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1.
J Clin Med ; 13(5)2024 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-38592073

RESUMO

Background: Malnutrition is an underdiagnosed condition that negatively affects the clinical outcomes of patients, being associated with an increased risk of adverse events, increased hospital stay, and higher mortality. Therefore, nutritional assessment is a required and necessary process in patient care. The objective of this study was to identify the factors associated with nutritional risk by applying the Malnutrition Universal Screening Tool (MUST) scale in a population of critically ill patients. Methods: This was an observational, analytical, and retrospective study. Sociodemographic, clinical, hematological, and biochemical variables and their relationship with nutritional risk and mortality were analyzed. Results: Of 630 patients, the leading cause of admission was pathologies of the circulatory and respiratory system (50%); 28.4% were at high nutritional risk; and mortality was 11.6% and associated with nutritional risk, hemoglobin, and plasma urea nitrogen. Conclusions: The presence of gastrointestinal symptoms and the type of nutritional support received during hospitalization could increase the likelihood of presenting a medium/high nutritional risk, while polycythemia reduced this probability. An associative model was found to determine nutritional risk with an adequate specificity and diagnostic validity index.

2.
Midwifery ; 129: 103908, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38142650

RESUMO

OBJECTIVE: To determine the influence of pre-pregnancy maternal BMI and increases in maternal weight during pregnancy on perinatal and child outcomes at birth and at 5 years. RESEARCH DESIGN/SETTING: A prospective cohort study was conducted between November 2016 and December 2021. The participants were a total of 115 women-child dyads, selected from among pregnant women receiving routine prenatal care in different health centres belonging to 2 health districts. Follow-ups were conducted with the women during pregnancy and with their children during the 10 days after birth and at 5 years. FINDINGS: The total weight gain during pregnancy is influenced by an inadequate pre-pregnancy BMI (0.03; 95 % CI, 0.004 - 0.25; P=.001) and a greater increase in maternal BMI during the first and second term of pregnancy. A greater increase in BMI during pregnancy was associated with higher breastfeeding rates both in the short term (1.21; 95 % CI, 1.01-1.44; P = 0.04) and the long term (12 months: 1.30; 95 % CI, 1.02 - 1.67; P = 0.04; 24 months: 1.30; 95 % CI, 1.02 - 1.69; P = 0.04). No links were found between gains in maternal weight and the weight of the newborn, nor between maternal weight and/or pre-pregnancy BMI with the nutritional status of the child. KEY CONCLUSIONS: After studying these results, it was concluded that promoting and implementing health and education policies focused on enhancing maternal nutritional status is essential to improve the nutritional status of children. IMPLICATIONS FOR PRACTICE: Healthy gestational weight gain (GWG) is an important issue to be addressed by the midwife in primary care, both in the preconception period and throughout pregnancy. As a result, it is important that the midwife is trained and has the appropriate resources and tools to work with pregnant women individually and collectively. In addition to paying attention to overweight and obese pregnant women, the midwife should also pay attention to women with a normal BMI, as they seem to have greater difficulty in maintaining a healthy weight gain. Another line of intervention to be addressed is breastfeeding (BF), where the midwife should be the main point of reference from the beginning of this process, taking into account the relationship between BMI and BF.


Assuntos
Ganho de Peso na Gestação , Recém-Nascido , Feminino , Gravidez , Humanos , Estado Nutricional , Estudos Prospectivos , Índice de Massa Corporal , Aumento de Peso , Sobrepeso , Peso ao Nascer
3.
Nutrients ; 15(23)2023 Nov 23.
Artigo em Inglês | MEDLINE | ID: mdl-38068749

RESUMO

Cervical cancer is a global public health problem. It is the second leading cause of death among women of childbearing age worldwide. Several factors, including diet, have been shown to influence the risk of persistent HPV infection and tumor progression. This paper determines the relationship between dietary patterns and cervical cancer. It is an ecological study of multiple groups, based on two national sources: the High-Cost Account and the National Survey of Nutritional Situation of Colombia of 2015. The population consisted of 3472 women aged 35 to 64. The incidence of cervical cancer was used as the dependent variable while the independent variables included food consumption according to established patterns, area of residence, age, physical activity, and BMI, among other variables. The statistical analysis performed through associations between variables was evaluated by multiple linear regression using R2. 38.9% of the evaluated population belonged to the first quartile of wealth, and 76.5% resided in the municipal capital. The incidence of cervical cancer in Colombia was associated with being affiliated to a state-subsidized health regime and having diabetes mellitus. A conservative eating pattern, as well as belonging to a rural area, are evidenced as protective factors. These results invite the need to encourage public policies and promote healthy lifestyles.


