Análisis de la evidencia disponible para el consumo de edulcorantes no calóricos. Documento de expertos / Analysis of the available evidence for the intake of non-caloric sweeteners. Expert document

Resumen Los edulcorantes no calóricos representan una buena alternativa para sustituir los sabores dulces sin la respuesta fisiológica que genera el consumo de azúcares. Por sí solos no son herramientas para el control de peso. Su consumo debe ir acompañado de una dieta correcta y un estilo de vida saludable que incluya actividad física. Su utilidad radica en proporcionar el agradable sabor dulce sin el aporte energético. La inocuidad de cada uno de los compuestos aprobados está comprobada y se reevalúa constantemente para tomar en cuenta los resultados de nuevos estudios. Debido a que no existe un edulcorante perfecto, la variedad ayuda a que se desarrollen productos cada vez más agradables para el consumidor. Este trabajo es fruto de una revisión exhaustiva de la bibliografía y de las discusiones de un panel de expertos de diversas especialidades: toxicología, ginecoobstetricia, pediatría, endocrinología, nutrición, medicina interna, salud pública y medicina preventiva, en el que se analizó extensamente la bibliografía se revisó una variedad de trabajos científicos que responden a las interrogantes que habitualmente se hacen los profesionales de la salud acerca de seguridad en diferentes grupos etáreos y con afecciones específicas, ingestión diaria admisible, etc.

Abstract Non-caloric sweeteners are a good alternative to replace the sweet flavors without the physiological response generated by the consumption of sugars. Alone they are not tools for weight control. Its intake must be accompanied by a proper diet and a healthy lifestyle that includes physical activity. Its usefulness lies in providing a pleasant sweet taste without the energy intake. The safety of each of the compounds is tested and approved and constantly reassessed to take into account the results of new studies. Since there is no perfect sweetener, variety helps that more and more pleasing to the consumer products are developed. This work is the result of a comprehensive review of the literature and discussions of a panel of experts from various specialties: toxicology, obstetrics and gynecology, pediatrics, endocrinology, nutrition, internal medicine, public health and preventive medicine, where literature was widely analyzed reviewing a variety of scientific papers that address the questions that usually are made by health professionals on safety in different age groups and with specific diseases, acceptable daily intake, etc.

Nutrición e insuficiencia renal crónica / Nutrition and chronic renal failure

En los pacientes con insuficiencia renal crónica es frecuente la malnutrición calórico-proteica y además es un buen predictor de morbilidad y mortalidad. En este artículo, se resumen las causas y las diferentes aproximaciones terapéuticas para revertir esta situación, destacando la suplementación nutricional mediante la administración oral o parenteral especialmente en el momento de la diálisis. Son necesarios más estudios sobre las diferentes intervenciones nutricionales para evaluar su eficacia en cuanto a calidad de vida, morbilidad y mortalidad (AU)

Protein-calorie malnutrition is common in chronic kidney disease patients and is a powerful predictor of morbidity and mortality. Causes and management are shown in this article, highlighting nutritional supplementation, administered orally or parenterally, especially during dialysis. Further larger scale randomized, controlled trials of nutritional interventions should be performed to assess their efficacy regarding quality of life, morbidity and mortality (AU)

[Geriatric nutrition]. / Nutrición en geriatría.

The elderly population is increasing rapidly over the last decades. This population has a high risk for malnutrition due to metabolic and organic changes that occur during the aging process. Malnutrition is especially prevalent in hospitalized elderly patients and those with other disease. Malnutrition in the elderly increases the morbido-mortality as the nutrients influence the immune function, the cognitive function, vision.... Caloric intakes of 30 Kcal/kg/day and protein ingestion of 1-1.25 g/kg/day are recommended. However, almost a third of the population does not meet these macronutrient requirements, and therefore does not meet the micronutrient requirements either. The easiest method for detecting malnutrition in the elderly is the Mini-Nutritional Assessment, which also accurately predicts the 1-year mortality. If malnutrition is detected, attempts should be made to correct this using an adequate and personalized oral diet, and it may be useful to associate energetic protein supplements.

[Update on the role of diet in recurrent nephrolithiasis]. / Actualización del papel de la dieta en la nefrolitiasis recidivante.

The role of nutritional factors in the pathogenesis of recidivating nephrolithiasis is reviewed. The ingestion of liquid calcium and citrates is inversely associated with the risk of developing stones, while the ingestion of proteins, sodium, uric, and oxalates have a direct relationship. One should not restrict the ingestion of calcium in the diet, but rather one should recommended a normal or high ingestion of some 850 mg/day, and rather, one should restrict the ingestion of proteins, oxalate, and sodium, as well as keeping up a diuresis greater than 1500 cc/day.

Tuberoinfundibular dopaminergic tonus in common migraine.

Changes in dopaminergic tonus have been hypothesized in patients with common migraine, suggesting that prolactin may play a role in the pathogenesis of the migraine. We investigated the prolactin response to domperidone, a dopamine receptor blocker. We tested 22 patients with common migraine (8 men, 7 women in the follicular phase of the menstrual cycle, and 7 women in the luteal phase), and 22 normal subjects adjusted for age, sex and phase of the menstrual cycle. Domperidone produced a significant rise of serum prolactin (p less than 0.01) in migrainous patients (7.77 +/- 3.09 vs 71.06 +/- 9.97 in men, 7.05 +/- 2.3 vs 129.58 +/- 14.15 in women in the follicular phase of the menstrual cycle, and 14.28 +/- 3.51 vs 169.71 +/- 16.63 in women in the luteal phase) and control subjects. The response did not show significant differences between migrainous patients and normal subjects. These data do not suggest changes in the tuberoinfundibular dopaminergic tonus in migrainous patients, in contrast to reports of other authors.

[Smoking habits: a study of hospital staff]. / Hábitos tabáquicos: estudio en personal hospitalario.

The results of a survey carried out in our hospital about the use of cigarettes in which 680 staff members participated (257 men and 423 women) are presented. The percentage of current smokers was 50% (51.8% amongst women and 45.1% amongst men). The highest percentages of smokers were found amongst nurses (61%), maintenance staff (50%) and administrative staff (45.1%); 41% of physicians smoked. Quitting the smoking habit was more frequent amongst physicians and higher grade staff, with a predominance of older males. The smallest number of quitters was found amongst nurses. 93.5% of the surveyed subjects agreed with the establishment of restrictive measures, finding no differences according to age, sex, or professional status, although there were differences according to the smoking habit. The results obtained point out the importance of the smoking problem amongst health professionals and could be used to promote programs against smoking in hospitals.