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Los TCA configuran un grupo de problemas de salud en los que la insatisfacción con la imagen corporal se combina con alteraciones en la conducta alimentaria, baja autoestima, problemas de perfeccionismo, depresión o ansiedad social, entre otros. Estos trastornos pueden ser graves y acompañarse de serias complicaciones y comorbilidades. Se presentan generalmente en adolescentes y adultos jóvenes y los mejor caracterizados son la anorexia nerviosa (AN), la bulimia nerviosa (BN) y el trastorno por atracón (TA). Analizando los programas de prevención de estos trastornos, se observa que en su mayor parte se dirigen a mujeres adolescentes en educación secundaria y jóvenes. Son escasas las intervenciones en edades tempranas, en adultos y en varones. Los programas con buenos resultados se han centrado en uno o más factores de riesgo, se basan en enfoques cognitivos o conductuales e incluyen contenidos sobre alimentación saludable o nutrición, alfabetización mediática o presiones socioculturales y aceptación corporal o satisfacción corporal. Muchos de ellos, incorporan nuevas tecnologías y son interactivos. Se necesita más investigación y programas de prevención de TCA innovadores dirigidos a niños pequeños, adultos y varones.Los TCA configuran un grupo de problemas de salud en los que la insatisfacción con la imagen corporal se combina con alteraciones en la conducta alimentaria, baja autoestima, problemas de perfeccionismo, depresión o ansiedad social, entre otros. Estos trastornos pueden ser graves y acompañarse de serias complicaciones y comorbilidades. Se presentan generalmente en adolescentes y adultos jóvenes y los mejor caracterizados son la anorexia nerviosa (AN), la bulimia nerviosa (BN) y el trastorno por atracón (TA). Analizando los programas de prevención de estos trastornos, se observa que en su mayor parte se dirigen a mujeres adolescentes en educación secundaria y jóvenes. Son escasas las intervenciones en edades tempranas, en adultos y en varones. Los programas con buenos resultados se han centrado en uno o más factores de riesgo, se basan en enfoques cognitivos o conductuales e incluyen contenidos sobre alimentación saludable o nutrición, alfabetización mediática o presiones socioculturales y aceptación corporal o satisfacción corporal. Muchos de ellos, incorporan nuevas tecnologías y son interactivos. Se necesita más investigación y programas de prevención de TCA innovadores dirigidos a niños pequeños, adultos y varones.

There are many clinical situations and pathologies typically treated in secondary care that are closely related to eating disorders (EDs). In fact,secondary care is often the first (and sometimes only) contact patients with EDs have with a healthcare professional. In these situations, EDs can go unnoticed by healthcare professionals treating the patient if they do not have proper training. In this article we will discuss diseases and clinical situations typically managed in secondary care that may be associated with or attributed to EDs. We will discuss how to collect evidence regarding their role in the development or perpetuation of ED, and the preventive measurements that can be taken.Existen numerosas situaciones clínicas y patologías cuyo manejo se realiza de forma habitual en la atención especializada y que están estrechamente relacionadas con los trastornos de la conducta alimentaria (TCA). De hecho, la atención especializada es a menudo el primer (y a veces único) contacto con el profesional sanitario en un paciente con TCA. En este contexto, los trastornos de la conducta alimentaria pueden pasar inadvertidos para el profesional que trata al paciente si no tiene una adecuada formación. En este artículo se desarrollan aquellas enfermedades y situaciones clínicas propias de la atención especializada en las que existe una posible asociación con los TCA, intentando recoger la evidencia en cuanto a su papel en el desarrollo o mantenimiento de estos trastornos y los aspectos preventivos.

Obesity is a public health problem due to its high prevalence, high morbidity, and high mortality. The relationship between eating disorders (ED) and obesity is widely established. A healthcare professional that cares for people with obesity must take into account a series of best practices to minimize the risk of developing an ED in the course of treatment for weight loss. Bariatric surgery (BS) is an effective, long-term treatment in selected patients with severe obesity. During the preoperative period, it is essential to detect any ED due to its high prevalence in this group. After surgery, the presence of a post-op ED and its possible relationship in terms of poorer outcomes make screening during follow-up after surgery essential. From a preventive perspective, cognitive-behavioral therapy before BS could positively influence postoperative results, and its use after BS could improve weight loss efficacy and reduce binge eating and grazing. From a more holistic preventive perspective, many believe in an integrative approach to both obesity and ED. In order to be successful, it is essential to identify any relevant risk and protective factors for both disorders.La obesidad constituye un problema de salud pública por su alta prevalencia y elevada morbimortalidad. La relación entre los trastornos de la conducta alimentaria (TCA) y la obesidad está ampliamente establecida. Es importante que el profesional que atiende a personas con obesidad tenga en cuenta una serie de premisas que minimicen el riesgo de aparición de un trastorno alimentario en el transcurso del tratamiento para perder peso. La cirugía bariátrica (CB) constituye un tratamiento efectivo a largo plazo en los pacientes adecuadamente seleccionados con obesidad grave. Por un lado, la elevada prevalencia de los TCA en este colectivo hace imprescindible la detección de estos trastornos en el preoperatorio. Por otro lado, la presencia de los TCA después de la cirugía y su posible relación en cuanto a peores resultados hace fundamental el cribado durante el seguimiento tras la intervención. Desde el punto de vista preventivo, la realización de una terapia cognitivo-conductual antes de la CB podría influir positivamente en los resultados posoperatorios y su empleo después podría mejorar la eficacia en cuanto a pérdida de peso y disminuir los atracones y el “grazing”. Desde una perspectiva más global en relación a la prevención, son muchos quienes apuestan por un enfoque integrador para la obesidad y los TCA. Para ello es fundamental identificar los factores de riesgo y los protectores que tengan relevancia en ambos trastornos.

Hydroxytyrosol (HT) and punicalagin (PC) exert cardioprotective and antiatherosclerotic effects. This study evaluated the effect of an oral supplement containing HT and PC (SAx) on dyslipidemia in an adult population. A randomized, double-blind, controlled, crossover trial was conducted over a 20-week period. SAx significantly reduced the plasma levels of triglycerides (TG) in subjects with hypertriglyceridemia (≥150 mg/dL) (from 200.67 ± 51.38 to 155.33 ± 42.44 mg/dL; p < 0.05), while no such effects were observed in these subjects after the placebo. SAx also significantly decreased the plasma levels of low-density lipoprotein cholesterol (LDL-C) in subjects with high plasma levels of LDL-C (≥160 mg/dL) (from 179.13 ± 16.18 to 162.93 ± 27.05 mg/dL; p < 0.01), while no such positive effect was observed with the placebo. In addition, the placebo significantly reduced the plasma levels of high-density lipoprotein cholesterol (HDL-C) in the total population (from 64.49 ± 12.65 to 62.55 ± 11.57 mg/dL; p < 0.05), while SAx significantly increased the plasma levels of HDL-C in subjects with low plasma levels of HDL-C (

Background Diabetes and older age are associated with an increased risk of malnutrition and mortality. Recently, the Global Leadership Initiative on Malnutrition (GLIM) provided a 2-step approach for the malnutrition diagnosis. In this study, we aimed to determine whether GLIM nutrition status at admission was associated with long-term survival in elderly patients with type 2 diabetes mellitus (T2DM). Additionally, we aimed to identify which GLIM criteria were more able to become prognostic indicators of early or late death. Methods Our study included a convenience sample of 159 patients with T2DM older than 65 years and admitted to the internal medicine wards of different Spanish hospitals: the VIDA-survival cohort. Nutrition status was retrospectively assessed with the new GLIM criteria. The main outcome was long-term mortality in the cohort during an 8-year follow-up. Bivariate tables summarized the variables of interest. Kaplan-Meier survival curves and adjusted Cox regressions were also performed. Results According to the GLIM criteria, we observed that the 35.8% and 16.3% of the VIDA-survival cohort were categorized as having moderate and severe malnutrition, respectively. Severe malnutrition was associated with increased mortality (hazard ratio [HR] = 2.09; 95% CI, 1.29-3.38), compared with nonmalnourished participants. Moderate malnutrition had a neutral effect on all-cause mortality (HR = 1.30; 95% CI, 0.88-1.92). Low plasma albumin levels, a surrogate marker of inflammation, were strongly associated with early mortality. Conclusion Our study provides evidence that severe malnutrition according to GLIM criteria is associated with increased long-term all-cause mortality among elderly individuals with T2DM.

