AVONET: morphological, ecological and geographical data for all birds.

Functional traits offer a rich quantitative framework for developing and testing theories in evolutionary biology, ecology and ecosystem science. However, the potential of functional traits to drive theoretical advances and refine models of global change can only be fully realised when species-level information is complete. Here we present the AVONET dataset containing comprehensive functional trait data for all birds, including six ecological variables, 11 continuous morphological traits, and information on range size and location. Raw morphological measurements are presented from 90,020 individuals of 11,009 extant bird species sampled from 181 countries. These data are also summarised as species averages in three taxonomic formats, allowing integration with a global phylogeny, geographical range maps, IUCN Red List data and the eBird citizen science database. The AVONET dataset provides the most detailed picture of continuous trait variation for any major radiation of organisms, offering a global template for testing hypotheses and exploring the evolutionary origins, structure and functioning of biodiversity.

Impact of Routine and Long-Term Follow-Up on Weight Loss after Bariatric Surgery.

BACKGROUND: Weight loss after bariatric surgery varies among patients. Patients who do not complete long-term follow-up are considered to loose less weight than those with regular follow-up visits. OBJECTIVE: To evaluate the influence of patients' follow-up compliance on long-term excess weight loss (%EWL) and total weight loss (%TWL) after bariatric surgery, comparing results between gastric bypass (GB) and sleeve gastrectomy (SG). METHODS: Patients with up to 5 years of follow-up data after bariatric surgery were included in this retrospective analysis. Patients were divided in 2 groups: those in group 1 who had attended every scheduled postoperative appointment and those in group 2 who had been lost to follow-up before 1 year and were later contacted by telephone. %EWL and %TWL were compared to determine the possible relationship between type of surgery and regularity of the follow-up. RESULTS: A total of 385 patients were included. A significant difference in EWL was observed at 5 years in the SG group (78% for group 1 versus 39% for group 2; p = 0.02) and GB group (75% for group 1 versus 62% for group 2; p = 0.01). No significant differences between surgeries were found when comparing long-term EWL in group 1 patients 77% for SG versus 75% for GB. For group 2 patients, GB achieved greater EWL than SG; p = 0.005. %TWL patients in group 2 showed significant differences in all periods of study (p < 0.05). CONCLUSION: Bariatric surgery patients who attended all scheduled follow-up appointments experienced significantly greater long-term EWL and TWL than those who did not. GB has apparent increased benefits for weight loss in long-term follow-up when compared with SG for patients who did not attend long-term follow-up. Therefore, continued long-term follow-up of bariatric patients should be encouraged to increase postoperative weight loss results.

Role of ghrelin isoforms in the mitigation of hepatic inflammation, mitochondrial dysfunction, and endoplasmic reticulum stress after bariatric surgery in rats.

BACKGROUND/OBJECTIVES: Bariatric surgery improves nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH), but the underlying mechanisms remain elusive. We evaluated the potential role of ghrelin isoforms in the amelioration of hepatic inflammation after sleeve gastrectomy and Roux-en-Y gastric bypass (RYGB). SUBJECTS/METHODS: Plasma ghrelin isoforms were measured in male Wistar rats (n = 129) subjected to surgical (sham operation, sleeve gastrectomy, or RYGB) or dietary interventions [fed ad libitum a normal (ND) or a high-fat diet (HFD) or pair-fed diet]. The effect of acylated and desacyl ghrelin on markers of inflammation, mitochondrial dysfunction, and endoplasmic reticulum (ER) stress in primary rat hepatocytes under palmitate-induced lipotoxic conditions was assessed. RESULTS: Plasma desacyl ghrelin was decreased after sleeve gastrectomy and RYGB, whereas the acylated/desacyl ghrelin ratio was augmented. Both surgeries diminished obesity-associated hepatic steatosis, CD68+- and apoptotic cells, proinflammatory JNK activation, and Crp, Tnf, and Il6 transcripts. Moreover, a postsurgical amelioration in the mitochondrial DNA content, oxidative phosphorylation (OXPHOS) complexes I and II, and ER stress markers was observed. Specifically, following bariatric surgery GRP78, spliced XBP-1, ATF4, and CHOP levels were reduced, as were phosphorylated eIF2α. Interestingly, acylated and desacyl ghrelin inhibited steatosis and inflammation of palmitate-treated hepatocytes in parallel to an upregulation of OXPHOS complexes II, III, and V, and a downregulation of ER stress transducers IRE1α, PERK, ATF6, their downstream effectors, ATF4 and CHOP, as well as chaperone GRP78. CONCLUSIONS: Our data suggest that the increased relative acylated ghrelin levels after bariatric surgery might contribute to mitigate obesity-associated hepatic inflammation, mitochondrial dysfunction, and ER stress.

