Predictors of response to a dietary intervention in patients with irritable bowel syndrome.

BACKGROUND: Different diets have emerged as potential therapeutic options for patients with irritable bowel syndrome (IBS). OBJECTIVE: To identify predictors of improvement after a low-FODMAP, low-starch and low-sucrose diet among patients with IBS. METHODS: We performed a descriptive cross-sectional study including patients with IBS according to Rome IV criteria undertaking a social-media based program with a two-week dietary intervention. Patients completed an online survey before and after the intervention including the presence of intestinal and extra-intestinal symptoms, the IBS-SSS (irritable bowel syndrome symptoms severity scale) and the PHQ-9 (patient health questionnaire-9). Clinical improvement was defined as a decrease of at least 50% in IBS-SSS post dietary intervention. Variables associated with symptomatic response were identified with logistic regression analysis. A clinical score to predict response was created and tested with a with a receiver operating characteristic (ROC) curve analysis. RESULTS: A total of 3583 patients with IBS were included. Mean IBS-SSS before and after dietary intervention was 295.5±52.32 and 240±48.66, respectively (p=0.01); 1178 (32.8%) patients showed clinical improvement. A mean basal IBS-SSS >400 (OR 3.04), chronic headache (OR 1.96), and chronic fatigue (OR 1.81) were significantly associated with symptomatic response. Patients with arthralgia (OR 0.41) and/or fibromyalgia (OR 0.33) were less likely to improve. Each variable received the following individuals scores: IBS-SSS >400: +2, chronic headache: +1.5, chronic fatigue: +1, arthralgia: -1, and fibromyalgia: -1. The ROC curve analysis of the proposed score showed an area under the curve of 0.72 (95% CI 0.69-0.76). A score ≥3 had a sensitivity of 72.64% and specificity of 60.56% for predicting symptomatic improvement. CONCLUSIONS: There are clinical variables that could serve as reliable predictors of response to a low-FODMAP, low-sucrose, low-starch diet among patients with IBS. Further research is needed to understand the link between the presence of extra-intestinal symptoms and clinical improvement after dietary interventions for IBS.

Popular Diets and Skin Effects: A Narrative Review. / Dietas populares y su impacto en la piel. Una revisión narrativa.

Numerous diets for losing weight, building strength, and managing a range of cardiovascular, neurologic, and skin diseases have become popular in recent years. The ketogenic diet and intermittent fasting in particular have shown promising results in clinical and sports medicine. The Mediterranean diet, in turn, is widely recognized for its numerous health benefits. Also popular are the paleo diet and vegan and gluten-free diets. Positive effects on inflammatory conditions, such as psoriasis, atopic dermatitis, hidradenitis suppurativa, and acne, have been observed in patients who practice intermittent fasting or follow ketogenic or Mediterranean diets. This last choice may also protect against certain skin cancers. We review the role of several popular diets in the management of skin disorders.

Species-level correlates of land-use responses and climate-change sensitivity in terrestrial vertebrates.

Land-use and climate change are major pressures on terrestrial biodiversity. Species' extinction risk and responses to human pressures relate to ecological traits and other characteristics in some clades. However, large-scale comparative assessments of the associations between traits and responses to multiple human pressures across multiple clades are needed. We investigated whether a set of ecological characteristics that are commonly measured across terrestrial vertebrates (ecological traits and geographic range area) are associated with species' responses to different land-use types and species' likely sensitivity to climate change. We aimed to test whether generalizable patterns in response to these pressures arise across both pressures and across vertebrate clades, which could inform assessments of the global signature of human pressures on vertebrate biodiversity and guide conservation efforts. At the species level, we investigated associations between land-use responses and ecological characteristics with a space-for-time substitution approach, making use of the PREDICTS database. We investigated associations between ecological characteristics and expected climate-change sensitivity, estimated from properties of species realized climatic niches. Among the characteristics we considered, 3 were consistently associated with strong land-use responses and high climate-change sensitivity across terrestrial vertebrate classes: narrow geographic range, narrow habitat breadth, and specialization on natural habitats (which described whether a species occurs in artificial habitats or not). The associations of other traits with species' land-use responses and climate-change sensitivity often depended on species' class and land-use type, highlighting an important degree of context dependency. In all classes, invertebrate eaters and fruit and nectar eaters tended to be negatively affected in disturbed land-use types, whereas invertebrate-eating and plant- and seed-eating birds were estimated to be more sensitive to climate change, raising concerns about the continuation of ecological processes sustained by these species under global changes. Our results highlight a consistently higher sensitivity of narrowly distributed species and habitat specialists to land-use and climate change, which provides support for capturing such characteristics in large-scale vulnerability assessments.