Some studies have reported that milk and dairy product consumption reduces bladder cancer incidence, whereas others have reported null or opposite findings. This meta-analysis of 26 cohort and case-control studies has been conducted to pool the risk of the association between milk and dairy products and bladder cancer. A systematic search in MEDLINE, EMBASE, and the Web of Science (from inception to 30 April 2018) was conducted. Random-effects models were used to compute pooled estimates of RR for high or medium compared with low consumption of milk and dairy. Sensitivity analyses were conducted. Subgroup analyses were performed based on type of dairy, gender, geographic location, and type of study design. Random-effects meta-regression was used to evaluate other confounding factors. Overall, medium compared with low consumption was associated with lower pooled risk of bladder cancer for total dairy products (RR = 0.90; 95% CI: 0.81, 0.98), milk (RR = 0.90; 95% CI: 0.82, 0.98), and fermented dairy products (RR = 0.87; 95% CI: 0.79, 0.96). The inverse association for milk consumption was stronger in Asians (RR = 0.79; 95% CI: 0.59, 0.98) and in cohort design studies (RR = 0.85; 95% CI: 0.71, 0.99). Moreover, high compared with low consumption was significantly associated with a lower pooled risk for milk (RR = 0.89; 95% CI: 0.81, 0.98) and fermented dairy products (RR = 0.78; 95% CI: 0.61, 0.94). However, high compared with low consumption of whole milk was significantly associated with a higher risk (RR = 1.21; 95% CI: 1.04, 1.38). The statistical heterogeneity was considerable. In conclusion, the present meta-analysis suggests a decreased risk of bladder cancer associated with medium consumption of total dairy products and with medium and high consumption of milk and fermented dairy products. An increased risk of bladder cancer was observed with high consumption of whole milk. Interpretations of the results should be made with caution. This review was registered at www.crd.york.ac.uk/prospero as CRD42018097020.

espanolLa educacion nutricional (EN), dentro del tratamiento de los trastornos de la conducta alimentaria (TCA), juega un papel fundamental ya que contribuye a que el paciente modifique sus actitudes y rutinas en relacion con la comida, pierda miedos y restablezca un patron de alimentacion saludable, favoreciendo de este modo su recuperacion nutricional. Sin embargo, existe falta de consenso y estandarizacion acerca de los procedimientos para llevarla a cabo. El objetivo de este trabajo es elaborar un protocolo consensuado de EN en el contexto del tratamiento de los TCA que permita ayudar a la toma de decisiones sobre: los pacientes candidatos a recibirla, los agentes (familia, comunidad escolar) y profesionales implicados, los ambitos de implementacion de la intervencion, la informacion sobre los pacientes que es necesario conocer, los temas, objetivos y contenidos a trabajar, y la necesidad de evaluacion de la progresion del paciente y los programas desarrollados. EnglishNutrition education (NE), as part of the treatment of eating disorders (EDs), plays a crucial role in helping patients to change their food attitudes and routines, lose fears, and recover a healthy eating pattern. All these changes may contribute to improving their nutritional status. However, there is a lack of consensus and standardization concerning the procedures to teach it. This work’s objective was to elaborate a consensual protocol for NE implementation in the treatment of EDs to help in decision-making regarding which patients are appropriate candidates to receive NE, the agents (family, school community) and professionals involved, and the areas in the healthcare system that are best suited for implementation. Moreover, it would help in selecting the the topics to be imparted, and in following up treatment progression.

Surgical stress predisposes patients to have immune dysfunction and an increased risk of infection. Malnourished surgical patients have higher postoperative morbidity and mortality rates, higher readmission rates, and higher hospital costs. The use of an immunomodulatory formula is associated in the ESPEN guidelines with a reduction in wound healing problems, suture failure, and infectious and global complications. Several authors have suggested that, since most clinical trials evaluating the efficacy of immunonutrition have been carried out in a traditional perioperative setting, it would be interesting to investigate its efficacy in a more controlled setting, such as in the ERAS (Enhanced Recovery after Surgery) protocol. The objective of this work was: a) to define the role that immunonutrition should play in ERAS protocols based on the best scientific evidence available; b) to analyze the difficulties that continue to exist in real-life clinical practice to screen the nutritional risk of patients; c) to make a proposal of algorithms adapted to the characteristics of our environment regarding the screening, assessment, and nutritional treatment of surgical patients in fast-track surgery.El estrés quirúrgico predispone a los pacientes a la disfunción inmune y a un mayor riesgo de infección. Los pacientes quirúrgicos desnutridos presentan una mayor morbimortalidad posoperatoria, mayores tasas de reingreso y costes hospitalarios más elevados. En las guías de la ESPEN se asocia el uso de una fórmula inmunomoduladora a una reducción significativa de los problemas de la cicatrización de heridas, de los fallos de la sutura y de las complicaciones infecciosas y globales. Varios autores han sugerido que, dado que la mayoría de los ensayos clínicos que evalúan la eficacia de la inmunonutrición se han realizado en un entorno perioperatorio tradicional, sería interesante investigar su eficacia en un entorno más controlado, como en el protocolo ERAS (Enhanced Recovery after Surgery). El objetivo de este trabajo es: a) definir el papel que debe jugar la inmunonutrición en los protocolos ERAS sobre la base de la mejor evidencia científica; b) analizar las dificultades que siguen existiendo en la práctica clínica real para realizar el cribado del riesgo nutricional del paciente; c) proponer unos algoritmos adaptados a las características de nuestro entorno sobre el cribado, la valoración y el tratamiento nutricional del paciente quirúrgico en modalidad fast-track.

Studies comparing different types of exercise-based interventions have not shown a consistent effect of training on long-term weight maintenance. The aim of this study was to compare the effects of exercise modalities combined with diet intervention on body composition immediately after intervention and at 3 years&rsquo, follow-up in overweight and obese adults. Two-hundred thirty-nine people (107 men) participated in a 6-month diet and exercise-based intervention, split into four randomly assigned groups: strength group (S), endurance group (E), combined strength and endurance group (SE), and control group (C). The body composition measurements took place on the first week before the start of training and after 22 weeks of training. In addition, a third measurement took place 3 years after the intervention period. A significant interaction effect (group &times, time) (p = 0.017) was observed for the fat mass percentage. It significantly decreased by 5.48 &plusmn, 0.65%, 5.30 &plusmn, 0.65%, 7.04 &plusmn, 0.72%, and 4.86 &plusmn, 0.65% at post-intervention for S, E, SE, and C, respectively. Three years after the intervention, the fat mass percentage returned to values similar to the baseline, except for the combined strength and endurance group, where it remained lower than the value at pre-intervention (p &lt, 0.05). However, no significant interaction was discovered for the rest of the studied outcomes, neither at post-intervention nor 3 years later. The combined strength and endurance group was the only group that achieved lower levels of fat mass (%) at both post-intervention and 3 years after intervention, in comparison with the other groups.