Theory, simulation and experiments for precise deflection control of radiotherapy electron beams.

Conventional radiotherapy is mainly applied by linear accelerators. Although linear accelerators provide dual (electron/photon) radiation beam modalities, both of them are intrinsically produced by a megavoltage electron current. Modern radiotherapy treatment techniques are based on suitable devices inserted or attached to conventional linear accelerators. Thus, precise control of delivered beam becomes a main key issue. This work presents an integral description of electron beam deflection control as required for novel radiotherapy technique based on convergent photon beam production. Theoretical and Monte Carlo approaches were initially used for designing and optimizing device´s components. Then, dedicated instrumentation was developed for experimental verification of electron beam deflection due to the designed magnets. Both Monte Carlo simulations and experimental results support the reliability of electrodynamics models used to predict megavoltage electron beam control.

Role of aquaporin-7 in ghrelin- and GLP-1-induced improvement of pancreatic ß-cell function after sleeve gastrectomy in obese rats.

BACKGROUND/OBJECTIVES: Glycerol is a key metabolite for lipid accumulation in insulin-sensitive tissues as well as for pancreatic insulin secretion. We examined the role of aquaporin-7 (AQP7), the main glycerol channel in ß-cells, and AQP12, an aquaporin related to pancreatic damage, in the improvement of pancreatic function and steatosis after sleeve gastrectomy in diet-induced obese rats. SUBJECTS/METHODS: Male Wistar obese rats (n=125) were subjected to surgical (sham operation and sleeve gastrectomy) or dietary (pair-fed to the amount of food eaten by sleeve-gastrectomized animals) interventions. The tissue distribution and expression of AQPs in the rat pancreas were analyzed by real-time PCR, western blotting and immunohistochemistry. The effect of ghrelin isoforms and glucagon-like peptide 1 (GLP-1) on insulin secretion, triacylglycerol (TG) accumulation and AQP expression was determined in vitro in RIN-m5F ß-cells. RESULTS: Sleeve gastrectomy reduced pancreatic ß-cell apoptosis, steatosis and insulin secretion. Lower ghrelin and higher GLP-1 concentrations were also found after bariatric surgery. Acylated and desacyl ghrelin increased TG content, whereas GLP-1 increased insulin release in RIN-m5F ß-cells. Sleeve gastrectomy was associated with an upregulation of AQP7 together with a normalization of the increased AQP12 levels in the rat pancreas. Interestingly, ghrelin and GLP-1 repressed AQP7 and AQP12 expression in RIN-m5F ß-cells. AQP7 protein was negatively correlated with intracellular lipid accumulation in acylated ghrelin-treated cells and with insulin release in GLP-1-stimulated ß-cells. CONCLUSIONS: AQP7 upregulation in ß-cells after sleeve gastrectomy contributes, in part, to the improvement of pancreatic steatosis and insulin secretion by increasing intracellular glycerol used for insulin release triggered by GLP-1 rather than for ghrelin-induced TG biosynthesis.

Dissociation of body mass index, excess weight loss and body fat percentage trajectories after 3 years of gastric bypass: relationship with metabolic outcomes.

