[Properties of milk in sleep induction]. / Propiedades de la leche en la inducción del sueño.

Introduction: Sleep induction and its quality are issues of growing concern because its deterioration affects a large number of people and poses a risk to their well-being and quality of life and long-term health. There are several factors involved in the problem, but nutrition is one of them and in particular milk consumption has often been linked to sleep habits, sometimes as a promoter and sometimes as an inhibitor. The purpose of this review is to examine the matter further. On reaching the brain, tryptophan is the basis for the synthesis of serotonin and melatonin, which improve the induction and quality of sleep. But there is competition between tryptophan and other long-chain neutral amino acids (LNAA) (valine, leucine, isoleucine, tyrosine and phenylalanine) to cross the blood-brain barrier and reach the brain. In this sense, milk proteins with a high tryptophan content and the highest ratio between tryptophan and LNAA are very useful in promoting sleep. Moreover, milk also provides various micronutrients that help in the transformation of tryptophan into serotonin and melatonin, as well as antioxidant components, anti-inflammatory and bioactive peptides, and recent studies indicate that it favorably modulates the composition of the intestinal microbiota. Studies show that increasing milk consumption, up to the recommended intake and within a correct diet, favors the achievement and maintenance of quality sleep.

Introducción: La inducción del sueño y su calidad son temas de preocupación creciente porque su deterioro afecta a un número elevado de personas y supone un riesgo en su bienestar y calidad de vida y en la salud a largo plazo. Hay diversos factores implicados en el problema, pero la nutrición es uno de ellos y, en concreto, el consumo de leche se ha relacionado frecuentemente con los hábitos de sueño, a veces como factor promotor y otras como inhibidor. Profundizar en el tema es el objeto de la presente revisión. El triptófano, al llegar al cerebro, es la base para la síntesis de serotonina y melatonina, que mejoran la inducción y la calidad del sueño. Pero hay una competencia entre el triptófano y otros aminoácidos neutros de cadena larga (ANCL) (valina, leucina, isoleucina, tirosina y fenilalanina) para cruzar la barrera hematoencefálica y llegar al cerebro. En este sentido, las proteínas de la leche, con elevado contenido en triptófano y la relación más elevada entre triptófano y ANCL, son muy útiles en la promoción del sueño. Por otra parte, la leche también aporta diversos micronutrientes que ayudan en la transformación del triptófano en serotonina y melatonina, así como componentes antioxidantes, antiinflamatorios y péptidos bioactivos, y estudios recientes indican que modula favorablemente la composición de la microbiota intestinal. Los estudios realizados ponen de relieve que aumentar el consumo de leche, hasta el aporte aconsejado y dentro de una alimentación correcta, favorece el conseguir y mantener un sueño de calidad.

Adherence to 24-h movement guidelines in Spanish schoolchildren and its association with insulin resistance: a cross-sectional study.

Introduction: Being more active, being less sedentary, and sleeping enough are associated with adequate body weight and adiposity in children. However, few researchers have analyzed these different lifestyle behaviors and the adherence to 24 h movement guidelines with respect to insulin resistance (IR) at school age. Therefore, we aimed to analyse the association between the adherence to 24 h movement guidelines (physical activity, sedentary time, sleep) and IR in Spanish schoolchildren. Methods: A cross-sectional study of 839 children (8-13 years, 51.1% girls) were studied. Anthropometric, biochemical, and lifestyle behavioral data were collected. IR was defined as HOMA-IR>3.16. Compliance with the 24 h movement guidelines were defined as ≥60 min/day of moderate and/or vigorous physical activity, < 120 min/day of screen time, and 9-11 h/day of sleep time. Associations between adherence to the 24 h movement guidelines and IR were performed by multivariate logistic regression analyses. Results: The IR in our sample was 5.0%, being higher in girls. Compliance with physical activity or screen time, but not with sleep recommendations, was associated with lower fasting glucose, fasting insulin, and HOMA-IR values. A low adherence to 24 h movement guidelines was associated with a higher risk of IR (odds ratio (95% CI): 2.150 [1.089-4.247]), especially in girls (odds ratio (95% CI): 2.800 [1.180-6.645]). Conclusion: Higher physical activity levels and lower screen times were associated with a lower risk of IR in schoolchildren, underlining the importance of adhering to as many healthy lifestyle recommendations as possible.

Breakfast Quality and Insulin Resistance in Spanish Schoolchildren: A Cross-Sectional Study.

