Oral and dental health status in patients with eating disorders in Madrid, Spain.

BACKGROUND: The aim of the present study was to describe and compare the oral and dental health status of two groups, one diagnosed with eating disorders (EDs), and another group without this pathology, assessing the following oral manifestations: dental alterations, periodontal disorders, soft tissue disorders, non-stimulated salivary flow, and oral pH. MATERIAL AND METHODS: This comparative transversal epidemiological study included 179 participants, of whom 59 were diagnosed with EDs (Eating Disorder Group: EDG) and 120 had no antecedents of EDs (No Eating Disorder Group: NEDG). All patients fulfilled the following inclusion criteria: women aged over 18 years, diagnosed with an ED by a specialist, patients who had undergone at least 1 year monitoring by the Clinical Nutrition Unit, and had not received any periodontal treatment during the previous 6 months. Both groups were homogeneous in terms of sex, age, education, and socioeconomic level. Oral exploration was performed, registering clinical variables, as well as sociodemographic and socioeconomic data, oral hygiene habits, and smoking. Statistical significance was established as p<0.05 (confidence level > 95%). RESULTS: The dental erosion (DE) was the most significative feature of dental alterations. The degree of DE was significantly greater in the EDG (p<0.001). A significant association between soft tissue lesions and EDs was found (p<0.001) A notable difference in non-stimulated salivary flow was found between the groups (p<0.001). No significant differences between the groups were found for periodontal status, dental caries, or oral hygiene practices. CONCLUSIONS: On the basis of the results obtained, it is necessary to carry out oral/dental examination as soon as an ED is diagnosed with regular check-ups thereafter.

Accuracy of Different Mini Nutritional Assessment Reduced Forms to Evaluate the Nutritional Status of Elderly Hospitalised Diabetic Patients.

BACKGROUND: Disease-associated malnutrition (DAM) is a health problem involving all sanitary levels, especially hospitalised elderly patients. Different MNA (Mini Nutritional Assessment)-based forms have been validated in different settings, but it remains unclear if they are appropriate to evaluate the nutritional status of geriatric hospitalised patients with diabetes. OBJECTIVE: The aim of this work was to analyse the accuracy of several MNA reduced forms to detect malnutrition in hospitalised elderly diabetic patients. METHODS: A multicentre observational study was carried out in diabetic patients, who were over the age of 65, from 35 Spanish hospitals. Principal component analysis (PCA) selected the minimal components to elaborate the newly-proposed reduced new version of the MNA (r-MNA). Cohen's Kappa index (KI), with its 95% confidence interval (CI), was used to measure the agreement between the different reduced forms (r-MNA, MNA-SF-BMI, MNA-SF-CC, m-MNA) with the original MNA. RESULTS: Five hundred and ninety-one elderly diabetic patients were included in the study. ROC analysis determined the following cut-off points for the newly proposed r MNA: 0-<10 "malnourished", 10-12 "at risk" and >12-15 "well-nourished". The upper cut-off point demonstrated a sensitivity of 87.7%, a specificity of 78.3% and an area under the curve of 0.93. The lower cut-off point showed a sensitivity of 95.9%, a specificity of 78.3% and an area under the curve of 0.95. The best agreement with the original MNA was observed for the MNA-SF-BMI (Κ index 80.7; 95% CI: 77.4-84) and the worst for the r-MNA (Κ index 72; 95% CI: 68.2-75.4). CONCLUSIONS: This study found that MNA-SF-BMI is the most accurate screening tool for determining the nutritional status of hospitalised diabetic elderly patients. This is an easy-to-use, fast screening tool with a low risk of misclassification.

The Role of Omega-3 Fatty Acids in Diets.