Assuntos
Neoplasias do Colo do Útero , Humanos , Feminino , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/prevenção & controle , Neoplasias do Colo do Útero/etiologia , Colômbia/epidemiologia , Dieta/efeitos adversos , Comportamento Alimentar
4.
J Clin Med ; 12(22)2023 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-38002657

RESUMO

Background: Metabolic syndrome (MetS) is a group of metabolic abnormalities characterised by central obesity, hypertension, dyslipidaemia, and dysregulation of blood glucose, which is associated with the risk of diabetes, cardiovascular disease, and overall mortality. White blood cell count is a selective marker of acute infection and inflammation, which could provide information on the metabolic status of subjects. This study aims to provide the best evidence on the association between MetS and white blood cell count by determining the effect size of this biomarker. Methods: A systematic review and meta-analysis of studies indexed in the PubMed and Scopus databases were performed. Methodological quality was assessed using the STROBE tool, overall risk of bias using RevMan (Cochrane Collaboration), and quality of evidence using Grade Pro. Results: We included 14 articles comparing leukocyte concentrations in 21,005 subjects with MetS and 66,339 controls. Subjects with MetS had a higher mean leukocyte count, 0.64 cells ×109/L; CI95% 0.55-0.72; p < 0.00001; I2 = 93%. Conclusions: An in-depth evaluation of the relationship of leukocytes in the pathophysiological process of MetS could lead to new insights into early diagnosis.

5.
Diabetol Metab Syndr ; 15(1): 220, 2023 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-37899468

RESUMO

BACKGROUND: Metabolic syndrome (MetS) is a group of metabolic abnormalities characterised by hypertension, central obesity, dyslipidaemia and dysregulation of blood glucose, associated with the risk of diabetes, cardiovascular disease and overall mortality. The presence of elevated liver enzymes may precede the development of MetS, with alterations of the liver being observed that are directly related to metabolic problems. The study aims to provide the best evidence on the association between liver enzymes (ALT, AST, GGT) and MetS by determining the effect size of these biomarkers. METHODS: A systematic review and meta-analysis of studies indexed in PubMed and Scopus databases were performed. Study quality was assessed using the STROBE tool. The Grade Pro tool was used to evaluate the evidence, and the quantitative synthesis was performed using RevMan (Cochrane Collaboration). RESULTS: Seventeen articles comparing liver enzyme concentrations between 76,686 with MetS (MetS+) and 201,855 without MetS (MetS-) subjects were included. The concentration of ALT, AST and GGT in the MetS + subjects was significantly higher than in the control group 7.13 IU/L (CI95% 5.73-8.54; p < 0.00001; I2 = 96%), 2.68 IU/L (CI95% 1.82-3.54; p < 0.00001; I2 = 96%) and 11.20 IU/L (CI95% 7.11-15.29; p < 0.00001; I2 = 96%), respectively. CONCLUSIONS: The evaluation of the relationship of liver enzymes in the pathophysiological process of MetS could lead to new insights into early diagnosis.

6.
JMIR Public Health Surveill ; 9: e43737, 2023 09 05.
Artigo em Inglês | MEDLINE | ID: mdl-37669095

RESUMO

BACKGROUND: Metabolic syndrome (MetS) is a constellation of risk factors increasingly present in the world's population. People with this syndrome are at an increased risk of cardiovascular disease and type 2 diabetes mellitus. Moreover, evidence has shown that it affects different organs. MetS and its risk factors are independently associated with impaired lung function, which can be quantified through spirometric variables. OBJECTIVE: This study aims to determine whether a high number of MetS criteria is associated with increased lung function decline. METHODS: We conducted a descriptive cross-sectional study with a random sample of 1980 workers. Workers with acute respiratory pathology (eg, influenza), chronic respiratory pathology (eg, chronic bronchitis), or exposure to substances harmful to the lungs (eg, organic and inorganic dust) were not included. MetS was established based on harmonized criteria, and lung function was assessed according to spirometric variables. On the basis of these, classification into restrictive lung disease (RLD), obstructive lung disease, and mixed lung disease (MLD) was performed. In addition, the association between MetS and lung function was established based on analysis of covariance, linear trend analysis, and multiple linear regression. RESULTS: MetS was associated with worse lung function according to all the spirometric parameters analyzed (percentage of predicted forced expiratory volume in 1 second: mean 83, SD 13.8 vs mean 89.2, SD 12.8; P<.001 and percentage of predicted forced vital capacity: mean 85.9, SD 11.6 vs mean 92, SD 11.3; P<.001). Moreover, those diagnosed with MetS had a higher prevalence of lung dysfunction (41% vs 21.9%; P<.001), RLD (23.4% vs 11.2%; P<.001), and MLD (7.3% vs 2.2%; P<.001). Furthermore, an increasing number of MetS criteria was associated with a greater impairment of pulmonary mechanics (P<.001). Similarly, with an increasing number of MetS criteria, there was a significant linear trend (P<.001) in the growth of the prevalence ratio of RLD (0 criteria: 1, 1: 1.46, 2: 1.52, 3: 2.53, 4: 2.97, and 5: 5.34) and MLD (0 criteria: 1, 1: 2.68, 2: 6.18, 3: 9.69, and 4: 11.37). Regression analysis showed that the alteration of all MetS risk factors, adjusted for various explanatory variables, was significantly associated with a worsening of spirometric parameters, except for forced expiratory volume in 1 second/forced vital capacity. CONCLUSIONS: The findings have shown that an increase in cardiometabolic risk factors is associated with a more significant worsening of spirometric variables and a higher prevalence of RLD and MLD. As spirometry could be a crucial tool for monitoring patients at risk of developing chronic pathologies, we conclude that this inexpensive and easily accessible test could help detect changes in lung function in patients with cardiometabolic disorders. This highlights the need to consider the importance of cardiometabolic health in lung function when formulating public health policies.