Background: Breakfast has traditionally been considered one of the most important meals of the day; however, there is little evidence for the influence of breakfast quality and insulin resistance (IR). This study aimed to assess the quality of breakfast in a group of schoolchildren, and its association with IR. Methods: A cross-sectional study with 852 children (8−13 years) was carried out. Fasting plasma glucose, insulin and anthropometric parameters were measured. A three-day dietary record was used to assess their diet and to calculate the Breakfast Quality Index (BQI). The sample was divided into tertiles according to the BQI (tertile 3: better breakfast quality). The homeostatic model was used to assess insulin resistance (HOMA-IR), and IR was defined as HOMA-IR > 3.16. Results: The prevalence of IR was 5.2%. The mean BQI score was 4.50 ± 1.25, and boys had lower scores than girls. Children in the BQI tertile 3 had a better global diet quality. In boys, being in the BQI tertile 3 was associated with a lower risk of IR (OR [95% CI]: 0.10 [0.01−0.77], p < 0.05). Conclusions: A higher-quality breakfast was associated with better overall diet quality and a lower risk of IR, especially in boys.

Propiedades de la leche en la inducción del sueño / Properties of milk in sleep induction

La inducción del sueño y su calidad son temas de preocupación creciente porque su deterioro afecta a un número elevado de personas y suponeun riesgo en su bienestar y calidad de vida y en la salud a largo plazo. Hay diversos factores implicados en el problema, pero la nutrición es unode ellos y, en concreto, el consumo de leche se ha relacionado frecuentemente con los hábitos de sueño, a veces como factor promotor y otrascomo inhibidor. Profundizar en el tema es el objeto de la presente revisión.El triptófano, al llegar al cerebro, es la base para la síntesis de serotonina y melatonina, que mejoran la inducción y la calidad del sueño. Pero hayuna competencia entre el triptófano y otros aminoácidos neutros de cadena larga (ANCL) (valina, leucina, isoleucina, tirosina y fenilalanina) paracruzar la barrera hematoencefálica y llegar al cerebro. En este sentido, las proteínas de la leche, con elevado contenido en triptófano y la relaciónmás elevada entre triptófano y ANCL, son muy útiles en la promoción del sueño. Por otra parte, la leche también aporta diversos micronutrientesque ayudan en la transformación del triptófano en serotonina y melatonina, así como componentes antioxidantes, antiinflamatorios y péptidosbioactivos, y estudios recientes indican que modula favorablemente la composición de la microbiota intestinal.Los estudios realizados ponen de relieve que aumentar el consumo de leche, hasta el aporte aconsejado y dentro de una alimentación correcta,favorece el conseguir y mantener un sueño de calidad. (AU)

Sleep induction and its quality are issues of growing concern because its deterioration affects a large number of people and poses a risk to theirwell-being and quality of life and long-term health. There are several factors involved in the problem, but nutrition is one of them and in particularmilk consumption has often been linked to sleep habits, sometimes as a promoter and sometimes as an inhibitor. The purpose of this review isto examine the matter further.On reaching the brain, tryptophan is the basis for the synthesis of serotonin and melatonin, which improve the induction and quality of sleep. Butthere is competition between tryptophan and other long-chain neutral amino acids (LNAA) (valine, leucine, isoleucine, tyrosine and phenylalanine)to cross the blood-brain barrier and reach the brain. In this sense, milk proteins with a high tryptophan content and the highest ratio betweentryptophan and LNAA are very useful in promoting sleep.Moreover, milk also provides various micronutrients that help in the transformation of tryptophan into serotonin and melatonin, as well as antioxidantcomponents, anti-inflammatory and bioactive peptides, and recent studies indicate that it favorably modulates the composition of the intestinalmicrobiota. Studies show that increasing milk consumption, up to the recommended intake and within a correct diet, favors the achievementand maintenance of quality sleep. (AU)

Association of Healthy Eating Index-2015 and Dietary Approaches to Stop Hypertension Patterns with Insulin Resistance in Schoolchildren.

Background: Diet quality patterns are associated with a lower incidence of insulin resistance (IR) in adults. The aim of this study was to investigate the association between two diet quality indices and IR in schoolchildren and to identify the best diet quality index associated with a lower risk of IR. Methods: A total of 854 schoolchildren (8−13 years) were included in a cross-sectional study, who completed a three-day dietary record to assess their diet. Fasting plasma glucose and insulin were also measured, and anthropometric data were collected. Healthy Eating Index-2015 (HEI-2015), Dietary Approaches to Stop Hypertension (DASH), and adjusted DASH (aDASH) were calculated as diet quality indices. The homeostasis model assessment of insulin resistance (HOMA-IR) was used, and IR was defined as HOMA-IR > 3.16. Results: The prevalence of IR was 5.5%, and it was higher in girls. The mean HEI-2015 and DASH scores were 59.3 and 23.4, respectively, and boys scored lower in both indices. In girls, having a HEI-2015 score above the 33rd percentile was associated with a lower risk of IR (odds ratio [95% CI]: 0.43 [0.19−0.96], p = 0.020). Conclusion: Greater adherence to a healthy dietary pattern, as assessed by a higher HEI-2015 score, was associated with a lower risk of IR in schoolchildren, especially in girls.