The article is a summary of Dra. Carmen Gómez Candela's presentation at the Science in Nutrition 3rd International Congress in Milan, March 2014. The article covers omega-3 fatty acids use in different medical areas and several institutions' opinions in relation to the topic. Omega-3 acids are essential fatty acids. A certain amount of omega-3 is needed in our daily diet; however, the usual consumption is generally less than the recommended amount. Changes in dietary patterns in the course of history have led to deficit levels of omega-3 in the human body. Currently, there is increasing evidence of the benefits of omega-3 in different medical specialities. There are still some gaps regarding its role in illnesses such as dementia, psychiatric disorders, and inflammatory diseases. Nevertheless, stronger evidence is being proved in cardiovascular diseases and cancer. This article provides a reflection on possible ways to increase omega-3 daily consumption and the constraints associated with food with high contents of heavy metals, which, in turn, are also rich in omega-3s.

Impact of cooked functional meat enriched with omega-3 fatty acids and rosemary extract on inflammatory and oxidative status; a randomised, double-blind, crossover study.

BACKGROUND & AIM: n-3 fatty acid intake has been associated with inflammatory benefits in cardiovascular disease (CVD). Functionalising meat may be of great interest. The aim of the present study was to assess the effect of functional meat containing n-3 and rosemary extract on inflammatory and oxidative status markers in subjects with risk for CVD. METHODS AND RESULTS: A randomised, double-blind, cross-over study was undertaken to compare the effects on the above markers of consuming functional or control meat products. 43 volunteers with at least two lipid profile variables showing risk for CVD were randomly assigned to receive functional meat (FM) or control meat (CM) over 12-weeks with a 4-week wash-out interval before crossover. Functional effects were assessed by examining lipid profile, CRP, PAI-1, TNF-alpha, IL-6, fibrinogen (inflammatory markers), and TBARS, FRAP and 8-iso-PGF2 (oxidative status markers). 33 subjects (24 women) aged 50.7±8.8 years completed the study. In FM treatment, PAI-1, fibrinogen and 8-iso-PGF2 decreased significantly after 12 weeks, while FRAP significantly increased. In contrast, in CM treatment, a significant increase was seen in PAI-1, while FRAP significantly declined. Significant differences were also seen between the FM and CM treatments after 12 weeks in terms of the change observed in PAI-1, FRAP and 8-iso-PGF2 values. No significant differences were seen in anthropometric variables nor were adverse effects reported. CONCLUSION: The consumption of FM containing n-3 and rosemary extract improved oxidative and inflammatory status of people with at least two lipid profile variables showing risk for CVD. The inclusion of such functional meat in a balanced diet might be a healthy lifestyle option.

Objetivos: La ingesta de omega-3 se ha asociado con efectos antinflamatorios relacionados con la prevención de la enfermedad cardiovascular (ECV). Desarrollar productos cárnicos funcionales podría ser de gran interés para la población. El objetivo del presente estudio fue evaluar el efecto de una carne funcional con omega-3 y extracto de romero sobre marcadores de inflamación y oxidación en personas con riesgo cardiovascular. Pacientes y métodos: Se diseñó un ensayo clínico cruzado y doble-ciego para estudiar el efecto del consumo de un producto cárnico funcional sobre marcadores de inflamación y oxidación. Se incluyeron 43 voluntarios con al menos 2 parámetros del perfil lipídico alterado, indicando riesgo de ECV. Fueron asignados aleatoriamente en 2 grupos que consumieron en cruzado carne funcional (CF) o carne control (CC) durante 12 semanas con un periodo de lavado de 4 semanas entre ellos. Al finalizar el estudio se evaluó: perfil lipídico, marcadores de inflamación (PCR, PAI-1, TNF-alpha, IL-6, fibrinógeno) y marcadores de oxidación (TBARS, FRAP, 8-iso-PGF2). Resultados: Completaron el estudio 33 personas (24 mujeres) con edad media de 50.7±8.8 años. Tras consumir CF durante 12 semanas se observó una disminución significativa del PAI-1, fibrinógeno y 8-iso-PGF2, mientras que el FRAP incrementó significativamente. Sin embargo, con CC incrementó PAI-1 y disminuyó FRAP significativamente. Además se observaron diferencias significativas entre los cambios producidos tras consumir uno u otro producto de los marcadores PAI-1, FRAP y 8-iso-PGF2. Al final de cada intervención no se observaron cambios en variables antropométricas ni efectos adversos. Conclusiones: El consumo de CF con omega-3 y extracto de romero mejora el estado inflamatorio y oxidativo de personas con al menos 2 parámetros del perfil lipídico alterado. La inclusión de estas CF en una dieta equilibrada podría ser una opción más para mantener un estilo de vida saludable. ClinicalTrials.gov NCT0199088.

