Working conditions and emotional impact in healthcare workers during COVID-19 pandemic / Condiciones de trabajo versus daño emocional en trabajadores de la salud que enfrentan COVID-19

No disponible

Variation in scale cortisol concentrations of a wild freshwater fish: Habitat quality or seasonal influences?

A significant body of literature suggests that aquatic pollutants can interfere with the physiological function of the fish hypothalamic-pituitary-interrenal (HPI) axis, and eventually impair the ability to cope with subsequent stressors. For this reason, development of accurate techniques to assess fish stress responses have become of growing interest. Fish scales have been recently recognized as a biomaterial that accumulates cortisol, hence it can be potentially used to assess chronic stress in laboratory conditions. We, therefore, aimed to evaluate the applicability of this novel method for cortisol assessment in fish within their natural environment. Catalan chub (Squalius laietanus) were sampled from two sites; a highly polluted and a less polluted (reference) site, in order to examine if habitat quality could potentially influence the cortisol deposition in scales. We also evaluated the seasonal variation in scale cortisol levels by sampling fish at three different time points during spring-summer 2014. In each sampling, blood was collected to complement the information provided by the scales. Our results demonstrated that blood and scale cortisol levels from individuals inhabiting the reference site were significantly correlated, therefore increasing the applicability of the method as a sensitive-individual measure of fish HPI axis activity, at least in non-polluted habitats. Since different environmental conditions could potentially alter the usefulness of the technique, results highlight that further validation is required to better interpret hormone fluctuations in fish scales. Scale cortisol concentrations were unaffected by habitat quality although fish from the polluted environment presented lower circulating cortisol levels. We detected a seasonal increase in scale cortisol values concurring with an energetically costly period for the species, supporting the idea that the analysis of cortisol in scales reveals changes in the HPI axis activity. Taken together, the present study suggests that cortisol levels in scales are more likely to be influenced by mid-term, intense energetically demanding periods rather than by long-term stressors. Measurement of cortisol in fish scales can open the possibility to study novel spatio-temporal contexts of interest, yet further research is required to better understand its biological relevance.

Hair cortisol and progesterone detection in dairy cattle: interrelation with physiological status and milk production.

Hair cortisol concentrations (HCCs) and hair progesterone concentrations (HPCs) allow monitoring long-term retrospective steroid levels. However, there are still gaps in the knowledge of the mechanisms of steroid deposition in hair and its potential application in dairy cattle research. This study aimed to evaluate the potential uses of hair steroid determinations by studying the interrelations between HCC, HPC, physiological data from cows, and their milk production and quality. Cortisol and progesterone concentrations were analyzed in hair from 101 milking Holstein Friesian cows in a commercial farm. Physiological data were obtained from the 60 d prior to hair collection. Moreover, productive data from the month when hair was collected and the previous one were also obtained as well as at 124 d after hair sampling. Significant but weak correlations were found between HCC and HPC (r = 0.25, P < 0.0001) and between HPC and age (r = 0.06, P = 0.0133). High HCC were associated with low milk yields from the 2 previous months to hair sampling (P = 0.0396) and during the whole lactation (P < 0.0001). High HCC were also related to high somatic cell count (P = 0.0241). No effect of HCC on fat or protein content was detected. No significant correlations were detected between hair steroid concentrations and pregnancy status, days of gestation, parturition category (primiparous vs multiparous), number of lactations or days in milk. The relationship between physiological variables and HCC or HPC could depend on the duration of the time period over which hair accumulates hormones. Steroid concentrations in hair present high variability between individuals but are a potential tool for dairy cattle welfare and production research by providing a useful and practical tool for long-term steroid monitoring.

Acute ACTH-induced elevations of circulating cortisol do not affect hair cortisol concentrations in calves.

