Functional foods and nutraceuticals in the treatment of hypercholesterolemia: Statement of the Spanish Society of Arteriosclerosis 2023. / Alimentos funcionales y nutracéuticos en el tratamiento de la hipercolesterolemia: posicionamiento de la Sociedad Española de Arteriosclerosis 2023.

In the management of hypercholesterolemia, besides advising a healthy, plant-based diet, it may be useful to recommend functional foods or nutraceutical with cholesterol-lowering properties. Given the progressive increase in the number of these products and their rising use by the population, the Spanish Society of Arteriosclerosis (SEA) has considered it appropriate to review the available information, select the results of the scientifically more robust studies and take a position on their usefulness, to recommend to health professionals and the general population their potential utility in terms of efficacy and their possible benefits and limitations. The following clinical scenarios have been identified in which these products could be used and will be analyzed in more detail in this document: (1) Hypolipidemic treatment in subjects with statin intolerance. (2) Hypolipidemic treatment «a la carte¼ in individuals in primary prevention. (3) Long-term cardiovascular prevention in individuals with no indication for lipid-lowering therapy. (4) Patients with optimized lipid-lowering treatment who do not achieve therapeutic objectives.

Qualidade da dieta e fatores associados em pacientes adultos e idosos atendidos em um ambulatório de nutrição na cidade de Recife, Pernambuco / Diet quality and associated factors in adult and elderly patients treated in a nutrition outpatient clinic in the city of Recife, Pernambuco

O consumo alimentar atual, caracterizado pelo aumento da ingestão de alimentos de alta densidade calórica e baixo valor nutricional pode influenciar negativamente no estado nutricional e surgimento de agravos à saúde. Este estudo teve como objetivo avaliar a qualidade da dieta e fatores associados em pacientes adultos e idosos atendidos num ambulatório de nutrição. Trata-se de um estudo transversal realizado de maio a outubro de 2021 no ambulatório de nutrição do Instituto de Medicina Integral Prof. Fernando Figueira em Recife, Pernambuco. Foram coletadas as informações do perfil sociodemográfico e econômico, estilo de vida, variáveis clínicas e estado nutricional, no momento do atendimento nutricional (primeira consulta e/ou consulta de acompanhamento). A avaliação do consumo alimentar foi realizada por meio da análise do Índice de Qualidade da Dieta Revisado (IQDR). A amostra foi composta por 102 pacientes, e foi evidenciada uma maior frequência de excesso de peso/obesidade e risco cardiovascular muito elevado. Com relação ao IQDR, 72,6% da amostra apresentam dieta saudável. O tempo de acompanhamento foi correlacionado positivamente com a qualidade da dieta (ρ 0,199; p<0,045); e quanto à glicemia de jejum, houve uma correlação negativa com o consumo de cereais totais (ρ -0,229; p<0,050), e positiva com o consumo de leite e derivados (ρ0,265; p<0,023). No que se refere às variáveis antropométricas, evidenciou-se correlações negativas com o consumo de hortifrútis e cereais integrais. O consumo alimentar é considerado complexo e necessita da avaliação dos fatores que possam interferir no mesmo. O acompanhamento nutricional, a modificação e a melhora da qualidade da alimentação, favorecem à adoção de um estilo de vida mais saudável, relacionando-se com a prevenção e/ou o controle das doenças crônicas não transmissíveis e suas complicações.

Current food consumption, characterized by increased intake of high-density foods and low nutritional value can negatively influence nutritional status and the emergence of health problems. This study aimed to evaluate the quality of the diet and associated factors in adult and elderly patients treated in a nutrition outpatient clinic. This is a cross-sectional study conducted from May to October 2021 at the Nutrition Outpatient Unit of the Fernando Figueira Institute of Integral Medicine in Recife, Pernambuco. The information of the sociodemographic and economic profile, lifestyle, clinical variables, and nutritional status was collected at the time of nutritional consultation (first consultation and/or follow-up consultation). The evaluation of food consumption was performed through the analysis of the Diet Quality Index - Revised (DQI-R). The sample consisted of 102 patients, and there was a higher frequency of overweight/obesity and very high cardiovascular risk. Regarding DQI-R, 72.6% of the sample has a healthy diet. The follow-up time was positively correlated with the quality of the diet (ρ 0.199; p <0.045); and regarding fasting blood glucose, there was a negative correlation with the consumption of total cereals (ρ -0.229; p <0.050) and a positive correlation with the consumption of milk and derivatives (ρ 0.265; p <0.023). Regarding anthropometric variables, negative correlations with the consumption of whole grains and cereals was demonstrated. Food consumption is considered complex and requires the evaluation of factors that may interfere with it. Nutritional monitoring, modifying, and improving the quality of food, favors the adoption of a healthier lifestyle, which relates to the prevention and/or control of chronic non-communicable diseases and their complications.

Lack of association between metabolic phenotype and food consumption by degree of food processing: results from the Study of Workers' Health (ESAT) / Falta de asociación del fenotipo metabólico con el consumo de alimentos por grado de procesamiento de alimentos: resultados del Estudio de la Salud de los Trabajadores (ESAT)

Introduction: an increase in the consumption of processed and ultra-processed foods may predispose to metabolic abnormalities. Objective: to verify the association of food consumption with metabolic phenotype in workers from a quaternary hospital in Rio de Janeiro, Brazil. Methods: workers of both sexes aged > 18 years were eligible. A food frequency questionnaire and the NOVA classification were used in the food consumption analysis. Metabolic phenotype considered the presence of at least one metabolic alteration (blood glucose, serum lipids, and blood pressure) combined with BMI (eutrophic or excess weight) as follows: 1) metabolically healthy eutrophic (MHE); 2) metabolically unhealthy eutrophic (MUE); 3) metabolically healthy excess weight (MHEW); 4) metabolically unhealthy excess weight (MUEW). Results: from the included 160 participants (mean age, 45.2 ± 1.1 years; 59.4 %, women), 21.9 % self-reported arterial hypertension and 4.4 % diabetes. Most presented excess weight (74.6 %), with approximately 40 % being obese. The MUEW phenotype had higher body fat percentage and central adiposity represented by higher WC and VFA in comparison to the other phenotypes. The lean body mass was similar between the groups. The median of ultra-processed foods was 32.4 % for eutrophic, 32.7 % for overweight, and 34.3 % for obese subjects. No significant associations were observed between ultra-processed food consumption and metabolically unhealthy eutrophic (OR: 1.01; 95 % CI: 0.96-1.06), metabolically healthy excess weight (OR: 1.03; 95 % CI: 0.98-1.08), and metabolically unhealthy excess weight (OR: 1.00; 95 % CI: 0.96-1.05) in comparison to metabolically healthy eutrophic. (AU)