BACKGROUND/OBJECTIVES: Body weight, body mass index (BMI) and excess weight loss (EWL) are the most frequently used measures to analyse bariatric surgery outcomes. However, these measurements do not provide accurate information on body composition (BC) with body fat (BF), importantly determining the levels of cardiometabolic risk factors. Our aim was to analyse the evolution of BC after Roux-en-Y Gastric Bypass (RYGB) and its influence on the changes of cardiometabolic risk factors in comparison to BMI and EWL. SUBJECTS/METHODS: A group of 81 obese Caucasian patients (19 males/62 females) aged 44.9±1.3 years undergoing RYGB between January 2006 and December 2011 was prospectively followed up for a period of 3 years. BC was determined by air-displacement plethysmography. Visceral adiposity, physical activity and cardiometabolic risk factors were measured. RESULTS: BF was markedly (P<0.001) reduced after the first year, increasing progressively during the second and third years after RYGB, following a different trajectory than body weight, BMI and EWL that decreased up to the second year post surgery. Markers of glucose homeostasis decreased during the first month and continued to decrease during the first year (P<0.05), remaining stabilised or slightly increased between the second and third years following RYGB. However, markers of lipid metabolism decreased (P<0.05) markedly during the first 12 months, increasing thereafter in parallel to the changes observed in BC, with the exception of high-density lipoprotein-cholesterol, which increased progressively throughout the whole period analysed. CONCLUSIONS: The adverse switch in the changes in BC between the first and the second years after RYGB may underlie the changes observed in cardiometabolic risk factors. Tracking of adiposity during the follow-up of bariatric/metabolic surgery yields clinically relevant information to better identify patients in need of increased lifestyle advice or treatment intensification.

Guanylin and uroguanylin stimulate lipolysis in human visceral adipocytes.

BACKGROUND/OBJECTIVES: Uroguanylin and guanylin are secreted by intestinal epithelial cells as prohormones postprandially and act on the hypothalamus to induce satiety. The impact of obesity and obesity-associated type 2 diabetes (T2D) on proguanylin and prouroguanylin expression/secretion as well as the potential role of guanylin and uroguanylin in the control of lipolysis in humans was evaluated. SUBJECTS/METHODS: Circulating and gastrointestinal expression of proguanylin (GUCA2A) and prouroguanylin (GUCA2B) were measured in 134 subjects. In addition, plasma proguanylin and prouroguanylin were measured before and after weight loss achieved either by Roux-en-Y gastric bypass (RYGB) (n=24) or after a conventional diet (n=15). The effect of guanylin and uroguanylin (1-100 nmol l(-1)) on lipolysis was determined in vitro in omental adipocytes. RESULTS: Circulating concentrations of prouroguanylin, but not proguanylin, were decreased in obesity in relation to adiposity. Weight loss achieved by RYGB increased plasma proguanylin and prouroguanylin. Obese T2D individuals showed higher expression of intestinal GUCA2A as well as of the receptors of the guanylin system, GUCY2C and GUCY2D, in omental adipocytes. The incubation with guanylin and uroguanylin significantly stimulated lipolysis in differentiated omental adipocytes, as evidenced by hormone-sensitive lipase phosphorylation at Ser563, an increase in fatty acids and glycerol release together with an upregulation of several lipolysis-related genes, including AQP3, AQP7, FATP1 or CD36. CONCLUSIONS: Both guanylin and uroguanylin trigger lipolysis in human visceral adipocytes. Given the lipolytic action of the guanylin system on visceral adipocytes, the herein reported decrease of circulating prouroguanylin concentrations in obese patients may have a role in excessive fat accumulation in obesity.

Reduced hepatic aquaporin-9 and glycerol permeability are related to insulin resistance in non-alcoholic fatty liver disease.

BACKGROUND/OBJECTIVES: Glycerol represents an important metabolite for the control of lipid accumulation and hepatic gluconeogenesis. We investigated whether hepatic expression and functionality of aquaporin-9 (AQP9), a channel mediating glycerol influx into hepatocytes, is impaired in non-alcoholic fatty liver disease (NAFLD) and steatohepatitis (NASH) in the context of insulin resistance. SUBJECTS/METHODS: Liver biopsies were obtained from 66 morbid obese patients undergoing bariatric surgery (66% women, mean body mass index (BMI) 46.1±1.0 kg m(-2)) with available liver echography and pathology analysis of the biopsies in this cross-sectional study. Subjects were classified according to normoglycemia (NG), impaired glucose tolerance (IGT) or type 2 diabetes (T2D). Hepatic expression of AQP9 was analyzed by real-time PCR, western blotting and immunohistochemistry, while glycerol permeability (P(gly)) was measured by stopped-flow light scattering. RESULTS: AQP9 was the most abundantly (P<0.0001) expressed aquaglyceroporin in human liver (AQP9>>>AQP3>AQP7>AQP10). Obese patients with T2D showed increased plasma glycerol as well as lower P(gly) and hepatic AQP9 expression. The prevalence of NAFLD and NASH in T2D patients was 100 and 65%, respectively. Interestingly, AQP9 expression was decreased in patients with NAFLD and NASH as compared with those without hepatosteatosis, in direct relation to the degree of steatosis and lobular inflammation, being further reduced in insulin-resistant individuals. The association of AQP9 with insulin sensitivity was independent of BMI and age. Consistent with these data, fasting insulin and C-reactive protein contributed independently to 33.1% of the hepatic AQP9 mRNA expression variance after controlling for the effects of age and BMI. CONCLUSIONS: AQP9 downregulation together with the subsequent reduction in hepatic glycerol permeability in insulin-resistant states emerges as a compensatory mechanism whereby the liver counteracts further triacylglycerol accumulation within its parenchyma as well as reduces hepatic gluconeogenesis in patients with NAFLD.