Introduction: excess weight represents a public health problem due to its associated risk factors. A sedentary lifestyle, an inadequate diet or a decrease in the feeling of satiety are some of the causes. Objetives: to evaluate the satiating properties of the consumption of a functional Iberian broth enriched with phospho-fructooligosaccharides (FOS) in healthy people through the plasma concentration of hormones involved in appetite. Material and method: acute, crossover, randomized, double-blind and controlled nutritional clinical trial carried out in 18 randomized participants in two treatment sequences (functional broth (CF), composed of 5.6 g POS/100 g and control broth (CC), with 0.4 g of maltodextrin/100 g) with 14 days of washing in between. Satiety-related parameters (glucose, insulin, leptin, ghrelin, GLP-1, PYY) and visual analog scales (VAS) were measured. Results: the percentage of body fat decreased in those who took the CF (-0.15 ± 0.32 vs 0.09 ± 0.52) (p0.05). Leptin concentration was higher with CF (p0.001), which was shown at time points -30 (p0.001), 0 (p0.001), 30 (p = 0.026) and 120 (p = 0.049) when compared to CC. The areas under the curve (AUC) for GLP-1 (p = 0.0033) and PYY (p = 0.022) were higher for CF as compared to CC. Conclusions: consumption of an Iberian broth enriched with POS improves the plasma concentration of hormones involved in the control of satiety, and reduces the amount of body fat. This result could have beneficial effects for the prevention and treatment of overweight.Introducción: el exceso de peso representa un problema de salud pública debido a los factores de riesgo asociados. El sedentarismo, una alimentación inadecuada o una disminución de la sensación de saciedad son algunas de sus causas. Objetivos: evaluar las propiedades saciantes del consumo de un caldo ibérico funcional enriquecido con fosfofructooligosacáridos (FOS) en personas sanas a través de la concentración plasmática de las hormonas involucradas en el apetito. Material y métodos: ensayo clínico nutricional, agudo, cruzado, aleatorizado, doble ciego y controlado, llevado a cabo en 18 participantes aleatorizados en dos secuencias de tratamiento (caldo funcional (CF) compuesto de 5,6 g de FOS/100 g y caldo de control (CC), con 0,4 g de maltodextrina/100 g) con 14 días de lavado entre ellas. Se midieron parámetros relacionados con la saciedad (glucosa, insulina, leptina, ghrelina, GLP-1, PYY) y escalas analógicas visuales (EAV). Resultados: el porcentaje de grasa corporal disminuyó en los que tomaron el CF (-0,15 ± 0,32 vs. 0,09 ± 0,52) (p0,05). La concentración de leptina fue superior con el CF (p0,001), mostrándose dicho aumento en los tiempos -30 (p0,001), 0 (p0,001), 30 (p = 0,026) y 120 (p = 0,049) con respecto al CC. Las áreas bajo la curva (AUC) de GLP-1 (p = 0,0033) y PYY (p = 0,022) fueron superiores con el CF en comparación con el CC. Conclusión: el consumo de un caldo ibérico enriquecido con FOS mejora la concentración plasmática de las hormonas involucradas en el control de la saciedad y reduce la cantidad de grasa corporal. Dichos resultados podrían tener efectos beneficiosos para la prevención y el tratamiento del exceso de peso corporal.

Introduction: breast cancer is the most common invasive cancer among women in developed countries. At diagnosis, approximately 70 % of women are overweight, and the additional weight gain that can result from the ensuing treatments has been associated with cancer recurrence and progression. Objectives: the main objective was to compare the effect of only a nutritional intervention (CG) with a nutrition education program (nutritional intervention, nutrition education, and physical activity) (IG) for 1 year. Methods: a total of 65 women with breast cancer who had been evaluated at the Clinical Nutrition Department, La Paz University Hospital, Madrid, Spain were recruited into 2 groups: a control group (CG) and an intervention group (IG). Results: the IG showed a significant reduction in body weight (-1.87 ± 3.41 vs. 1.48 ± 2.01 kg, p0.05), BMI (-0.61 ± 1.40 vs. 0.65 ± 0.88 kg/m2, p0.05), total cholesterol (-32.92 ± 38.45 vs. -3.23 ± 39.73 mg/dl, p0.05), and low-density lipoprotein cholesterol (-35.29 ± 27.50 vs. 6.33 ± 40.70 mg/dl, p0.05). Both groups were shown to be more conscious of the importance of physical activity, with increased consumption of grains, fruits, oily fish, and dairy. Conclusions: dietary interventions and physical activity were shown to be important to achieving several physical and physiological benefits that could reduce some risk factors associated with breast cancer recurrence and progression.Introducción: el cáncer de mama es el cáncer invasivo más común entre las mujeres de los países desarrollados. En el momento del diagnóstico, aproximadamente el 70 % de las mujeres tienen sobrepeso, y el aumento de peso adicional que puede resultar de los tratamientos subsiguientes se ha asociado con la recurrencia y progresión de la enfermedad. Objetivos: el objetivo principal del estudio fue comparar el efecto de solo una intervención nutricional (GC) con un programa integral de educación nutricional (intervención y educación nutricional y actividad física) (IG) durante 1 año. Métodos: un total de 65 mujeres con cáncer de mama previamente evaluadas en la Unidad de Nutrición Clínica y Dietética del Hospital Universitario La Paz, Madrid, España, fueron reclutadas y divididas en 2 grupos: grupo de control (GC) y grupo de intervención (GI). Resultados: el GI mostró una reducción significativa del peso corporal (-1,87 ± 3,41 vs. 1,48 ± 2,01 kg, p0,05), IMC (-0,61 ± 1,40 vs. 0,65 ± 0,88 kg/m2, p0,05), colesterol total (-32,92 ± 38,45 vs. -3,23 ± 39,73 mg/dl, p0,05) y colesterol unido a lipoproteínas de baja densidad (LDL) (-35,29 ± 27,50 vs. 6,33 ± 40,70 mg/dl, p0,05). Al finalizar el estudio, ambos grupos fueron más conscientes de la importancia de la actividad física y demostraron consumir una cantidad más elevada de cereales, frutas, pescado azul y lácteos. Conclusiones: las intervenciones dietéticas junto con la práctica de actividad física son importantes para lograr beneficios físicos y fisiológicos que podrían reducir algunos factores de riesgo asociados con la recurrencia y progresión del cáncer de mama.

Aim: to communicate the home parenteral nutrition (HPN) data obtained from the HPN registry of the NADYA-SENPE group (www.nadya-senpe.com) for the year 2019. Material and methods: a descriptive analysis of the data collected from adult and pediatric patients with HPN in the NADYA-SENPE group registry from January 1 to December 31, 2019. Results: a total of 283 patients (51.9 % women), 31 children, and 252 adults from 47 Spanish hospitals were registered, which represents a prevalence rate of 6.01 patients per million inhabitants for year 2019. The most frequent diagnosis in adults was "palliative oncological" and "others" (21.0 %). In children, it was Hirschsprung's disease together with necrotizing enterocolitis, alterations in intestinal motility, and chronic intestinal pseudo-obstruction, with 4 cases each (12.9 %). The first reason for the indication was short-bowel syndrome in both children (51.6 %) and adults (37.3 %). The most used type of catheter was tunnelled both in children (75.9 %) and in adults (40.8 %). Sixty-eight episodes ended, all in adults, and the most frequent cause was death (54.4 %); 38.2 % were switched to oral. Conclusions: the number of collaborating centers and professionals in the NADYA registry is increasing. The main indications and reasons for HPN termination remain stable.Objetivo: comunicar los datos de nutrición parenteral domiciliaria (NPD) obtenidos del registro del grupo NADYA-SENPE (www.nadya-senpe.com) del año 2019. Material y métodos: análisis descriptivo de los datos recogidos de pacientes adultos y pediátricos con NPD en el registro NADYA-SENPE desde el 1 de enero al 31 de diciembre de 2019. Resultados: se registraron 283 pacientes (51,9 %, mujeres), 31 niños y 252 adultos procedentes de 47 hospitales españoles, lo que representa una tasa de prevalencia de 6,01 pacientes/millón de habitantes/año 2019. El diagnóstico más frecuente en los adultos fue “oncológico paliativo” y “otros” (21,0 %). En los niños fue la enfermedad de Hirschsprung junto a la enterocolitis necrotizante, las alteraciones de la motilidad intestinal y la pseudoobstrucción intestinal crónica, con 4 casos cada uno (12,9 %). El primer motivo de indicación fue el síndrome del intestino corto tanto en los niños (51,6 %) como en los adultos (37,3 %). El tipo de catéter más utilizado fue el tunelizado tanto en los niños (75,9 %) como en los adultos (40,8 %). Finalizaron 68 episodios, todos en adultos: la causa más frecuente fue el fallecimiento (54,4 %). Pasaron a la vía oral el 38,2 %. Conclusiones: el número de centros y profesionales colaboradores con el registro NADYA va incrementándose. Se mantienen estables las principales indicaciones y los motivos de finalización de la NPD.

