Prevalencia de déficit de vitamina B12 en sangre periférica de madres cursando el puerperio inmediato en el Centro Hospitalario Pereira Rossell / Prevalence of vitamin B12 deficiency in peripheral blood of mothers undergoing immediate puerperium at the Pereira Rossell Hospital Center / Prevalência de deficiência de vitamina B12 no sangue periférico de mães no puerpério imediato no Centro Hospitalar Pereira Rossell

Objetivo: evaluar la prevalencia del déficit de vitamina B12 en mujeres cursando puerperio inmediato. Material y método: estudio observacional descriptivo de captación prospectiva de la cohorte en estudio. Muestra de 133 mujeres cursando el tercer trimestre de embarazo en la maternidad del Centro Hospitalario Pereira Rossell (CHPR), Montevideo, Uruguay, entre setiembre de 2021 y octubre de 2022. Se obtuvieron muestras de sangre materna en el puerperio inmediato por punción venosa periférica. Estas muestras fueron procesadas mediante inmunoensayo de electroquimioluminiscencia. Además, se aplicó una entrevista para la evaluación de los hábitos nutricionales. Resultados: todas las pacientes reportaron tener una dieta omnívora, excepto una, que manifestó llevar una dieta vegana y recibía suplementación diaria de vitamina B12. El 75,9% de la muestra del estudio presentó un nivel socioeconómico bajo, puntuado según el cuestionario de medición de nivel socioeconómico del INSE (Índice de nivel socioeconómico, 2018 - Cámara de Empresas de Investigación Social y Mercado del Uruguay, CEISMU). Se registró una prevalencia de déficit de vitamina B12 de 39,10% (n: 52). Conclusiones: a pesar de que esta muestra de embarazadas presenta una dieta omnívora, se detectó una elevada prevalencia de déficit de vitamina B12. Dada la importancia de esta vitamina en la salud materna, fetal y neonatal, se deberían considerar políticas de salud pública de prevención de la deficiencia tanto en embarazadas como en madres lactantes.

Objective: To assess the prevalence of vitamin B12 deficiency in women during the immediate postpartum period. Method: Descriptive observational study with prospective cohort recruitment, involving a sample of 133 women in their third trimester of pregnancy at the Maternity Department of the Pereira Rossell Hospital Center (CHPR) in Montevideo, Uruguay, between September 2021 and October 2022. Maternal blood samples were obtained during the immediate postpartum period through peripheral venous puncture. These samples were processed using electrochemiluminescence (ECL) immunoassay. Additionally, a nutritional interview was conducted to assess dietary habits. Results: All patients reported following an omnivorous diet, except for one who reported following a vegan diet and received daily vitamin B12 supplementation. Seventy-five point nine percent (75.9%) of the study sample exhibited a low socioeconomic status as determined by the Socioeconomic Level Measurement Questionnaire of the INSE (Socioeconomic Level Index, 2018 - CEISMU, Uruguay). Resulting in a vitamin B12 deficiency prevalence of 39.10% (n: 52). Conclusions: Despite the fact that this sample of pregnant women maintains an omnivorous diet, a high prevalence of vitamin B12 deficiency was detected. Given the significance of vitamin B12 for maternal, fetal, and neonatal health, public health policies for preventing deficiency should be considered for both pregnant women and lactating mothers.

Objetivos: Avaliar a prevalência da deficiência de vitamina B12 em mulheres durante o pós-parto imediato. Métodos: Estudo observacional descritivo de recrutamento prospectivo da coorte em estudo; amostra com 133 mulheres no terceiro trimestre de gravidez na maternidade do Centro Hospitalar Pereira Rossell (CHPR), em Montevidéu Uruguai, entre setembro de 2021 e outubro de 2022. As amostras de sangue materno foram obtidas no pós-parto imediato por punção venosa periférica que foram processadas por imunoensaio eletroquimioluminescente. Além disso, foi realizada uma entrevista nutricional para avaliar hábitos nutricionais. Resultados: Todas as pacientes relataram ter dieta onívora, exceto uma que relatou ter dieta vegana e receber suplementação diária de vitamina B12. 75,9% da amostra apresentou baixo nível socioeconômico de acordo com o Questionário de Medição do Nível Socioeconômico do INSE (Índice de Nível Socioeconômico, 2018 - CEISMU, Uruguai). Uma prevalência de deficiência de vitamina B12 de 39,10% (n: 52) foi registrada. Conclusões: Embora esta amostra de gestantes tenha dieta onívora, uma alta prevalência de deficiência de vitamina B12 foi detectada. Dada a importância da vitamina B12 na saúde materna, fetal e neonatal, devem ser consideradas políticas de saúde pública para prevenir a deficiência tanto em mães grávidas como em lactantes.

