RESUMO
ANTECEDENTES Y OBJETIVOS: La leche ultrapasteurizada (leche UHT) de vaca es la más consumida en el suroeste europeo. Los objetivos del estudio fueron: 1) describir el patrón que sigue la concentración de yodo (CY) en la leche convencional UHT de vaca a lo largo del año y 2) averiguar si existen diferencias en la CY en este tipo de leche según su procedencia geográfica. MATERIAL Y MÉTODOS: Se compraron briks de leche convencional UHT de vaca de marcas comerciales disponibles en los grandes establecimientos de alimentación de Vitoria-Gasteiz (Araba/Álava) durante 12 meses consecutivos y se determinó su CY mediante cromatografía líquida de alta resolución. RESULTADOS: La mediana (P25-P75) de la CY en la leche (n = 489) fue de 190 (159-235) μg/L. La CY experimentó grandes variaciones a lo largo del año, alcanzando valores máximos entre enero y mayo, 241 (201-272) μg/L, y mínimos entre julio y noviembre, 162 (134-185) μg/L (p < 0,0001). La CY de la leche envasada en Alemania fue significativamente menor que la de las leches envasadas en España y en Francia, 119 (106-156) μg/L frente a 189 (159-229) μg/L y 205 (176-243) μg/L respectivamente (p < 0,0001). CONCLUSIONES: La leche convencional UHT de vaca es una fuente alimentaria muy importante de yodo, pero su CY es altamente variable. Conocer el patrón que sigue la CY en la leche a lo largo del año tiene mucho interés para la planificación de los estudios epidemiológicos sobre el estado de nutrición de yodo en escolares y para la interpretación de los resultados
BACKGROUND AND OBJECTIVES: Ultra-high temperature (UHT) processed cow milk is the milk most commonly consumed in Southwest Europe. The study objectives were: 1) to describe the pattern followed by iodine concentration (IC) in conventional UHT milk over the year, and 2) to find out any differences in IC in this type of milk depending on its geographical origin. MATERIAL AND METHODS: Bricks of conventional UHT cow milk of commercial brands available in food stores in Vitoria-Gasteiz (Araba/Álava), Basque Country (Spain) were bought for 12 consecutive months, and their ICs were measured using high performance liquid chromatography. RESULTS: Median (P25-P75) IC in UHT milk (n = 489) was 190 (159-235) μg/L. IC in milk showed great changes over the year, reaching peak values between January and May (241 [201-272] μg/L), and minimal levels between July and November (162 [134-185] μg/L) (P < .0001). The IC of milk packed in Germany was significantly lower than that of milks packed in Spain and France, 119 (106-156) μg/L versus 189 (159-229) μ g/L and 205 (176-243) μg/L respectively (P < .0001). CONCLUSIONS: Conventional UHT cow milk is a very important nutritional source of iodine, but its IC is highly variable. Knowledge of the pattern followed by IC in milk over the year is of great interest for planning epidemiological studies on iodine nutritional status in schoolchildren and for interpretation of their results
Assuntos
Humanos , Leite/química , Estado Nutricional , Iodo/análise , Substitutos do Leite Humano , Pasteurização , Iodo/administração & dosagem , Estudos Longitudinais , Compostos de Iodo/química , Nutrição do Lactente , Intervalos de ConfiançaRESUMO
BACKGROUND AND OBJECTIVES: Ultra-high temperature (UHT) processed cow milk is the milk most commonly consumed in Southwest Europe. The study objectives were: 1) to describe the pattern followed by iodine concentration (IC) in conventional UHT milk over the year, and 2) to find out any differences in IC in this type of milk depending on its geographical origin. MATERIAL AND METHODS: Bricks of conventional UHT cow milk of commercial brands available in food stores in Vitoria-Gasteiz (Araba/Álava), Basque Country (Spain) were bought for 12 consecutive months, and their ICs were measured using high performance liquid chromatography. RESULTS: Median (P25-P75) IC in UHT milk (n=489) was 190 (159-235)µg/L. IC in milk showed great changes over the year, reaching peak values between January and May (241 [201-272]µg/L), and minimal levels between July and November (162 [134-185]µg/L) (P<.0001). The IC of milk packed in Germany was significantly lower than that of milks packed in Spain and France, 119 (106-156)µg/L versus 189 (159-229)µg/L and 205 (176-243)µg/L respectively (P<.0001). CONCLUSIONS: Conventional UHT cow milk is a very important nutritional source of iodine, but its IC is highly variable. Knowledge of the pattern followed by IC in milk over the year is of great interest for planning epidemiological studies on iodine nutritional status in schoolchildren and for interpretation of their results.