[Childhood obesity as a health priority. Guidelines for improving weight control]. / La obesidad infantil como prioridad sanitaria. Pautas en la mejora del control de peso.

Introduction: Childhood obesity is a growing concern, because the problem affects a high percentage of children and is the source of many diseases in the present and in the future, which can lead to a decrease in life expectancy and quality of life. In order to combat the problem, it is necessary to analyze the factors associated with excess weight in childhood in order to act on them and try to curb the trend observed in recent years. Various socio-demographic aspects, as well as inactivity and sedentary lifestyle in children are factors that are associated with an increased risk of obesity and central adiposity. With great prominence in this issue, we have to highlight that the consumption of food is improvable: decrease the consumption of sugar, fat and sodium, and above all increase the consumption of fruits, vegetables, whole grains, fish, dairy is associated with lower obesity and central obesity in children. There is no single responsible for the problem and the interaction between healthy behaviors increases the chances of success in the fight against childhood obesity, which should be considered when planning nutritional education campaigns. Many aspects of the diet and lifestyle of the child population must be improved, perhaps now more emphasis is being placed on restrictive guidelines. Of course, it is desirable to reduce the consumption of sweets and snacks, but messages aimed at increasing the consumption of vegetables, fruits, whole grains and approximating the diet to the theoretical ideal can be prioritized. Constructive guidelines should stand out from restrictive ones.

Introducción: La obesidad infantil es objeto de preocupación creciente, porque el problema afecta a un elevado porcentaje de niños y es el origen de numerosas enfermedades en el presente y en el futuro, pudiendo condicionar un descenso en la esperanza y calidad de vida. Para combatir el problema es necesario analizar los factores que se asocian con el exceso de peso en la infancia para actuar sobre ellos e intentar frenar la tendencia observada en los últimos años. Diversos aspectos sociodemográficos, así como la inactividad y el sedentarismo de los niños son factores que se asocian con mayor riesgo de padecimiento de obesidad y adiposidad central. Con gran protagonismo en este tema debe destacarse que el consumo de alimentos es mejorable: disminuir el consumo de azúcar, grasa y sodio, y sobre todo aumentar el consumo de frutas, verduras, cereales integrales, pescado, lácteos se asocia con menor padecimiento de obesidad y obesidad central en los niños. Pero no hay un único responsable del problema y la interacción entre conductas saludables aumenta las posibilidades de éxito en la lucha contra la obesidad infantil, lo que debe ser considerado al planificar campañas de educación nutricional. Se deben mejorar numerosos aspectos de la alimentación y estilo de vida de la población infantil, quizá en este momento se hace más hincapié en pautas restrictivas, aunque es muy conveniente reducir el consumo de dulces y snacks, resulta muy deseable y quizá prioritario el aumentar el consumo de verduras, hortalizas, frutas, cereales integrales y aproximar la dieta al ideal teórico. Las pautas constructivas deberían destacar respecto a las restrictivas.

[Nutritional problems in celiac patients. Difficulties in achieving an adequate nutritional status]. / Problemática nutricional en pacientes celíacos. Dificultades para conseguir una situación nutricional adecuada.

Introduction: Celiac disease is the most common chronic intestinal disease. It affects approximately 1 % of the world population, affects all age groups and has symptoms both digestive and extra-digestive. The treatment of celiac disease is based on the strict withdrawal of gluten from the diet. This treatment supposes the improvement of symptoms and histology and the reduction of long-term comorbidities. People with celiac disease often follow diets that are far from the theoretical ideal, so they must be supervised and guided to achieve gluten-free diets that are also varied and balanced. In these patients it is important to avoid gluten consumption, but also to achieve an adequate supply of nutrients. However, their health problems, together with the limitations they must introduce in the diet make it more difficult to achieve a correct diet, so the group deserves special nutritional monitoring and surveillance.

Introducción: La enfermedad celíaca es la enfermedad crónica intestinal más frecuente que existe. Afecta aproximadamente al 1 % de la población mundial, a todos los grupos de edad y tiene síntomas de presentación tanto digestivos como extradigestivos. El tratamiento de la enfermedad celíaca se basa en la retirada estricta del gluten de la dieta. Este tratamiento supone la mejora de los síntomas y de la histología y la disminución de comorbilidades a largo plazo. Las personas con enfermedad celíaca realizan con frecuencia dietas alejadas del ideal teórico, por lo que deben ser supervisadas y orientadas para lograr dietas sin gluten y también variadas y equilibradas. En estos pacientes es importante evitar el consumo de gluten, pero también lograr un aporte adecuado de nutrientes y su problemática sanitaria, junto con las limitaciones que deben introducir en la dieta, hacen más difícil lograr una alimentación correcta, por lo que el colectivo merece una vigilancia y un control nutricional especiales.