Comprehensive Approach to Medical Nutrition Therapy in Patients with Type 2 Diabetes Mellitus: From Diet to Bioactive Compounds.

In the pathogenesis of type 2 diabetes mellitus (T2DM), diet plays a key role. Individualized medical nutritional therapy, as part of lifestyle optimization, is one of the cornerstones for the management of T2DM and has been shown to improve metabolic outcomes. This paper discusses major aspects of the nutritional intervention (including macro- and micronutrients, nutraceuticals, and supplements), with key practical advice. Various eating patterns, such as the Mediterranean-style, low-carbohydrate, vegetarian or plant-based diets, as well as healthy eating plans with caloric deficits have been proven to have beneficial effects for patients with T2DM. So far, the evidence does not support a specific macronutrient distribution and meal plans should be individualized. Reducing the overall carbohydrate intake and replacing high glycemic index (GI) foods with low GI foods have been shown as valid options for patients with T2DM to improve glycemic control. Additionally, evidence supports the current recommendation to reduce the intake of free sugars to less than 10% of total energy intake, since their excessive intake promotes weight gain. The quality of fats seems to be rather important and the substitution of saturated and trans fatty acids with foods rich in monounsaturated and polyunsaturated fats lowers cardiovascular risk and improves glucose metabolism. There is no benefit of supplementation with antioxidants, such as carotene, vitamins E and C, or other micronutrients, due to the lack of consistent evidence showing efficacy and long-term safety. Some studies suggest possible beneficial metabolic effects of nutraceuticals in patients with T2DM, but more evidence about their efficacy and safety is still needed.

Clinical and nutritional management of very-low-calorie ketogenic diet (VLCKD) in patients with psoriasis and obesity: a practical guide for the nutritionist.

Psoriasis is an immune-mediated inflammatory skin disease associated with multiple comorbidities. Considered one of the most common inflammatory skin diseases among the general population, it not only affects the skin, but also negatively impacts other organs and joints. In addition, psoriasis has been associated with several chronic cardio-metabolic diseases such as obesity, which would seem to be (i) a risk factor for the onset of psoriasis and (ii) a worsening factor of the severity of the disease. Weight loss appears to improve severity in overweight patients. Recently proposed as an obesity management nutritional strategy, the very-low-calorie ketogenic diet (VLCKD) has demonstrated significant effects in reducing inflammatory processes. In the current review, we describe the evidence available on psoriasis and VLCKD, and provide a practical guide to the prescription of VLCKD in the different phases, evaluation and management of possible adverse events, and the importance of physical activity as a lifestyle modification to reduce psoriasis and associated comorbidities. Randomized control trials are, however, necessary to determine the most effective VLCKD protocol for patients with obesity and psoriasis, optimal protocol duration, composition of micronutrients and macronutrients, choice of special supplements, and management of carbohydrate reintroduction.

Vitamin D: A Role Also in Long COVID-19?

Coronavirus disease 2019 (COVID-19) has quickly become a global pandemic. Reports from different parts of the world indicate that a significant proportion of people who have recovered from COVID-19 are suffering from various health problems collectively referred to as "long COVID-19". Common symptoms include fatigue, shortness of breath, cough, joint pain, chest pain, muscle aches, headaches, and so on. Vitamin D is an immunomodulatory hormone with proven efficacy against various upper respiratory tract infections. Vitamin D can inhibit hyperinflammatory reactions and accelerate the healing process in the affected areas, especially in lung tissue. Moreover, vitamin D deficiency has been associated with the severity and mortality of COVID-19 cases, with a high prevalence of hypovitaminosis D found in patients with COVID-19 and acute respiratory failure. Thus, there are promising reasons to promote research into the effects of vitamin D supplementation in COVID-19 patients. However, no studies to date have found that vitamin D affects post-COVID-19 symptoms or biomarkers. Based on this scenario, this review aims to provide an up-to-date overview of the potential role of vitamin D in long COVID-19 and of the current literature on this topic.