In recent times, the detection of cortisol in hair is intended to be used as an animal-based indicator for the assessment of chronic stress. However, the relationship between the ability to report average values of long-term circulating cortisol concentrations and the sensitivity to acute peaks of cortisol is still unclear. To gain insight into this relationship, 24 Holstein-Friesian bull calves under the same management conditions were used in this study. Two injections of ACTH (at D0 and D7) were administrated to twelve animals with the aim to create two acute increases of serum cortisol concentrations. Blood samples were taken in order to determine the duration of serum cortisol peaks and to confirm a mediated response by the administration of ACTH. Cortisol concentrations from 14-day-old white hair samples collected from forehead and hip were analysed separately by EIA and compared with those from the control group. Serum cortisol analyses revealed an acute increase of cortisol concentrations for approximately three hours after each ACTH administration. Concentrations of hair cortisol from forehead and hip locations showed no differences between ACTH-administrated and control animals. Hair cortisol concentrations from 14-day old samples were not altered by two acute elevations of serum cortisol suggesting that hair cortisol is not masked by short and non-recurrent moments of stress. These results are a step forward in the validation of hair cortisol detection as a robust integrative measure of serum cortisol concentrations from an extended period of time.

Hair cortisol detection in dairy cattle by using EIA: protocol validation and correlation with faecal cortisol metabolites.

Hair may be a useful matrix to detect cumulative cortisol concentrations in studies of animal welfare and chronic stress. The aim of this study was to validate a protocol for cortisol detection in hair from dairy cattle by enzyme immunoassay (EIA). Seventeen adult Holstein-Friesian dairy cows were used during the milking period. Hair cortisol concentration was assessed in 25-day-old hair samples taken from the frontal region of the head, analysing black and white coloured hair separately. Concentrations of cortisol metabolites were determined in faeces collected twice a week during the same period of time. There was a high correlation between cortisol values in faeces and cortisol in white colour hair samples but such correlation was not significant with the black colour hair samples. The intra- and inter-assay coefficients of variation were 4.9% and 10.6%, respectively. The linearity showed R 2=0.98 and mean percentage error of -10.8 ± 1.55%. The extraction efficiency was 89.0 ± 23.52% and the parallelism test showed similar slopes. Cortisol detection in hair by using EIA seems to be a valid method to represent long-term circulating cortisol levels in dairy cattle.

Feather corticosterone evaluated by ELISA in broilers: a potential tool to evaluate broiler welfare.

The measure of corticosterone (CORT) in feathers has been recently recognized as a valid and easily obtainable measure of chronic glucocorticoids secretion in avian species. This measure provides meaningful interpretations of how individuals respond to environmental perturbations. The growing interest of the public toward animal-food production welfare shows the need for improving and expanding objective tools to evaluate this issue. The present study evaluates whether it is possible to detect CORT in broiler feathers, and thus, assess if it would be a useful measure to study broiler welfare. Twenty-two broilers were randomly selected from an intensive farm. Four to 6 dorsal feathers were collected from each bird, and sex, weight, and morphological aspects of feather status were recorded. We tested the feasibility for detecting CORT in broiler feathers by ELISA, which had never been done before, and an assay validation test was performed. No significant relationships were found between feather CORT concentrations and physiological variables such as sex, weight, and fault bars in broilers. To our knowledge, this is the first study that uses broiler feathers as a matrix that provides a retrospective record of their hypothalamic-pituitary-adrenal activity. Results indicate that ELISA is a valid tool to detect feather CORT levels in broilers.

Iron status biomarkers in iron deficient women consuming oily fish versus red meat diet.

Specific recommendations for anemic individuals consist in increasing red meat intake, but the population at large is advised to reduce consumption of red meat and increase that of fish, in order to prevent the risk of developing cardiovascular disease. This study aimed to determine the effects of consuming an oily fish compared to a red meat diet on iron status in women with low iron stores. The study was designed attending the Consolidated Standards of Reporting Trials (CONSORT) statement guidelines. It was a randomised crossover dietary intervention study of two 8-week periods. Twenty-five young women with low iron stores completed the study. Two diets containing a total of 8 portions of fish, meat and poultry per week were designed differing only in their oily fish or red meat content (5 portions per week). At the beginning and the end of each period blood samples were taken and hemoglobin, hematocrit, serum ferritin, serum iron, serum transferrin, serum transferrin receptor-2 and the Zn-protoporphyrin/free-protoporphyrin ratio were determined. Food intake and body weight were monitored. During the oily fish diet, PUFA intake was significantly higher (p=0.010) and iron intake lower (mean+/-SD, 11.5+/-3.4 mg/day vs. 13.9+/-0.1 mg/day, p=0.008), both diets providing lower mean daily iron intake than recommended for menstruating women. Although there were no significant differences after 16 weeks, serum ferritin moderately decreased and soluble transferrin receptor increased with the oily fish, while changes with the red meat diet were the opposite. In conclusion, an oily fish diet compared to a red meat diet does not decrease iron status after 8 weeks in iron deficient women.

