[Eating behavior disorders in patients hospitalized in a Mental Health Service]. / Trastornos de la alimentación en pacientes hospitalizados en un Servicio de Salud Mental Pediátrico.

INTRODUCTION: Eating disorders (ED) have a high prevalence during adolescence, associated with high morbidity and mortality. In our country, there are no data that characterize adolescent inpatients with ED. OBJECTIVE: To describe and analyze hospitalizations of children and adolescents due to ED admitted in a Pediatric Mental Health Service (PMHS). PATIENTS AND METHOD: Data were collected from the clinical record of patients with ED hospitalized in the PMHS of the Hospital Roberto del Río during 2005-2015. The following admission variables were studied: cause for hospitalization, ED type, nu tritional status, systemic involvement, and psychosocial variables (psychiatric comorbidities, family functioning, abuse, and suicide ideation/attempt). The t-Student test was used for quantitative varia bles and the chi-square or Fisher Test for qualitative variables for the comparison between groups. RESULTS: 93 patients were included, with an average age of 14.6 years, 84% of them were women. The most frequent diagnosis was anorexia nervosa (AN) (71%) and the most frequent cause for hospita lization was the failure of outpatient treatment, followed by suicide ideation/attempt. At admission, 40% of the patients had malnutrition, 96% psychiatric comorbidity, and 88% family dysfunction. CONCLUSION: AN was the most frequent ED among inpatients and the failure of outpatient treatment was the main cause for hospitalization. The latter could be explained, in part, by the high prevalence of family dysfunction and psychiatric comorbidity of patients and their families which would com plicate outpatient treatment.

Trastornos de la alimentación en pacientes hospitalizados en un Servicio de Salud Mental Pediátrico / Eating behavior disorders in patients hospitalized in a Mental Health Service

INTRODUCTION: Los trastornos de la alimentación e ingesta (TAI) tienen una elevada prevalencia durante la adolescencia, asociándose a alta morbimortalidad. En nuestro país no existen datos que caractericen a los adolescentes con TAI que requieren hospitalización. OBJETIVO: Describir y analizar las hospitaliza ciones debidas a TAI en niños y adolescentes en un Servicio de Salud Mental Pediátrico (SSMP). PACIENTES Y MÉTODO: Se recolectaron los datos de los registros clínicos de pacientes con TAI hospitalizados en el SSMP del Hospital Roberto del Río entre 2005-2015. Se estudiaron las variables de ingreso: motivo de hospitalización, tipo de TAI, estado nutricional, repercusión sistémica y variables sicosociales (comorbilidades siquiátricas, funcionamiento de la familia, abuso e ideación/intento suicida). Para la comparación de variables cuantitativas entre grupos se utilizó el test t-Student y para variables categóricas chi-cuadrado o Test Fisher. RESULTADOS: Se incluyeron 93 pacientes, me diana de edad 14,6 años, 84% género femenino. El diagnóstico más frecuente fue anorexia nerviosa (AN) (71%) y la causa más frecuente de hospitalización fue el fracaso del tratamiento ambulatorio, seguido por ideación/intento suicida. Al ingreso, 40% de los pacientes presentaban déficit nutricio nal, 96% comorbilidad psiquiátrica y 88% disfunción familiar. CONCLUSIÓN: La AN fue el TAI más frecuente dentro de los pacientes hospitalizados y el fracaso del tratamiento ambulatorio el principal motivo de ingreso. Esto último podría ser explicado, en parte, por la alta prevalencia de disfunción familiar y comorbilidad psiquiátrica de los pacientes y su familia, que estaría complicando el trata miento ambulatorio.

