Copper and Copper/Zinc Ratio in a Series of Cystic Fibrosis Patients.

Cystic fibrosis (CF) patients require a stable and sufficient supply of micronutrients. Since copper is an essential micronutrient for human development, a cross-sectional study was carried out to investigate the serum copper levels, serum copper/zinc (Cu/Zn) ratios, and their relationship with nutritional indicators in a group of CF patients. Anthropometric, biochemical, and dietary measurements, an abdominal ultrasound, and respiratory and pancreatic tests were conducted. Seventeen CF patients were studied (10 females, 59%), 76.5% of whom were ∆F580. Their mean serum copper (113 ± 23 µg/dL) was normal, and there was only one teenager with hypocupremia (6%) and two children with hypercupremia (18%). A significant association between serum copper and zinc levels was discovered. The Cu/Zn ratio was higher than 1.00 for 94% of patients, which is an indicator of an inflammation status. There was no significant correlation between the serum copper concentrations and respiratory and pancreatic function, respiratory colonization, and the results of the abdominal ultrasound. Linear regression analysis showed that serum copper had a positive association with both the Z-score body mass index (BMI) and mean bone conduction speed (BCS). Therefore, since 94% of CF patients had a Cu/Zn ratio > 1.00, this factor must alert us to consider the risk of zinc deficiency and high inflammatory response. The measurement of serum zinc alone does not show one's zinc status. However, the Cu/Zn ratio may be an indicator of zinc deficiency and the inflammatory status of CF patients.

Zinc Nutritional Status in Patients with Cystic Fibrosis.

BACKGROUND: Zinc is an essential nutrient for all forms of life and its deficiency affects the normal growth and development of human beings. OBJECTIVE: The main aim was to investigate zinc nutritional status by serum zinc concentration (SZC) and dietary zinc intake and their association in cystic fibrosis (CF) patients. METHODS: A cross-sectional study was conducted in CF patients. Anthropometric measurements and respiratory and pancreatic tests were conducted. Hypozincemia was determined by SZC while using atomic absorption spectrophotometry and dietary zinc deficiency by prospective 72-h dietary surveys. RESULTS: Mean SZC (87.2 ± 16.7 µg/dL) and dietary zinc intake (97 ± 26.9% Dietary Reference Intake) were normal. Three of 17 patients with CF (17.6%) had hypozincemia and four (23.5%) had a dietary zinc deficiency. No patient with dietary zinc deficiency had hypozincemia. A positive and significant association was observed between SZC and Z-score of BMI-for-age (p = 0.048) and weight-for-height (p = 0.012) and between dietary zinc intake and energy intake (EI, p = 0.036) and Z-score of weight-for-high (p = 0.029). CONCLUSION: SZC was associated with the nutritional status, expressed as BMI (Body Mass Index) and weight-for-height Z score, and dietary zinc intake with EI and weight-for-height Z-score. No patient with hypozincemia had dietary zinc deficiency. This situation should alert us to a marginal zinc deficiency and it may explain why there were no overlapping cases between the two groups. We suggest that probably 41% of the cases in this study would be at elevated risk of zinc deficiency and a zinc supplementation may be considered.

Bioelectrical impedance vector reference values for assessing body composition in a Spanish child and adolescent population.

OBJECTIVES: Reference values of the bioelectrical impedance vector for the Spanish child and adolescent population are needed for assessing body composition and hydration status in this population. The aim of this study is to provide reference values of the bioelectrical impedance vector in Spanish children and adolescents aged 4-18 years from Castilla y León. METHODS: This was a cross-sectional descriptive study conducted in 4401 Spanish healthy children and adolescents aged 4-18 years (2265 boys and 2136 girls). Resistance and reactance were measured with a single-frequency impedance analyzer at 50 kHz (tetrapolar analysis). The values of resistance and reactance normalized by height were used to plot the bivariate 50th, 75th, and 95th percentiles of the population by age group. Mean impedance vectors were compared with Hotelling's T2 test for vector analysis (differences being considered significant if p < .05). RESULTS: Tolerance ellipses were drawn for the Spanish child and adolescent population studied. The mean impedance vector showed displacement across all age groups except for (1) girls aged 12-13 years, (2) girls aged 15-18 years, and (3) boys aged 16-18 years. There were sex-related differences in the mean impedance vector in all age ranges, even in prepubertal children. Among adolescents, the patterns of the vector displacement were consistent with the timing of normal growth and development in all groups and are attributable to the maturation process. CONCLUSIONS: New tolerance ellipses have been constructed for Spanish children and adolescents by sex and age. These ellipses reflect the timing of normal childhood growth and development.

Ingesta dietética y adherencia a la dieta mediterránea en un grupo de estudiantes universitarios en función de la práctica deportiva.