The usefulness of plasma histamine and different tryptase cut-off points in the diagnosis of peranaesthetic hypersensitivity reactions.

UNLABELLED: Anaesthetic hypersensitivity reactions can be IgE- or not IgE-mediated and are a challenge to find the causal agent. Histamine and tryptase determination are classically considered useful in the diagnosis of these reactions. The aim of our study was to assess the diagnostic usefulness of plasma histamine and different cut-off points of serum tryptase. METHODS: Patients suffering a reaction suggestive of hypersensitivity during general anaesthesia in Clínica Universidad de Navarra (2008-2012) were included. Serum tryptase and plasma histamine were measured at the time of the reaction and 2 h later. Baseline tryptase was also determined. Four to eight weeks after the reaction an allergological study was performed to all the drugs or products involved in the reaction. RESULTS: Sixty-five patients suffered an immediate hypersensitivity reaction during the period of the study. Thirty-seven patients (20 male) with median age 48 years (12-79) were included because they completed allergological study, and histamine and tryptase were correctly obtained. Elevated plasma histamine was observed in 34 cases (92%). Tryptase exceeded twice the basal values in 10 patients (31%). Using different cut-off points of tryptase, the number of patients with elevated tryptase would be 15 patients (41%) for a cut-off point of 5 µg/L; 12 patients (32%) for a cut-off point of 8.23 µg/L; nine patients (24%) for 10.5 µg/L; and eight patients (22%) for 11.4 µg/L. The median tryptase level for the IgE-mediated reactions was 9.0 µg/L (2-70 µg/L) and 4.0 µg/L (3-13 µg/L) in non-IgE-mediated reactions (P < 0.01). Median tryptase levels were higher in more severe reactions (grade 2 or 3) in comparison with grade 1. The best ratio for serum-tryptase-during-reaction/basal-serum-tryptase to discriminate between IgE and non-IgE reactions was 2.0. CONCLUSION: The best criterion for discriminating IgE- and non IgE-mediated hypersensitivity reactions in anaesthesia was a tryptase value exceeding twice the basal one.

Early skin testing is effective for diagnosis of hypersensitivity reactions occurring during anesthesia.

Allergic skin tests have to be performed 4-6 weeks after an allergic anesthetic reaction. Patients with allergic reactions during anesthesia were prospectively included (n = 44). Skin tests were performed in two stages: (i) Stage 1 (S1), 0-4 days after the reaction; and (ii) Stage 2 (S2), 4-8 weeks after. Five (11.5%) surgical procedures were suspended due to the reaction. Positive skin tests were obtained in 25/44 patients (57%). Allergic diagnosis was carried out at S1 in 15/25 (60%) and at S2 in 10/25 (40%). Three patients resulted positive only in S1. Overall agreement among S1 and S2 skin tests was 70.45%. The kappa statistic was 0.41 (P-value = 0.002). Odds ratio of obtaining a false negative in S1 (compared with S2) was 3.33. Early allergological study is useful, could minimize false negatives, but should be considered as a complement to late skin tests.

Early Diagnosis of an Allergic Reaction to Cisatracurium

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¿Siguen patrones de dieta mediterránea los universitarios españoles? / Do the Spanish university students follow Mediterranean dietary patterns?