Olive oil-diet improves the simvastatin effects with respect to sunflower oil-diet in men with increased cardiovascular risk: a preliminary study.

BACKGROUND AND AIMS: Concomitant intake of statins together with certain foods may affect their therapeutic effects. The purpose of this preliminary study was to determine the modulating effect of two culinary oils on the hypolipemic effect of statins. SUBJECT AND METHODS: Twenty-five men with severe hypercholesterolemia and high estimate cardiovascular risk (> 20% according to the Adult Treatment Panel III of USA National Institutes of Health, ATP-III) were enrolled in an observational follow-up study to test lipoprotein profile changes after ix month 20-mg/d Simvastatin treatment. Thirteen volunteers using sunflower oil as the habitual culinary fat, and 12 using olive oil, were selected by non-probabilistic incidental sampling. Volunteers consent in follow their habitual diets and to maintain diet characteristics throughout the study. Diet was evaluated through the study by three 24-h recalls and a food frequency questionnaire. RESULTS: The energy contribution of fat (P = 0.019) and MUFA (P < 0.001) was higher in the olive oil-group while that of PUFA (P = 0.001) and alcohol (P = 0.005) was higher in the sunflower oil-group. TC/HDL-cholesterol and the ATP-III 10-year risk percent decreased more (P < 0.05) in the olive oil group. TC and the TC/HDL-cholesterol and the LDL-cholesterol/HDL-cholesterol ratios and the ATP-III 10-year risk percent decreased significantly more (P < 0.05) in the olive oil-group after BMI, energy and alcohol intakes were adjusted. CONCLUSION: Data suggest that although Simvastatin is a very effective hypolipemic drug, olive oil-diets in preference to sunflower oil-diets must be consumed in patients with high cardiovascular risk.

Comparativa de las Ingestas Dietéticas de Referencia (IDR) de los diferentes países de la Unión Europea, de Estados Unidos (EEUU) y de la Organización Mundial de la Salud (OMS) / Comparison of dietary reference intakes (DRI) between different countries of the European Union, The United States and the world health organization

Antecedentes: En España, existen varios organismos y sociedades científicas que han editado sus propios de valores de referencia sobre la ingesta recomendada de nutrientes, que no siempre coinciden en los contenidos y formas presentadas. Objetivo: Revisar los conceptos, datos y la metodología que han seguido otros países o grupos de países para obtener y documentar sus propios Valores de Referencia, con objeto de ofrecer una información básica que facilite el establecimiento de los valores de referencia que mejor puedan adaptarse a la población española, en base a la mejor evidencia científica disponible en la actualidad. Ámbito: Revisión de la información disponible en los distintos países (o grupos de países) de la Unión Europea, Estados Unidos y la Organización Mundial de la Salud. Los datos estudiados corresponden a poblaciones sanas. Conclusiones: Las ingestas de referencia difieren notablemente entre los distintos países estudiados en cuanto a grupos de población, tipo de nutrientes incluidos, metodología y periodicidad de las revisiones publicadas. Sin embargo, la mayoría definen de manera semejante los conceptos más importantes, aunque tengan distintas denominaciones en cada país. Por otro lado, en la mayoría de los casos estudiados existe un único organismo científico encargado de la publicación y actualización de los valores de ingestas dietéticas de referencia, no siendo así en España. En este contexto, parece conveniente alcanzar un acuerdo entre todos los organismos y sociedades científicas españolas implicadas en esta tarea, con objeto de establecer unos valores de referencia únicos para todo el país, con el consenso de todos (AU)

