Niveles de inseguridad alimentaria y características asociadas en mujeres gestantes de Colombia en el 2015 / Food insecurity levels and associated characteristics in pregnant women in Colombia in 2015

Introducción La inseguridad alimentaria es la incapacidad que tienen los hogares para adquirir alimentos inocuos, nutricionalmente adecuados que satisfagan las necesidades fisiológicas de una vida sana y activa. Objetivo Describir los niveles de inseguridad alimentaria y factores asociados en mujeres gestantes de Colombia. Metodología Estudio transversal-analítico; es un análisis secundario de la Encuesta de Situación Nutricional de Colombia del año 2015. Se evaluaron 1393 gestantes de entre 12 y 48 años, mediante la Escala Latinoamericana y Caribeña de Seguridad Alimentaria. Se examinaron características sociodemográficas, antropométricas y micronutrientes. Se realizó la descripción de la distribución de la inseguridad alimentaria por cada una de las variables seleccionadas, a través de frecuencias absolutas y porcentuales. Para estimar la asociación entre las diferentes características de interés y la inseguridad alimentaria se utilizaron modelos de regresión de Poisson multivariados. Resultados El 60,4% (IC95% 55,6-64,7%) de las gestantes residían en hogares con algún grado de inseguridad alimentaria; severa: 9,4% (IC95% 7,4-11,9%); moderado: 17,6% (IC95% 13,5-22,8%) y leve del 33,2% (IC95% 28,9-37,8%). Se encontró que las gestantes en la categoría negra/mulata/afrodescendiente (RP 1,22 IC95% 1,01-1,47), pertenecer al cuartil 1 de riqueza (RP 2,23 IC95% 1,41-3,68) y residir en la región Atlántica (RP 1,34; IC95%; 1,08-1,67) se asociaba con algún grado de inseguridad alimentaria. Conclusión Se identificó una alta proporción de gestantes residentes de hogares con algún grado de inseguridad alimentaria. Las gestantes de los bajos niveles socioeconómicos y aquellas pertenecientes a la etnia negra/mulata/afrodescendiente mostraron ser las principales características asociadas con residir en hogares con algún grado de inseguridad alimentaria (AU)

ntroduction Food insecurity is the inability of households to acquire safe, nutritionally adequate food that meets physiological needs for leading a healthy and active life. Objectiv To describe the levels of food insecurity and associated factors in pregnant women in Colombia. Methodolog Cross-sectional-analytical study; is a secondary analysis of the 2015 Nutritional Situation Survey of Colombia. 1393 pregnant women between 12 and 48 years old were examined. Food insecurity was assessed using the Latin American and Caribbean Food Security Scale. Sociodemographic, anthropometric and micronutrient characteristics were evaluated. The description of food insecurity distribution was made for each of the selected variables, through absolute and percentage frequencies. To estimate the association between the different variables and food insecurity, we used multivariate Poisson regression models. Results 60.4% (CI95% 55.6%–64,7%) of pregnant women resided in homes with some degree of food insecurity; severe: 9.4% (CI95% 7.4%–11.9%), moderate: 17.6% (CI95% 13.5%–22.8%) and light: 33.2% (CI95% 28.9%–37.8%); we found that Black/Mulatto/Afro-descendant pregnant women (PR 1.22 CI95% 1.01–1.47), belong to quartile 1 of wealth (PR 2.23 CI95% 1.41–3.68), and residing in the región Atlántica (PR 1.34 CI95% 1.08–1.67), was associated with some food insecurity level. Conclusion A high proportion of pregnant women living in households with some food insecurity level. The pregnant women of low socioeconomic levels and those belonging to the black/mulatto/Afro-descendant ethnic group showed to be the main characteristics associated with residing in households with some degree of food insecurity (AU)

Understanding Cystic Fibrosis Comorbidities and Their Impact on Nutritional Management.

