Prevalencia de la desnutrición al ingreso en los pacientes del Hospital General Nuestra Señora del Prado, Talavera de la Reina / Malnutrition prevalence at admission to Hospital General Nuestra Señora del Prado, Talavera de la Reina

INTRODUCCIÓN: la malnutrición es un problema global. En los países desarrollados no puede ignorarse la desnutrición debida a las alteraciones en los hábitos alimentarios de la población o a la presencia de enfermedades, lo que afecta de forma destacable a los pacientes hospitalizados. OBJETIVO: determinar la prevalencia del riesgo de desnutrición al ingreso en el Hospital General Nuestra Señora del Prado de Talavera de la Reina (Toledo, España). MÉTODOS: estudio observacional, transversal y descriptivo. Desde septiembre de 2017 a octubre de 2018, a todos los pacientes que ingresaban en el hospital y cumplían los criterios de selección se les realizó un cribado nutricional mediante el test NRS-2002(R). Se recogieron datos antropométricos y clínicos de los pacientes en riesgo nutricional (puntuación NRS-2002(R) ≥ 3). Se diagnosticó la desnutrición observada según su tipología y gravedad, emitiendo indicaciones nutricionales recogidas en el informe al clínico y en el informe al alta. RESULTADOS: en total, 476 pacientes realizaron el test NRS-2002(R), detectándose riesgo de desnutrición al ingreso en 137 (28,8 %; IC 95 %: 24,8 % a 33,0 %). El IMC promedio (DE) de estos fue de 24,6 (5,4) kg/m2. La dietista-nutricionista recomendó al 78,4 % de los pacientes una suplementación nutricional, y en el 82,1 % de los casos la codificación del estado nutricional (CIE-10). En el informe de alta se omitieron más del 70 % de estas recomendaciones. CONCLUSIONES: el 28,8 % de los pacientes analizados estaban en riesgo de desnutrición o desnutridos al ingreso. La desnutrición hospitalaria continúa siendo un problema en la actualidad, por lo que resulta de vital importancia incluir métodos de cribado al ingreso que permitan una intervención nutricional precoz en el paciente hospitalizado, así como la incorporación de personal sanitario formado para su realización

INTRODUCTION: malnutrition is a global problem. In developed countries, malnutrition due to alterations in the population's eating habits or the presence of disease cannot be ignored, and affects hospitalized patients in particular. OBJECTIVE: to determine the prevalence of malnutrition risk upon admission to Hospital General Nuestra Señora del Prado in Talavera de la Reina (Toledo, Spain). METHODS: this was an observational, cross-sectional, descriptive study. From September 2017 to October 2018 all patients admitted to hospital who met the selection criteria were assessed for nutritional status using the NRS-2002(R) test. Anthropometric and clinical data were collected from patients at nutritional risk (NRS-2002(R) score ≥ 3). The malnutrition observed was diagnosed according to type and severity, and nutritional indications were given, which were recorded in the report to the clinician and in the discharge report. RESULTS: a total of 476 patients took the NRS-2002(R) test, which detected risk of malnutrition upon admission in 137 (28.8 %; 95 % CI: 24.8 % to 33.0 %). Average BMI (SD) was 24.6 (5.4) kg/m2. The dietitian-nutritionist recommended nutritional supplementation for 78.4 % of patients, and coding of nutritional status (ICD-10) for 82.1 %. In the discharge report, more than 70 % of these recommendations were omitted. CONCLUSIONS: in all, 28.8 % of the patients analyzed were at risk of malnutrition or undernourished on admission. Hospital malnutrition continues to be a problem, so it is vitally important that screening methods be included at admission to allow early nutritional intervention in hospitalized patients, and that trained healthcare personnel be incorporated to this end

[Malnutrition prevalence at admission to Hospital General Nuestra Señora del Prado, Talavera de la Reina]. / Prevalencia de la desnutrición al ingreso en los pacientes del Hospital General Nuestra Señora del Prado, Talavera de la Reina.

INTRODUCTION: Introduction: malnutrition is a global problem. In developed countries, malnutrition due to alterations in the population's eating habits or the presence of disease cannot be ignored, and affects hospitalized patients in particular. Objective: to determine the prevalence of malnutrition risk upon admission to Hospital General Nuestra Señora del Prado in Talavera de la Reina (Toledo, Spain). Methods: this was an observational, cross-sectional, descriptive study. From September 2017 to October 2018 all patients admitted to hospital who met the selection criteria were assessed for nutritional status using the NRS-2002® test. Anthropometric and clinical data were collected from patients at nutritional risk (NRS-2002® score ≥ 3). The malnutrition observed was diagnosed according to type and severity, and nutritional indications were given, which were recorded in the report to the clinician and in the discharge report. Results: a total of 476 patients took the NRS-2002® test, which detected risk of malnutrition upon admission in 137 (28.8 %; 95 % CI: 24.8 % to 33.0 %). Average BMI (SD) was 24.6 (5.4) kg/m2. The dietitian-nutritionist recommended nutritional supplementation for 78.4 % of patients, and coding of nutritional status (ICD-10) for 82.1 %. In the discharge report, more than 70 % of these recommendations were omitted. Conclusions: in all, 28.8 % of the patients analyzed were at risk of malnutrition or undernourished on admission. Hospital malnutrition continues to be a problem, so it is vitally important that screening methods be included at admission to allow early nutritional intervention in hospitalized patients, and that trained healthcare personnel be incorporated to this end.