Surgical stress predisposes patients to have immune dysfunction and an increased risk of infection. Malnourished surgical patients have higher postoperative morbidity and mortality rates, higher readmission rates, and higher hospital costs. The use of an immunomodulatory formula is associated in the ESPEN guidelines with a reduction in wound healing problems, suture failure, and infectious and global complications. Several authors have suggested that, since most clinical trials evaluating the efficacy of immunonutrition have been carried out in a traditional perioperative setting, it would be interesting to investigate its efficacy in a more controlled setting, such as in the ERAS (Enhanced Recovery after Surgery) protocol. The objective of this work was: a) to define the role that immunonutrition should play in ERAS protocols based on the best scientific evidence available; b) to analyze the difficulties that continue to exist in real-life clinical practice to screen the nutritional risk of patients; c) to make a proposal of algorithms adapted to the characteristics of our environment regarding the screening, assessment, and nutritional treatment of surgical patients in fast-track surgery.

Osteoporosis is a multifactorial disease characterized by the loss of bone mass and deterioration of the internal structure of the bone, increasing the risk of fractures, and is becoming an economic and social problem. The main treatment is pharmacological, however, the population demands other therapies, such as foods with nutrients beneficial to bone health. Seventy-eight healthy menopausal women at risk of osteoporosis or untreated osteopenia were recruited for a randomized, parallel, double-blind clinical trial with two intervention groups: one group consumed a serving a day of the experimental enriched product (experimental group (EG)) and the other group (control group (CG)) consumed the same product without enrichment. The main objective was to compare the effect of consuming a dairy preparation to reconstitute, similar to yogurt when prepared, enriched in calcium, vitamin D, vitamin K, vitamin C, zinc, magnesium, L-leucine and probiotic (Lactobacillus plantarum 3547) on bone metabolism markers for 24 weeks. The EG showed a significantly increased bone mass compared to the CG (0.01 &plusmn, 0.03 vs. &minus, 0.01 &plusmn, 0.03 kg, p &lt, 0.05). In addition, the EG maintained their bone mineral density (BMD) compared to the CG, whose BMD significantly decreased at the end of the study. For biochemical markers, the EG significantly increased the serum levels of the N-terminal propeptide of type I collagen (P1NP) bone formation marker (13.19 &plusmn, 25.17 vs. &minus, 4.21 &plusmn, 15.62 ng/mL, 0.05), and decreased the carbo-terminal telopeptide of type I collagen (CTx) bone resorption marker compared to the CG (&minus, 0.05 &plusmn, 0.19 vs. 0.04 &plusmn, 0.14 ng/mL, 0.05). On the other hand, the EG exhibited a significantly decreased systolic and diastolic blood pressure compared to the start of the study. Finally, the EG significantly increased their dietary calcium and vitamin D intake compared to the CG. In conclusion, the regular consumption of a dairy product to reconstitute enriched with bioactive nutrients improves bone health markers in menopausal women at risk of osteoporosis without pharmacological treatment.

Obesity is a global public health problem. Objective: To evaluate the effect of the regular consumption of the product Lipigo&reg, on body weight and rebound effect on overweight/obese subjects undergoing a comprehensive weight loss program. Methods: A randomized, parallel, double-blind, placebo-controlled clinical trial was conducted with male and female subjects presenting a BMI 25&ndash, 39.9 kg/m2. All subjects underwent a comprehensive weight loss program (WLP) for 12 weeks, which included an individualized hypocaloric diet, physical activity recommendations, nutritional education seminars, and three times a day consumption of the product Lipigo&reg, or Placebo. After-WLP, subjects continued the treatment for 9 months to assess rebound effect. Body weight (BW), BMI, and body composition were measured at the beginning and the end of the WLP, and in the follow-up. Results: A total of 120 subjects (85% women) 49.0 &plusmn, 9.5 years old and with a BW of 81.57 &plusmn, 13.26 kg (BMI 31.19 &plusmn, 3.44 kg/m2) were randomized and 73 subjects finished the study. At the end of the WLP, there was a tendency toward reduced BW (p = 0.093), BMI (p = 0.063), and WC (p = 0.059) in the treated group. However, subjects with obesity type 1 (OB1) from the treated group significantly reduced body weight (&minus, 5.27 &plusmn, 2.75 vs. &minus, 3.08 &plusmn, 1.73 kg, p = 0.017) and BMI (&minus, 1.99 &plusmn, 1.08 vs. &minus, 1.09 &plusmn, 0.55 kg/m2, p = 0.01) compared with placebo. They also presented a minor rebound effect after 9 months with product consumption (&minus, 4.19 &plusmn, 3.61 vs. &minus, 1.44 &plusmn, 2.51 kg, p = 0.026), minor BMI (&minus, 1.61 &plusmn, 1.43 vs. &minus, 0.52 &plusmn, 0.96 kg/m2, p = 0.025) and tended to have less fat-mass (&minus, 3.44 &plusmn, 2.46 vs. &minus, 3.29 kg, p = 0.080) compared with placebo. Conclusions: The regular consumption of the product Lipigo&reg, promotes the reduction of body weight and reduces the rebound effect of obese people after 52 weeks (12 months), mainly in obesity type 1, who undergo a comprehensive weight loss program.

espanolIntroduccion: la desnutricion relacionada con la enfermedad (DRE) es un tipo especifico de desnutricion producida por la respuesta inflamatoria de la enfermedad de base. Su prevalencia en todo el mundo varia del 30 al 50 %, siendo similar en los hospitales espanoles. La DRE no se reconoce comunmente, se diagnostica inadecuadamente y generalmente no se trata. Se asocia a un mayor riesgo de morbilidad, mortalidad y costes. Las sociedades nutricionales recomiendan que el cribado se realice en las primeras 24 a 48 horas posteriores al ingreso para la deteccion temprana de la desnutricion. Ninguna herramienta de cribado se acepta universalmente. Objetivos: evaluar la validez predictiva (estancia hospitalaria, complicaciones, reingresos y mortalidad) del metodo CONUT en comparacion con la VGS y el VEN. Material y metodo: estudio retrospectivo incluido en un prospectivo observacional de 365 pacientes hospitalizados de julio a diciembre de 2012. Resultados: los servicios de ingreso mas frecuentes fueron Medicina Interna y Oncologia (30,7 % y 29,3 %). Deteccion de los riesgos moderado y severo de desnutricion: CONUT, 42,2 y 12,1 %; VSG, 25,8 % y 10,1 %; VEN, 13,7 y 14,5 %. La desnutricion evaluada utilizando el metodo CONUT se relaciono significativamente con las complicaciones (p = 0,036), los reingresos (p = 0,041) y la mortalidad (p = 0,007). Las curvas ROC de la mortalidad, para todos los metodos evaluados, mostraron que CONUT es la mejor herramienta. Conclusiones: CONUT es una herramienta de deteccion automatica que se puede utilizar como primer paso en el diagnostico del riesgo de desnutricion. CONUT ofrece la ventaja de ser un factor pronostico de complicaciones, reingreso y mortalidad. EnglishIntroduction: disease-related malnutrition (DRM) is a specific type of malnutrition caused by the inflammatory response to the underlying disease. Its prevalence worldwide varies from 30 % to 50 %, being similar in Spanish hospitals. DRE is not commonly recognized but is usually misdiagnosed and generally not treated. It is associated with an increased risk of morbidity, mortality, and costs. Nutritional societies recommend that screening be performed within the first 24 to 48 hours after admission for the early detection of malnutrition. No screening tool is universally accepted. Objectives: to evaluate the predictive validity (hospital stay, complications, readmissions and mortality) of the CONUT method as compared to SGA and NSA. Material and method: a retrospective study included in a prospective observational study of 365 hospitalized patients from July to December 2012. Results: the most frequent admission services were Internal Medicine and Oncology (30.7 % and 29.3 %). Moderate and severe risk of malnutrition: CONUT, 42.2 % and 12.1 %, SGA 25.8 % and 10.1 %, and NSA 13.7 % and 14.5 %. Malnutrition evaluated using the CONUT method was significantly related to complications (p = 0.036), readmissions (p = 0.041) and mortality (p = 0.007). The ROC curves for mortality, for all the methods evaluated, showed that CONUT is the best tool. Conclusions: CONUT is an automatic detection tool that can be used as a first step in the diagnosis risk of malnutrition. CONUT offers the advantage of being a prognostic factor for complications, readmission, and mortality.