Introducción: el incremento del consumo de alimentos procesados y ultraprocesados puede predisponer a alteraciones metabólicas. Objetivo: verificar la asociación del consumo de alimentos con el fenotipo metabólico en trabajadores de un hospital cuaternario de Rio de Janeiro, Brasil. Métodos: fueron elegibles trabajadores de ambos sexos de edad > 18 años. El cuestionario de frecuencia de alimentos y la clasificación NOVA se utilizaron en el análisis del consumo de alimentos. El fenotipo metabólico consideró la presencia de al menos una alteración metabólica (glucemia, lípidos séricos y presión arterial) combinada con el IMC (eutrófico o exceso de peso) de la siguiente manera: 1) eutrófico metabólicamente saludable (EHM); 2) eutróficos metabólicamente no saludables (MUE); 3) exceso de peso metabólicamente saludable (MHEW); 4) exceso de peso metabólicamente no saludable (MUEW). Resultados: de los 160 participantes incluidos (edad media: 45,2 ± 1,1 años, 59,5 % de mujeres), el 21,9 % refirieron hipertensión arterial y el 4,4 % diabetes. La mayoría presentaron exceso de peso (74,6 %), siendo aproximadamente un 40 % obesos. El fenotipo MUEW presentó mayor porcentaje de grasa corporal y adiposidad central representada por mayor CC y VFA en comparación con los otros fenotipos. La masa corporal magra fue similar entre los grupos. La mediana de alimentos ultraprocesados fue de 32,4 % para los eutróficos, 32,7 % para el sobrepeso y 34,3 % para los obesos. No se observaron asociaciones significativas entre el consumo de ultraprocesados y el fenotipo eutrófico metabólicamente no saludable (OR: 1,01; IC 95 %: 0,96-1,06), exceso de peso metabólicamente saludable (OR: 1,03; IC 95 %: 0,98-1,08) y exceso de peso metabólicamente no saludable (OR: 1,00; IC 95 %: 0,96-1,05) en comparación con los eutróficos metabólicamente sanos. (AU)

Ultra-processed food intake and risk of depression: a systematic review / Ingestión de alimentos ultraprocesados y riesgo de depresión: revisión sistemática

Objective: to conduct a systematic review of the observational studies analyzing the association between ultra-processed food (UPF) intake and the risk of depression. Design: the search adhered to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA); a search for observational studies published until June 2020 was performed in PubMed, Embase, Cochrane Library, and Web of Science databases, followed by additional manual searches. Eight reviewers, working independently in teams of two, screened studies for eligibility, extracted data, and assessed risk of bias. We resolved disagreements through discussion or, if necessary, through adjudication by a third (LH). And the study assessed cross-sectional studies using the Agency for Healthcare Research and Quality (AHRQ) methodological checklist and cohort and case-control studies using the Newcastle-Ottawa Scale (NOS) for quality. We used a tabular format to summarize the articles. Results: twenty-eight studies evaluating UPF intake and risk of depression were finally selected, 21 of which had a cross-sectional design, 6 studies had a cohort design, and 1 had a case-control design. Of these, 4 cohort studies and 17 cross-sectional studies found that consumption of UPF were positively associated with depression or depressive symptoms. Conclusions: our review demonstrated that most studies included in the systematic review showed that UPF consumption is associated with the risk of depression. Future studies should consider the use of validated food intake assessments and standardized depression assessment methods to promote comparability between studies. (AU)

Objetivo: realizar una revisión sistemática de los estudios observacionales que analizan la asociación entre la ingesta de alimentos ultraprocesados (UPF) y el riesgo de depresión. Material y métodos: la búsqueda se adhirió a las directrices Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA); se realizó una búsqueda de estudios observacionales publicados hasta junio de 2020 en las bases de datos PubMed, Embase, Cochrane Library y Web of Science, seguida de búsquedas manuales adicionales. Ocho revisores, que trabajaron de forma independiente en equipos de dos, seleccionaron los estudios para su elegibilidad, extrajeron los datos y evaluaron el riesgo de sesgo. Los desacuerdos se resolvieron a través de la discusión o, si era necesario, a través de la adjudicación de un tercero. Se evaluaron los estudios transversales mediante la lista de comprobación metodológica de la Agency for Healthcare Research and Quality (AHRQ) y los estudios de cohortes y de casos y controles mediante la escala Newcastle-Ottawa (NOS) para la calidad. Se utilizó un formato tabular para resumir los artículos. Resultados: finalmente se seleccionaron 28 estudios que evaluaban la ingesta de UPF y el riesgo de depresión, 21 de los cuales tenían un diseño transversal, 6 un diseño de cohortes y 1 un diseño de casos y controles. De ellos, 4 estudios de cohortes y 17 estudios transversales encontraron que el consumo de UPF se asociaba positivamente con la depresión o los síntomas depresivos. Conclusiones: nuestra revisión demostró que la mayoría de los estudios incluidos en la revisión sistemática mostraron que el consumo de UPF está asociado con el riesgo de depresión. Los estudios futuros deberían considerar el uso de evaluaciones validadas del consumo de alimentos y métodos estandarizados de evaluación de la depresión para promover la comparabilidad entre los estudios. (AU)

Acidosis metabólica neonatal por síndrome de enterocolitis inducido por proteína de alimentos: reporte de caso / Neonatal metabolic acidosis caused by food proteininduced enterocolitis syndrome: a case report

El síndrome de enterocolitis inducido por proteínas de los alimentos (FPIES, por su sigla en inglés) es una reacción alérgica no mediada por inmunoglobulina E (IgE) con síntomas gastrointestinales, como vómitos y diarrea. El diagnóstico se basa en criterios clínicos y en una prueba de provocación para confirmarlo. Es una enfermedad desconocida en las unidades neonatales, debido a la inespecificidad de los síntomas en los recién nacidos. La cifra de metahemoglobina elevada es una opción sencilla de aproximación diagnóstica. Se describe el caso clínico de un recién nacido que ingresa al servicio de urgencias por deshidratación, letargia, vómitos, diarrea y acidosis metabólica grave con elevación de metahemoglobina, con mejora clínica y recuperación total tras el inicio del aporte de fórmula elemental. La sospecha diagnóstica se confirmó tras la prueba de provocación positiva.

Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE mediated allergic reaction with gastrointestinal symptoms, such as vomiting and diarrhea. FPIES diagnosis is based on clinical criteria and on a food challenge test. It is an unknown disease in neonatal units due to its nonspecific symptoms in newborn infants. An elevated methemoglobin level is a simple way to approach diagnosis. Here we describe a clinical case of a newborn admitted to the emergency department because of dehydration, lethargy, vomiting, diarrhea, severe metabolic acidosis, and a high methemoglobin level. Clinical improvement and complete recovery was achieved after initiation of elemental formula. The diagnostic suspicion was confirmed after a positive challenge test.

Proteínas oxidadas de origen animal y su impacto sobre la salud intestinal / Oxidized proteins of animal origin and their impact on intestinal health / Proteínas oxidadas de origem animal e seu impacto na saúde intestinal

Los alimentos de origen animal como la carne de pollo, res, pescado y cerdo poseen una amplia demanda en todo el mundo debido, entre otros aspectos, a su valor nutricional, asociado al alto contenido proteico. No obstante, este tipo de proteínas son susceptibles de sufrir reacciones de oxidación, las cuales pueden mediar procesos de fragmentación, agregación, pérdida de solubilidad, funcionalidad y digestibilidad proteica; eventos implicados en la pérdida de su valor nutricional. En este sentido, las proteínas agrega­das tienden a no ser digeridas en el tracto gastrointestinal y acumularse en el intestino (colon), donde la microbiota colónica las degrada a productos mutagénicos como fenol y p-cresol, lo que incrementa el riesgo de cáncer colorrectal. Por otra parte, los ami­noácidos o péptidos oxidados liberados en la digestión podrían incorporarse en las vías de señalización celular intestinal y favorecer o exacerbar procesos intestinales crónicos como colon irritable o enfermedad de Crohn. Debido al gran interés de esta temática en los últimos años, el objetivo de esta revisión es realizar una descripción general del impacto de proteínas oxidadas de origen animal sobre la salud intestinal.