Background: In Spain, there are some organizations and scientific societies that have edited reference values of recommended nutrient intake, but whose data does not always agree in terms of format and content. Aims: To review the definitions, data and methodology that other countries or groups of countries have followed to obtain and document their own reference values in order to offer basic information to facilitate the establishment of the best reference values for the Spanish population. Field: Review of the available information in different countries (or groups of countries) from the European Union, the United States and World Health Organization. The analysed data concerned to healthy populations. Conclusions: Reference intakes differ among the examined countries according to population groups, included nutrients, methodology and frequency of published reviews. However, most of the countries define major concepts in the same way, although with different names in each country. On the other hand, most of the studied cases represent only a scientific organization in charge of the publication and update of the values of dietary reference intakes, but not in Spain. In that context, it looks convenient to reach a consensus among all Spanish organizations and scientific societies that are involved in this task, in order to establish an acceptable reference values (AU)

Olive oil-diet improves the simvastatin effects with respect to sunflower oil-diet in men with increased cardiovascular risk. A preliminary study / Las dietas conteniendo aceite de oliva mejoran los efectos de simvastatina respecto a dietas con aceite de girasol en hombres con riesgo cardiovascular elevado. Estudio preliminar

Background and aims: Concomitant intake of statins together with certain foods may affect their therapeutic effects. The purpose of this preliminary study was to determine the modulating effect of two culinary oils on the hypolipemic effect of statins. Subject and Methods: Twenty-five men with severe hypercholesterolemia and high estimate cardiovascular risk (> 20% according to the Adult Treatment Panel III of USA National Institutes of Health, ATP-III) were enrolled in an observational follow-up study to test lipoprotein profile changes after ix month 20-mg/d Simvastatin treatment. Thirteen volunteers using sunflower oil as the habitual culinary fat, and 12 using olive oil, were selected by non-probabilistic incidental sampling. Volunteers consent in follow their habitual diets and to maintain diet characteristics throughout the study. Diet was evaluated through the study by three 24-h recalls and a food frequency questionnaire. Results: The energy contribution of fat (P = 0.019) and MUFA (P < 0.001) was higher in the olive oil-group while that of PUFA (P = 0.001) and alcohol (P = 0.005) was higher in the sunflower oil-group. TC/HDL-cholesterol and the ATP-III 10-year risk percent decreased more (P < 0.05) in the olive oil group. TC and the TC/HDL-cholesterol and the LDL-cholesterol/HDL-cholesterol ratios and the ATP-III 10-year risk percent decreased significantly more (P < 0.05) in the olive oil-group after BMI, energy and alcohol intakes were adjusted. Conclusion: Data suggest that although Simvastatin is a very effective hypolipemic drug, olive oil-diets in preference to sunflower oil-diets must be consumed in patients with high cardiovascular risk (AU)

Introducción y objetivos: La ingesta de algunos alimentos junto con estatinas puede afectar los efectos terapéuticos del fármaco. Este estudio preliminar pretende determinar el efecto modulador de dos tipos de aceites culinarios sobre los efectos hipolipemiantes de las estatinas. Métodos: Mediante muestreo no probabilístico, 25 hombres con hipercolesterolemia severa y alto riesgo cardiovascular (> 20% según el Panel III para tratamiento de adultos de los Institutos de Salud USA, ATP-III) participaron en el estudio observacional para ver los cambios en el perfil lipoproteico después de seis meses de tratamiento con 20 mg/día de Simvastatina. 13 voluntarios consumían habitualmente aceite de girasol como principal grasa culinaria y 12 aceite de oliva. Todos los sujetos consintieron en mantener sus hábitos alimentarios durante el estudio. Para evaluar la dieta se usaron 3 recuerdos de 24 horas y una frecuencia de consumo. Resultados: El aporte calórico de la grasa (P = 0,019) y de los AGM (P < 0,001) fue mayor en el grupo que consumía aceite de oliva, mientras que el de AGP (P = 0,001) y alcohol (P = 0,005) fue menor. El cociente colesterol/HDL-colesterol y el riesgo cardiovascular disminuyeron más (P<0.05) en los pacientes consumiendo aceite de oliva. Después de ajustar para IMC y para ingesta caló y de alcohol, el colesterol total y los ratios colesterol/HDL-colesterol y LDL-colesterol/HDL-colesterol y el riesgo cardiovascular ATP-III disminuyeron significativamente más (P < 0,05) en el grupo de aceite de oliva. Conclusiones: Los resultados sugieren que aunque Simvastatina es un fármaco hipolipemiante muy efectivo, la inclusión de aceite de oliva, frente a aceite de girasol, mejora dicho efecto en pacientes con alto riesgo cardiovascular (AU)

