Effect of an Immune-Boosting, Antioxidant and Anti-Inflammatory Food Supplement in Hospitalized COVID-19 Patients: A Prospective Randomized Pilot Study.

BACKGROUND: COVID-19 disease is a serious global health problem. Few treatments have been shown to reduce mortality and accelerate time to recovery. The aim of this study was to evaluate the potential effect of a food supplement (probiotics, prebiotics, vitamin D, zinc and selenium) in patients admitted with COVID-19. METHODS: A prospective randomized non-blinded clinical trial was conducted in a sample of 162 hospitalized patients diagnosed with COVID-19 recruited over eight months. All patients received standard treatment, but the intervention group (n = 67) was given one food supplement stick daily during their admission. After collecting the study variables, a statistical analysis was performed comparing the intervention and control groups and a multivariate analysis controlling for variables that could act as confounding factors. RESULTS: ROC curve analysis with an area under the curve (AUC) value of 0.840 (p < 0.001; 95%CI: 0.741-0.939) of the food supplement administration vs. recovery indicated good predictive ability. Moreover, the intervention group had a shorter duration of digestive symptoms compared with the control group: 2.6 ± 1.3 vs. 4.3 ± 2.2 days (p = 0.001); patients with non-severe disease on chest X-ray had shorter hospital stays: 8.1 ± 3.9 vs. 11.6 ± 7.4 days (p = 0.007). CONCLUSIONS: In this trial, the administration of a food supplement (Gasteel Plus®) was shown to be a protective factor in the group of patients with severe COVID-19 and allowed early recovery from digestive symptoms and a shorter hospital stay in patients with a normal-mild-moderate chest X-ray at admission (ClinicalTrials.gov number, NCT04666116).

Degree of Accuracy of the BMI Z-Score to Determine Excess Fat Mass Using DXA in Children and Adolescents.

Obesity is caused by fat accumulation. BMI Z-score is used to classify the different degrees of weight status in children and adolescents. However, this parameter does not always express the true percentage of body fat. Our objective was to determine the degree of agreement between the fat mass percentage measured by DXA and the stratification of weight according to BMI Z-score in the pediatric age group. We designed a descriptive cross-sectional study. The patients were classified as underweight/normal weight with Z-scores between -2 and +0.99, overweight from 1 to 1.99, obese from 2 to 2.99, and very obese ≥3. We included 551 patients (47% girls), with a mean age of 11.5 ± 2.8 years (3.7-18 years). Higher BMI Z-scores were associated with a higher percentage of total fat (p < 0.001). However, there were important overlaps between both parameters, such that the BMI Z-score classified patients with the same percentage of total fat mass as having a different nutritional status classification. In conclusion, the stratification of weight status according to BMI Z-score revealed that 46.7% of patients had a fat percentage that did not correspond to their classification. For a more accurate weight assessment in clinical practice, we recommend combining anthropometric indices with diagnostic tools that better correlate with DXA, such as electrical bioimpedance.

Factors Associated with Non-Adherence to Drugs in Patients with Chronic Diseases Who Go to Pharmacies in Spain.

BACKGROUND: Pharmacological non-adherence in chronic diseases is 40-65%. No predictive profile of non-adherence exists in patients with multiple chronic diseases. Our study aimed to quantify the prevalence of non-adherence to pharmacological treatment and its associated factors in patients who visit pharmacies in Spain. METHODS: This observational cross-sectional study included patients with one or more chronic diseases. The variables analyzed were demographics, diseases involved, self-medication, information about disease, and lifestyle. The main variable was adherence using the Morisky-Green test. A total of 132 pharmacies collaborated, providing 6327 patients representing all Spain regions (April-December 2016). Bivariate and multivariate analyses were performed and the area under the receiver operating characteristic (ROC) curve was calculated. RESULTS: Non-adherence was 48.4% (95% confidence interval (CI): 47.2-49.7%). The variables that reached significance in the multivariate model were: difficulty in taking medication, self-medication, desire for more information, smoking, lower physical activity, younger age and number of chronic treatments. Discrimination was satisfactory (area under the ROC curve = 70%). Our study found that 50% patients was non-adherent and we obtained a profile of variables associated with therapeutic non-adherence. CONCLUSIONS: It is cause for concern that in patients with multiple diseases and taking multiple medications, there is an association between non-adherence, self-medication and worse lifestyle.