Animal foods such as chicken, beef, fish and pork are in wide demand throughout the world due, among other things, to their nutritional value, associated with their high protein content. However, this type of protein is susceptible to oxidation reactions, which can mediate processes of fragmentation, aggregation, loss of solubility, functionality, and protein digestibility, which are events involved in the loss of their nutritional value. In this sense, aggregated proteins tend not to be digested in the gastrointestinal tract and accumulate in the intestine (colon), where the colonic microbiota degrades them into mutagenic products such as phenol and p-cresol, which increases the risk of colorectal cancer. On the other hand, the oxidized amino acids or peptides released in digestion could be incorporated into intestinal cell signaling pathways and favor or exacerbate chronic intestinal processes such as irritable bowel syndrome or Crohn's disease. Due to the great interest in this topic in recent years, the objective of this review is to provide a general overview of the impact of oxidized proteins of animal origin on intestinal health.

Alimentos de origem animal como frango, carne bovina, peixe e carne suína são muito procurados em todo o mundo devido, entre outros fatores, ao seu valor nutricional, associado ao seu alto teor de proteínas. No entanto, esse tipo de proteína é suscetível a reações de oxidação, que podem mediar processos de fragmentação, agregação, perda de solubilidade, funcionalidade e digestibilidade da proteína; eventos envolvidos na perda de seu valor nutritivo. Nesse sentido, as proteínas agregadas tendem a não ser digeridas no trato gastrointestinal e se acumulam no intestino (cólon), onde a microbiota colônica as degrada em produtos mutagênicos como fenol e p - cresol, aumentando o risco de câncer colorretal. Por outro lado, os aminoácidos ou peptídeos oxidados liberados na digestão poderiam ser incorporados às vias de sinalização das células intestinais e favorecer ou exacerbar processos intestinais crônicos, como a síndrome do intestino irritável ou a doença de Crohn. Devido ao grande interesse neste tema nos últimos anos, o objetivo desta revisão é fornecer uma descrição geral do impacto das proteínas oxidadas de origem animal na saúde intestinal.

Correlaciones entre la ingesta de sal en la dieta y la eliminación de sodio en la orina de 24 h en una muestra de población urbana de Cáceres / Correlations between dietary salt intake and 24-h urine sodium excretion in a sample of the urban population of Cáceres

Objetivo: La ingesta excesiva de sal se asocia a mayores cifras de tensión arterial y prevalencia de enfermedades cardiovasculares. La OMS recomienda consumir menos de 5 g/día de sal (equivalente a 2 g de Na+/día). Identificar alimentos y comportamientos con mayor contribución al exceso de aporte facilitaría el consejo dietético preventivo. Diseño: Estudio observacional. Sitio: Centro de Salud Urbano en Cáceres. Medidas principales: Estimamos el consumo de sal mediante dos cuestionarios de frecuencia de consumo de alimentos (CFA), uno genérico y otro con alimentos con elevado contenido en Na+, y encuesta recordatoria de 24 h. Empleamos el programa Evalfinut para la valoración nutricional de la dieta. Analizamos correlaciones entre ingesta estimada de sal y eliminación de sodio en orina de 24 h (gold standard). Resultados: El 92% de la muestra presenta consumos superiores a las recomendaciones con ingestas equivalentes a 9,5 g/día de sal (3,7 g/día de Na+). Cuando la ingesta de sodio se determina por el cociente Na+/K+, el 79,54% tiene ingestas elevadas. La eliminación de sodio sigue una tendencia ligeramente creciente con el IMC. La percepción de consumo de sal es baja, el 56,3% lo considera «adecuado»; el 32,4% añade sal a los alimentos una vez servidos. Los CFA infraestiman la ingesta de Na+ y encuestas dirigidas aportan valores más elevados. La correlación entre CFA y eliminación urinaria de Na+ es débil. Conclusión: Debemos reducir la ingesta de sal aumentando la percepción del consumo, mejorando el conocimiento sobre el contenido de sal en alimentos e identificando a pacientes diana del consejo sanitario.(AU)

Objective: Excessive salt intake is associated with higher levels of AHT and prevalence of cardiovascular diseases. WHO recommends consuming less than 5 g/day of salt (equivalent to 2 g Na+/day). Identifying foods and behaviours with greater contribution to excess intake would facilitate preventive dietary advice. Design: Observational study. Site: Urban Health Center in Cáceres. Main measurements: We estimated salt consumption using two food consumption frequency (FFQ) questionnaires, one generic and one with high Na+ content, and a 24 h follow-up survey. We use the Evalfinut program for nutritional evaluation of the diet. We analyzed correlations between estimated salt intake and 24-h urine sodium elimination (gold standard). Results: 92% of the population had consumption higher than the recommendations with intakes equivalent to 9.5 g/day of salt (3.7 g/d of Na+). When sodium intake is determined by the Na+/K+ ratio, 79.54% have high intakes. Sodium elimination follows a slightly increasing trend with BMI. The perception of salt consumption is low, 56.3% consider it “adequate”. 32.4% add salt to food once served. FFQ underestimate Na+ intake and targeted surveys provide higher values. The correlation between FFQ and Na+ urinary elimination is weak. Conclusion: We must reduce salt intake by increasing the perception of consumption, improving knowledge about the salt content in food and identifying target patients of the health council.(AU)

First molecular characterization of Escherichia coli O157:H7 isolates from clinical samples in Paraguay using whole-genome sequencing.

Escherichia coli O157:H7 is a foodborne pathogen implicated in numerous outbreaks worldwide that has the ability to cause extra-intestinal complications in humans. The Enteropathogens Division of the Central Public Health Laboratory (CPHL) in Paraguay is working to improve the genomic characterization of Shiga toxin-producing E. coli (STEC) to enhance laboratory-based surveillance and investigation of foodborne disease outbreaks. Whole genome sequencing (WGS) is proposed worldwide to be used in the routine laboratory as a high-resolution tool that allows to have all the results in a single workflow. This study aimed to carry out for the first time, the genomic characterization by WGS of nine STEC O157:H7 strains isolated from human samples in Paraguay. We were able to identify virulence and resistance mechanisms, MLST subtype, and even establish the phylogenetic relationships between isolates. Furthermore, we detected the presence of strains belonging to hypervirulent clade 8 in most of the isolates studied.