Dietary Intake of Individual (Intrinsic and Added) Sugars and Food Sources from Spanish Children Aged One to <10 Years­Results from the EsNuPI Study

Currently, in Spain there are no studies assessing the intakes and sources of intrinsic and added sugars by both children consuming standard milks and children regularly consuming adapted milk formulas. Our goal was to evaluate current sugar intake levels (intrinsic and added) and their major dietary sources within the EsNuPI study participants by applying two 24-h dietary recalls that were completed by 1448 children (1 to <10 years) divided into two subsamples: One "Spanish Reference Sample" (SRS) of the general population (n = 707) and another sample which included children consuming adapted milks including follow-on milk, toddler's or growing up milk and fortified and enriched milks, here called "Adapted Milk Consumers Sample" (AMS) (n = 741). Estimates of intrinsic and added sugar intakes from the Spanish EsNuPI population as well as the adherence to recommendations varied notably according to age segment, but no major differences between subsamples were found. Younger children (1 to <3 years) showed the highest added sugar contribution to total energy intake (TEI) (SRS: 12.5% for boys and 11.7% for girls; AMS: 12.2% for boys and 11.3% for girls) and the lowest adherence to recommendations set at <10% TEI (SRS: 27.4% for boys and 37.2% for girls; AMS: 31.3% for boys and 34.7% for girls). Adherence increased with age but remains inadequate, with approximately one in two children from the older age segment (6 to <10 years) exceeding the recommendations. Main food sources of intrinsic sugars for both subsamples were milk and dairy products, fruits, vegetables and cereals, while for added sugars, these were milk and dairy products (mainly yogurts), sugars and sweets (mainly sugary cocoa and nougat), bakery products (mainly cookies) and cereals (mainly bread and wheat flour). However, for the AMS, the groups milk and dairy products and cereals showed a significantly lower contribution to intrinsic sugar intake but a significantly higher contribution to that of added sugars. These results demonstrate that sugar intake and the adherence to recommendations in the studied population varied notably according to age but not to the type of milk consumed. In addition, our results highlight the need to monitor the consumption of added sugars by the infant population, as well as the need to make efforts to facilitate this task, such as harmonizing the recommendations regarding free/added sugars and the inclusion of information on their content on the nutritional labeling of products in order to incorporate them into food composition databases.

La obesidad infantil como prioridad sanitaria. Pautas en la mejora del control de peso / Childhood obesity as a health priority. Guidelines for improving weight control

La obesidad infantil es objeto de preocupación creciente, ya que es un problema que afecta a un elevado porcentaje de niños y es el origen de numerosas enfermedades en el presente y en el futuro, lo que puede condicionar un descenso en la esperanza y en la calidad de vida. Para combatir el problema es necesario analizar los factores que se asocian con el exceso de peso en la infancia para actuar sobre ellos e intentar frenar la tendencia observada en los últimos años. Diversos aspectos sociodemográficos, así como la inactividad y el sedentarismo de los niños, son factores que se asocian con un mayor riesgo de padecer obesidad y adiposidad central.Con gran protagonismo en este tema debe destacarse que el consumo de alimentos es mejorable: disminuir el consumo de azúcar, grasa y sodio, y sobre todo aumentar el de frutas, verduras, cereales integrales, pescado y lácteos, se asocia con menor padecimiento de obesidad y obesidad central en los niños.Pero no hay un único responsable del problema y la interacción entre conductas saludables aumenta las posibilidades de éxito en la lucha contra la obesidad infantil, lo que debe considerarse al planificar campañas de educación nutricional.Deben mejorarse numerosos aspectos de la alimentación y del estilo de vida de la población infantil. Quizá en este momento se hace más hincapié en pautas restrictivas. Aunque es muy conveniente reducir el consumo de dulces y de snacks, resulta muy deseable y quizá prioritario aumentar el consumo de verduras, hortalizas, frutas, cereales integrales y aproximar la dieta al ideal teórico. Las pautas constructivas deberían destacar respecto a las restrictivas. (AU)