Assuntos
Doenças Cardiovasculares , Diabetes Mellitus Tipo 2 , Pneumopatias , Síndrome Metabólica , Humanos , Síndrome Metabólica/complicações , Síndrome Metabólica/epidemiologia , Estudos Transversais , Fatores de Risco , Pulmão
7.
J Clin Med ; 12(13)2023 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-37445212

RESUMO

Intensive care unit (ICU) hospitalization involves critically ill patients with multiple diseases and possible complications, including malnutrition, which increases hospital stay and mortality. Therefore, identifying the patient's prior nutritional state, following up during hospitalization, and implementing early intervention positively affect patient's vital situations at discharge. The objective of this study is to determine the nutritional state of patients admitted to an ICU in Cali (Colombia) in 2019 and its association with immunological and biochemical parameters and mortality observed during hospitalization. This was an observational, analytical, and retrospective study of patients admitted to an ICU in a clinic in Cali (Colombia) from 1 January to 31 March 2019. The association between their nutritional state and outcome variables such as hospital stay, immunological and biochemical function, and mortality was analyzed. Logistic regression was used to predict patients' vital status at hospital discharge. In terms of the nutritional level, low weight was observed in 17.5% patients, and overweight/obesity was observed in 53.5% of the population. Nutritional state was associated with leukocytosis. The patients with lymphocytosis had longer hospital stays than those with normal lymphocyte ranges. Age, blood leukocytes, and creatinine and potassium levels increased the risk of mortality. Lymphocyte values have been used as predictors of severity and hospitalization time. The scientific literature has also evidenced a higher leukocyte count in people with obesity, and such leukocytosis is associated with the risk of mortality. The results of blood and laboratory tests determining kidney function and blood electrolytes allow for the prediction of mortality risk in critically ill patients.

8.
Nutrients ; 15(9)2023 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-37432184

RESUMO

The selection of food depends on various factors such as cultural, social, economic and biological. This paper determines the factors associated with dietary patterns in Colombia. It is an observational, descriptive exploratory study collecting secondary data from the National Survey of Nutritional Status of Colombia (ENSIN, 2015) of 16,216 people between 15 and 64 years of age. The variables were the following: area, age range, sex, educational level, high blood pressure arterial hypertension (HTA), diabetes (DM), cancer, wealth quartile and dietary pattern. For the data analysis, logistic regression models were generated for each pattern and OR was used as a measure of association. Of those studied, 74.6% live in urban areas, all were aged between 15 and 49 years and 45.4% were in the first wealth quartile (Q1). There was a greater probability of traditional and conservative dietary patterns in people with diabetes and hypertension. Consumption of the conservative pattern was associated with being a woman, while consumption of the traditional pattern was associated with people in the first and second wealth level. Consumption of grill/beverage was more likely in men. Socio-demographic factors and chronic non-communicable diseases are associated with dietary patterns. This makes it relevant for health professionals to take into account these characteristics for nutritional interventions.


Assuntos
Bebidas , Hipertensão , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Colômbia/epidemiologia , Análise de Dados , Escolaridade , Hipertensão/epidemiologia
9.
Pediatr Res ; 94(5): 1824-1831, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37308682

RESUMO

BACKGROUND: A variable percentage of children and adolescents with obesity do not have cardiometabolic comorbidities. A phenotype called metabolically healthy obese (MHO) has emerged to describe this population subgroup. Early identification of this condition may prevent the progression to metabolically unhealthy obesity (MUO). MATERIAL AND METHODS: A cross-sectional descriptive study of 265 children and adolescents from Cordoba (Spain) conducted in 2018. The outcome variables were MHO, established based on three criteria: International Criterion, HOMA-IR, and a combination of the previous two. RESULTS: The prevalence of MHO ranged from 9.4% to 12.8% of the study population, between 41% and 55.7% of the sample with obesity. The highest agreement was reached between the HOMA-IR definitions and the combined criteria. The waist-to-height ratio (WHtR) was the indicator with the highest discriminant capacity for MHO in 2 of the three criteria, with its best cut-off point at 0.47 for both. CONCLUSION: The prevalence of MHO in children and adolescents differed according to the criteria used for diagnosis. The anthropometric variable with the most remarkable discriminating capacity for MHO was WHtR, with the same cut-off point in the three criteria analysed. IMPACT STATEMENT: This research work defines the existence of metabolically healthy obesity through anthropometric indicators in children and adolescents. Definitions that combine cardiometabolic criteria and insulin resistance are used to identify metabolically healthy obesity, as well as the prediction of this phenomenon through anthropometric variables. The present investigation helps to identify metabolically healthy obesity before metabolic abnormalities begin.


