[A prevalence study of dysphagia and intervention with dietary counselling in nursing home from Seville]. / Estudio de prevalencia de disfagia e intervención con consejo dietético, en residencias de mayores de Sevilla.

INTRODUCTION: The prevalence of swallowing disorders widely varies depending on age and comorbidity. OBJECTIVES: To determine the prevalence of dysphagia and feeding disorders in elderly people living in nursing homes from the province of Seville and assess the effectiveness of dietary counselling. METHODS: We carried out a cross-sectional descriptive study on a population of 3921 residents distributed among 86 nursing homes. At the first phase of the study, we pretended to estimate the prevalence of dysphagia so that we selected 373 residents in 23 nursing homes. At the second phase, a sample of residents with dysphagia was selected, being reassessed a month later after receiving dietary counselling and basic measures for managing dysphagia. RESULTS: The median age was 80 (73.86) years, 60 (17.3%) had dysphagia and 50 (13.4%) had feeding difficulties. Both conditions were significantly (p < 0.05) associated with neurological diseases. Forty (11.3%) presented cerebrovascular accident and 123 (34.8%) dementia. Twelve patients with dysphagia were studied at the second phase, the mean age being 80.6+/-11.9 years, MNA 19 +/- 3, Barthel 24 +/- 27, and dysphagia Karnell level of 3-4 in 75% of the cases. These patients, receiving dietary counselling and basic measures for managing dysphagia, did not improve their intake level, dysphagia or dependency. CONCLUSIONS: The prevalence of dysphagia and feeding difficulties is high among nursing homes residents. The standard measures for controlling dysphagia are little effective in patients with severe dependence or advanced dementia.

Estudio de prevalencia de disfagia e intervención con consejo dietético, en residencias de mayores de Sevilla / A prevalence study of dysphagia and intervention with dietary councelling in nursing home from Seville

Introducción: La prevalencia de las alteraciones de la deglución varia ampliamente según la edad y comorbilidad. Objetivos: Determinar la prevalencia de disfagia y alteraciones de la alimentación en personas mayores que viven en residencias de la provincia de Sevilla, valorando la efectividad del consejo dietético. Métodos: Se realizó un estudio descriptivo transversal sobre una población de 3.921 residentes distribuidos en 86 residencias. En una primera fase del estudio se pretendía estimar la prevalencia de disfagia, para lo cual se seleccionaron 373 residentes en 23 residencias. En una segunda fase se seleccionó una muestra de residentes con disfagia, siendo reevaluados un mes después tras recibir consejo dietético y medidas básicas para control de disfagia. Resultados: La mediana de edad fue 80 (73-86) años, presentaron disfagia 60 (17,3%), y dificultades de alimentación 50 (13,4%). Ambas se asociaron de forma significativa (p < 0,05) con enfermedades neurológicas. Presentaron accidente cerebrovascular (AVC) 40 (11,3%), y demencia 123 (34,8%). En la segunda parte se estudiaron 12 pacientes con disfagia, de edad media 80,6 ± 11,9 años, MNA 19 ± 3, Barthel 24 ± 27, y grado de disfagia Karnell 3-4, en un 75% de los casos. Estos pacientes a los que se sometió a consejo dietético y medidas básicas para control de disfagia no mejoraron el nivel de ingesta, disfagia o dependencia. Conclusiones: La prevalencia de disfagia y dificultades de la alimentación es muy elevada en residencias. Las medidas estándar para el control de la disfagia son poco efectivas en pacientes con dependencia severa o demencia avanzada (AU)

Introduction: The prevalence of swallowing disorders widely varies depending on age and comorbidity. Objectives: To determine the prevalence of dysphagia and feeding disorders in elderly people living in nursing homes from the province of Seville and assess the effectiveness of dietary counselling. Methods: We carried out a cross-sectional descriptive study on a population of 3921 residents distributed among 86 nursing homes. At the first phase of the study, we pretended to estimate the prevalence of dysphagia so that we selected 373 residents in 23 nursing homes. At the second phase, a sample of residents with dysphagia was selected, being reassessed a month later after receiving dietary counselling and basic measures for managing dysphagia. Results: The median age was 80 (73.86) years, 60 (17.3%) had dysphagia and 50 (13.4%) had feeding difficulties. Both conditions were significantly (p < 0.05) associated with neurological diseases. Forty (11.3%) presented cerebrovascular accident and 123 (34.8%) dementia. Twelve patients with dysphagia were studied at the second phase, the mean age being 80.6±11.9 years, MNA 19 ± 3, Barthel 24 ± 27, and dysphagia Karnell level of 3-4 in 75% of the cases. These patients, receiving dietary counselling and basic measures for managing dysphagia, did not improve their intake level, dysphagia or dependency. Conclusions: The prevalence of dysphagia and feeding difficulties is high among nursing homes residents. The standard measures for controlling dysphagia are little effective in patients with severe dependence or advanced dementia (AU)

[Nutritional value of the diet in healthy pregnant women. Results of a nutrition survey of pregnant women]. / Valor nutricional de la dieta en embarazadas sanas. Resultados de una encuesta dietética en gestantes.