Childhood obesity is a growing concern, because the problem affects a high percentage of children and is the source of many diseases in the present and in the future, which can lead to a decrease in life expectancy and quality of life. In order to combat the problem, it is necessary to analyze the factors associated with excess weight in childhood in order to act on them and try to curb the trend observed in recent years.Various socio-demographic aspects, as well as inactivity and sedentary lifestyle in children are factors that are associated with an increased risk of obesity and central adiposity.With great prominence in this issue, we have to highlight that the consumption of food is improvable: decrease the consumption of sugar, fat and sodium, and above all increase the consumption of fruits, vegetables, whole grains, fish, dairy is associated with lower obesity and central obesity in children.There is no single responsible for the problem and the interaction between healthy behaviors increases the chances of success in the fight against childhood obesity, which should be considered when planning nutritional education campaigns. Many aspects of the diet and lifestyle of the child population must be improved, perhaps now more emphasis is being placed on restrictive guidelines. Of course, it is desirable to reduce the consumption of sweets and snacks, but messages aimed at increasing the consumption of vegetables, fruits, whole grains and approximating the diet to the theoretical ideal can be prioritized. Constructive guidelines should stand out from restrictive ones. (AU)

Problemática nutricional en pacientes celíacos. Dificultades para conseguir una situación nutricional adecuada / Nutritional problems in celiac patients. Difficulties in achieving an adequate nutritional status

La enfermedad celíaca es la enfermedad crónica intestinal más frecuente que existe. Afecta aproximadamente al 1 % de la población mundial, a todos los grupos de edad y tiene síntomas de presentación tanto digestivos como extradigestivos.El tratamiento de la enfermedad celíaca se basa en la retirada estricta del gluten de la dieta. Este tratamiento supone la mejora de los síntomas y de la histología y la disminución de comorbilidades a largo plazo.Las personas con enfermedad celíaca realizan con frecuencia dietas alejadas del ideal teórico, por lo que deben ser supervisadas y orientadas para lograr dietas sin gluten y también variadas y equilibradas.En estos pacientes es importante evitar el consumo de gluten, pero también lograr un aporte adecuado de nutrientes y su problemática sanitaria, junto con las limitaciones que deben introducir en la dieta, hacen más difícil lograr una alimentación correcta, por lo que el colectivo merece una vigilancia y un control nutricional especiales. (AU)

Celiac disease is the most common chronic intestinal disease. It affects approximately 1 % of the world population, affects all age groups and has symptoms both digestive and extra-digestive.The treatment of celiac disease is based on the strict withdrawal of gluten from the diet. This treatment supposes the improvement of symptoms and histology and the reduction of long-term comorbidities.People with celiac disease often follow diets that are far from the theoretical ideal, so they must be supervised and guided to achieve gluten-free diets that are also varied and balanced.In these patients it is important to avoid gluten consumption, but also to achieve an adequate supply of nutrients. However, their health problems, together with the limitations they must introduce in the diet make it more difficult to achieve a correct diet, so the group deserves special nutritional monitoring and surveillance. (AU)

Dietary Intake, Nutritional Adequacy, and Food Sources of Protein and Relationships with Personal and Family Factors in Spanish Children Aged One to <10 Years: Findings of the EsNuPI Study.

Diet in the first years of life is an important factor in growth and development. Dietary protein is a critical macronutrient that provides both essential and nonessential amino acids required for sustaining all body functions and procedures, providing the structural basis to maintain life and healthy development and growth in children. In this study, our aim was to describe the total protein intake, type and food sources of protein, the adequacy to the Population Reference Intake (PRI) for protein by the European Food Safety Authority (EFSA), and the Recommended Dietary Allowance (RDA) by the Institute of Medicine (IoM). Furthermore, we analyzed whether the consumption of dairy products (including regular milk, dairy products, or adapted milk formulas) is associated with nutrient adequacy and the contribution of protein to diet and whole dietary profile in the two cohorts of the EsNuPI (in English, Nutritional Study in the Spanish Pediatric Population) study; one cohort was representative of the Spanish population from one to <10 years old (n = 707) (Spanish reference cohort, SRS) who reported consuming all kinds of milk and one was a cohort of the same age who reported consuming adapted milk over the last year (including follow-on formula, growing up milk, toddler's milk, and enriched and fortified milks) (n = 741) (adapted milk consumers cohort, AMS). The children of both cohorts had a high contribution from protein to total energy intake (16.79% SRS and 15.63% AMS) and a high total protein intake (60.89 g/day SRS and 53.43 g/day AMS). We observed that protein intake in Spanish children aged one to <10 years old was above the European and international recommendations, as well as the recommended percentages for energy intakes. The main protein sources were milk and dairy products (28% SRS and 29% AMS) and meat and meat products (27% SRS and 26% AMS), followed by cereals (16% SRS and 15% AMS), fish and shellfish (8% in both cohorts), eggs (5% SRS and 6% AMS), and legumes (4% in both cohorts). In our study population, protein intake was mainly from an animal origin (meat and meat products, milk and dairy products, fish and shellfish, and eggs) rather than from a plant origin (cereals and legumes). Future studies should investigate the long-term effect of dietary protein in early childhood on growth and body composition, and whether high protein intake affects health later in life.