INTRODUCCIÓN: Introducción: la malnutrición es un problema global. En los países desarrollados no puede ignorarse la desnutrición debida a las alteraciones en los hábitos alimentarios de la población o a la presencia de enfermedades, lo que afecta de forma destacable a los pacientes hospitalizados. Objetivo: determinar la prevalencia del riesgo de desnutrición al ingreso en el Hospital General Nuestra Señora del Prado de Talavera de la Reina (Toledo, España). Métodos: estudio observacional, transversal y descriptivo. Desde septiembre de 2017 a octubre de 2018, a todos los pacientes que ingresaban en el hospital y cumplían los criterios de selección se les realizó un cribado nutricional mediante el test NRS-2002®. Se recogieron datos antropométricos y clínicos de los pacientes en riesgo nutricional (puntuación NRS-2002® ≥ 3). Se diagnosticó la desnutrición observada según su tipología y gravedad, emitiendo indicaciones nutricionales recogidas en el informe al clínico y en el informe al alta. Resultados: en total, 476 pacientes realizaron el test NRS-2002®, detectándose riesgo de desnutrición al ingreso en 137 (28,8 %; IC 95 %: 24,8 % a 33,0 %). El IMC promedio (DE) de estos fue de 24,6 (5,4) kg/m2. La dietista-nutricionista recomendó al 78,4 % de los pacientes una suplementación nutricional, y en el 82,1 % de los casos la codificación del estado nutricional (CIE-10). En el informe de alta se omitieron más del 70 % de estas recomendaciones. Conclusiones: el 28,8 % de los pacientes analizados estaban en riesgo de desnutrición o desnutridos al ingreso. La desnutrición hospitalaria continúa siendo un problema en la actualidad, por lo que resulta de vital importancia incluir métodos de cribado al ingreso que permitan una intervención nutricional precoz en el paciente hospitalizado, así como la incorporación de personal sanitario formado para su realización.

Associations between Dairy Intake, Body Composition, and Cardiometabolic Risk Factors in Spanish Schoolchildren: The Cuenca Study.

Full-fat dairy has been traditionally associated with obesity and cardiovascular disease (CVD); however, recent evidence shows that the amount of dairy intake might have a beneficial effect over these pathologies, regardless of their fat content. The aim of this study was to examine the association between the intake of dairy products (including milk with different fat contents) with both adiposity and serum lipid concentration, adjusted by cardiorespiratory fitness (CRF), in Spanish schoolchildren. A cross-sectional study of 1088 children, aged 8 to 11 years, was conducted in which anthropometric variables (body mass index (BMI), waist circumference (WC), fat mass percentage (FM%) and fat mass index (FMI)), blood lipid profile, and dairy intake (using a food frequency questionnaire), and CRF (through a 20-m shuttle run test) were measured. Results showed that children with lower BMI, WC, FM%, and FMI had higher whole-fat milk intake and lower skimmed and semi-skimmed milk intake than children with higher BMI, WC, FM%, and FMI. Children with normal levels of triglycerides and high density lipoproteins (HLD) cholesterol consumed more whole-fat milk and less reduced-fat milk than children with dyslipidemic patterns. These relationships persisted after adjustment for CRF. Our findings suggest that full-fat milk intake should be promoted in children without obesity or high cardiometabolic risk.

Movement behaviors and cardiometabolic risk in schoolchildren.

Growing evidence has accumulated in recent years showing that movement behaviors have important implications for health in children, especially for cardiovascular health, whose risk factors could track from childhood to adulthood. However, these findings are mixed and inconsistent in children. The aim of this study was to examine the relationship between different movement behaviors (sedentary behavior, physical activity and sleep duration) and cardiometabolic risk in schoolchildren. The study shows cross-sectional results of baseline measurement from 146 Spanish schoolchildren, aged 8-to-11 years old, participating in the MOVI-2 study. Movement behaviors were determined using accelerometry combined with self-reported sleep time. Cardiometabolic risk was assessed using a validated metabolic syndrome index. Logistic regression analysis showed that higher levels of vigorous physical activity (OR = 0.110, p = 0.004) and sleeping more than 9 hours (OR = 0.269, p = 0.015) could be protective factors against metabolic syndrome risk in children. ANCOVA analysis showed associations between vigorous physical activity and waist circumference (p < 0.001), and sleep time with insulin resistance (p = 0.017) and lipid profile (p = 0.035). No association was observed between light and moderate physical activity, sedentary behavior and metabolic syndrome (index and components). No statistically significant differences were found for blood pressure and any of the movement behaviors. Our data suggest that both the amount of vigorous physical activity accumulated and sleep duration are independently associated with higher cardiometabolic risk in children.

The relationship between socioeconomic status and beverage consumption in children: The Cuenca Study.

INTRODUCTION: beverage consumption constitutes a source of children's daily energy intake. Some authors have suggested that consumption of caloric beverages is higher in children with a low socioeconomic position because families limit their spending on healthy food in order to save money. OBJECTIVE: the aim of this study was to explore the relationship between socioeconomic status and Spanish children's beverage consumption. METHODS: a cross-sectional study was conducted in a sub-sample of 182 children (74 girls) aged 9-11 from the province of Cuenca (Spain). Beverage consumption was assessed using the YANA-C assessment tool, validated for HELENA study. Data for parental socioeconomic status were gathered by using self-reported occupation and education questions answered by parents and classified according to the scale proposed by the Spanish Society of Epidemiology. RESULTS: beverage intake was higher in children belonging to a middle-status family than in those of upper socioeconomic status (p = 0.037). The energy from beverages was similar in most water intake categories, except for water from beverages (p = 0.046). Regarding other beverages categories, middle-status children had higher consumption levels. In contrast, lower status children drank more fruit juices and skimmed milk. All of these do not show statistically significant differences. CONCLUSIONS: our study did not find significant associations between beverages consumption and socioeconomic status in children. In fact, intake for most beverage categories was higher in middle-status children than in both other socioeconomic groups. Future research is needed in order to identify this complex relation between socioeconomic inequality and beverage intake behavior.