Macronutrients and micronutrients in Spanish adult vegans (Mediterranean population).

INTRODUCTION: Objective: studies have been published in Europe comparing the mean macronutrient and micronutrient intake values of the general population with those of the vegan population, but none has been conducted in a country that mainly follows the Mediterranean diet. Therefore, the aim of this study was to carry out this comparison in Spain. Methods: a cross-sectional study of a sample of Spanish vegans was designed in 2015. To compare the distribution of nutrients with those of the general population, we used data from the Spanish Agency for Food Safety and Nutrition, which was considered to be normally distributed as it was a large population with biological parameters. All participants were asked about their dietary intake for the previous day (24 hour reminder) and the nutrients were calculated using specialized software. The distributions were compared using the Kolmogorov-Smirnov test. Results: The sample comprised 102 vegans, 67 of whom were women. The vegan population consumed more carbohydrates and fiber, less total fat (women only), fewer saturated fatty acids, and more polyunsaturated fatty acids. They had much lower cholesterol intake, lower calcium and iodine intake, higher iron and folic acid intake, and much lower intake of vitamins B12 and D. Conclusions: Spanish vegans had nutritional deficiencies compared to the general population and should therefore ensure their diet includes the necessary supplements.

INTRODUCCIÓN: Antecedentes: se han publicado en Europa estudios que comparan los valores medios de ingesta de macronutrientes y micronutrientes de la población general con los de la población vegana, pero ninguno se ha llevado a cabo en un país que sigue principalmente la dieta mediterránea. Por lo tanto, el objetivo de este estudio fue llevar a cabo esta comparación en España. Métodos: se diseñó un estudio transversal de una muestra de veganos españoles en 2015. Para comparar la distribución de nutrientes con los de la población general, utilizamos datos de la Agencia Española de Seguridad Alimentaria y Nutrición, considerando dichos datos como una distribución normal de parámetros biológicos al constituir una gran muestra. A todos los participantes se les preguntó sobre su ingesta dietética en el día anterior y los nutrientes se calcularon utilizando un software especializado. Las distribuciones se compararon mediante la prueba de Kolmogorov-Smirnov. RESULTADOS: La muestra comprendió 102 veganos, 67 de los cuales eran mujeres. La población vegana consumió más carbohidratos y fibra, menos grasa total (solo mujeres), menos ácidos grasos saturados y más ácidos grasos poliinsaturados. Tenían una ingesta mucho más baja de colesterol, una ingesta más baja de calcio y yodo, una mayor ingesta de hierro y ácido fólico, y una ingesta mucho más baja de vitaminas B12 y D. Conclusión: los veganos españoles tenían deficiencias nutricionales en comparación con la población general y, por lo tanto, deben asegurarse de que su dieta incluya los suplementos necesarios.

[Which variables influence compliance with physical activity recommendations in young children?] / ¿Qué variables influyen en el cumplimiento de las recomendaciones de actividad física en preescolares?

INTRODUCTION: There are established European guidelines for physical activity in childhood. The main goal of our study was to determine the factors that may influence compliance with European recommendations for physical activity in young children. METHODS: We included 136 children (aged 2-8 years) classified by weight status, calculated based on the body mass index z-score using the growth standards of the World Health Organization. We measured physical activity over 5 consecutive days with accelerometers and recorded the food intake. RESULTS: A greater level of physical activity was associated with a lower weight status category (B=-1.55; 95% CI: -2.02 to -1.08; P<.001), lower age (B=-1.33; 95% CI: -1.72 to -0.93; P<.001) and greater energy expenditure (B=0.02; 95% CI: 0.02 to 0.03; P<.001). The overall physical activity in the sample was light (mean=589 cpm/day). Children with overweight and obesity spent less time engaged in moderate to vigorous physical activity (P=.005) and more time engaged in sedentary activities (P=.005) compared to children with normal weight. All groups spent between 90 and 130minutes a day in sedentary activities, with a mean time spent that amounted to 15.5% of their time (excluding time spent sleeping). The adherence to European recommendations varied in association with sex (P=.010) and weight status (P=.038). CONCLUSION: Young children spent more than 100minutes a day engaged in sedentary activities. Most of the sample met the European recommendations for daily moderate to vigorous physical activity. However, the degree of adherence depended on sex and weight status.