Marcadores del estado de hierro en mujeres con deficiencia de hierro que consumen una dieta de pescado azul frente a una dieta de carne roja / Iron status biomarkers in iron deficient women consuming oily fish versus red meat diet

Specific recommendations for anemic individuals consist in increasing red meatintake, but the population at large is advised to reduce consumption of red meat andincrease that of fish, in order to prevent the risk of developing cardiovascular disease.This study aimed to determine the effects of consuming an oily fish compared to ared meat diet on iron status in women with low iron stores. The study was designedattending the Consolidated Standards of Reporting Trials (CONSORT) statementguidelines. It was a randomised crossover dietary intervention study of two 8-weekperiods. Twenty-five young women with low iron stores completed the study. Twodiets containing a total of 8 portions of fish, meat and poultry per week weredesigned differing only in their oily fish or red meat content (5 portions per week).At the beginning and the end of each period blood samples were taken and hemoglobin,hematocrit, serum ferritin, serum iron, serum transferrin, serum transferrinreceptor-2 and the Zn-protoporphyrin/free-protoporphyrin ratio were determined.Food intake and body weight were monitored. During the oily fish diet, PUFAintake was significantly higher (p=0.010) and iron intake lower (mean±SD, 11.5±3.4mg/day vs. 13.9±0.1 mg/day, p=0.008), both diets providing lower mean daily ironintake than recommended for menstruating women. Although there were no significantdifferences after 16 weeks, serum ferritin moderately decreased and solubletransferrin receptor increased with the oily fish, while changes with the red meat dietwere the opposite. In conclusion, an oily fish diet compared to a red meat diet doesnot decrease iron status after 8 weeks in iron deficient women(AU)

Las recomendaciones nutricionales dirigidasa personas con anemia consisten generalmenteen aumentar el consumo de carne roja,mientras que las recomendaciones para lapoblación general están enfocadas a la reduccióndel consumo de esta carne y aumentar elconsumo de pescado, con el fin de reducir elriesgo de desarrollar enfermedades cardiovasculares.El presente estudio se diseñó parainvestigar los efectos del consumo de una dietabasada en pescado azul frente a una de carneroja sobre el estado de hierro de mujeres conbajas reservas de hierro. Este estudio se planteóde acuerdo con la guía CONSORT (patronesconsolidados para la publicación de ensayos).Se trató de una intervención nutricional cruzada,aleatorizada, con 2 periodos de 8 semanascada uno. Veinticinco mujeres finalizaron elestudio. Se diseñaron dos dietas que contenían8 raciones de pescado, carne y aves a la semana.Sólo se diferenciaban en el contenido de pescadoazul o carne roja (4 raciones semanales). Alinicio y final de cada periodo se obtuvieronmuestras de sangre y se analizó la concentraciónde hemoglobina, hematocrito, ferritina,hierro sérico, transferrina, receptor-2 de latransferrina y el cociente Zn-protoporfirina/protoporfirina libre. El peso y la ingesta de alimentosse controlaron durante el estudio.Durante la dieta de pescado azul la ingesta deácidos grasos poliinsturados (AGP) fue significativamentemayor (p=0,010) y la ingesta dehierro se redujo (media±SD, 11,5±3,4 frente a13,9±0,1 mg/día, p=0.008), siendo el aporte dehierro menor al recomendado para esta población(AU)

Aunque no se encontraron diferenciassignificativas durante 16 semanas, la ferritina descendió ligeramente y la concentración del receptor de transferrina aumentó con la dieta de pescado azul, mientras que los cambios observados con la dieta rica en carne roja fueron los opuestos. En conclusión, una dieta basada en pescado azul comparada con una dieta rica en carne roja, no provoca un descenso en el estado de hierro de mujeres con deficiencia de hierro después de 8 semanas(AU)

Afectación meníngea en granulomatosis de Wegener / No disponible

No disponible

[Vein of Galen malformation in an adult: MRI diagnosis]. / Malformación de la vena de Galeno en un adulto: diagnóstico por imagen por resonancia magnética.