Correlaciones a nivel de especie de las respuestas al uso de suelo y la susceptibilidad al cambio climático en los vertebrados terrestres Resumen El uso de suelo y el cambio climático tienen una presión importante sobre la biodiversidad terrestre. En algunos clados, el riesgo de extinción de las especies y las respuestas a las presiones humanas se relacionan con los rasgos ecológicos y otras características. Sin embargo, varios clados necesitan evaluaciones comparativas a gran escala de las asociaciones entre los rasgos y las respuestas a las presiones humanas. Investigamos si un conjunto de rasgos ecológicos medidos comúnmente en los vertebrados terrestres (rasgos ecológicos y extensión del área geográfica) está asociado con la respuesta de las especies a los diferentes tipos de uso de suelo y la posible susceptibilidad de la especie al cambio climático. Buscamos comprobar si los patrones generalizables de las respuestas a estas presiones surgen en ambas presiones y en todos los clados de vertebrados, lo que podría guiar las evaluaciones de la huella mundial de presiones humanas sobre la diversidad de vertebrados y los esfuerzos de conservación. Investigamos las asociaciones entre la respuesta al uso de suelo y los rasgos ecológicos a nivel de especie con una estrategia de reemplazo de espacio por tiempo y con información de la base de datos PREDICTS. También investigamos las asociaciones entre los rasgos ecológicos y la susceptibilidad al cambio climático esperada, la cual estimamos a partir de las propiedades de los nichos climáticos de las especies. Entre las características que consideramos, tres estuvieron asociadas de manera regular con respuestas fuertes al uso de suelo y alta susceptibilidad al cambio climático en las diferentes clases de vertebrados: la extensión geográfica limitada, la amplitud reducida de hábitat y la especialización en los hábitats naturales (la cual describe si una especie está presente en un hábitat artificial o no). Las asociaciones de otros rasgos con la respuesta de la especie al uso de suelo y su susceptibilidad al cambio climático con frecuencia dependieron de la clase de la especie y el tipo de uso de suelo, lo que resalta un grado importante de dependencia del contexto. En todas las clases, los frugívoros, nectarívoros y los que comen invertebrados eran propensos a sufrir efectos negativos en los usos de suelo de tipo perturbado, mientras que se estimó que las aves herbívoras, las que se alimentan de semillas y las que se alimentan de invertebrados eran más susceptibles al cambio climático, lo que incrementa la preocupación por la continuación de los procesos ecológicos que viven estas especies bajo los cambios globales. Nuestros resultados resaltan una susceptibilidad al uso de suelo y al cambio climático cada vez mayor en las especies con distribución limitada y las especialistas de hábitat, lo que proporciona un respaldo para la captura de dichas características en las evaluaciones a gran escala de la vulnerabilidad.

Effectiveness of a high fiber diet in improving constipation in patients with defecatory dyssynergy under treatment with anorrectal biofeedback. Exploratory, randomized clinical trial. / Eficacia de la dieta alta en fibra en la mejora del estreñimiento en pacientes con disinergia defecatoria en tratamiento con biofeedback anorrectal. Ensayo clínico exploratorio, aleatorizado.

INTRODUCTION: Fiber is the initial treatment in chronic functional constipation. However, its role in the group of patients with defecatory dyssynergy is not well established. The objective of the study is to evaluate the efficacy and safety of a high fiber diet in patients with defecatory dyssynergy in the treatment with anorectal biofeedback. PATIENTS AND METHODS: An exploratory, randomized (1:1), double-blind, controlled «add-on¼ clinical trial was carried out in a reference center in Spain in patients with functional constipation and defecatory dyssynergy according to the ROMEIV criteria. CONTROL GROUP: treatment with biofeedback and low-fiber diet (15-20g/day). Experimental group: treatment with biofeedback and high fiber diet (25-30g/day). Analyzed: responder (primary endpoint), patient whose defecatory dyssynergy had been corrected (>20% reduction in anal pressure during the defecation maneuver and normal balloon expulsion test); anorectal parameters (anal relaxation, reduced straining); safety (abdominal symptoms: flatulence, pain, borborygmus, bloating). RESULTS: A total of 44 patients were randomized: 22 per group. The percentage of responders was 75% (15/20; 95%CI: 53 89%) control group and 70% (14/20; 95%CI: 48-85%) experimental group, P=.225. Differences in favor of the control group were only observed in abdominal symptoms: flatulence (P=.028), abdominal distension (P=.041) and digestive comfort (P=.043). CONCLUSIONS: In patients with defecatory dyssynergy, a high-fiber diet not only does not improve the efficacy of anorectal biofeedback but is associated with a loss of improvement in abdominal symptoms.

