyleCrossRef" href="#tblfn0045">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PRAL &#40;mEq&#47;day&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;033 &#40;1&#46;000&#44; 1&#46;067&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;047<a class="elsevierStyleCrossRef" href="#tblfn0045">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NEAP &#40;mEq&#47;day&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;025 &#40;1&#46;001&#44; 1&#46;051&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;045<a class="elsevierStyleCrossRef" href="#tblfn0045">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
            ]
          ]
          "notaPie" => array:2 [
            0 => array:3 [
              "identificador" => "tblfn0040"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0040">Values are odds ratio &#40;95&#37; confidence interval&#41; estimated through logistic regression using the non-IR group as reference&#46; All models were adjusted for age&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0045"
              "etiqueta" => "&#42;"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0045"><span class="elsevierStyleItalic">p</span>-for trend<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Association of dietary acid load and diet quality scores with risk of insulin resistance&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:41 [
            0 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Obesity and insulin resistance in children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "V&#46;M&#46; Tagi"
                            1 => "F&#46; Chiarelli"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/MOP.0000000000000913"
                      "Revista" => array:6 [
                        "tituloSerie" => "Curr Opin Pediatr"
                        "fecha" => "2020"
                        "volumen" => "32"
                        "paginaInicial" => "582"
                        "paginaFinal" => "588"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32520824"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Obesity in children and adolescents"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46;M&#46; Cali"
                            1 => "S&#46; Caprio"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1210/jc.2008-1363"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Endocrinol Metab"
                        "fecha" => "2008"
                        "volumen" => "93"
                        "numero" => "Suppl&#46; 1"
                        "paginaInicial" => "s31"
                        "paginaFinal" => "s36"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Association between diet quality and obesity indicators among the working-age adults in Inner Mongolia Northern China&#58; a cross-sectional study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "L&#46; Jia"
                            1 => "H&#46; Lu"
                            2 => "J&#46; Wu"
                            3 => "X&#46; Wang"
                            4 => "W&#46; Wang"
                            5 => "M&#46; Du"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/s12889-020-09281-5"
                      "Revista" => array:5 [
                        "tituloSerie" => "BMC Public Health"
                        "fecha" => "2020"
                        "volumen" => "20"
                        "paginaInicial" => "1"
                        "paginaFinal" => "10"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Inverse association between regular milk consumption and insulin resistance in obese children and adolescents"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "Z&#46; Caferoglu"
                            1 => "N&#46; Hatipoglu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Nutr Diet"
                        "fecha" => "2017"
                        "volumen" => "45"
                        "paginaInicial" => "12"
                        "paginaFinal" => "19"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dietary support in insulin resistance&#58; an overview of current scientific reports"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "K&#46;D&#46; Golabek"
                            1 => "B&#46; Regulska-Ilow"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.17219/acem/109976"
                      "Revista" => array:6 [
                        "tituloSerie" => "Adv Clin Exp Med"
                        "fecha" => "2019"
                        "volumen" => "28"
                        "paginaInicial" => "1577"
                        "paginaFinal" => "1585"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31756065"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dietary patterns and breakfast consumption in relation to insulin resistance in children&#46; The Healthy Growth Study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "K&#46; Karatzi"
                            1 => "G&#46; Moschonis"
                            2 => "A&#46;-A&#46; Barouti"
                            3 => "C&#46; Lionis"
                            4 => "G&#46;P&#46; Chrousos"
                            5 => "Y&#46; Manios"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1017/s1368980013003327"
                      "Revista" => array:6 [
                        "tituloSerie" => "Public Health Nutr"
                        "fecha" => "2014"
                        "volumen" => "17"
                        "paginaInicial" => "2790"
                        "paginaFinal" => "2797"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24477051"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluation of the Healthy Eating Index &#40;HEI-2010&#41; of obese adolescent children&#58; a tertiary hospital experience"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "K&#46; Nevra"
                            1 => "H&#46; Yard&#305;mc&#305;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.12956/tjpd.2017.309"
                      "Revista" => array:5 [
                        "tituloSerie" => "Turk J Pediatr Dis"
                        "fecha" => "2017"
                        "volumen" => "12"
                        "paginaInicial" => "155"