Cystic fibrosis (CF) is a chronic, multisystem disease with multiple comorbidities that can significantly affect nutrition and quality of life. Maintaining nutritional adequacy can be challenging in people with cystic fibrosis and has been directly associated with suboptimal clinical outcomes. Comorbidities of CF can result in significantly decreased nutritional intake and intestinal absorption, as well as increased metabolic demands. It is crucial to utilize a multidisciplinary team with expertise in CF to optimize growth and nutrition, where patients with CF and their loved ones are placed in the center of the care model. Additionally, with the advent of highly effective modulators (HEMs), CF providers have begun to identify previously unrecognized nutritional issues, such as obesity. Here, we will review and summarize commonly encountered comorbidities and their nutritional impact on this unique population.

Patterns of Egg Consumption Can Help Contribute to Nutrient Recommendations and Are Associated with Diet Quality and Shortfall Nutrient Intakes.

Limited data are available on how eggs are consumed in the typical American eating pattern and the contribution to usual intakes, diet quality and in meeting recommendations. The objectives of the present analysis included identifying how eggs are consumed within U.S. dietary patterns and how these patterns are associated with the usual intakes of shortfall nutrients and diet quality (Healthy Eating Index 2015) using data from the combined National Health and Nutrition Examination Survey (NHANES) from 2001-2016. An additional objective included assessing the differences between egg consumers and egg non-consumers in nutrient intakes and nutrient adequacy. Several egg-containing dietary patterns were identified, and two egg patterns were associated with a greater diet quality compared to a no egg pattern (p < 0.0001). Most egg patterns identified were similar in diet quality scores when compared to the no egg pattern; however, the two egg patterns had lower diet quality scores. Egg consumption combined with a greater intake of total protein foods, seafood and plant protein, total vegetables, total fruit, whole fruit, whole grains and dairy foods, and a lower intake of refined grains and added sugars contributed to an improved diet quality, supporting that no one food is responsible for a healthy dietary pattern. Egg consumers demonstrated significantly higher intakes of dietary fiber, calcium, magnesium, potassium, total choline, vitamin A, vitamin C, vitamin D and vitamin E when compared to egg non-consumers. A comparison of egg consumers and egg non-consumers found egg consumers had significantly less percentages of the population below the EAR for calcium, iron, magnesium, vitamin A, vitamin C and vitamin E. Similarly, the percentage of the population above the recommendations for potassium and choline were greater for egg consumers vs. egg non-consumers. In egg consumers, 24.4% of the population was above the AI for dietary choline when compared to 4.3% of egg non-consumers (p < 0.0001). Findings from the present analysis demonstrate that eggs and egg-containing foods can be an important part of a healthy dietary pattern when balanced accordingly with other nutrient-dense foods.

Association between polygenic propensity for psychiatric disorders and nutrient intake.

Despite the observed associations between psychiatric disorders and nutrient intake, genetic studies are limited. We examined whether polygenic scores for psychiatric disorders are associated with nutrient intake in UK Biobank (N = 163,619) using linear mixed models. We found polygenic scores for attention-deficit/hyperactivity disorder, bipolar disorder, and schizophrenia showed the highest number of associations, while a polygenic score for autism spectrum disorder showed no association. The relatively weaker obsessive-compulsive disorder polygenic score showed the greatest effect sizes suggesting its association with diet traits may become more apparent with larger genome-wide analyses. A higher alcohol dependence polygenic score was associated with higher alcohol intake and individuals with higher persistent thinness polygenic scores reported their food to weigh less, both independent of socioeconomic status. Our findings suggest that polygenic propensity for a psychiatric disorder is associated with dietary behaviour. Note, nutrient intake was self-reported and findings must therefore be interpreted mindfully.

Nutritional Disorders in a Group of Children and Adolescents with Syndromes or Diseases Involving Neurodysfunction.