Evaluation of food intake through residual analysis in 90 Basque school canteens / Evaluación de la ingesta de alimentos a través del análisis residual en 90 comedores escolares vascos

Objective: To measure the consumption of 25 food items (Comstock scale), to test whether school management type (public schools vs. private with subsidy schools) and food origin (on-site preparation vs. catering) affected food consumption and to quantify variability associated with territory, school and individual. Method: This cross-sectional study involved 14,717 schoolchildren of ages 2-16, recruited in 90 schools of the Basque Autonomous Community (Spain). Waste (non-consumed food) of 25 analysed food items was visually estimated by trained school monitors, via the Comstock categorical scale thus adapted: 1 = 0%; 2 = 25%; 3 = 50%, 4 = 75% and 5 = 100%. To analyse the data, mixed modelling was applied. Results: Vegetables, fish and fruits were the less-accepted food types. While school management did not affect food intake, on-site food preparation had better acceptance for legumes with vegetables, oily and lean fish, meat and pre-cooked meals. The largest source of variability in food intake not accounted for by school management and food preparation was the individual subject, while school and territory had moderate and almost no effects, respectively. Conclusions: Acceptance of the 25 evaluated foods is adequate, albeit can be improved. We believe that promoting on-site food preparation should improve the acceptance of legumes with vegetables, oily/lean fish, meat and pre-cooked meals. We recommend that future interventions oriented to improve intake should focus on individual subjects. (AU)

Objetivo: Medir el consumo de 25 alimentos (escala Comstock), comprobar si el tipo de gestión escolar (pública o concertada) y el origen de los alimentos (in situ o transportados) afecta al consumo, y cuantificar la variabilidad asociada con el territorio, la escuela y los individuos. Método: Estudio transversal con 14.717 escolares de 2-16 años reclutados en 90 escuelas del País Vasco. La estimación de residuos (alimento no consumido) de 25 grupos de alimentos la realizó visualmente personal escolar entrenado, mediante la escala categórica de Comstock así adaptada: 1 = 0%, 2 = 25%, 3 = 50%, 4 = 75% y 5 = 100%. Para analizar los datos se aplicó un modelo estadístico de efectos mixtos. Resultados: Verduras, pescado y frutas fueron los alimentos menos consumidos. Aunque el tipo de gestión escolar no afectó a la ingesta alimentaria, se determinó que la cocina in situ logró una mejor aceptación de legumbres con verduras, pescado azul y blanco, carne y precocinados. La mayor fuente adicional de variabilidad en la ingesta alimentaria fue el sujeto individual, mientras que la escuela y el territorio tuvieron efectos moderados y casi nulos, respectivamente. Conclusiones: La aceptación de los 25 alimentos evaluados es adecuada, aunque mejorable. Creemos que la promoción de cocinas in situ mejoraría la aceptación de legumbres con verduras, pescado azul y blanco, carne y platos precocinados. Recomendamos que las futuras intervenciones para mejorar la ingesta se dirijan al sujeto individual. (AU)

Violations in the marketing of milks and complementary foods that compete with breastfeeding in Rio de Janeiro City, Brazil / Infrações na comercialização de leites e alimentos de transição que competem com o aleitamento materno na cidade do Rio de Janeiro

ABSTRACT Objective: To analyze if milk and complementary foods are being sold under the Brazilian Code of Marketing of Infant and Toddler's Food, Teats, Pacifiers and Baby Bottles (NBCAL), Law 11265/2006 of breastfeeding protection. Methods: Epidemiological survey that analyzed the marketing practices of pharmacies, supermarkets, and department stores in the Southern region of the city of Rio de Janeiro, Brazil, by direct observation. Results: Among the 349 stores in Rio de Janeiro's South Region, 339 traded milk and complementary foods and, among them, 60.8% were not complying with NBCAL. Infractions to NBCAL were more common for the selling of milk (58.6%) than complementary foods (22.8%). The most recurrent promotion strategy infringing NBCAL was discount pricing without the Ministry of Health disclaimer. Conclusions: Most retail stores infringe NBCAL in the commercialization of milk and complementary foods in the city of Rio de Janeiro, Brazil, a violation of the right to information that may impact mothers' choice regarding their child's feeding.

RESUMO Objetivo: Analisar se leites e alimentos de transição estão sendo comercializados de acordo com a Norma Brasileira de Comercialização de Alimentos para Lactentes e Crianças de Primeira Infância, Mamadeiras, Bicos e Chupetas (NBCAL), Lei n. 11.265/2006, de proteção ao aleitamento materno. Métodos: Inquérito epidemiológico que analisou as práticas de promoção comercial de leites e alimentos de transição em um censo de farmácias, supermercados e lojas de departamento da Zona Sul da cidade do Rio de Janeiro, por meio de observação direta. Resultados: Dos 349 estabelecimentos da Zona Sul, 339 comercializavam leites e alimentos de transição e, destes, 60,8% faziam promoção comercial em desacordo com a NBCAL. Mais da metade dos estabelecimentos (58,6%) tinha leites e 22,8%, alimentos de transição vendidos em inconformidade com a NBCAL. A estratégia de promoção comercial mais praticada foi o desconto no preço sem a frase informativa preconizada pelo Ministério da Saúde. Conclusões: A maior parte dos estabelecimentos comerciais infringe a NBCAL na comercialização de leites e alimentos de transição, configurando uma violação ao direito à informação que pode impactar na escolha das mães quanto à alimentação de seus filhos.

Ultra-processed food intake and risk of depression: a systematic review.

Introduction: Objective: to conduct a systematic review of the observational studies analyzing the association between ultra-processed food (UPF) intake and the risk of depression. Design: the search adhered to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA); a search for observational studies published until June 2020 was performed in PubMed, Embase, Cochrane Library, and Web of Science databases, followed by additional manual searches. Eight reviewers, working independently in teams of two, screened studies for eligibility, extracted data, and assessed risk of bias. We resolved disagreements through discussion or, if necessary, through adjudication by a third (LH). And the study assessed cross-sectional studies using the Agency for Healthcare Research and Quality (AHRQ) methodological checklist and cohort and case-control studies using the Newcastle-Ottawa Scale (NOS) for quality. We used a tabular format to summarize the articles. Results: twenty-eight studies evaluating UPF intake and risk of depression were finally selected, 21 of which had a cross-sectional design, 6 studies had a cohort design, and 1 had a case-control design. Of these, 4 cohort studies and 17 cross-sectional studies found that consumption of UPF were positively associated with depression or depressive symptoms. Conclusions: our review demonstrated that most studies included in the systematic review showed that UPF consumption is associated with the risk of depression. Future studies should consider the use of validated food intake assessments and standardized depression assessment methods to promote comparability between studies.

Introducción: Objetivo: realizar una revisión sistemática de los estudios observacionales que analizan la asociación entre la ingesta de alimentos ultraprocesados (UPF) y el riesgo de depresión. Diseño: la búsqueda se adhirió a las directrices Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA); se realizó una búsqueda de estudios observacionales publicados hasta junio de 2020 en las bases de datos PubMed, Embase, Cochrane Library y Web of Science, seguida de búsquedas manuales adicionales. Ocho revisores, que trabajaron de forma independiente en equipos de dos, seleccionaron los estudios para su elegibilidad, extrajeron los datos y evaluaron el riesgo de sesgo. Los desacuerdos se resolvieron a través de la discusión o, si era necesario, a través de la adjudicación de un tercero. Se evaluaron los estudios transversales mediante la lista de comprobación metodológica de la Agency for Healthcare Research and Quality (AHRQ) y los estudios de cohortes y de casos y controles mediante la escala Newcastle-Ottawa (NOS) para la calidad. Se utilizó un formato tabular para resumir los artículos. Resultados: finalmente se seleccionaron 28 estudios que evaluaban la ingesta de UPF y el riesgo de depresión, 21 de los cuales tenían un diseño transversal, 6 un diseño de cohortes y 1 un diseño de casos y controles. De ellos, 4 estudios de cohortes y 17 estudios transversales encontraron que el consumo de UPF se asociaba positivamente con la depresión o los síntomas depresivos. Conclusiones: nuestra revisión demostró que la mayoría de los estudios incluidos en la revisión sistemática mostraron que el consumo de UPF está asociado con el riesgo de depresión. Los estudios futuros deberían considerar el uso de evaluaciones validadas del consumo de alimentos y métodos estandarizados de evaluación de la depresión para promover la comparabilidad entre los estudios.