Influence of Olive Extracts on the Expression of Genes Involved in Lipid Metabolism in Medaka Fish.

Aims. To assess the possible effect of polyphenol-rich olive extracts on lipid metabolism in medaka fish by quantifying the expression of lipogenic and lipolytic genes. Materials and methods. Adult medaka fish were maintained in tanks for five days with five extracts at 0.01% in water, causing obesity through a diet rich in carbohydrates, with a control group maintained in water with a normal diet. The extracts contained polyphenols ranging between 7 and 116 mg/g (oleuropein, hydroxytyrosol) with an antioxidant power of 2-13 mmol of 2,4,6-tri(2-pyridyl)-1,3,5-triazine/100 g. After five days, the fish were sacrificed and the hepatic mRNA and its complementary DNA were extracted by reverse transcription. Complementary DNAs were quantified for three lipolytic and three lipogenic genes by real-time PCR. The relative gene expression was calculated from the amplification curves in reference to the control group. Results. The expression of genes involved in lipolysis, including peroxisome proliferator-activated receptor-±, acyl-CoA oxidase 1, and carnitine palmitoyltransferase 1, were clearly decreased in fish subjected to an obesogenic diet, and this situation could not be reversed in fish maintained with polyphenol-rich extracts. In contrast, lipogenic fatty acid synthase, acetyl-CoA carboxylase 1, and sterol regulatory element-binding protein 1 genes increased considerably with the obesogenic diet and reverted to the normal state with the olive extracts. The effect was not dependent on the total polyphenol content, the specific oleuropein or hydroxytyrosol concentration, or the antioxidant power, suggesting a synergistic effect. Conclusion. Olive polyphenols, acting as anti-lipogenic agents, have a positive effect on lipid metabolism, but their mechanism in each gene is different according to the extract, which supports synergistic mechanisms with the different proportions of polyphenols and accompanying phytochemicals in each extract.

Burnout syndrome in nurses working in palliative care units: An analysis of associated factors.

AIMS: To analyse the association between psychological, labour and demographic factors and burnout in palliative care nursing. BACKGROUND: There is a lack of published research evaluating burnout in palliative care nursing. METHODS: This observational cross-sectional study involved 185 palliative care nurses in Mexico. The primary variables were burnout defined by its three dimensions (emotional exhaustion, depersonalization and personal accomplishment). As secondary variables, psychological, labour and demographic factors were considered. A binary logistic regression model was constructed to determine factors associated with burnout. RESULTS: A total of 69 nurses experienced high emotional exhaustion (37.3%), 65 had high depersonalization (35.1%) and 70 had low personal performance (37.8%). A higher proportion of burnout was found in the participants who were single parents, working >8 hr per day, with a medium/high workload, a lack of a high professional quality of life and a self-care deficit. CONCLUSION: Our multivariate models were very accurate in explaining burnout in palliative care nurses. These models must be externally validated to predict burnout and prevent future complications of the syndrome accurately. IMPLICATIONS FOR NURSING MANAGEMENT: Nurses who present the factors found should be the focus of interventions to reduce work stress.

Impact of paid work on the academic performance of nursing students.