The relationship between socioeconomic status and beverage consumption in children: The Cuenca Study / Relación entre el estatus socioeconómico y el consumo de bebidas en niños: Estudio de Cuenca

Introduction: beverage consumption constitutes a source of children's daily energy intake. Some authors have suggested that consumption of caloric beverages is higher in children with a low socioeconomic position because families limit their spending on healthy food in order to save money. Objective: the aim of this study was to explore the relationship between socioeconomic status and Spanish children’s beverage consumption. Methods: a cross-sectional study was conducted in a sub-sample of 182 children (74 girls) aged 9-11 from the province of Cuenca (Spain). Beverage consumption was assessed using the YANA-C assessment tool, validated for HELENA study. Data for parental socioeconomic status were gathered by using self-reported occupation and education questions answered by parents and classified according to the scale proposed by the Spanish Society of Epidemiology. Results: beverage intake was higher in children belonging to a middle-status family than in those of upper socioeconomic status (p = 0.037). The energy from beverages was similar in most water intake categories, except for water from beverages (p = 0.046). Regarding other beverages categories, middle-status children had higher consumption levels. In contrast, lower status children drank more fruit juices and skimmed milk. All of these do not show statistically significant differences. Conclusions: our study did not find significant associations between beverages consumption and socioeconomic status in children. In fact, intake for most beverage categories was higher in middle-status children than in both other socioeconomic groups. Future research is needed in order to identify this complex relation between socioeconomic inequality and beverage intake behavior

Introducción: el consumo de bebidas supone una elevada carga energética en la dieta y algunos autores han sugerido que el consumo de bebidas azucaradas es mayor en niños con un estatus socioeconómico menor, debido a que las familias limitan su gasto en alimentación saludable para ahorrar dinero. Objetivo: el objetivo de este estudio fue analizar la relación entre el estatus socioeconómico y el consumo de bebidas en niños. Material y métodos: estudio transversal en el que se analizó una muestra de 182 niños (74 niñas) de 9-11 años de la provincia de Cuenca (España). El consumo de bebidas se obtuvo mediante el software YANA-C, validado para el estudio HELENA. Los datos de estatus socioeconómico de los padres se obtuvieron mediante un cuestionario autoadministrado de preguntas sobre ocupación y educación, clasificado según la Sociedad Española de Epidemiología. Resultados: el consumo de bebidas fue mayor en niños de estatus socioeconómico medio (p = 0,037) con respecto a los niños de estatus socioeconómico alto. Los mismos datos se obtuvieron para la energía proveniente de las bebidas y en la mayoría de las categorías de agua analizadas, aunque solo fue significativo para el agua proveniente de bebidas (p = 0,046). En cuanto a otras categorías, los niños de estatus socioeconómico medio tienen mayores consumos. En cambio, los niños de estatus socioeconómico bajo reportan mayores ingestas de zumos de frutas y leches desnatadas, sin significación estadística. Conclusiones: nuestro estudio no ha encontrado relaciones significativas entre el consumo de bebidas y el estatus socioeconómico en niños. Los mayores consumos de bebidas se dan en niños con un estatus socioeconómico medio con respecto a los otros dos grupos. Son necesarios más estudios para explorar las complejas relaciones entre el estatus socioeconómico y el consumo de fluidos

Cardiorespiratory Fitness as a Mediator of the Influence of Diet on Obesity in Children.

The association between diet and obesity has been widely studied and it continues to be controversial; however, the extent to which cardiorespiratory fitness (CRF) acts as a confounder or mediator in this relation has not been analyzed. The aim of this study is to examine if the relation between diet and obesity is mediated by CRF. In this cross-sectional study, fat mass (by electronic bioimpedance) was measured in 320 schoolchildren, aged 9-11 years. Diet was measured through two computerised 24-h dietary recalls and CRF was assessed by the 20-m shuttle run test. Simple mediation analyses were fitted. CRF acts as a partial mediator in the negative relationship between dietary factors (energy intake/weight, carbohydrate intake/weight, protein intake/weight, and fat intake/weight) and fat mass. The percentage of mediation ranged from 24.3 to 33.2%. Thus, Spanish schoolchildren with higher levels of energy and macronutrients intake had lower adiposity levels, especially when they had good levels of CRF.

The association between water intake, body composition and cardiometabolic factors among children - The Cuenca study.

INTRODUCTION: Beverage consumption and its possible association with current obesity epidemic and metabolic syndrome is under investigation in recent years, however water intake is probably the most underestimated of all beverages and could play an important role. OBJECTIVE: The aim of this study was to examine the association between water intake, body composition and cardiometabolic factors in a sample of Spanish children. METHODS: A cross-sectional study was conducted in 366 schoolchildren (53.5% girls) aged 9-11 years from the province of Cuenca in Spain. Data of anthropometrics, body composition, cardiometabolic risk factors and ardiorespiratory fi tness variables were collected. Beverage consumption was assessed using two non-consecutive 24 h dietary recalls. RESULTS: We found an inverse association between the consumption of water (ml)/kg per weight with BMI, body fat, fat-free mass, waist circumference, insulin levels, HOMA-IR (p < 0.001), and with arterial pressure parameters, systolic (p < 0.010) and diastolic blood pressure (p < 0.028), and mean arterial pressure (p < 0.012), as well as direct associations with HDL cholesterol (p < 0.001). In ANCOVA analyses, children who drank less water (ml)/kg per weight, had higher levels of LDL cholesterol (p < 0.050) and lower levels of HDL cholesterol (p < 0.042), and overweight-obesity subjects drank less water (ml)/kg per weight than normal peers (p < 0.011). Besides, children with lower levels of HDL cholesterol and higher levels of triglycerides and blood pressure had less water intake as a beverage. Finally, children who drank less water from beverages had high levels of LDL cholesterol. CONCLUSIONS: Higher consumption of water (ml)/kg per weight was negatively associated with BMI, body fat, fat-free mass, waist circumference, insulin levels, HOMA-IR, and positively with HDL cholesterol in children independently of age, sex and cardiorespiratory fi tness. In addition, overweight-obese children drank less water (ml)/kg per weight than normoweight ones. Therefore, water consumption is associated with numerous health benefi ts and its adequate intake could contribute to prevent obesity and metabolic syndrome in childhood.