A study of the literature shows the lack of data on a comprehensive analysis of eating disorders in children with neurodysfunction, which constitute a clinical subgroup with an increased risk of abnormalities in this area. Therefore, the aim of this study was to determine the relationship between the coexistence of nutritional disorders and diseases or syndromes associated with neurodysfunction based on data collected during hospitalization at a rehabilitation center for children and adolescents. A retrospective analysis was carried out in a group of 327 children and adolescents aged 4-18 years. The study group covered various types of diseases or syndromes involving damage to the central nervous system. A retrospective analysis of baseline data (age, sex, main and additional diagnosis and Body Mass Index-BMI) was performed. Two assessment criteria of nutritional status were taken into account (z-score BMI and other previously published normative values). In the study group, malnutrition was found more frequently (18.0% of the respondents) than obesity (11.3% of the subjects). Hypothyroidism coexisting with malnutrition was identified in the study group (N% = 43.8%, p = 0.011) and malnutrition with tetraplegia in the subgroup of spastic cerebral palsy (N% = 34.2 %, p = 0.029).

Prophylactic gastrostomy in locally advanced head and neck cancer: results of a national survey among radiation oncologists.

BACKGROUND: Nutritional complications in patients with locally advanced head and neck cancer (LA-HNC) treated by concurrent chemoradiotherapy (CCRT) often lead to placement of a prophylactic gastrostomy (PG) tube, while indication lacks harmonization. Our aim was to explore the current PG tube utilization among Belgian radiation oncology centers. METHODS: A survey was distributed to all 24 Belgian Radiation oncology departments, with questions about the number of patient treated per year, whether the PG indication is discussed at the multidisciplinary board, placement technique, time of starting nutrition and removal, its impact on swallowing function and importance of clinical factors. For the latter Relative Importance and Discordance Indexes were calculated to describe the ranking and agreement. RESULTS: All 24 centers submitted the questionnaire. Twenty three treat more than 20 head and neck (HNC) patients per year, while four (1 in 21-50; 3 in 51-100) are not discussing the gastrostomy tube indication at the multidisciplinary board. For the latter, endoscopic placement (68%) is the dominant technique, followed by the radiologic (16%) and laparoscopic (16%) methods. Seventy-five percent start the enteral nutrition when clinically indicated, 17% immediately and 8% from the start of radiotherapy. Majority of specialists (19/24) keep the gastrostomy tube until the patient assume an adequate oral feeding. Fifteen centres are considering PG decrease swallowing function. Regarding factors and their importance in the decision for the PG, foreseen irradiated volume reached highest importance, followed by 'anatomical site', 'patients' choice' and 'postoperative versus definitive' and 'local expertise', with decreasing importance respectively. Disagreement indexes showed moderate variation. CONCLUSIONS: The use of a PG tube for LAHNC patients treated by CCRT shows disparity at national level. Prospective studies are needed to ensure proper indication of this supportive measure.

High nutritional risk using NUTRIC-Score is associated with worse outcomes in COVID-19 critically ill patients.

INTRODUCTION: Background: nutritional risk has been associated with worse outcomes at the critical care unit. The aim of this study was to describe the association between nutritional risk and length of stay, days on mechanical ventilation, and in-hospital mortality in patients infected with SARS-CoV-2. Methods: a retrospective cohort of ventilated, critically ill patients. We assessed nutrition risk at baseline using NUTRIC-score. Logistic and linear regression models were used to analyze the association between NUTRIC-score and clinical outcomes (days on mechanical ventilation, hospital length of stay, and in-hospital mortality). A survival analysis was performed using Kaplan-Meier curves. Results: a total of 112 patients were included, 39.3 % were overweight and 47.3 % were obese. Based on NUTRIC-Score, 66 % and 34 % of patients were at high and low nutritional risk, respectively. High nutritional risk was associated with increased mortality risk (OR: 2.4, 95 % CI, 1.06-5.47, p = 0.036) and higher 28-day mortality (HR: 2.05, 95 % CI, 1.01-4.23, p = 0.04) in comparison with low risk. Conclusion: high nutritional risk is related to mortality in SARS-CoV-2 critically ill patients. Overweight and obesity are common in this sample. More studies are needed to elucidate the impact of nutritional therapy on infection course and outcomes.