INTRODUCTION: Eating disorders (ED) have a high prevalence during adolescence, associated with high morbidity and mortality. In our country, there are no data that characterize adolescent inpatients with ED. OBJECTIVE: To describe and analyze hospitalizations of children and adolescents due to ED admitted in a Pediatric Mental Health Service (PMHS). PATIENTS AND METHOD: Data were collected from the clinical record of patients with ED hospitalized in the PMHS of the Hospital Roberto del Río during 2005-2015. The following admission variables were studied: cause for hospitalization, ED type, nu tritional status, systemic involvement, and psychosocial variables (psychiatric comorbidities, family functioning, abuse, and suicide ideation/attempt). The t-Student test was used for quantitative varia bles and the chi-square or Fisher Test for qualitative variables for the comparison between groups. RESULTS: 93 patients were included, with an average age of 14.6 years, 84% of them were women. The most frequent diagnosis was anorexia nervosa (AN) (71%) and the most frequent cause for hospita lization was the failure of outpatient treatment, followed by suicide ideation/attempt. At admission, 40% of the patients had malnutrition, 96% psychiatric comorbidity, and 88% family dysfunction. CONCLUSION: AN was the most frequent ED among inpatients and the failure of outpatient treatment was the main cause for hospitalization. The latter could be explained, in part, by the high prevalence of family dysfunction and psychiatric comorbidity of patients and their families which would com plicate outpatient treatment.

Bone mineral density, lung function, vitamin D and body composition in children and adolescents with cystic fibrosis: a multicenter study.

BACKGROUND: cystic fibrosis (CF) is the most common inherited disease in Caucasian population. Nowadays, long survival has led to the emergence of new complications, such as CF bone disease (CFBD), which is characterized by increased fracture risk. OBJECTIVES: evaluate the association of bone mineral density (BMD) with lung function and BMD with 25-hydroxivitamin D (25OHD) plasmatic levels in children/adolescents with CF. METHODS: we conducted a multicenter, cross-sectional study with clinically stable CF patients between five and 18 years. Weight, height, pubertal development, BMD and body composition (DXA), pulmonary function (FEV1 and FEF25-75) and 25OHD plasmatic levels were measured. Patients answered food intake and physical activity surveys. p values under 0.05 were considered as statistically significant. RESULTS: thirty-seven patients were enrolled, 51% with normal respiratory function. Mean BMD Z-score in lumbar spine and in total body less head were -0.4 and -0.5 respectively. Twenty seven percent had a fat free mass index below the third percentile, 89% had 25OHD levels lower than 30 ng/ml and 78.4% had a low calcium intake. We did not find any correlations between BMD Z-scores, lung function or 25OHD levels. Patients with fat free mass (FFM) below the third percentile had BMD Z-score lower than -1 more frequently, in both locations (p < 0.006 and p < 0.001, respectively). CONCLUSIONS: although most assessed patients had normal BMD and normal lung function, a high proportion had low: FFM, calcium intake and 25OHD levels. The association between low FFM and low BMD highlights the importance of improving body composition in CF patients, in order to prevent future CFBD.

Bone mineral density, lung function, vitamin d and body composition in children and adolescents with cystic fibrosis: a multicenter study / Densidad mineral ósea, función pulmonar, vitamina D y composición corporal en niños y adolescentes con fibrosis quística: estudio multicéntrico

Background: cystic fibrosis (CF) is the most common inherited disease in Caucasian population. Nowadays, long survival has led to the emergence of new complications, such as CF bone disease (CFBD), which is characterized by increased fracture risk. Objectives: evaluate the association of bone mineral density (BMD) with lung function and BMD with 25-hydroxivitamin D (25OHD) plasmatic levels in children/adolescents with CF. Methods: we conducted a multicenter, cross-sectional study with clinically stable CF patients between five and 18 years. Weight, height, pubertal development, BMD and body composition (DXA), pulmonary function (FEV1 and FEF25-75) and 25OHD plasmatic levels were measured. Patients answered food intake and physical activity surveys. p values under 0.05 were considered as statistically significant. Results: thirty-seven patients were enrolled, 51% with normal respiratory function. Mean BMD Z-score in lumbar spine and in total body less head were -0.4 and -0.5 respectively. Twenty seven percent had a fat free mass index below the third percentile, 89% had 25OHD levels lower than 30 ng/ml and 78.4% had a low calcium intake. We did not find any correlations between BMD Z-scores, lung function or 25OHD levels. Patients with fat free mass (FFM) below the third percentile had BMD Z-score lower than -1 more frequently, in both locations (p < 0.006 and p < 0.001, respectively).Conclusions: although most assessed patients had normal BMD and normal lung function, a high proportion had low: FFM, calcium intake and 25OHD levels. The association between low FFM and low BMD highlights the importance of improving body composition in CF patients, in order to prevent future CFBD