Assuntos
Iodo/análise , Leite/química , Estado Nutricional , Animais , Bovinos , Estudos Epidemiológicos , Feminino , França , Alemanha , Iodo/deficiência , Pasteurização , Espanha , Fatores de TempoRESUMO
Introducción: Un estudio epidemiológico realizado entre 1988 y 1992 puso de manifiesto la existencia de deficiencia de yodo y bocio endémico en la población escolar de la comunidad autónoma del País Vasco. Objetivos: 1) Conocer el estado de nutrición de yodo de los escolares de 6-7 años de edad y 2) estimar la prevalencia de concentraciones anormales de TSH en sangre capilar. Población y métodos: Fueron estudiados 497 escolares seleccionados mediante muestreo aleatorizado. Para evaluar el estado de nutrición de yodo se utilizó la mediana de las concentraciones urinarias de yodo (mCUY). Para estimar la prevalencia de concentraciones anormales de TSH se utilizó el intervalo de referencia derivado de la población estudiada. Resultados: La mCUY (P25-P75) fue de 140 μg/L (82-217). Fue mayor en los que utilizaban sal yodada en sus domicilios que en los que no lo hacían (146 [85-222] frente a 126 μg/L [73-198]; p < 0,05). También fue mayor en los que consumían 2 o más raciones diarias de leche y yogur que en los que consumían menos de 2 raciones (146 [87-225] vs. 110 μg/L [66-160]; p < 0,0001). La prevalencia de concentraciones anormales de TSH fue del 2%. No hubo correlación entre las concentraciones de TSH en sangre capilar y las CUY (R = 0,082; p = 0,076). Discusión y conclusiones: Los escolares de 6-7 años de la comunidad autónoma del País Vasco tienen un estado de nutrición de yodo adecuado. La utilización de sal yodada en el domicilio y el consumo diario de leche y yogur se asociaron con las mayores CUY
Introduction: An epidemiological study conducted between 1988 and 1992 showed iodine deficiency and endemic goiter in the schoolchildren of the autonomous community of the Basque Country. Objectives: 1) To ascertain the iodine nutrition status of schoolchildren aged 6-7 years, and 2) to estimate the prevalence of abnormal TSH levels in capillary blood. Population and methods: The study was conducted on 497 schoolchildren selected by random sampling. Median urinary iodine concentration (mUIC) was used to assess iodine nutritional status, and the reference interval derived from the study population was used to estimate the prevalence of abnormal TSH levels. Results: The mUIC (P25-P75) was 140 (82-217) μg/L. A higher value was found in those who used iodized salt at home than in those who did not (146 [85-222] versus 126 μg/L [73-198], P<0.05). It was also higher in those who consumed 2 or more daily servings of milk and yogurt than in those taking less than 2 servings (146 [87-225] versus 110 μg/L [66-160], P<0.0001). Abnormal TSH levels were found in 2% of children. There was no correlation between TSH levels in capillary blood and urinary iodine concentrations (R=0.082; P=0.076). Discussion and conclusions: Schoolchildren aged 6-7 years of the autonomous community of the Basque Country have an adequate iodine nutrition status. Use of iodized salt at home and daily consumption of milk and yogurt were associated to the highest UICs
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Deficiência de Iodo/complicações , Bócio Endêmico/epidemiologia , Tireotropina/análise , Espanha/epidemiologia , Pré-Escolar , Bócio Endêmico/etiologia , Distúrbios Nutricionais/epidemiologia , Tireotropina/sangue , Estudos Epidemiológicos , Urinálise/métodos , Estudo Observacional , Estudos Transversais , Fluorimunoensaio/métodos , DietaRESUMO
INTRODUCTION: An epidemiological study conducted between 1988 and 1992 showed iodine deficiency and endemic goiter in the schoolchildren of the autonomous community of the Basque Country. OBJECTIVES: 1) To ascertain the iodine nutrition status of schoolchildren aged 6-7 years, and 2) to estimate the prevalence of abnormal TSH levels in capillary blood. POPULATION AND METHODS: The study was conducted on 497 schoolchildren selected by random sampling. Median urinary iodine concentration (mUIC) was used to assess iodine nutritional status, and the reference interval derived from the study population was used to estimate the prevalence of abnormal TSH levels. RESULTS: The mUIC (P25-P75) was 140 (82-217) µg/L. A higher value was found in those who used iodized salt at home than in those who did not (146 [85-222] versus 126 µg/L [73-198], P<0.05). It was also higher in those who consumed 2 or more daily servings of milk and yogurt than in those taking less than 2 servings (146 [87-225] versus 110 µg/L [66-160], P<0.0001). Abnormal TSH levels were found in 2% of children. There was no correlation between TSH levels in capillary blood and urinary iodine concentrations (R=0.082; P=0.076). DISCUSSION AND CONCLUSIONS: Schoolchildren aged 6-7 years of the autonomous community of the Basque Country have an adequate iodine nutrition status. Use of iodized salt at home and daily consumption of milk and yogurt were associated to the highest UICs.
