Association between Adherence to Swedish Dietary Guidelines and Mediterranean Diet and Risk of Stroke in a Swedish Population.

Dietary factors associated with stroke risk are still rather unknown. The aim was to examine the association between adherence to healthy dietary patterns and incidence of stroke among 25,840 individuals from the Swedish Malmö Diet and Cancer Study cohort. Dietary data were obtained using a combination of a 7-day food record, diet questionnaire, and interview. A Swedish Dietary Guidelines Score (SDGS), including five dietary components based on the current Swedish dietary guidelines, and a modified Mediterranean diet score (mMDS), composed of ten dietary components, were constructed. Over a mean follow-up period of 19.5 years, 2579 stroke cases, of which 80% were ischaemic, were identified through national registers. Weak, non-significant associations were found between the dietary indices and the risk of stroke. However, after excluding potential misreporters and individuals with unstable food habits (35% of the population), we observed significant inverse association (p-trend < 0.05) between SDGS and mMDS and total and ischaemic stroke (HR per point for total stroke: 0.96; 95% CI: 0.92−1.00 for SDGS and 0.95; 95% CI: 0.91−0.99 for mMDS). In conclusion, high quality diet in line with the current Swedish dietary recommendations or Mediterranean diet may reduce the risk of total and ischaemic stroke.

Effect of changes in adherence to Mediterranean diet on nutrient density after 1-year of follow-up: results from the PREDIMED-Plus Study.

BACKGROUND: The prevalence of overweight/obesity and related manifestations such as metabolic syndrome (MetS) is increasing worldwide. High energy density diets, usually with low nutrient density, are among the main causes. Some high-quality dietary patterns like the Mediterranean diet (MedDiet) have been linked to the prevention and better control of MetS. However, it is needed to show that nutritional interventions promoting the MedDiet are able to improve nutrient intake. OBJECTIVE: To assess the effect of improving MedDiet adherence on nutrient density after 1 year of follow-up at the PREDIMED-Plus trial. METHODS: We assessed 5777 men (55-75 years) and women (60-75 years) with overweight or obesity and MetS at baseline from the PREDIMED-Plus trial. Dietary changes and MedDiet adherence were evaluated at baseline and after 1 year. The primary outcome was the change in nutrient density (measured as nutrient intake per 1000 kcal). Multivariable-adjusted linear regression models were fitted to analyse longitudinal changes in adherence to the MedDiet and concurrent changes in nutrient density. RESULTS: During 1-year follow-up, participants showed improvements in nutrient density for all micronutrients assessed. The density of carbohydrates (- 9.0%), saturated fatty acids (- 10.4%) and total energy intake (- 6.3%) decreased. These changes were more pronounced in the subset of participants with higher improvements in MedDiet adherence. CONCLUSIONS: The PREDIMED-Plus dietary intervention, based on MedDiet recommendations for older adults, maybe a feasible strategy to improve nutrient density in Spanish population at high risk of cardiovascular disease with overweight or obesity.

Association between dairy product consumption and hyperuricemia in an elderly population with metabolic syndrome.

BACKGROUND AND AIMS: The prevalence of hyperuricemia has increased substantially in recent decades. It has been suggested that it is an independent risk factor for weight gain, hypertension, hypertriglyceridemia, metabolic syndrome (MetS), and cardiovascular disease. Results from epidemiological studies conducted in different study populations have suggested that high consumption of dairy products is associated with a lower risk of developing hyperuricemia. However, this association is still unclear. The aim of the present study is to explore the association of the consumption of total dairy products and their subtypes with the risk of hyperuricemia in an elderly Mediterranean population with MetS. METHODS AND RESULTS: Baseline cross-sectional analyses were conducted on 6329 men/women (mean age 65 years) with overweight/obesity and MetS from the PREDIMED-Plus cohort. Dairy consumption was assessed using a food frequency questionnaire. Multivariable-adjusted Cox regressions were fitted to analyze the association of quartiles of consumption of total dairy products and their subtypes with the prevalence of hyperuricemia. Participants in the upper quartile of the consumption of total dairy products (multiadjusted prevalence ratio (PR) = 0.84; 95% CI: 0.75-0.94; P-trend 0.02), low-fat dairy products (PR = 0.79; 95% CI: 0.70-0.89; P-trend <0.001), total milk (PR = 0.81; 95% CI: 0.73-0.90; P-trend<0.001), low-fat milk (PR = 0.80; 95% CI: 0.72-0.89; P-trend<0.001, respectively), low-fat yogurt (PR = 0.89; 95% CI: 0.80-0.98; P-trend 0.051), and cheese (PR = 0.86; 95% CI: 0.77-0.96; P-trend 0.003) presented a lower prevalence of hyperuricemia. Whole-fat dairy, fermented dairy, and yogurt consumption were not associated with hyperuricemia. CONCLUSIONS: High consumption of total dairy products, total milk, low-fat dairy products, low-fat milk, low-fat yogurt, and cheese is associated with a lower risk of hyperuricemia.

