What is happening with the clinical nutritionist? Realities and challenges.

BACKGROUND: At hospital level, clinical nutritionists play a fundamental role in health recovery, contributing to shorter hospital stays and addressing hospital malnutrition. However, in Latin America no studies have been conducted on the activities of the nutritionist and the factors influencing their performance. AIMS: to describe the activities of the clinical nutritionist in public and private hospital settings in Latin America and to determine the factors associated with disciplinary practice. METHODS: A cross-sectional analytical, quantitative study was conducted. Participants consisted of hospital nutritionists from 13 Latin American countries who had participated in a previously validated online survey on the activities performed during their daily work, obtaining a Professional Activities Score (PAS). RESULTS: 1222 nutritionists participated. Of the activities associated with the professional role, the only ones who reached over 75 % of execution were: performing nutritional intervention; performing nutritional assessment and diagnosis; providing counseling and dietary prescription; developing nutritional care plans for patients with nutritional problems; and performing the monitoring and evaluation of results of priority patients. The least frequent activities were: university teaching and collaborating in research. Regarding the reasons for not performing activities: 34.0 % reported not being included in the activities, 24.5 % mentioned lack of time, and 13.6 % indicated that the activities were conducted by another professional. Variables positively associated with an increase in the PAS were: having spent more years exercising the profession (Beta: 0.028, 95 % CI: 0.004; 0.051), and having a greater number of specialties (4 or more, Beta: 2.294, 95 % CI: 1.031; 3.557). Working in lower-complexity facilities (Low: Beta: -1.037, 95 % CI: -1.443; -0.630), and having more reasons for not performing the activities (3 or more: Beta: -3.105, 95 % CI: -4.111; -2.099) were inversely associated. From the sample, 1.8 % held a doctorate in clinical nutrition, 43.9 % had a specialty, and 64.4 % had a diploma or postgraduate degree in clinical nutrition. CONCLUSION: None of the activities related to the nutritionist work was performed on a 100 % basis. In Latin America, Ministries of Health should standardize and regulate the functions of the clinical nutritionist, as well as quantifying understaffing and proposing solutions to alleviate the shortage of these professionals, acknowledging the positive impact that they have on the recovery of hospital patients.

Self-Reported Nutritional Status and Breakfast Characterization in Latin American University Students.

OBJECTIVE: To associate breakfast consumption frequency with self-reported nutritional status and dietary patterns of Latin American university students by human development. MATERIAL AND METHODS: This was a cross-sectional, multicenter observational study. University students from 11 Latin American countries (Argentina, Chile, Colombia, Costa Rica, Ecuador, Guatemala, Mexico, Peru, Paraguay, Panama and Uruguay) were invited to participate by answering an online self-administered questionnaire on food consumption and sociodemographic indicators, associations were investigated using logistic regression. RESULTS: The logistic regression analysis showed significant associations between breakfast consumption and the crude model, models 2 and 3 in countries with very high and upper-middle/high human development. However, after adjustment in the most comprehensive model, the association is no longer statistically significant. In the fully adjusted model of the variables, a significant relationship was observed between breakfast consumption and both healthy and unhealthy dietary patterns. Specifically, students who typically consume breakfast exhibit greater consumption of oatmeal and fruits, as well as healthier dinner choices. Conversely, they exhibit lower consumption of fast food, sugary drinks, and juices. In particular, in highly developed countries, along with the mentioned foods, consumption of dairy was linked to breakfast consumption in a positive way, while alcohol consumption was negatively associated. CONCLUSION: University students who eat breakfast on a regular basis maintain a healthier diet in comparison to those who do not, irrespective of their country's level of human development.

Barriers and Opportunities for Clinical Nutritionists in 13 Latin American Countries: A Qualitative Study.

A clinical nutritionist (CN) is a university-educated professional trained to perform preventive and recovery functions in the health of patients. The actions of these professionals, both worldwide and in Latin America, may face barriers and opportunities that require careful identification and examination. The main objective of this study is to identify the most important barriers and opportunities for the clinical nutritionist in 13 Latin American countries. A qualitative study was carried out; the initial phase involved conducting in-depth individual interviews with 89 informants, experienced CNs from 13 Latin American countries. After calculating the mean and standard deviation, we ranked the top 10 most frequently reported barriers by assigning a score ranging from 1 to 10. Additionally, 3 opportunities were identified with a lower score from 1 to 3. Means and standard deviation were calculated to sort the responses. Results: the most important barrier was the absence of public policies that regulate and/or monitor compliance with the staffing of CNs according to the number of hospital beds, while the most important opportunity was the advances in technology such as software, body analysis equipment and other tools used in Nutritional Care. The identified barriers can interfere with the professional performance of CNs and, moreover, make it difficult to monitor the good nutritional status of patients. It is recommended to consider the barriers identified in this study, as well as the opportunities, with a view to improving the quality of hospital services with an adequate supply of nutritionists.