Inadequate diabetes knowledge is associated with poor glycemia control in patients with type 2 diabetes.

OBJECTIVE: To identify the association between glycemia control with level of diabetes knowledge, diabetes education, and lifestyle variables in patients with type 2 diabetes. DESIGN: Cross-sectional analytical study. SITE: Clinics of the Mexican Institute of Social Security (IMSS), Mexico. PARTICIPANTS: Patients with type 2 diabetes. MAIN MEASUREMENTS: Glycated hemoglobin (HbA1c), glucose, and lipid profile levels were measured from fasting venous blood samples. Assessment of disease knowledge was performed using the Diabetes Knowledge Questionnaire (DKQ-24). Systolic and diastolic blood pressure was measured. Weight and abdominal circumference were measured, as well as body composition using bioimpedance. Sociodemographic, clinical, and lifestyle variables were obtained. RESULTS: A total of 297 patients were included, sixty-seven percent (67%) were women with a median of six years since the diagnosis of diabetes. Only 7% of patients had adequate diabetes knowledge, and 56% had regular knowledge. Patients with adequate diabetes knowledge had a lower body mass index (p=0.016), lower percentage of fat (p=0.008), and lower fat mass (p=0.018); followed a diet (p=0.004) and had received diabetes education (p=0.002), and to obtain information about their illness (p=0.001). Patients with low levels of diabetes knowledge had a higher risk of HbA1c≥7% (OR: 4.68; 95% CI: 1.48,14.86; p=0.009), as well as those who did not receive diabetes education (OR: 2.17; 95% CI: 1.21-3.90; p=0.009) and those who did not follow a diet (OR: 2.37; 95% CI: 1.01,5.55; p=0.046). CONCLUSION: Inadequate knowledge of diabetes, lack of diabetes education, and dietary adherence are associated with poor glycemia control in patients with diabetes.

[Correlations between dietary salt intake and 24-h urine sodium excretion in a sample of the urban population of Cáceres]. / Correlaciones entre la ingesta de sal en la dieta y la eliminación de sodio en la orina de 24 h en una muestra de población urbana de Cáceres.

OBJECTIVE: Excessive salt intake is associated with higher levels of AHT and prevalence of cardiovascular diseases. WHO recommends consuming less than 5 g/day of salt (equivalent to 2 g Na+/day). Identifying foods and behaviours with greater contribution to excess intake would facilitate preventive dietary advice. DESIGN: Observational study. SITE: Urban Health Center in Cáceres. MAIN MEASUREMENTS: We estimated salt consumption using two food consumption frequency (FFQ) questionnaires, one generic and one with high Na+ content, and a 24 h follow-up survey. We use the Evalfinut program for nutritional evaluation of the diet. We analyzed correlations between estimated salt intake and 24-h urine sodium elimination (gold standard). RESULTS: 92% of the population had consumption higher than the recommendations with intakes equivalent to 9.5 g/day of salt (3.7 g/d of Na+). When sodium intake is determined by the Na+/K+ ratio, 79.54% have high intakes. Sodium elimination follows a slightly increasing trend with BMI. The perception of salt consumption is low, 56.3% consider it "adequate". 32.4% add salt to food once served. FFQ underestimate Na+ intake and targeted surveys provide higher values. The correlation between FFQ and Na+ urinary elimination is weak. CONCLUSION: We must reduce salt intake by increasing the perception of consumption, improving knowledge about the salt content in food and identifying target patients of the health council.

Socioeconomic development and ecological traits as predictors of human-bird conflicts.

Because of the significant impacts on both human interests and bird conservation, it is imperative to identify patterns and anticipate drivers of human-bird conflicts (HBCs) worldwide. Through a global systematic review, following the PRISMA 2020 guidelines, we analyzed the socioeconomic factors and bird ecological traits driving the degree of knowledge and extent of HBCs. We included 166 articles published from 1971 to 2020 in our analyses through which we built a profile of the socioeconomic conditions of 52 countries with reported conflicts and the ecological traits of the 161 bird species involved in HBCs. Although HBC expanded worldwide, it had the greatest impact in less-developed countries (estimate 0. 66 [SE 0.13], p< 0.05), where agriculture is critical for rural livelihoods. Species with a relatively greater conflict extent had a relatively broader diet (estimate 0.80 [SE 0.22], p<0.05) and an increasing population trend (estimate 0.58 [SE 0.15], p<0.05) and affected human interests, such as agriculture and livestock raising. In countries with greater biodiversity, HBCs caused greater socioeconomic impacts than in more developed countries. Our results highlight the importance of understanding and addressing HBCs from multiple perspectives (ecological, sociocultural, and political) to effectively protect both biodiversity and local livelihoods.