                        "paginaFinal" => "162"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The role of dietary acid load and mild metabolic acidosis in insulin resistance in humans"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46;S&#46; Williams"
                            1 => "P&#46; Kozan"
                            2 => "D&#46; Samocha-Bonet"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.clnu.2015.08.002"
                      "Revista" => array:6 [
                        "tituloSerie" => "Biochimie"
                        "fecha" => "2016"
                        "volumen" => "124"
                        "paginaInicial" => "171"
                        "paginaFinal" => "177"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26363101"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Association of dietary acid load with anthropometric indices in children and adolescents"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "Z&#46; Aslani"
                            1 => "M&#46; Bahreynian"
                            2 => "N&#46; Namazi"
                            3 => "N&#46; Shivappa"
                            4 => "J&#46;R&#46; Hebert"
                            5 => "M&#46;E&#46; Asayesh"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s40519-020-00883-x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eat Weight Disord"
                        "fecha" => "2021"
                        "volumen" => "26"
                        "paginaInicial" => "555"
                        "paginaFinal" => "567"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32172506"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dietary acid load&#58; a novel nutritional target in overweight&#47;obese children with asthma&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46; Cunha"
                            1 => "I&#46; Paciencia"
                            2 => "J&#46; Cavaleiro Rufo"
                            3 => "F&#46; Castro Mendes"
                            4 => "M&#46; Farraia"
                            5 => "R&#46; Barros"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3390/nu11092255"
                      "Revista" => array:4 [
                        "tituloSerie" => "Nutrients"
                        "fecha" => "2019"
                        "volumen" => "11"
                        "paginaInicial" => "2255"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Increased body fatness adversely relates to 24-h urine pH during childhood and adolescence&#58; evidence of an adipo-renal axis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "Y&#46; Hua"
                            1 => "D&#46; Krupp"
                            2 => "J&#46; Esche"
                            3 => "T&#46; Remer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/ajcn/nqy379"
                      "Revista" => array:5 [
                        "tituloSerie" => "J Am Diet Assoc"
                        "fecha" => "2019"
                        "volumen" => "109"
                        "paginaInicial" => "1279"
                        "paginaFinal" => "1287"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0265"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Higher dietary acid load is weakly associated with higher adiposity measures and blood pressure in Japanese adults&#58; The National Health and Nutrition Survey"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "K&#46; Murakami"
                            1 => "M&#46;B&#46;E&#46; Livingstone"
                            2 => "H&#46; Okubo"
                            3 => "S&#46; Sasaki"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.nutres.2017.06.005"
                      "Revista" => array:6 [
                        "tituloSerie" => "Nutr Res"
                        "fecha" => "2017"
                        "volumen" => "44"
                        "paginaInicial" => "67"
                        "paginaFinal" => "75"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28821319"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0270"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Association between dietary acid load and insulin resistance&#58; Tehran Lipid and Glucose Study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "S&#46;K&#46; Moghadam"
                            1 => "Z&#46; Bahadoran"
                            2 => "P&#46; Mirmiran"
                            3 => "M&#46; Tohidi"
                            4 => "F&#46; Azizi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3746/pnf.2016.21.2.104"
                      "Revista" => array:5 [
                        "tituloSerie" => "Prev Nutr Food Sci"
                        "fecha" => "2016"
                        "volumen" => "21"
                        "paginaInicial" => "104"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27390726"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0275"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Reference values for weight&#44; height&#44; head circumference&#44; and body mass index in Turkish children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "O&#46; Neyzi"
                            1 => "R&#46; Bundak"
                            2 => "G&#46; Gokcay"
                            3 => "H&#46; Gunoz"
                            4 => "A&#46; Furman"
                            5 => "F&#46; Darendeliler"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.4274/jcrpe.2183"
                      "Revista" => array:4 [
                        "tituloSerie" => "J Clin Res Pediatr Endocrinol"
                        "fecha" => "2015"
                        "volumen" => "7"
                        "paginaInicial" => "280"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0280"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Homeostasis model assessment is more reliable than the fasting glucose&#47;insulin ratio and quantitative insulin sensitivity check index for assessing insulin resistance among obese children and adolescents"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46; Keskin"
                            1 => "S&#46; Kurtoglu"
                            2 => "M&#46; Kendirci"
                            3 => "M&#46;E&#46; Atabek"