Malformation of the vein of Galen is an uncommon intracranial vascular anomaly that is mainly seen in pediatric patients. It presents with diverse manifestations and variable severity. It consists of dilated deep venous structures in the system of Galen, fed by abnormal arteriovenous communications in the midline. Magnetic resonance imaging and magnetic resonance angiography are better than computed tomography for the study of this condition. The case reported here joins the set of rare cases in which a vein of Galen malformation is discovered in an adult.

Food, energy and macronutrient intake of postmenopausal women from a menopause program.

OBJECTIVE: This study aimed to analyse the food, energy and macronutrient intake of a group of postmenopausal women participating in a health-care-program. METHODS: Subjects included were 38 healthy postmenopausal women aged between 46 and 60 years, recruited from the Menopause Program of the Madrid City Council. Physical activity, some anthropometric data and dietary information was obtained using a modified version of the dietary history method, which contained a 24-hour-recall and a food frequency questionnaire covering the preceding month as reference period. Dietary quality indexes, including those of the energy provided by macronutrients, alcohol and fatty acids and PUFA + MUFA/SFA and PUFA/SFA ratios were calculated. RESULTS: This group consumed a diet very similar to the traditional Mediterranean diet. Intake of vegetables (415 +/- 165 g/d), fruits (396 +/- 178 g/d) and fish (131 +/- 69 g/d) was high and a wide variety of these products was consumed. Potato and cereal (157 +/- 76 g/d) intake was low. Dairy products, meat, poultry and eggs were only a modest part of this diet. The fat quality (PUFA + MUFA/SFA = 2.26) was satisfactory. CONCLUSION: The diet of this group of postmenopausal women attending a prevention program closely conforms to current nutritional guidelines. Physical activity, body weight and intake of vegetable foods are adequate and may be very useful to counterbalance the increased risk of several pathologies after menopause. However, consumption of carbohydrate rich foods is lower than recommended. Participation in the menopause health-care-program is useful for weight control and dietary advice.

Nutritional assessment, health markers and lipoprotein profile in postmenopausal women belonging to a closed community.

OBJECTIVE: To assess the dietary characteristics of a closed community and their relationship with several health markers and lipid and lipoprotein values in postmenopausal women. DESIGN: Energy and nutrient intake, serum lipids, lipoproteins, antioxidants, peroxides and low-density lipoprotein (LDL) peroxides in addition to several health markers were measured in a closed, postmenopausal female community consuming a diet without meat, meat products and alcoholic beverages. SETTING: Departamento de Nutrición and Sección Departamental de Química Analítica and Escuela de Especialización de Análisis Clínicos, Universidad Complutense de Madrid, Spain and Lerma, Burgos, Spain. RESULTS: Cereals, vegetables, legumes and fruit, together with milk and eggs, constituted the most important ingredients of the diet consumed. Dietary carbohydrates contributed 42%en and lipids 46.4%en. The SFA/MUFA/PUFA ratio was 1/2/1 and the n-3/n-6 ratio 0.05 (SFA=saturated fatty acids, MUFA=monounsaturated fatty acids, PUFA=polyunsaturated fatty acids). The study community diet was monotonous and made for possible deficiencies of iron, magnesium, zinc, vitamin B(6) and vitamin D, in variable proportions. Routine biochemical and haematological normality markers indicate that only one woman presented hyperglycaemia and hyperuricaemia. Two women had haemoglobin levels <12 g/dl, but their mean corpuscular volume or mean corpuscular haemoglobin was normal. The prevalence of high cholesterol values (>6.21 mmol/l) was 42.8%, while that of high LDL-cholesterol levels (>3.88 mmol/l) was 35.7%, but none of the women displayed levels of high-density lipoprotein (HDL)-cholesterol <1.16 mmol/l, triglycerides >1.2 mmol/l or an LDL-cholesterol/HDL-cholesterol ratio>3. Only one woman had apolipoprotein (Apo) B levels >1.5 g/l, while most of the women presented Apo B values <1.2 g/l and an ApoA-1/ApoB ratio &<1.1. Plasma and LDL-peroxide levels, together with the tocopherol and carotene intakes, suggest a good antioxidant status in this population. CONCLUSIONS: The diet of the study group seems compatible with a healthy life-profile and permits a more-than-acceptable degree of cardiovascular disease protection. However, the consumption of certain nutrients should be improved.