Associations between Dietary Polyphenols and Type 2 Diabetes in a Cross-Sectional Analysis of the PREDIMED-Plus Trial: Role of Body Mass Index and Sex.

Overweight and obesity are important risk factors for type 2 diabetes (T2D). Moving towards healthier diets, namely, diets rich in bioactive compounds, could decrease the odds of suffering T2D. However, those individuals with high body mass index (BMI) may have altered absorption or metabolism of some nutrients and dietary components, including polyphenols. Therefore, we aimed to assess whether high intakes of some classes of polyphenols are associated with T2D in a population with metabolic syndrome and how these associations depend on BMI and sex. This baseline cross-sectional analysis includes 6633 participants from the PREDIMED-Plus trial. Polyphenol intakes were calculated from food frequency questionnaires (FFQ). Cox regression models with constant time at risk and robust variance estimators were used to estimate the prevalence ratios (PRs) for polyphenol intake and T2D prevalence using the lowest quartile as the reference group. Analyses were stratified by sex and BMI groups (overweight and obese) to evaluate potential effect modification. Catechins, proanthocyanidins, hydroxybenzoic acids, and lignans were inversely associated with T2D. Hydroxycinnamic acids were directly related in men. These associations were different depending on sex and BMI, that is, women and overweight obtained stronger inverse associations.

Seafood Consumption, Omega-3 Fatty Acids Intake, and Life-Time Prevalence of Depression in the PREDIMED-Plus Trial.

BACKGROUND: The aim of this analysis was to ascertain the type of relationship between fish and seafood consumption, omega-3 polyunsaturated fatty acids (ω-3 PUFA) intake, and depression prevalence. METHODS: Cross-sectional analyses of the PREDIMED-Plus trial. Fish and seafood consumption and ω-3 PUFA intake were assessed through a validated food-frequency questionnaire. Self-reported life-time medical diagnosis of depression or use of antidepressants was considered as outcome. Depressive symptoms were collected by the Beck Depression Inventory-II. Logistic regression models were used to estimate the association between seafood products and ω-3 PUFA consumption and depression. Multiple linear regression models were fitted to assess the association between fish and long-chain (LC) ω-3 PUFA intake and depressive symptoms. RESULTS: Out of 6587 participants, there were 1367 cases of depression. Total seafood consumption was not associated with depression. The odds ratios (ORs) (95% confidence intervals (CIs)) for the 2nd, 3rd, and 4th quintiles of consumption of fatty fish were 0.77 (0.63⁻0.94), 0.71 (0.58⁻0.87), and 0.78 (0.64⁻0.96), respectively, and p for trend = 0.759. Moderate intake of total LC ω-3 PUFA (approximately 0.5⁻1 g/day) was significantly associated with a lower prevalence of depression. CONCLUSION: In our study, moderate fish and LC ω-3 PUFA intake, but not high intake, was associated with lower odds of depression suggesting a U-shaped relationship.

Determinants of increasing serum POPs in a population at high risk for cardiovascular disease. Results from the PREDIMED-CANARIAS study.