Importancia de la nutrición en la defensa inmunitaria. Papel de la leche y sus componentes naturales / Importance of nutrition for immune defense. The role of milk and its natural components

El sistema inmunitario es un sistema complejo e integrado cuya función principal es proteger al organismo de agresiones externas provocadas por microorganismos, alergenos o agentes tóxicos. Diferentes estudios ponen de manifiesto que el mantenimiento de las cantidades óptimas de diferentes nutrientes es esencial para garantizar la síntesis de diferentes factores y mediadores de este sistema. Entre los nutrientes y compuestos bioactivos con mayor interés destacan: las vitaminas A, B6, B12, C, D, E, ácido fólico (B9) y biotina (B7); minerales como el zinc, hierro, selenio, magnesio y cobre; proteínas (lactoferrina) y péptidos bioactivos; ácidos grasos omega-3, y otros nutrientes y compuestos bioactivos como fibra, polifenoles, carotenoides, probióticos, etc. El seguimiento de una dieta variada y equilibrada que incluya las raciones recomendadas por las guías alimentarias para cada grupo de alimentos es fundamental para alcanzar los requerimientos de estos nutrientes. Y entre los grupos de alimentos a los que se debe prestar especial atención están: las frutas y verduras (por su alto contenido en micronutrientes y compuestos antioxidantes), los pescados azules (por contener omega-3) y los lácteos (por ser alimentos con gran cantidad de nutrientes). En concreto, la leche, especialmente enriquecida, contiene muchos de los nutrientes anteriormente mencionados y su consumo diario, dentro de una dieta equilibrada, puede contribuir a cubrir cantidades importantes de sus valores de referencia. Por último, es importante considerar las leches enriquecidas como una buena alternativa dietética para aumentar la ingesta de muchos nutrientes importantes para el buen funcionamiento del sistema inmune y, en especial, de algunos de ellos, como la vitamina D, en los que un gran porcentaje de la población presenta deficiencias nutricionales. (AU)

The immune system is a complex and integrated system whose main function is to protect the body from external aggression by microorganisms, allergens, or toxic agents. Different studies show that maintaining optimal amounts of different nutrients in the body is essential to ensure the synthesis of different factors related to the immune system. Most interesting nutrients and bioactive compounds include: vitamins A, B6, B12, C, D, E, folic acid (B9) and biotin (B7); minerals such as zinc, iron, selenium, magnesium and copper; proteins (lactoferrin) and bioactive peptides; omega-3 fatty acids; and other nutrients and bioactive compounds such as fiber, polyphenols, carotenoids, probiotics, etc. Following a varied and balanced diet, including the servings recommended by food guides for each food group, is essential to achieve nutrient requirements. Food groups to which special attention should be paid are: fruits and vegetables (because of their high content in micronutrients and antioxidant compounds), fatty fish (because it contains omega-3 fatty acids), and dairy products (because this group contains a large number of nutrients). In particular, milk–especially enriched milk–contains many of the nutrients mentioned above. Moreover, their daily consumption, within a balanced diet, can help significantly cover their nutrient reference values. Finally, it is important to consider enriched kind of milk as a good dietary alternative to increase the intake of some important nutrients for the proper functioning of the immune system, most especially some of them such as vitamin D, since a large percentage of the population have nutritional deficiencies. (AU)

Problemática nutricional en fumadores y fumadores pasivos / Nutritional problems in smokers and passive smokers

Objetivos: el consumo de tabaco, activo o pasivo, afecta a un elevado porcentaje de individuos y se asocia a diversos riesgos sanitarios. Profundizar en los problemas nutricionales específicos de los fumadores que pueden contribuir a perjudicar su salud constituye el objeto de la presente revisión. Métodos: búsqueda bibliográfica en relación con el tema. Resultados: los fumadores consumen cantidades inferiores de diversos alimentos, especialmente: frutas, verduras, cereales y lácteos. Como consecuencia, su ingesta de vitaminas, minerales y fitoquímicos es inferior a la observada en los no fumadores. Su consumo de carne, cafeína y alcohol suele ser superior y su actividad inferior a la de los no fumadores, coexistiendo en los fumadores conductas poco saludables que se potencian, perjudicando la salud y la calidad de vida del colectivo. El estrés oxidativo y los cambios metabólicos hacen que las necesidades de algunos nutrientes sean superiores en los fumadores para lograr la misma situación bioquímica que en los no fumadores. Las ingestas recomendadas de vitamina C se han incrementado, pero probablemente sea necesario aumentar las de otros nutrientes. En general, los fumadores sufren deficiencias con más frecuencia (vitaminas C, E, β-caroteno, B1, B2, B12, ácido fólico, calcio, magnesio, hierro, yodo, etc.) que los no fumadores. Los fumadores pasivos se ven afectados también en sus hábitos alimentarios y su situación nutricional. Conclusiones: la peor situación nutricional de los fumadores puede contribuir a la aparición/el empeoramiento de diversas patologías asociadas al hábito de fumar (cardiovasculares, cáncer, cataratas, osteoporosis, etc.), por lo que la vigilancia nutricional y la corrección de las deficiencias nutricionales podrían suponer un beneficio sanitario para los fumadores y fumadores pasivos que debe ser considerada en el futuro. (AU)