Assuntos
Doenças Cardiovasculares , Resistência à Insulina , Síndrome Metabólica , Obesidade Metabolicamente Benigna , Obesidade Pediátrica , Humanos , Criança , Adolescente , Obesidade Metabolicamente Benigna/diagnóstico , Obesidade Metabolicamente Benigna/epidemiologia , Estudos Transversais , Obesidade/diagnóstico , Obesidade/epidemiologia , Fenótipo , Síndrome Metabólica/epidemiologia , Índice de Massa Corporal , Obesidade Pediátrica/diagnóstico , Obesidade Pediátrica/epidemiologia , Fatores de Risco
10.
Int J Med Inform ; 175: 105089, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-37172506

RESUMO

BACKGROUND: Technological health tools (e-Health) may potentially facilitate the treatment of patients with chronic diseases through development of self-management and -care skills in patients and caregivers. However, these tools are usually marketed without prior analysis and without providing any context to final users, which frequently results in low adherence to their use. PURPOSE: To determine the usability of and satisfaction toward a mobile app for the clinical monitoring of patients with chronic obstructive pulmonary disease (COPD) receiving oxygen therapy at home. METHODS: This was a participative-qualitative study focused on final users-with direct intervention by patients and professionals-consisting of three phases as follows: (i) medium-fidelity mockups design, (ii) development of a usability test for each user profile, and (iii) assessment of the satisfaction level regarding the usability of the mobile app. A sample was established and selected through non-probability convenience sampling and was divided into two groups as follows: healthcare professionals (n = 13) and patients (n = 7). Each participant received a smartphone with mockup designs. The "think-aloud" method was applied in the usability test. Participants were audio recorded and the anonymous transcriptions were analyzed, highlighting fragments about mockups characteristics and the usability test. The difficulty level of the tasks was assessed with a scale from 1 (very easy) to 5 (too difficult), and task non-completion was considered a critical mistake. The satisfaction level related to test usability was assessed with a 4-score Likert scale ranging from 4 (totally agree) to 1 (totally disagree). RESULTS: Regarding the difficulty level, >60% of professionals described most tasks as "very easy" and 70% of patients as "easy." No participant made critical mistakes and both groups reported a high satisfaction level regarding the usability variables. The patient and professionals group required 18 and 11 min to complete all tasks, respectively. CONCLUSIONS: Participants described the app as intuitive and easy to use. The usability satisfaction results show a high level of satisfaction for both groups. This positive assessment and performance in user tests showed that the mobile application was able to be apprehended and used by participants in the circumstances of use in the usability tests. Usability evaluation through satisfaction surveys and qualitative data analysis allows for greater insight into the use of mobile applications in healthcare.


Assuntos
Aplicativos Móveis , Doença Pulmonar Obstrutiva Crônica , Humanos , Seguimentos , Smartphone , Doença Pulmonar Obstrutiva Crônica/terapia , Oxigênio
11.
J Clin Med ; 12(9)2023 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-37176636

RESUMO

BACKGROUND: The coexistence of malnutrition due to over- and under-nutrition in the Peruvian Amazon increases chronic diseases and cardiovascular risk. METHODS: A cross-sectional study of a male population where anthropometric, clinical, and demographic variables were obtained to create a binary logistic regression predictive model of cardiovascular risk. RESULTS: We compared two methods with good predictive results, finally choosing Model 4 (r2 = 0.57, sensitivity 73.68%, specificity 95.35%, Youden index 0.69, and validity index 94.21), with non-invasive variables such as blood pressure (p < 0.001), hip circumference (p < 0.001), and FINDRISC test result (p < 0.05); Conclusions: We developed a cheap, fast, and non-invasive tool to determine cardiovascular risk in the population of this endemic area.