Assuntos
Iodo/urina , Tireotropina/sangue , Criança , Estudos Transversais , Laticínios , Uso de Medicamentos , Comportamento Alimentar , Feminino , Humanos , Iodo/deficiência , Masculino , Estado Nutricional , Prevalência , Amostragem , Cloreto de Sódio na Dieta , Espanha/epidemiologiaRESUMO
PURPOSE: Median urinary iodine concentration (UIC) is used to describe the iodine status of a population. However, the link between UIC and iodine intake may vary during pregnancy. The aim of this study was to compare UIC during and after pregnancy, adjusting for factors that affect iodine intake. METHODS: Two repeated measures of UIC and data on maternal iodine intake estimated through questionnaires were collected during pregnancy and 1-4 years after pregnancy in a subsample of women (n = 598) from a mother and child cohort study in Spain. Random-effects interval regression was used to assess the changes in UIC according to pregnancy status. RESULTS: Median UIC was similar during (133 µg/L) and after pregnancy (139 µg/L). After adjusting for iodised salt, iodine supplement consumption, and socio-demographic related variables, UIC was 24.0% (95% CI 11.3, 38.2) higher after than during pregnancy. This difference was maintained in a subsample of women with exhaustive information on diet (n = 291): 26.2%, 95% CI 10.3, 44.4. CONCLUSIONS: In an iodine sufficient area for the general population, iodine excretion was lower during than after pregnancy when factors affecting iodine intake were controlled for. Current recommendations of median UIC during pregnancy are based on the equivalence between iodine intake and UIC estimated from studies in non-pregnant populations, which might lead to overestimation of iodine deficiency during gestation. Further studies should evaluate the equivalence between iodine intake and its urinary excretion during pregnancy.
Assuntos
Iodo , Estado Nutricional , Gravidez/urina , Adulto , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Iodetos , Iodo/administração & dosagem , Iodo/deficiência , Iodo/metabolismo , Iodo/urina , Cloreto de Sódio na Dieta/administração & dosagem , Cloreto de Sódio na Dieta/metabolismo , EspanhaRESUMO
BACKGROUND AND OBJECTIVE: Changes to dairy cow feeding have made milk a very important food source of iodine in several European countries and in USA. We aimed to measure the iodine content in ultra-high temperature (UHT) milk, the most widely consumed milk in Spain and in the south-west of Europe. MATERIAL AND METHODS: Every month, throughout 2008, UHT milk samples of commercial brands available in Vitoria-Gasteiz (Basque Country, Spain) were collected and their iodine content was determined using high-performance liquid chromatography, according to official method 992.22 of the Association of Official Analytical Chemists International. RESULTS: The average (SD) iodide content and median (P25-P75) of standard UHT milk samples (n=489) were 197.6 (58.1) and 190 (159-235) µg/L, respectively. There were no significant differences between the iodide content in whole, semi-skimmed and skimmed milk (P=.219). The average iodide concentration and median in organic UHT milk (n=12) were 56.4 (8.6) and 55 (50.5-61.5) µg/L, figures that are much lower than those found in standard milk (P<.0001). CONCLUSIONS: Standard UHT milk available in our food-retailing outlets constitutes a very important source of iodine. One glass of standard UHT milk (200-250mL) provides an average amount of 50µg of iodine. This amount represents around 50% of the iodine intake recommended during childhood or 20% of the iodine intake recommended for pregnant and lactating women.