Introducción: la alimentación de los jóvenes universitarios se aleja cada vez más de la dieta mediterránea (DM). El binomio alimentación-actividad física es fundamental para mantener un adecuado estado de salud.Objetivo: comparar la ingesta en un grupo de estudiantes universitarios deportistas frente a otro que no realiza deporte habitualmente.Sujetos y métodos:estudio observacional transversal realizado en 49 voluntarios de la Universidad de Valladolid. Se determinaron peso, talla y actividad física (cuestionario GPAQ). La ingesta se evaluó a partir de un cuestionario de frecuencia de consumo y un registro de alimentos de 3 días. La adherencia a la DM se estimó con el Mediterranean Diet Score. Las diferencias entre las variables en función del sexo y la práctica deportiva se analizaron con la t de Student o la U-Mann-Whitney. Significación estadística: p < 0,05.Resultados: todos los sujetos presentaron normopeso, sin diferencias en función de la práctica deportiva. El nivel de actividad física fue inferior en las mujeres. En todos los estudiantes la dieta fue ligeramente hiperproteica, rica en grasas y colesterol, con un inadecuado perfil lipídico y deficiente en hidratos de carbono y fibra. Se cubren los requerimientos de micronutrientes. Destaca un escaso consumo de frutas-verdurashortalizas, cereales, aceite de oliva, pescado y frutos secos; y un exceso de carne, mantequilla, bollería-industrial, dulces, snacksy refrescos. El 50% de la muestra tiene una adherencia baja o muy baja a la DM.Conclusión: las dietas de los jóvenes universitarios no cumplen los objetivos nutricionales para la población española y presentan una adherencia media-baja a la DM, independientemente de la práctica deportiva.

[Not Available]. / Nutritional approach of inpatients with anorexia nervosa.

Anorexia nervosa (AN) is the most prevalent of eating disorders in children and adolescents, and its treatment is long and complex, involving a multidisciplinary team. Nutritional rehabilitation and restoration of a healthy body weight is one of the central goals in the initial stages of inpatient treatment. However, current recommendations on initial energy requirements for these patients are inconsistent, with a clear lack of controlled studies, available scientific evidence and global consensus on the most effective and safe refeeding practices in hospitalized adolescents with anorexia nervosa (AN). Conservative refeeding recommendations have been classically established in order to prevent the refeeding syndrome. Nevertheless, various works have recently appeared advocating a higher initial caloric intake, without observing more complications or refeeding syndrome, and allowing a shorter average stay. We present our experience in the treatment of restricting AN with a conservative progressive treatment. We have obtained good results with this approach, which was well tolerated by patients, with no observing complications. As a consequence, the medical team could establish a pact about the therapeutic goals with the patients in an easier way.

[Nutritional status assessment in Geriatrics: Consensus declaration by the Spanish Society of Geriatrics and Gerontology NutritionWork Group]. / Valoración del estado nutricional en Geriatría: declaración de consenso del Grupo de Nutrición de la Sociedad Española de Geriatría y Gerontología.

Ongoing population ageing is one of the factors influencing the increase in the prevalence of undernutrition, as elderly people are a vulnerable group due to their biological, psychological and social characteristics. Despite its high prevalence, undernutrition is underdiagnosed in the geriatric sphere. For this reason, the aim of this consensus document is to devise a protocol for geriatric nutritional assessment. A multidisciplinary team has been set up within the Spanish Society of Geriatrics and Gerontology (in Spanish Sociedad Española de Geriatría y Gerontología [SEGG]) in order to address undernutrition and risk of undernutrition so that they can be diagnosed and treated in an effective manner. The MNA-SF is a practical tool amongst the many validated methods for nutritional screening. Following suspicion of undernutrition, or after establishing the presence of undernutrition, a full assessment will include a detailed nutritional history of the patient. The compilation of clinical-nutritional and dietetic histories is intended to help in identifying the possible risk factors at the root of a patient's undernutrition. Following this, an anthropometric assessment, combined with laboratory data, will describe the patient's physical and metabolic changes associated to undernutrition. Currently, the tendency is for further nutritional assessment through the use of non-invasive techniques to study body composition in association with functional status. The latter is an indirect index for nutritional status, which is very interesting from a geriatrician's point of view. To conclude, correct nutritional screening is the fundamental basis for an early undernutrition diagnosis and to assess the need for nutritional treatment. In order to achieve this, it is fundamental to foster research in the field of nutritional geriatrics, in order to expand our knowledge base and to increasingly practice evidence-based geriatrics.

Bioimpedance vector analysis and conventional bioimpedance to assess body composition in older adults with dementia.

OBJECTIVE: Although dementia and nutritional status have been shown to be strongly associated, differences in body composition (BC) among older people with dementia have not yet been firmly established. The aim of this study was to assess BC through conventional and vector bioimpedance analysis (BIA and BIVA, respectively) in a sample of institutionalized older men with and without dementia, in order to detect dementia-related BC changes. METHODS: Forty-one institutionalized men ages ≥ 65 y (23 without dementia [CG] and 18 with dementia [DG]) were measured with BIA and interpreted with BIVA and predictive equations. RESULTS: Age (74.4 and 75.7 y) and body mass index (22.5 and 23.6 kg/m(2)) were similar for DG and CG, respectively. Resistance and ratio of resistance to height did not differ significantly between the two groups. Reactance and ratio of reactance to height were 21.2% and 20.4% lower in DG than in CG. Phase angle was significantly lower in DG (mean = 4.0; 95% confidence interval [CI], 3.6°-4.3°) than in CG (mean = 4.7; 95% CI, 4.3°-5.1°). Mean fat mass index (6 and 7 kg/m(2)), and mean fat-free mass index (16.4 and 16.6 kg/m(2)) were similar in both groups. BIVA showed a significant downward migration of the ellipse in DG with respect to CG (T(2) = 15.1; P < 0.01). CONCLUSION: Conventional BIA showed no significant differences in BC between DG and CG, although reactance and ratio of reactance to height were about 21% lower in DG. Nevertheless, a body cell mass depletion and an increase in the ratio of extracellular to intracellular water were identified in DG using BIVA. BIVA reflects dementia-related changes in BC better than BIA.