Lack of association between metabolic phenotype and food consumption by degree of food processing: results from the Study of Workers' Health (ESAT).

Introduction: Introduction: an increase in the consumption of processed and ultra-processed foods may predispose to metabolic abnormalities. Objective: to verify the association of food consumption with metabolic phenotype in workers from a quaternary hospital in Rio de Janeiro, Brazil. Methods: workers of both sexes aged > 18 years were eligible. A food frequency questionnaire and the NOVA classification were used in the food consumption analysis. Metabolic phenotype considered the presence of at least one metabolic alteration (blood glucose, serum lipids, and blood pressure) combined with BMI (eutrophic or excess weight) as follows: 1) metabolically healthy eutrophic (MHE); 2) metabolically unhealthy eutrophic (MUE); 3) metabolically healthy excess weight (MHEW); 4) metabolically unhealthy excess weight (MUEW). Results: from the included 160 participants (mean age, 45.2 ± 1.1 years; 59.4 %, women), 21.9 % self-reported arterial hypertension and 4.4 % diabetes. Most presented excess weight (74.6 %), with approximately 40 % being obese. The MUEW phenotype had higher body fat percentage and central adiposity represented by higher WC and VFA in comparison to the other phenotypes. The lean body mass was similar between the groups. The median of ultra-processed foods was 32.4 % for eutrophic, 32.7 % for overweight, and 34.3 % for obese subjects. No significant associations were observed between ultra-processed food consumption and metabolically unhealthy eutrophic (OR: 1.01; 95 % CI: 0.96-1.06), metabolically healthy excess weight (OR: 1.03; 95 % CI: 0.98-1.08), and metabolically unhealthy excess weight (OR: 1.00; 95 % CI: 0.96-1.05) in comparison to metabolically healthy eutrophic. Conclusion: consumption of ultra-processed food was high. In this cross-sectional analysis, no association of metabolic phenotypes with consumption of food groups according to degree of food processing were observed.

Introducción: Introducción: el incremento del consumo de alimentos procesados y ultraprocesados puede predisponer a alteraciones metabólicas. Objetivo: verificar la asociación del consumo de alimentos con el fenotipo metabólico en trabajadores de un hospital cuaternario de Rio de Janeiro, Brasil. Métodos: fueron elegibles trabajadores de ambos sexos de edad > 18 años. El cuestionario de frecuencia de alimentos y la clasificación NOVA se utilizaron en el análisis del consumo de alimentos. El fenotipo metabólico consideró la presencia de al menos una alteración metabólica (glucemia, lípidos séricos y presión arterial) combinada con el IMC (eutrófico o exceso de peso) de la siguiente manera: 1) eutrófico metabólicamente saludable (EHM); 2) eutróficos metabólicamente no saludables (MUE); 3) exceso de peso metabólicamente saludable (MHEW); 4) exceso de peso metabólicamente no saludable (MUEW). Resultados: de los 160 participantes incluidos (edad media: 45,2 ± 1,1 años, 59,5 % de mujeres), el 21,9 % refirieron hipertensión arterial y el 4,4 % diabetes. La mayoría presentaron exceso de peso (74,6 %), siendo aproximadamente un 40 % obesos. El fenotipo MUEW presentó mayor porcentaje de grasa corporal y adiposidad central representada por mayor CC y VFA en comparación con los otros fenotipos. La masa corporal magra fue similar entre los grupos. La mediana de alimentos ultraprocesados fue de 32,4 % para los eutróficos, 32,7 % para el sobrepeso y 34,3 % para los obesos. No se observaron asociaciones significativas entre el consumo de ultraprocesados y el fenotipo eutrófico metabólicamente no saludable (OR: 1,01; IC 95 %: 0,96-1,06), exceso de peso metabólicamente saludable (OR: 1,03; IC 95 %: 0,98-1,08) y exceso de peso metabólicamente no saludable (OR: 1,00; IC 95 %: 0,96-1,05) en comparación con los eutróficos metabólicamente sanos. Conclusión: el consumo de alimentos ultraprocesados fue elevado. En este análisis transversal, no se observó asociación de fenotipos metabólicos y consumo de grupos de alimentos según el grado de procesamiento de los alimentos.

Coexistence of high content of critical nutrients and claims in food products targeted at Brazilian children / Coexistência de altos teores de nutrientes críticos e alegações em produtos alimentícios voltados para crianças brasileiras

ABSTRACT Objective: This study aimed to evaluate food labels targeted at children and identify the concomitant presence of claims and high levels of critical nutrients and/or the presence of sweeteners. As a secondary objective, it aimed to list different types of claims and check which marketing strategies are most used. Methods: We collected 409 products, from 8 popular food groups targeted at children, in Brazilian market (i.e., fruit drinks, dairy drinks, sandwich cookies, cakes, breakfast cereals, jellies, corn snacks, and yogurts). The contents of critical nutrients (e.g., sugar, total fat, saturated fat, and trans-fat, and sodium) and presence/absence of sweetener were calculated, considering Pan American Health Organization (PAHO) parameters. Then, we verified the presence and types of claims in these products. Results: Overall, 265 (64.7%) labels presented claims. In three of the eight categories (i.e., breakfast cereals, dairy drinks, and yogurt), all products with claims (50, 34, and 34 products, respectively) had one or more nutrients in harmful concentrations (critical nutrients above PAHO's nutritional profile and/or presence of sweeteners). In the other categories, only one product (of 63 sandwich cookies and 26 breakfast cereals with claims) and three products (of 22 cakes and 28 jellies with claims) had no nutrient in critical concentration. The presence of claims, like "rich/source" of micronutrient, was predominant in seven of the eight food groups. Conclusion: In the present study, there was a high presence of claims, of different types, in foods targeted at children, which, for the most part, also have excess of at least one critical nutrient, according to PAHO.