Introducción: la fibrosis quística (FQ) es la enfermedad hereditaria más frecuente en la población caucásica. La mayor sobrevida alcanzada ha favorecido la aparición de la enfermedad ósea (EO) asociada, con el consiguiente aumento del riesgo de fracturas. Objetivo: evaluar la asociación de la densidad mineral ósea (DMO) con la función pulmonar y con la concentración plasmática de 25-hidroxivitamina D (25OHD) en niños y adolescentes con FQ. Métodos: estudio transversal y multicentrico, de pacientes con FQ de entre cinco y 18 años, clínicamente estables. Se evaluó peso, talla, desarrollo puberal, DMO y composición corporal (DXA), función pulmonar (FEF25-75 y VEF1), 25OHD plasmática e ingesta alimentaria y actividad física por encuestas. Se consideró una diferencia significativa si p < 0,05. Resultados: ingresaron 37 pacientes, 51% con función pulmonar normal. Los DMO-z promedio en columna lumbar y cuerpo total sin cabeza fueron -0,4 y -0,5, respectivamente. El 27% tuvo un índice de masa libre de grasa (IMLG) < p3, el 89% tuvo niveles insuficientes o deficientes de 25OHD y el 78,4% tuvo déficit de ingesta de calcio. No encontramos correlación entre el DMO-z con la función pulmonar ni con la concentración de 25OHD. Los pacientes con MLG < p3 tuvieron con mayor frecuencia DMO-z baja o en riesgo, en ambas localizaciones (p = 0,006 y p = 0,001 respectivamente). Conclusiones: aunque la mayoría de los pacientes tuvo una DMO y una función pulmonar normal, una alta proporción de sujetos presentaron déficit de MLG, baja ingesta de calcio y deficit de 25OHD. La asociación entre déficit de MLG y menor DMO revela la importancia de mejorar este factor para prevenir la enfermedad ósea futura

[Evaluation of bone mineral density in children with vertical infection by HIV]. / Evaluación de la densidad mineral ósea en niños con infección vertical por VIH.

Changes in bone mineral density (BMD) are common in adults infected with human immunodeficiency virus (HIV). There are few studies evaluating bone involvement in children infected. OBJECTIVE: To evaluate BMD in vertically HIV-infected children. METHODS: We studied 53 infected children (8-18 years) from five hospitals. Disease status, nutritional assessment, vitamin D (25-OHD) levels and immunological status were recorded. BMD was measured by densitometry. Descriptive analysis, comparison of means and simple and multiple linear regression were used. RESULTS: 88.7% children were in stage B and C, 57% were eutrophic and 18.9% had short stature. 33.3% had 25-OHD levels < 20 ng / ml. 11%, 6% and 4% of the children had BMD <-2DE in hip, spine and whole body respectively. BMD was correlated with BMI, height, disease stage and years of treatment. Only protease inhibitors (PIs) maintained their significance when adjusted for other variables. CONCLUSION: children infected with HIV had lower BMD by age compared to NHANES III data. The severity of the disease, height, zBMI, years of treatment with antiretrovirals, mainly IP, are related to the reduction of bone mass.

Evaluación de la densidad mineral ósea en niños con infección vertical por VIH / Evaluation of bone mineral density in children with vertical infection by HIV

Resumen Los cambios en la densidad mineral ósea (DMO) son comunes en adultos infectados con virus de la inmunodeficiencia humana (VIH). Existen pocos estudios que evalúen el compromiso óseo en niños. Objetivo: Evaluar la DMO en niños infectados verticalmente por VIH. Métodos: Se estudiaron 53 niños infectados (8-18) de cinco hospitales. Se registró severidad de enfermedad, evaluación nutricional, vitamina D (25-OHD) y estado inmunológico. La DMO se midió mediante densitometría. Se utilizó análisis descriptivo, comparación de medias y regresión lineal simple y múltiple. Resultados: El 88,7% estaban en estadio B y C, 57% eran eutróficos y 18,9% tenían talla baja. El 33,3% presentaba niveles de 25-OHD < 20 ng/ml. El 11%, 6% y 4% de los niños tenían DMO < 2DE en cadera, columna y cuerpo entero, respectivamente. La DMO se correlacionó con IMC, talla, severidad de enfermedad y años de tratamiento. Sólo inhibidores de las proteasas (IP) mantuvieron su significancia al ajustar por otras variables. Conclusión: Los niños infectados con VIH tuvieron DMO más baja por edad comparados con datos de NHANES III. La severidad de la enfermedad, talla, zIMC, los años de tratamiento con anti-retrovirales, principalmente IP, están relacionados con la reducción de la masa ósea.