Objetivo: Determinar el patrón de consumo de alimentos del alumnado de la Universidad de Alicante (UA) mediante el grado de adecuación a la dieta mediterránea. Método: Estudio transversal descriptivo para estimar la ingesta individual a través de un cuestionario de frecuencia de consumo de alimentos (CFCA) en una muestra representativa de 380 universitarios. Variables a estudio: edad, sexo, área geográfica de procedencia, peso y talla autoreferidos. Así como los alimentos y frecuencias de consumo que componen el CFCA. Se determinó el porcentaje de adecuación teniendo en cuenta, consumo real sobre consumo recomendado por la guía dieta mediterránea tradicional: (100 x raciones consumidas/raciones recomendadas). Se establecieron 5 rangos de porcentaje adecuación: consumo óptimo (80%-119%), consumo aceptable (60%-79%), consumo deficiente (40%-59%), consumo muy deficiente (< 39%), consumo excesivo (> 120%). Se realizó contraste de diferencia de proporciones y la prueba t-Student con EPIDAT 3.1, y SPSS 15.0. Resultados: Prevalencia de sobrepeso-obesidad, es mayor en hombres (34,6%) que en mujeres (9,8%), p < 0,001. Mientras que las mujeres presentan mayor prevalencia de bajo peso (7,0%) que hombres (0,7%), p < 0,05. El consumo de cereales y derivados es muy deficiente (mujeres = 90,6; hombres = 94,9), y el consumo de carnes rojas (mujeres = 90,6; hombres = 92,7) y embutidos (mujeres = 95,9%, hombres = 96,3%) es excesivo. Ningún alumno cubre un "consumo óptimo" o un "consumo aceptable" de todos los grupos de alimentos (n = 12). Discusión: El nivel educativo y el acceso a la información no protegen a la población universitaria de factores socioambientales que influencian sus hábitos alimentarios. Deben reforzarse estrategias de salud pública dirigidas a este grupo de población (AU)

Objective: To determine the pattern of food intake among the students of the University of Alicante (UA) by the level of adherence to the Mediterranean diet. Methods: Descriptive trans-sectional study estimating the individual intake by means of a questionnaire of food intake frequency (QFIF) in a representative sample of 380 college students. Study variables: age, gender, geographical area of origin, self-communicated weight and height; types and intake frequencies of the foods included in the QFIF. The percentage of adherence was calculated taking into account the actual intake and the intake recommended in the guideline of traditional Mediterranean diet: 100 x servings consumed/recommended servings. We established 5 ranges of percentage of adherence: optimal intake (80%-119%), acceptable intake (60%-79%), deficient intake (40%-59%), very deficient intake (< 39%), excessive intake (> 120%). We analyzed the differences in proportions distribution and the Student's t test with EPIDAT 3.1 and SPSS 15.0. Results: The prevalence of overweight/obesity is higher in men (34.6%) than in women (9.8%), p < 0.001, whereas women had higher prevalence of low weight (7.0%) than men (0.7%), p < 0.05. The consumption of grains and derivatives was very deficient (women = 90.6; men = 94.9) whereas the intake of red meats (women = 90.6; men = 92.7) and cold meats (women = 95.9%, men = 96.3%) was excessive. No student had an "optimal intake" or an "acceptable intake" of all the dietary groups (n = 12). Discussion: The educational level and access to the information do not protect the university population from socio-environmental factors that have an influence on their dietary habits. The public health strategies focused on this population group should be strengthen (AU)

[Do the Spanish university students follow Mediterranean dietary patterns?]. / ¿Siguen patrones de dieta Mediterránea los universitarios Españoles?