Persistent organic pollutants (POPs) are well-known ubiquitous environmental chemicals which have been related to adverse health outcomes, including cardiovascular disease (CVD). The purpose of this study was to evaluate POPs burden, and its determinants, in a population at high risk of suffering CVD enrolled in the PREDIMED Study (Spanish acronym for PREvention by means of MEDiterranean Diet). This cohort was formed by 343 participants (55-80 y.o.), which were selected for a preventive nutritional intervention for CVD based on the Mediterranean Diet. Relevant information on demographic, behavioral, dietary, and socioeconomic characteristics was obtained from each participant through a specific questionnaire, and their anthropometric and clinical measurements were recorded. In addition, the levels of 35 POPs were determined in serum samples taken before the beginning of the nutritional intervention. All the samples showed detectable levels of, at least, one POP, being DDT-derivatives and marker-PCBs the most frequently detected compounds. Our results showed that people at high risk for CVD showed a higher level of contamination by POPs as compared to other studies done in cohorts of Western people at no special risk of CVD. Although educational level seems to be a relevant determinant for POPs burden in our population, the main determining factor seems to be the diet. Thus, while the intake of food of animal origin was significantly associated with levels of PCBs, especially in men, the intake of vegetal-origin food was positively related to levels of organochlorine pesticides, indicating a different dietary source for these two groups of chemicals. Our results showing that subjects at high risk for cardiovascular disease present elevated POPs burden might have a relevant public health impact given the generalized and difficult to avoid exposure to POPs and the elevated worldwide frequency of the CVD.

Beverage Intake Assessment Questionnaire: Relative Validity and Repeatability in a Spanish Population with Metabolic Syndrome from the PREDIMED-PLUS Study.

We assess the repeatability and relative validity of a Spanish beverage intake questionnaire for assessing water intake from beverages. The present analysis was performed within the framework of the PREDIMED-PLUS trial. The study participants were adults (aged 55-75) with a BMI ≥27 and <40 kg/m², and at least three components of Metabolic Syndrome (MetS). A trained dietitian completed the questionnaire. Participants provided 24-h urine samples, and the volume and urine osmolality were recorded. The repeatability of the baseline measurement at 6 and 1 year was examined by paired Student's t-test comparisons. A total of 160 participants were included in the analysis. The Bland-Altman analysis showed relatively good agreement between total daily fluid intake assessed using the fluid-specific questionnaire, and urine osmolality and 24-h volume with parameter estimates of -0.65 and 0.22, respectively (R² = 0.20; p < 0.001). In the repeatability test, no significant differences were found between neither type of beverage nor total daily fluid intake at 6 months and 1-year assessment, compared to baseline. The proposed fluid-specific assessment questionnaire designed to assess the consumption of water and other beverages in Spanish adult individuals was found to be relatively valid with good repeatability.

Influence of a Mediterranean Dietary Pattern on Body Fat Distribution: Results of the PREDIMED-Canarias Intervention Randomized Trial.

OBJECTIVE: To assess the influence of a Mediterranean dietary pattern (MeDiet) on anthropometric and body composition parameters in one of the centers of the PREDIMED randomized dietary trial. SUBJECTS/SETTINGS: 351 Canarian free-living subjects aged 55 to 80 years, with type 2 diabetes or ≥3 cardiovascular risk factors. INTERVENTION: Participants were randomly assigned to one of 3 different dietary interventions: MeDiet + extra-virgin olive oil (EVOO), MeDiet + nuts (walnuts, almonds, and hazelnuts), or a control low-fat diet. Total energy intake was ad libitum. OUTCOME MEASURES: Measures included changes in anthropometric measures (weight, body mass index [BMI] and waist circumference [WC]), body fat distribution, energy, and nutrient intake after 1 year. Body composition (percentage of total body fat [%TBF], total fat mass [TFM], free fat mass [FFM], percentage of truncal fat [%TrF], truncal fat mass [TrFM]) and total body water (TBW) were estimated by octapolar electrical impedance analysis. STATISTICAL ANALYSES: Paired t tests were conducted to assess within-group changes. Analyses of variance (ANOVAs) were used to assess the effect of the dietary intervention on the percentage change in anthropometric variables, body composition, and dietary intake profile. All pairwise comparisons that were statistically significant in ANOVA were subsequently adjusted using the Benjamini-Hochberg test, which penalizes for multiple comparisons. RESULTS: After 1 year of intervention, significant within-group reductions in all anthropometric variables were observed for the MeDiet + EVOO and the control group. The MeDiet + nuts group exhibited a significant reduction in WC and TBW. The control group showed a significant increase in %TBF and a reduction in TBW. The control group showed a significant increase in the percentage of total body fat and a reduction in TBW. However, we did not find any between-group significant difference in anthropometric or body composition changes. CONCLUSIONS: Mediterranean diets enriched with EVOO or specific mixed nuts (walnuts, almonds, hazelnuts) that contain approximately 40% total fat can be alternative options to low-fat diets for weight maintenance regimes in older overweight or obese adults.