12.
Pain Manag Nurs ; 24(5): 535-541, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37248125

RESUMO

BACKGROUND: Physical activity's established health benefits include pain control, yet there is no consensus on the required dosage according to the literature. AIM: To test the influence of exercise on perceived health in patients whose daily activities are limited due to pain. Besides, analyze the possible moderating effect of age and find a formula for exercise dosage based on the perceived level of health. METHODS: Cross-sectional study based on the 2017 Spanish National Health Survey with 4,123 participants reporting activity limitations in their daily activities due to pain. The International Physical Activity Questionnaire (short version) was used to calculate energy expenditure. Data included age, sex, leisure-time physical activity, sitting time, pain-related impairments, pain medication, and perceived health. Mediation regression analysis was conducted using the SPSS PROCESS 4.0 macro. RESULTS: Results indicate a decline in perceived health with age. The relationship between exercise (energy expenditure) and perceived health was highly significant (d=-0.224, p<0.001). Age moderated the association between pain and energy expenditure up to 75.61 years (0.1568, p=0.05) and between energy expenditure and perceived health up to 75.74 years (-0.289, p=0.05), but this effect diminished afterwards. A formula was developed to estimate energy expenditure based on the desired level of health. CONCLUSIONS: The perception of health in people who are limited in their daily activities due to pain (moderate to very much) is mediated by the amount of physical activity they perform. Besides, this perception is moderated by age, up to 76 years.


Assuntos
Exercício Físico , Dor , Humanos , Idoso , Estudos Transversais
13.
Metabolites ; 13(2)2023 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-36837911

RESUMO

The pediatric population has various criteria for measuring metabolic syndrome (MetS). The diversity of consensus for diagnosis has led to different non-comparable reported prevalence. Given the increase in its prevalence in pediatric ages, it is necessary to develop efficient methods to encourage early detection. Consequently, early screening for the risk of MetS could favor timely action in preventing associated comorbidities in adulthood. This study aimed to establish the diagnostic capacity of models that use non-invasive (anthropometric) and invasive (serum biomarkers) variables for the early detection of MetS in Chilean children. A cross-sectional study was carried out on 220 children aged 6 to 11. Multivariate logistic regressions and discriminant analyses were applied to determine the diagnostic capacity of invasive and non-invasive variables. Based on these results, four diagnostic models were created and compared: (i) anthropometric, (ii) hormonal (insulin, leptin, and adiponectin), (iii) Lipid A (high-density cholesterol lipoprotein [HDL-c] and triglycerides [TG]) and (iv) Lipid B (TG/HDL-c). The prevalence of MetS was 26.8%. Lipid biomarkers (HDL-c and TG) and their ratio (TG/HDL-c) presented higher diagnostic capacity, above 80%, followed by body mass index (BMI, 0.71-0.88) and waist-to-height ratio (WHtR, 0.70-0.87). The lipid model A was the most accurate (sensitivity [S] = 62.7%, specificity [E] = 96.9%, validity index 87.7%), followed by the anthropometric model (S = 69.5%, E = 88.8% and validity index = 83.6%). In conclusion, detecting MetS was possible through invasive and non-invasive methods tested in overweight and obese children. The proposed models based on anthropometric variables, or serum biomarkers of the lipid model A, presented acceptable validity indices. Moreover, they were higher than those that measured adipokines, leptin, and adiponectin. The anthropometric model was the most cost-effective and easy to apply in different environments.

14.
Nutrients ; 14(24)2022 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-36558548

RESUMO

Background: The traditional therapeutic approach has perceived the role of nutrition as a minor intervention in psychiatry. The microbiota−gut−brain axis theory evidences the influence of dietary and nutritional patterns on mental health. Aims: To evidence the impact of dietary advice on increasing symbiotic intake on nutritional status and dietary habits in individuals with schizophrenia spectrum disorders. Methods: Randomised clinical trial (two-arm, double-blind, balanced-block, six-month intervention) in 50 individuals diagnosed with schizophrenia spectrum disorders. The control group received conventional dietary advice on an individual basis. A personal nutritional education programme was established in the intervention group (IG) to increase prebiotic and probiotic intake through dietary advice (dairy and fermented foods, green leafy vegetables, high-fibre fruit, whole grains, etc.). Data on nutritional status and dietary habits were collected (baseline and six months). The degree of dietary adherence to the recommended patterns was recorded weekly. Anthropometric parameters were also analysed monthly. Results: Finally, 44 subjects completed the follow-up. All participants exceeded the dietary reference intakes. The overall and intra-group analysis showed a statistically significant (p < 0.05) reduction in macro and micronutrient intakes with a closer approximation to the recommended dietary intakes, except for polyunsaturated fatty acids, oligosaccharides, polysaccharides and dietary fibre. After six months of intervention, statistical differences (p < 0.001) were found in all variables of the anthropometric profile in the IG, as well as an increase in the consumption of foods with a high symbiotic content (at baseline and six months). Likewise, a reduction in eggs, meat, fish, sugars and ultra-processed foods was evident, leading to significant intra-group differences (p < 0.05). Conclusions: Implementing conventional nutritional education strategies and specific nutritional advice with a symbiotic effect improves the dietary-nutritional profile in patients with schizophrenia spectrum disorders. Furthermore, it highlights the nutritional impact on mental health, stating itself as adjuvant therapy for physical health and lifestyle improvement.