                            4 => "C&#46; Yazici"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1542/peds.2004-1921"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatrics"
                        "fecha" => "2005"
                        "volumen" => "115"
                        "paginaInicial" => "e500"
                        "paginaFinal" => "e503"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15741351"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0285"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Insulin resistance determined by Homeostasis Model Assessment &#40;HOMA&#41; and associations with metabolic syndrome among Chinese children and teenagers"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Yin"
                            1 => "M&#46; Li"
                            2 => "L&#46; Xu"
                            3 => "Y&#46; Wang"
                            4 => "H&#46; Cheng"
                            5 => "X&#46; Zhao"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/1758-5996-5-71"
                      "Revista" => array:5 [
                        "tituloSerie" => "Diabetol Metab Syndr"
                        "fecha" => "2013"
                        "volumen" => "5"
                        "paginaInicial" => "1"
                        "paginaFinal" => "9"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0290"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Update of the healthy eating index&#58; HEI-2015"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46;M&#46; Krebs-Smith"
                            1 => "T&#46;E&#46; Pannucci"
                            2 => "A&#46;F&#46; Subar"
                            3 => "S&#46; Kirkpatrick"
                            4 => "J&#46; Lerman"
                            5 => "J&#46; Tooze"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jand.2018.05.021"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Acad Nutr Diet"
                        "fecha" => "2018"
                        "volumen" => "118"
                        "paginaInicial" => "1591"
                        "paginaFinal" => "1602"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30146071"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0295"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Turkey dietary guidelines"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46;G&#46; Pekcan"
                            1 => "N&#46; Sanl&#305;er"
                            2 => "M&#46; Bas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2016"
                        "editorial" => "Ministry of Turkey Health Publication"
                        "editorialLocalizacion" => "Ankara"
                      ]
                    ]
                    1 => array:1 [
                      "WWW" => array:1 [
                        "link" => "https&#58;&#47;&#47;hsgm&#46;saglik&#46;gov&#46;tr&#47;depo&#47;birimler&#47;saglikli-beslenme-hareketli-hayat-db&#47;Yayinlar&#47;kitaplar&#47;Kitaplar-eski&#47;Turkiye-Beslenme-Rehberi-ingilizce&#46;pdf"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0300"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Potential renal acid load of foods and its influence on urine pH"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "T&#46; Remer"
                            1 => "F&#46; Manz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0002-8223(95)00219-7"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Diet Assoc"
                        "fecha" => "1995"
                        "volumen" => "95"
                        "paginaInicial" => "791"
                        "paginaFinal" => "797"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7797810"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0305"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Estimation of net endogenous noncarbonic acid production in humans from diet potassium and protein contents"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "L&#46;A&#46; Frassetto"
                            1 => "K&#46;M&#46; Todd"
                            2 => "R&#46;C&#46; Morris Jr&#46;"
                            3 => "A&#46; Sebastian"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/ajcn/68.3.576"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Clin Nutr"
                        "fecha" => "1998"
                        "volumen" => "68"
                        "paginaInicial" => "576"
                        "paginaFinal" => "583"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9734733"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0310"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Purposeful selection of variables in logistic regression"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "Z&#46; Bursac"
                            1 => "C&#46;H&#46; Gauss"
                            2 => "D&#46;K&#46; Williams"
                            3 => "D&#46;W&#46; Hosmer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/1751-0473-3-17"
                      "Revista" => array:5 [
                        "tituloSerie" => "Source Code Biol Med"
                        "fecha" => "2008"
                        "volumen" => "3"
                        "paginaInicial" => "1"
                        "paginaFinal" => "8"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0315"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The relationship between diet quality and insulin resistance in obese children&#58; adaptation of the Healthy Lifestyle-Diet Index in Turkey"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "Y&#46;E&#46; Ozturk"
                            1 => "R&#46; Bozbulut"
                            2 => "E&#46; Doger"
                            3 => "A&#46; Bideci"
                            4 => "E&#46; Koksal"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1515/jpem-2017-0271"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediatr Endocrinol Metab"
                        "fecha" => "2018"
                        "volumen" => "31"
                        "paginaInicial" => "391"