Asociación entre consumo de alcohol y exceso de peso entre estudiantes universitarios de América Latina

Introducción: El sobrepeso y la obesidad son problemas de salud pública de nivel mundial. Si bien existe información respecto al consumo de alcohol en estudiantes universitarios durante la pandemia, pocos autores han señalado la asociación entre este hábito y el exceso de peso en esta población. El objetivo fue determinar la asociación entre el consumo de alcohol y el exceso de peso en estudiantes universitarios de 10 países de Latinoamérica durante la pandemia por COVID-19. Metodología: Se realizó un estudio transversal y multicéntrico con 4.539 estudiantes universitarios matriculados en diez países de América Latina. Para la valoración del consumo de alcohol se utilizó la pregunta ¿Consumes bebidas alcohólicas? (1 porción 1 vaso de 200 ml). El índice de masa corporal (IMC) se determinó a partir del peso y la altura auto informado. Para determinar si el exceso de peso (IMC ≥25 kg/m2) estaba asociado con el consumo de alcohol, se utilizó un análisis de regresión logística, ajustado por edad, sexo, año de estudio, nivel socioeconómico, actividad física y tabaquismo. Resultados: Entre los estudiantes con estado nutricional normal, un 59,6% no consumía alcohol, mientras entre los que presentaban un exceso de peso era un 55,1%. Los estudiantes que consumían 2 o más porciones de alcohol al día tenían 2,18 veces más riesgo de tener exceso de peso (OR: 2.18 [95% IC: 1,26 a 3,77]), comparado con aquellos que no consumían alcohol. Conclusión: Se observó que aquellos estudiantes que consumieron más alcohol tuvieron más probabilidades de tener exceso de peso.

Introduction: Overweight and obesity are public health problems worldwide. Alcoholic beverages could increase total energy intake causing an increase in body weight. However, few authors have pointed out the association between this habit and excess weight in this population. The objective of this study was to determine the association between alcohol consumption and excess weight in university students from 10 Latin American countries during the COVID-19 pandemic. Methodology: A cross-sectional and multicenter study was carried out with 4,539 university students enrolled in ten Latin American countries. To assess alcohol consumption, the question Do you consume alcoholic beverages? (1 portion 1 glass of 200 ml). Body mass index (BMI) kg/m2 was determined from self-reported weight and height. To determine if excess weight was associated with alcohol consumption, a logistic regression analysis was used, adjusted for age, sex, year of study, socioeconomic level, physical activity, and smoking. Results: Among students with normal nutritional status, 59.6% did not consume alcohol, while among those with a BMI ≥25 kg/m2 it was 55.1%. Students who consumed 2 or more servings of alcohol per day had a 2.18 times greater risk of being overweight (OR: 2.18 [95% CI: 1.26 to 3.77]), compared with those who did not consume alcohol. Conclusion: It was observed that those students who consumed more alcohol were more likely to be overweight.

Healthy Lifestyle Habits in Latin American University Students during COVID-19 Pandemic: A Multi-Center Study.

Background: Deterioration in the health-related quality of life (HRQoL) and healthy eating behavior due to the effect of COVID-19 lockdown has been reported. The aim of this study was to associate eating habits and HRQoL with physical activity behavior in Latin American university students during COVID-19 pandemic.Methods: Measured 4,859 university students with a mean age of 22.4 years and they were mostly female (73.7%) from 10 Latin American countries (Argentina, Chile, Colombia, Costa Rica, Ecuador, Guatemala, Mexico, Panama, Paraguay and, Peru). Eating habits were measured using a survey validated with other university students, HRQoL was assessments using the short version of the World Health Organization (WHOQOL-BREF) scale and physical activity behavior with a dicotomous question based on the international recommendations for physical activity.Results: There is a higher complaince for all the international recommendations for healthy foods intake in the physically active group of students (p < 0.01), with the exception of alcohol and salt. In addition, physically active students presented a significantly higher HRQoL (p < 0.001) in all the dimensions analyzed when compared to physically inactive students.Conclusions: Latin American university students who are physically active are more likely to have a healthier eating behavior and a lower risk of a decreased HRQoL during COVID-19 pandemic.

Bodyweight change and its association with food and beverage consumption at the beginning COVID-19 confinement.