Home enteral nutrition in Spain; NADYA registry 2011-2012.

OBJECTIVE: To describe the results of the home enteral nutrition (HEN) registry of the NADYA-SENPE group in 2011 and 2012. MATERIAL AND METHODS: We retrieved the data of the patients recorded from January 1st 2011 to December 31st 2012. RESULTS: There were 3021 patients in the registry during the period from 29 hospitals, which gives 65.39 per million inhabitants. 97.95% were adults, 51.4% male. Mean age was 67.64 ± 19.1, median age was 72 years for adults and 7 months for children. Median duration with HEN was 351 days and for 97.5% was their first event with HEN. Most patients had HEN because of neurological disease (57.8%). Access route was nasogastric tube for 43.5% and gastrostomy for 33.5%. Most patients had limited activity level and, concerning autonomy, 54.8% needed total help. Nutritional formula was supplied from chemist's office to 73.8% of patients and disposables, when necessary, was supplied from hospitals to 53.8% of patients. HEN was finished for 1,031 patients (34.1%) during the period of study, 56.6% due to decease and 22.2% due to recovery of oral intake. CONCLUSIONS: Data from NADYA-SENPE registry must be explained cautiously because it is a non-compulsory registry. In spite of the change in the methodology of the registry in 2010, tendencies regarding HEN have been maintained, other than oral route.

Objetivos: Describir los resultados del registro de nutrición enteral domiciliaria (NED) del grupo NADYASENPE de los años 2011 y 12. Material y métodos: Se recopilaron los datos introducidos en el registro desde el 1 de enero de 2011 al 31 de diciembre de 2012. Resultados: Hubo 3021 pacientes en el registro durante el periodo, procedentes de 29 hospitales, lo que da una prevalencia de 65,39 casos por millón de habitantes. 97.95% fueron adultos, 51,4% varones. La edad media fue 67,64 ± 19,1 años y la mediana 72 años para los adultos y 7 meses para los niños. La duración media de la NED fue 351 días y para el 97,5% fue el primer episodio con NED. La mayoría de pacientes tenían NED por una enfermedad neurológica (57,8%). La vía de acceso fue sonda nasogástrica para el 43,5% y gastrostomía para el 33,5%. La mayoría de pacientes tuvieron un nivel de actividad física limitado y, respecto a la autonomía, 54,8% necesitaba ayuda total. La fórmula de nutrición se suministró desde las oficinas de farmacia para el 73,8% y los fungibles, cuando fueron necesarios, desde los hospitales para el 53,8%. La NED se suspendió en 1.031 pacientes (34,1%) durante el periodo de estudio, 56,6% debido a fallecimiento y 22,2% debido a recuperación de la vía oral. Conclusiones: Los datos del registro NADYA-SENPE deben ser interpretados con precaución ya que se trata de un registro voluntario. A pesar del cambio de metodología del registro en 2010, las tendencias en NED se han mantenido, salvo la importancia cuantitativa de la vía oral.

[Home parenteral nutrition in Spain 2011 and 2012; a report of the home and ambulatory artificial nutrition group NADYA]. / Nutrición Parenteral Domiciliaria en España 2011 y 2012: informe del grupo de nutrición artificial domiciliaria y ambulatoria NADYA.

OBJECTIVE: To report the data of the Home Parenteral Nutrition (HPN) registry of the NADYA-SENPE working group for the years 2011 and 2012. METHODOLOGY: We compiled the data from the on-line registry introduced by reviewers of NADYA group responsible for monitoring of NPD introduced by since January 1, 2011 to december 31, 2012. Included fields were: age, sex, diagnosis and reason for HPN, access path, complications, beginning and end dates, complementary oral or enteral nutrition, activity level, autonomy degree, product and fungible material supply, withdrawal reason and intestinal transplant indication. RESULTS: Year 2010: 184 patients from 29 hospitals , representing a rate of 3.98 patients/million inhabitants/ year 2011, with 186 episodes were recorded NPD . During 2012, 203 patients from 29 hospitals , representing a rate of 4.39 patients/million inhabitants/year 2012 , a total of 211 episodes were recorded NPD . CONCLUSIONS: We observe an increase in registered patients with respect to previous years.Neoplasia remains as the main pathology since 2003. Although NADYA is consolidated registry and has been indispensable source of information relevant to the understanding of the progress of Home Artificial Nutrition in our country, there is ample room for improvement. Especially that refers to the registration of pediatric patients and the registration of complications.