RESUMO Objetivo: Avaliar rótulos de alimentos direcionados ao público infantil e identificar a presença concomitante de alegações e de altos teores de nutrientes críticos e/ou presença de adoçantes. Como objetivo secundário, listar os diferentes tipos de alegações e verificar quais estratégias de marketing são mais utilizadas. Métodos: Foram coletados 409 produtos provenientes das oito categorias de alimentos mais populares entre crianças brasileiras (bebidas à base de frutas, bebidas lácteas, biscoitos recheados, bolos, cereais matinais, gelatinas, salgadinhos de milho e iogurtes). Foram calculados os teores de nutrientes críticos (açúcares, gorduras totais, saturadas e trans e sódio) e presença/ausência de adoçante, considerando-se os parâmetros da Organização Pan-Americana de Saúde (OPAS). Em seguida, verificamos a presença e os tipos de alegações nesses produtos. Resultados: No total, 265 (64,7%) rótulos apresentaram alegações. Em três das oito categorias (cereais matinais, bebidas lácteas e iogurtes), todos os produtos com alegações (50, 34 e 34 produtos, respectivamente) continham um ou mais nutrientes em concentrações prejudiciais (nutrientes críticos acima do preconizado pela OPAS e/ou presença de edulcorantes). Nas demais categorias, apenas um produto (de 63 biscoitos recheados e 26 cereais matinais com alegação) e três (de 22 bolos e 28 gelatinas com alegação) não apresentavam nutrientes em concentração crítica. A presença de alegações, como "rico" ou "fonte" de micronutriente, foi predominante em sete dos oito grupos de alimentos. Conclusões: Observou-se alta presença de alegações, de diferentes tipos, em alimentos destinados a crianças, que, em sua maioria, também possuem excesso de pelo menos um nutriente crítico, de acordo com a OPAS.

Body composition, growth performance and enzyme activities of Labeo rohita fed different commercial fish feeds / Composição corporal, desempenho de crescimento e atividades enzimáticas de diferentes alimentos para peixes comerciais alimentados por Labeo rohita

Abstract We have evaluated the effects of different fish feeds on the body composition, growth, and enzyme activities of Labeo rohita (Rohu). In total, 240 fishes between the average weights of 24.77±2.15g were studied. The treatments were applied in a completely randomized design, with 4 treatments of 60 fishes each. Treatments consisted of four different fish feeds [Oryza (T1), AMG (T2), Aqua (T3), and Supreme (T4)]. Body composition, growth performance, and enzyme activities were evaluated. There was a significant variation in performance of fishes fed with different type of feed; as fishes having Oryza feed showed the highest weight gain, specific growth rate (SGR), and best feed conversion ratio (FCR) as compared to other groups that were considered to be significant (P ≤ 0.05). High net weight gain was obtained in T4 when compared with T2 and T3. FCR value of T4 was less than T1 but higher than T2, T3 and T2, which showed the lowest values. The specific growth rate was recorded as average in T4, but T2 led a high SGR than T3. Similarly, crude protein level and digestive enzymes activity was recorded significantly highest in fed with Oryza (T1) as compared to AMG (T2), Aqua (T3), and Supreme (T4). Water quality parameters were recorded significant in all treatments except pH and DO of treatment (T1), significantly different from other treatments. It was concluded that Rohu (Labeo rohita) could show a promising growth rate and protease enzyme activity when fed with the Oryza feed of 25% protein.

Resumo Avaliamos os efeitos de diferentes alimentos para peixes em relação à composição corporal, crescimento e atividades enzimáticas de Labeo rohita (Rohu). No total, foram estudados 240 peixes com pesos médios de 24,77 ± 2,15 g. Os tratamentos foram aplicados em delineamento inteiramente casualizado, com quatro tratamentos de 60 peixes cada. Os tratamentos consistiram em quatro alimentos diferentes para peixes: Oryza (T1), AMG (T2), Aqua (T3) e Supreme (T4). Foram avaliados a composição corporal, o desempenho de crescimento e as atividades enzimáticas. Houve uma variação significativa no desempenho dos peixes alimentados com diferentes tipos de ração. Peixes com alimentação Oryza apresentaram maior ganho de peso, taxa de crescimento específico (SGR) e melhor taxa de conversão alimentar (FCR) em comparação com outros grupos que foram considerados significativos (P ≤ 0,05). Elevado ganho de peso líquido foi obtido em T4 quando comparado com T2 e T3. O valor da FCR de T4 foi menor que T1, mas maior que T2 e T3, que apresentaram os menores valores. A taxa de crescimento específico foi registrada como média em T4, mas T2 teve uma SGR alta do que T3. Da mesma forma, o nível de proteína bruta e a atividade das enzimas digestivas foram registrados significativamente mais altos nos peixes alimentados com Oryza (T1) em comparação com AMG (T2), Aqua (T3) e Supreme (T4). Os parâmetros de qualidade da água foram registrados como significativos em todos os tratamentos, exceto pH e OD do tratamento (T1), significativamente diferente dos demais tratamentos. Concluiu-se que Rohu (Labeo rohita) pode apresentar uma taxa de crescimento promissora e atividade da enzima protease quando alimentado com Oryza de 25% de proteína.

Síndrome de Rapunzel asociado a obstrucción intestinal y hemorragia de vías digestivas altas: reporte de caso y revisión de literatura.

Rapunzel syndrome is an unusual and rare disease that occurs in young people, caused by intragastric accumulation of ingested hair (gastric trichobezoar) that keeps stuck in the gastric lumen and extends to the small intestine, associated with trichophagia. We report the case of a 25-year-old female patient with a history of trichophagia who is admitted in our institution with abdominal pain, distention, nausea, weight loss and concomitant upper gastrointestinal bleeding. Preoperative diagnosis was made by prior abdominal computed tomography scan with duodenal extension. Success surgical laparotomy and multimodal psychiatric follow up was made. This entity must be considered as a differential diagnosis with Acute Abdomen with Bowel obstruction and upper gastrointestinal bleeding.

El síndrome de Rapunzel es una enfermedad inusual y rara que se presenta en personas jóvenes, caracterizada por un acúmulo de cabello ingerido (tricobezoar gástrico) y confinado generalmente a la cámara gástrica que se extiende al intestino delgado, asociada a tricofagia. Reportamos el caso de una paciente de 25 años con antecedente de tricofagia que ingresa a un centro de salud en curso de dolor, distensión abdominal y datos de obstrucción intestinal asociado a hemorragia digestiva alta. Con documentación preoperatoria por tomografía computada abdominal de un tricobezoar con extensión duodenal, el cual se extrae por laparotomía. La paciente se remite para manejo multimodal por servicio de psiquiatría. Es una afección para tener en cuenta como diagnóstico diferencial en los cuadros de abdomen agudo quirúrgico, de la mano con obstrucción intestinal y sangrado gastrointestinal.

