La aplicación de las DRI (Dietary Reference Intakes) en la evaluación de la ingesta de micronutrientes en individuos / The application of DRI (Dietary Reference Intakes) in micronutrient intake assessment of individuals

El asesoramiento dietético dentro de la valoración del estado nutricional puede realizarse tanto para grupos como en individuos, difiriendo en ambos casos la metodología estadística a aplicar. En el presente artículo se describe la metodología para analizar la ingesta de micronutrientes en individuos. Para ello, se presupone una distribución normal tanto de las ingestas como de los requerimientos. Siguiendo las "Aplicaciones para el asesoramiento dietético" promulgadas por el Instituto de Medicina de EEUU, se citan ejemplos de cómo realizar el asesoramiento de la ingesta de micronutrientes, tanto en el caso de que tengan definido un Requerimiento Medio Estimado (EAR, Estimated Average Requirement) o una Ingesta Adecuada (AI, Adequate Intake). La aceptación a nivel mundial de estas directrices es un requisito previo para la armonización internacional de la interpretación de datos. En el caso de distribuciones sesgadas, no se pueden aplicar estos métodos y por tanto se deben desarrollar nuevas metodologías en el futuro (AU)

Valoración nutricional de los menús de la guardería de la Universidad Politécnica de Valencia / Nursery Menu assessment from Politechnical University of Valencia

Introducción: la alimentación del niño de 1 a 3 años debe tener como objetivo satisfacer las necesidades nutricionales y potenciar un adecuado crecimiento y desarrollo. El menú del comedor escolar debe aportar entre un 30 y un 35 por ciento de las necesidades energéticas diarias, y debe ajustarse a las necesidades de micronutrientes esenciales. Objetivos: en el presente trabajo de investigación se evaluó el aporte de calorías y nutrientes de los menús ofrecidos por la guardería de la Universidad Politécnica de Valencia, con el fin de corregir deficiencias (por exceso o defecto), y obtener una oferta más saludable y equilibrada. Resultados: los resultados obtenidos ponen de manifiesto que los menús ofrecidos en la guardería presentan aportes inadecuados de energía, proteínas, y grasas. Asimismo, se han detectado déficits de algunos micronutrientes esenciales, como el hierro, ácido fólico, zinc y vitamina B12, nutrientes de gran relevancia en la nutrición de los escolares. Conclusiones y recomendaciones: se considera esencial el rol de los padres en la optimización de la calidad de la alimentación de los niños, y en la importancia del desayuno, como aporte energético elemental en la etapa de crecimiento y desarrollo (AU)

Ingesta de micronutrientes en adolescentes de comedores escolares de Soria / Micronutrients intake in adolescents who attend the school dining halls in Soria

En este trabajo se examina la ingesta de ciertos micronutrientes en adolescentes de entre 10 y 19 años, habitantes de una ciudad española. Un grupo de 111 adolescentes (49,5 por ciento varones, 50,5 por ciento mujeres) escolarizados en escuelas públicas de Soria fueron encuestados sobre el consumo de alimentos durante 7 días para medir la ingesta de minerales, calcio, hierro, magnesio y cinc y vitaminas, A, E, C y ácido fólico. Utilizando la prueba de Student entre los resultados obtenidos de ingesta y la ingesta individual recomendada se observó una ingesta excesiva de vitaminas A, E, C y ácido fólico en todos los grupos a excepción del grupo de mujeres entre 16 y 19 años en el que la diferencia no fue estadísticamente significativa. La ingestión de calcio y cinc fue superior a las recomendaciones en todos los grupos, aunque no significativa para calcio en el grupo de mujeres de entre 16 y 19 años y para cinc en el grupo de mujeres de 10 a 12 años. La ingesta diaria de magnesio fue claramente insuficiente para ambos sexos entre los adolescentes encuestados y finalmente el consumo estimado de hierro en mujeres fue inadecuado para todos los grupos de edad y suficiente en todos los grupos de varones. A la vista de los resultados obtenidos en este estudio y sobre todo en lo que concierne a lo inadecuado del consumo de hierro y magnesio, especialmente en mujeres, sería conveniente realizar algún tipo de intervención nutricional entre los adolescentes de centros públicos de la provincia de Soria (AU)

Asistencia nutricional del paciente pediátrico quemado / Nutritional care of burned pediatric patient

El cuidado del niño quemado demanda una atención detallada de todas sus necesidades, desde el inicio del daño hasta su recuperación; esto incluye maniobras iniciales de resucitación, procedimientos quirúrgicos, apoyo en unidades especializadas, terapia nutricional y de rehabilitación. La quemadura es provocada por múltiples agentes, las más comunes ocurren por efecto térmico (fuego y líquidos calientes), el grupo etario más afectado está contituido por niños de 0 a 5 años (1). En nuestro país fallecen por esta causa, según constancia en certificados de defunción un número total de 60 niños entre 0 y 19 años (2). La mejoría de las técnicas de resucitación, ha permitido la supervivencia de estos pacientes durante la crítica etapa inicial. Durante este lapso, entre otros factores, la instalación de un apropiado apoyo nutricional ha mejorado el pronóstico y disminuido las complicaciones intrahospitalarias. Las posibilidades de sobrevivir tras un traumatismo térmico entre otros factores, están determinadas por la intensidad y extensión de la quemadura, la reserva cardiopulmonar y metabólica, estas últimas depdendientes de la edad (3)

Snack patterns of older Europeans.