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Iodo/análise , Leite/química , Valor Nutritivo , Oligoelementos/análise , Animais , Cromatografia Líquida de Alta Pressão , Temperatura Alta , Humanos , Estudos Longitudinais , Pasteurização/métodos , EspanhaRESUMO
BACKGROUND: Obesity impairs quality of life, but the perception of the impairment could be different from one country to another. The purpose was to compare weight-related quality of life (QOL) between cohorts from Spain and North America. METHODS: A cross-sectional case-control study was performed between two populations. Four hundred Spanish and 400 North American obese subjects suitable for bariatric surgery closely matched for race, gender, age, and body mass index (BMI) were included. Two non-obese control groups matched for gender, age, and BMI from each population were also evaluated (n = 400 in each group). The participants completed the Impact of Weight on Quality of Life-Lite (IWQOL-Lite) questionnaire, a measure of weight-related QOL. RESULTS: Spanish morbidly obese patients showed poorer QOL than their North American counterparts in physical function, sexual life, work, and total score. By contrast, Spanish non-obese control subjects reported better QOL in all domains than their North American counterparts. Women, both in Spain and North America, reported reduced QOL compared to men on the domain of self-esteem. In addition, North American women reported reduced QOL on the sexual life domain compared to men. BMI correlated negatively with all domains of QOL except for self-esteem in both national groups. CONCLUSIONS: Spanish obese subjects suitable for bariatric surgery report poorer weight-related quality of life than their North American counterparts, and obese women, regardless of nationality, perceive a reduced quality of life compared to men.
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Cirurgia Bariátrica , Índice de Massa Corporal , Obesidade Mórbida/psicologia , Qualidade de Vida , Autoimagem , Adulto , Cirurgia Bariátrica/psicologia , Estudos de Casos e Controles , Comparação Transcultural , Estudos Transversais , Emprego/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , América do Norte/epidemiologia , Obesidade Mórbida/epidemiologia , Obesidade Mórbida/cirurgia , Comportamento Sexual/psicologia , Espanha/epidemiologia , Inquéritos e QuestionáriosRESUMO
Introduccion Un estudio epidemiologico demostro en 1992 la existencia de deficiencia de yodo y bocio endemico en los escolares de la Comunidad Autonoma del Pais Vasco (CAPV).Objetivos1) Conocer el porcentaje de las viviendas de escolares en las que se consume sal yodada (SY); 2) estudiar el estado de nutricion del yodo en la poblacion escolar y comparar los datos obtenidos con los disponibles de estudios epidemiologicos anteriores. Metodos Estudio descriptivo transversal en 720 escolares seleccionados mediante muestreo aleatorio. Las determinaciones de concentracion urinaria de yodo (CUY) se realizaron mediante cromatografia liquida de alta resolucion (HPLC) (..) (AU)
Background: An epidemiologic survey showed in 1992 iodine deficiency and endemic goiter in schoolchildren from the Basque Country. Objectives: 1) To determine the percentage of homes of schoolchildren where iodized salt (IS)is used; 2) to assess iodine nutrition status in schoolchildren and to compare the data collected to those available from previous epidemiological studies. Design and Methods: A cross-sectional study in 720 randomly selected schoolchildren. Urinary iodine concentration (UIC) was measured using high-performance liquid chromatography(HPLC)with electrochemical detection. Results: IS was used at 53.0% of the homes (95% confidence interval [CI], 49.2-56.7%). Median UIC has increased by 226%, from 65 g/L in 1992 to 147 g/L (percentile [P], P25, 99 g/L;P75, 233 g/L) today. Both schoolchildren consuming IS and those using unfortified salt at their homes had UICs corresponding to adequate iodine intakes (165 and 132 g/L respectively). UICs experienced great seasonal fluctuations, being 55% higher during the November-February period than in June-September period (191 g/L vs 123 g/L; p < 0.001)Conclusions: Schoolchildren from the Basque Country have normalized their iodine nutrition status. The strong seasonal pattern of UICs suggests that consumption of milk and iodine-rich dairy products coming from cows feed iodized fodder is one of the most significant factors involved in the increase in iodine intake since 1992 (AU)