Assuntos
Enfermagem Psiquiátrica , Esquizofrenia , Humanos , Animais , Dieta , Comportamento Alimentar , Promoção da Saúde , Esquizofrenia/terapia
15.
Front Nutr ; 9: 962054, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36466409

RESUMO

Approximately one-third of overweight individuals, and half of those with obesity, do not have cardiometabolic disorders. For this reason, a phenotype called metabolically healthy obese (MHO) has emerged to describe this population group. The early detection of this situation could save costs associated with the development of comorbidities or pharmacological interventions. Therefore, the aim is to know the prevalence of MHO in the working population and propose variables for its detection. Cross-sectional descriptive study of 635 workers of the Cordoba City Council was carried out based on the results of the 2016 health surveillance. The outcome variables were the MHO, established based on the criteria of the IDF, NCEP-ATP III, and Aguilar-Salinas. In addition, the degree of agreement between the different MHO criteria was studied using Cohen's kappa (k), and the predictive capacity of the anthropometric variables was assessed with Receiver Operator Curves. The prevalence of MHO ranged from 6.6 to 9%. The highest agreement was reached between the IDF and NCEP-ATP III definitions (k = 0.811; 95% CI 0.724-0.898; p < 0.001). The waist-to-height ratio (WHtR) showed the highest discriminant capacity for MHO, with its best cut-off point at 0.55 for all criteria used. Sensitivity ranged from 84 to 93%. The prevalence of MHO in the working population differed according to the criteria used for diagnosis. The anthropometric variable with the highest discriminant capacity for MHO was WHtR, presenting the same cut-off point in the three criteria analyzed. Therefore, WHtR is the variable that best detects the presence of MHO.

16.
BMC Psychiatry ; 22(1): 781, 2022 12 12.
Artigo em Inglês | MEDLINE | ID: mdl-36510155

RESUMO

BACKGROUND: The development of new aetiological premises, such as the microbiota-gut-brain axis theory, evidences the influence of dietary and nutritional patterns on mental health, affecting the patient's quality of life in terms of physical and cardiovascular health. The aim was to determine the impact of a nutritional programme focused on increasing the intake of prebiotic and probiotic food on cardio-metabolic status in individuals with schizophrenia spectrum disorders in the contextual setting of the SARS-CoV-2 era. METHODS: A randomised clinical trial (two-arm, double-blind, balanced-block, six-month intervention) was conducted in a group of 50 individuals diagnosed with schizophrenia spectrum disorder during the SARS-CoV-2 confinement period. The control group received conventional dietary counselling on an individual basis. In the intervention group, an individual nutritional education programme with a high content of prebiotics and probiotics (dairy and fermented foods, green leafy vegetables, high-fibre fruit, whole grains, etc.) was established. Data on cardiovascular status were collected at baseline, three and six months. In addition, anthropometric parameters were analysed monthly. RESULTS: Forty-four subjects completed follow-up and were analysed. Statistical differences (p < 0.05) were found in all anthropometric variables at baseline and six months of intervention. A 27.4% reduction in the prevalence of metabolic syndrome risk factors in all its components was evidenced, leading to a clinically significant improvement (decrease in cardiovascular risk) in the intervention group at six months. CONCLUSIONS: The development of a nutritional programme focused on increasing the dietary content of prebiotics and probiotics effectively improves the cardio-metabolic profile in schizophrenia spectrum disorders. Therefore, nursing assumes an essential role in the effectiveness of dietary interventions through nutritional education and the promotion of healthy lifestyles. Likewise, nursing acquires a relevant role in interdisciplinary coordination in confinement contexts. TRIAL REGISTRATION: The study protocol complied with the Declaration of Helsinki for medical studies; the study received ethical approval from referral Research Ethics Committee in November 2019 (reg. no. 468) and retrospectively registered in clinicaltrials.gov (NCT04366401. First Submitted: 28th April 2020; First Registration: 25th June 2020).


Assuntos
COVID-19 , Esquizofrenia , Humanos , SARS-CoV-2 , Prebióticos , Esquizofrenia/terapia , Qualidade de Vida , Metaboloma
17.
Sci Rep ; 12(1): 18412, 2022 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-36319728