INTRODUCCIÓN: Introducción: el riesgo nutricional se asocia a peores desenlaces en los pacientes en estado crítico. El objetivo de este estudio es describir la asociación entre el riesgo nutricional y los días de estancia hospitalaria, los días de ventilación mecánica y la mortalidad en pacientes infectados por el SARS-CoV-2. Métodos: cohorte retrospectiva de pacientes en estado crítico bajo ventilación mecánica invasiva. Se evaluó el riesgo nutricional utilizando la herramienta NUTRIC-Score. Se utilizaron regresiones lineares y logísticas para evaluar la asociación entre el riesgo nutricional y los desenlaces clínicos (días de ventilación mecánica, días de estancia hospitalaria y mortalidad hospitalaria). Se utilizaron curvas de Kaplan-Meier para analizar la sobrevivencia. Resultados: se incluyeron 112 pacientes, el 39,3 % con diagnóstico de sobrepeso y el 47,3 % con obesidad de acuerdo con el IMC. Utilizando la herramienta NUTRIC-Score, el 66 % tenían riesgo nutricional alto y el 34 % riesgo nutricional bajo. El riesgo nutricional alto se asoció a un mayor riesgo de mortalidad (OR: 2,4; IC 95 %: 1,06-5,47; p = 0,036) y mayor mortalidad a 28 días (HR: 2,05; IC 95 %: 1,01-4,23; p = 0,04) en comparación con los individuos con riesgo nutricional bajo. Conclusión: el riesgo nutricional alto se asocia con mortalidad en los pacientes con infección por SARS-CoV-2 en estado crítico. El sobrepeso y la obesidad son comunes en este grupo de pacientes. Se necesitan más estudios que evalúen el impacto de la terapia nutricional sobre el curso de la infección y los desenlaces clínicos.

Obesity and Other Nutrition Related Abnormalities in Pre-Dialysis Chronic Kidney Disease (CKD) Participants.

Chronic kidney disease (CKD) is increasing in sub-Saharan Africa. Undernutrition has been prevalent amongst end stage CKD patients, with limited data on the prevalence of obesity. The aim of this study was to assess the nutritional status of CKD patients using various methods sensitive to over and under-nutrition. Stage 3 to 5 CKD patients (glomerular filtration rate (GFR) < 60 mL/min/1.73 m2) attending a pre-dialysis clinic in Cape Town, were enrolled. Exclusion criteria included infectious and autoimmune conditions. Sociodemographic, clinical and biochemical data were collected, and anthropometric measurements were performed. Dietary intake was measured with a quantified food frequency questionnaire (FFQ). Statistical Package for the Social Sciences (SPSS) version 26 was used for statistical analysis. Seventy participants, with mean age of 41.8 ± 11.8 years, 52.9% females and 47.1% males were enrolled. Participants enrolled mainly had stage 5 kidney failure. Thirty percent were overweight (21) and 25 (36%) were obese, 22 (60%) of females were overweight and obese, while 13 (39.4%) of males were predominantly normal weight. Abdominal obesity was found in 42 (60%) of participants, mainly in females. Undernutrition prevalence was low at 3%. Dietary assessment showed a high sugar and protein intake. There was a high prevalence of overweight, obesity and abdominal obesity in CKD stage 35 patients, with unhealthy dietary intake and other nutritional abnormalities.

Effect of Bariatric Surgery on Weight Loss, Nutritional Deficiencies, Postoperative Complications and Adherence to Dietary and Lifestyle Recommendations: A retrospective cohort study from Bahrain.