UNLABELLED: Background. Little research exists on the impact of paid work on academic performance of students of health sciences. No research exists on this subject for students in Colombia. Objectives. This paper seeks to analyze the impact of paid work on academic performance among nursing students. DESIGN, SETTINGS AND PARTICIPANTS: cross-sectional research, involving 430 of nursing students from the National University of Colombia (N = 566). Methods. Variables analyzed: sex, age, work activity, attendance, current semester, degree subjects studied and unavailable, lost credits, grades during the second semester of 2013, and delayed semesters. Subgroups analyzed: (i) according to labor activity: do not work, work up to 20 h and work more than 20 h per week; (ii) Grade point average: failing is considered as less than 3.0 and passing 3.0 or above out of 5.0. Percentage of delayed semesters were calculated. Qualitative and quantitative variables were analyzed for groups by work activity. The percentage and probability of students getting a grade point average less than 3.0 and delaying semesters were calculated by multivariate logistic regression. Results. A total of 219 of the students work (50.9%), the main reason is socioeconomic, of which 99 (45.2%) work more than 20 h per week and have an increased risk of failing, which is higher in the first semester. They also get lower grades, lose more credits and take longer to finish the degree. The logistic bivariate regressions of success (grade point average, credits gained, courses gained and not having delayed semesters) reduce with work, above all in those who work more than 20 h per week and increase as the number of semesters completed increases, independent of sex. Conclusion. A high percentage of nursing students work more than 20 h per week. The compatibility of paid work with studies in university nursing students has a negative impact on academic performance, more so when they work more than 20 h per week. This negative impact diminishes as the student completes semesters, irrespective of the sex of the students.

Protection by polyphenol extract from olive stones against apoptosis produced by oxidative stress in human neuroblastoma cells

OBJECTIVE: We evaluated the protective activity of an extract from a by-product such as olive stones, through its ability to inhibit H202 induced apoptosis in the SH-SY5Y human neuroblastoma cell line. MATERIAL AND METHODS: To such end, 20,000 cells/well were cultivated and differentiation with retinoic acid was initiated. Once the cells were differentiated, apoptosis was induced with and without H2O2 extract. Finally, cDNA extraction was performed, and pro-apoptotic genes Bax and anti-apoptotic genes Bcl-2 were analyzed. Quantification of the gene expression was performed using the GAPDH gene marker. RESULTS: Cell viability with the extract is 97.6% (SD 5.7) with 10 mg/l and 62.8% (SD 1.2) to 50 mg/l, using 10 mg/l for the biomarker assay. The retinoic acid differentiated SH-S cell line (10 µM) shows a clear apoptosis when treated with H2O2 150 µM, with a Bax/Bcl-2 ratio of 3.75 (SD 0.80) in contrast to the differentiated control cells subjected to H2O2 and with extract, which have the same ratio of 1.02 (SD 0.01-0.03). CONCLUSION: The olive stone extract shows anti-apoptotic activity in the provoked cell death of SH-SY5Y human neuroblastoma cells in their normal state, defending them from oxidative stress which produces a significant increase in the apoptotic gene ratio in contrast to anti-apoptotic genes (Bax/Bcl-2).

INDICATORS OF SUCCESS IN THE DIETARY MANAGEMENT OF OVERWEIGHT AND OBESITY: WEIGHT, BODY FAT LOSS AND QUALITY.

CONCEPTS: %WL: Percentage of weight loss; %FL: Percentage of fat loss. OBJECTIVE: evaluate which unit of measurement for weight loss could determine the success or failure of dietary treatment for overweight and obesity. METHOD: 4,625 consultations carried out on 616 patients in the southeast of Spain from 2006 to 2012. All of the patients were over 25 years of age and suffered from overweight or obesity. The consultations were carried out every fortnight, using the Mediterranean or low-calorie diet. The patients were divided into four groups according to their %WL and %FL. RESULTS: most of the sample consisted of: women; participants between 25-45 years of age; attended consultations for over a month and a half; obese. 80% of the patients obtained a %FL ≥ 5% (15.5 } 12.8). The groups with a higher %FL obtained significant differences in weight loss (22.6 vs 11.2%, p = 0.000). The multinomial analysis shows significant differences between the groups with the highest %FL and the lowest %WL and %FL: sex (p = 0.006 vs p = 0.005), BMI (p = 0.010 vs p = 0.003) and attendance (p = 0.000 vs p = 0.000). CONCLUSION: the patients who lost < 5% of fat had higher initial parameters (percentage of weight and fat); most of the sample lost ≥ 5% of fat. This means that the method of personalised dietary treatment results in a high fat loss; fat is an indicator of the quality loss obtained. RECOMMENDATIONS: use the measurement of fat as a complementary unit of measurement to weight loss; establish a limit of 5% to evaluate such loss; and increase this type of research in any method of weight loss.