Análisis de la miel de abeja en Chile: un estudio de caso en el sector apícola / Honey bee analysis in Chile: a case study in the beekeeping sector / Análise das abelhas no Chile: estudo de caso no setor da apicultura

RESUMEN La finalidad de este estudio consiste en analizar la miel de abeja en Chile para proponer lineamientos estratégicos que permitan contribuir a la gestión del sector apícola chileno. Para ello, la metodología utilizada es un estudio de caso, para lo cual se aplica en el año 2021 una encuesta a 84 consumidores y a 40 apicultores de la Región del Biobío en Chile. Los resultados del estudio permiten apreciar que el 38% de los apicultores se dedica hace más de 10 años a la producción de miel y el 50% senala que aprendió solo del rubro, siendo las principales dificultades enfrentadas la organización y el tiempo, la sanidad y nutrición. Además, el 42% de los apicultores plantean que el cambio climático, las plagas y sequías afectaron la producción de la miel entre un 0 y 20%. Mientras que el 30% de los consumidores encuestados considera como prioridad el prestigio o reputación del producto. Se concluye la relevancia de los lineamientos estratégicos para guiar el desarrollo de la cadena de la miel en Chile y se recomienda su implementación para el fortalecimiento del sector apícola a nivel nacional e internacional. СLASIFICACIÓN JEL: 170, 013

ABSTRACT The purpose of this study is to analyze bee honey in Chile to propose strategic guidelines that allow contributing to the management of the Chilean beekeeping sector For this, the methodology used is a case study for which a survey of 84 consumers and 40 beekeepers of the Biobío Region in Chile is applied in 2021. The results of the study allow us to appreciate that 38% of beekeepers have been dedicated to honey production for more than 10 years and 50% indicate that they only learned about the field, the main difficulties faced being organization and time, health and nutrition. In addition, 42% of beekeepers indicate that climate change, plagues and droughts affected honey production between 0 and 20%. While 30% of consumers surveyed consider the prestige or reputation of the product as a priority. The relevance of the strategic guidelines to guide the development of the honey chain in Chile is concluded and its implementation is recommended for the strengthening of the beekeeping sector at a national and international level. JEL CLASSIFICATION: 170, 013

RESUMO O objetivo deste estudo é analisar a análise das abelhas no Chile a fim de propor diretrizes estratégicas que contribuam para a gestão do setor apícola chileno. Para este fim, a metodologia utilizada é um estudo de caso, para o qual foi realizada uma pesquisa com 84 consumidores e 40 apicultores na Região de Biobío, no Chile, em 2021. Os resultados do estudo mostram que 38% dos apicultores estão envolvidos na produção de mel há mais de 10 anos e 50% dizem que só aprenderam sobre o negócio, sendo as principais dificuldades a organização e o tempo, a saúde e a nutrição. Além disso, 42% dos apicultores dizem que a mudança climática, as pragas e as secas afetaram a produção de mel em 0-20%. Enquanto 30% dos consumidores pesquisados consideram o prestígio ou a reputação do produto como prioridade. A relevância das diretrizes estratégicas para orientar o desenvolvimento da cadeia do mel no Chile está concluída e sua implementação é recomendada para o fortalecimento do setor apícola a nível nacional e internacional. CLASSIFICAÇÃO JEL: 170, 013

Edulcorantes no calóricos empleados en alimentos procesados: caso de estudio Ecuador / Non-caloric sweeteners used in processed foods in Ecuador

En el Ecuador se optó por la implementación del etiquetadode advertencia debido a la gran oferta de alimentos procesa-dos endulzados con edulcorantes no calóricos (ENC) en res-puesta a la implementación de políticas públicas tanto parareducción del consumo azúcar, por lo que se considera muynecesario conocer los alimentos que ofrecen al consumidor,así como el nivel de dulzor clásico emplean uno o más ENC.Además, para captar la atención del cliente varios empaquespresentan frases como “cero azúcares”, “endulzado con este-via” o “libre de calorías” pese a tener una mezcla de edulco-rantes no calóricos y calóricos. El presente trabajo se desa-rrolló con el objetivo de crear una base de datos de alimentosprocesados para evidenciar los ENC más empleados. Se reco-lectó la información de 450 alimentos procesados que seagruparon en seis categorías. El 61% de los alimentos estu-diados empleó un solo ENC, 37% contaba con la combinaciónde dos ENC y el 2% empleó la mezcla tres ENC. El edulco-rante más empleado fue la sucralosa y la combinación másutilizada fue el aspartame y acesulfame K.(AU)

In Ecuador, the implementation of warning labeling waschosen due to the large supply of processed foods sweetenedwith non-caloric sweeteners (ENC) in response to the imple-mentation of public policies both to reduce sugar consump-tion, for which it is considers it very necessary to know thefoods offered to the consumer, as well as the level of classicsweets using one or more ENC. Additionally, to capture thecustomer’s attention, several packages present phrases suchas “zero sugar”, “sweetened with stevia” or “calorie free” de-spite having a mixture of non-caloric and caloric sweeteners.The present work was developed with the objective of creat-ing a database of processed foods to show the most usedENC. Information was collected from 450 processed foodsthat were grouped into six categories. 61% of the foods stud-ied used a single ENC, 37% had the combination of two ENCand 2% used the mixture of three ENC. The most used sweet-ener was sucralose and the most used combination was as-partame and acesulfame K.(AU)

Validação de conteúdo e aplicação de instrumento para avaliara aceitação de dietas hospitalares / Content validation and application of an instrument to evaluate the acceptance of hospital diets

Introdução: Apesar de ser fator de risco para a desnutri-ção, a aceitação da dieta hospitalar ainda é pouco estudada,e, na maioria dos serviços de nutrição hospitalar, é avaliadade forma subjetiva. Objetivo: Elaborar, validar o conteúdo e aplicar um instru-mento para avaliar a aceitação das dietas hospitalares. Métodos: Este foi um estudo realizado em um hospital dereferência para o tratamento de doenças infecciosas do Riode Janeiro, Brasil. Após a elaboração do instrumento combase em formulários disponíveis na literatura científica, estefoi enviado a um painel de especialistas para validação deconteúdo através da técnica Delphi modificada, e posterior-mente aplicado em uma amostra de conveniência de 50 pa-cientes hospitalizados, sendo comparado ao método de pesa-gem direta dos restos alimentares através da correlação dePearson. O estudo foi aprovado pelo Comitê de Ética da ins-tituição e todos os participantes assinaram termo de consen-timento livre e esclarecido. Resultados: O conteúdo do instrumento foi inteiramentevalidado na segunda rodada do painel e sua versão final apre-senta ilustrações que representam as seis refeições diárias,divididas em quatro partes, permitindo o preenchimento pelanutricionista em percentuais, de acordo com o relato do pa-ciente. O almoço e o jantar foram as refeições com menoraceitação, e os motivos mais relatados foram hiporexia, náu-seas e vômitos. Na comparação entre a aceitação aferida peloinstrumento e pelo método de pesagem, a maioria das pre-parações apresentou correlação forte. Conclusões: Consideramos a utilização da técnica Delphimodificada como útil e apropriada para o aperfeiçoamento doinstrumento elaborado. O instrumento constitui-se uma ferra-menta de baixo custo, rápido e simples de aplicar. Espera-seque sua utilização seja ampliada para outras instituições, comas necessárias adaptações, e contribua para a melhor avalia-ção dietética dos pacientes hospitalizados.(AU)

Introduction: Despite being a risk factor for malnutrition,the acceptance of hospital diet is still poorly studied, and inmost hospital nutrition services, it is evaluated subjectively. Aim: To elaborate, validate the content and apply an in-strument to evaluate the acceptance of hospital diets. Methods: This was a study carried out in a referral hospi-tal for the treatment of infectious diseases in Rio de Janeiro,Brazil. After preparing the instrument based on forms avail-able in the scientific literature, the instrument was sent to apanel of experts to be validated using the modified Delphitechnique, and posteriorly, was applied to a sample of hospi-talized patients, and the acceptance obtained compared tothe direct weighing method of food remains through thePearson correlation. The Research Ethics Committee of the in-stitution approved the study and all the participants signed afree and informed consent term. Results: The elaborated instrument was considered vali-dated by the panel in the second round and its final versionpresents illustrations that represent the six meals a day, di-vided into four parts, allowing the nutritionist to fill in per-centages, according to patient’s report. Lunch and dinnerwere the least accepted meals, and the most reported rea-sons were hyporexia, nausea and vomiting. In the compari-son between the acceptance measured by the instrumentand the weighing method, most preparations showed astrong correlation. Conclusions:We consider the use of the modified Delphitechnique as useful and appropriate for the improvement ofthe elaborated instrument. The instrument constituted a lowcost tool, quick and simple to apply. We expect that its usecould be expanded to other institutions, with the necessaryadaptations, contributing to the better dietary assessment ofhospitalized patients.(AU)