OBJECTIVE: To describe the snack consumption of older people from several European towns. Subjects with similar snack patterns are clustered into groups to explore the contribution of snacks to daily energy and micronutrient intake. DESIGN: Data from the 1993 Survey in Europe on Nutrition and the Elderly: A Concerted Action (SENECA) follow-up study were collected from a random, age-stratified sample of inhabitants of small traditional towns in Europe. Food intake data collected by the 3-day estimated record method were used for grouping snack foods into 15 food groups. From these data daily energy intake and intake of calcium; iron; and vitamins B-1, B-2, B-6, and C were calculated. Additional self-reported data were collected for health status, presence of chronic diseases, and activity level. SUBJECTS/SETTING: The study population consisted of 379 men and 428 women aged 74 to 79 years and who were inhabitants of the following towns: Haguenau, France; Romans, France; Padua, Italy; Culemborg, The Netherlands; Yverdon, Switzerland; and Marki, Poland. STATISTICAL ANALYSES: Cluster analysis was used to classify subjects into groups based on similarity in snack patterns. RESULTS: In general, older people from the various European towns consumed the same snack types. Five distinct snack patterns emerged from our analyses. The large group light snackers had a low snack use and low energy and micronutrient intakes. Alcohol drinkers and dairy snackers had a high snack use and high intakes of energy and several vitamins and minerals. Fruit and vegetable snackers and sweet drinkers often had intake values between the other 3 groups. APPLICATIONS: Our study indicates the existence of identifiable snack patterns that coincide with different intakes of energy and micronutrients. Especially in countries in which people derive high percentages of energy through snacking, the identification of snack patterns can improve dietary advice, gearing it to personal needs.

Nutritional factors and colon carcinoma: a case-control study involving French Canadians in Montréal, Quebec, Canada.

BACKGROUND: In a population-based case-control study of colon carcinoma and nutrition involving the francophone community in Greater Montreal, a total of 402 cases (200 males and 202 females) and 668 controls (239 males and 429 females) were interviewed. METHODS: Cases from 1989-1993 were identified through the admission offices of 5 major francophone teaching hospitals in Montreal and were ages 35-79 years. Controls matched by age, place of residence, and language were selected by a modified random digit dialing method. Information on dietary intake was collected with a quantitative food frequency questionnaire. RESULTS: No associations were evident between colon carcinoma and total energy, protein, or carbohydrate consumption, whereas a suggestive inverse association was found with total fat intake, with an odds ratio (OR) of 0.78 (P = 0.0637), and with saturated fat intake as well (OR = 0.71, P = 0.0893). A strongly significant inverse association was found with dietary fiber (OR = 0.50, P = 0.0018). The strongest inverse association concerning fiber was found with fiber from vegetable sources (OR = 0.57, P = 0.0096), and a suggestive (although nonsignificant) inverse association (OR = 0.74, P = 0.0687) was found with fiber from fruits. Calcium was inversely associated with risk (OR = 0.69, P = 0.0411), as was dietary intake of vitamin A (OR = 0.67, P = 0.0162), retinol, (OR = 0.069, P = 0.0409), vitamin E (OR = 0.53, P = 0.0028), and alphatocopherol (OR = 0.63, P = 0.0256). Although there was no association demonstrated between dietary beta-carotene intake and risk, a suggestive (although nonsignificant) inverse association with intake of other types of carotene was observed (OR = 0.76, P = 0.0740). No association was found between intake of other nutrients investigated in this study and risk of colon carcinoma. CONCLUSIONS: There is strong evidence from epidemiologic studies that high intake of fat and meat are risk factors for colorectal carcinoma in humans, whereas high intake of vegetable and fruit are inversely associated with risk of colon carcinoma. The findings from this study are in agreement with this observation.

Micronutrient regulation in pregnant and lactating wome from Rio de Janeiro / Regulación de micrnutrientes en embarazadas y mujeres lactantes de Río Janeiro

Studies with low-income pregnant and lactating women from the city of Rio de Janeiro, conceened mainly with the changes in micronutrient homeostasis during pregnancy and lactation in the absence of overt clinical deficiencies, are reported. These studies focused on folate, cobalamin, iron, zinc and vitamin A. Factors that may effect the maternal micronutrient state, such as dietary intakes, use of supplements and interrelationships of micronutrients have been considered, as well as the implications of changes for maternal-fetal transfer and milk composition. Although these studies were not designed to evaluate the prevalence of sub-clinical micronutrient deficiencies in pregnant and women, they indicate that high frequencies of sub-clinical deficiencies of folate, iron, zinc and vitamin A, especially in pregnant women, are expected to be found in Rio de Janeiro