GOAL: The purpose of the present paper is to describe the level of nutritional adequacy of the regular diet of pregnant women belonging to our health-care area. SCOPE: Health-care area of Valme Hospital, Seville. DESIGN: Randomized transversal descriptive study. SUBJECTS: Forty-nine pregnant women during their first trimester. INTERVENTIONS: The daily intake was assessed by means of a 24-hour reminder sheet and a weekly consumption survey. The data obtained were compared with the recommended daily intake of nutrients and with the recommended daily allowances for various foods. At the same time, an anthropometric and basic analysis were also carried out. RESULTS: The calorie intake was as recommended (2,208 +/- 475 kcal/day). The diet contained excessive amounts of proteins (88 +/- 21 g/day) and fat (97 +/- 27 g/day), with a predominance of monounsaturated fats (46.9 +/- 5.5%) over saturated (36.6 +/- 7.2%) or polyunsaturated fats (15.1 +/- 7%), (p < 0.0005). Nonetheless, the diet was short on carbohydrates (44%), fibre (18 +/- 4.9 g/day), calcium (948 +/- 353 mg/day), iron (13.4 +/- 3.1 mg/day) and vitamin B6 (1.1 +/- 0.8 mg/day) (p < 0.0005), and extremely short on folic acid (172 +/- 101 micrograms/day), (p < 0.0005). In the assessment of the diet in terms of daily allowances, this was sufficient in fruit (2.3 +/- 1.8/day), but short on dairy products (1.9 +/- 1.1/day) and extremely short on vegetables (1 +/- 0.4/day), (p < 0.0005). Only 2% of the subjects fulfilled with the recommended daily intake for key vitamins and minerals. The prevalence of obesity (BMI > 30 kg/m2) was 18.4%. CONCLUSIONS: The normal diet of pregnant women in our health-care area is short on calcium, iron, folic acid and dietary fibre, although with an excess of animal protein and fat.

Valor nutricional de la dieta en embarazadas sanas. Resultados de una encuesta dietética en gestantes / Nutritional value of the diet in healthy pregnant women

Objetivo: El objetivo de este trabajo es describir el nivel de adecuación nutricional de la dieta habitual en gestantes pertenecientes a nuestra área sanitaria. Ámbito: Área Sanitaria Valme. Sevilla. Diseño: Estudio descriptivo aleatorio transversal. Sujetos: Cuarenta y nueve gestantes de primer trimestre. Intervenciones: Se valoró la ingesta diaria, por recordatorio de 24 horas y por encuesta de consumo semanal. Los datos obtenidos se comparan con las ingestas diarias recomendadas de nutrientes y con las raciones diarias recomendadas para determinados grupos de alimentos. Al mismo tiempo, se realizó una valoración antropométrica y analítica básica. Resultados: La ingesta calórica fue la recomendada (2.208 ñ 475 kcal/día). La dieta contenía un exceso de proteínas (88 ñ 21 g/día), de grasa (97 ñ 27 g/día), con predominio de grasas monoinsaturadas (46,9 ñ 5,5 por ciento) sobre las saturadas (36,6 ñ 7,2 por ciento) y poliinsaturadas (15,1 ñ 7 por ciento), (p 30 kg/m2) fue de un 18,4 por ciento. Conclusiones: La dieta habitual de las gestantes de nuestra área es deficitaria en calcio, hierro, ácido fólico, y fibra dietética, aunque excesiva en proteína animal y grasas (AU)

Goal: The purpose of the present paper is to describe the level of nutritional adequacy of the regular diet of pregnant women belonging to our health-care area. Scope: Health-care area of Valme Hospital, Seville. Design: Randomized transversal descriptive study. Subjects: Forty-nine pregnant women during their first trimester. Interventions: The daily intake was assessed by means of a 24-hour reminder sheet and a weekly consumption survey. The data obtained were compared with the recommended daily intake of nutrients and with the recommended daily allowances for various foods. At the same time, an anthropometric and basic analysis were also carried out. Results: The calorie intake was as recommended (2,208 ± 475 kcal/day). The diet contained excessive amounts of proteins (88 ± 21 g/day) and fat (97 ± 27 g/day), with a predominance of monounsaturated fats (46.9 ± 5.5%) over saturated (36.6 ± 7.2%) or polyunsaturated fats (15.1 ± 7%), (p < 0.0005). Nonetheless, the diet was short on carbohydrates (44%), fibre (18 ± 4.9 g/day), calcium (948 ± 353 mg/day), iron (13.4 ± 3.1 mg/day) and vitamin B6 (1.1 ± 0.8 mg/day) (p < 0.0005), and extremely short on folic acid (172 ± 101 µg/day), (p < 0.0005). In the assessment of the diet in terms of daily allowances, this was sufficient in fruit (2.3 ± 1.8/day), but short on dairy products (1.9 ± 1.1/day) and extremely short on vegetables (1 ± 0.4/day), (p < 0.0005). Only 2% of the subjects fulfilled with the recommended daily intake for key vitamins and minerals. The prevalence of obesity (BMI > 30 kg/m2) was 18.4%. Conclusions: The normal diet of pregnant women in our health-care area is short on calcium, iron, folic acid and dietary fibre, although with an excess of animal protein and fat (AU)