El desarrollo socioeconómico y las características ecológicas como pronosticadores de los conflictos entre aves y humanos Resumen Debido a los impactos significativos sobre los intereses humanos y la conservación de las aves, es imperativo identificar patrones y anticiparse a las causas de los conflictos humano-aves (CHA) a nivel mundial. Por medio de una revisión sistemática, siguiendo los lineamientos de PRISMA 2020, analizamos los factores socioeconómicos y las características ecológicas de las aves que impulsan el grado de conocimiento y la extensión de los CHA. Incluimos 166 artículos publicados desde 1971 hasta 2020 en nuestros análisis, con los cuales construimos un perfil de las condiciones socioeconómicas de 52 países con reportes de conflictos y de las características ecológicas de 161 especies de aves involucradas en los CHA. Aunque los CHA se expandieron mundialmente, tuvieron un mayor impacto en los países menos desarrollados (estimado 0. 66 [ES 0.13], p< 0.05), en donde la agricultura es crítica para el sustento rural. Las especies con una extensión de conflicto relativamente más larga también contaban con una dieta más amplia (estimado 0.80 [ES 0.22], p<0.05) y una tendencia poblacional en aumento (estimado 0.58 [ES 0.15], p<0.05), lo que afectó los intereses humanos, como la agricultura y la cría de ganado. En los países con mayor biodiversidad, los CHA ocasionaron impactos socioeconómicos mayores que en los países más desarrollados. Nuestros resultados resaltan la importancia de abordar y entender los CHA desde múltiples perspectivas (ecológica, sociocultural, política) para proteger de manera efectiva tanto a la biodiversidad como a los sustentos locales.

Using interview surveys and multispecies occupancy models to inform vertebrate conservation.

Species distribution data are an essential biodiversity variable requiring robust monitoring to inform wildlife conservation. Yet, such data remain inherently sparse because of the logistical challenges of monitoring biodiversity across broad geographic extents. Surveys of people knowledgeable about the occurrence of wildlife provide an opportunity to evaluate species distributions and the ecology of wildlife communities across large spatial scales. We analyzed detection histories of 30 vertebrate species across the Western Ghats biodiversity hotspot in India, obtained from a large-scale interview survey of 2318 people who live and work in the forests of this region. We developed a multispecies occupancy model that simultaneously corrected for false-negative (non-detection) and false-positive (misidentification) errors that interview surveys can be prone to. Using this model, we integrated data across species in composite analyses of the responses of functional species groups (based on disturbance tolerance, diet, and body mass traits) to spatial variation in environmental variables, protection, and anthropogenic pressures. We observed a positive association between forest cover and the occurrence of species with low tolerance of human disturbance. Protected areas were associated with higher occurrence for species across different functional groups compared with unprotected lands. We also observed the occurrence of species with low disturbance tolerance, herbivores, and large-bodied species was negatively associated with developmental pressures, such as human settlements, energy production and mining, and demographic pressures, such as biological resource extraction. For the conservation of threatened vertebrates, our work underscores the importance of maintaining forest cover and reducing deforestation within and outside protected areas, respectively. In addition, mitigating a suite of pervasive human pressures is also crucial for wildlife conservation in one of the world's most densely populated biodiversity hotspots.

Uso de Encuestas y Modelos de Ocupación Multiespecies para Orientar la Conservación de Vertebrados Resumen Los datos de distribución de especies son una variable esencial de la biodiversidad que requieren de un monitoreo sólido para orientar la conservación de la fauna. Aun así, dichos datos permanecen inherentemente escasos debido a los obstáculos logísticos del monitoreo de la biodiversidad a lo largo de extensiones geográficas generalizadas. Las encuestas realizadas a personas conocedoras de la incidencia de fauna proporcionan una oportunidad para evaluar la distribución de las especies y la ecología de las comunidades de fauna en escalas espaciales grandes. Analizamos las historias de detección de 30 especies de vertebrados en los Ghats Occidentales de la India obtenidos a partir de una encuesta a gran escala realizada por entrevistas a 2318 personas que viven y trabajan en los bosques de esta región. Desarrollamos un modelo de ocupación multiespecies que corrigió simultáneamente los errores falsos negativos (no detección) y los falsos positivos (identificación correcta) a los que están propensos las encuestas por entrevista. Con este modelo, integramos los datos de todas las especies a un análisis compuesto de las respuestas de los grupos funcionales de especies (con base en la tolerancia a la perturbación, dieta y características de masa corporal) para la variación espacial en las variables ambientales, protección y presiones antropogénicas. Observamos una asociación positiva entre la incidencia de especies con la baja tolerancia a la perturbación humana y a la cobertura forestal. Las áreas protegidas estuvieron asociadas con una incidencia mayor para las especies ubicadas en diferentes grupos funcionales comparadas con las áreas desprotegidas. También observamos que la incidencia de especies con una tolerancia baja a las perturbaciones, herbívoros y especies de mayor tamaño estaba asociada negativamente con las presiones de desarrollo, como los asentamientos humanos, la producción de energías y minería, y las presiones demográficas, como la extracción de recursos biológicos. Para la conservación de vertebrados amenazados, nuestro trabajo hace hincapié en la importancia de mantener la cobertura forestal y reducir la deforestación dentro y fuera de las áreas protegidas, respectivamente. Además, la mitigación de un conjunto de presiones humanas dominantes también es crucial para la conservación de la naturaleza en uno de los puntos calientes de biodiversidad con una de las mayores densidades poblacionales del mundo.