Changes in bone mineral density (BMD) are common in adults infected with human immunodeficiency virus (HIV). There are few studies evaluating bone involvement in children infected. Objective: To evaluate BMD in vertically HIV-infected children. Methods: We studied 53 infected children (8-18 years) from five hospitals. Disease status, nutritional assessment, vitamin D (25-OHD) levels and immunological status were recorded. BMD was measured by densitometry. Descriptive analysis, comparison of means and simple and multiple linear regression were used. Results: 88.7% children were in stage B and C, 57% were eutrophic and 18.9% had short stature. 33.3% had 25-OHD levels < 20 ng / ml. 11%, 6% and 4% of the children had BMD <-2DE in hip, spine and whole body respectively. BMD was correlated with BMI, height, disease stage and years of treatment. Only protease inhibitors (PIs) maintained their significance when adjusted for other variables. Conclusion: children infected with HIV had lower BMD by age compared to NHANES III data. The severity of the disease, height, zBMI, years of treatment with antiretrovirals, mainly IP, are related to the reduction of bone mass.

Estrés, afrontamiento y calidad de vida relacionada a la salud en mujeres con cáncer de mama

Este estudio examina la contribución que tienen el estrés traumático, el estrés percibido y el afrontamiento sobre los componentes físico y mental de la CVRS de 53 mujeres diagnosticadas con cáncer de mama. Los instrumentos utilizados fueron el cuestionario de salud SF-36, el inventario de estimación del afrontamiento COPE, la escala de estrés percibido EEP y la adaptación peruana de la escala de estrés traumático. Se encontraron niveles promedio y altos de CVRS. La condición de migración, el tipo de tratamiento y el estrés traumático explican el 30% de la variabilidad del componente físico; mientras que, el estrés traumático, el estrés percibido y el estilo orientado a la emoción, explican el 43% de la variabilidad del componente mental.

This study analyzes the contribution that traumatic stress, perceived stress, and coping have on the variability of physical and metal components of the HRQoL of 53 women with breast cancer. The instruments used include the SF36 health survey, the COPE Inventory, the Perceived Stress Scale PSS and the Peruvian adaptation of the traumatic stress scale. The analysis found medium and high levels of global HRQoL. The migration status, type of treatment and traumatic stress account for 30 % of the variability of the physical component of HRQoL, whereas traumatic stress, perceived stress and emotional oriented style account the 43% of the variability of the mental component.

[Tenofovir-associated Fanconi`s syndrome and rickets in a HIV infected girl]. / Síndrome de Fanconi y raquitismo hipofosfatémico asociado al uso de tenofovir en una niña infectada con VIH.

Tenofovir (TDF) is an inhibitor of reverse transcriptase nucleotide analogue, although it has good tolerability and high anti-retroviral activity, its effect on the kidney has been a concern. OBJECTIVE: To describe a girl infected with HIV who presented Fanconi syndrome during antiretroviral therapy with TDF. CLINICAL CASE: We describe a HIV-1-infected girl, who after 18 months treatment with TDF presented loss of strength and pain of the lower extremities with functional impairment. Laboratory findings were consistent with Fanconi syndrome. Radiographs showed bilateral hip fracture and wrists. Full recovery of Fanconi syndrome was achieved four months after changing antiretroviral therapy. CONCLUSIONS: TDF-prescribing physicians must be prepared to detect signs and symptoms of renal dysfunction and immediately consider switching to another antiviral drug.

Síndrome de Fanconi y raquitismo hipofosfatémico asociado al uso de tenofovir en una niña infectada con VIH / Tenofovir-associated Fanconi`s syndrome and rickets in a HIV infected girl

El tenofovir (TDF) es un inhibidor de la transcriptasa reversa análogo de nucleótidos, aunque tiene buena tolerabilidad y alta actividad antirretroviral, su efecto sobre el riñón ha sido un motivo de preocupación. Objetivo: Describir el caso de una niña infectada por VIH que presenta síntomas y hallazgos de laboratorio compatibles con un síndrome de Fanconi durante el tratamiento con TDF como parte de su terapia antirretroviral. Caso clínico: Niña infectada por el VIH-1, que después de 18 meses con el tratamiento con TDF presentó pérdida de fuerza y dolor de las extremidades inferiores con deterioro funcional. Los hallazgos de laboratorio fueron compatibles con el síndrome de Fanconi. Las radiografías mostraron fractura bilateral de cadera y muñecas. El síndrome de Fanconi se recuperó por completo cuatro meses después del cambio de terapia antirretroviral. Conclusiones: Los médicos que prescriben TDF deben estar preparados para detectar signos y síntomas indicativos de disfunción renal y considerar de inmediato el cambio del fármaco a otro antirretroviral.