OBJECTIVE: To determine the pattern of food intake among the students of the University of Alicante (UA) by the level of adherence to the Mediterranean diet. METHODS: Descriptive trans-sectional study estimating the individual intake by means of a questionnaire of food intake frequency (QFIF) in a representative sample of 380 college students. STUDY VARIABLES: age, gender, geographical area of origin, self-communicated weight and height; types and intake frequencies of the foods included in the QFIF. The percentage of adherence was calculated taking into account the actual intake and the intake recommended in the guideline of traditional Mediterranean diet: 100 x servings consumed/recommended servings. We established 5 ranges of percentage of adherence: optimal intake (80%-119%), acceptable intake (60%-79%), deficient intake (40%-59%), very deficient intake (< 39%), excessive intake (> 120%). We analyzed the differences in proportions distribution and the Student's t test with EPIDAT 3.1 and SPSS 15.0. RESULTS: The prevalence of overweight/obesity is higher in men (34.6%) than in women (9.8%), p < 0.001, whereas women had higher prevalence of low weight (7.0%) than men (0.7%), p < 0.05. The consumption of grains and derivatives was very deficient (women = 90.6; men = 94.9) whereas the intake of red meats (women = 90.6; men = 92.7) and cold meats (women = 95.9%, men = 96.3%) was excessive. No student had an "optimal intake" or an "acceptable intake" of all the dietary groups (n = 12). DISCUSSION: The educational level and access to the information do not protect the university population from socio-environmental factors that have an influence on their dietary habits. The public health strategies focused on this population group should be strengthen.

Priority issues, study designs and geographical distribution in nutrition journals / Temas prioritarios, diseño de estudios y distribución geográfica de artículos publicados en revistas de nutrición

Introduction: The increased number of articles published in nutrition is a reflection of the relevance to scientific community. The characteristics and quality of nutritional studies determine whether readers can obtain valid conclusions from them, as well as their usefulness for evidence-based strategic policies. Objective: To determine the characteristics of papers published in nutrition journals. Method: Descriptive study design. We reviewed 330 original papers published between January-June 2007. From: American Journal of Clinical Nutrition (AJCN), Journal of Nutrition, European Journal Nutrition, European Journal of Clinical Nutrition and Public Health Nutrition. We classified them according to the subjects studied; risk factors, study design and country of origin. Results: Almost half the papers studied healthy people(53.3%). The most frequent illness was obesity (13.9%).Food consumption is the most frequent risk factor (63.3%).Social factors appear exclusively only in 3.6% of the papers. Clinical trials were the most common analytical design (31.8%), mainly in the AJCN (45.6%). Cross-sectional studies were the most frequent type of observational design (37.9%). Ten countries produced over half of the papers (51.3%). The US publishes the highest number of papers (20.6%), whilst developing countries make only scarce contributions to scientific literature on nutrition. Conclusions: Most of the papers had inferential power. They generally studied both healthy and sick subjects, coinciding with the aims of international scientific policies. However, the topics covered reflect a clear bias, prioritizing problems pertaining to developed countries. Social determinants of health should also be considered, along with behavioral and biological risk factors (AU)

Introducción: El crecimiento de la producción científica nutricional indica relevancia para la comunidad científica. Las características y calidad de los estudios determinan si sus lectores pueden obtener conclusiones válidas, y su utilidad en la orientación de estrategias políticas basadas en la evidencia. Objetivo: Determinar las características de las publicaciones en revistas de nutrición. Método: Estudio descriptivo. Se revisaron 330 artículos originales publicados entre enero-junio de 2007 en las revistas: American-Journal of Clinical-Nutrition (AJCN), Journalof Nutrition, European-Journal Nutrition, European-Journal of Clinical-Nutrition y Public-Health-Nutrition. Los artículos se clasificaron según los temas estudiados, factores de riesgo, diseño del estudio y país de origen. Resultados: Las personas saludables representan la mitad (53,3%) de la población estudiada. La obesidad fue la enfermedad más frecuente (13,9%). El consumo de alimentos fue el factor de riesgo más frecuente (63,3%). Un 3,6% de artículos consideraron factores sociales. Los ensayos-clínicos fueron los estudios analíticos más comunes(31,8%), principalmente en AJCN (45,6%). Los estudios-transversales más frecuentes fueron observacionales(37,9%). Diez países producen más de la mitad de los artículos(51,3%). Los EEUU publican el mayor número de artículos (20,6%); siendo escasa la contribución de los países en desarrollo. Conclusiones: La mayoría de los artículos presentan poder inferencial. La población estudiada se distribuye entre sana y enferma, coincidiendo con los objetivos de las políticas científicas internacionales. Sin embargo, los temas tratados reflejan un sesgo, dando prioridad a los problemas relativos a países desarrollados. Deberían considerarse determinantes sociales de la salud, junto con factores de riesgo de comportamiento y biológicos (AU)

[Spanish diet quality according to the healthy eating index]. / Calidad de la dieta española según el índice de alimentación saludable.