Effect of the Mediterranean diet on histological indicators and imaging tests in non-alcoholic fatty liver disease. / Efecto de la dieta mediterránea sobre indicadores histológicos y pruebas de imagen en enfermedad de hígado graso no alcohólico.

AIM: To analyze the scientific evidence regarding to the effect of the Mediterranean diet on the imaging tests and biopsy characteristics in subjects with non-alcoholic fatty liver disease (NAFLD). METHODS: A bibliographic search was carried out in this narrative review in Pubmed and Web of Science databases, considering studies published between 2011 and 2020, in English or Spanish, randomized clinical trials and observational studies in patients with a diagnosis of NAFLD, in subjects over 18years of age of both sexes. RESULTS: In the observational studies found, an inverse association between adherence to a Mediterranean diet and liver damage stands out, while in the intervention studies with measurement of liver biopsy a 4.4% reduction in intrahepatic lipids and with magnetic resonance a reduction between 4.2 and 10.2% was found. In experimental studies with ultrasound measurement, the proportion of people with moderate (6-16%) and severe (25%) degree decreased and the studies with transient elastography showed a decrease in liver stiffness between 0.5 and 2.1kPa. CONCLUSIONS: The Mediterranean diet contributes to the treatment of NAFLD, which is manifested in the liver and histological imaging tests characteristics.

Association of dietary fiber consumption with disease activity in ulcerative colitis: An exploratory study in the Mexican population.

INTRODUCTION: Dietary fiber intake helps in the remission of ulcerative colitis (UC). OBJECTIVE: To evaluate if there is an association between the amount of fiber in usual diet and disease activity in patients with UC. METHODS: Cross-sectional study of a cohort of patients with UC. Dietary fiber intake was calculated and compared with the recommended amount (14 g/1000 kcal) with Mann-Whitney's U-test. Using Spearman's correlation coefficient, the number of relapses and the amount of consumed fiber were analyzed, and the relationship of dietary fiber consumption with disease activity was established by logistic regression. RESULTS: The group without ongoing UC activity consumed a higher amount of dietary fiber (20 g, IQR = 18-26, p = 0.062), and 47% consumed more than the recommended amount; the logistic regression analysis showed that compliance with recommended fiber consumption was associated as a protective factor against UC current activity (OR = 0.227, p = 0.032). As for dietary fiber intake and the number of relapses within previous year, an inversely proportional correlation was observed (r = -0.399, p = 0.011). CONCLUSIONS: Consumption of the recommended dietary fiber amount in the general population had a protective effect against UC activity in Mexican patients.

INTRODUCCIÓN: La fibra dietética suplementada coadyuva en la remisión de la colitis ulcerosa crónica idiopática (CUCI). OBJETIVO: Evaluar la asociación entre la cantidad de fibra de la dieta habitual y la actividad de la enfermedad en pacientes con CUCI. MÉTODOS: Estudio transversal de una de cohorte de pacientes con CUCI. Se calculó el consumo de fibra dietética y con U de Mann-Whitney se comparó con la cantidad recomendada (14 g/1000 kcal). Con coeficiente de correlación de Spearman se analizaron el número de recaídas y la cantidad de fibra consumida, y la relación de esta con la actividad de la enfermedad mediante regresión logística. RESULTADOS: El grupo sin actividad actual de CUCI consumió más fibra dietética (RIC = 18-26, p = 0.062) y 47 % consumió más de la cantidad recomendada; el análisis de regresión logística mostró que cumplir con esta se asoció como factor protector en contra de la actividad actual de la CUCI (RM = 0.227, p = 0.032). En la fibra y el número de recaídas en el último año se observó una correlación inversamente proporcional (r = −0.399, p = 0.011). CONCLUSIONES: El consumo recomendado de fibra en la población general tuvo un efecto protector para la actividad actual de la CUCI en pacientes mexicanos.