                        "paginaFinal" => "398"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29494339"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0320"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Insulin resistance in obese children and adolescents&#58; HOMA-IR cut-off levels in the prepubertal and pubertal periods"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "S&#46; Kurtoglu"
                            1 => "N&#46; Hatipoglu"
                            2 => "M&#46; Maz&#305;c&#305;oglu"
                            3 => "M&#46; Kendirici"
                            4 => "M&#46; Keskin"
                            5 => "M&#46; Kondolot"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.4274/jcrpe.v2i3.100"
                      "Revista" => array:5 [
                        "tituloSerie" => "J Clin Res Pediatr Endocrinol"
                        "fecha" => "2010"
                        "volumen" => "2"
                        "paginaInicial" => "100"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21274322"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0325"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Association between frequency of breakfast consumption and insulin resistance using triglyceride-glucose index&#58; a cross-sectional study of the Korea National Health and Nutrition Examination Survey &#40;2016&#8211;2018&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "H&#46;J&#46; Joo"
                            1 => "G&#46;R&#46; Kim"
                            2 => "E&#46;-C&#46; Park"
                            3 => "S&#46;-I&#46; Jang"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3390/ijerph17093322"
                      "Revista" => array:4 [
                        "tituloSerie" => "Int J Environ Res Public Health"
                        "fecha" => "2020"
                        "volumen" => "17"
                        "paginaInicial" => "3322"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0330"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Tri-ponderal mass index vs body mass index in estimating body fat during adolescence"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46;M&#46; Peterson"
                            1 => "H&#46; Su"
                            2 => "D&#46;M&#46; Thomas"
                            3 => "M&#46; Heo"
                            4 => "A&#46; Golnabi"
                            5 => "A&#46; Pietrobelli"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jamapediatrics.2017.0460"
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA Pediatr"
                        "fecha" => "2017"
                        "volumen" => "171"
                        "paginaInicial" => "629"
                        "paginaFinal" => "636"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28505241"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0335"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence of insulin resistance and impaired glucose tolerance in a sample of obese Spanish children and adolescents"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Bahillo-Curieses"
                            1 => "F&#46; Hermoso-L&#243;pez"
                            2 => "M&#46; Martinez-Sopena"
                            3 => "P&#46; Cobreros-Garcia"
                            4 => "P&#46; Garcia-Saseta"
                            5 => "M&#46; Trigues-Garcia"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s12020-011-9540-8"
                      "Revista" => array:6 [
                        "tituloSerie" => "Endocrine"
                        "fecha" => "2012"
                        "volumen" => "41"
                        "paginaInicial" => "289"
                        "paginaFinal" => "295"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21964644"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0340"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hyperinsulinism assessment in a sample of prepubescent children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "S&#46;F&#46;A&#46; Mieldazis"
                            1 => "L&#46;A&#46; Azzalis"
                            2 => "V&#46;B&#46;C&#46; Junqueira"
                            3 => "F&#46;I&#46;S&#46; Souza"
                            4 => "R&#46;O&#46;S&#46; Sarni"
                            5 => "F&#46;L&#46;A&#46; Fonseca"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2223/jped.1993"
                      "Revista" => array:5 [
                        "tituloSerie" => "J Pediatr &#40;Rio J&#41;"
                        "fecha" => "2010"
                        "volumen" => "86"
                        "paginaInicial" => "245"
                        "paginaFinal" => "249"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0345"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A study of insulin resistance by HOMA-IR and its cut-off value to identify metabolic syndrome in urban Indian adolescents"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "Y&#46; Singh"
                            1 => "M&#46; Garg"
                            2 => "N&#46; Tandon"
                            3 => "R&#46;K&#46; Marwaha"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.4274/jcrpe.1127"
                      "Revista" => array:5 [
                        "tituloSerie" => "J Clin Res Pediatr Endocrinol"
                        "fecha" => "2013"
                        "volumen" => "5"
                        "paginaInicial" => "245"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24379034"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0350"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Metabolic profiles in obese children and adolescents with insulin resistance"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46; Kostovski"
                            1 => "V&#46; Simeonovski"
                            2 => "K&#46; Mironska"
                            3 => "V&#46; Tasic"
                            4 => "Z&#46; Gucev"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3889/oamjms.2018.097"
                      "Revista" => array:5 [
                        "tituloSerie" => "Open Access Maced J Med Sci"
                        "fecha" => "2018"
                        "volumen" => "6"