Zinc in urban infants and children from Brasilia / Zinc en infantes y niños urbanos de Brasilia

The substandard living conditions of the poor families in the growing urban population of Brazilian cities puts children in the more vulnerable group of micronutrient deficiency. The chemical analysis of milk diets consumed by infants showed that zinc is insufficiently provided in bottle-fed infants and possibly a first-limiting nutrient in breast-fed babies, at least during the first 6 months of life

Micronutrients and urban life-style: lessons from Guatemala / Micronutrientes y estilo de vida urbana: lección de Guatemala

Guatemala is a nation of 10 million persons, at the northern point of the chain of five Republics derived from Spanish colonies on the Ishmus of Central America. The country is diverse in its ethnicities, its climate and terrain, and its agricultural pursuits. The majority of its population is poor, illiterate, and under-employed. It has had aunique and turbulent political history, and only recently has emerged. The traditional basis of the diet, dating to Mayan times, is maize and beans. Guatemala City, with its population in excess of 2 million inhabitants, having doubled since the Earthquake of 1976, is the only major metropolis. The pattern of dietary selection and the format of eating meals is changing in relationship to the size, congestion, economic evolution, and modernization of the capital city. A wider selection of foods is consumed in the city, but preparation follows the traditions of the cuisine. Street vendors play an ever larger role in the feeding of the urban poor. Quantitative data are only available for vitamin A and zinc, and only in certain subsegment of the population. The vitamin A in fortified foods, notably table sugar which is fortified with retinyl palmitate by legal mandate, makes up over one-third of the intake. The maize tortilla is an important sources of calcium, iron, zinc and copper. Average zinc intakes are appropriate, but the biological availability of the metal is low. The intake of iodine is totally dependent upon table salt which is inconsistently fortified. Data on micronutrient status exists for vitamin A, iron, iodine, riboflavin and zinc. With respect to rural areas, no major advantages or disadvantages in the adequacy of micronutrient nutriture can be calimed for the urban population. IT is probable that, in the metropolitan area, vitamin A nutriture is slightly better and riboflavin status somewhat poorer than in the countryside. The prospects for tuture directions in urban lifestyle, in micronutrient status and in their interaction are uncertain. The pressures of growth are straining the ability of the municipal infrastructure and the industrial base to respond with provision of services and employment

Micronutrient deficiency in urban Indonesia / Deficiencia de micronutrientes en area urbana de Indonesia

The economic situation of characterized by a large increase in the gross national product which has been on average 7 por ciento annually during the last ten years. This was accompanied by rapid urbanization. With the economic improvement, "First World" health and nutrition problems are coexisting in Indonesia. In 1992, the most common of death cause was cardiovascular disease whereas tuberculosis was the second ranking. About 40 por ciento of the preschool children are stunted. The main stable food and source is rice, although the urban population has a more diverse food pattern than the rural population. In Jakarta, many children receive too late colostrum feeding and mothers are not aware about the importance of correct breastfeeding practices after delivery. Three studies had shown that about one fidth of preschool children and one fourth of elderly take micronutriens. Nevertheless are prevalent in Jakarta. About one third of women suffer from moderate vitamin A deficiency (plasma retino <0.70 mmol/L) and 50 por ciento of pregnant women are anemic. More information is necessary on other micronutrient deficiencies. For example, a small study revealed that nearly two thirds of non-institutionalized alderly living in Jakarta experience thiamine deficiency. Appropriate interventions to reduce micronutrient deficienies should sensitiza the urban population to the fact that the government should restrict itself no use its resources to assist only the poorest individuals and groups, whereas it must be expected from the middle class to spend more to solve their own problemas

Use of micronutrients and alternative drugs by children with acute lymphoblastic leukemia.

The use of alternative therapies is thought to be common among cancer patients. To clarify the popularity of micronutrients among children with cancer, we performed a controlled follow-up survey. The use of micronutrients and alternative drugs by 15 families of children with acute lymphoblastic leukemia (ALL) receiving chemotherapy (62 members) and 26 control families (106 members) was monitored by means of daily diaries from November 1987 to December 1989. Forty percent of children with ALL (6 of 15) and 7.7% of their controls (2 of 26) took alternative medicines, the usage among the children with ALL being statistically significantly more common (difference, 32.3%; 95% confidence interval for difference [CI] 7.1, 57.5%; P < 0.04). All children with ALL and 50.0% of the control children (13 of 26) took vitamins (difference, 50.0%; 95% CI, 20.4-79.6%; P < 0.01). A total of 27.7% of the other members of the ALL families (13 of 47) and 11.1% of their counterparts in the control families (10 of 90) took alternative medicines, the usage in the index families being statistically significantly more common (difference, 16.6%; 95% CI, 3.4-29.7%; P < 0.03). The malignancy increased the use of alternative medicines among all members of the family and of vitamins and trace elements among the affected children.