Glycemic index, glycemic load and invasive breast cancer incidence in postmenopausal women: The PREDIMED study.

The objective of this study was to evaluate the prospective associations between dietary glycemic index (GI) and glycemic load (GL) and the risk for invasive breast cancer incidence in postmenopausal women at high cardiovascular disease (CVD) risk. This study was conducted within the framework of the PREvención con DIeta MEDiterránea (PREDIMED) study, a nutritional intervention trial for primary cardiovascular prevention. We included 4010 women aged between 60 and 80 years who were initially free from breast cancer but at high risk for CVD disease. Dietary information was collected using a validated 137-item food frequency questionnaire. We assigned GI values using the International Tables of GI and GL values. Cases were ascertained through yearly consultation of medical records and through consultation of the National Death Index. Only cases confirmed by results from cytology tests or histological evaluation were included. We estimated multivariable-adjusted hazard ratios for invasive breast cancer risk across tertiles of energy-adjusted dietary GI/GL using Cox regression models. We repeated our analyses using yearly repeated measures of GI/GL intakes. No associations were found between baseline dietary GI/GL and invasive breast cancer incidence. The multivariable hazard ratio and 95% confidence interval (CI) for the top tertile of dietary GI was 1.02 (95% CI: 0.42-2.46) and for dietary GL was 1.00 (95% CI: 0.44-2.30) when compared with the bottom tertile. Repeated-measures analyses yielded similar results. In sensitivity analyses, no significant associations were observed for women with obesity or diabetes. Dietary GI and GL did not appear to be associated with an increased risk for invasive breast cancer in postmenopausal women at high CVD risk.

A high dietary glycemic index increases total mortality in a Mediterranean population at high cardiovascular risk.

OBJECTIVE: Different types of carbohydrates have diverse glycemic response, thus glycemic index (GI) and glycemic load (GL) are used to assess this variation. The impact of dietary GI and GL in all-cause mortality is unknown. The objective of this study was to estimate the association between dietary GI and GL and risk of all-cause mortality in the PREDIMED study. MATERIAL AND METHODS: The PREDIMED study is a randomized nutritional intervention trial for primary cardiovascular prevention based on community-dwelling men and women at high risk of cardiovascular disease. Dietary information was collected at baseline and yearly using a validated 137-item food frequency questionnaire (FFQ). We assigned GI values of each item by a 5-step methodology, using the International Tables of GI and GL Values. Deaths were ascertained through contact with families and general practitioners, review of medical records and consultation of the National Death Index. Cox regression models were used to estimate multivariable-adjusted hazard ratios (HR) and their 95% CI for mortality, according to quartiles of energy-adjusted dietary GI/GL. To assess repeated measures of exposure, we updated GI and GL intakes from the yearly FFQs and used Cox models with time-dependent exposures. RESULTS: We followed 3,583 non-diabetic subjects (4.7 years of follow-up, 123 deaths). As compared to participants in the lowest quartile of baseline dietary GI, those in the highest quartile showed an increased risk of all-cause mortality [HR = 2.15 (95% CI: 1.15-4.04); P for trend  = 0.012]. In the repeated-measures analyses using as exposure the yearly updated information on GI, we observed a similar association. Dietary GL was associated with all-cause mortality only when subjects were younger than 75 years. CONCLUSIONS: High dietary GI was positively associated with all-cause mortality in elderly population at high cardiovascular risk.