Objetivo: comunicar los datos de nutrición parenteral domiciliaria (NPD) obtenidos del registro del grupo NADYA-SENPE (www.nadya-senpe.com) del año 2018. Material y métodos: análisis descriptivo de los datos recogidos de pacientes adultos y pediátricos con NPD en el registro NADYA-SENPE del 1 de enero al 31 de diciembre de 2018. Resultados: se registraron 278 pacientes (54,7% mujeres), 23 niños y 255 adultos, procedentes de 45 hospitales españoles, lo que representa una tasa de prevalencia de 5,95 pacientes/millón de habitantes/año 2018. El diagnóstico más frecuente en adultos fue “oncológico paliativo” (22,0%), seguido de “otros”. En niños fue la enfermedad de Hirschsprung junto con la enterocolitis necrotizante, con cuatro casos (17,4%). El primer motivo de indicación fue síndrome de intestino corto tanto en niños (60,9%) como en adultos (35,7%). El tipo de catéter más utilizado fue el tunelizado tanto en niños (81,0%) como en adultos (41,1%). Finalizaron 75 episodios, la causa más frecuente fue el fallecimiento (52,0%) y el paso a vía oral (33,3%). Conclusiones: el número de centros y profesionales colaboradores en el registro de pacientes que reciben NPD se mantiene estable, así como las principales indicaciones y los motivos de finalización de la NPD. Aim: to communicate home parenteral nutrition (HPN) data obtained from the HPN registry of the NADYA-SENPE group (www.nadya-senpe.com) for the year 2018 Material and methods: descriptive analysis of the data collected from adult and pediatric patients with HPN in the NADYA-SENPE group registry from January 1st, 2018 to December 31st, 2018. Results: there were 278 patients from 45 Spanish hospitals (54.7% women), 23 children and 255 adults, which represent a prevalence rate of 5.95 patients/million inhabitants/year 2018. The most frequent diagnosis in adults was "palliative cancer" (22.0%), followed by "others". In children it was Hirschsprung's disease together with necrotizing enterocolitis, with four cases (17.4%). The first indication was short bowel syndrome in both children (60.9%) and adults (35.7%). The most frequently used type of catheter was tunneled in both children (81.0%) and adults (41.1%). Ending 75 episodes, the most frequent cause was death (52.0%) and change to oral feeding (33.3%). Conclusions: the number of centers and collaborating professionals in the registry of patients receiving HPN remains stable, as well as the main indications and reasons for termination of HPN.

Studies with overweight people are a priority in order to observe the effect of the timing of intervention on pre-obesity people. The aim was to compare different physical activity programs plus an individualized hypocaloric diet on body composition in overweight subjects. A randomized controlled clinical trial was carried out in overweight adults with no history of relevant illness. Primary outcome was total fat mass (TFM). Participants were allocated into four activity programs with equal intensity and volume of exercise for 22 weeks: strength training (S), endurance training (E), strength + endurance training (SE), and ‘adhering to physical activity recommendations’ (C). Participants followed a diet with 25% less energy (50%–55% carbohydrates, 30%–35% fat) measured by accelerometer. Variables were assessed at baseline and at the end of the intervention. Body composition was measured by dual-energy X-ray absorptiometry. One hundred nineteen from 205 subjects were randomized in the four exercise groups (S = 30/E = 30/SE = 30/C = 29) and 84 participants (36 men/48 women) ended the intervention (S = 19/E = 25/SE = 22/C = 18). At the end of the experiment, all groups except C increased their total physical activity (S = 1159 ± 1740, E = 1625 ± 1790, SE = 1699 ± 2516, C = 724 ± 1979 MET-min/week). Using an ANOVA-test, improvements were observed in body weight (S = −4.6 ± 4.5, E = −6.6 ± 4.6, SE = −8.5 ± 2.8, C = −6.1 ± 5.6 kg, p = 0.059) and TFM (S = −4.24 ± 2.02, E = −4.74 ± 2.96, SE = −6.74 ± 3.27, C = −3.94 ± 4.18%, p &lt, 0.05). The main conclusion was that there were no adverse events. Strength and endurance training with a balanced, individualized hypocaloric diet was the most effective at reducing weight loss and fat mass in overweight subjects. Trial registration: NCT01116856.

Aim: To communicate home parenteral nutrition (HPN) data obtained from the HPN registry of the NADYA-SENPE group (www.nadya-senpe. com) for the year 2018. Material and methods: Descriptive analysis of the data collected from adult and pediatric patients with HPN in the NADYA-SENPE group registry from January 1st, 2018 to December 31st, 2018. Results: There were 278 patients from 45 Spanish hospitals (54.7% women), 23 children and 255 adults, which represent a prevalence rate of 5.95 patients/million inhabitants/year 2018. The most frequent diagnosis in adults was “palliative cancer” (22.0%), followed by “others”. In children it was Hirschsprung’s disease together with necrotizing enterocolitis, with four cases (17.4%). The first indication was short bowel syndrome in both children (60.9%) and adults (35.7%). The most frequently used type of catheter was tunneled in both children (81.0%) and adults (41.1%). Ending 75 episodes, the most frequent cause was death (52.0%) and change to oral feeding (33.3%). Conclusions: The number of centers and collaborating professionals in the registry of patients receiving HPN remains stable, as well as the main indications and reasons for termination of HPN., Objetivo: comunicar los datos de nutrición parenteral domiciliaria (NPD) obtenidos del registro del grupo NADYA-SENPE (www.nadyasenpe. com) del año 2018. Material y métodos: análisis descriptivo de los datos recogidos de pacientes adultos y pediátricos con NPD en el registro NADYA-SENPE del 1 de enero al 31 de diciembre de 2018. Resultados: se registraron 278 pacientes (54,7% mujeres), 23 niños y 255 adultos, procedentes de 45 hospitales españoles, lo que representa una tasa de prevalencia de 5,95 pacientes/millón de habitantes/año 2018. El diagnóstico más frecuente en adultos fue “oncológico paliativo” (22,0%), seguido de “otros”. En niños fue la enfermedad de Hirschsprung junto con la enterocolitis necrotizante, con cuatro casos (17,4%). El primer motivo de indicación fue síndrome de intestino corto tanto en niños (60,9%) como en adultos (35,7%). El tipo de catéter más utilizado fue el tunelizado tanto en niños (81,0%) como en adultos (41,1%). Finalizaron 75 episodios, la causa más frecuente fue el fallecimiento (52,0%) y el paso a vía oral (33,3%). Conclusiones: el número de centros y profesionales colaboradores en el registro de pacientes que reciben NPD se mantiene estable, así como las principales indicaciones y los motivos de finalización de la NPD.