Gut microbes and health. / Microbiota intestinal y salud.

The human body is populated by myriads of microorganisms throughout its surface and in the cavities connected to the outside. The microbial colonisers of the intestine (microbiota) are a functional and non-expendable part of the human organism: they provide genes (microbiome) and additional functions to the resources of our species and participate in multiple physiological processes (somatic development, nutrition, immunity, etc.). Some chronic non-communicable diseases of developed society (atopias, metabolic syndrome, inflammatory diseases, cancer and some behaviour disorders) are associated with dysbiosis: loss of species richness in the intestinal microbiota and deviation from the ancestral microbial environment. Changes in the vertical transmission of the microbiome, the use of antiseptics and antibiotics, and dietary habits in industrialised society appear to be at the origin of dysbiosis. Generating and maintaining diversity in the microbiota is a new clinical target for health promotion and disease prevention.

Increasing the low residue diet to 3 days does not improve the bowel cleansing in hard to prepare patients: Post hoc analysis of a randomized controlled trial.

BACKGROUND: Recent evidence suggests that the number of low residue diet (LRD) days does not influence the bowel cleansing quality in non-selected patients. However, there are not data in the subgroup of patients with risk factors of inadequate bowel cleansing. OBJECTIVE: The aim of this study was to assess whether a 3-day LRD improved the bowel cleansing quality in patients with risk factors of poor bowel cleansing. PATIENTS AND METHODS: Post hoc analysis of a randomized controlled trial carried out between December 2017 and March 2018 in a tertiary care hospital. Patients with high risk of poor bowel cleansing were selected following a validated score. The patients were randomized to the 1-day LRD or 3-day LRD groups. All patients received a 2-L split-dose of polyethylene glycol plus ascorbic acid. Intention-to-treat (ITT) and per-protocol (PP) analyses were conducted for the main outcome. RESULTS: 135 patients (1-day LRD group=67, 3-day LRD=68) were included. The rate of adequate cleansing quality was not significantly different between the groups in the ITT analysis: 76.1%, 95% CI: [64.6-84.8] vs. 79.4%, 95% CI: [68.2-87.4]; odds ratio (OR) 1.2, 95% CI [0.54-2.73]) or in the PP analysis: 77.3%, 95% CI: [65.7-85.8] vs. 80.3%, 95% CI: [69.0-88.3]; OR 1.2, 95% CI [0.52-2.77]). Compliance with the diet or cleansing solution, satisfaction or difficulties with the LRD and the polyp/adenoma detection rates were not significantly different. CONCLUSION: Our results suggest that 1-day LRD is not inferior to 3-day LRD in patients with risk factors of inadequate bowel cleansing.

[Diet quality in a population aged over 65 and related socioeconomic factors]. / Calidad de la dieta en mayores de 65 años y factores socioeconómicos relacionados.

INTRODUCTION: The consumption of certain foods and healthy eating habits are related to preventing and suffering from a number of chronic diseases. These foods tend to be included in food pyramids, such as that proposed by the Spanish Society for Community Nutrition. One method of analysing diet quality is the use of indices that assess the frequency of consumption of different food groups. AIM: To analyse diet quality in a Spanish population of persons aged over 65years using the Healthy Eating Index and to determine how sociodemographic factors affect scores on the index. DESIGN: A cross-sectional, descriptive study was conducted on the diet followed at home by Spanish population aged over 65years, using the Healthy Eating Index and taking information from the 2014 European Health Interview Survey in Spain. Multiple linear regression analysis was used to determine the socioeconomic factors associated with diet quality. RESULTS: Of the study population, 89.6% need to make changes in their diet, while only 8.2% follow a healthy diet. Suffering from chronic diseases, overweight and occasional physical exercise were associated with higher scores on the Healthy Eating Index. CONCLUSION: Most of the population aged 65years or over need to make changes in their dietary patterns. Those with potential health risks are more careful about their diet. These findings confirm the need to promote guidelines for healthy eating in the non-clinical population.

Executive summary: Updates to the dietary treatment of prediabetes and type 2 diabetes mellitus. / Resumen ejecutivo: actualización en el tratamiento dietético de la prediabetes y la diabetes mellitus tipo 2.

