[Pharmacological treatment of obesity for Primary Care physicians]. / Tratamiento farmacológico de la obesidad para médicos de Atención Primaria.

Obesity is a disease of high prevalence in Primary Care clinics. It is associated with major comorbidities (dyslipidaemia, diabetes, hypertension) that increase morbidity and mortality, health expenditure, and reduces the quality of life of patients. Changes in lifestyle are still the pillars of the treatment of excess weight. Pharmacological treatment should be considered when there are difficulties in achieving weight loss goals. In this article, a review is presented on the currently authorised drugs for the treatment of obesity and overweight with major comorbidities.

Costs resulting from premature mortality due to cardiovascular causes: A 20-year follow-up of the DRECE study. / Mortalidad prematura cardiovascular y sus costes: 20 años de seguimiento del estudio DRECE.

OBJECTIVES: Cardiovascular diseases are still the leading cause of death in Spain. The DRECE study (Diet and Cardiovascular Disease Risk in Spain), based on a representative cohort of the Spanish general population, analyzed nutritional habits and lifestyle and their association with morbidity and mortality patterns. We estimated the impact, in terms of loss of productivity, of premature mortality attributed to cardiovascular diseases. METHODS: The loss of productivity attributed to premature mortality was calculated from 1991, based on the potential years of life lost and the potential years of working life lost. RESULTS: During the 20-year follow-up of a cohort of 4779 patients, 225 of these patients died (men, 152). Sixteen percent of the deaths were attributed to cardiovascular disease. The costs due to lost productivity by premature mortality exceeded 29 million euros. Of these, 4 million euros (14% of the total cost) were due to cardiovascular causes. CONCLUSIONS: Premature cardiovascular mortality in the DRECE cohort represented a significant social cost due to lost productivity.

Check-ups in obese and diabetic patients: preventive medicine.

Obesity is a chronic disease associated with important additional diseases, such as DM 2, that both reduce life quality and increase morbimortality from any cause. In the Western world, obesity is directly responsible for most deaths due to associated chronic disease. Therefore, substantial effort should be directed towards adequate primary prevention campaigns and policies, as well as towards an intensive and long-term multidisciplinary treatment of obesity, in an attempt to combat this threat to the health of a large part of our population.

Dietary habits and cardiovascular risk in the Spanish population: the DRECE study (II) micronutrient intake. Dieta y Riesgo de Enfermedades Cardiovasculares en España.

OBJECTIVE: To evaluate the dietary micronutrient intake in the adult Spanish population participating in the DRECE study. METHODS: The cross-sectional study was performed in two stages in 1991 and 1996 in 43 primary care clinics. One thousand two hundred people 'with cardiovascular risk' and 600 'without risk' answered a food frequency questionnaire. RESULTS: Significant increases in vitamin C, retinol, lycopenes, beta-cryptoxanthin and vitamin E intakes were found. Vitamin A, alpha-carotenoid and lutein intakes decreased. Vitamin B(12), B(6) and folic acid intakes increased in people with cardiovascular risk, whereas only the last two increased in the control group. Nearly 100% of the people consumed the recommended dietary allowances for vitamins B(12) and B(6) and >70% for folic acid. Calcium, iron, and zinc intake increased in both groups, but magnesium and selenium intake increased only in people at risk. Vitamin A, B(1) and zinc intakes have decreased, and >50% of the people do not consume the recommended dietary allowance. CONCLUSION: Antioxidant vitamins and vitamin B(12), B(6) and folic acid intakes seem to be adequate in the adult Spanish population, no significant differences appear regarding their cardiovascular risk status. Vitamin A, B(1) and zinc intakes are not appropriate.

Dietary habits and cardiovascular risk in the Spanish population: the DRECE study (I). Diet and Cardiovascular Events Risk in Spain.

BACKGROUNDS/AIMS: To investigate dietary habits and their evolution with regard to cardiovascular risk status in Spain. METHODS: Cross-sectional study performed in two phases in 1991 and 1996 in 43 primary care clinics. One thousand and two hundred people classified as 'with cardiovascular risk' and 600 'without risk' were studied. Each participant answered a food frequency questionnaire. RESULTS: The risk group did not change oil, cereals and dairy products consumption, decreased egg, legume and meat, and increased fish, fruits and vegetables intake. The control group differed in increasing dairy products and not decreasing eggs and vegetables consumption. A small decrease in energy intake happened, from 11,315. 1 to 10,941.5 kJ in the risk group (p < 0.05). Carbohydrates intake showed a not statistically significant falling trend from 41.3 to 40.6% in people at risk and 41.8 to 40.7% in those without risk. Protein intake increased in both groups up to 16.5% and fat consumption kept at around 42.9% in both groups. The decrease in saturated fat and increase in polyunsaturated fat were statistically significant in people at risk (p = 0.000). High cholesterol intakes were found. CONCLUSION: People with cardiovascular problems changed their dietary habits in a 'healthier' way than people without risk.

[Nutritional recommendations in gynecology]. / Recomendaciones nutricionales para ginecología.

In pregnant women, appropriate eating habits has a key role to play in the development of the foetus and is also related with the amount of labour at delivery, helping to avoid complications. In addition, correct nutrition is also necessary during the puerperium to encourage breast feeding and provide the new-born child with an adequate nutritional status without leading to any deficits in the mother.

[Influence of pancreatic insulin reserve on the metabolic control of type I and II diabetes mellitus]. / Influencia de la reserva pancreática de insulina sobre el control metabólico de las diabetes tipos I y II.

We have studied 22 diabetic patients, 14 type I and 8 type II, in order to determine if there is a correlation between metabolic control and pancreatic reserve of insulin. All the patients were treated with optimum doses of bolus/basal insulin. They underwent a peptide C test (at baseline and after 3 stimulus with glucagon) and every month, during 3 months, HbA1c and fructosamine were measured, with monthly self control of glycemia. Both HbA1c and fructosamine showed a statistically significant improvement during the study. In all the cases, there was a negative correlation between metabolic control and pancreatic reserve, with statistical significance for type I, especially regarding the response of peptide C to the administration of glucagon. We conclude that the preservation of a good endogenous secretion of insulin benefits the metabolic control of diabetes.