OBJECTIVES: SARS-CoV-2, a newly identified coronavirus responsible for the COVID-19 pandemic, has challenged health services and profoundly impacted people's lifestyles. The objective of the present study was to evaluate the effect of confinement during the COVID-19 pandemic on food consumption patterns and body weight in adults from 12 Ibero-American countries. METHODS: Multicentric, cross-sectional study. Data was collected using an online survey disseminated by social networks. The sample included 10 552 people from Spain and 11 Latin American countries who were selected by snowball sampling. RESULTS: While 38.50% of the sample reported weight gain, 16.90% reported weight lost. Weight change was associated with sex, age, country of residence, and education level. People who were not confined more often reported having maintained their weight in comparison to people who were confined. All Latin American countries showed an increased consumption of sweetened drinks, pastry products, fried foods, and alcoholic beverages during confinement. Consumption of eggs and dairy products was independent from body weight change. People who consumed more fruits and vegetables during confinement more often reported having lost weight. In contrast, body weight gain during confinement was associated with increased intake of sugary drinks, baked goods and pastries, pizza, fried foods, and alcoholic beverages. CONCLUSION: During COVID-19 confinement, the Latin American countries included in this study showed a change in their consumption patterns toward less healthy diets, which in turn was associated with an increase in the body weight of their population.

Conocimientos de la población adulta sobre etiquetado nutricional de alimentos

Los consumidores a menudo informan dificultades para interpretar la información cuantitativa contenida en las etiquetas nutricionales de los alimentos. El objetivo fue estudiar los principales conocimientos sobre etiquetado de alimentos que la población adulta del Paraguay tiene incorporado en el periodo de agosto de 2021. Este es un estudio descriptivo observacional de corte trasversal en el cual se evaluaron a adultos de ambos sexos de 18 a 60 años consumidores de alimentos con etiquetado nutricional. Se recabarón datos sociodemográficos y de conocimientos sobre etiquetado nutricional de alimentos a través de una encuesta tipo on-line con la herramienta de Google forms. El 73% fueron del sexo femenino, la edad promedio fue de 36,9 años, 57,1% residía en Gran Asunción, 49,1% tenía nivel educativo universitario y 37,5%eran profesionales de la salud. Los aspectos generales sobre etiquetado nutricional revelaron que 88,3% sabía su concepto, 55,3% refirió que lo lee casi siempre, 84% sabía que es obligatorio y 44% se fijaba más en las calorías. Al evaluar los conocimientos generales, 91% sabía la diferencia entre caducidad y consumo preferente, 71,4% conocía el concepto de cantidades orientativas, 62,5% supo cuáles son las grasas menos saludables, y 71,4% respondió correctamente el concepto de alimento light. Los encuestados tuvieron un conocimiento general adecuado sobre etiquetado nutricional, no obstante, hubo un porcentaje considerable de individuos que no supieron los conceptos básicos, por lo que se debe realizar intervenciones de educación nutricional enfocadas al consumidor.

Consumers often report difficulties in interpreting the quantitative information contained in the nutritional labels of foods. The objective was to study the main knowledge about food labeling that the adult population of Paraguay has incorporated in the period of August 2021. This is a cross-sectional descriptive observational study in which male and female adults between 18 and 60 years old consumers of foods with nutrition labelling were evaluated. Sociodemographic data and knowledge about nutritional labeling of food was collected through an online survey with the Google forms tool. Seventy three percent was female, the average age was 36.9 years, 57.1% lived in Greater Asunción, 49.1% had a university education level, and 37.5% were health professionals. The general aspects about nutritional labeling revealed that 88.3% knew the concept, 55.3% said that they read it almost always, 84% knew that it was mandatory and 44% paid more attention to calories. When evaluating general knowledge, 91% knew the difference between expiration and preferential consumption, 71.4% knew the concept of indicative quantities, 62.5% knew which are the less healthy fats, and 71.4% correctly answered the concept of light food. The survey respondents had an adequate general knowledge about nutrition labeling, however, there was a considerable percentage of individuals who did not know the basic concepts, for which consumer-focused nutrition education interventions should be carried out.

Utilidad de la circunferencia de pantorrilla como marcador de desnutrición comparado con el mini nutritional assessment, nutritional risk screening 2002 y albúmina sérica en adultos mayores / Utility of calf circumference as a marker of malnutrition in relation to the mini nutritional assessment, nutritional risk screening 2002 and serum albumin in older adults

Introducción:la evaluación de la desnutrición en el adulto mayor puede basarse en medidas antropométricas, parámetros bioquímicos, pruebas nutricionales y la circunferencia de la pantorrilla que es uno de los métodos de evaluación nutricional. Objetivo:evaluar la utilidad de la circunferencia de la pantorrilla como marcador de desnutrición comparadaal Mini Nutritional Assessment(MNA), Nutrition Risk Screening2002 (NRS-2002) y la albúmina plasmática en adultos mayores hospitalizados en el Hospital Geriátrico Prof. Dr. Gerardo Buongermini ­IPS entre marzo y abril de 2019. Metodología:estudio observacional descriptivo transversal en 300 adultos mayores hospitalizados en el Hospital Geriátrico. Se estudiaron variables demográficas y de evaluación nutricional. Se evaluó la sensibilidad y especificidad de la circunferencia de la pantorrilla en relación con el MNA, NRS-2002 y albúmina plasmática. Resultados:el 60,3% de los pacientes estaba en el rango de edad de 75 a 90 años, el 57,7% de sexo femenino. El riesgo nutricional según la circunferencia de la pantorrilla fue del 69%, según MNA, la desnutrición fue en 54,7% y riesgo de desnutrición 34%, según NRS-2002, 69,7% presentó riesgo de desnutrición y según albúmina plasmática el 32,3% tuvo desnutrición leve. La sensibilidad del perímetro de la pantorrilla con respecto al MNA, NRS-2002 y albúmina plasmática fueron del 91%, 95,6%, 100% y la especificidad 100%, 65,3% y 65,3%, respectivamente. Conclusión:la circunferencia de la pantorrilla tuvo una alta sensibilidad y es elmétodo ideal y de bajo costo para evaluar de manera rápida y segura a esta población.