Introduction Accurate and sensitive measurement of body composition is an important tool in the diagnosis and control of obesity. Objective To compare body fat changes measured by dual-energy X-ray absorptiometry (DXA), bioelectrical impedance analysis (BIA), and skinfolds (SK) in healthy overweight adults in order to evaluate whether all three methods can be used during a weight loss program (WLP). Methods Eighty-four men (n=36) and women (n=48), body mass index 25–29.9 kg/m2, aged between 18-50 years, non-smokers and sedentary, were randomly assigned to strength, endurance, combined strength plus endurance, or physical activity recommendations groups. All subjects followed a hypocaloric diet (25-30% decrease in energy intake in terms of the total daily energy expenditure). The intervention lasted 22 weeks. Results The highest correlation was obtained between DXA and SK when men and women were studied together (r=0.864, p0.05) when changes in body fat caused by intervention were analyzed. However, considering results of the minimal difference compared to DXA, BIA showed the greatest sensitivity to detect changes in fat percentage and fat mass, while SK underestimated the changes, with a significantly lower percentage considered real (p=0.01). Conclusion The SK method seems to underestimate real changes, therefore DXA and BIA can serve as more effective tools to measure the change in fat percentage and fat mass during WLP. Level of evidence II, Diagnosis. RESUMO Introdução A mensuração precisa e sensível da composição corporal é uma importante ferramenta para o diagnóstico e controle da obesidade. Objetivo Comparar as alterações da gordura corporal mensuradas através da absorciometria com raios-X de dupla energia (DEXA), análise da impedância bioelétrica (BIA) e dobras cutâneas (DC) em adultos saudáveis com sobrepeso, a fim de avaliar se os três métodos podem ser utilizados durante um programa de perda de peso (PPP). Métodos Oitenta e quatro homens (n=36) e mulheres (n=48) com índice de massa corporal entre 25-29,9 kg/m2, idade entre 18-50 anos, não-fumantes e sedentários foram divididos aleatoriamente em grupos de de força, resistência, combinados de força mais resistência ou com recomendações de atividade física. Todos os indivíduos seguiram uma dieta hipocalórica (25-30% de redução na ingestão energética em relação ao gasto energético total diário). A intervenção durou 22 semanas. Resultados A maior correlação foi obtida entre a DEXA e DC quando homens e mulheres foram estudados juntos (r=0,864, p0,05) quando foram analisadas alterações na gordura corporal ocasionadas pela intervenção. No entanto, considerando os resultados da mínima diferença comparados à DEXA, a BIA apresentou maior sensibilidade para detectar mudanças no percentual de gordura e massa gorda, enquanto a DC subestimou as mudanças, com um percentual significativamente mais baixo considerado real (p=0,01). Conclusão O método de DC parece subestimar as mudanças reais, portanto, a DEXA e BIA podem ser ferramentas mais eficazes para mensurar a alteração no percentual de gordura e a massa gorda durante um PPP. Nível de evidência II, Diagnóstico. RESUMEN Introducción La medición precisa y sensible de la composición corporal es una herramienta importante para el diagnóstico y control de la obesidad. Objetivo Comparar las alteraciones de la grasa corporal medidas a través de la absorciometría con rayos X de doble energía (DXA), análisis de la impedancia bioeléctrica (BIA) y los pliegues cutáneos (PC) en adultos saludables con sobrepeso, con el fin de evaluar si se pueden utilizar los tres métodos durante un programa de pérdida de peso (PPP). Métodos Ochenta y cuatro hombres y mujeres (varones n=36 y mujeres n=48), con índice de masa corporal entre 25-29,9kg/m2, edad entre 18-50 años, no fumadores y sedentarios fueron divididos aleatoriamente en grupos de fuerza, resistencia, combinados de fuerza más resistencia o con recomendaciones de actividad física. Todos los individuos siguieron una dieta hipocalórica (25-30% de reducción en la ingestión energética con relación al gasto energético total diario). La intervención duró 22 semanas. Resultados La mayor correlación fue obtenida entre DXA y PC cuando hombres y mujeres fueron estudiados conjuntamente (r=0,864, p0,05), cuando se analizaron alteraciones en la grasa corporal causadas por la intervención. Sin embargo, considerando los resultados de la mínima diferencia comparados a DXA, la BIA presentó mayor sensibilidad para detectar cambios en el porcentual de grasa y masa grasa, mientras que la PC subestimó los cambios, con un porcentual significativamente más bajo considerado real (p=0,01). Conclusión El método de PC parece subestimar los cambios reales, por lo tanto, la DXA y la BIA pueden ser herramientas más eficaces para medir la alteración en el porcentual de grasa y masa grasa durante un PPP. Nivel de evidencia II, Diagnóstico.

Summary Objective The aim of this study was to compare the metabolic benefits of diabetes-specific formulas (DSF) high in monounsaturated fatty acids (MUFA) with standard formulas (STDF) in adult patients with type 1, type 2 diabetes or stress-induced hyperglycaemia. Research design and methods A systematic review and meta-analysis were conducted through a literature search using different electronic databases from the index date to December 2018. We included randomised controlled trials that assessed the health benefits of high MUFA DSF vs STDF. Included outcomes were glycaemic control, lipid metabolism and tolerance. Effect sizes were calculated as standardised mean differences (SMDs) ( 0.7 large). This systematic review was registered as CRD42018108931 on Prospero. Results Of 385 references reviewed, 18 studies involving 845 adults met our inclusion criteria and contributed to the meta-analysis. Use of a high MUFA DSF compared with a STDF was associated with a statistically significant decrease in peak of postprandial glucose [SMD −1.53, 95% confidence interval (CI) −2.44 to −0.61], incremental glucose response (SMD −1.19, 95% CI −1.71 to −0.68), area under the curve of plasma insulin (SMD −0.65, 95% CI −1.03 to −0.26), mean blood glucose level (SMD −0.41, 95% CI −0.63 to −0.19), glycosylated haemoglobin (HbA1c) change (SMD −0.63, 95% CI −1.21 to −0.05), glucose variability (SMD −0.93, −1.55 to −0.31), mean administered insulin dose (SMD −0.49, 95% CI −0.85 to −0.14), mean blood triglycerides (SMD −0.34, 95% CI −0.65 to −0.03) and increase of mean blood high-density lipoproteins (SMD +0.42, 95% CI 0.08 to 0.76). Non-significant differences were found for tolerance [odds ratio (OR) 0.95, 95% CI 0.87 to 1.05]. Conclusions This meta-analysis shows that a DSF (oral supplements and tube feeds) high in MUFAs can improve glucose control and metabolic risk factors among patients with diabetes or stress-induced hyperglycaemia compared with a STDF.

Introduction: frailty and sarcopenia are prevalent conditions in older adults which diagnosis and treatment often overlap. Objective: to analyze the nutritional problematic related to frailty and sarcopenia in older adults. Methods: a literature review, about particularities of frailty and sarcopenia, diagnosis and nutritional treatment, has been carried out. Results: frailty is a geriatric syndrome that can be identified by at least three of the following criteria: weight loss, exhaustion, reduced physical activity, increased walk time, low grip strength. Sarcopenia is a muscular disease characterized by low muscle mass and reduced muscle strength as the main determinant. Both conditions can benefit from adequate protein intake (1-1.5 g/kg/day) and regular physical activity. Conclusion: identification, prevention, monitoring and nutritional treatment of frailty and sarcopenia in older adults is important because of its high prevalence. The main goal is to maintain the muscular integrity and minimize muscle loss in older adults. A healthy aging includes regular physical activity and the fulfillment of the protein requirements of this population.Introducción: la fragilidad y la sarcopenia son dos condiciones altamente prevalentes en el adulto mayor que se solapan en diferentes vertientes del diagnóstico y del tratamiento. Objetivos: analizar la problemática nutricional relacionada con la fragilidad y la sarcopenia en personas de edad avanzada. Métodos: se ha realizado una revisión bibliográfica de las particularidades de la fragilidad y de la sarcopenia, así como del diagnóstico y del tratamiento nutricional. Resultados: la fragilidad es un síndrome geriátrico que puede identificarse si se tienen al menos tres de los siguientes criterios: pérdida de peso, fuerza de presión de la mano disminuida, velocidad de la marcha lenta, actividad física reducida y agotamiento. La sarcopenia es una enfermedad muscular que se caracteriza por una masa muscular baja y una fuerza muscular reducida como determinantes principales. Ambas condiciones pueden verse beneficiadas por un consumo adecuado de proteínas (1-1,5 g/kg/día) y una actividad física de resistencia regular. Conclusión: la identificación, prevención, seguimiento y tratamiento nutricional de la fragilidad y la sarcopenia en adultos mayores es de vital importancia dada su elevada prevalencia. El objetivo es mantener la integridad y minimizar la pérdida muscular en los adultos mayores. Un envejecimiento saludable incluye la realización de actividad física regular y el cumplimiento de los requerimientos proteicos de esta población.