Conceptos: %WL: Porcentaje de perdida de peso; %FL: Percentage of fat loss. Objetivo: evaluar que unidad de medida en la perdida podria determinar el exito o fracaso del tratamiento dietetico en el sobrepeso y obesidad. Método: 4.625 consultas se llevaron a cabo con 616 pacientes mayores de 25 anos con sobrepeso y obesidad, en el sur-este de Espana, durante los anos 2006-12. Las consultas se realizaban quincenalmente, se utilizo la dieta mediterranea e hipo-calorica. Se formaron cuatro grupos en funcion del menor o mayor %WL y %FL. Resultados: la mayoria de la muestra esta formada por: mujeres; participantes entre 25-45 anos; asistentes a mas de mes y medio; obesos. El 80% de los pacientes obtienen un %FL ≥ 5% (15,5}12,8). Los grupos con mayor %FL obtiene diferencias significativas en la perdida (22,6 vs 11,2%, p=0,000). El analisis multinomial, destaca diferencias significativas cuando se compara los grupos de mayor %FL con el menor %WL y %FL: en el sexo (p=0.006 vs p=0.005), IMC (p=0.010 vs p=0.003) y asistencia (p=0.000 vs p=0.000). Conclusión: los pacientes que pierden < 5% de grasa, muestran parametros iniciales mayores (Porcentaje de peso y grasa); la mayoria de la muestra pierde ≥ 5% de grasa, por lo que el tratamiento dietetico individualizado es un metodo que obtiene una elevada perdida de grasa; la grasa es un indicador de la calidad de la perdida obtenida. Se recomienda: la medicion de la grasa como unidad de medida complementaria al peso; establecer el limite del 5% para evaluar dicha perdida; y aumentar la investigacion en esta linea en cualquier metodo de perdida.

[PREDICTORS OF WEIGHT LOSS AND FAT IN THE DIETARY MANAGEMENT: SEX, AGE, BMI AND CONSULTING ASSISTANCE]. / FACTORES PREDICTORES DE PÉRDIDA DE PESO Y GRASA EN EL TRATAMIENTO DIETÉTICO: SEXO, EDAD, ÍNDICE DE MASA CORPORAL Y CONSULTA DE ASISTENCIA.

UNLABELLED: WL%: percentage of weight loss; % FL: percentage fat loss; PNLWF: patients who lose weight or fat; PLWF: patients who lose weight and fat. OBJECTIVE: assess whether the% WL and FL% in the dietary treatment was affected by gender, age, BMI and assistance to the query. METHOD: 4,700 consultations, 670 patients (BMI ≥25), in the south-east of Spain (2006-12). Balanced and hypo-caloric diet was used. Two types of patients: PNLWF and PLWF (91.9%). RESULTS: in PLWF, men and those attending a greater number of occasions to the consultation have shown a greater loss against women (%FL: 23.0 vs 14.3%, p = 0.000; %WL: 7.7 vs 6.6%, p = 0.020), and those who attend less frequently (%FL: 19.1 vs 7.3%, p = 0.000; %WL: 7.8 vs 2.9%, p = 0.000). Multinomial regression analysis (PNLWF / PLWF) indicates that only attend more than one and a half to the consultation is a factor in the loss, OR 8.3 (IC 95% 4.5-15.1; p = 0.000). CONCLUSION: the body fat measurement provides additional information lost weight; Most patients attend more than six weeks, obtained a high %FL; attendance is a predictor of loss; the %FL indicates that the dietary management plays a major role in the resolution of this pathology; It is recommended to design practical schemes of action process nutritionists according to the IMCI and variable.