                        "paginaInicial" => "511"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29610610"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0355"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Body composition&#44; biochemical and clinical changes of adolescents with excessive adiposity"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "H&#46;M&#46;S&#46; Serrano"
                            1 => "G&#46;Q&#46; Carvalho"
                            2 => "P&#46;F&#46; Pereira"
                            3 => "M&#46;d&#46;C&#46;G&#46; Peluzio"
                            4 => "S&#46;d&#46;C&#46;C&#46; Franceschini"
                            5 => "S&#46;E&#46; Priore"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1590/s0066-782x2010005000109"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arq Bras Cardiol"
                        "fecha" => "2010"
                        "volumen" => "95"
                        "paginaInicial" => "464"
                        "paginaFinal" => "472"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20721518"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0360"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Accuracy of tri-ponderal mass index and body mass index in estimating insulin resistance&#44; hyperlipidemia&#44; impaired liver enzymes or thyroid hormone function and vitamin D levels in children and adolescents"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "N&#46; Akcan"
                            1 => "R&#46; Bundak"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.4274/jcrpe.galenos.2019.2018.0279"
                      "Revista" => array:5 [
                        "tituloSerie" => "J Clin Res Pediatr Endocrinol"
                        "fecha" => "2019"
                        "volumen" => "11"
                        "paginaInicial" => "366"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30991791"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib0365"
              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Leptin is associated with the tri-ponderal mass index in children&#58; a cross-sectional study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "B&#46; Empringham"
                            1 => "W&#46;J&#46; Jennings"
                            2 => "R&#46; Rajan"
                            3 => "A&#46; Flemin"
                            4 => "C&#46; Portwine"
                            5 => "D&#46; Johnston"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2147/ahmt.s289973"
                      "Revista" => array:5 [
                        "tituloSerie" => "Adolesc Health Med Ther"
                        "fecha" => "2021"
                        "volumen" => "12"
                        "paginaInicial" => "9"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33727877"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib0370"
              "etiqueta" => "33"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Triglyceride to HDL-C ratio is associated with insulin resistance in overweight and obese children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "N&#46;A&#46;K&#46;Z&#46; Iwani"
                            1 => "M&#46;Y&#46; Jalaludin"
                            2 => "R&#46;M&#46;W&#46;M&#46; Zin"
                            3 => "M&#46;Z&#46; Fuziah"
                            4 => "J&#46;Y&#46;H&#46; Hong"
                            5 => "Y&#46; Abqariyah"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/srep40055"
                      "Revista" => array:6 [
                        "tituloSerie" => "Sci Rep"
                        "fecha" => "2017"
                        "volumen" => "7"
                        "paginaInicial" => "1"
                        "paginaFinal" => "7"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28127051"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib0375"
              "etiqueta" => "34"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Insulin resistance&#44; prediabetes&#44; metabolic syndrome&#58; what should every pediatrician know&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46; Ighbariya"
                            1 => "R&#46; Weiss"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.4274/jcrpe.2017.s005"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Res Pediatr Endocrinol"
                        "fecha" => "2017"
                        "volumen" => "9"
                        "numero" => "Suppl&#46; 2"
                        "paginaInicial" => "49"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29280741"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            34 => array:3 [
              "identificador" => "bib0380"
              "etiqueta" => "35"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Is metabolic health affected from dietary quality and sedentary time in obesity phenotypes&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "B&#46; Pelin"
                            1 => "S&#46; &#214;teles"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.21020/husbfd.541591"
                      "Revista" => array:5 [
                        "tituloSerie" => "Hacettepe Univ Fac Health Sci J"
                        "fecha" => "2019"
                        "volumen" => "6"
                        "paginaInicial" => "39"
                        "paginaFinal" => "54"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            35 => array:3 [
              "identificador" => "bib0385"
              "etiqueta" => "36"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Assessment of diet quality&#44; nutrient intake&#44; and dietary behaviours in obese children compared to healthy children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Koziol-Kozakowska"
                            1 => "M&#46; Kozlowska"
                            2 => "P&#46; Jagielski"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.5114/pedm.2020.93250"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Endocrinol Diabetes Metab"
                        "fecha" => "2020"
                        "volumen" => "26"
                        "paginaInicial" => "27"
                        "paginaFinal" => "38"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32272828"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            36 => array:3 [
              "identificador" => "bib0390"