Introduction: Abdominal fat and its increment over time in particular has become a cardiovascular risk factor in uraemic patients. Objectives: To analyse changes in abdominal fat in haemodialysis patients over one year and study their possible correlation with the variation in adipocytokine serum levels. As a secondary objective, we tried to validate the data obtained by bioelectrical impedance analysis (BIA) with data obtained by dual X-ray absorptiometry (DXA). Material and methods: A prospective one-year study was performed in 18 patients on haemodialysis (HD). In each patient, body composition by BIA and DXA was estimated at baseline and after one year. Several adipocytokine and biochemical parameters were determined. Results: A significant increase in phase angle [4.8° (4.1–5.6) vs. 5.2° (4.4–5.8), p

Hydroxytyrosol (HT) and Punicalagin (PC) exert cardioprotective and anti-atherosclerotic effects. This study evaluates the effect of oral supplementation with HT and PC (SAx) on early atherosclerosis markers in middle-aged, seemingly healthy adults. A randomized, double-blinded, placebo-controlled, crossover trial was performed for 20 weeks. There were two treatment sequences (Placebo/SAx, n = 41, SAx/Placebo, n = 43) for which the intervention periods (Placebo and SAx) were 8 weeks long, followed by a 4-week wash out period. The supplement was composed of 9.9 mg of HT and 195 mg of PC, and the placebo was composed of maltodextrin. SAx increased endothelial function (Flow-mediated dilatation [FMD]: 2.36%, p &lt, 0.001) in the endothelial dysfunction subgroup compared to the placebo (2.36 &plusmn, 3.9 vs. 0.76 &plusmn, 3.5%, p &lt, 0.05). SAx also reduced oxLDL by &minus, 28.74 ng/mL (p &lt, 0.05) in subjects with higher levels of oxLDL, which was an improvement compared with the placebo (&minus, 28.74 &plusmn, 40.2 vs. 25.64 &plusmn, 93.8 ng/mL, p &lt, 0.001). The prehypertension and hypertension subgroups exhibited decreased systolic (&minus, 15.75 &plusmn, 9.9 mmHg, 0.001) and diastolic (&minus, 6.36 &plusmn, 8.7 mmHg, 0.001) blood pressure after SAx consumption. Moreover, the systolic prehypertension and hypertension subgroups presented significant differences in systolic blood pressure compared to the placebo (&minus, 9.9 vs. &minus, 2.67 &plusmn, 12.0 mmHg, p &lt, 0.05). In conclusion, the supplement exerted anti-atherosclerotic effects by improving endothelial function, blood pressure, and levels of circulating oxLDL, especially for persons in whom these parameters were altered.

Background The aim of the present study was to describe and compare the oral and dental health status of two groups, one diagnosed with eating disorders (EDs), and another group without this pathology, assessing the following oral manifestations: dental alterations, periodontal disorders, soft tissue disorders, non-stimulated salivary flow, and oral pH. Material and Methods This comparative transversal epidemiological study included 179 participants, of whom 59 were diagnosed with EDs (Eating Disorder Group: EDG) and 120 had no antecedents of EDs (No Eating Disorder Group: NEDG). All patients fulfilled the following inclusion criteria: women aged over 18 years, diagnosed with an ED by a specialist, patients who had undergone at least 1 year monitoring by the Clinical Nutrition Unit, and had not received any periodontal treatment during the previous 6 months. Both groups were homogeneous in terms of sex, age, education, and socioeconomic level. Oral exploration was performed, registering clinical variables, as well as sociodemographic and socioeconomic data, oral hygiene habits, and smoking. Statistical significance was established as p 95%). Results The dental erosion (DE) was the most significative feature of dental alterations. The degree of DE was significantly greater in the EDG (p

breast cancer (BC) is the most commonly diagnosed tumor in women and it continues to be the leading cause of cancer death in women. Quality of life decreases significantly during treatment and in the survivors. There is growing evidence linking the intake of certain foods, or their bioactive compounds, with better prognosis of the disease or improvements in physiological parameters that can increase BC patients' quality of life. But there are hardly any reviews to clarify the scientific evidence.gathering and summarizing the available evidence on the effectiveness of the dietary compounds use as coadjuvants for BC treatment.literature search using Pubmed to identify and analyze bioactive compounds as coadjvants for BC treatment.all tested compounds showed antitumor effects in vitro. Vvitamin D decrease risk of bone fracture, and marine lipids may reduce bone resorption and inflammation.there are bioactive compounds with potential to improve the quality of life of women with BC. Vitamin D a marine lipids provide a solid quality scientific evidence. Despite this, more controlled clinical trials are required to establish a direct link between the use of these compounds and the tumor progression or patient survival.INTRODUCCIÓN: el cáncer de mama (CM) es el tumor más diagnosticado en mujeres y la primera causa de muerte por cáncer en este grupo de población. La calidad de vida disminuye durante los tratamientos, así como a largo plazo en las supervivientes. Numerosos estudios relacionan la ingesta de algunos alimentos o sus compuestos bioactivos con un mejor pronóstico de la enfermedad o mejoras en la calidad de vida de pacientes con CM, pero apenas existen revisiones que permitan aclarar la evidencia científica. OBJETIVOS: agrupar y sintetizar la evidencia disponible sobre la efectividad del empleo de compuestos bioactivos de alimentos como coadyuvantes del tratamiento del CM. MÉTODOS: revisión bibliográfica mediante sistema de búsqueda PubMed para la identificación y estudio de compuestos bioactivos con posible efecto coadyuvantes en el tratamiento de CM. RESULTADOS: todos los compuestos analizados mostraron efectos antitumorales in vitro. La vitamina D contribuye a reducir las fracturas óseas. Los lípidos marinos disminuyen la resorción ósea y la inflamación. CONCLUSIÓN: existen compuestos bioactivos con potencial terapéutico para mejorar la calidad de vida de mujeres con CM. La vitamina D y los lípidos marinos son los que presentan mayor evidencia. Sin embargo, se necesitan más ensayos clínicos controlados para confirmar una relación directa entre el empleo de estos compuestos y la evolución tumoral o la supervivencia en CM.

Individualized parenteral nutrition is the most specialized type of nutritional support in the hospital setting. The composition and prescribing patterns for parenteral nutrition have evolved due to new emerging scientific evidence. In the last few years, there has been a tendency to increase the nitrogen and lipid content and decrease the carbohydrate content. To assess the prescribing pattern in a tertiary referral hospital in Spain, the nutritional composition of individualized parenteral nutrition was evaluated retrospectively from January to December of 2016. A total of 3029 parenteral nutrition units were analysed, corresponding to 257 hospitalized adult patients. Medical specialists in General Surgery and Haematology were the most common petitioners. The three most frequently prescribed parenteral nutrition formulae contained 13.4 (28.8%), 15.7 (19.54%) and 17.9 (17.79%) g of nitrogen. The quantity of carbohydrates and lipids showed a mean non-protein calories-to-nitrogen ratio of approximately 78:1 and a carbohydrate-to-lipid ratio that was near 50:50 in most cases. These results suggest a trend towards the administration of parenteral nutrition with a high content of nitrogen and smaller proportion of the non-protein components.