%WL: porcentaje de pérdida de peso; %FL: porcentaje de pérdida de grasa; PNLWF: pacientes que pierden peso o grasa; PLWF: pacientes que pierden peso y grasa. Objetivo: evaluar si el %WL y el %FL en el tratamiento dietético, se vieron afectados por el género, la edad, el IMC y la asistencia a la consulta. Método: 4.700 consultas, 670 pacientes (IMC ≥25), en el sur-este de España (2006-12). Se utilizó la dieta equilibrada e hipocalórica. Dos tipos de pacientes: PNLWF y PLWF (91,9%). Resultados: en los PLWF, los hombres y los que asisten en mayor número de ocasiones a la consulta han mostrado una mayor pérdida, frente a las mujeres (%FL: 23,0 vs 14,3%, p = 0,000; %WL: 7,7 vs 6,6%, p = 0,020), y los que asisten con menor frecuencia (%FL: 19,1 vs 7,3%, p = 0,000; %WL: 7,8 vs 2,9%, p = 0,000). El análisis de regresión multinomial (PNLWF/ PLWF) indica que solo el asistir a más de mes y medio a la consulta es un factor que influye en la pérdida, OR 8,3 (IC 95% 4,5-15,1; p = 0,000). Conclusión: la medición de la grasa corporal proporciona una información adicional al peso perdido; la mayoría de los pacientes que asisten más de mes y medio obtienen un elevado %FL; la asistencia es un factor predictor de la pérdida; el %FL indica que el tratamiento dietético juega un papel principal en la resolución de esta patología; se recomienda diseñar esquemas prácticos del proceso de actuación de los nutricionistas en función del IMCi y el variable.

Diagnostic inertia in dyslipidaemia: results of a preventative programme in Spain.

Others have analysed the relationship between inadequate behaviour by healthcare professionals in the diagnosis of dyslipidaemia (diagnostic inertia) and the history of cardiovascular risk factors. However, since no study has assessed cardiovascular risk scores as associated factors, we carried out a study to quantify diagnostic inertia in dyslipidaemia and to determine if cardiovascular risk scores are associated with this inertia. In the Valencian Community (Spain), a preventive programme (cardiovascular, gynaecologic and vaccination) was started in 2003 inviting persons aged ≥40 years to undergo a health check-up at their health centre. This cross-sectional study examined persons with no known dyslipidaemia seen during the first six months of the programme (n = 16, 905) but whose total cholesterol (TC) was ≥5.17 mmol/L. Diagnostic inertia was defined as lack of follow-up to confirm/discard the dyslipidaemia diagnosis. Other variables included in the analysis were gender, history of cardiovascular risk factors/cardiovascular disease, counselling (diet/exercise), body mass index (BMI), age, blood pressure, fasting blood glucose and lipids. TC was grouped as ≥/<6.20 mmol/L. In patients without cardiovascular disease and <75/≤65 years (n = 15, 778/13, 597), the REGICOR (REgistre GIroní del COr)/SCORE (Systematic COronary Risk Evaluation) cardiovascular risk functions were used to classify risk (high/low). Inertia was quantified and the adjusted odds ratios calculated from multivariate models. In the overall sample, the rate of diagnostic inertia was 52% (95% CI [51.2-52.7]); associated factors were TC ≥ 6.20 mmol/L, high or "not measured" BMI, hypertension, smoking and higher values of fasting blood glucose, systolic blood pressure and TC. In the REGICOR sample, the rate of diagnostic inertia was 51.9% (95% CI [51.1-52.7]); associated factors were REGICOR high and high or "not measured" BMI. In the SCORE sample the rate of diagnostic inertia was 51.7% (95% CI [50.9-52.5]); associated factors were SCORE high and high or "not measured" BMI. Diagnostic inertia existed in over half the patients and was associated with a greater cardiovascular risk.

The variability in adherence to dietary treatment and quality of weight loss: overweight and obesity.