Adequate lifestyle changes significantly reduce the cardiovascular risk factors associated with prediabetes and type 2 diabetes mellitus. Therefore, healthy eating habits, regular physical activity, abstaining from using tobacco, and good sleep hygiene are recommended for managing these conditions. There is solid evidence that diets that are plant-based; low in saturated fatty acids, cholesterol, and sodium; and high in fiber, potassium, and unsaturated fatty acids are beneficial and reduce the expression of cardiovascular risk factors in these subjects. In view of the foregoing, the Mediterranean diet, the DASH diet, a low-carbohydrate diet, and a vegan-vegetarian diet are of note. Additionally, the relationship between nutrition and these metabolic pathologies is fundamental in targeting efforts to prevent weight gain, reducing excess weight in the case of individuals with overweight or obesity, and personalizing treatment to promote patient empowerment. This document is the executive summary of an updated review that includes the main recommendations for improving dietary nutritional quality in people with prediabetes or type 2 diabetes mellitus. The full review is available on the webpages of the Spanish Society of Arteriosclerosis, the Spanish Diabetes Society, and the Spanish Society of Internal Medicine.

[Nutritional composition of vending foods of public university and hospital buildings in Asturias]. / Composición nutricional de los alimentos de las vending de edificios públicos universitarios y hospitalarios de Asturias.

OBJECTIVE: To evaluate the nutritional composition of food vending machines (VM) located in university public buildings and hospitals in Asturias. DESIGN: Descriptive cross-sectional study. LOCATION: The analysis was made of the contents of VMs located in public buildings, hospitals, and university teaching centres in the Principality of Asturias. MAIN MEASUREMENTS: After the public buildings were mapped, each of them was visited to check for the presence of the VMs. A a photograph was then taken of the food contained in them. The variables analysed were the type of products and their nutritional composition. RESULTS: The VMs of 19 buildings (12 university and 7 hospital), contained 215 foods that were grouped into 11 categories. The most frequent were "chocolates and chocolate bars" (30,2%), "cookies" (11.6%) and "chips" (11.6%). The Kcal average was 216 (SD=133.1). The mean fat, in grams was 12.52 (SD=11.21), saturated fat 4.48 (SD=3,83), sugars 11.88 (SD=31.13), fibre 1.9 (SD=2.47), proteins 3.38 (SD=3.62), and salt 0.3 (SD=0.62). A high excess of fat, saturated fat, and salt was observed, as well as a medium excess of sugars. CONCLUSIONS: The nutritional quality of VM in hospitals and public university centres of the Principality of Asturias cannot be defined as healthy. Therefore, health promotion strategies could be developed with the aim of improving their nutritional composition or guiding the population/users towards the selection and consumption of healthier foods.

Importancia de la vitamina B12 y el folato en la salud perinatal.

Fetal development is characterized by great plasticity and the ability to respond to environmental factors, where DNA methylation is essential for proper embryonic development. One-carbon metabolism provides methyl groups for methylation and fetal DNA development and is highly dependent on maternal nutritional status. During pregnancy, the supply of methyl donors is critical and the demand for nutrients that support this process, such as folate and vitamin B12, is increased. Insufficiency or imbalance of these 2 micronutrients can alter epigenetic patterns, DNA synthesis and repair, and affect fetal growth and development, having negative long-term consequences on the offspring's health. Folate and vitamin B12 status have been associated with wide DNA methylation, as well as with specific genes related to neurological functions, embryonic development, energy metabolism, growth, and leptin. Furthermore, inadequate concentrations of both vitamins have been associated with an increased risk of perinatal outcomes such as neural tube defects, prematurity, low birth weight, pre-eclampsia, as well as maternal and infant obesity and insulin resistance, and decreased infant neurocognitive development. Supplementation, combined with a healthy diet, could be an essential strategy to prevent these results and improve maternal and fetal health.

El desarrollo fetal se caracteriza por una gran plasticidad y capacidad para responder a factores ambientales, donde la metilación del ADN es indispensable para el desarrollo embrionario adecuado. El metabolismo de un carbono proporciona grupos metilo para la metilación y el desarrollo del ADN fetal, y depende en gran medida del estado nutricio materno. El embarazo es una etapa donde el suministro de donantes de metilo es crítico y la demanda de nutrimentos que apoyen este proceso, como lo son el folato y la vitamina B12, está aumentada. La insuficiencia o desequilibrio de estos dos micronutrimentos puede alterar los patrones epigenéticos, la síntesis y reparación del ADN, y afectar procesos del crecimiento y desarrollo fetal, teniendo consecuencias negativas en la salud de la descendencia a largo plazo. El estado del folato y la vitamina B12 se han asociado con la metilación global del ADN, así como con genes específicos relacionados con funciones neurológicas, con el desarrollo embrionario, el metabolismo energético, el crecimiento, y con la leptina. Además, estados alterados de ambas vitaminas se han asociado con mayor riesgo de resultados perinatales como defectos del tubo neural, prematurez, bajo peso al nacer, preeclampsia, así como obesidad y resistencia a la insulina materna e infantil, y disminución del desarrollo neurocognitivo infantil. La suplementación, aunada a una dieta adecuada, podría ser una estrategia necesaria para prevenir dichos resultados y mejorar la salud maternofetal.