La soja en la prevención de la enfermedad cardiovascular / Soy in the prevention of cardiovascular disease

Los alimentos de soja o aislados de proteína de soja contienen dos componentes bioactivos principales, las isoflavonas (ISF) asociadas con la proteína de soja y los péptidos generados a partir de las dos principales proteínas de la soja, B-conglicina y la glicina. Algunos componentes de la dieta con soja controlan las funciones de adhesión del endotelio vascular, mediante la regulación de los mecanismos claves de control de las moléculas de adhesión endoteliales, la función de la integrina en los monocitos, citoquinas y quimoquinas en el control del tráfico y migración de los monocitos. También podrían regular la oxLDL en la generación y regulación de la expresión de los recogedores de radicales libres. La dieta con soja y otras dietas con efectos antiinflamatorios pueden bloquear el proceso inflamatorio asociado con la aterogénesis, reduciendo así el riesgo de ECV. Se requieren de más estudios que aclaren tanto a nivel experimental como clínico los mecanismos de acción de las ISF en la protección cardiovascular (AU)

Soy food or soybean protein isolates contain two major bioactive components, isoflavones (ISF) associated with soy protein, and peptides generated from two major soybean protein, B-conglycinin and glycine. Some components of the diet with soybean control the functions of vascular endotelial adhesion, by regulating the control key mechanisms of endothelial adhesion molecules, integrin function in monocytes, cytokines and chemokines in the traffic control and migration of monocytes. OxLDL may also regulate the generation and regulation of expression of catchers of free radicals. The diet with soy and other anti-inflammatory diets can block the inflammatory process associated with atherogenesis, thus reducing the risk of CVD. Further studies are required to clarify both experimental and clinical mechanism of action of the ISF cardiovascular protection (AU)

Factores condicionantes de la lactancia materna durante el puerperio inmediato en el Hospital Universitario Materno-Infantil de Canarias (Las Palmas de Gran Canaria) / No disponible

Antecedentes: Los beneficios de la lactancia materna prolongadapara el binomio madre-niño están documentadosen una amplia bibliografía científica. Las recomendacionesdel informe Healthy People 2010 del Departamento delos Servicios de Salud de los U.S.A. establece como metaque el 75 % de las madres amamanten a sus bebés en elpuerperio y que por lo menos a los 6 meses lo mantengaun 50 %. El hospital ha sido un centro de esfuerzos en lapromoción del inicio de la lactancia.Objetivo: Conocer los factores que inciden positiva o negativamenteen la LM, en las parturientas atendidas en elHUMIC durante su estancia en el hospital, con el fin dedesarrollar e implementar estrategias que favorezcan elamamantamiento de los niños.Materiales y métodos: Estudio epidemiológico, prospectivo,observacional y descriptivo, en una muestra poblacionalde mujeres puérperas y sus bebés, seleccionadas al azar(n = 200 pares). Una enfermera especializada en LM lasentrevistó personalmente con un cuestionario previamenteelaborado, durante la visita diaria y en Diciembre del 2005,mediante llamada telefónica para preguntar por la duraciónde la lactancia y la razón del destete.Resultados: El mayor porcentaje de madres que dieronalguna de las modalidades de LM (especialmente LM exclusiva),habían recibido educación prenatal, informaciónen el hospital, técnica “piel con piel”, primera puesta alpecho en paritorio y ayuda de la enfermera para colocar elniño al pecho, mientras que aquellas que dieron lactanciaartificial representaron un porcentaje considerablementemenor en todos los casos.Conclusiones: Los factores demográficos maternos condicionantesde la LM coinciden con hallazgos previos...(AU)

Background: The benefits of breastfeeding at long time bythe binomial mother-child are documented in an amplescientific bibliography. The recommendations of the reportHealthy People 2010 of the Department of the Servicesof Health of the U.S.A. establish as goal that 75 % of themothers who breastfeed their babies in early postpartumperiod and that at least to the 6 months maintains 50 to it%. The Hospital has been a center of efforts in the promotionof the beginning of breast-feeding.Objective: To know the factors that affect positively or negativelythe breast-feeding in mothers in the HUMIC during their stay inthe hospital, with the purpose of developing and implementingstrategies that promote the breast-feeding of the babies.Materials and methods: Epidemiologic, prospective, descriptiveand observational study, in a population sample of motherspost-partum and their babies, randomized (n = 200 pairs).A nurse specialist in BF interviewed with a questionnairepreviously elaborated, during the daily visit and in Decemberof the 2005, by the telephone call to ask for the duration ofthe breastfeeding and the reason of the weaning.Results: The greater percentage of mothers than gave someof the breast-feeding modalities (specially exclusive breastfeeding),had received prenatal education, information in thehospital, technique “skin with skin”, first putting to the chestin delivery room and helps of the nurse to place the boy to thechest, whereas those that gave formula feeding representeda considerably smaller percentage in all the cases.Conclusions: The demographic factors maternal conditioners ofthe breast-feeding agree with previous findings...(au)