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Humanos , Masculino , Feminino , Criança , Bócio Endêmico/epidemiologia , Deficiência de Iodo , Iodo/urina , Estado Nutricional , Suplementos Nutricionais , Comportamento AlimentarRESUMO
BACKGROUND: An epidemiologic survey showed in 1992 iodine deficiency and endemic goiter in schoolchildren from the Basque Country. OBJECTIVES: (1) To determine the percentage of homes of schoolchildren where iodized salt (IS) is used; (2) to assess iodine nutrition status in schoolchildren and to compare the data collected to those available from previous epidemiological studies. DESIGN AND METHODS: A cross-sectional study in 720 randomly selected schoolchildren. Urinary iodine concentration (UIC) was measured using high-performance liquid chromatography(HPLC) with electrochemical detection. RESULTS: IS was used at 53.0% of the homes (95% confidence interval [CI], 49.2-56.7%). Median UIC has increased by 226%, from 65 µg/L in 1992 to 147 µg/L (percentile [P], P(25), 99 µg/L; P(75), 233 µg/L) today. Both schoolchildren consuming IS and those using unfortified salt at their homes had UICs corresponding to adequate iodine intakes (165 and 132 µg/L respectively). UICs experienced great seasonal fluctuations, being 55% higher during the November-February period than in June-September period (191 µg/L vs 123 µg/L; p<0.001) CONCLUSIONS: Schoolchildren from the Basque Country have normalized their iodine nutrition status. The strong seasonal pattern of UICs suggests that consumption of milk and iodine-rich dairy products coming from cows feed iodized fodder is one of the most significant factors involved in the increase in iodine intake since 1992.
Assuntos
Iodo/administração & dosagem , Estado Nutricional , Cloreto de Sódio na Dieta/administração & dosagem , Adolescente , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Masculino , EspanhaRESUMO
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Humanos , Masculino , Feminino , Adolescente , Obesidade/diagnóstico , Saúde do Adolescente , Obesidade/epidemiologia , Obesidade/terapia , Obesidade/psicologia , Dobras Cutâneas , Dieta Redutora , Fármacos Antiobesidade , Fármacos Antiobesidade/uso terapêutico , Índice de Massa Corporal , Nutrição do Adolescente , Derivação Gástrica , ComorbidadeRESUMO
La obesidad mórbida es, habitualmente, refractaria a los tratamientos convencionales, por lo que la modificación de hábitos dietéticos y de actividad física y/o el uso de fármacos consiguen pérdidas de peso parciales con habitual recuperación posterior. La cirugía bariátrica constituye una opción terapéutica para los casos de obesidad con elevado índice de masa corporal(IMC) asociada a comorbilidades, con buenos resultados a corto y largo plazo. El Grupo de Trabajo sobre Obesidad de la Sociedad Española de Endocrinología y Nutrición (GOSEEN) ha elaborado un documento con recomendaciones prácticas basadas en la evidencia para el tratamiento quirúrgico de la obesidad.La revisión se estructura en 3 partes. En la primera se definen los conceptos de obesidad y comorbilidades asociadas, los tratamientos médicos y sus resultados, las indicaciones y contraindicaciones para el tratamiento quirúrgico con los criterios de selección de los pacientes, el manejo pre y perioperatorio y la valoración de grupos especiales, como adolescentes y personas de edad avanzada. En la segunda parte se describen las distintas técnicas quirúrgicas, las vías de acceso y los resultados comparativos, las complicaciones tanto a corto como a largo plazo, la repercusión de la pérdida ponderal sobre las comorbilidades y los criterios para evaluar la efectividad de la cirugía. En la tercera parte se desarrolla el seguimiento postoperatorio, el control dietético en fases tempranas y más tardías tras la cirugía, y el calendario de control médico y analítico con la suplementación de los distintos macro y micronutrientes en función de la técnica quirúrgica empleada. Se incluye un apartado final sobre gestación y cirugía bariátrica, así como tablas y gráficos complementarios al texto desarrollado. La cirugía bariátrica sigue siendo un tratamiento discutido para la obesidad, pero los resultados en la corrección del exceso ponderal con mejoría en las patologías asociadas y en la calidad de vida confirman que puede ser el tratamiento de elección en pacientes seleccionados, con la técnica quirúrgica apropiada y con un correcto control pre y postoperatorio (AU)