The association between water intake, body composition and cardiometabolic factors among children - The Cuenca study

Introduction: Beverage consumption and its possible association with current obesity epidemic and metabolic syndrome is under investigation in recent years, however water intake is probably the most underestimated of all beverages and could play an important role. Objective: The aim of this study was to examine the association between water intake, body composition and cardiometabolic factors in a sample of Spanish children. Methods: A cross-sectional study was conducted in 366 schoolchildren (53.5% girls) aged 9-11 years from the province of Cuenca in Spain. Data of anthropometrics, body composition, cardiometabolic risk factors and cardiorespiratory fitness variables were collected. Beverage consumption was assessed using two non-consecutive 24 h dietary recalls. Results: We found an inverse association between the consumption of water (ml)/kg per weight with BMI, body fat, fat-free mass, waist circumference, insulin levels, HOMA-IR (p < 0.001), and with arterial pressure parameters, systolic (p < 0.010) and diastolic blood pressure (p < 0.028), and mean arterial pressure (p < 0.012), as well as direct associations with HDL cholesterol (p < 0.001). In ANCOVA analyses, children who drank less water (ml)/kg per weight, had higher levels of LDL cholesterol (p < 0.050) and lower levels of HDL cholesterol (p < 0.042), and overweight-obesity subjects drank less water (ml)/kg per weight than normal peers (p < 0.011). Besides, children with lower levels of HDL cholesterol and higher levels of triglycerides and blood pressure had less water intake as a beverage. Finally, children who drank less water from beverages had high levels of LDL cholesterol. Conclusions: Higher consumption of water (ml)/kg per weight was negatively associated with BMI, body fat, fat-free mass, waist circumference, insulin levels, HOMA-IR, and positively with HDL cholesterol in children independently of age, sex and cardiorespiratory fitness. In addition, overweight-obese children drank less water (ml)/kg per weight than normo-weight ones. Therefore, water consumption is associated with numerous health benefits and its adequate intake could contribute to prevent obesity and metabolic syndrome in childhood (AU)

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ASSOCIATIONS BETWEEN ENERGY AND FAT INTAKES WITH ADIPOSITY IN SCHOOLCHILDREN - THE CUENCA STUDY.

INTRODUCTION: the relationship between changes in energy intake (EI) over the last few decades and the trends towards of excess weight in children is still debated. OBJECTIVE: to examine the relationship between energy and macronutrient intakes with adipostity in children, controlling for cardiorespiratory fitness (CRF) as a surrogate measure of physical activity. METHOD: we conducted a cross-sectional study of 320 schoolchildren aged 9-11 years (54.5% girls). We collected data on socio-demographic variables, and measured weight, height, waist circumference (WC), and fat mass percentage by bioimpedance analysis. Fat mass index (FMI) was calculated as fat mass (kg) divided by height (m) squared, to adjust for body size. Energy (kcal) and macronutrient intake (percentages) were measured by two non-consecutive 24-h recalls (weekday and weekend day), using the Young Adolescents' Nutrition Assessment on Computer (YANA-C) software program; CRF was measured by the 20-m shuttle run test. RESULTS: boys in the 4th quartile of the WC distribution had lower fat intake (34.9%) than boys in the 1st (42.4%; p = 0.019) and 2nd quartiles (41.6%; p = 0.022). Children in the 1st quartile of the FMI distribution had higher daily EIs than children in the 4th quartile (1762.3 kcal vs. 1496.8 kcal; p = 0.023). All macronutrient intakes relative to weight were lower in children in the more adipose categories for weight status, WC and FMI (p < 0.001). CONCLUSION: adiposity was inversely related to energy and fat intakes. Excessive EI and high EI from fats not appears to be directly associated with the current obesity epidemic among schoolchildren living in Cuenca (Spain).

Introducción: la relación entre los cambios en la ingesta energética en las últimas décadas y el incremento en las cifras de obesidad en niños está aún en debate. Objetivo: examinar la asociación entre la ingesta energética y de macronutrientes con diferentes medidas de adiposidad en niños, controlando por resistencia cardiorrespiratoria como una medida sustituta de la actividad física. Método: se realizó un estudio observacional sobre 320 escolares de entre 9 y 11 años (54,5% niñas). Se tomó información sobre variables sociodemográficas y se midió peso, altura, perímetro de cintura y porcentaje de masa grasa a través de bioimpedancia. El índice de masa grasa fue calculado dividiendo la masa grasa (en kg) entre la altura al cuadrado (en m), para ajustar por el tamaño corporal. La ingesta energética y el porcentaje de macronutrientes fueron medidos con dos recordatorios de 24-h en días no consecutivos (entre semana y fin de semana), empleando el software Young Adolescents' Nutrition Assessment on Computer (YANA-C); el fitness cardiorrespiratorio fue medido a través del test de 20 metros de ida y vuelta. Resultados: los niños en el cuarto cuartil de perímetro de cintura tienen una ingesta de grasas menor (34,9%) que los chicos en el primer (42,4%; p = 0,019) y segundo cuartil (41,6%; p = 0,022). Los escolares en el primer cuartil de índice de masa grasa tienen mayor ingesta energética total que los escolares del cuarto cuartil (1762,3 kcal vs. 1496,8 kcal; p = 0,023). Las ingestas de macronutrientes relativas al peso son menores en los sujetos de las categorías más altas de estatus ponderal, perímetro de cintura e índice de masa corporal (p < 0,001). Conclusión: la adiposidad está inversamente asociada con las ingestas energética y de grasas. Una excesiva ingesta energética y de grasas no parece estar directamente asociada con la actual epidemia de obesidad de los escolares de Cuenca (España).