Introduction:the evaluation of malnutrition in the elderly can be based on anthropometric measurements, biochemical parameters, nutritional tests and calf circumference is one of the methods of nutritional evaluation. Objective: To evaluate the usefulness of calf circumference as a marker of malnutrition in relation to the Mini Nutritional Assessment (MNA), Nutrition Risk Screening 2002 (NRS-2002) and plasma albumin in older adults hospitalized at the Hospital Geriatrico Prof. Dr. Gerardo Buongermini ­IPS between March and April 2019. Methodology:cross-sectional descriptive observational study in 300 older adults hospitalized in the nursing hospital. Sociodemographic variables and nutritional assessment were studied. The sensitivity and specificity of calf circumference compared to MNA, NRS 2002 and plasma albumin were evaluated. Results:60.3% of the patients were in the age range of 75 to 90 years, 57.7% were female. Nutritional risk according to calf circumference was present in 69%, malnutrition in 54.7% and risk of malnutrition 34% according to MNA, 69.7% risk of malnutrition according to NRS-2002 and mild malnutrition in 32.3% according to plasma albumin. The sensitivity of calf circumference with respect to MNA, NRS 2002 and plasma albumin were 91%, 95.6%, and 100%, and specificity 100%, 65.3% and 65.3%, respectively. Conclusion:calf circumference had a high sensitivity and it is the ideal method and low cost to quickly and safely evaluate this population.

Relevant laboratory parameters in patients at hospital admission between July 2020 and October 2021 due to covid-19 at the Tesãi Foundation Hospital

Background:in the fight against COVID-19, the identification of laboratory predictors in the progression of severe and fatal forms is urgently needed. Aims:to describe the alterations of laboratory parameters of patients diagnosed with COVID-19 at admission to Tesãi Foundation Hospital in Ciudad del Este-Paraguay between July 2020 to October 2021.Methods:A retrospective study using the medical charts of 103 patients admitted to the hospital due to a diagnosis of COVID-19 was carried out. Demographic, clinical, and laboratory data were collected at hospital admission. Results:53.4% of the patients were male, mean age of 62.3±15.4 years, and 43.6% were admitted due to pneumonia. According to the complete blood count, 54.3% had lymphopenia, 26% thrombocytopenia, and 27% anemia. In the liver and kidney profiles, 37.9% had elevated urea levels, 56.3% elevated GOT levels, 26% elevated GPT, and 61% GGT levels. Regarding biomarkers, 80% had elevated LDH levels, 34% elevated D-dimer levels, 100% elevated C-reactive protein, 43.7% elevated procalcitonin, and 89.3% elevated ferritin. Significant differences (p<0.05) were found according to sex for the parameters of hemoglobin, hematocrit, creatinine, and the LMR ratio. Conclusion:patients presented several alterations in hematological, renal, hepatic, and inflammatory marker parameters, which offer a general overviewof the state of health with which the patient with COVID-19 is admitted to the hospital.

Introducción: en la lucha contra el COVID-19 es urgente la identificación de predictores de laboratorio en la progresión de formas graves y fatales. Objetivo:describir las alteraciones de los parámetros de laboratorio de pacientes con COVID 19 ingresados al Hospital Fundación Tesãi de Ciudad del Este-Paraguay en el período de julio de 2020 a octubre de 2021. Métodos:estudio retrospectivo, utilizando los registros de 103 pacientes ingresados al hospital por diagnóstico de COVID 19. Se recolectaron datos demográficos, clínicos y de laboratorio al ingreso hospitalario. Resultados:el 53,4% de los pacientes era del sexo masculino, edad media de 62,3±15,4 años y el 43,6% ingresó por neumonía. El 54,3% presentaba linfopenia, el 26% trombocitopenia y el 27% anemia. En el perfil hepático y renal, el 37,9% tenían niveles elevados de urea, el 56,3% niveles elevados de GOT, 26% y 61% niveles elevados de GPT y GGT, respectivamente. En cuanto a los biomarcadores, el 80 % tenía niveles elevados de LDH, el 34 % niveles elevados de dímero D, el 100 % proteína C reactiva elevada, el 43,7 % procalcitonina elevada y el 89,3 % ferritina elevada. Se encontraron diferencias significativas (p<0,05) según el sexo en los parámetros de hemoglobina, hematocrito, creatinina y el índice LMR. Conclusión:los pacientes presentaron diversas alteraciones en casi todos los parámetros evaluados, resultados que ofrecen un panorama general del estado de salud con el que ingresa el paciente con COVID 19 al hospital.