              "etiqueta" => "37"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Childhood dietary patterns and later obesity&#58; a review of the evidence"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "G&#46;L&#46; Ambrosini"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1017/s0029665113003765"
                      "Revista" => array:7 [
                        "tituloSerie" => "Proc Nutr Soc"
                        "fecha" => "2014"
                        "volumen" => "73"
                        "paginaInicial" => "137"
                        "paginaFinal" => "146"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24280165"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S1053811919300540"
                          "estado" => "S300"
                          "issn" => "10538119"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            37 => array:3 [
              "identificador" => "bib0395"
              "etiqueta" => "38"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The use of a dietary quality score as a predictor of childhood overweight and obesity"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "C&#46;P&#46; Perry"
                            1 => "E&#46; Keane"
                            2 => "R&#46; Layte"
                            3 => "A&#46;P&#46; Fitzgerald"
                            4 => "I&#46;J&#46; Perry"
                            5 => "J&#46;M&#46; Harrington"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/s12889-015-1907-y"
                      "Revista" => array:5 [
                        "tituloSerie" => "BMC Public Health"
                        "fecha" => "2015"
                        "volumen" => "15"
                        "paginaInicial" => "1"
                        "paginaFinal" => "9"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            38 => array:3 [
              "identificador" => "bib0400"
              "etiqueta" => "39"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The independent association between diet quality and body composition"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "C&#46; Drenowatz"
                            1 => "R&#46;P&#46; Shook"
                            2 => "G&#46;A&#46; Hand"
                            3 => "J&#46;R&#46; Hebert"
                            4 => "S&#46;N&#46; Blair"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/srep04928"
                      "Revista" => array:5 [
                        "tituloSerie" => "Sci Rep"
                        "fecha" => "2014"
                        "volumen" => "4"
                        "paginaInicial" => "1"
                        "paginaFinal" => "6"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            39 => array:3 [
              "identificador" => "bib0405"
              "etiqueta" => "40"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Associations between plant-based dietary indices and dietary acid load with cardiovascular risk factors among diabetic patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "E&#46; Daneshzad"
                            1 => "F&#46; Jahangir"
                            2 => "J&#46; Heshmati"
                            3 => "B&#46; Larijani"
                            4 => "P&#46;J&#46; Surkan"
                            5 => "L&#46; Azadbakht"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s13410-020-00862-z"
                      "Revista" => array:4 [
                        "tituloSerie" => "Int J Diabetes Dev Ctries"
                        "fecha" => "2020"
                        "paginaInicial" => "1"
                        "paginaFinal" => "13"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            40 => array:3 [
              "identificador" => "bib0410"
              "etiqueta" => "41"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Positive association between dietary acid load and future insulin resistance risk&#58; findings from the Korean Genome and Epidemiology Study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "K&#46;W&#46; Lee"
                            1 => "D&#46; Shin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/s12937-020-00653-6"
                      "Revista" => array:6 [
                        "tituloSerie" => "Nutr J"
                        "fecha" => "2020"
                        "volumen" => "19"
                        "paginaInicial" => "1"
                        "paginaFinal" => "11"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31901246"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
    "agradecimientos" => array:1 [
      0 => array:4 [
        "identificador" => "xack610430"
        "titulo" => "Acknowledgements"
        "texto" => "<p id="par0125" class="elsevierStylePara elsevierViewall">We are grateful to all the participants and their parents who took part in this study&#46;</p>"
        "vista" => "all"
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/25300164/0000006900000006/v1_202206110728/S2530016421002172/v1_202206110728/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "63844"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Originales"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/25300164/0000006900000006/v1_202206110728/S2530016421002172/v1_202206110728/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2530016421002172?idApp=UINPBA00004N"
]

Article information

ISSN: 25300164
Original language: English

DOI:10.1016/j.endinu.2021.07.008

The statistics are updated each day

Year/Month	Html	Pdf	Total

2024 November	4	2	6
2024 October	25	11	36
2024 September	12	17	29
2024 August	24	37	61
2024 July	18	20	38
2024 June	25	13	38
2024 May	26	14	40
2024 April	27	15	42
2024 March	69	11	80
2024 February	49	9	58
2024 January	38	3	41
2023 December	37	2	39
2023 November	45	11	56
2023 October	79	11	90
2023 September	35	1	36
2023 August	53	6	59
2023 July	25	5	30
2023 June	27	2	29
2023 May	16	2	18
2023 April	18	5	23
2023 March	14	7	21
2023 February	17	13	30
2023 January	20	6	26
2022 December	20	20	40
2022 November	6	5	11
2022 October	6	5	11
2022 September	4	5	9
2022 August	1	0	1
2022 June	10	4	14

Show all

Indexed in:

Follow us:

Subscribe:

Statistics

Indexed in:

Follow us:

Subscribe:

Statistics

Subscribe to our newsletter