OBJECTIVES: This study aimed to investigate the effect of bariatric surgery on degree of weight loss, as well as the prevalence of nutritional deficiencies, postoperative complications and adherence to dietary and lifestyle recommendations in a cohort of patients from Bahrain. METHODS: This retrospective cohort study took place between March and September 2018 at two hospitals in Bahrain. All adult patients who had undergone bariatric surgery between 2012-2017 were included. Sociodemographic and clinical information was collected from the patients' medical records and during phone interviews. RESULTS: A total of 341 patients participated in the study. The mean age was 39.82 ± 9.95 years and 67.7% were female. There was a significant relationship between postoperative body mass index and both the type of surgery and time since surgery (P = 0.025 and 0.008, respectively). While type of surgery had no significant effect on percent of excess weight loss (EWL) or percent of total weight loss (TWL), time since surgery significantly affected both of these weight loss measures (P = 0.006 and 0.001, respectively). Biochemical tests revealed haemoglobin, mean corpuscular volume, 25-hydroxy vitamin D, ferritin and iron deficiencies. Commonly reported complications included hair loss (59.5%), flatulence/abdominal pain (39.3%), dry skin (34.3%) and gastroesophageal reflux disease (33.1%). The level of adherence to dietary and lifestyle recommendations was high to moderate. CONCLUSION: Bariatric surgery was effective in accelerating EWL and TWL; however, it also resulted in complications such as nutritional deficiencies and gastrointestinal side-effects.

Evaluación del riesgo y estado ponderal en adultos mayores institucionalizados de la ciudad de Guayaquil-Ecuador / Nutritional risk and weight status in older adults institutionalized of Guayaquil-Ecuador

FUNDAMENTOS: Los adultos mayores requieren de evaluaciones periódicas para determinar su estado de salud. El objetivo fue evaluar el estado ponderal y riesgo nutricional de adultos mayores que se encontraban en centros gerontológicos de Guayaquil, Ecuador, en febrero de 2018. MÉTODOS: El análisis de riesgo nutricional se realizó a 479 personas a quienes se les aplicó la herramienta Nutrition Screening Initiative Checklist, mientras que el análisis de estado ponderal incluyó a 465 personas a través de la medición del índice de masa corporal (IMC). Las pruebas se realizaron en 3 centros gerontológicos. RESULTADOS: Un total de 77% hombres y 81% mujeres se encontraban en un estado de riesgo nutricional grave por sus hábitos alimenticios, y un 61% de hombres y 45% de mujeres presentaron un estado ponderal normal. CONCLUSIONES: Los adultos mayores de la ciudad de Guayaquil requieren más atención por parte de los distintos gestores encargados de su salud para reducir el estado de riesgo grave en el que se encuentran actualmente, esto también tendrá incidencia para mejorar el estado nutricional que, si bien se encuentra controlado, no deja de ser un posible problema en el futuro

BACKGROUND: Older adults require periodic evaluations to determine their health status. The objectives were to evaluate the weight status and nutritional risk of elderly people in gerontological centers located in Guayaquil, Ecuador, in February 2018. METHODS: For the nutritional risk analysis 479 people were used to whom the Nutrition Screening Initiative Checklist tool was applied, while for the weight status analysis 465 people were used through the measurement of body mass index (BMI), the tests They were carried out in 3 centers. RESULTS: A total of 77% men and 81% women are in serious risk from their eating habits, and 61% men and 45% women have a normal weight status. CONCLUSIONS: Elderly people in Guayaquil require more attention from different managers in charge of their health, to reduce the serious risk that they're currently facing, this will also have an incidence improving the weight status that, even though is controlled, it's a possible problem in the future

Prevalence of nutritional disorders in Saudi children with inflammatory bowel disease based on the national growth reference.