Quality of the diet during the COVID-19 pandemic in 11 Latin-American countries.

BACKGROUND AND OBJECTIVES: The confinement by COVID-19 has affected the food chain and environments, which added to factors such as anxiety, frustration, fear and stress have modified the quality of the diet in the population around the world. The purpose of this study was to explore diet quality during the COVID-19 pandemic in 11 Latin American countries. METHODOLOGY: Multicentric, cross-sectional study. An online survey was applied to residents of 11 Latin-American countries, during April and May 2020, when confinement was mandatory. Diet quality was evaluated using a validated questionnaire. RESULT: 10,573 people participated in the study. The quality of the food by country shows that Colombia presented the best quality, while Chile and Paraguay presented the lowest. When comparing the overall results of diet quality by gender, schooling and age, women, people with more schooling and people under 30 years of age, presented better diet quality. The regression model showed that the variables associated with diet quality were: age (df = 3, F = 4. 57, p < 0.001), sex (df = 1, F = 131.01, p < 0.001), level of education (df = 1, F = 38.29, p < 0.001), perception of weight change (df = 2, F = 135.31, p < 0.001), basis services (df = 1, F = 8.63, p = 0.003), and quarantine (df = 1, F = 12.14, p = 0.001). CONCLUSION: It is necessary for governments to intervene to reverse these indicators, considering that inadequate feeding favors the appearance of no communicable diseases, which favor a higher risk of infection and worse prognosis with COVID-19.

Body weight in relation to hours of sleep, and physical activity in Latin American university students during the Covid-19 pandemic.

Introduction: Short sleep, physical inactivity, and being locked up are risk factors for weight gain. Objective: We evaluated weight gain according to sex, age, hours of sleep and physical activity in university students from 10 Latin American countries during the COVID-19 pandemic. Methods: Cross-sectional and multicenter study (n = 4880). Results: The average age was 22.5 ± 4.4 years. 60.2% were currently locked up. 73.6% were women, 48.2% increased their body weight, 66% reported insufficient sleep hours, and 65.9% were inactive. Women gained more weight than men (73.2%) and younger students gained more weight (85.1%). Those who had insufficient sleep hours gained most weight (67.6%). Inactive participants gained most weight (74.7%). Students who have insufficient sleep are 21% more likely to have changes in body weight compared to students who have optimal sleep. Conclusion: The increase in body weight and its risk factors during confinement should be considered as emerging from public health.

Calidad de la dieta, estado nutricional y nivel de actividad físicaen estudiantes universitarios de la carrera de enfermería / Diet quality, nutritional status and physical activity level in university students of the nursing career

Fundamentos: Para los estudiantes comenzar los estudios en la universidad es un momento en donde lospatrones nutricionales adquiridos previamente, relacionados con la satisfacción de las necesidades dietéticas,se fijan o se forman nuevos patrones de comportamiento. El objetivo fue evaluar la calidad de la dieta, elestado nutricional y el nivel de actividad física de estudiantes universitarios de enfermería.Métodos: estudio observacional, analítico de corte transversal realizado en 50 universitarios de primer ysegundo año de enfermería. Se recabaron datos sociodemográficos como sexo, estado civil, ocupación yprocedencia, datos antropométricos como peso, talla e IMC; y datos de nivel de actividad física a través delcuestionario internacional versión corta IPAQ. Para evaluar la calidad de la dieta, se aplicó una encuestacerrada de frecuencia de consumo de alimentos basada en las Guías Alimentarias del Paraguay.Resultados: la edad promedio fue de 22,2±4,9 años, 76% fue del sexo femenino, el 86% de los estudiantestenía una calidad poco saludable. 52% de la población se encontraba con estado nutricional adecuado, el 58%de la población universitaria tiene un nivel de actividad física bajo. La calidad de dieta según el sexo, mostróque las mujeres tienen la mayor proporción de dieta poco saludable (64%). Según el estado nutricional, losque se encontraban en normopeso tuvieron la mayor proporción de dieta poco saludable seguidos de losobesos 44% y 28%, respectivamente; y según el nivel de actividad física, los que presentaban un nivel bajo,fueron los que mayormente tuvieron una dieta poco saludable. Se encontraron diferencias significativas entodos los grupos (p<0,05).Conclusiones: la mayor parte de la población universitaria tiene una dieta poco saludable y bajo nivel deactividad física. (AU)