Objetivo: Comunicar los datos del registro de Nutrición Parenteral Domiciliaria (NPD) del grupo de trabajo NADYA-SENPE de los años 2011 y 2012. Material y métodos: Recopilación de los datos del registro "on-line" introducidos por los colaboradores del grupo NADYA responsables del seguimiento de la NPD desde el 1 de enero de 2011 al 31 de diciembre de 2012 dividido por años naturales. Resultados: Año 2010: Se registraron 184 pacientes, procedentes de 29 hospitales, lo que representa una tasa de 3,98 pacientes/millón habitantes/año 2011, con 186 episodios de NPD. Durante el año 2012 se registraron 203 pacientes, procedentes de 29 hospitales, lo que representa una tasa de 4,39 pacientes/millón habitantes/año 2012, con un total de 211 episodios de NPD. Conclusiones: Se observa un aumento progresivo de los pacientes registrados respecto a años anteriores. El principal grupo patológico sigue siendo oncológico ocupando el primer lugar desde 2003. Aunque el registro NADYA es un registro consolidado y ha sido y es fuente imprescindible de información relevante para el conocimiento de los avances de la Nutrición Artificial Domiciliaria en nuestro país, queda un amplio margen para la mejora. En especial lo que hace referencia al registro de pacientes pediátricos y al registro de las complicaciones.

[Effectiveness of a program for treatment of overweight and nonmorbid obesity in primary healthcare and its influence lifestyle modification]. / Eficacia de un programa para el tratamiento del sobrepeso y la obesidad no mórbida en atención primaria y su influencia en la modificación de estilos de vida.

BACKGROUND: Lifestyle intervention is fundamental for obesity treatment. The aim of this study was to evaluate the effects of a program focused on diet, exercise and psychological support on Lifestyle Modification in overweight and obese patients treated in Primary Health Care setting. METHODS: 60 patients with grade II overweight and non-morbid grade I-II obesity were included in this pilot clinical trial. Ages ranged from 18 to 50 years. They were provided with a program combining nutritional education, physical activity and psychological support. Subjects attended group sessions every 2 weeks. The main outcome measures at baseline and 6 months were body composition parameters (BMI, body fat percentage, waist circumference) and lifestyle intervention using the Questionnaire for the assessment of overweight and obesity related lifestyles at baseline and six months. This questionnaire yields an five dimensions: diet caloric intake (CC), healthy eating (AS), physical activity (EF), searching for psychological well-being eating (BP) and alcohol intake (CA). The higher score indicates better lifestyles for CC, AS, EF and worse for BP y CA. RESULTS: At the end of the intervention the program achieved improvements in Questionnaire related lifestyles subscales: CC (2,60 ± 0,5 vs. 3,49 ± 0,7, p<0,001), EF (2,19 ± 0,9 vs. 3,17 ± 1,0, p<0,001) and AS (3,04 ± 0,4 vs. 3,43 ± 0,4, p<0,05); CA (3,98 ± 0,7 vs. 4,25 ± 0,7, p<0,05) and BP (2,82 ± 1,0 vs. 3,34 ± 0,7, p<0,001) has got worse. CONCLUSION: The Program focused on balanced and moderate energy-restricted diets, increased physical activity and psychological support may improve the anthropometric parameters and the Lifestyle intervention in obese patients treated in a primary healthcare center.