BACKGROUND AND STUDY AIM: The prevalence of nutritional disorders in Saudi children with inflammatory bowel diseases (IBDs) has been reported using the World Health Organization (WHO) reference. Our aim was to provide more accurate definition of the prevalence of nutritional impairment in Saudi children with IBDs based on the national growth reference and to demonstrate the effect of using a reference from other populations on the prevalence rates. PATIENTS AND METHODS: Weight, height, and body mass index data, from the multicenter study of IBDs in Saudi children and adolescents, were plotted on the new Saudi national growth reference. Statistical analyses included frequency calculations and z-test for proportions to investigate the significance of the difference in prevalence. A p-value of < 0.05 was considered significant. RESULTS: Among a total of 374 patients, 119 (32%) had ulcerative colitis (UC) and 255 (68%) had Crohn's disease (CD). Compared with the WHO reference, the Saudi national reference produced a significantly lower prevalence of thinness in patients with UC (24% vs. 8%, p = 0.001), CD (35% vs. 20%, p = 0.002), and of short stature in patients with CD (28% vs. 11%, p < 0.001). The difference in the prevalence of overweight was not significant. CONCLUSIONS: We provide more accurate prevalence estimate of nutritional disorders in Saudi children with IBDs based on national reference. The use of the WHO reference overestimated the prevalence of thinness and short stature in Saudi children. Prevalence estimates based on references from other populations should be interpreted with caution.

Strengthening national nutrition research: rationale and options for a new coordinated federal research effort and authority.

BACKGROUND: The US faces remarkable food and nutrition challenges. A new federal effort to strengthen and coordinate nutrition research could rapidly generate the evidence base needed to address these multiple national challenges. However, the relevant characteristics of such an effort have been uncertain. OBJECTIVES: Our aim was to provide an objective, informative summary of 1) the mounting diet-related health burdens facing our nation and corresponding economic, health equity, national security, and sustainability implications; 2) the current federal nutrition research landscape and existing mechanisms for its coordination; 3) the opportunities for and potential impact of new fundamental, clinical, public health, food and agricultural, and translational scientific discoveries; and 4) the various options for further strengthening and coordinating federal nutrition research, including corresponding advantages, disadvantages, and potential executive and legislative considerations. METHODS: We reviewed government and other published documents on federal nutrition research; held various discussions with expert groups, advocacy organizations, and scientific societies; and held in-person or phone meetings with >50 federal staff in executive and legislative roles, as well as with a variety of other stakeholders in academic, industry, and nongovernment organizations. RESULTS: Stark national nutrition challenges were identified. More Americans are sick than are healthy, largely from rising diet-related illnesses. These conditions create tremendous strains on productivity, health care costs, health disparities, government budgets, US economic competitiveness, and military readiness. The coronavirus disease 2019 (COVID-19) outbreak has further laid bare these strains, including food insecurity, major diet-related comorbidities for poor outcomes from COVID-19 such as diabetes, hypertension, and obesity, and insufficient surveillance on and coordination of our food system. More than 10 federal departments and agencies currently invest in critical nutrition research, yet with relatively flat investments over several decades. Coordination also remains suboptimal, documented by multiple governmental reports over 50 years. Greater harmonization and expansion of federal investment in nutrition science, not a silo-ing or rearrangement of existing investments, has tremendous potential to generate new discoveries to improve and sustain the health of all Americans. Two identified key strategies to achieve this were as follows: 1) a new authority for robust cross-governmental coordination of nutrition research and other nutrition-related policy and 2) strengthened authority, investment, and coordination for nutrition research within the NIH. These strategies were found to be complementary, together catalyzing important new science, partnerships, coordination, and returns on investment. Additional complementary actions to accelerate federal nutrition research were identified at the USDA. CONCLUSIONS: The need and opportunities for strengthened federal nutrition research are clear, with specific identified options to help create the new leadership, strategic planning, coordination, and investment the nation requires to address the multiple nutrition-related challenges and grasp the opportunities before us.

Nutrition in times of Covid-19, how to trust the deluge of scientific information.