OBJECTIVE: To determine the quality of the Spanish diet by means of the Healthy Feeding Index (IASE) and its relationship with geographical and socioeconomic variables. METHODS: Cross-sectional descriptive study from the National Heath Questionnaire 2006 (ENS-2006). 29,478 people answering the Frequency of Consumption Questionnaire (CFC) were studied (women = 15,019; men =14,459). The IASE comprises 10 variables (grains and derivatives, vegetables, fruits, dairy products, meats, legumes, cold-processed meats, sweets, beverages, and diet-variety) constructed from the CFC and the recommendations of the Feeding Guidelines (Spanish Society of Community Nutrition 2004). The IASE categories (maximum score: 100) were: healthy feeding > 80 points; Need-for-change > 5,080; Little healthy, 50. A descriptive analysis was performed with differences of the means (Kruskal-Wallis and Mann-Whitney tests), and the Chi-square test to study the independency of the variables such as age, gender, social class, and educational level with the IASE categories. RESULTS: 72% of the whole sample needs changes in their feeding patterns. The mean score for women was 73.7 ± 10.5 and for men 69.9 ± 11.3 (p < 0.001). Among the healthy category, the age group > 65 years and women obtain higher percentage (38.8% and 28.3%, respectively) in comparison to men (18.4%). Besides, the higher the social class the higher the healthy diet index will be (class-I: 24.4%, class-II: 25.0%, class-III: 25.8%) (p < 0.001). The Autonomous Communities from Valencia (5.4%), Balearic Islands (4.6%) and Andalusia (4.3%) are the ones presenting the highest index of little healthy feeding. CONCLUSIONS: The IASE is a rapid and cheap method to estimate the quality of the diet in the population since it uses secondary data coming from the ENS and the feeding guidelines. It is useful to planning the nutritional policies in Spain.

Calidad de la dieta española según el índice de alimentación saludable / Spanish diet quality according to the healthy eating index

Objetivo: determinar la calidad de la dieta española mediante el Índice de Alimentación-Saludable (IASE) y su relación con variables geográficas y socioeconómicas. Metodología: Estudio descriptivo transversal a partir de Encuesta-Nacional-Salud-2006 (ENS-2006) Se estudiaron 29.478 personas (Mujeres = 15.019; Hombres = 14.459) que respondieron el Cuestionario de Frecuencia de Consumo (CFC). El IASE se compone de 10 variables (Cereales-derivados, Verduras-hortalizas, Frutas, Leche-derivados, Carnes, Legumbres, Embutidos-fiambres, Dulces, Refrescos-azúcar y Variedad-dieta), construidas a partir del CFC y las recomendaciones de las Guías-Alimentarias (Sociedad-Española-Nutrición-Comunitaria-2004). Categorías IASE (puntuación-máxima 100): Alimentación-saludable: > 80 puntos; Necesita-cambios: > 5.080; Poco-saludable: 50. Se realizó un análisis descriptivo, de diferencias de medias (pruebas Krus-kal-Wallis y Mann-Whitney), y prueba Chi-Cuadrado, para estudiar la independencia de las variables edad, sexo, clase-social y nivel de estudios con las categorías de IASE. Resultados: El 72% del total de la muestra necesita cambios en su alimentación. La puntuación media para mujeres es 73,7 ± 10,5 y para hombres 69,9 ± 11,3 (p < 0,001). En la categoría saludable obtienen mayor porcentaje (38,8%) el grupo de edad > 65 años y las mujeres (28,3%) frente a los hombres (18,4%). Así mismo, las clases-sociales mas altas (clase-I: 24,4%, clase-II: 25,0%, clase-III: 25,8%) presentan mayor índice de alimentación-saludable, (p < 0,001). Las Comunidades-Autónomas: Comunitat Valenciana (5,4%), Illes Balears (4,6%) y Andalucía (4,3%) son las que presentan mayor índice en la categoría poco-saludable. Conclusiones: El IASE es un método rápido y económico de estimación de la calidad de la dieta de la población, porque utiliza datos secundarios procedente de la ENS y de las guías-alimentarias; siendo útil en la planificación de políticas nutricionales en España (AU)