Introducción y Objetivos: la modificación de conductas no saludables es fundamental para tratar la obesidad. El objetivo de este estudio fue evaluar los efectos de un programa basado en dieta, ejercicio y apoyo psicológico en la modificación conductual de pacientes con sobrepeso y obesidad tratados en Atención Primaria. Métodos: 60 pacientes con sobrepeso grado II y obesidad grado I-II fueron incluidos en este ensayo piloto. Edad entre 18-50 2013s. Los pacientes recibieron un programa que combinaba educación nutricional, actividad física y apoyo psicológico. Formato grupal, periodicidad quincenal. Los principales resultados medidos al inicio y 6 meses fueron parámetros antropométricos (índice de masa corporal, porcentaje de masa grasa, perímetro cintura) y de estilos de vida usando el Cuestionario para la valoración de hábitos de vida relacionados con el sobrepeso y la obesidad. Consta de 5 dimensiones: contenido calórico de la dieta (CC), alimentación saludable (AS), ejercicio físico (EF), comer por bienestar psicológico (BP) y consumo de alcohol (CA). La mayor puntuación indica mejores hábitos para CC, AS y EF y peores para BP y CA. Resultados: al final de la intervención mejoraron las escalas CC (2,60± 0,5 vs 3,49± 0,7, p<0,001), EF (2,19± 0,9 vs 3,17± 1,0, p<0,001) y AS (3,04± 0,4 vs 3,43± 0,4, p<0,05) del cuestionario; CA (3,98± 0,7 vs. 4,25± 0,7, p<0,05) y BP (2,82± 1,0 vs. 3,34± 0,7, p<0,001) empeoraron. Conclusión: el programa basado en moderada restricción de la dieta, aumento de actividad física y apoyo psicológico puede mejorar parámetros antropométricos y estilos de vida en pacientes obesos tratados en un centro de Atención Primaria.

[The registry of home artificial nutrition and ambulatory of the Spanish Society of Parenteral and Enteral Nutrition; SWOT analysis]. / El registro de Nutrición Artificial Domiciliaria y Ambulatoria de la Sociedad Española de Nutrición Parenteral y Enteral; análisis DAFO.

OBJECTIVE: To evidence by means of a SWOT-R analysis performed by an expert consensus the most worrying characteristics of the register on Home-based and Outpatient Artificial Nutrition. MATERIAL AND METHODS: SWOT-R analysis with expert consensus. We requested the participation of the active members of the NADYA group within the last 5 years with the premise of structuring the SWOT-R based on the characteristics of the NADYA registry from its beginning. RESULTS: 18 experts from hospitals all over Spain have participated. The internal analysis seems to be positive, presenting the registry as having important resources. The external analysis did not show a great number of threats, there are very potent factors, "the voluntariness" of the registry and the "dependence on external financing". The opportunities identified are important. The recommendations are aimed at stabilizing the system by decreasing the threats as one of the main focus of the strategies to develop as well as promoting the items identified as opportunities and strengths. CONCLUSIONS: The analysis shows that the NADYA register shows a big potentiality for improvement. The proposed recommendations should be structured in order to stay on the track of development and quality improvement that has characterized the NADYA register from the beginning.

Nutritional intervention in oncohematological patient.

BACKGROUND: Oncohematological diseases such as lymphoma or leukaemia affect an increasing number of newly diagnosed patients in Spain and other countries. Both disease and treatment may have a negatively impact in the nutritional status of the patient. Malnutrition is not uncommon among oncohematological patients. This situation can compromised the course of the disease, the clinical response of the treatment and the patient's quality of life. METHOD: The implementation of a multidisciplinary approach and a systematic and protocolled nutritional assessment would be useful when dealing with haematological malignancies. RESULTS: We present a proposal of protocol for nutritional intervention in oncohematological patients. This proposal is been developed from the analysis of the published literature as well as clinical practice of a multi-disciplinary team specialized in the management of patients with haematological malignancies.

Immunoenhanced enteral nutrition formulas in head and neck cancer surgery: a systematic review.