Milk and dairy product consumption has been associated with an increase in prostate cancer risk; however, discrepancies have been observed in the literature. This first overview of systematic reviews and meta-analyses was carried out with the main objective of compiling and discussing the evidence generated to date related to milk and dairy product consumption and prostate cancer risk and mortality. A systematic search in MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, and the Web of Science (from inception to 30 April 2018) was conducted. The inclusion criteria were as follows: adult men, meta-analyses of longitudinal studies, dairy product consumption, and risk of prostate cancer or related outcomes. The AMSTAR2 checklist was used to evaluate methodological quality. The synthesis methods included dairy product exposure (high compared with low consumption or dose-response), dairy product type (total dairy products, milk, cheese, yogurt, and others), and prostate cancer outcomes (total, nonadvanced, and advanced prostate cancer and mortality) displayed in forest plots. Six meta-analyses were identified. These studies reported on the analysis of the 2 to 32 cohorts (up to 848,395 subjects/38,107 cases; 4–28 y of follow-up) and 2 case-control meta-analyses (12,435 subjects). The meta-analysis quality was valued as mostly “good” according to the AMSTAR2 criteria. All RRs of high compared with low consumption (dose-response) for total prostate cancer ranged from 1.68 to 1.09 (1.07 per 400 g/d) for total dairy products, 1.50 to 0.92 (1.06 to 0.98 per 200 g/d) for milk (whole, low-fat, and skim milk considered separately), and 1.18 to 0.74 (1.10 per 50 g/d) for cheese. RRs have decreased since the first meta-analysis. Statistical heterogeneity generates uncertainty in the observed results (up to I(2) = 77.1%). In conclusion, although there are some data indicating that higher consumption of dairy products could increase the risk of prostate cancer, the evidence is not consistent. This review was registered with PROSPERO as CRD42018094737.

Over the last years, there has been an increase in adverse food reactions, probably associated with life style changes in the past decades. An adverse food reaction is any clinically abnormal response that can be attributed to ingestion, contact or inhalation of a food, its derivatives or an additive contained in it. They can be classified as food allergy or intolerance. Food allergies are usually immune-mediated, associated with IgE. Adverse reactions to food have a large clinical and social repercussion, which can be fatal in some cases and impair the quality of life of patients. This implies directly the services of collective catering and food manufacturing, which is why a legislature and regulations were implemented for its correct management. The most allergenic foods change according to the age group; being the egg the most frequent in children under 5 years, and fresh fruits in the older than 5 years. The most frequent clinical manifestations are cutaneous-mucous type. Food intolerances may be due to a pharmacological, metabolic, mixed or idiosyncratic mechanism. Clinical manifestations are usually dose dependent. The most common and known food intolerance is lactose, which is a metabolic type. The main treatment of both types of adverse reaction to foods is avoidance of the causal food of the reaction.En estos últimos años se ha evidenciado un aumento de las reacciones adversas a alimentos, probablemente asociadas a los cambios en el estilo de vida producidos en las últimas décadas. Una reacción adversa a alimentos es cualquier respuesta clínicamente anormal que puede atribuirse a la ingestión, contacto o inhalación de un alimento, de sus derivados o de uno de sus aditivos.Pueden clasificarse en alergia o intolerancia alimentaria. Las alergias alimentarias suelen tener un componente inmunológico generalmente asociado a inmunoglobulina E (IgE). Las reacciones adversas a alimentos tienen una gran repercusión tanto clínica como social y perjudican la calidad de vida de los pacientes y, en algunos casos, resultan fatales, de ahí que se implique directamente a los servicios de restauración colectiva y de manufacturación de alimentos para su correcto manejo.Los alimentos más alérgenos cambian según el grupo etario. La alergia al huevo es la más frecuente en menores de 5 años y a las frutas frescas, en los mayores de 5 años. Las manifestaciones clínicas más frecuentes son de tipo cutáneo-mucosas. Las intolerancias alimentarias pueden deberse a un mecanismo farmacológico, metabólico, mixto o idiosincrático, pero no inmunológico. Las manifestaciones clínicas suelen ser dosis dependientes, mientras que las alérgicas son dosis independientes.La intolerancia alimentaria más frecuente y conocida es la intolerancia a la lactosa, que es de tipo metabólica. El tratamiento principal para ambos tipos de reacciones adversas a alimentos consiste en evitar el alimento que causa de la reacción.

Disease-associated malnutrition (DAM) is a health problem involving all sanitary levels, especially hospitalised elderly patients. Different MNA (Mini Nutritional Assessment)-based forms have been validated in different settings, but it remains unclear if they are appropriate to evaluate the nutritional status of geriatric hospitalised patients with diabetes.The aim of this work was to analyse the accuracy of several MNA reduced forms to detect malnutrition in hospitalised elderly diabetic patients.A multicentre observational study was carried out in diabetic patients, who were over the age of 65, from 35 Spanish hospitals. Principal component analysis (PCA) selected the minimal components to elaborate the newly-proposed reduced new version of the MNA (r-MNA). Cohen's Kappa index (KI), with its 95% confidence interval (CI), was used to measure the agreement between the different reduced forms (r-MNA, MNA-SF-BMI, MNA-SF-CC, m-MNA) with the original MNA.Five hundred and ninety-one elderly diabetic patients were included in the study. ROC analysis determined the following cut-off points for the newly proposed r MNA: 0-10 "malnourished", 10-12 "at risk" and12-15 "well-nourished". The upper cut-off point demonstrated a sensitivity of 87.7%, a specificity of 78.3% and an area under the curve of 0.93. The lower cut-off point showed a sensitivity of 95.9%, a specificity of 78.3% and an area under the curve of 0.95. The best agreement with the original MNA was observed for the MNA-SF-BMI (Κ index 80.7; 95% CI: 77.4-84) and the worst for the r-MNA (Κ index 72; 95% CI: 68.2-75.4).This study found that MNA-SF-BMI is the most accurate screening tool for determining the nutritional status of hospitalised diabetic elderly patients. This is an easy-to-use, fast screening tool with a low risk of misclassification.

The aim of the present study was to compare the effects of different physical activity programs, in combination with a hypocaloric diet, on anthropometric variables and body composition in obese subjects. Ninety-six obese (men: n = 48; women: n = 48; age range: 18-50 yr) participated in a supervised 22-wk program. They were randomized into four groups: strength training (S; n = 24), endurance training (E; n = 26), combined strength + endurance training (SE; n = 24), and physical activity recommendations (C; n = 22). In addition, all groups followed the same hypocaloric diet. At baseline and at the end of the intervention, dietetic and physical activity variables were assessed using validated questionnaires. Anthropometric variables were recorded along with body composition variables measured using dual-energy X-ray absorptiometry techniques. At the end of the intervention, significant improvements were seen within groups in terms of body weight (S: −9.21 ± 0.83 kg; E: −10.55 ± 0.80 kg; SE: −9.88 ± 0.85 kg; C: −8.69 ± 0.89 kg), and total fat mass (S: −5.24 ± 0.55%; E: −5.35 ± 0.55%; SE: −4.85 ± 0.56%; C: −4.89 ± 0.59%). No differences were seen between groups at this time in terms of any other anthropometric or body composition variables examined. All groups increased their total physical activity in metabolic equivalents (MET) per week during the intervention, but with no difference between groups (S: 976 ± 367 MET-min/wk; E: 954 ± 355 MET-min/wk; SE: 1 329 ± 345 MET-min/wk; C: 763 ± 410 MET-min/wk). This study shows that, when combined with a hypocaloric diet, exercise training and adherence to physical activity recommendations are equally effective at reducing body weight and modifying body composition in the treatment of obesity (Clinical Trials Gov. number: NCT01116856).