Dietary patterns and components to prevent and treat heart failure: a comprehensive review of human studies.

Growing evidence has emerged about the role of dietary patterns and components in heart failure (HF) incidence and severity. The objective here is to provide a comprehensive summary of the current evidence regarding dietary patterns/components and HF. A comprehensive search of online databases was conducted using multiple relevant keywords to identify relevant human studies. The Dietary Approaches to Stop Hypertension (DASH) and Mediterranean diets have consistently been associated with decreased HF incidence and severity. Regarding specific dietary components, fruit, vegetables, legumes and whole grains appear beneficial. Current evidence suggests that red/processed meats, eggs and refined carbohydrates are harmful, while fish, dairy products and poultry remain controversial. However, there is a notable lack of human intervention trials. The existing but limited observational and interventional evidence from human studies suggests that a plant-based dietary pattern high in antioxidants, micronutrients, nitrate and fibre but low in saturated/trans-fat and Na may decrease HF incidence/severity. Potential mechanisms include decreased oxidative stress, homocysteine and inflammation but higher antioxidant defence and NO bioavailability and gut microbiome modulation. Randomised, controlled trials are urgently required.

Desempeño de las ecuaciones para estimar la tasa de filtración glomerular en pacientes mexicanos receptores de trasplante renal.

INTRODUCTION: The management of kidney transplant recipients requires glomerular filtration rate (GFR) monitoring, which is an indicator of graft primary function and patient survival. OBJECTIVE: To evaluate the performance of different creatinine or cystatin-based formulas in the estimation of glomerular filtration rate in Mexican patients receiving kidney transplantation. METHOD: 30 transplant recipients were included, in whom the glomerular filtration rate was measured by means of iothalamate, and was also calculated using seven equations based on cystatin or creatinine. RESULTS: The formula with the best performance was the one proposed by the chronic kidney disease epidemiology collaboration (CKD-EPI), with a bias of -2.4 mL/min/1.73 m2 and an accuracy of 9.6; 96.7 % of patients were within 30 % of the measured GFR. The second best formula was the modification of diet in renal disease (MDRD) equation. Cystatin-based equations showed a poor performance. CONCLUSIONS: Our study suggests that, in Mexican patients receiving kidney transplantations, the best equations to estimate GFR are the CKD-EPI and MDRD equations.

INTRODUCCIÓN: El manejo de los pacientes receptores de trasplante renal requiere vigilancia de la tasa de filtrado glomerular (TFG), la cual es un indicador de la función primaria del injerto y de la supervivencia del paciente. OBJETIVO: Evaluar el rendimiento en la estimación de la función renal de diferentes fórmulas basadas en creatinina o cistatina en pacientes mexicanos receptores de trasplante renal. MÉTODO: Se incluyeron 30 pacientes receptores de trasplante renal en quienes se midió tasa de filtrado glomerular por iodotalamato, la cual también se calculó por siete ecuaciones basadas en cistatina o creatinina. RESULTADOS: La fórmula con mejor desempeño fue la propuesta por CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration), con un sesgo de −2.4 mL/minuto/1.73 m2 y precisión de 9.6; 96.7 % estaba dentro de 30 % de la tasa de filtrado glomerular medida. La segunda mejor ecuación fue la MDRD (Modification of Diet in Renal Disease). Las ecuaciones basadas en cistatina mostraron pobre desempeño. CONCLUSIONES: Nuestro estudio sugiere que en pacientes mexicanos receptores de trasplante renal las mejores ecuaciones para estimar la TFG son CKD y MDRD.

New coeliac disease treatments and their complications. / Nuevas terapias en la enfermedad celiaca y sus complicaciones.

The only accepted treatment for coeliac disease is strict adherence to a gluten-free diet. This type of diet may give rise to reduced patient quality of life with economic and social repercussions. For this reason, dietary transgressions are common and may elicit intestinal damage. Several treatments aimed at different pathogenic targets of coeliac disease have been developed in recent years: modification of gluten to produce non-immunogenic gluten, endoluminal therapies to degrade gluten in the intestinal lumen, increased gluten tolerance, modulation of intestinal permeability and regulation of the adaptive immune response. This review evaluates these coeliac disease treatment lines that are being researched and the treatments that aim to control disease complications like refractory coeliac disease.