Objective: To determine the quality of the Spanish diet by means of the Healthy Feeding Index (IASE) and its relationship with geographical and socioeconomic variables. Methods: Cross-sectional descriptive study from the National Heath Questionnaire 2006 (ENS-2006). 29,478 people answering the Frequency of Consumption Questionnaire (CFC) were studied (women = 15,019; men =14,459). The IASE comprises 10 variables (grains and derivatives, vegetables, fruits, dairy products, meats, legumes, cold-processed meats, sweets, beverages, and diet-variety) constructed from the CFC and the recommendations of the Feeding Guidelines (Spanish Society of Community Nutrition 2004). The IASE categories (maximum score: 100) were: healthy feeding > 80 points; Need-for-change > 5,080; Little healthy, 50. A descriptive analysis was performed with differences of the means (Kruskal-Wallis and Mann-Whitney tests), and the Chi-square test to study the independency of the variables such as age, gender, social class, and educational level with the IASE categories. Results: 72% of the whole sample needs changes in their feeding patterns. The mean score for women was 73.7 ± 10.5 and for men 69.9 ± 11.3 (p < 0.001). Among the healthy category, the age group > 65 years and women obtain higher percentage (38.8% and 28.3%, respectively) in comparison to men (18.4%). Besides, the higher the social class the higher the healthy diet index will be (class-I: 24.4%, class-II: 25.0%, class-III: 25.8%) (p < 0.001). The Autonomous Communities from Valencia (5.4%), Balearic Islands (4.6%) and Andalusia (4.3%) are the ones presenting the highest index of little healthy feeding. Conclusions: The IASE is a rapid and cheap method to estimate the quality of the diet in the population since it uses secondary data coming from the ENS and the feeding guidelines. It is useful to planning the nutritional policies in Spain (AU)

Priority issues, study designs and geographical distribution in nutrition journals.

INTRODUCTION: The increased number of articles published in nutrition is a reflection of the relevance to scientific community. The characteristics and quality of nutritional studies determine whether readers can obtain valid conclusions from them, as well as their usefulness for evidence-based strategic policies. OBJECTIVE: To determine the characteristics of papers published in nutrition journals. METHOD: Descriptive study design. We reviewed 330 original papers published between January-June 2007. From: American Journal of Clinical Nutrition (AJCN), Journal of Nutrition, European Journal Nutrition, European Journal of Clinical Nutrition and Public Health Nutrition. We classified them according to the subjects studied; risk factors, study design and country of origin. RESULTS: Almost half the papers studied healthy people (53.3%). The most frequent illness was obesity (13.9%). Food consumption is the most frequent risk factor (63.3%). Social factors appear exclusively only in 3.6% of the papers. Clinical trials were the most common analytical design (31.8%), mainly in the AJCN (45.6%). Cross-sectional studies were the most frequent type of observational design (37.9%). Ten countries produced over half of the papers (51.3%). The US publishes the highest number of papers (20.6%), whilst developing countries make only scarce contributions to scientific literature on nutrition. CONCLUSIONS: Most of the papers had inferential power. They generally studied both healthy and sick subjects, coinciding with the aims of international scientific policies. However, the topics covered reflect a clear bias, prioritizing problems pertaining to developed countries. Social determinants of health should also be considered, along with behavioral and biological risk factors.

Mapping public policy options responding to obesity: the case of Spain.

This study assesses the opinions of the main Spanish stakeholders from food and physical exercise policy networks on public policy options for responding to obesity. We followed the multi-criteria mapping methodology in the framework of the European project 'Policy options in responding to obesity' (PorGrow), through a structured interview to 21 stakeholders. A four-step approach was taken: options, criteria, scoring and weighting, obtaining in this way a measure of the performance of each option which integrates qualitative and quantitative information. In an overall analysis, the more popular policy options where those grouped as educational initiatives: include food and health in the school curriculum, improve health education to the general public, improve the training of health professionals in obesity care and prevention, incentives to caterers to provide healthier menus and improve community sports facilities. Fiscal measures as subsidies and taxes had the lowest support. The criteria assessed as priorities were grouped as efficacy and societal benefits. Obesity in Spain can be approached through public policies, although the process will not be easy or immediate. The feasibility of changes requires concerned public policymakers developing long-term actions taking into account the map of prioritized options by the stakeholders.