Associations between energy and fat intakes with adiposity in schoolchildren - the Cuenca Study / Asociación entre la ingesta energética y de grasas y la adiposidad en escolares - Estudio Cuenca

Introduction: the relationship between changes in energy intake (EI) over the last few decades and the trends towards of excess weight in children is still debated. Objective: to examine the relationship between energy and macronutrient intakes with adipostity in children, controlling for cardiorespiratory fitness (CRF) as a surrogate measure of physical activity. Method: we conducted a cross-sectional study of 320 schoolchildren aged 9-11 years (54.5% girls). We collected data on socio-demographic variables, and measured weight, height, waist circumference (WC), and fat mass percentage by bioimpedance analysis. Fat mass index (FMI) was calculated as fat mass (kg) divided by height (m) squared, to adjust for body size. Energy (kcal) and macronutrient intake (percentages) were measured by two non-consecutive 24-h recalls (weekday and weekend day), using the Young Adolescents’ Nutrition Assessment on Computer (YANA-C) software program; CRF was measured by the 20-m shuttle run test. Results: boys in the 4th quartile of the WC distribution had lower fat intake (34.9%) than boys in the 1st (42.4%; p = 0.019) and 2nd quartiles (41.6%; p = 0.022). Children in the 1st quartile of the FMI distribution had higher daily EIs than children in the 4th quartile (1762.3 kcal vs. 1496.8 kcal; p = 0.023). All macronutrient intakes relative to weight were lower in children in the more adipose categories for weight status, WC and FMI (p <0.001). Conclusion: adiposity was inversely related to energy and fat intakes. Excessive EI and high EI from fats not appears to be directly associated with the current obesity epidemic among schoolchildren living in Cuenca (Spain) (AU)

Introducción: la relación entre los cambios en la ingesta energética en las últimas décadas y el incremento en las cifras de obesidad en niños está aún en debate. Objetivo: examinar la asociación entre la ingesta energética y de macronutrientes con diferentes medidas de adiposidad en niños, controlando por resistencia cardiorrespiratoria como una medida sustituta de la actividad física. Método: se realizó un estudio observacional sobre 320 escolares de entre 9 y 11 años (54,5% niñas). Se tomó información sobre variables sociodemográficas y se midió peso, altura, perímetro de cintura y porcentaje de masa grasa a través de bioimpedancia. El índice de masa grasa fue calculado dividiendo la masa grasa (en kg) entre la altura al cuadrado (en m), para ajustar por el tamaño corporal. La ingesta energética y el porcentaje de macronutrientes fueron medidos con dos recordatorios de 24-h en días no consecutivos (entre semana y fin de semana), empleando el software Young Adolescents’ Nutrition Assessment on Computer (YANA-C); el fitness cardiorrespiratorio fue medido a través del test de 20 metros de ida y vuelta. Resultados: los niños en el cuarto cuartil de perímetro de cintura tienen una ingesta de grasas menor (34,9%) que los chicos en el primer (42,4%; p = 0,019) y segundo cuartil (41,6%; p = 0,022). Los escolares en el primer cuartil de índice de masa grasa tienen mayor ingesta energética total que los escolares del cuarto cuartil (1762,3 kcal vs. 1496,8 kcal; p = 0,023). Las ingestas de macronutrientes relativas al peso son menores en los sujetos de las categorías más altas de estatus ponderal, perímetro de cintura e índice de masa corporal (p <0.001). Conclusión: la adiposidad está inversamente asociada con las ingestas energética y de grasas. Una excesiva ingesta energética y de grasas no parece estar directamente asociada con la actual epidemia de obesidad de los escolares de Cuenca (España) (AU)

The relationship between beverage intake and weight status in children: the Cuenca study.

INTRODUCTION: Beverage consumption is becoming more important in current research regarding its possible association with the childhood obesity epidemic. The influence of physical activity on fluid intake has been poorly studied, and cardiorespiratory fitness (CRF) may be a reliable marker for this type of assessment. The present study analysed beverage intake related to weight, adjusted by CRF, in children aged 9 to 11 years. METHODS: A cross-sectional, school-based study was conducted on 373 children, aged 9 to 11 years, from the Cuenca province in Spain. To obtain beverage consumption we averaged two 24-h recalls, collected using the YANA-C assessment tool, validated for HELENA study. CRF was assessed by the 20-m shuttle run test. RESULTS: Fluid intake was 1483.39 mL/day, and energy ascribed to fluids was 16% of total energy intake. Beverages were 40% of total sugar intake from diet. The largest amount of fluid consumed among thinness boys came from fruit juices and milk drinks. Thinner girls consumed more diet drinks and whole milk than their normal and overweight counterparts, after adjusting for age and CRF. CONCLUSIONS: Overweight-obese boys consumed less fruit juices and milk drinks and girls ingested less diet drinks and whole milk than their normal-weight counterparts. These results suggest the importance of investigating the hydration habits of children to draw reliable conclusions about the best way to hydrate in different situations to avoid adiposity increases.