Background: for students, starting their studies at the university is the moment where previously acquirednutritional patterns, related to the satisfaction of dietary needs, are fixed or new patterns of behavior areformed. Objective: to evaluate the quality of the diet, the nutritional status and the level of physical activity ofuniversity nursing students.Methods: observational, analytical cross-sectional study carried out in 50 first- and second-year nursingstudents. Sociodemographic data such as sex, marital status, occupation and origin, anthropometric data suchas weight, height and BMI, physical activity level data were collected through the international short versionIPAQ questionnaire. To evaluate the quality of the diet, a closed survey of food consumption frequency wasapplied, based on the Food Guidelines of Paraguay.Results: the average age was 22.2 ± 4.9 years, 76% were female, 86% of the students had an unhealthyquality. 52% of the population had adequate nutritional status, most of the university population has a lowlevel of physical activity (58%). The quality of diet according to sex, showed that women have the highestproportion of unhealthy diet (64%). According to the nutritional status, the normal weight had the highestproportion of an unhealthy diet followed by the obese 44% and 28% respectively and according to the level ofphysical activity, those who had a low level were the ones who had an unhealthy diet the most. Significantdifferences were found in all groups (p <0.05).Conclusions: most of the university population has an unhealthy diet and low level of physical activity. (AU)

Psychological factors of diet quality among rural populations of Latin America during the COVID-19 pandemic: a cross-sectional study.

INTRODUCTION: This study aimed to determine the relationship between symptoms of anxiety and/or anhedonia (inability to feel pleasure) and diet quality during confinement due to COVID-19 in rural populations in Latin America. METHODS: This was a multicentric, cross-sectional study. An online survey was applied, which included the Beck Anxiety Inventory, Snaith-Hamilton Pleasure Scale for assessing the presence of anhedonia, the Food Intake Questionnaire and sociodemographic questions. RESULTS: The study included 10 552 people from 11 countries; 708 participants were living in rural areas. More than half of the participants were quarantined at the time of the survey. Diet quality was inversely associated with anhedonia (p<0.001) and anxiety (p=0.003). In addition, a healthier diet was associated with being female (p=0.030), having a higher level of education (p=0.008) and country of residence (p=0.001). CONCLUSION: Among the rural population during the COVID pandemic, this study found a worse diet quality was associated with symptoms of anhedonia and anxiety, as well as lower level of education and being male. Proposals to improve the quality of the diet could include interventions aimed at people's mental health.

Processed and ultra-processed foods consumption in adults and its relationship with quality of life and quality of sleep / Consumo de alimentos processados e ultraprocessados em adultos e sua relação com qualidade de vida e qualidade do sono

ABSTRACT Objective: To evaluate the consumption of processed and ultra-processed foods in Paraguayan adults and its relationship with quality of life and sleep quality. Methods: A cross-sectional descriptive observational study was carried out on Paraguayan adults in May 2022. An online survey was applied in which sociodemographic data, frequency of food consumption using the NOVA classification and Pan American Health Organization criteria, quality of life evaluated by the European Quality of Life-5 Dimensions and report of hours of sleep were collected. Results: A total of 273 Paraguayan adults were included in the study, of which 71.1% were female, 51.6% lived in the capital, 53.1% were single, 66% had a university educational level and the average age was 36.48±13.2. Regarding the consumption of processed and ultra-processed foods, the critical nutrients most consumed daily were free sugars by 34.0%, and fats by 23.4% of the population. The global quality of life index was low (0,58±0,05) and 69.0% reported insufficient hours of sleep. Statistically significant relationships were found between the consumption of processed and ultra-processed foods with quality of life and quality of sleep (p<0.05 for both). Conclusion: The most consumed critical nutrients in the Paraguayan adult population are free sugars and fats, finding a significant relationship between the consumption of processed and ultra-processed foods with quality of life and quality of sleep.

RESUMO Objetivo: Avaliar o consumo de alimentos processados e ultraprocessados em adultos paraguaios e sua relação com a qualidade de vida e qualidade do sono. Métodos: Foi realizado um estudo observacional descritivo transversal em adultos paraguaios em maio de 2022. Foi aplicado um questionário online onde foram questionados datos sociodemográficos, frequência de consumo alimentar pela classificação NOVA e critérios da Organização Pan-Americana da Saúde, qualidade de vida avaliada pelo Qualidade de Vida Europeia-5 Dimensões - foram coletados e relato de horas de sono. Resultados: Foram incluídas no estudo 273 paraguaios, das quais 71,1% eram do sexo feminino, 51,6% residiam na capital, 53,1% eram solteiras, 66,0% tinham nível universitário e a média de idade foi de 36,48±13,2 anos. Em relação ao consumo de alimentos processados e ultraprocessados, os nutrientes críticos mais consumidos diariamente foram os açúcares livres por 34.0% e as gorduras por 23,4% da população. O índice global de qualidade de vida foi baixo (0,58±0,05) e 69.0% relataram horas insuficientes de sono. Foram encontradas relações estatisticamente significativas entre o consumo de alimentos processados e ultraprocessados com qualidade de vida e qualidade do sono (p<0,05 para ambos). Conclusão: Os nutrientes críticos mais consumidos na população adulta paraguaia são os açúcares e gorduras livres, encontrando uma relação significativa entre o consumo de alimentos processados e ultraprocessados com a qualidade de vida e qualidade do sono.