Morbid obesity is usually refractory to conventional treatments. Consequently, weight that is lost by modifying diet and exercise and/or the use of drugs is usually later regained. Bariatric surgery constitutes a therapeutic option in obese patients with a high body mass index associated with comorbidities and achieves good results in both the short and the long term. The Obesity Working Group of the Spanish Society of Endocrinology and Nutrition has produced a document with practical, evidence based recommendations for the surgical treatment of obesity .The review is structured in three parts. The first part defines the concepts of obesity and associated comorbidities, medical treatments, their results, and the indications and contraindications for surgical treatment, as well as the criteria for patient selection, pre- and perisurgica lmanagement, and assessment of special groups such as adolescents and the elderly. The second part discusses the different surgical techniques, approaches and comparative results, short- and long-term complications, the repercussions of weight loss on comorbidities, and the criteria for assessing the effectiveness of surgery. The third part discusses postsurgical follow-up, dietary control in the early and subsequent stages after surgery and the schedule for medical and laboratory follow-up, together with the different macro- and micronutrient supplements that should be used depending on the surgical technique employed. A final section is included on pregnancy and bariatric surgery, as well as tables and figures that complement the text. Although bariatric surgery continues to be a questionable treatment for obesity, the results correcting excess weight, with improvements in associated comorbidities and in quality of life, confirm that this option could be the treatment of choice in selected patients when the appropriate surgical technique and correct preandpostoperative follow-up are employed (AU)
Assuntos
Humanos , Obesidade Mórbida/cirurgia , Derivação Gástrica/métodos , Gastroplastia/métodos , Índice de Massa Corporal , ComorbidadeRESUMO
El manejo nutricional de la enfermedad inflamatoria intestinal (EII) incluye: 1) la vigilancia del estado nutricional, debido al elevado riesgo de desnutrición asociado a la colitis ulcerosa (CU) y, especialmente, a la enfermedad de Crohn (EC); 2) el tratamiento dietético y el nutricional, para mantener o restaurar el estado nutricional, y 3) el tratamiento primario de la EC activa mediante nutrición enteral (NE). El tratamiento con glucocorticoides es más efectivo que la NE en la EC activa, pero en los niños y adolescentes puede estar justificado el uso de NE como tratamiento primario, especialmente en los que presentan retraso del crecimiento. El tratamiento con NE también está indicado en los casos de EC en los que existe contraindicación, ineficacia o intolerancia a los tratamientos farmacológicos. La evidencia disponible sobre la eficacia de los prebióticos, ácidos grasos de cadena corta, probióticos, aceites de pescados, antioxidantes y TGF-ß para el control de la inflamación intestinal es limitada y resulta insuficiente para recomendar su utilización para el tratamiento primario de la EII. El aporte reducido de micropartículas podría desempeñar un papel en el control de la actividad en la EC (AU)
The nutritional management of inflammatory bowel diseases (IBD) includes: 1) monitoring of the patient's nutritional status due to the high risk of developing malnutrition associated with ulcerative colitis (UC) and, especially, Crohn's disease (CD); 2) dietetic and nutritional therapies to maintain or restore nutritional status; and 3) primary therapy with enteral nutrition (EN) for active CD. Primary therapy with EN is not as effective as steroids in active CD, but may be justified in children and adolescents, especially in those with growth failure. EN is also indicated in CD when drug therapy is unsuccessful or contraindicated. Currently available data on the effectiveness of prebiotics, short-chain fatty acids, probiotics, fish oils (omega-3-fatty acids), antioxidants, and transforming growth factor (TGF-ß) are too limited to allow the use of these substances to be recommended as primary therapy to control inflammation in patients with IBD. Reducing microparticle intake could play a role in controlling active CD (AU)