Introducción: El consumo de bebidas está cobrando mayor importancia en las investigaciones actuales en relación a una posible asociación con la epidemia de obesidad infantil. La influencia de la actividad física en este consumo de fluidos ha sido escasamente estudiada y la resistencia cardiorespiratoria (RCR) puede resultar un marcador fiable para su valoración. Nuestro estudio analiza la ingesta de fluidos y su relación con el estatus ponderal ajustado por RCR en niños de 9-11 años. Métodos: Estudio transversal en el que participaron 373 niños de 9-11 años de colegios de la provincia de Cuenca (España). Para obtener la ingesta de bebidas, se realizó la media de dos recordatorios de 24 horas obtenidos mediante el programa YANA-C, validado para el estudio HELENA. La condición física cardiorrespiratoria fue evaluada a través del test de 20 metros ida y vuelta. Resultados: La ingesta media de líquidos fue de 1483,39 ml/día, y la energía proveniente de fluidos supone un 16% del aporte energético diario. Las bebidas suponen el 40% del aporte de azúcares ingeridos en la dieta. Las bebidas más consumidas en niños son los zumos naturales y las bebidas lácteas. Las niñas delgadas consumen más leches enteras y bebidas refrescantes "light" que sus homólogas con peso normal y sobrepeso-obesidad. Conclusiones: Los niños con exceso de peso consumen menos zumos naturales y bebidas lácteas, y las niñas consumen menos leches enteras y bebidas refrescantes "light" que sus compañeras en normopeso. Es de gran importancia revisar los hábitos de hidratación de los escolares para establecer conclusiones fiables sobre cuál es la mejor forma de hidratarse en diferentes situaciones para evitar ganancias ponderales.

The relationship between beverage intake and weight status in children: the Cuenca study / Relación entre la ingesta de bebidas y el estatus ponderal en niños: estudio Cuenca

Introduction: Beverage consumption is becoming more important in current research regarding its possible association with the childhood obesity epidemic. The influence of physical activity on fluid intake has been poorly studied, and cardiorespiratory fitness (CRF) may be a reliable marker for this type of assessment. The present study analysed beverage intake related to weight, adjusted by CRF, in children aged 9 to 11 years. Methods: A cross-sectional, school-based study was conducted on 373 children, aged 9 to 11 years, from the Cuenca province in Spain. To obtain beverage consumption we averaged two 24-h recalls, collected using the YANA-C assessment tool, validated for HELENA study. CRF was assessed by the 20-m shuttle run test. Results: Fluid intake was 1483.39 mL/day, and energy ascribed to fluids was 16% of total energy intake. Beverages were 40% of total sugar intake from diet. The largest amount of fluid consumed among thinness boys came from fruit juices and milk drinks. Thinner girls consumed more diet drinks and whole milk than their normal and overweight counterparts, after adjusting for age and CRF. Conclusions: Overweight-obese boys consumed less fruit juices and milk drinks and girls ingested less diet drinks and whole milk than their normal-weight counterparts. These results suggest the importance of investigating the hydration habits of children to draw reliable conclusions about the best way to hydrate in different situations to avoid adiposity increases (AU)

Introducción: El consumo de bebidas está cobrando mayor importancia en las investigaciones actuales en relación a una posible asociación con la epidemia de obesidad infantil. La influencia de la actividad física en este consumo de fluidos ha sido escasamente estudiada y la resistencia cardiorespiratoria (RCR) puede resultar un marcador fiable para su valoración. Nuestro estudio analiza la ingesta de fluidos y su relación con el estatus ponderal ajustado por RCR en niños de 9-11 años. Métodos: Estudio transversal en el que participaron 373 niños de 9-11 años de colegios de la provincia de Cuenca (España). Para obtener la ingesta de bebidas, se realizó la media de dos recordatorios de 24 horas obtenidos mediante el programa YANA-C, validado para el estudio HELENA. La condición física cardiorrespiratoria fue evaluada a través del test de 20 metros ida y vuelta. Resultados: La ingesta media de líquidos fue de 1483,39 ml/día, y la energía proveniente de fluidos supone un 16% del aporte energético diario. Las bebidas suponen el 40% del aporte de azúcares ingeridos en la dieta. Las bebidas más consumidas en niños son los zumos naturales y las bebidas lácteas. Las niñas delgadas consumen más leches enteras y bebidas refrescantes "light" que sus homólogas con peso normal y sobrepeso-obesidad. Conclusiones: Los niños con exceso de peso consumen menos zumos naturales y bebidas lácteas, y las niñas consumen menos leches enteras y bebidas refrescantes "light" que sus compañeras en normopeso. Es de gran importancia revisar los hábitos de hidratación de los escolares para establecer conclusiones fiables sobre cuál es la mejor forma de hidratarse en diferentes situaciones para evitar ganancias ponderales (AU)

[Food habits and nutritional assessment in a university population]. / Hábitos alimentarios y evaluación nutricional en una población universitaria.

