[Comparison of dietary reference intakes (DRI) between different countries of the European Union, The United States and the World Health Organization]. / Comparativa de las Ingestas Dietéticas de Referencia (IDR) de los diferentes países de la Unión Europea, de Estados Unidos (EEUU) y de la Organización Mundial de la Salud (OMS).

BACKGROUND: In Spain, there are some organizations and scientific societies that have edited reference values of recommended nutrient intake, but whose data does not always agree in terms of format and content. AIMS: To review the definitions, data and methodology that other countries or groups of countries have followed to obtain and document their own reference values in order to offer basic information to facilitate the establishment of the best reference values for the Spanish population. FIELD: Review of the available information in different countries (or groups of countries) from the European Union, the United States and World Health Organization. The analysed data concerned to healthy populations. CONCLUSIONS: Reference intakes differ among the examined countries according to population groups, included nutrients, methodology and frequency of published reviews. However, most of the countries define major concepts in the same way, although with different names in each country. On the other hand, most of the studied cases represent only a scientific organization in charge of the publication and update of the values of dietary reference intakes, but not in Spain. In that context, it looks convenient to reach a consensus among all Spanish organizations and scientific societies that are involved in this task, in order to establish an acceptable reference values.

[Management models in clinical nutrition: weaknesses and strengths]. / Modelos de gestión en nutrición clínica: Puntos débiles y puntos fuertes.

At the 6th Abbott-SENPE Debate Forum a multidisciplinary and multiprofessional discussion was established in order to seek for the model or the models of clinical management most appropriate for Clinical Nutrition and Dietetics Units (CNAD) in Spain. The weaknesses and strengths as well as opportunities for the current systems were assessed concluding that a certain degree of disparity was observed not only due to regional differences but also to different hospital types. It was proposed, from SENPE, the creation of a working group helping to standardize the models and promote the culture of Integral Control and Change Management.

Green tea reduces LDL oxidability and improves vascular function.

OBJECTIVE: Several different epidemiological studies have examined the association between the consumption of tea and coronary heart disease. Some, though not all, support the view that tea or flavonoids reduce the risk of cardiovascular heart disease. The aim of this study was to determine the short-to medium-term effect of a green tea extract on vascular function and lipid peroxidation as compared with placebo. METHODS: The study was undertaken with 14 healthy women, none of whom were receiving any medical treatment. Measurements were made of antibodies and immune complexes by ELISA, endothelial dependent vascular function by Doppler ultrasound, and the concentration of oxidized LDL by TBARS. RESULTS: The mean diameter of the brachial artery following the post-compression hyperaemia phase rose significantly (p < 0.0001) after treatment with green tea extract. Flow-mediated brachial artery vasodilation ranged from 5.68% for the placebo phase to 11.98% after the green tea extract (p = 0.02). The consumption of green tea extract was associated with a significant 37.4% reduction in the concentration of oxidized LDL (TBARS) (p = 0.017). The levels of anti-oxidized LDL IgM antibodies fell significantly after treatment (p = 0.002). CONCLUSION: This study found that consumption of green tea extract by women for five weeks produced modifications in vascular function and an important decrease in serum oxidizability.

Effects of pork vs veal consumption on serum lipids in healthy subjects.