RESUMO

This systematic review and meta-analysis aim to provide the best evidence on the association between metabolic syndrome (MetS) and uric acid (UA) by determining the size of the effect of this biomarker on MetS. The review protocol is registered with PROSPERO (CRD42021231124). The search covered the PubMed and Scopus databases. Methodological quality was assessed with the STROBE tool, overall risk of bias with RevMan (Cochrane Collaboration) and quality of evidence with Grade Pro. Initially, 1582 articles were identified. Then, after excluding duplicates and reviewing titles and abstracts, 1529 articles were excluded from applying the eligibility criteria. We included 43 papers (56 groups) comparing UA concentrations between subjects 91,845 with MetS and 259,931 controls. Subjects with MetS had a higher mean UA of 0.57 mg/dl (95% CI 0.54-0.61) (p < 0.00001). Given the heterogeneity of the included studies, the researchers decided to perform subgroups analysis. Men with MetS have a higher UA concentration mg/dl 0.53 (95% CI 0.45-0.62, p < 0.00001) and women with MetS 0.57 (95% CI 0.48-0.66, p < 0.00001) compared to subjects without MetS. Assessment of UA concentration could provide a new avenue for early diagnosis of MetS, as a new biomarker and the possibility of new therapeutic targets.


Assuntos
Síndrome Metabólica , Ácido Úrico , Masculino , Humanos , Feminino , Biomarcadores
18.
Nutr Hosp ; 39(6): 1325-1332, 2022 Dec 20.
Artigo em Espanhol | MEDLINE | ID: mdl-36373650

RESUMO

Introduction: Introduction: evidence has shown a relationship between obesity and binge eating disorder (BED) as well as differences in dietary pattern. The objective was to establish the risk of BED in nutrition and dietetics consultations (N&D) and its relationship with dietary pattern. Methods: a cross-sectional study in 113 people who attended the N&D clinic to lose weight. They completed the BES questionnaire, a food consumption frequency questionnaire, and anthropometric measurements were taken. A descriptive analysis of the variables was performed, and an attempt was made to establish a relationship between the different explanatory variables and risk of BED. Results: 35.3 % of subjects were at risk for BED. The variables that showed significant differences for risk of BED were sex (p = 0.047), BMI (p < 0.001), previous diagnosis of eating disorder (p = 0.002), cabrohydrate intake higher than recommendations (p < 0.001), and protein intake lower or equal than recommendations (p < 0.001). In the adjusted logistic regression model the variables finally included were BMI, OR = 1.2 (95 % CI, 0.8-1.4, p = 0.02), cabrohydrate intake higher than recommendations, OR = 1.4 (95 % CI, 0.1-2.8, p = 0.02), and protein intake lower or equal than recommendations, OR = 1.2 (95 % CI, 0.4-4.1, p = 0.04). Conclusion: the risk of BED in overweight patients who come to consult for weight loss is high. There is a relationship between this risk and dietary pattern. Other similar studies are required.


Introducción: Introducción: la evidencia ha mostrado relación entre la obesidad y el trastorno por atracones (TPA) y diferencias en el patrón dietético. El objetivo fue establecer el riesgo de TPA en las consultas de nutrición y dietética (NyD) y su relación con el patrón dietético. Métodos: estudio transversal sobre 113 personas que acudieron a consulta de NyD para perder peso. Se seleccionaron aquellas que acudían a su primera consulta. Cumplimentaron el cuestionario Binge Eating Scale (BES), un cuestionario de frecuencia de consumo de alimentos, y se tomaron medidas antropométricas. Se realizó el análisis descriptivo de las variables y se trató de establecer una asociación entre las diferentes variables explicativas con el riesgo de TPA. Resultados: el 35,3 % de los individuos presentaron riesgo de TPA. Las variables que mostraron diferencias significativas para el riesgo de TPA fueron el sexo (p = 0,047), el IMC (p < 0,001), el diagnóstico previo de TCA (p = 0,002), la ingesta de carbohidratos superior a las recomendaciones (p < 0,001) y la ingesta de proteínas igual o inferior a las recomendaciones (p < 0,001). En el modelo de regresión logística ajustado, las variables incluidas finalmente fueron: IMC, OR = 1,2 (IC 95 %: 0,8-1,4; p = 0,02); ingesta de carbohidratos superior a las recomendaciones, OR = 1,4 (IC 95 %: 0,1-2,8; p = 0,02); e ingesta de proteínas igual o inferior a las recomendaciones, OR = 1,2 (IC 95 %: 0,4-4,1; p = 0,04). Conclusión: el riesgo de TPA en los pacientes con sobrepeso que acuden a consulta para pérdida de peso es elevado. Existe relación entre este riesgo y el patrón dietético. Es necesario realizar otros trabajos similares..