Objective: active or passive tobacco use affects a high percentage of individuals and is associated with various health risks. The aim of this review was to look more closely at the nutritional problems that are specific of smokers, which may harm their health. Methods: a bibliographic search related to the topic. Results: smokers consume lower amounts of various foods, especially fruits, vegetables, cereals and dairy. As a result, their intake of vitamins, minerals, and phytochemicals is lower than that observed in non-smokers. Their consumption of meat, caffeine and alcohol is usually higher, and their activity lower than those of non-smokers, coexisting in smokers unhealthy behaviors that contribute to harming their health and quality of life. Oxidative stress and metabolic changes render the needs for some nutrients higher in smokers to achieve the same biochemical situation as in non-smokers. Recommended intakes of vitamin C have increased, but it will probably be necessary to also increase the intakes of other nutrients. In general, smokers suffer from deficiencies more frequently (vitamins C, E, β-carotene, B1, B2, B12, folic acid, calcium, magnesium, iron, iodine, etc.) than non-smokers. Passive smokers are also affected in their eating habits and nutritional status. Conclusions: the worse nutritional status of smokers can contribute to the appearance/worsening of various diseases associated with smoking (cardiovascular, cancer, cataracts, osteoporosis, etc.); therefore, nutritional surveillance and correction of nutritional deficiencies could represents health benefits for smokers and passive smokers, which should be considered in the future. (AU)

La nutrición en la prevención y curación de heridas crónicas. Importancia en la mejora del pie diabético / Nutrition in the prevention and healing of chronic wounds. Importance in improving the diabetic foot

La nutrición tiene un papel esencial en la cicatrización de las heridas crónicas ya que se necesita un aporte extra de nutrientes en la reparación tisular y para restablecer las pérdidas originadas a través del exudado de la herida. El aporte insuficiente de energía, proteínas, antioxidantes (vitamina C, vitamina A y zinc) y vitamina D es frecuente en los pacientes con heridas crónicas y se ha relacionado con retrasos en la curación y dehiscencia de la herida. También otros factores de riesgo como la obesidad, la diabetes, la edad avanzada, el consumo de glucocorticoides y la deshidratación pueden disminuir o impedir el proceso de la cicatrización, siendo importante la realización de un cribado nutricional para identificar a los pacientes con desnutrición. Las proteínas, los aminoácidos (arginina, glutamina y metionina), las vitaminas C y A, y el zinc se han utilizado como nutrientes farmacológicos para la cicatrización de las úlceras por presión; sin embargo, los ácidos grasos omega-3, aunque parecen disminuir su progresión, no muestran mejores tasas de curación. En los pacientes con pie diabético, la suplementación con vitaminas D, C, A y E, magnesio, zinc y ácidos grasos omega-3, así como la administración de probióticos, reduce el tamaño de la úlcera y mejora el control glucémico, aunque no se han relacionado con una cicatrización completa; sin embargo, la suplementación con arginina, glutamina y β-hidroxi-β-metilbutirato logra la curación de la herida, aunque es necesaria una mayor evidencia que confirme estos resultados. (AU)

Nutrition plays an essential role in chronic wound healing as extra nutrients are needed for tissue repair and to restore losses through wound exudate. Insufficient intake of energy, protein, antioxidants (vitamin C, A, and zinc) and vitamin D are common in patients with chronic wounds and have been linked to delayed wound healing and dehiscence. Other risk factors such as obesity, diabetes, advanced age, corticosteroid use, and dehydration can also reduce or impede the healing process, and nutritional screening is important to identify patients with malnutrition. Proteins, amino acids (arginine, glutamine and methionine), vitamins C and A, and zinc have been used as pharmacological nutrients in pressure ulcer healing; however, omega-3 fatty acids, although they appear to slow progression, do not show improved healing rates. In patients with diabetic foot, supplementation with vitamins D, C, A, and E, magnesium, zinc, omega-3 fatty acids, and probiotics reduces ulcer size and improves glycemic control, although they have not been associated with complete healing; however, supplementation with arginine, glutamine, and β-hydroxy-β-methylbutyrate does show wound healing, although further evidence is needed to confirm these results. (AU)

Patterns of Change in Dietary Habits and Physical Activity during Lockdown in Spain Due to the COVID-19 Pandemic.