INTRODUCTION: The university students are in critical period for the development of life styles which are very important for their future health. The eating behaviour of other students, the alcohol consumption, their economic situation and the ability of cooking make them change their dietary habits. In Spain there are a few studies on the quality of the diet in this population group. Most of them show Spanish students diet does not follow an adequate Mediterranean dietary pattern. OBJECTIVES: To describe the dietary habits of a population of university students and to assess the quality of their diet. METHODS: Cross sectional study conducted on a sample of 80 students from the Faculty of Nursing of Albacete (University of Castilla-La Mancha). Nine 24-hours follow-ups questionnaires were self-administered in three different seasons. The quality of the diet was assessed by the IAS and the MDS2. In all tests a level of significance p < 0.05 was considered. RESULTS AND DISCUSSION: Students diet is slightly low in calories. The contribution of the macronutrients to the total daily energy intake showed a diet high in protein (17%), lacking in carbohydrates (40%) and high in saturated fat and cholesterol. The consumption of simple sugars is almost the double of the recommended amount. Meat products are the main source of fat while fish accounts for only 3,1%. The intake of meat and dairy products is much higher than the one of other Mediterranean university students. More than 91% of the students need "diet changes" in order to acquire healthier dietary patterns. Adherence to the Mediterranean diet was only 53%.

Introducción: Los estudiantes universitarios se encuentran en un periodo crítico para el desarrollo de estilos de vida que tienen mucha importancia en su futura salud, ya que la influencia en el comportamiento alimentario de los compañeros, el consumo de alcohol, su situación económica y la habilidad para cocinar hacen que cambien sus hábitos de alimentación. Los pocos estudios en España sobre calidad de la dieta en este grupo de población reflejan mayoritariamente un inadecuado seguimiento del patrón mediterráneo. Objetivos: Caracterizar los hábitos alimentarios en una población de estudiantes universitarios y evaluar la calidad de su dieta. Métodos: Estudio transversal de una muestra de 80 estudiantes de la Facultad de Enfermería de Albacete (Universidad de Castilla-La Mancha). Los datos se recogieron mediante 9 recordatorios de 24 horas autoadministrados en tres periodos estacionales. El IAS y el MDS2 han sido usados como indicadores de la calidad de la dieta. En todas las pruebas el nivel de significación utilizado fue de 0,05. Resultados y discusión: La dieta de los estudiantes es ligeramente hipocalórica. La contribución de los macronutrientes a la energía total diaria la definen como hiperproteica (17%), pobre en hidratos de carbono, alrededor del 40%, casi duplica las recomendaciones de azúcares simples y es alta en grasa saturada y colesterol. La principal fuente de grasa son los alimentos cárnicos, mientras que el grupo del pescado sólo representa el 3,1%. La ingesta de cárnicos y lácteos supera ampliamente a la de poblaciones universitarias en otros países mediterráneos europeos. Más del 91% de los estudiantes se encuentra en una situación de «necesidad de cambios en la dieta¼ hacia patrones más saludables. La adherencia a la dieta mediterránea fue sólo del 53%.

Hábitos alimentarios y evaluación nutricional en una población universitaria / Food habits and nutritional assessment in a university population

Introducción: Los estudiantes universitarios se encuentran en un periodo crítico para el desarrollo de estilos de vida que tienen mucha importancia en su futura salud, ya que la influencia en el comportamiento alimentario de los compañeros, el consumo de alcohol, su situación económica y la habilidad para cocinar hacen que cambien sus hábitos de alimentación. Los pocos estudios en España sobre calidad de la dieta en este grupo de población reflejan mayoritariamente un inadecuado seguimiento del patrón mediterráneo. Objetivos: Caracterizar los hábitos alimentarios en una población de estudiantes universitarios y evaluar la calidad de su dieta. Métodos: Estudio transversal de una muestra de 80 estudiantes de la Facultad de Enfermería de Albacete (Universidad de Castilla-La Mancha). Los datos se recogieron mediante 9 recordatorios de 24 horas autoadministrados en tres periodos estacionales. El IAS y el MDS2 han sido usados como indicadores de la calidad de la dieta. En todas las pruebas el nivel de significación utilizado fue de 0,05. Resultados y discusión: La dieta de los estudiantes es ligeramente hipocalórica. La contribución de los macronutrientes a la energía total diaria la definen como hiperproteica (17%), pobre en hidratos de carbono, alrededor del 40%, casi duplica las recomendaciones de azúcares simples y es alta en grasa saturada y colesterol. La principal fuente de grasa son los alimentos cárnicos, mientras que el grupo del pescado sólo representa el 3,1%. La ingesta de cárnicos y lácteos supera ampliamente a la de poblaciones universitarias en otros países mediterráneos europeos. Más del 91% de los estudiantes se encuentra en una situación de "necesidad de cambios en la dieta" hacia patrones más saludables. La adherencia a la dieta mediterránea fue sólo del 53% (AU)

Introduction: The university students are in critical period for the development of life styles which are very important for their future health. The eating behaviour of other students, the alcohol consumption, their economic situation and the ability of cooking make them change their dietary habits. In Spain there are a few studies on the quality of the diet in this population group. Most of them show Spanish students' diet does not follow an adequate Mediterranean dietary pattern. Objectives: To describe the dietary habits of a population of university students and to assess the quality of their diet. Methods: Cross sectional study conducted on a sample of 80 students from the Faculty of Nursing of Albacete (University of Castilla-La Mancha). Nine 24-hours follow-ups questionnaires were self-administered in three different seasons. The quality of the diet was assessed by the IAS and the MDS2. In all tests a level of significance p < 0.05 was considered. Results and discussion: Students' diet is slightly low in calories. The contribution of the macronutrients to the total daily energy intake showed a diet high in protein (17%), lacking in carbohydrates (40%) and high in saturated fat and cholesterol. The consumption of simple sugars is almost the double of the recommended amount. Meat products are the main source of fat while fish accounts for only 3,1%. The intake of meat and dairy products is much higher than the one of other Mediterranean university students. More than 91% of the students need "diet changes" in order to acquire healthier dietary patterns. Adherence to the Mediterranean diet was only 53% (AU)