Consumo de alimentos ricos en ácidos grasos omega-3: Estudio en mujeres españolas durante el primer trimestre del embarazo (2002-2004) / No disponible

Objetivo: Conocer la frecuencia de consumo de alimentos queson fuente de ácidos grasos ω-3 (EPA y DHA) en mujeres embarazadasespañolas durante el primer trimestre de la gestación.Material y Métodos: Estudio de campo, descriptivo, en 888mujeres embarazadas en el primer trimestre de gestaciónprocedentes de los Centros de Salud de 18 provinciasespañolas, durante el período 2003-2004. Los médicosy/o matronas realizaron una entrevista que incluía losdatos socio-económicos y un cuestionario de frecuencia deconsumo de alimentos.Resultados: La edad media fue de 32,1 años (D.E.: 4,67) enun rango de 16 a 48 años. El pescado azul quedó ubicadomuy distante de los primeros puestos entre las preferenciasde las mujeres embarazadas ocupando el puesto número21 con un 4% y el séptimo lugar entre los alimentos quemenos gustan con un 7%.Conclusión: En la población de embarazadas estudiada, laingesta de alimentos ricos en ω-3, tales como los pescadosazules, lo consumen menos de una vez al mes más de un40% de las mujeres. El pescado azul no está dentro de losalimentos preferidos por la población estudiada y ocupa laséptima posición entre los alimentos que menos gustan(AU)

Objective: To know the frequency food consumption that isfatty acid source w-3 (EPA and DHA) in Spanish pregnantwomen during the first trimester of the gestation.Materials and Methods: Descriptive study was conducted ineight hundred and eighty eight pregnant women in the firsttrimester of pregnancy coming from the Centers of Health ofeigtheen Spanish provinces were interviewed during period2003-2004. The doctors and/or matrons made an interviewthat included the socioeconomic data and a questionnaireof frequency of food consumption.Results: The average age was of 32.1 years (D.E.: 4.67) ina rank of 16 to 48 years. The cold-water fish was locatedfar distant of the first positions between the preferences ofthe pregnant women occupying the position number 21with a 4% and the seventh place between the foods thatless please with a 7%.Conclusions: In the population of pregnant womenstudied, the rich food ingestion in w-3, such as coldwaterfish. fish, less consume it of once to the monthmore of a 40% of the women. The cold-water fish isnot within foods preferred by the studied populationand occupies the seventh position between the foodsthat less please(AU)

Potencial cariogénico: dieta de preescolares del municipio de Santa Lucía de Tirajana (Gran Canaria) / No disponible

Antecedentes: La enfermedad dental en niños ha sidoatribuida a una higiene bucal deficiente y a una dieta inadecuada,con mayor riesgo en zonas con baja concentraciónde flúor en el agua.Objetivo: Evaluar el potencial cariogénico de la dieta de niñospreescolares del Municipio de Santa Lucía de Tirajana.Materiales y métodos: Estudio epidemiológico observacionaly transversal, en una muestra poblacional de preescolares (n= 175). Se administraron Registros Dietéticos de 3 días y elCuestionario de Consumo de Alimentos Cariogénicos, de lospreescolares que fueron cumplimentados por los padres Elanálisis estadístico se realizó con el programa SPSS v. 13.01.Resultados: El 61,1% de los preescolares tenían unadieta entre moderado y alto riesgo cariogénico. En la zonaurbana el 67,5% y 11,3% de los niños tenían una dietaentre moderado y alto riesgo cariogénico, respectivamente,siendo inferior la edad crítica en el área urbana (4 años).Conclusiones: Más del 60% de los preescolares del municipiode Santa Lucía de Tirajana, tienen un potencial deriesgo, entre moderado y alto, de desarrollar caries dental,con los hábitos dietéticos actuales (alimentos cariogénicos,frecuencia y ocasión de consumo), especialmente los delárea urbana(AU)