OBJECTIVE: Observation of weight loss and the maximum time that individualized dietary treatment qualitative and quantitative is shown to be effective. METHOD: 4625 consultations were conducted with 616 patients over 25 years old, in the nutrition consultation, using the qualitative and quantitative individualized dietary treatment. As a result we controlled the weight loss, the fat and the quality and variability of the loss, monthly according to sex, age and BMI in an urban area of southeastern Spain. RESULTS AND DISCUSSION: A low level of abandonment was proved in men, patients older than 45 years old compared to obese showed a higher degree. The quality of the loss was greater in men under 45 years old, overweight patients, however, more research is needed in this area. Measuring the waist and hips has led to an increasing interest in measuring indicators of body fat. CONCLUSION: The individualized dietary treatment has been proved to be effective for six months and then a multidisciplinary mode of this treatment is recommended. The use of new ways to assess weight loss is proposed taking into consideration the quality and variability of loss, regardless of the treatment used.

Objetivo: Observación de la pérdida de peso y el tiempo máximo que se muestra el tratamiento dietético individualizado cuali-cuantitativo para ser eficaz. Método: 4625 consultas se llevaron a cabo con 616 pacientes mayores de 25 años, en la consulta de nutrición, utilizando la herramienta de tratamiento dietético individualizado cuali-cuantitativo, como resultado se controló la pérdida de peso, la grasa, la calidad y la variabilidad de la pérdida, mensualmente en función del sexo, la edad y el IMC en una zona urbana del sureste de España. Resultados y discusión: Se demostró un bajo nivel de abandono en los hombres, en los pacientes mayores de 45 años, frente a los obesos que mostraron un mayor grado. La calidad de la pérdida fue mayor en los hombres, los menores de 45 años, los pacientes con sobrepeso, sin embargo, se necesita más investigación en esta área. La medición de la cintura y las caderas ha llevado a un creciente interés en los indicadores de medición de grasa corporal. Conclusión: El tratamiento dietético individualizado ha demostrado ser eficaz en los seis meses y, posteriormente, se recomienda su uso en el modo multidisciplinario. Se propone el uso de nuevas formas de evaluar la pérdida de peso: la calidad y la variabilidad de la pérdida, independientemente del tratamiento utilizado.

Are obese patients assisted in losing weight?

OBJECTIVES: To quantify obesity inertia (OI) in primary healthcare in the Valencian Community (Spain) and determine the related factors. STUDY DESIGN: Cross-sectional analysis. METHODS: In 2003, the whole population 40 years and older was invited to undergo a check-up. We included all obese persons (body mass index [BMI] ≥ 30 kg/m2) of the first 6 months after the invitation (n = 8687). OI was defined as the lack of advice by the healthcare professionals to lose weight. Other data recorded: gender, history of cardiovascular risk factors (CVRFs) or cardiovascular disease (CVD), groups of BMI (Class I obesity [BMI < 35 kg/m2] and the rest), age, blood pressure, and lipids. The patients without CVD and who were younger than 75 years (n = 7700) were classified according to the REGICOR cardiovascular risk as either high or low. The OI was quantified and related factors assessed, calculating the adjusted odds ratios (ORs) from multivariate models. RESULTS: In the overall sample, OI was 16.6% (95% confidence interval [CI], 15.8-17.4). Associated factors: male (OR = 1.19; 95% CI, 1.06-1.35); no history of hypertension (OR = 0.85; 95% CI, 0.74-0.97), or dyslipidaemia (OR = 0.86; 95% CI, 0.73-1.01), or diabetes (OR = 0.80; 95% CI, 0.64-1.00), or CVD (OR = 0.79; 95% CI, 0.62-1.01); and Class I obesity (OR = 0.83; 95% CI, 0.72-0.96). In the REGICOR sample, the OI was 16.9% (95% CI, 16.0-17.7). Associated factors: high REGICOR (OR = 2.27; 95% CI, 1.30-3.98) and Class I obesity (OR = 0.82; 95% CI, 0.71-0.95). CONCLUSIONS: OI exists in 1 of every 6 patients. OI occurs less frequently in patients with a history of CVRF, and more frequently in Class I obesity and in those with a high cardiovascular risk.