Cirugía bariátrica mediante la técnica del cruce duodenal: evolución ponderal y deficiencias nutricionales asociadas / Bariatric surgery in duodenal switch procedure: weight changes and associated nutritional deficiencies

Introducción La cirugía bariátrica mediante la técnica del cruce duodenal está considerada como uno de los tratamientos más efectivos para conseguir la pérdida de peso y la disminución de comorbilidades en pacientes obesos mórbidos. Derivada de su práctica se pueden producir deficiencias nutricionales que debemos conocer y tratar. Objetivos Valoración de la pérdida de peso y del desarrollo de síndromes carenciales en pacientes obesos mórbidos sometidos a cirugía bariátrica mediante la técnica del cruce duodenal. Material y métodos Se ha estudiado la evolución de 128 pacientes obesos mórbidos sometidos a cirugía bariátrica mediante la técnica del cruce duodenal en el Hospital General Universitario de Albacete. Se realizaron controles ponderales y de las deficiencias nutricionales más relevantes surgidas tras la intervención. Resultados El peso corporal desciende de manera acusada desde un índice de masa corporal (IMC) promedio de 52,9±7,7kg/m2 (40,7-78,5) hasta un IMC de 30,8±5,2kg/m2, con un porcentaje de exceso de peso perdido (%EPP) de 81,4±16,4% a los 18 meses tras la intervención. La pérdida de peso se ralentiza en el seguimiento posterior, llegando a su valor más bajo a los 30 meses postintervención (%EPP del 82,1±16,8; IMC de 30,2±4,3kg/m2) y tiende a estabilizarse en los pacientes con seguimiento más prolongado. Las deficiencias nutricionales más significativas que requirieron tratamiento sustitutivo se detectaron en algunos micronutrientes como el hierro (42,9%), zinc (38,3%) y vitaminas liposolubles A (55,5%) y D (57,8%), entre otros. Conclusiones El tratamiento de la obesidad mórbida mediante cruce duodenal es una técnica muy efectiva para conseguir una importante pérdida de peso de forma mantenida. La elevada presencia de déficits nutricionales durante el seguimiento obliga a realizar revisiones periódicas de forma indefinida (AU)

Introduction: Bariatric surgery using the technique of duodenal switch is considered as one of the most effective treatments to lose weight and decrease comorbidity in morbidly obese patients. However, we have to be familiar with and adequately manage the various nutritional deficiencies that may occur as a consequence of its practice.Objectives: To assess weight loss and development of nutritional deficiencies in morbidly obesepatients undergoing bariatric surgery through the duodenal switch procedure. Material and methods: One hundred and twenty-eight morbidly obese patients underwent aduodenal switch procedure at Hospital General Universitario in Albacete. Weight changes and the most important nutritional deficiencies occurring after surgery were recorded. Results: Median follow-up time was 30 months (interquartile range, 18 months). Body weightmarkedly decreased, with mean body mass index (BMI) decreasing from a preoperative value of 52.9±7.7 kg/m2 to 30.8±5.2 kg/m2 18 months after surgery. The percentage of excess weight lost (% EWL) was 81.4±16.4% in this period. Weight loss slowed down subsequently, reaching its lowest value 30 months after surgery (% EWL 82.1%±16.8, BMI 30.2±4.3 kg/m2) and tended tostabilize in patients with longer follow-up times. Significant nutritional deficiencies requiring replacement therapy were detected in some micronutrients with iron (42.9%), zinc (38.3%),vitamin A (55.5%), and vitamin D (57.8%) deficiencies being most relevant.Conclusions: Duodenal switch is a very effective surgical procedure for treating morbidly obesepatients because it allows for achieving a significant and sustained weight loss.Close lifetimemonitoring is required in these patients because of the high prevalence of nutritional deficiencies during follow-up (AU)

[Bariatric surgery in duodenal switch procedure: weight changes and associated nutritional deficiencies]. / Cirugía bariátrica mediante la técnica del cruce duodenal: evolución ponderal y deficiencias nutricionales asociadas.

INTRODUCTION: Bariatric surgery using the technique of duodenal switch is considered as one of the most effective treatments to lose weight and decrease comorbidity in morbidly obese patients. However, we have to be familiar with and adequately manage the various nutritional deficiencies that may occur as a consequence of its practice. OBJECTIVES: To assess weight loss and development of nutritional deficiencies in morbidly obese patients undergoing bariatric surgery through the duodenal switch procedure. MATERIAL AND METHODS: One hundred and twenty-eight morbidly obese patients underwent a duodenal switch procedure at Hospital General Universitario in Albacete. Weight changes and the most important nutritional deficiencies occurring after surgery were recorded. RESULTS: Median follow-up time was 30 months (interquartile range, 18 months). Body weight markedly decreased, with mean body mass index (BMI) decreasing from a preoperative value of 52.9±7.7kg/m(2) to 30.8±5.2kg/m(2) 18 months after surgery. The percentage of excess weight lost (% EWL) was 81.4±16.4% in this period. Weight loss slowed down subsequently, reaching its lowest value 30 months after surgery (% EWL 82.1%±16.8, BMI 30.2±4.3kg/m(2)) and tended to stabilize in patients with longer follow-up times. Significant nutritional deficiencies requiring replacement therapy were detected in some micronutrients with iron (42.9%), zinc (38.3%), vitamin A (55.5%), and vitamin D (57.8%) deficiencies being most relevant. CONCLUSIONS: Duodenal switch is a very effective surgical procedure for treating morbidly obese patients because it allows for achieving a significant and sustained weight loss.Close lifetime monitoring is required in these patients because of the high prevalence of nutritional deficiencies during follow-up.