Tenofovir (TDF) is an inhibitor of reverse transcriptase nucleotide analogue, although it has good tolerability and high anti-retroviral activity, its effect on the kidney has been a concern. Objective: To describe a girl infected with HIV who presented Fanconi syndrome during antiretroviral therapy with TDF. Clinical case: We describe a HIV-1-infected girl, who after 18 months treatment with TDF presented loss of strength and pain of the lower extremities with functional impairment. Laboratory findings were consistent with Fanconi syndrome. Radiographs showed bilateral hip fracture and wrists. Full recovery of Fanconi syndrome was achieved four months after changing antiretroviral therapy. Conclusions: TDF-prescribing physicians must be prepared to detect signs and symptoms of renal dysfunction and immediately consider switching to another antiviral drug.

[Mercury in fish and its importance in health]. / Mercurio en pescados y su importancia en la salud.

The contamination of fish with methylmercury (MeHg) could hamper the health promoting properties of fish. Currently, there is strong evidence about the health benefits of seafood consumption. When consumed by the mother before and during pregnancy it improves neurodevelopment of infants and toddlers. Thereafter it reduces the risk of cardiovascular and other chronic diseases. The benefits of fish are mainly due to its content of omega-3 long chain polyunsaturated fatty acids, including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Other constituents, such as high biological value proteins, fat-soluble vitamins, minerals and trace elements contribute to the benefits. On the other hand, there is also convincing evidence about the adverse effects of MeHg on neurodevelopment both during gestation and in early childhood. We herein review the effects of mercury on health. Based on international evidence and new data on the mercury content in Chilean fish, we also propose a recommendation for fish consumption for our population.

Mercurio en pescados y su importancia en la salud / Mercury in fish and its importance in health

The contamination of fish with methylmercury (MeHg) could hamper the health promoting properties of fish. Currently, there is strong evidence about the health benefits of seafood consumption. When consumed by the mother before and during pregnancy it improves neurodevelopment of infants and toddlers. Thereafter it reduces the risk of cardiovascular and other chronic diseases. The benefits of fish are mainly due to its content of omega-3 long chain polyunsaturated fatty acids, including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Other constituents, such as high biological value proteins, fat-soluble vitamins, minerals and trace elements contribute to the benefits. On the other hand, there is also convincing evidence about the adverse effects of MeHg on neurodevelopment both during gestation and in early childhood. We herein review the effects of mercury on health. Based on international evidence and new data on the mercury content in Chilean fish, we also propose a recommendation for fish consumption for our population.

Incremental replacement of saturated fats by n-3 fatty acids in high-fat, high-cholesterol diets reduces elevated plasma lipid levels and arterial lipoprotein lipase, macrophages and atherosclerosis in LDLR-/- mice.

OBJECTIVE: Effects of progressive substitution of dietary n-3 fatty acids (FA) for saturated FA (SAT) on modulating risk factors for atherosclerosis have not been fully defined. Our previous reports demonstrate that SAT increased, but n-3 FA decreased, arterial lipoprotein lipase (LpL) levels and arterial LDL-cholesterol deposition early in atherogenesis. We now questioned whether incremental increases in dietary n-3 FA can counteract SAT-induced pro-atherogenic effects in atherosclerosis-prone LDL-receptor knockout (LDLR-/-) mice and have identified contributing mechanisms. METHODS AND RESULTS: Mice were fed chow or high-fat diets enriched in SAT, n-3, or a combination of both SAT and n-3 in ratios of 3:1 (S:n-3 3:1) or 1:1 (S:n-3 1:1). Each diet resulted in the expected changes in fatty acid composition in blood and aorta for each feeding group. SAT-fed mice became hyperlipidemic. By contrast, n-3 inclusion decreased plasma lipid levels, especially cholesterol. Arterial LpL and macrophage levels were increased over 2-fold in SAT-fed mice but these were decreased with incremental replacement with n-3 FA. n-3 FA partial inclusion markedly decreased expression of pro-inflammatory markers (CD68, IL-6, and VCAM-1) in aorta. SAT diets accelerated advanced atherosclerotic lesion development, whereas all n-3 FA-containing diets markedly slowed atherosclerotic progression. CONCLUSION: Mechanisms whereby dietary n-3 FA may improve adverse cardiovascular effects of high-SAT, high-fat diets include improving plasma lipid profiles, increasing amounts of n-3 FA in plasma and the arterial wall. Even low levels of replacement of SAT by n-3 FA effectively reduce arterial lipid deposition by decreasing aortic LpL, macrophages and pro-inflammatory markers.