BACKGROUND: Lockdown due to COVID-19 influenced food habits and lifestyles with potential negative health impact. This study aims to identify patterns of change in eating habits and physical activity during COVID-19 lockdown in Spain and to identify associations with sociodemographic factors and usual habits. METHODS: This cross-sectional study included 1155 adults recruited online to answer a 10-section questionnaire. The protocol assessed usual diet by means of a semi-quantitative food frequency questionnaire, usual physical activity (PA) and supplement use, dietary changes, sedentary time, PA, exposure to sunlight, sleep quality, and smoking during confinement. Patterns of dietary change were identified by factor analysis. Factor scores were included in cluster analysis together with change in PA. RESULTS: Six patterns of dietary change were identified that together with PA changes during lockdown defined three clusters of lifestyle change: a cluster less active, a more active cluster, and a third cluster as active as usual. People who were usually less active were more likely to be classified in the cluster that increased physical activity in confinement. Scores of the Healthy Mediterranean-Style dietary pattern were higher in this group. Conclusions: Different patterns of change in lifestyles in confinement suggest the need to tailor support and advice to different population groups.

[Weight status, body composition, and diet quality of Spanish schoolchildren according to their level of adherence to the 24-hour movement guidelines]. / Situación ponderal, composición corporal y calidad de la dieta de los escolares españoles en función del nivel de adherencia a las guías de movimiento de 24 horas.

INTRODUCTION: Introduction: moderate to vigorous physical activity, limiting sedentary behaviors, and getting adequate rest are lifestyle factors that help prevent overweight and obesity. However, there are few studies that relate all of these factors to weight status, body composition, and diet quality in school children. Objective: to assess the differences in anthropometric status and diet quality in a group of Spanish schoolchildren, according to their level of adherence to the 24-hour movement guidelines. Methods: a total of 367 schoolchildren aged 7-11 years were studied. Anthropometric, dietary, and movement patterns were collected. Subsequently, they were divided into three groups based on their adherence to the extant guidelines: low adherence (BA), medium adherence (AM) and high adherence (AA). Results: only 15 % of the schoolchildren met the guidelines. The percentage of overweight was higher in the BA group than in the AM and AA groups. The BA group also had a lower fibre intake; a lower contribution to the recommendations for vitamins B6, B12 and C, selenium and magnesium; and a higher intake of saturated fatty acids. The schoolchildren who did not meet screen time recommendations had a higher odds ratio for overweight/obesity (OR = 1.92 (1.10-3.36); p = 0.022). Conclusion: schoolchildren who adhere to 2 or more movement guideline recommendations had less overweight and a diet of better nutritional quality. Non-compliance with the screen time recommendation leads to a higher risk of overweight or obesity.

INTRODUCCIÓN: Introducción: la actividad física moderada o vigorosa, la limitación de los comportamientos sedentarios y el descanso adecuado son factores del estilo de vida que ayudan a prevenir el sobrepeso y la obesidad. Sin embargo, existen pocos trabajos que relacionen el conjunto de estos factores con la situación ponderal, la composición corporal y la calidad de la dieta en escolares. Objetivo: conocer las diferencias en cuanto a situación antropométrica y calidad de la dieta de un grupo de escolares españoles en función del nivel de adherencia a las guías de movimiento de 24 horas. Métodos: se han estudiado 367 escolares de 7-11 años de edad. Se recogieron datos antropométricos, dietéticos y de comportamientos de movimiento. Posteriormente se dividieron en tres grupos sobre la base de su adherencia a las guías: baja adherencia (BA), adherencia media (AM) y alta adherencia (AA). Resultados: solo un 15 % de los escolares cumplía con las guías. El porcentaje de sobrepeso era mayor en el grupo BA que en el AM y el AA. El grupo BA también presentaba una menor ingesta de fibra; una menor contribución a las recomendaciones de vitaminas B6, B12 y C, selenio y magnesio; y una mayor ingesta de ácidos grasos saturados. Los escolares que incumplían la recomendación referente al tiempo de pantalla tenían mayor riesgo de desarrollar sobrepeso u obesidad (OR = 1,92 (1,10-3,36); p = 0,022). Conclusión: los escolares que se adhieren a 2 o más recomendaciones de las guías de movimiento presentan menos sobrepeso y una mejor calidad nutricional de la dieta. El incumplimiento de la recomendación de tiempo de pantalla supone un mayor riesgo de sobrepeso u obesidad.