Conocimiento y prácticas sobre la lactancia materna exclusiva en madres primíparas que acuden a consultar a dos hospitales amigo del niño de Paraguay / Knowledge and practices on exclusive breastfeeding in primiparous mothers who consult in two child friendly hospitals in Paraguay

La lactancia materna brinda un medio incomparable para otorgar un alimento ideal para el crecimiento y desarrollo del recién nacido. El objetivo fue evaluar los conocimientos y las prácticas relacionadas a la lactancia materna exclusiva en madres primíparas que acuden a los hospitales Materno Infantil Reina Sofía de la Cruz Roja Paraguaya y Hospital Materno Infantil de Trinidad que tienen la denominación "amigo del niño y de la madre" y la asociación entre estas variables. Se realizó un estudio descriptivo analítico de corte transversal, realizado en los meses de enero y febrero del 2020 a 90 primíparas. Las variables estudiadas fueron sociodemográficas, de conocimientos y prácticas sobre lactancia materna exclusiva. La edad promedio fue de 27. La mayoría eran solteras (46 %). El secundario fue el nivel de escolaridad en general con un 49 %. La ocupación de las madres fue el de ama de casa en su mayoría (57 %). En cuanto al conocimiento sobre lactancia materna exclusiva se encontraron las siguientes proporciones: regular fue el mayor con 53%, seguido de bueno en un 29% y por último deficiente con 18 %. En cuanto al nivel de prácticas, se halló un 54 % inadecuada y adecuada en 45%. Al analizar si existe asociación entre los conocimientos y prácticas sobre lactancia materna exclusiva, no hemos encontrado asociación entre estas variables (P=0,233). El conocimiento sobre lactancia materna en primíparas fue regular en su mayoría, y en cuanto a las prácticas se observó un nivel inadecuado en mayor cantidad. No se encontró asociación entre el conocimiento y las prácticas sobre lactancia materna exclusiva.

Hábitos alimentarios y estado nutricional en niños y adolescentes con trastornos del espectro autista que acuden a la Asociación Esperanza / Food habits and nutritional status in children and teenagers with autism spectrum disorders attending the hope association

Los trastornos del espectro autista (TEA) son un grupo de síndromes de desarrollo neurológico, que se manifiestan en la primera infancia. Debido a la selectividad que estos pacientes presentan respecto a los alimentos, es crucial velar por su estado nutricional y calidad de su alimentación. El objetivo fue evaluar los hábitos alimentarios y estado nutricional de niños y adolescentes con TEA que acuden a la fundación Esperanza para el Autismo. El estudio es del tipo observacional, descriptivo de corte transversal realizado en diciembre del 2019 a 30 niños y adolescentes con TEA de 2 a 15 años. Se estudiaron variables sociodemográficas, estado nutricional y hábitos alimentarios. El 80 % de la población fue de sexo masculino. La edad promedio fue de 4,7 años. 83,3 % tenía escolarización. El estado nutricional predominante fue el de obesidad en un 30 %. En relación a los hábitos alimentarios, el consumo de los diferentes alimentos fue de diariamente para los lácteos, frutas y verduras, moderado en cuanto al consumo de carnes, huevo y cereales y azúcares. Los hábitos alimentarios de la población fueron adecuados en cuanto a frecuencia semanal. El estado nutricional predominante fue el de obesidad.

Escolaridad materna y estrato socioeconómico según el estado nutricional de preescolares evaluados en guarderías