INTRODUCTION: Significant malnutrition exists in a high percentage of patients with head and neck cancer. Malnutrition is associated with defects in immune function that may impair the host response to malignancy. Malnutrition and immunosupression make patients highly susceptible to postoperative infections and complications. OBJECTIVES: Some studies of patients receiving immuno-nutrition in the perioperative period in head and neck cancer have shown beneficial effects on clinical outcome and inmune status. The authors carried out a systematic review of randomised control trials to determine whether perioperative immunonutrition has a role in the treatment of head and neck cancer. METHODS: 14 trials of polymeric nutritional supplementation with immunonutrition were identified. Two studies compared two types of immunonutrition. RESULTS: A reduction in the length of postoperative hospital stay was seen in some trials, but the reason for this reduction is not clear. Some studides showed statistical differences with less complications in arginine-enhanced group and also showed a significant decrease of fistula complications in patients treated with a high arginine dose enhanced formula, if compared with a medium dose of arginine. CONCLUSION: [corrected] Those planning future studies face challenges. A suitable powered clinical trial is required before firm recommendations can be made on the use of immunonutrition in head and neck cancer patients postoperatively.

[Perception about the importance of feeding in a group of hematologic cancer patients]. / Percepción de la importancia de la alimentación en un grupo de pacientes con cáncer hematológico.

INTRODUCTION: Oncohematologic patients usually present nutritional deficits associated with the disease, the treatments and side effects, etc. However, there are hardly any descriptive data about the dietary recommendations used and the patient's self-perception of its usefulness in their disease. AIM: To assess the self-perception of the nutritional importance in a group of oncohematologic patients. MATERIALS AND METHODS: 111 oncohematologic patients self-reported a questionnaire containing items about socio-sanitary data and self-perception of the nutritional importance in their disease. RESULTS: The mean age was 40.0 ± 12.8 years (64.86% women). The most frequent diagnosis and treatment was lymphoma (83.78%) and chemotheraphy (92.80%). 75% considered "very important" relationship between oncohematologic disease and nutritional status. Only 54.1% received dietary advice. And 53.2% and 50.5% considered that the use of nutritional supplements improve quality of life and/or disease respectively. CONCLUSIONS: A significant percentage of patients had advanced stages of their disease. However, half the group had not received dietary advice despite high interest in receiving nutritional care. Therefore, the nutritional assessment and the personalized nutritional support implementation of the patient should be included in routine clinical practice.

[Home enteral nutrition in Spain: NADYA registry in 2010]. / Nutrición enteral domiciliaria en España: registro NADYA del año 2010.

OBJECTIVE: To describe the results of the home enteral nutrition (HEN) registry of the NADYA-SENPE group in 2010. MATERIAL AND METHODS: We retrieved the data of the patients recorded from January 1st to December 31st 2010. RESULTS: We registered 6,591 patients (51% males) with 6,688 episodes of HEN, from 32 hospitals. Mean age in those younger than 14 yr (4%) was 1 ± 2 yrs (m ± SD) and 69,9 ± 17,8 yrs in those older than 14 yr. The length of HEN was longer than 2 yrs in 76% of the patients. The most frequent underlying disease was neurological disorders 42%, followed by cancer 28% (mostly head and neck cancer 18%). We had information related to the enteral access route in only 626 cases (9,4%), 51% of them used nasogastric tubes, 27% gastrostomies, 10% oral route and 3% jejunostomies. Only 251 episodes were closed during the year, mostly due to patient death 57% and progress to oral diet 14%. The activity level was limited in 29% of the patients and 39% of them were bed- or chairridden. Total or partial help was needed by 68% of the patients. The hospitals and the private pharmacies delivered the enteral formula in 63% and 34% of the cases, respectively. The hospitals and the primary care centres delivered the disposables in 83% and 16% of the cases, respectively. CONCLUSIONS: The results of the 2010 HEN registry are similar to those published in previous years regarding the number and characteristics of the patients. We continue finding problems in the entrance of data referred to the enteral access route and the closing of the episodes.

Effects of dietary restriction combined with different exercise programs or physical activity recommendations on blood lipids in overweight adults.