PURPOSE OF REVIEW: The Covid-19 pandemic has daunted the world with its enormous impact on healthcare, economic recession, and psychological distress. Nutrition is an integral part of every person life care, and should also be mandatorily integrated to patient care under the Covid-19 pandemic. It is crucial to understand how the Covid-19 does develop and which risk factors are associated with negative outcomes and death. Therefore, it is of utmost importance to have studies that respect the basic tenets of the scientific method in order to be trusted. The goal of this review is to discuss the deluge of scientific data and how it might influence clinical reasoning and practice. RECENT FINDINGS: A large number of scientific manuscripts are daily published worldwide, and the Covid-19 makes no exception. Up to now, data on Covid-19 have come from countries initially affected by the disease and mostly pertain either epidemiological observations or opinion papers. Many of them do not fulfil the essential principles characterizing the adequate scientific method. SUMMARY: It is crucial to be able to critical appraise the scientific literature, in order to provide adequate nutrition therapy to patients, and in particular, to Covid-19 infected individuals.

Morbidity of School Children in Panauti Municipality of Kavrepalanchowk: A Descriptive Cross-sectional Study.

INTRODUCTION: School health has been considered as a high priority intervention in developing countries but it has not been prioritized in Nepal. The objectives of the study are to find out the prevalence of morbidity and nutritional status in school children. METHODS: A descriptive cross-sectional study was conducted in a private school located at Panauti Municipality of Kavrepalanchowk district for one week of November 2019. A convenient sampling technique was used. From a selected school, a total number of 356 students studying from Grade I to X were included in the study using. Confidence Interval at 95% was calculated along with frequency and proportion for binary data using Statistical Package for Social Science (SPSS) software. RESULTS: Among 356 students, the most common three morbidities were dental caries 43 (18.1%), tonsillitis 26 (6.2 %), and headache 18 (7.1 %). Based on weight for age, 43 (23.9%) boys and 22 (12.5%)girls were underweight and 12 (6.7%) boys and 4 (2.7%) girls were overweight and 6 (2%) were obese. Thus school health programs should give more emphasis on oral health, nutrition, personal hygiene, etc. CONCLUSIONS: The health and nutritional status of school children in this study were found to be satisfactory compared to other studies. The present study emphasized oral health. The school health program is important in the school for the prevention of diseases like a parasitic infestation, improving personal hygiene, and nutritional status.

Gastrointestinal, nutritional, endocrine, and microbiota conditions in autism spectrum disorder. / Problemas gastrointestinales, nutricionales, endocrinológicos y de microbiota en el trastorno del espectro autista.

Gastrointestinal, nutritional, metabolic, endocrine, and microbiota medical problems in pediatric patients diagnosed with autism spectrum disorder (ASD) are some of the coexisting medical conditions in ASD diagnosis. Their prevalence reaches more than 91 % for gastrointestinal problems, up to 89 % for nutritional and metabolic disorders, more than 50 % for thyroid dysfunction, and up to 100 % for microbiota-related conditions. There is an urgency for medical practice to be updated and to include the assessment, testing, diagnosis, and treatment of these coexisting medical conditions in ASD diagnosis in the pediatric, adolescent, and adult population. A strict management of such conditions results in positive changes in the quality of life and symptoms based on which ASD is diagnosed many times. It should be based on high-quality scientific evidence with an adequate medical care and control.

Los problemas médicos gastrointestinales, nutricionales, metabólicos, endocrinológicos y de microbiota en los pacientes pediátricos con diagnóstico de trastorno del espectro autista (TEA) son parte de los problemas médicos concomitantes al diagnóstico. La prevalencia alcanza a más del 91 % en el caso de los problemas gastrointestinales, hasta el 89 % para los nutricionales y metabólicos, más del 50 % de disfunción tiroidea y hasta el 100 % para los relacionados con la microbiota. Es urgente actualizar la práctica médica para incluir la evaluación, testeo, diagnóstico y tratamiento de estos problemas médicos concomitantes al diagnóstico de TEA en la población pediátrica, adolescente y adulta. El tratamiento riguroso de dichos problemas genera cambios positivos en la calidad de vida y en la sintomatología bajo la cual el TEA se diagnostica en muchos casos. Debe basarse en evidencia científica de alta calidad, con control y cuidado médico adecuado.

Probiotics as a Tx resource in primary care.

While probiotics have not been marketed as drugs, clinicians can still recommend them in an evidence-based manner.