Introducción: La problemática del elevado índice de malnutrición a nivel mundial se relaciona con factores causales comunes relacionados con la escolaridad materna, que junto con el estrato socioeconómico, podrían influir en la nutrición de los niños/as sobre todo aquellos que se encuentran en edad preescolar. Objetivo: Evaluar la escolaridad y el estrato socioeconómico maternos según el estado nutricional de preescolares. Materiales y Métodos: Se llevó a cabo un estudio observacional analítico de corte transversal. Fueron evaluados por antropometría, según criterios de la OMS, 82 niños/as en edad preescolar y se aplicaron encuestas a sus respectivas madres. Resultados: Según el indicador de Peso/Talla, 57,31% de los preescolares presentó estado nutricional adecuado (entre -1 y+1 DE), 29,3% sobrepeso (entre +1 y+2 DE) y 7,31% obesidad (por encima de +2 DE). El 6,1% presentó riesgo de desnutrición (entre -1 DE y -2 DE). En cuanto al indicador Talla/Edad, el 87,8% presentó talla adecuada (por encima de -1 DE), 11% riesgo de talla baja (entre -1 DE y -2 DE) y 1,22% talla baja (por debajo de -2 DE). Al comparar las medianas de los años de escolaridad materna según el estado nutricional de los hijos/as (18, 15, 14 y 13,5), no se encontraron diferencias significativas entre los grupos (p=0,247 Kruskal Wallis) y al comparar las medianas de los puntajes de la estratificación socioeconómica según el estado nutricional de los preescolares (7, 15 y 10,5), se encontraron diferencias significativas entre los grupos (p=0,023 Kruskal Wallis). Conclusiones: Más de la mitad de los preescolares presentó estado nutricional adecuado y talla adecuada. No se encontraron diferencias entre los años de escolaridad materna según el estado nutricional de los preescolares pero sí entre los puntajes de estratificación económica.

Introduction: The problem of the high rate of malnutrition worldwide is related to common causal factors related to maternal education, along with socioeconomic status, they could influence the nutrition of children, especially those who are in preschool. Objective: To evaluate maternal education and socioeconomic status as the nutritional status of preschool children. Materials and Methods: An analytical observational cross-sectional study was conducted. 82 children were evaluated by anthropometry, according to WHO criteria and surveys were applied to their respective mothers. Results: According to the indicator Weight/Height, 57.31% of preschool children presented adequate nutritional status (between -1 y+1 SD), 29.3% overweight (between +1 y+2 SD) and 7.31% obesity (above +2SD). Moreover, 6.1% presented risk of malnutrition (between -1 DE y -2 SD). For the indicator Height/Age, 87.8% had adequate size (above - 1 SD), 11% risk of low height (between -1 DE y -2 SD) and 1.22% presented low height (under -2 SD). When comparing the medians of the years of maternal schooling according to the nutritional status of (18, 15, 14 and 13.5), no significant differences between groups were found (p=0.247 Kruskal Wallis) and comparing medians of the socioeconomic stratification scores according to the nutritional status of preschool children (7, 15 and 10.5), significant differences between groups were found (p=0.023 Kruskal Wallis). Conclusions: More than half of preschool children presented adequate nutritional status and adequate height. No differences between maternal schooling were found according to the nutritional status of preschoolers but it did among economic stratification scores.

Olive oil phenolic compounds decrease the postprandial inflammatory response by reducing postprandial plasma lipopolysaccharide levels.

We investigated the molecular mechanisms by which phenolic compounds (phenols) in virgin olive oil reduce the postprandial inflammatory response with the aim of identifying the transcription factor involved and the downstream effects. Olive oil-based breakfasts prepared with virgin olive oil (VOO) with high (398 ppm), intermediate (149 ppm) and low (70 ppm) phenol content were administered to 49 metabolic syndrome patients following a randomized crossover design. The consumption of a high-phenol VOO-based breakfast limited the increase of lipopolysaccharide plasma levels, TLR4, and SOCS3 proteins (p<0.001, p=0.041 and p=0.008, respectively), the activation of NF-κB (p=0.016) and the IL6 (p=0.007 and p=0.048, low and intermediate oil, respectively), IL1B (p=0.002, intermediate oil), and CXCL1 (p=0.001) postprandial gene expression, in peripheral blood mononuclear cells, as compared with the consumption of a breakfast prepared with the same oil but with low or intermediate phenol content. Virgin olive oil phenolic compounds reduce the postprandial inflammatory response in association with postprandial plasma lipopolysaccharide levels.

Postprandial oxidative stress is modulated by dietary fat in adipose tissue from elderly people.

We have investigated whether dietary fat modifies the postprandial oxidative stress in adipose tissue of elderly people. Twenty participants received three diets for 4 weeks each: SFA-rich diet, Mediterranean (Med) diet enriched in MUFA with virgin olive oil, and a low-fat, high-carbohydrate diet enriched in n-3 PUFA (α-linolenic acid from plant origin) (CHO-PUFA diet). After 12 h of fasting, volunteers received a breakfast reflecting the fatty acid composition of the diet ingested in the preceding dietary period. Med diet induced higher postprandial SOD2 and TrxR mRNA levels, and CHO-PUFA diet induced higher GPx1 and TrxR mRNA levels compared with SFA-rich diet. Med and CHO-PUFA breakfasts induced a postprandial increase in plasma reduced glutathione (GSH), and a greater postprandial GSH/oxidized glutathione ratio compared to the SFA-rich diet. Our study suggests that the consumption of Med and CHO-PUFA diets may reduce postprandial oxidative stress compared to an SFA-rich diet, which may be due to higher antioxidant enzymes gene expression in adipose tissue.