Uso de redes sociales y consumo de alimentos en adultos jovenes que asisten a gimnasios de la ciudad de Guayaquil / Use of social networks and food consumption of young adults who attendgyms in the city of Guayaquil

Introducción: La capacidad de las redes sociales para in-fluir en las audiencias de adultos jóvenes también ha desper-tado el interés de los profesionales de la salud pública comouna plataforma potencial para la promoción de la salud.Objetivo: Determinar uso de las redes sociales y consumode alimentos de adultos jóvenes que asisten a gimnasios dela ciudad de Guayaquil. Materiales y Métodos: Estudio transversal de tipo des-criptivo. Se trabajó con una muestra 509 adultos jóvenes de18 a 26 años que asisten a diferentes gimnasios de la ciudadde Guayaquil en Ecuador durante los meses de julio a di-ciembre del 2021. Se recolectó la información por medio deluso de un cuestionario online estructurado y creado enGoogle forms previamente validado. Para la identificación delos hábitos alimentarios se utilizó el cuestionario semicuanti-tativo de frecuencia de consumo de alimentos. Resultados: El 91,8% de los investigados usan casi siem-pre las redes sociales (p0,018), el tiempo promedio dedicadoal uso de las redes sociales es de 1 a 2 horas por día (37,7%; p0,048) y la red social que más utilizan es Facebook (42,4%;p<0,0001). Con respecto a la alimentación los jóvenes siguenpáginas que brindan información sobre dietas (62,1%;p<0,0001) teniendo la intención de prepararlas en algún mo-mento (80,7%), la información es brindada por nutricionistas(63,5%; p0,015). De acuerdo con la frecuencia de consumode alimentos (Tabla III) los investigados refieren una ingestainsuficiente de lácteos y derivados (84,1%; p<0,0001), ver-duras y hortalizas (71,5%), frutas (78,2%; p<0,0001), cere-ales y derivados (55,2%). Conclusiones: Las redes sociales pueden influir en formapositiva o negativa en la conducta alimentaria de los adoles-centes y adultos jóvenes, por lo cual es necesaria la educa-ción alimentaria de expertos en nutrición para prevenir quelas publicaciones engañosas puedan repercutir en el estadode salud del individuo.(AU)

Introduction: The ability of social media to influenceyoung adult audiences has also piqued the interest of pub-lic health professionals as a potential platform for healthpromotion. Objective: To determine the use of social networks andfood consumption of young adults who attend gyms in thecity of Guayaquil. Materials and Methods: Cross-sectional descriptivestudy. We worked with a sample of 509 young adults from 18to 26 years old who attend different gyms in the city ofGuayaquil in Ecuador during the months of July to December2021. The information was collected through the use of astructured online questionnaire created in Google forms pre-viously validated. For the identification of eating habits, thesemi-quantitative food frequency questionnaire was used.Results: 91.8% of those surveyed almost always use so-cial networks (p0.018), the average time spent using socialnetworks is 1 to 2 hours per day (37.7%; p0.048) and thesocial network they use the most is Facebook (42.4%;p<0.0001). Regarding food, young people follow pages thatprovide information on diets (62.1%; p<0.0001) with the in-tention of preparing them at some point (80.7%), the infor-mation is provided by nutritionists (63, 5%; p0.015).According to the frequency of food consumption (Table III),those surveyed report an insufficient intake of dairy prod-ucts and derivatives (84.1%; p<0.0001), greens and veg-etables (71.5%), fruits (78.2%; p<0.0001), cereals and de-rivatives (55.2%).Conclusions: Social networks can positively or negativelyinfluence the eating behavior of adolescents and youngadults, which is why food education from nutrition experts isnecessary to prevent misleading publications from havingrepercussions on the individual’s health status.(AU)

Anisakidae parasites in frozen fish fillets intended for human consumption. / Parásitos anisákidos en filetes de pescado congelado destinados a consumo humano

INTRODUCTION: Anisakiasis is a human parasitic disease caused by the consumption of raw fish or shellfish containing larvae of the Anisakidae family. It is currently considered an emerging disease of public health interest. OBJECTIVE: To identify the presence of larvae of the Anisakidae family in samples of frozen raw fish fillets intended for human consumption in markets in Medellín and its metropolitan area in Antioquia, Colombia. MATERIALS AND METHODS: A cross-sectional study was carried out, in which larvae of the Anisakidae family were detected and identified in frozen raw fish fillets from three representative markets in Medellín and its metropolitan area. A total of 384 ready for consumption fillets were analyzed (197 sawfish, 137 salmon, 37 tuna, and 13 hake), using the pressing and ultraviolet light method. Taxonomic keys were used to identify the collected parasites and to establish its genus. Conventional PCR and Sanger sequencing was performed to determine the species. RESULTS: Four larvae were found in 4 of the 384 (1.04%) fillets (CI95% 1.04 ± 1.01%). The species of fish in which the larvae were found was sawfish (Scomberomorus spp.) and the genus and species of the larvae was established as Anisakis pegreffii. CONCLUSIONS: According to the study, the presence of Anisakis parasites in frozen raw fish fillets in the influence area is evident.

Introducción. La anisakiasis es una infección producida por parásitos de la familia Anisakidae, transmitida a los humanos por el consumo de pescado o mariscos crudos. En la actualidad, se considera una enfermedad emergente de interés en salud pública. Objetivo. Identificar la presencia de larvas de la familia Anisakidae en muestras de filetes de pescado crudo congelado destinados a consumo humano, en mercados de Medellín y su área metropolitana en Antioquia (Colombia). Materiales y métodos. Se realizó un estudio transversal, en el cual se buscó la presencia de larvas de la familia Anisakidae en filetes de pescado crudo congelado de tres mercados representativos de Medellín y su área metropolitana. Se analizaron 384 filetes listos para el consumo (197 sierras, 137 salmones, 37 atunes y 13 merluzas). Cada filete fue analizado mediante el método de prensado y luz ultravioleta. Los parásitos recolectados se identificaron a partir de claves taxonómicas para establecer el género, así como PCR convencional y posterior secuenciación Sanger, para determinar la especie. Resultados. Se encontraron 4 larvas en 4 de los 384 filetes (1,04 %) (IC95% 1,04 ± 1,01 %). Las larvas encontradas fueron identificadas como Anisakis pegreffi y el tipo de pescado en el cual se encontraron fue la sierra (Scomberomorus spp.). Conclusiones. De acuerdo con el estudio realizado, se evidencia la presencia de parásitos anisákidos en filetes de pescado crudo congelado en el área de influencia.