AIMS: To analyse the influence of lean pork (P) and veal (V) consumption on the lipid profile of healthy subjects within the framework of a healthy diet comprising low levels of total fat (TF), saturated fatty acids (SFA) and cholesterol. DESIGN: Double-crossover, randomized and controlled trial SUBJECTS: 44 healthy individuals (22 male and 22 female), recruited voluntarily from the University Complutense of Madrid. The weight and lipid profiles of these volunteers were normal and their dietary patterns were typical for people in our area. INTERVENTIONS: The study comprised 4 phases: stabilisation phase (5 weeks), the participants followed their normal diet; second phase (6 weeks), half of the subjects, were randomised to lean pork or veal consumption, 150 g per day, for their main meal of the day; washout period (5 weeks) and final phase, which was the second phase of intervention (6 weeks). During the intervention stages, only the main meal of the day was taken in the Hospital. The rest of the subjects' diets consisted of different fortnightly menus designed in accordance with the recommendations of the Spanish Society of Arteriosclerosis (SEA). RESULTS: After both stages of intervention had been completed, there was a mean reduction of 5.5% in low-density lipoprotein cholesterol. However, after each intervention there were no significant differences between those who had consumed P, 2.62 (0.55) mmol/L and those who had consumed V, 2.71 (0.47) mmol/L. No differences were observed in any of the other parameters between those who had consumed P and those who had consumed V. CONCLUSIONS: Lean pork and veal produces similar effects on the lipid profiles of healthy subjects. Its consumption, as part of the saturated fat and cholesterol-controlled diet, could therefore be included in food guidelines, both for normal and therapeutic diets.

Severe hypocalcemia following total thyroidectomy after biliopancreatic diversion.

Patients undergoing malabsoprtive operations for bariatric surgery are prone to disturbances of bone metabolism, but this does not commonly lead to clinical symptoms. We present a morbidly obese patient who had undergone the biliopancreatic diversion of Larrad, and presented clinical symptoms of severe hypocalcemia and tetany after total thyroidectomy. Very high doses of i.v. calcium and calcitriol and 10 days of hospitalization were required to control the symptoms and correct plasma levels. The physiological aspects that contribute to this situation are discussed.

[Parenteral nutrition of patients under intensive chemotherapy: comparative study of two lipid emulsions]. / Nutrición parenteral en pacientes con quimioterapia intensiva: estudio comparativo de dos emulsiones lipídicas.

Neoplastic patients receiving intensive chemotherapy often need total parenteral nutrition (TPN), with lipid emulsions based on long-chain triglycerides (LCT) or medium-chain triglycerides (MCT). Potential benefits of MCT include easier metabolism and limited storage. Our present investigation was performed to define if there is any real clinical advantage of any of these lipid emulsions in this group of patients. Fifty-one patients receiving the LCT emulsion and sixty of them receiving the MCT-LCT one were evaluated retrospectively. TPN with 40% of non-protein kilocalories as fat was administered during a mean time of 11.5 days. No differences in total cholesterol, albumin, prealbumin, transferrin, bilirubin, alkaline phosphatase, gamma-glutamyl transpeptidase and transaminases were found between both groups, neither in nitrogen balances. In conclusion, in a group of neoplastic patients receiving intensive chemotherapy, we did not found any advantage of TPN with LCT or MCT-LCT either in nutritional laboratory parameters or in liver function.

[Importance of water in the hydration of the Spanish population: FESNAD 2010 document]. / Importancia del agua en la hidratación de la población española: documento FESNAD 2010.

For any healthy individual, thirst is an appropriate sign to drink water, except for babies, sportsmen, and most of ill and elderly people. In these instances, it is convenient to schedule appropriate times to drink water since great demands and the physiological mechanisms that determine thirst in these situations may condition water unbalances with important consequences for health and the physical and intellectual performance. The human body has a number of mechanisms that allow keeping constant the water content by adjusting intakes and wastes. Water balance is determined by intake (consumed water, beverages, and water contained in foods) and wastes (urine, stools, the skin, and expired air from the lungs). Failure of these mechanisms and subsequent impairments in water balance may produce severe disarrangements that may threaten somebody's life. In the present document, we analyze the evidences regarding the factors conditioning water needs in the different life stages and physiological situations, as well as the consequences of water unbalance under different situations. A proper hydration may be achieved by feeding and the use of water and other liquids. Although water is the beverage by excellence and represents the ideal way of restoring the losses and get hydrated, we should be aware that, from the very beginning, we have sought other liquid sources with hydration properties. In the last decades we have increased the consumption of different beverages, with a proliferation of sugar-containing beverages. Since excessive sugar consumption has been related to obesity and other chronic conditions, it is evident that the use of these caloric beverages should be rationalized, especially in children. In this document all the considerations regarding hydration are presented and different recommendations are exposed.