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Milk is a liquid food that possesses an important quantity of highly bioavailable macronutrients. In addition, it is readily accessible, as well as relatively inexpensive. Given that the knowledge of physicians about nutrition and food composition is deficient, in general, many of the dietary interventions recommended in diverse clinical settings lack a scientific basis. The aim of the present review was to produce a technical opinion that serves as a frame of reference to best sustain recommendations for consuming milk and dairy products as daily nutrition in the adult and older adult. The effects of milk and dairy products during the pediatric stage are not addressed in the present work. The Asociación Mexicana de Gastroenterología and the Asociación Mexicana de Gerontología y Geriatría jointly discussed and analyzed topics dealing with the legal designation of milk, the classification and nutritional profile of cow's milk, its nutritional characteristics, its consumption in the adult, intolerance to cow's milk, and associations of milk consumption with digestive tract alterations and other conditions. Finally, certain aspects of milk consumption in the older adult and its relation to overall health are briefly discussed. Resumen: La leche es un alimento que tiene una importante cantidad de macronutrimentos de gran biodisponibilidad, accesible y de relativo bajo costo. El conocimiento de los médicos en general sobre nutrición y composición de los alimentos es deficiente por lo que muchas de las intervenciones dietéticas que tradicionalmente recomendamos en diversos escenarios clínicos carecen de sustento científico. El objetivo de esta revisión fue generar una opinión técnica que sirva como marco de referencia para sustentar de mejor forma la recomendación sobre el consumo de leche y productos lácteos en la nutrición diaria de adultos y adultos mayores. Los efectos de la leche y productos lácteos durante la etapa pediátrica salen del contexto del presente trabajo. La Asociación Mexicana de Gastroenterología y la Asociación Mexicana de Gerontología y Geriatría comentaron y analizaron de forma conjunta temas acerca de la denominación legal de la leche, clasificación y perfil nutrimental de la leche de vaca, sus características nutrimentales, su consumo en el adulto, intolerancia a la leche de vaca, asociaciones entre el consumo de leche y alteraciones del aparato digestivo y otras condiciones; finalmente, se mencionan de forma breve algunos aspectos sobre el consumo de leche en el adulto mayor y su relación con la salud. Keywords: Dairy products, Cow's milk, Diet, Adult, Older adult, Palabras clave: Lácteos, Leche de vaca, Alimentación, Adulto, Adulto mayor

Resumen: La leche es un alimento que tiene una importante cantidad de macronutrimentos de gran biodisponibilidad, accesible y de relativo bajo costo. El conocimiento de los médicos en general sobre nutrición y composición de los alimentos es deficiente por lo que muchas de las intervenciones dietéticas que tradicionalmente recomendamos en diversos escenarios clínicos carecen de sustento científico. El objetivo de esta revisión fue generar una opinión técnica que sirva como marco de referencia para sustentar de mejor forma la recomendación sobre el consumo de leche y productos lácteos en la nutrición diaria de adultos y adultos mayores. Los efectos de la leche y productos lácteos durante la etapa pediátrica salen del contexto del presente trabajo. La Asociación Mexicana de Gastroenterología y la Asociación Mexicana de Gerontología y Geriatría comentaron y analizaron de forma conjunta temas acerca de la denominación legal de la leche, clasificación y perfil nutrimental de la leche de vaca, sus características nutrimentales, su consumo en el adulto, intolerancia a la leche de vaca, asociaciones entre el consumo de leche y alteraciones del aparato digestivo y otras condiciones; finalmente, se mencionan de forma breve algunos aspectos sobre el consumo de leche en el adulto mayor y su relación con la salud. Abstract: Milk is a liquid food that possesses an important quantity of highly bioavailable macronutrients. In addition, it is readily accessible, as well as relatively inexpensive. Given that the knowledge of physicians about nutrition and food composition is deficient, in general, many of the dietary interventions recommended in diverse clinical settings lack a scientific basis. The aim of the present review was to produce a technical opinion that serves as a frame of reference to best sustain recommendations for consuming milk and dairy products as daily nutrition in the adult and older adult. The effects of milk and dairy products during the pediatric stage are not addressed in the present work. The Asociación Mexicana de Gastroenterología and the Asociación Mexicana de Gerontología y Geriatría jointly discussed and analyzed topics dealing with the legal designation of milk, the classification and nutritional profile of cow's milk, its nutritional characteristics, its consumption in the adult, intolerance to cow's milk, and associations of milk consumption with digestive tract alterations and other conditions. Finally, certain aspects of milk consumption in the older adult and its relation to overall health are briefly discussed. Palabras clave: Lácteos, Leche de vaca, Alimentación, Adulto, Adulto mayor, Keywords: Dairy products, Cow's milk, Diet, Adult, Older adult

Introduction/aim: Older people with rheumatic diseases tend to have a greater number of associated comorbidities, which will require the use of more drugs, increasing the risk of hospitalizations, complications, and drug interactions. In Mexico, there has been an estimated prevalence of polypharmacy of up to 55%, however there are scarce reports on the topic in our elderly population with rheumatic diseases. We aimed to determine the prevalence of polypharmacy and the association of drug interactions in patients treated for rheumatic disease., Methods: A retrospective observational study was conducted on patients undergoing treatment for rheumatic diseases who were treated in geriatrics and rheumatology clinics from January to December 2021. The presence of polypharmacy and drug interactions was evaluated using the BOT Plus Pharmacological Surveillance System. The prevalence of polypharmacy and the association of drug interactions were estimated., Results: We evaluated 320 patients, with a mean age of 67.05±5.8 years, predominantly female (85%). The prevalence of polypharmacy was 68.1% (n=218), of which 214 (98.1%) patients had related drug interactions; 27.1% were severe and 53.2% as moderate interactions. Factors related with increased risk of drug interactions were being exposed to hypertension increased the risk of drug interactions (POR 1.75, 95% CI 1.44-2.14; P<0.001), having osteoarthritis (POR 1.21, 95% CI 1.04-1.42; P=0.032) and thyroid disease (POR 1.45, 95% CI 1.28-1.65; P=0.001). The most prevalent serious interactions were leflunomide-methotrexate in 27 (46.5%) patients and buprenorphine-tramadol in 8 (13.7%)., Conclusions: A high prevalence of polypharmacy and drug interactions was observed in elderly patients with rheumatic diseases. The main associated factors were comorbidities, particularly high blood pressure, osteoarthritis and thyroid diseases., (Copyright © 2024 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.)