Assuntos
Transtorno da Compulsão Alimentar , Dietética , Humanos , Estudos Transversais , Obesidade , Estado Nutricional
19.
Nutr. hosp ; 39(6): 1325-1332, nov.-dic. 2022. tab
Artigo em Espanhol | IBECS | ID: ibc-214840

RESUMO

Introducción: la evidencia ha mostrado relación entre la obesidad y el trastorno por atracones (TPA) y diferencias en el patrón dietético. El objetivo fue establecer el riesgo de TPA en las consultas de nutrición y dietética (NyD) y su relación con el patrón dietético. Métodos: estudio transversal sobre 113 personas que acudieron a consulta de NyD para perder peso. Se seleccionaron aquellas que acudían a su primera consulta. Cumplimentaron el cuestionario Binge Eating Scale (BES), un cuestionario de frecuencia de consumo de alimentos, y se tomaron medidas antropométricas. Se realizó el análisis descriptivo de las variables y se trató de establecer una asociación entre las diferentes variables explicativas con el riesgo de TPA. Resultados: el 35,3 % de los individuos presentaron riesgo de TPA. Las variables que mostraron diferencias significativas para el riesgo de TPA fueron el sexo (p = 0,047), el IMC (p < 0,001), el diagnóstico previo de TCA (p = 0,002), la ingesta de carbohidratos superior a las recomendaciones (p < 0,001) y la ingesta de proteínas igual o inferior a las recomendaciones (p < 0,001). En el modelo de regresión logística ajustado, las variables incluidas finalmente fueron: IMC, OR = 1,2 (IC 95 %: 0,8-1,4; p = 0,02); ingesta de carbohidratos superior a las recomendaciones, OR = 1,4 (IC 95 %: 0,1-2,8; p = 0,02); e ingesta de proteínas igual o inferior a las recomendaciones, OR = 1,2 (IC 95 %: 0,4-4,1; p = 0,04). Conclusión: el riesgo de TPA en los pacientes con sobrepeso que acuden a consulta para pérdida de peso es elevado. Existe relación entre este riesgo y el patrón dietético. Es necesario realizar otros trabajos similares. (AU)


Introduction: evidence has shown a relationship between obesity and binge eating disorder (BED) as well as differences in dietary pattern. The objective was to establish the risk of BED in NUTRITION and dietetics consultations (N&D) and its relationship with dietary pattern. Methods: a cross-sectional study in 113 people who attended the N&D clinic to lose weight. They completed the BES questionnaire, a food consumption frequency questionnaire, and anthropometric measurements were taken. A descriptive analysis of the variables was performed, and an attempt was made to establish a relationship between the different explanatory variables and risk of BED. Results: 35.3 % of subjects were at risk for BED. The variables that showed significant differences for risk of BED were sex (p = 0.047), BMI (p < 0.001), previous diagnosis of eating disorder (p = 0.002), cabrohydrate intake higher than recommendations (p < 0.001), and protein intake lower or equal than recommendations (p < 0.001). In the adjusted logistic regression model the variables finally included were BMI, OR = 1.2 (95 % CI, 0.8-1.4, p = 0.02), cabrohydrate intake higher than recommendations, OR = 1.4 (95 % CI, 0.1-2.8, p = 0.02), and protein intake lower or equal than recommendations, OR = 1.2 (95 % CI, 0.4-4.1, p = 0.04). Conclusion: the risk of BED in overweight patients who come to consult for weight loss is high. There is a relationship between this risk and dietary pattern. Other similar studies are required. (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Transtorno da Compulsão Alimentar , Dietética , Estudos Transversais , Estado Nutricional , Obesidade , Sobrepeso
20.
Front Nutr ; 9: 912783, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36034912

RESUMO

Background/Objectives: The microbiota plays a vital role in the two-way communication between the gastrointestinal tract and numerous neuropsychiatric disorders, such as schizophrenia. Besides, the microbiota modulation through the use of psychobiotics (prebiotics and probiotics with nutraceutical action) is related to the improvement of the physical and psychopathological health. The objective to this study was to test the efficacy of prebiotic/probiotic dietary modulation in patients diagnosed with schizophrenia, attending to the nutritional and cardio-metabolic impact. Methods: Two-arms, double-blind, randomized in balanced blocks clinical trial of 6 months of intervention, will be developed in a group of 50 individuals. The control group will receive conventional dietary advice individually from specialized mental health nurses. In the intervention group, an individual dietetic-nutritional education program with high prebiotic and probiotic content (dairy and fermented foods, green leafy vegetables, high-fiber fruit, whole grains, etc.) will be developed by these nurses. Data will be collected on the psychopathological state, and blood test (at the beginning, at 3 and 6 months). The estimation of intestinal microbiota and the usual nutritional pattern will also be assessed at the beginning and 6 months, using a stool test. To evaluate the degree of adherence, the intervention group will fill a specific weekly record of the main dishes/food consumed. Anthropometric parameters will also be analyzed monthly. Discussion: The study is anticipated to establish feasibility an adequate dietary modulation with a high simbiotic content, leads to a significant improvement in the nutritional status and cardio-metabolic. Furthermore, it is presumed to reach a degree of evidence that allows establishing nutritional management as an effective therapeutic intervention in the psychopathological treatment of patients with schizophrenia spectrum disorders. Clinical Trial Registration: [www.ClinicalTrials.gov], identifier [NCT04366401].

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