[Nutrition and dietary recommendations for the elderly "Public Health" Working Group of the Spanish Nutrition Society]. / Nutrición y recomendaciones dietéticas para personas mayores. Grupo de trabajo "Salud pública" de la Sociedad Española de Nutrición (SEN).

With the increase of life expectancy, the desire to maintain good health, functionality and maximum quality of life at advanced ages, for which nutrition plays a critical role, is a priority for the elderly. Though genetic factors are a determinant of life expectancy, there are several extrinsic factors which have a great influence on the quality of life of the elderly. Diet and nutritional status have a great influence, especially in the prevention and treatment of several diseases, which affect this heterogeneous and vulnerable age group. The nutritional status and needs of elderly people are associated with age-related biological, psychological and often socio-economic changes. All of these changes can increase the risk of developing a number of age-related diseases. In developed countries the elderly are the most affected by malnutrition, either because of a deficiency (energy and several nutrients) or an excess, leading to obesity and related diseases. This review highlights the most important factors affecting nutritional status in elderly people and focus on the need to maintain adequate physical activity level and an optimal physic, psychic and social functional capacity. It discusses dietary reference intakes and guidelines to improve and/or maintain adequate nutritional status in older people in order to reduce susceptibility to some illness and disease.

Nutrición y recomendaciones dietéticas para personas mayores. Grupo de trabajo "Salud pública" de la Sociedad Española de Nutrición (SEN) / Nutrition and dietary recommendations for the elderly "public health" working group of the spanish nutrition society

Con el incremento de la esperanza de vida, el deseo de mantener una buena salud, funcionalidad y una máxima calidad de vida en edades avanzadas constituye una prioridad en las personas mayores. Aunque la genética es un determinante de esta expectativa de vida, existen otros factores extrínsecos directamente implicados en la calidad de vida del anciano, entre los que cabe destacar la alimentación. La dieta y el estado nutricional tienen gran influencia, particularmente en la prevención o tratamiento de diversas enfermedades que afectan a este grupo, uno de los más heterogéneos y vulnerables de la población de los países desarrollados con un mayor riesgo de sufrir desequilibrios, carencias y problemas nutricionales. Esto es debido, por un lado, a que las necesidades de algunos nutrientes pueden ser mayores que en etapas anteriores y, por otro, a su menor capacidad para regular todos los procesos relacionados con la ingesta de alimentos como consecuencia del progresivo deterioro de casi todas las funciones biológicas. Los numerosos cambios físicos, psíquicos y sociales que acompañan al envejecimiento y la mayor prevalencia de enfermedades crónicas, también contribuyen a esta situación. Diversos estudios han puesto de manifiesto el riesgo de ingestas inadecuadas y de malnutrición proteico-energética, aumentando la vulnerabilidad a otras enfermedades. En este trabajo se hace una revisión de los principales condicionantes del estado nutricional en el anciano, de la importancia de la capacidad funcional física, psíquica y social y de la actividad física y de su repercusión en el estado nutricional. Se describen las ingestas de referencia y las recomendaciones dietéticas más actuales, tratando de establecer las condiciones dietéticas y de estilo de vida que pueden contribuir a preservar las funciones corporales y minimizar las enfermedades crónicas en las personas de edad (AU)

With the increase of life expectancy, the desire to maintain good health, functionality and maximum quality of life at advanced ages, for which nutrition plays a critical role, is a priority for the elderly. Though genetic factors are a determinant of life expectancy, there are several extrinsic factors which have a great influence on the quality of life of the elderly. Diet and nutritional status have a great influence, especially in the prevention and treatment of several diseases, which affect this heterogeneous and vulnerable age group. The nutritional status and needs of elderly people are associated with age-related biological, psychological and often socio-economic changes. All of these changes can increase the risk of developing a number of age-related diseases. In developed countries the elderly are the most affected by malnutrition, either because of a deficiency (energy and several nutrients) or an excess, leading to obesity and related diseases. This review highlights the most important factors affecting nutritional status in elderly people and focus on the need to maintain adequate physical activity level and an optimal physic, psychic and social functional capacity. It discusses dietary reference intakes and guidelines to improve and/or maintain adequate nutritional status in older people in order to reduce susceptibility to some illness and disease (AU)