BACKGROUND AND AIM: Many exercise studies, although generally showing the beneficial effects of supervised aerobic, resistance or combined exercise on blood lipids, have sometimes reached equivocal conclusions. The aim of this study is to evaluate the impact of different programs that combined exercise and dietary restriction on blood lipids versus a clinical practice intervention for weight loss, in overweight adults. METHODS: For this study 66 subjects participated in a supervised 22 weeks training program, composed of three sessions per week and they were randomized in three groups: strength training (S; n = 19), endurance training (E; n = 25), a combination of E and S (SE; n = 22). Eighteen subjects served as physical activity group (PA) that followed a clinical intervention consisted of physical activity recommendations. All groups followed the same dietary treatment, and blood samples were obtained for lipids measurements, at the beginning and end of the study. RESULTS: Lipid profile improved in all groups. No significant differences for baseline and post-training values were observed between groups. In general, SE and PA decreased low-density lipoprotein cholesterol (LDL-C) values (p < 0.01). S decreased triglyceride levels (p < 0.01) and E, SE, and PA decreased total cholesterol levels (p < 0.05, p < 0.01 and p < 0.01, respectively). CONCLUSIONS: These results suggest that an intervention program of supervised exercise combined with diet restriction did not achieved further improvements in blood lipid profile than diet restriction and physical activity recommendations, in overweight adults. (Clinical Trials gov number: NCT01116856).

[Clinical management of homocystinuria: case report and review of the literature]. / Homocistinuria; curso clínico y tratamiento dietético: a propósito de dos casos.

Homocystinuria is a congenital disorder of methyonine metabolism that leads to increased plasmatic, urinary and tissue deposits of methyonine and its main metabolite: homocysteine. Homocysteine deposits are toxic for the skeletal system (osteoporosis), the eyes (lens dislocation), central nervous system (seizures, psychiatric disorders) and also induce vascular damage (stroke and other cardiovascular events). This article reports two patients with homocystinuria in two siblings, followed by a concise review on the therapeutic strategies available for this disorder.

Impact of two low-calorie meals with and without bread on the sensation of hunger, satiety and amount of food consumed.

BACKGROUND: The aim was to compare the differences in feelings of hunger and satiety in a group of overweight/obese women after eating a test meal with or without bread. PATIENTS AND METHODS: The study included 122 women (BMI≥25<40 kg/m²) who were randomly assigned to consume one of the following test meals: NO BREAD meal (2.40 MJ, 46% carbohydrates, 26% protein, 28% fat; which included rice or pasta) and BREAD meal (2.39 MJ, with equal caloric distribution and the same foods except with bread instead of rice or pasta). A visual analogue scale (VAS) was used, with 5 questions to be answered at different times: 1) just before eating, 2) just after eating and exactly 3) 60 and 4) 90 minutes after eating the test meal. The test was performed at the start and after 16 weeks of following a lifestyle modification program based on a low-calorie diet (with or without bread). RESULTS: 104 women completed the study (48.4±9.0 years) with a baseline BMI of 29.8±3.5 kg/m². At the start of the study there were no significant differences in any of the VAS parameters measured between the groups. After 16 weeks, BREAD group obtained higher scores in question 3 (referring to the sensation of satiety) that were significant at time 3 (7 versus 5; p<0.05) and time 4 (8 versus 4; p<0.01). CONCLUSIONS: The inclusion of bread in a low-calorie meal may result in a greater sensation of satiety after eating. These results contradict the recommendation to exclude bread from a food plan aimed at weight loss.

Importance of a balanced omega 6/omega 3 ratio for the maintenance of health: nutritional recommendations.

The modification of dietary patterns has led to a change in fatty acid consumption, with an increase in the consumption of ω-6 fatty acids and a marked reduction in the consumption of ω-3 fatty acids. This in turn has given rise to an imbalance in the ω-6/ω-3 ratio, which is now very different from the original 1:1 ratio of humans in the past. Given the involvement of ω-6 and ω-3 essential fatty acids in disease processes, the present article examines changes in dietary patterns that have led to the present reduction in the consumption of ω-3 essential fatty acids, and to study the importance of the ω-6/ω-3 balance in maintaining good health. In addition, an assessment is made of the established recommendations for preventing a poor intake of ω-3 essential fatty acids, and the possible options for compensating the lack of these fatty acids in the diet.