Fatty acids regulate endothelial lipase and inflammatory markers in macrophages and in mouse aorta: a role for PPARγ.

OBJECTIVE: Macrophage endothelial lipase (EL) is associated with increased atherosclerosis and inflammation. Because of their anti-inflammatory properties we hypothesized that n-3 fatty acids, in contrast to saturated fatty acids, would lower macrophages and arterial EL and inflammatory markers. METHODS AND RESULTS: Murine J774 and peritoneal macrophages were incubated with eicosapentaenoic acid or palmitic acid in the presence or absence of lipopolysaccaride (LPS). LPS increased EL mRNA and protein. Palmitic acid alone or with LPS dose-dependently increased EL mRNA and protein. In contrast, eicosapentaenoic acid dose-dependently abrogated effects of LPS or palmitic acid on increasing EL expression. EL expression closely linked to peroxisome proliferator activated receptor (PPAR)γ expression. Eicosapentaenoic acid blocked rosiglitazone (a PPARγ agonist)-mediated EL activation and GW9662 (a PPARγ antagonist)-blocked palmitic acid-mediated EL stimulation. Eicosapentaenoic acid alone or with LPS blunted LPS-mediated stimulation of macrophage proinflammatory interleukin-6, interleukin-12p40, and toll-like receptor-4 mRNA and increased anti-inflammatory interleukin-10 and mannose receptor mRNA. In vivo studies in low density lipoprotein receptor knockout mice showed that high saturated fat rich diets, but not n-3 diets, increased arterial EL, PPARγ, and proinflammatory cytokine mRNA. CONCLUSIONS: n-3 fatty acids, in contrast to saturated fatty acids, decrease EL in parallel with modulating pro- and anti-inflammatory markers, and these effects on EL link to PPARγ.

The omega-3 fatty acid nutritional landscape: health benefits and sources.

Dietary fatty acids (FA) are increasingly recognized as major biologic regulators and have properties that relate to health outcomes and disease. The longer chain, more bioactive (n-6) (or omega-6) FA and (n-3) (or omega-3) FA share similar elongation and desaturation enzymes in their conversion from the essential (n-6) FA, linoleic acid, and (n-3) FA, α-linolenic acid (ALA). Conversion from these essential FA is very inefficient. However, now for the (n-3) FA series, soy oil can be enriched with (n-3) stearidonic acid (SDA) to allow for much more efficient conversion to longer chain EPA. EPA and the longer chain DHA possess distinct physical and biological properties that generally impart properties to cells and tissue, which underlie their ability to promote health and prevent disease. Although active in a number of areas of human biology, mechanisms of action of EPA and DHA are perhaps best defined in cardiovascular disease. There is concern that to reach the intake recommendations of EPA and DHA, their supply from cold water fish will be insufficient. Gaps in understanding mechanisms of action of (n-3) FA in a number of health and disease areas as well as optimal sources and intake levels for each need to be defined by further research. Because of the inefficient conversion of ALA, the appearance of SDA in enriched soy oil offers a biologically effective and cost effective approach to providing a sustainable plant source for (n-3) FA in the future.

[Quality of fat intake, atherosclerosis and coronary disease: effects of saturated and trans fatty acids]. / Calidad de grasa, arterioesclerosis y enfermedad coronaria: efectos de los ácidos grasos saturados y ácidos grasos trans.