Background: The dental disease in children has been attributedto deficient a oral hygiene and to an inadequate diet,with greater risk in zones with low fluorine concentrationin the water.Objective: To evaluate the cariogenic potential of the dietof pre-scholar children of the Municipality of Santa Luciade Tirajana (Gran Canaria).Methods: Study epidemiologic, observational and crosssectionalin a population sample of pre-scholar children(n = 175). We administered to Dietary Recall of 3 daysand the Questionnaire of Cariogenic Foods Intake of thechildren who were fulfilled by the parents. The statisticalanalysis was made with program SPSS v. 13.01.Results: A 61.1% of the children had a moderate and highcariogenic potential diet. In the urban area the 67.5% and11.3% of the children had a moderate and high cariogenicrisk diet, respectively, being inferior the critical age in theurban area (4 years).Conclusions: More of 60% of the pre-scholar children of themunicipality of Santa Lucia de Tirajana, they have a cariogenicpotential risk between moderate and high, to developdental caries, with the present dietetic habits (cariogénicosfoods, frequency and occasion of consumption), speciallythose of the urban area(AU)

Fibra dietética: efecto sobre el control glucémico y el metabolismo de los carbohidratos y lípidos / No disponible

La prevalencia de diabetes mellitus continúa aumentandoen proporciones de epidemia, y para el año2010 se estima que a nivel mundial se dupliquen loscasos nuevos a 270 millones. Desde el descubrimientode la insulina, las recomendaciones del aporte decarbohidratos en la dieta de los diabéticos ha variadoconsiderablemente, pasando de la restricción severa decarbohidratos a un aporte entre un 60% a 75% de laenergía total, y la inclusión de polisacáridos altos en fibra.El papel de la fibra en el diabético está dirigido especialmentea mejorar el control glucémico, modificando lospicos postprandiales hiperglucémicos, y mejorando el perfillipídico. En esta revisión se discuten las recomendacionesnutricionales actuales en el manejo de la diabetes mellitus,los beneficios de la fibra dietética en el control glucémico ysus efectos en el metabolismo de carbohidratos y lípidos(AU)

The prevalence of diabetes mellitus is still on the rise, tothe point of currently being considered an epidemic. It isestimated that the number of new cases will duplicate upto 270 million cases by year 2010. Since the discoveryof insulin, the recommendation on the contribution ofcarbohydrates to the diet of diabetic patients has variedconsiderably, from a severe restriction of carbohydratesto a intake ranging from 60% to 75% of the total caloricintake, and the addition of high-fiber polysaccharides.The role of dietary fiber in the diabetic is specially aimedto improve the glycemic control, by modifying thepostprandial hyperglycemic peaks and improving thelipidic profile. In this review, the current dietary recommendationsin the management of diabetes mellitus arediscussed, as well as the benefits of the dietary fiber inthe glycemic control and its effects in the metabolism ofcarbohydrates and lipids(AU)

Vitamina A: Aspectos clínicos y uso terapeútico / Vitamin A: Clinical aspects and therapeutic

La vitamina A es esencial para la visión, el crecimiento y diferenciación celular, la reproducción y la integridad del sistema inmune. Su deficiencia constituye uno de los principales problemas de Salud pública en países en desarrollo, manifestada por la xeroftalmia y ceguera permanente, que afecta predominantemente a niños pre-escolares, estimándose que anualmente aparecen 1.000.000 de casos nuevos de deficiencia. La toxicidad ha sido asociada con un consumo excesivo de suplementos de vitamina A, pero los casos de hipervitaminosis A no pasan de los 200 anuales. En humanos, se han asociado las malformacionescongénitas con el uso indiscriminado de altas dosis de vitamina A por la madre. Actualmente, se están desarrollando numerosas investigaciones que revelan la utilidad terapeútica de esta vitamina en la prevención y tratamiento del cáncer, enfermedades dermatológicas y en pacientes que reciben soporte nutricional. El propósito de este articulo es revisar los conocimientos actuales acerca de la deficiencia, toxicidad y usos terapeúticos de la vitamina A