Epidemiological, clinical and metabolic research has shown a strong association between dietary fatty acids intake and cardiovascular disease (CVD) risk factors and clinical events. Saturated fatty acids (SFA) and trans fatty acids (TFA) derived from industrial hydrogenation of oils have been associated with an increased prevalence of CVD. However experimental results on the relationship between physiological pathologic effects and specific functions of individual SFA are often contradictory. Therefore a more detailed exploration of the potential benefit and risks of specific saturated and trans fatty acids is needed in order to update dietary recommendations. In the case of TFAs, the deleterious effect on CVD has been well demonstrated and a maximum accepted level of 1 % of total energy has been agreed internationally. What is currently under discussion is what would be the best alternative to replace them in the diet.

Calidad de grasa, arterioesclerosis y enfermedad coronaria: efectos de los ácidos grasos saturados y ácidos grasos trans / Quality of fat intake, atherosclerosis and coronary disease: effects of saturated and trans fatty acids

Epidemiological, clinical and metabolic research has shown a strong association between dietary fatty acids intake and cardiovascular disease (CVD) risk factors and clinical events. Saturated fatty acids (SFA) and trans fatty acids (TFA) derived from industrial hydrogenation of oils have been associated with an increased prevalence of CVD. However experimental results on the relationship between physiological pathologic effects and specific functions of individual SFA are often contradictory. Therefore a more detailed exploration of the potential benefit and risks of specific saturated and trans fatty acids is needed in order to update dietary recommendations. In the case of TFAs, the deleterious effect on CVD has been well demonstrated and a maximum accepted level of 1 percent of total energy has been agreed internationally. What is currently under discussion is what would be the best alternative to replace them in the diet.

n-3 Fatty acids and cardiovascular disease: mechanisms underlying beneficial effects.

Dietary n-3 fatty acids, particularly eicosapentaenoic acid and docosahexaenoic acid, are important nutrients through the life cycle. Evidence from observational, clinical, animal, and in vitro studies indicates a beneficial role of n-3 fatty acids in the prevention and management of cardiovascular disease. Although the precise mechanisms are still unclear, clinical and preclinical studies indicate that the cardioprotective effects of n-3 fatty acids may be attributed to a number of distinct biological effects on lipid and lipoprotein metabolism, blood pressure, platelet function, arterial cholesterol delivery, vascular function, and inflammatory responses.

Zinc and iron nutrition in Chilean children fed fortified milk provided by the Complementary National Food Program.

OBJECTIVE: Chilean infants are at risk for isolated zinc and iron deficiencies because of a low consumption of animal products in low socioeconomic sectors. In 1999, the National Complementary Food Program of Chile manufactured a new milk (2 kg of powdered milk/mo) fortified with iron (Fe; 10 mg/L), zinc (Zn; 5 mg/L), and copper (0.5 mg/L) to be provided to infants until age 18 mo and to pregnant women. We analyzed the nutrition status of zinc and iron at age 18 mo in infants who consumed the fortified cow's milk. METHODS: Forty-two healthy male children with normal growth and from lower socioeconomic groups were studied. A nutrition survey was conducted; blood and hair samples for Zn in plasma and hair, hemoglobin, hematocrit, and serum ferritin were obtained. RESULTS: Mean intakes were: energy, 106 +/- 27 kcal. kg(-1). d(-1); protein, 3.8 +/- 1.1 g. kg(-1). d(-1); Zn, 5.2 +/- 1.9 g/d (0.98 mg Zn/MJ; 68% of World Health Organization recommendations); Fe, 11.2 +/- 5.5 mg/d; and dietary fiber, 9.8 +/- 3.9 g/d. Plasma Zn in 54.8% of children was no greater than 12.3 microM/L; 36% had hair Zn level no greater than 1.23 microM/g and 39% had serum ferritin levels no greater than 10 microg/dL (12% were anemic). Hair Zn was correlated to socioeconomic level (Spearman's rank correlation, r = -0.53; P < 0.001) and plasma Zn was correlated to the z weight/length (r = 0.47; P < 0.05), subscapular skinfold (r = 0.46; P < 0.05), and Zn intake (r = 0.46; P < 0.05). CONCLUSIONS: The fortified powdered cow's milk provided to infants until age 18 mo by the Complementary Food Program in Chile favorably affects the Fe status of these children, but possibly not the Zn nutrition; we suggest re-evaluation of the levels of Zn fortification.